By David Robinson
Today the Institute for Public Policy Research publish a thought-provoking personal essay, by Community Links co-founder David Robinson setting out 10 principles for ‘whole system’ reform and provision of public services that is focused on the needs and resources of citizens and society.
Public services are changing, and will change radically and fundamentally. Demographic shifts are increasing need at the same time as expenditure is being reduced and while many services are shrinking. In combination, these trends are creating a spiral of decline. As the remaining resources are sucked into managing the greatest needs, earlier-stage interventions are abandoned – spending on prevention fell by almost 10 per cent between 2010/11 and 2011/12 (Reeder 2013-forthcoming) – and more problems are becoming more difficult, when they might have been prevented entirely. Effective services fall into a tailspin, leading to crisis management, with inevitable consequences.
Eighty per cent of the deficit reduction strategy is staked on cost-cutting and there is a long way to go. The Institute for Fiscal Studies estimates that 69 per cent of the cuts to current spending (excluding benefits) will still be outstanding at the end of this financial year (March 2014) – there is no precedent for administrative cost-cutting on this scale in the UK (Emmerson et al 2013). Christopher Hood and Ruth Dixon have shown that even the most effective period of cost reduction (in the later years of the John Major premiership) yielded less than one-fifth of the goal being pursued by the present government (Hood and Dixon 2012).
What if the targets are not achieved? Maybe the chancellor will return for another assault on local government – although Birmingham city council leader Sir Albert Bore was warning before the last budget round that we were witnessing ‘the end of local government as we know it’ (Butler 2012). The options get more limited and increasingly desperate.
In short, cuts without fundamental systems reform disrupt and disfigure without resolving or transforming. They generate more needs and more expensive needs, may well fail to deliver the short-term savings target, and are very likely to be storing up problems that will become increasingly complex and expensive.
We need now more than ever to challenge and change culture, systems and structures, to take a different approach.
It must be grounded in an understanding not just of the economic context but of the nature of the society that we are becoming, and it must articulate a more effective, sustainable and equitable alternative.
Reclaiming the old normal
The report into management and care at Mid Staffordshire hospital published in February 2013 revealed ‘the unnecessary suffering of hundreds of people’, ‘a lack of care, compassion and humanity’ and a ‘system which put corporate self-interest ahead of patient safety’ (HOC 2013). Three weeks later, Professor Bruce Keogh started work as the new NHS national medical director promising that hospitals would be fined if they failed to provide the best care (see Campbell 2013).
Care driven by fear of punishment? The prospect is discomforting but it isn’t new. Talk to social workers, teachers, probation officers and care workers and you will find that regulations and systems, impersonal transactions and a fear of risk and reprisal shape the culture in which they all work. Public services are reduced to a set of transactions when the real need is for a more personal relationship, for common sense and human kindness.
Now listen to those who use the services and those who do not. For some, family, friends and neighbours are more than adequate but for many they are not – moments of joy go unshared, battles are faced alone. More than a million pensioners enjoy less than 30 minutes’ social contact in any given week, our services must change. And so must our communities.
England is more segregated than at any time since 1966 (Dorling et al 2008). Weak communities and social isolation are widely considered to be one the greatest challenges facing Britain today (JRF 2008). Just one in five people know their neighbours well even though 95 per cent believe it would be positive to do so (Big Lunch 2010).
It is not a ‘new normal’ that we need to embrace but some part of the ‘old normal’ that we need to reclaim – our common humanity, mutual trust and a willing kindness. A piecemeal, programmatic response is one option, layering specific initiatives and isolated pilots over a failing system, more sanctions, inspections, enforcement, more waiting for trouble, more belated reaction and – ultimately and inevitably – more failure.
A better government, on the other hand, might understand the scale of the challenge and the importance of bold, whole-system reform. It would structure its narrative around the shared values which give our lives meaning, identity and purpose and align its vision with the deep-set rhythms of our daily lives, talking about opportunities and transitions and making readiness its primary goal. It would pr event the preventable and champion relationships as the organising principle at the heart of all our public services.
Then, because government can lead and can enable but cannot achieve anything alone, it would co-produce and co-locate, fostering cooperation in our communities, services and politics, and changing the structures and the behaviours that right now are getting in the way.
These “10 Principles for Better government” are developed in an essay published by the IPPR today.
None of the principles will be a surprise to regular readers of this blog but sometimes its necessary to keep saying the same things and from our position here in one of the UKs most disadvantaged communities we think these things are particularly important
None are about saving money although all of them would.
They are all about a social alternative that is bold and just and would work better for us all, now and in the future.