Reflecting on this yesterday, there is a further point I meant to make but didn’t. The Observer’s ‘secret civil servant’ has beaten me to it this morning. Another problem with reforming the public sector is that it is so interdependent. You can’t do something in one place without it affecting what goes on elsewhere.
Public services are interconnected. Without a proper strategy, cutting one just passes the costs on to others. Local authority cuts mean less housing and services. Together with huge welfare cuts, this puts pressure on the police to sort out the homeless and the hungry and increases demand on the NHS. Local authority cuts mean reduced social care services which means more pressure on the NHS. All this increases demand on the saddest social safety net of all. The one place where you always get free food and a bed – a prison.
This is why the claim that the NHS has been ring-fenced is absurd. The NHS does not exist in a bubble. Reduce services for the elderly, stop paying for people to live in warm, dry houses, cut back on social services visits so no-one spots the neglected children and, eventually, the casualties will all end up at the local hospital.
Even where there are beacons of excellence and efficiency, as there are in the public sector, despite what some would have us believe, the performance of these organisations will be hampered by those with whom they are forced to work to deliver services. Total Place is a great idea but if you work, say, for a super-efficient council, but the local NHS trusts, government departments and neighbouring councils are basket-cases, then the amount you will be able to improve will be held back by your partners’ lack of capability. It is no surprise that place-based budgeting schemes have already seen some tension between organisations that are supposed to be co-operating. We’ll probably see a lot more of this in the months ahead.
I know I keep banging on about this, but the scale of the spending cuts and the longer-term challenges to come mean that the public sector needs the biggest re-organisation since the 1940s. No large commercial organisation would allow such a massive change to be managed on an ad hoc piecemeal basis. As the ‘secret civil servant’ says, there is no plan, just a vague laissez-faire hope that efficiency savings, localism, social innovation and the Big Society will somehow sort it all out in the end.
Both the major parties have fundamental weaknesses when it comes to managing public sector reform. Labour has too many public sector professionals in its ranks and the Conservatives have too few. Labour always seems to bottle out of real reform, as it did over the last decade, but the Tories don’t really understand how the public sector works and, especially, how it all fits together. They are about to find out the hard way, as efficiency savings fail to materialise and services they thought they had protected crash and burn.