Think differently about the state

It is the poor – those for whom Labour claims to fight the hardest – who are the greatest victims of low-quality public services

Public service reform has long been derided by some on the left as unnecessary, technocratic and harmful to public sector workers. Worse still, an electorally calculated sop to the middle classes. While rejecting the characterisation, the controversy from past reforms should not deter a debate on how the public sector must continue to change. In fact successes of past reforms should only encourage Labour party members to discuss where next to take public services.

Progressives should make no apology for being concerned to ensure that public services are of sufficient quality, offer flexibility and choice, and that the middle classes do not feel forced to pay for private alternatives. That is, after all, in the interests of everyone. As the United States’ safety-net approach demonstrates, poor public services are services for the poor.

But to view public service reform simply through the prism of retaining middle-class political support is to miss the point. It is the poor – those for whom Labour claims to fight the hardest – who are the greatest victims of low-quality public services. Traditionally, it is their estates where policing is at its least responsive; their GP surgeries which are understaffed and overstretched; and their schools where standards are lowest. In government, Labour did much to challenge this with, for instance, its push for greater choice in the NHS, and academies and programmes such as London Challenge focused on the most deprived areas.

That, too, is the focus of the public service innovators profiled in this special Progress supplement. As Jim McMahon, leader of Oldham council, makes clear, his passion for reform is fired by a desire to help those who are ‘actually being let down by the system but don’t complain about it because maybe they’re not equipped to complain about it’. Many of these people, he fears, ‘don’t even know they’re getting a rubbish service … because that’s all they’re used to’.

Similarly, Josh MacAlister, the founder of Frontline, which is seeking to encourage high-flying graduates to train as social workers, wants to address the ‘really, really poor’ outcomes that children who need social workers still face. As he says, ‘If you’re a kid who’s got a social worker you’re probably 10 times more likely to be excluded from school. Only seven per cent of kids who are in care get to university; a quarter of the young prison population were in care when they were younger.’

Meanwhile, Gill Ruecroft and Sarahlee Richards have pioneered the use of personal health budgets in Northamptonshire, focusing on those with mental health problems, while Hilary Cottam’s organisation, Participle, has reengineered work with troubled families in Swindon, answering a call to help people described as the ‘canaries in the coal mine of the welfare state’.

As Labour prepares for government, it should look to those who have spent the past five years not simply opposing the coalition but delivering real change on the frontline of public services. While the work of each is very different, there are five broad lessons which can be drawn.

First, start with people, not institutions. As Cottam tells us, the key lesson is that ‘everything – the thinking, the action, the design – needs to start from the point of view of people, not the institutions and how to reform them.’ That, she admits, ‘sounds so basic but it never happens’. Ruecroft and Richards detail why traditional approaches to mental health service delivery are failing to ‘make any sense to the way [people] live their lives’ and how a personalisation agenda can overcome that.

Second, promote partnerships between users and staff. Too much of the coalition’s rhetoric around reform has suggested that public service workers are the barrier to raising public service standards. That is a false choice, which Labour should reject. As McMahon – who makes clear that he rewards success, not failure – suggests, most workers in poor services are as frustrated and trapped as the users of them. Creating a ‘culture and the conditions where people can actually innovate’ is key to addressing this. Moreover, the whole of MacAlister’s work is underpinned by the premise that the quality of public service workers is intimately tied to the quality of the public service.

Third, austerity is no excuse. Each of our innovators shows that, despite the toughest of financial constraints, outcomes can be improved. Indeed, as Ruecroft and Richards suggest, while personal health budgets are cost-neutral, they offer the prospect of better results and reduced spending, with more savings possible if the opportunities for prevention they outline are realised. Too often, though, as Jayne Moules, coordinator of Newcastle city council’s families programme, points out, the government departments or local authorities ‘who make the investment don’t get the benefits’, so there remains a real question about where the costs of upfront preventative investment fall.

Fourth, think differently about the role of the state. The Tories continue to believe that there is a linear connection between a smaller state and better public services. The real link, though, is with a smarter state. What might that look like? MacAlister’s conception of a state which ‘sets some really big and clear tram tracks and [then] lets wise people make good judgements within those tram tracks’ captures it well.

Finally, Labour needs to learn to let go. Perhaps the greatest obstacle to the success of the next Labour government is not financial but psychological. Labour, explains McMahon, is still ‘not used to allowing for difference’. ‘We use the language of postcode lotteries, because we’re scared of different places receiving different services. But actually the communities across England are so complicated and complex that you couldn’t even have a one-size-fits-all for Greater Manchester.’ That is not the voice of a London-based thinktank, but the leader of Oldham council, chosen as last year’s council leader of the year. Labour should heed it.

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Download the full pamphlet, Let it go: Power to the People in Public Services, here

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Comments: 1...

  1. On February 10, 2015 at 11:45 am Caroline Molloy responded with... #

    Do you really think this veneer of fluff for a privatisation agenda fools anyone? https://www.opendemocracy.net/ournhs/caroline-molloy/we-all-already-own-nhs-latest-mutual-spin-is-about-taking-it-out-of-our-hands

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