Reflections on ADASS Summer seminar and the session I co-presented: ‘How to deliver good adult social care - despite Covid’
Perhaps not unexpectedly, the government’s consultation on the creation of a market for children’s services has produced a storm of response much of which falls into the “what are you thinking!” category.
However, beneath the initial reaction that there is a holy grail of services that should never be delivered outside the public sector, there bubbles a much more complex set of issues to consider.I believe it is too simplistic to simply say that some things can only ever be delivered by the public sector. Without doubt there have been some high profile private sector contracts that have failed in the full glare of the media spotlight. However, without wishing to detract from the culpability of the organisations in question, surely the public sector organisations that were responsible for awarding and monitoring those contracts also hold some level of accountability for the failures.
Assuming a level playing field in terms of the skills and expertise deployed to deliver the work, surely the measure of success is not dependent on who delivers the work but rather that outcomes have been achieved and value has been added.
Understandably when you introduce market forces into a service there may be a risk of services being driven by a profit motive. Like most people, I would find abhorrent any proposal that intentionally or unintentionally put children at risk through a system that put profit ahead of doing the right thing. However, the scale of any risk will need to be judged in terms of what is being outsourced, who is bidding to deliver the work and how effectively the risk can be managed. If the Government does push ahead with proposals to widen the market then it needs to work with Councils to find a much more sophisticated way of measuring, monitoring and incentivising providers. We need to find a way of building in outcome based accountability and, for many, this will be a significant departure from the traditional contracting arrangements with which many authorities are still most familiar.
We’re already seeing a greater appreciation and understanding of the challenges confronting councils with children’s services in degrees of difficulty. This means the make up and architecture of, if any, market that is created will continue to evolve as more and more people come to the realisation that quick fixes aren’t the answer for problems that have been many years in the making. We have been arguing for some time that the complexity of the service and the behavioural and cultural dynamics influencing practice mean that a sustainable change requires more than a quick fix improvement plan. In the last few weeks Lord Warner has suggested a similar prescription to problems of this nature.
Finally, the killer question must be whether any of this will really achieve what is required? Will outsourcing, particularly in poor performing authorities, deliver what is needed to make change happen? I admit to a healthy dose of scepticism. External providers will be alert to the potentially catastrophic impact reputationally and financially of a high profile failure on their watch. Similarly, local authorities would be forgiven for having trepidations about any market artificially constructed by those in Whitehall. The concern, based on past experiences, being that only a handful of providers would ever be involved.
On the MJ website in a recent article Craig Dearden-Philips commented that; “What is now clear from just about any study into the workplace ever done is that better outcomes depend, first on foremost, on having staff who are confident, motivated, empowered to act and well-led.” From our experience this is most certainly the case. Does the current internal market achieve this on a consistent enough basis? Are we prepared to except the high level of staff churn and decreasing pool of available Directors willing to take on the challenge of running the service? Whilst these questions are intimately linked to the government’s consultation on the creation of a market, they are also worth asking in their own right. The answer must surely be that we can do things differently and better.
Ultimately, it will be external providers own internal risk assessment that will determine the success of any attempt to create a market. Potentially for some services, the risk premium attached will either be prohibitive or providers simply won’t bid. We may therefore see a situation where certain services are cherry picked by external providers and that could open up a whole lot of other challenges for local authorities.
Executive Director, IMPOWER
This article first appeared in The MJ – www.themj.co.uk