I've visited eight adult social care departments this year, and talked with front line staff in all of them.
Reforming the UK’s public services is one of the toughest challenges for any government. In the UK we expect to pay Anglo-Saxon rates of tax but get continental social democrat public services. In many respects the government is pretty well doomed from the start, which is why we are going to start from the more charitable end of the spectrum. I think Simon Parker, writing for Public Finance, this week broadly has it right when he says this is a great chance for localism (I paraphrase so do look at his piece).
Given it is near as dammit impossible to lay out how the government will reform all our public services in a single report, what this paper does quite well is to set out some clear and defining principles. Positively, it is pursuing the path of choice and contestability laid down almost decade ago by Tony Blair’s government – and enhancing this with some interesting ideas about shaking up the supplier market, giving greater voice to the individual and localising supply.
But of course it is open to interpretation and to future actions whether the ‘overwhelming imperative’ to reform public services will truly have translated into a set of historical reforms. Will we look back in ten years and claim this as a defining moment? Our sense is that this depends on tackling five key issues the report is silent, neglectful or muddled on
- Ministerial alignment. It is tough enough getting public services to change – impossible if your Ministerial team is playing up. David Cameron needs a mechanism where he holds his Ministers to account for a tight set of public service reform principles – backed up by a new Cabinet Office unit dedicated to that purpose. In this blog we have despaired of the counter-productive activities emanating from at least one department – Cameron needs to set a tone which is his and not based on ministerial whimsy
- Demand management and behaviour change. We find it hugely surprising that this White Paper isn’t stronger on how Big Society and citizen behaviour can shape not just who provides services but whether we need them at all. In fact, if you are to think about the relationship between citizen and state – the paper is all about the state, albeit in different shapes and sizes. Thinking about how demand is created in the first place would have been a hugely original place to start a white paper. Public services (provided by all sectors) are universally terrible at understanding their customers and shaping their behaviour. We can do something about this and if we success in changing citizen behaviour we succeed in shaping society far more fundamentally than shifting who or what on the supply side. My colleague David Welsh makes these points very powerfully in his piece that summarises our response to Scotland’s Christie Commission
- Civil service reform. Many have tried and all have failed (as far as I can tell since the Second World War). But effecting real change in the way Whitehall operates – turning navel-gazing ‘policy-making’ into real delivery and challenging the notion of Civil Service ‘independence’ would be a bold brushstroke that showed the rest of the sector the PM is up for change.
- Quality and consistency: As much as localism and a supply shake-up are important – so is the citizen expectation of a decent deal from public services wherever they live. It wasn’t so long ago that waiting two years for a hip operation was a strong possibility – depending on where you live and whether you could pay. The White Paper was launched on the same day that stricken private care-home chain Southern Cross announced its failure to secure a rescue deal, and that its 750 homes are to be taken over by private landlords (of which only 250 have any experience in the care sector). Frankly the White Paper raises more questions than answers in relation to how vulnerable children and adults will be protected from failures in service provision.
- Strategy: I see a lot from this government that is poorly thought through in terms of basic strategic planning. Governments can go so far in cutting, abolishing, exhorting, incentivising and even legislating. But at some stage – when dealing with complex systems like public services – they need to work out how to make change really happen. They have to get inside the guts of their public services and work really really hard at connecting up all the initiatives so they move the sector forward in some semblance on coherence. This was the lesson Blair learned in his first term – this stuff doesn’t just happen. He famously referred to the ‘scars on his back’ – I wonder when this government will be saying much the same.
Alex Khaldi is a Director at iMPOWER. To contact him to discuss this blog or any aspect of our work, please e-mail firstname.lastname@example.org or call 0776 413 2182
Lia Sims is a Consutlant at iMPOWER. To contact her to discuss this blog or any aspect of our work, please e-mail email@example.com