Andrew Haldenby, director of think tank Reform, appraises the potential of the public services white paper
The open public services white paper reaffirms the government’s commitment to public service reform – following its retreat on NHS reform earlier this year. Senior ministers, including the prime minister, met with public service leaders and commentators before the paper’s launch, and explained that thorough reform remains central to their ambitions. Speaking at the launch, which was hosted by Reform, David Cameron set out a number of principles which apply across public sector reform – at their heart being the idea that public services must be accountable to their users.
Some commentators criticised the paper for its caution. Its opening pages contain the following sentences: “The white paper sets out a comprehensive policy framework across public services. However, the government recognises that it cannot all be achieved at once.” A clarion call to action this is not. But at the very least, the paper is out – a major achievement given the breadth of policy that it covers, and the evident struggle involved (delivery had originally been promised for January).
It also represents a step forward on the previous government’s principles of reform as set out in, for example, the 2006 discussion paper The UK Government’s Approach to Public Service Reform. Both that document and the new paper argue for increased consumer choice, greater competition and stronger local government. But the 2006 document placed a much stronger emphasis on ‘top-down performance management’, which in the end is contradictory to the idea of consumer choice.
One criticism might be the complete absence of the concept of value for money from the paper. The coalition government could argue that it would have embarked on its reform programme regardless of the fiscal situation. But the practical task of reform for public service managers (which in the end is what matters) is all about value for money – whether to amend their services, reduce costs, invest this year to save in years to come, and so on. At the launch, both the Prime Minister and Cabinet Secretary Gus O’Donnell said they hoped that the paper would offer powerful support to reform-minded public servants who genuinely want to make change.
What these people really need is a firm statement from the government indicating that they are allowed to change their workforce and capital spending, or in other words, that the government supports both the means and the ends of reform. With the important exception of the Winsor report (an independent review of police officers’ and staff remuneration and conditions), that statement is yet to come. Nevertheless, the paper is a foundation on which to build.
The thinking behind the public services white paper is sound, but more detail is required says Nick Pearce, director of think tank IPPR
The coalition government has at last published its white paper on public service reform. The basic premise behind the paper is sound: sustaining and improving high-quality public services requires reform in the way those services are designed and delivered. This is because in the years ahead, public services will have to deal with enormous cost pressures in a context of constrained revenues. It is estimated that the cost of an ageing society alone will require an additional 6% of GDP to be found over the next 20 years.
Rising demand will have to be met, and in an environment in which the public are very reluctant to pay more tax. So if we are to invest more as a country in areas such as health and social care, we will have to find a way of making the big mainstream public services – the NHS, education and the police – more efficient.
Does the white paper help us meet these challenges? The coalition has chipped away at the worst elements of New Labour's statecraft: the plethora of indicators and targets; anaemic localism; and a latter-day preference for stakeholder management over bold reform. But it has said very little about the big strategic choices facing public services, and many of its plans simply rehearse familiar arguments.
The paper should have started by setting out which services we want to prioritise as a country in the coming decades. If we want to secure full employment, prepare for an ageing society and help raise family living standards, then universal, affordable childcare must come centre stage. Countries that invest heavily in affordable childcare and labour market activation policies have increased the labour supply, particularly among women, and generated higher employment rates and broader tax bases as a result.
The government’s main lever for efficiency and improvement is to expose more public services to competition. Tony Blair's 2006 NHS reforms introduced greater competition and successfully improved outcomes, measured by length of hospital stay and deaths from heart attacks. Competition has its place. But the government should be clearer that there are some services, such as schooling, where profit-seeking is neither justified nor necessary to raise standards.
Rather than relying on competition alone, we need a broader strategy for public service reform. There is an important role for a small set of core entitlements across public services to guarantee equity and minimum standards. The government’s thinking is most developed on this in the field of education, where it has raised the minimum threshold for school performance and is now looking at measures to deal with “coasting” schools. But this is the exception, and the government needs to be much clearer about where it must directly intervene to tackle failure. It needs to set key ambitions that must be met in different services.
The white paper is also insufficiently robust on tackling inequalities. The pupil premium is welcome, but we need to hold schools to account much more rigorously in terms of what they are doing to help the most disadvantaged pupils. In addition, the government should be putting much greater emphasis on the empowerment of service users. It talks about supporting existing pilots for personal budgets in the NHS, but rather than handing the whole budget to GPs and clinicians it should prioritise a much more radical extension of personal budgets to those with long-term health conditions.
The government is right that public services need reform, but it has provided no analysis of the mix of public services that the country needs in the decades ahead. Its white paper is too narrowly focused on the role of market forces, neglecting other proven means for raising standards.
Better information will be key to informed choices, says Chris Nicholson, chief executive of CentreForum, the liberal think tank
Reactions to the open public services white paper have ranged from calling it “an unambitious damp squib” to suggesting that it foreshadows the complete privatisation and break-up of all public services – and that was just from Labour MPs.
After the anguish felt by many about the NHS reforms, which led to the “listening period” and subsequent changes to the bill, few would argue with the wisdom of having a listening period before, rather than after, plans are firmed up. Nor would I disagree with the five key principles set out in the white paper: choice; decentralisation; diversity of providers; fair access; and accountability. The proposals for enhanced neighbourhood councils, local control of services, the encouragement of mutuals and employee ownership will be particularly welcomed by liberals.
While the directions set out in the paper are welcome, warm words will be of no use if real action does not follow. As my recent CentreForum paper, Your choice: how to get better public services argued, increased choice will only drive improvement in public services if there is much better information available with which to make decisions. Government must make improvement in information a top priority. Service users, particularly those from disadvantaged groups, will also need independent advice on which to base their choices, whether that is which is the best university course for their intended career, or which is the best care home to meet their needs.
The white paper echoes the emphasis placed by ministers on Payment by Results (PbR) as the best way to commission services. Initially, it will rarely be the case that PbR alone represents good value for money; there needs to be a greater sense of realism on this issue.
Employee ownership offers great potential for professionals to transform frontline services. However, in many other cases the most appropriate provider will be a large corporate with a good brand, strong balance sheet to enable it to finance new investment, and working capital for PbR. The skills to provide strong quality-control and staff development are also vital.
There are already some worrying signs that the government may seek to impose inappropriate forms of ownership on some services – driven more by fad and fashion than what makes sense in terms of value for money. Why is employee ownership being mandated in plans for My Civil Service Pension (MyCSP) when there are already pension administration companies who could do the job? By all means encourage employee ownership, but why make it a requirement?
Opening the proposals to consultation will enable some of these potential flaws to be ironed out, and points of concern clarified. Overall, the plans set out by the white paper offer the potential for the transformation of public services that the government is seeking.
