Public Service Blues
So finally the government has published its Open Public Services White Paper, outlining its vision of where it wants us to be by 2015: (nearly all) public services outsourced - from running elections (remember the Bush election in 04?) running the fire service, to doing the commissioning and procurement. We can expect to pay for our services, with promises only for safeguards against this when tops ups are ‘inappropriate.' In addition, where we live – parks, libraries, museums, parking, you name it – wherever possible to be placed in the hands of parish and town councils to raise the money to plan, pay and commission them.
It looks like the government has learnt lessons from strength of public (and professional) opinion against the NHS reforms. New opportunities for the VCS and social enterprises are all over the paper. So are equality, improving outcomes, increasing accountability. But do the actual proposals deliver any of these things or do they do precisely the opposite?
Whilst (interestingly) "acknowledging the limits of a pure market approach" the paper is based firmly on faith in ability of the market to drive standards up, innovate and keep costs down.
Well outsourcing and privatisation of public services are not exactly new, so surely we have evidence of what affect using this approach has on the quality of services and costs, as well as accountability and equality. Contracting out cleaning in hospitals, and the health costs of dirty hospitals are not unrelated. PFI deals might make huge profits, but they are costing us, the public, a fortune. And the 4 directors of the ill-fated Southern Cross care homes netted £35 million just before their share prices started dropping .
All of the things we don't like about how public services are organised - the narrowness of focus, the lack of co-ordination that could prevent problems becoming acute, the target culture, the obsession with getting the ‘outcomes' right on paper which bears little resemblance to reality of peoples experience, the increasing homogeneity of services, the deskilling and downgrading of front line staff - all come from taking precisely the same approach that we are now promised more of.
And do we think honestly, whether we are thinking as service users or whether our jobs are to support service users, that navigating your way through different providers, and the subcontractors of the subcontractors of the subcontractors puts us more in control or allows us to really hold providers to account? Of course residents and service users should have far more power to shape the services. This means organising services in such a way to make this easier, and ensuring that the time, money and resources are there to make this happen.
And of course things can always be done better, but with the best will in the world how realistic it is for already overstretched local authorities to increase the degree to which it scrutinises, monitors, inspects, sets standards, champions the needs of service users and minorities with more providers and fewer resources, along with ensuring free competition?
Many, including Urban Forum, have said we are risking exacerbating inequality. The white paper explicitly acknowledges the risk, and outlines various ways to mitigate this - regulating for equality of access, and against cherry picking, targeting help for those currently disadvantaged through funding incentives. These are good things if they happen in practice. But this isn't surely what our experience to date is. Competition and free market inevitably create winners and losers, and the fault lines in our communities run along existing divisions and inequalities.
At a time of cuts, many in the VCS will be interested (or feel they have no option but to be interested) in the prospect of delivering more public services. But there is a risk that this could just be either be the bits and pieces big firms cannot make enough money from to bother with, or if voluntary organisations can make themselves cheap enough, be subcontracted by these firms. Looking at the history of the VCS and commissioning is that the big story even under Labour was the huge growth in the outsourcing industry, and it was a small minority of organisations in the sector, mainly the larger charities, who became heavily dependent on public service contracts.
Not surprisingly almost all aspects of the public service reforms evoke strong and increasingly polarised views, which reach right to the heart of the set of beliefs they are based upon. There is more than a bit of selective memory syndrome going on here. As the White Paper itself says, the whole approach it outlines is a continuation of policies of the previous Labour administrations - the growth of outsourcing, PFI, the personalisation agenda, new autonomous semi-public bodies like Academy Schools and NHS Trusts. What is different, as the White Paper itself says, is the systematic application. What's proposed is finishing off the job.
Whilst there may be (in practice if not in rhetoric) a high degree of agreement on this tightly limited policy framework between our politicians, the same consensus cannot be seen amongst the general public. If the proposals for public services were put to the vote tomorrow does anyone imagine that they would get a majority? According to a Mori poll carried out in 2009 , even before the reality of cuts hit we were evenly split between those who want a society that emphasises social collective provision of welfare and those who want a society where individuals are encouraged to look after themselves. And it is no accident that politicians no longer call what they are doing to public services ‘privatisation'. The leak from the Governments meeting with the CBI showed nervousness about the political unacceptability of a rise in outsourcing. And the Archbishop of Canterbury has gone so far as to question the Government's democratic mandate.
Yes there are challenges - we are in an economic mess (not the fault of the UK public), we are living longer (a good thing!), and society is complex. But does this mean we have to accept as a given tired old policies that should be consigned to history along with unregulated banking, tax avoidance, expenses scandals and hacking journalists? Isnt it time we did some honest talking and produce some genuine choices and innovation in ideas and strategies to provide the public services we should have in a modern civilised society?
The VCS has a vital role to play in all of this - both doing the very best we can from how things are, and influencing the detail of how policies are implemented, but also in developing new ideas that aspire to something better.
Head of Policy and Research