The current general election campaign has brought commitments from both main parties to increase levels of public spending to historically high levels – dramatically in Labour’s case.
How does Government ensure that any new monies for front-line public services are spent effectively and not wasted?
With the introduction of additional money, there are two possible ways ahead. It is either a great opportunity for public services to invest in change and improve service outcomes or it can simply release the pressure and allow change to be put back into the ‘too difficult’ tray.
Necessity should be the mother of invention
In other spheres of activity, necessity is the mother of invention which drives innovation and changes in the way things get done.
In the public services arena, necessity doesn’t drive change in the same way. This is because the spending taps have either not been turned off for that long or, as currently after 10 years of austerity, have arguably been turned off for too long. Let me explain.
Public service managers act rationally. Historically, spending cuts have been temporary within the usual five-year election cycle. This means that the default response is salami slicing – implementing small incremental cost savings, avoiding making any potentially significant changes in the way things are done and reverting to ‘normal’ when spending taps are turned on again.
The period from 2010 to 2015 can be characterised in this way, with most managers hoping/expecting that the next government would relax austerity. Unfortunately for all of us, public finance conditions didn’t improve and austerity budgeting has continued up to now (late 2019).
So what effect did this have? On the ground, front line public services have consistently reduced scope to meet only acute or statutory needs e.g. qualification for social care support, and change comes about largely through closure of provision and services e.g. Sure Start, youth centres, elderly care day centres, libraries etc.
At the risk of oversimplification, after five years of salami slicing there was not enough capacity left to plan, consult on and implement significant services transformation. High staff turnover in times of low morale is another factor. There have, of course, been some changes such as joining up between local authority teams in for example children’s services. There has also been some innovative use of outcomes-based commissioning – something with which I have personally been involved.
However, these have been small scale. The overall picture is one of services that are hunkered down coping with day to day demands with only limited commissioning and back office support to help introduce any changes.
So what should we do now the taps are about to be turned on again? I have previously advocated three ideas for introducing change across the public services landscape.
Use an overarching theme – presumption of prevention – to drive change
For all public-sector organisations, I would argue for a presumption towards prevention as a sensible overarching hook or theme. Every organisation should be encouraged to ask:
“what would we spend this budget on if the aim was to prevent the problem arising or getting worse?”
One of the positive consequences of looking at a social challenge from a preventative basis is that it forces organisations to look at outcomes and work out how to collaborate with other spending bodies to find ways of combining resources differently to now. Equally importantly, it should be cheaper – but only if we can break the ‘safety first’ mindset of waiting until action is mandatory, and almost always much more expensive.
Explicitly invest in services R&D
If the answer in the private sector is R&D, why not the public sector too? One remedy could be to set an explicit Government services R&D budget allocation. If say 1% of Departmental expenditure were top-sliced and allocated to R&D, this would be around £3bn per annum aimed at improving public service innovation and productivity gains.
This would require a complete rethink of the way we test and implement change. Instead of scrutiny of policy initiatives after implementation with 20:20 hindsight, by the Public Accounts Committee, National Audit Office et al, we would be asking these or potentially different organisations to review an experimental spend and deciding whether to implement at scale.
Extend Individualisation and co-design
Essentially give service users a voice in designing the services they receive. Give them ownership of the budget and how it is spent. The ideas of personalisation and choice have been around for over 10 years now but they have not gone anywhere near far enough, with control of budgets remaining largely with government bodies.
With some imagination, this principle could and should be more widely encouraged and extended to areas such as employability and skills (especially re-training), management of long-term health conditions, and parental support.
Conclusion
If 2020 onwards is going to be a great opportunity for public services to invest in change and improve service outcomes then, whatever colour the new Government, it needs to set the change agenda from the centre and quite possibly reinforce it with legislation.