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“Business and State: Privatization and Public-Private Partnerships” short-term program in London

Featured in the above photo: Lord Kinnock with GW group in front of Parliament.

Reflection by Anna Coronado, Healthcare MBA student

Once I had landed at Heathrow International Airport, I headed to the hotel to quickly unpacked my things and walk through the streets of London. I could not help but feel extremely fortunate, mostly since I am American and looked the wrong way before crossing the street and was able to avoid being hit by a bus at the hotel corner, but also rejuvenated with curiosity. Recently, my brain was restless and my intellectual appetite unmet. I was unsure on what to expect from a week in London with people I had never met in a city I had never visited and not quite confident in my ability to articulate why a private entity should invest in a public service or why a public service would be better suited if privately funded. After learning from colleagues and listening to speakers who have been able to implement theories into practice, I can now clearly see nuances and hope to implement these practices in my own career.

London at night-- buses and all.

Firstly, in speaking with Richard Threlfall at KPMG, I was able to connect the conversation back to previous learnings and revelations at GW and ask how society and regulatory bodies would hold big business accountable. Although Threlfall was optimistic in the current state of business and the opportunities that lie ahead, despite the limitations of our doomsday timeline, he wasn’t necessarily convincing in his initiative to hold businesses accountable in being responsible citizens to the global environment. Yes, fines are a method to entice shareholders and firms to alter business practices and operations to be more sustainable, however, for the Meta’s of the world do fines ultimately produce the desired response? Can publicly traded organizations be forced to terminate business operations if regulatory standards are not met? Threlfall pushed the idea that the SDGs and international regulations proposed were enough to push businesses towards a more sustainable model. Which brought me to another thought: What power does the UN hold on businesses?

The UN is a regulatory body for governments and countries, not multinational businesses. Although KPMG is a leader in choosing partners that are internationally recognized as sustainable and responsible, where does the organization draw their internal line on who to engage with? In other words, a client could be a responsible partner by KPMG standards, however, one of the client vendors could potentially not meet the KPMG partnership criteria. Does that mean that KPMG will not pursue a relationship with the original firm? Given more time, I think I would have been able to push Threlfall and further understand the impacts of KPMG’s business ethics.

It’s hard to pinpoint the highlight of my experience however, meeting Carolyn Harris within the walls of Parliament was a professional highlight I did not expect. A charismatic and compassionate woman, it is easy to see why she has been elected to represent Swansea since 2015. What caught my attention was when she stated: “I can’t have an opinion on everything. I can only focus on what I can control and what I can change”. When I unpack this statement, two conflicting ideologies of mine come to mind. First, although not pragmatically possible, I would want my political representative to have an opinion on important topics such as climate change, women’s rights, civil rights and business regulations. However, I understand the sentiment of the second statement. In today’s political climate, the larger the issue the more partisan they become. I believe Harris’ statement is rooted in the idea that “smaller”, more digestible issues that impact everyday people can be seen as apolitical which can be solved by reaching across the aisle and positively impact people immediately. Hearing about Harris’ initiative to fully fund hormone replacement therapy for menopausal women and increase awareness and education had me reflect on my own career in Women’s Health in its current state and want to put in the practice of forming a public and private partnership.

Dr. Hothi discussing the UK National Health Service (NHS). 

I would have already considered Wednesday a success. Being escorted through parliament and down into the commons to have lunch with Lord Neil Kinnock had me feeling elated and I was beginning to feel the relief of my political conversational itch being scratched. Asking Lord Kinnock about voting tendencies in the United Kingdom and discovering how similar voting trends are to the United States was shocking. I expected the UK to have a greater turnout with more emphatic responses to local elections however, I realize now the impact of the UK leaving the European Union has decreased national morale and divided the country.

Winchester, outside the Great Hall (home of the Round Table from the King Arthur stories).

Listening to Lord Kinnock and analyzing his opinions and words I couldn't help but be in awe of his wisdom. His age and life experience has allowed him to look at society in its current form and use the lessons of the past to shape his rather progressive opinion of the present. And as we sat in the common room discussing voting rights, civil rights and societal pitfalls, he relayed a quote that his grandfather had said to him as a young boy when the UK was experiencing its own civil rights movement,  “The ‘buggars’ that are sodding us off are the ones sodding them off”. If politicians can unite a coalition of people and businesses, a partnership can be created between people and government for a better, more collaborative society.

As a young girl and throughout my undergraduate career, I had wanted to pursue nursing and clinical care so meeting Dr. Daljit Hothi and discussing a healthcare system fundamentally different from US private healthcare was enticing to me personally and intellectually. However, I was taken aback by some of Dr. Hothi’s opinions and personal observations. Firstly, I can appreciate the frustrations I’m sure many frontline responders share in the lack of funding and support from the government as they are the first to feel the impact of a nonfunctional system. As a fully, public funded entity, the system itself will not operate if those funds and resources are not provided or are mishandled. However, I fundamentally disagreed with the notion that people are abusing the NHS system by overuse, lack of education or disregard for professional opinion. I do not believe that the burden should be placed on the population when the system has been stretched but on the government and entities responsible for operating the NHS. I walked away from the discussion not knowing what the solution may be, however, I began to think about the privately funded hospitals in the US and how the UK may benefit from private equity funding facilities that could operate in a public system. This could potentially see long term returns if the facilities were state of the art, attracted top tier talent, and allotted for faster turnaround times and lower re-admittance rates. I’m unsure how this would be executed, or even if it's been discussed amongst leadership within the NHS, however, I think it’s something that should be explored as the UK looks to improve its national healthcare system.

Prior to the program, I was a huge proponent of publicly funded programs and having some degree of state regulation and management of public services. I knew that there were logistical nightmares and bureaucratic red tape across many departments and sectors; however, I felt that if the government allocated the appropriate funding to the necessary programs that ensured equity in society, then programs could be run adequately. In listening to Cat Hobbs, Director of We Own It, I came away with questions that led to doubt on the efficacy of programs being solely funded by a public entity. Where will the inefficiencies be removed? How does an increase in funding remove inefficiencies and ensure high success rates? Who decides how funds are allocated appropriately? Not only were these questions not answered, but I saw the benefit in private equity for public services when rolled out with transparency and oversight.

Meeting Cat Hobbs, Director of We Own It. 

In the end, I surprised myself and came away with such a different perspective on big business and the positive impact it can have on society. Prior to this experience, I was pessimistic in my world view, and thought big business would surely be the end of society - at least a more diverse and equitable society. However, coming out of the week and meeting other young business leaders and bright minds, I became more optimistic about where society and business is headed. While in London I was able to ask questions and hear responses in real time from some of the brightest minds in business and politics today. Not only did the program reinforce the knowledge I have gained from GW thus far, but it has given me the confidence to carve my own career path amongst bright and compassionate minds, the tools to navigate a dynamic and globalized business landscape and taught me that in fact we as Americans, look the wrong way when crossing the street.