Friday, 13 May 2016

Change in public services

Public service reform could be one of the defining issues of the coming Scottish Parliament session.

I was speaking at the 'Leading Change in Public Services' conference at Queen Margaret University in Edinburgh today. An international gathering of academics and practitioners on this issue. There is some very interesting academic work being done on this issue across Europe that should inform our debate. My task was to set the scene by outlining public service reform so far in Scotland, likely new directions and some alternative approaches.

The challenges is the easy bit to describe. Public services are being savaged by austerity economics, and in Scotland, has largely been dumped on local government services. The chart below demonstrates this in financial terms.



The workforce numbers show this even more dramatically. A staggering 87% of the public sector job losses in Scotland since the crash have been in local government.

Job losses and finance are the biggest challenges, but not the only ones. We also have demographic change that is increasing demand on council services, particularly social care. Poor economic performance is also increasing demand as is the need for public services to respond to climate change. However, underpinning all this is Scotland's deep seated inequalities. As the Christie Commission highlighted five years ago, failure demand accounts for around 40% of public spending in Scotland. 

The financial pressures are likely to get worse. There is about another £1.5bn of revenue cuts to come for Scotland in the current UK spending plans. The Scottish Government is not planning to use many of the new powers to take Scotland in a different direction to austerity. The tweaks to the higher rate tax bands and the Council Tax will mitigate the cuts by around £350m less £60m cost of cutting APD, unless as I hope, the opposition parties combine to stop this. Given the NHS spending commitments, it seems pretty clear that local government (less perhaps education) will continue to bear the brunt of cuts.

Apart from job losses, the impact on the workforce can be seen in UNISON Scotland's monthly 'Damage Series' of reports. Almost all staff groups comment on the salami slicing of services, the juggling of plates to the extent that many of them are now crashing. Just doing the statutory minimum, and often not even that, while abandoning much of the preventative work that they value and is so important if we are to tackle long term problems. It shows up in sickness absence, particularly stress and violence, and in a demoralised workforce with declining morale. We should also pay more attention to the ageing workforce and the lack of young people coming into public service.

Five years ago I was working on the Christie Commission report. It called for services to be designed from the bottom up with greater user involvement. The report argued for preventative spending and a focus on outcomes. It also called for more integrated working, breaking down the silos and even going as far as looking at the 'one public sector worker' concept.

While almost everyone agreed with the principles set out in the report, delivery has been mixed, as I set out in an article last year. While the essential Scottish public service model remains intact, we have greater centralisation, ministerial direction and a new approach of quangos directing policy, even when delivery remains local. In my experience, the longer ministers are in office, the stronger the temptation is to direct services from the centre, reinforced by the civil service culture.

The SNP manifesto points to a programme for the new government that envisages significant structural change. Reviews are promised of the structure of health boards and councils. New regional education bodies with more finance going directly to schools. There are also proposals to allow community councils to run some services and 1% of council budgets devoted to community budgeting. 

This could lead to fewer health boards, which might work for acute services, but not for primary care. Of course they are subject to the new integrated joint boards with social care. If this form of joint working doesn't deliver greater joined up working, then the pressure to make them formal structures and the employer of staff will grow.

With education and social work going elsewhere, leisure and housing has already largely gone arms length, you are left with rump local authorities. They could be left to wither on the vine or merged, with decentralisation schemes that give communities a larger say in how the few services that remain are delivered. 

Structural change is notoriously difficult and expensive. Organisations go into limbo while preparing for it and then spend years sorting out the new bodies. In the current financial climate it could be argued that is simply analogous to shifting the deck chairs on the Titanic. 

At today's conference I didn't offer a prescription for a different approach, but I did suggest some principles that we might consider in the debate to come. 

First and foremost, we should not simply roll over and accept austerity economics. Public services play an important role in tackling inequality, in part, as the OECD has observed, by mitigating the gross income inequality in the UK. We should recognise the value of proportionate universalism while targeting resources on preventative spending.

While centralisation is not the answer, that doesn't mean that in a small country there isn't a case for national frameworks. These could set out common standards, data sets and proportionate scrutiny. In particular, UNISON has long argued the case for a national workforce framework that would include common staff governance standards, training and start to break down the silos and make it easier for staff to move between services. I am personally increasing attracted to a longer term goal of the one public service worker with common terms and conditions, although I recognise that this has its challenges. Apart from facilitating integration, it would also reducing the significant costs associated with constantly reinventing the HR wheel.

Having national frameworks then enables greater localism, freeing up local democracy to focus on integrated service delivery rather than fragmenting services on the outsourced English model. This could be based around real communities; towns and discreet urban areas, with community hubs providing a base for most public service delivery. Services can then be designed with service users and staff, adopting system thinking principles, rather than the dead hand of the one size fits all approach.

Austerity may be the defining feature of public service delivery in Scotland, but we shouldn't let it define the sort of Scotland that we want. Public services play a central role in that vision and it is right that we take a considered look at how they are best delivered.


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