Public services: Improvement doesn’t always need reform

Luke Akehurst

NurseBy Luke Akehurst / @lukeakehurst

I read John Woodcock’s piece on Labour Uncut saying Labour must be the party of “radical public service reform” and gave a little bit of an inner groan.

One of the greatest consumers of political time and energy during our time in government was the brightest and best in the party dreaming up whizzy new ways of reforming public services in pursuit of a chimerical middle class appetite for choice, and then ending up not satisfying the intended, rather narrow, political market, whilst having had a punch-up with some of our own affiliates representing the people who actually deliver the services.

The pursuit of “public service reform” was from my perspective a massive waste of political capital that consumed Tony Blair’s and several key cabinet ministers’ time from 2001 onwards with very little noticeable impact on the frontline or on Labour’s political fortunes when they could have been zeroing in on a host of other more important issues.

I’m not against some of the actual reforms. I just don’t believe that the public sector reform agenda should be the central defining agenda of a Labour government, or consume so much intellectual effort or ministerial time.

My instincts are these:

By the time of the next election the public services will be 40% smaller thanks to Coalition cuts, so personalisation and reform are going to be irrelevant. You’ll be lucky if there are books in any of the local schools, let alone a choice of which one to go to.

Choice about important stuff like schools or hospitals is actually incredibly stressful and requires a high level of knowledge on the part of the parent or patient to make an informed choice. I didn’t want to have to choose a primary school for my son this year and learn a load of nonsense about the relative placings of each one in the league table. I wanted them all to be good so it didn’t matter which one he went to. Particularly as he had no chance whatsoever of getting into the one we most liked, where he had already been at nursery, as we weren’t prepared to jump through the hoop of moving house to achieve this. Similarly when I was ill last year the last thing I wanted was the additional stress of making choices about where and how I was treated. I just wanted to lie back and feel ill and let the doctors do the choosing.

When it comes to education choice is an illusion. Every parent who has the inclination to engage in this ‘choice’ wants the best for their child – what is being offered most of the time is not a choice between different pedagogical methods but a choice between institutions providing the same service with varying levels of success. The result is the best performing institutions are taken over by the strata of the middle class who possess the resources and mobility to get the best, e.g. by moving house to within the 192 metre catchment area of the most popular school in our area, which polarises schools to an even greater extent and consigns working class kids to under performing schools.

Most of our reforms tended to focus on structure e.g. “liberating” academies from LEA control and “liberating” Foundation Hospitals from various central NHS controls. The Tories have taken this several leaps further. I happen to believe academies have been a great success where I live in Hackney, with stunning exam results and loads of other benefits for their pupils compared to the failing schools we (Hackney Council) took the tough decisions to shut. But I don’t think the status was what made the difference. Mossbourne Academy is not one of the best performing schools in the country because it has a token £1m of private funding, or a differently composed governing body to an LEA school, or more independence from the LEA. It’s a brilliant school because it has a specially recruited and highly paid head teacher, smart uniforms, strict discipline, fantastic new buildings and an ethos that’s all about success. None of these things required the creation of a new genre of schools to achieve. In the case of my equally brilliant local Foundation Hospital, the Homerton, it got the “reformed” status with extra freedoms and a different governance model because it was already one of the best performing hospitals, it didn’t start performing well because of a change of status.

My personal experience as a Hackney councillor watching the turn round of our borough council from a national laughing-stock and basket case to one of the most improved authorities in the country was that it was all about leadership by our Mayor and successive Chief Executives and a clear political vision. We achieved a massive turnaround by changing key senior staff, investing in the workforce, bringing in expertise from other local authorities and tightening financial and legal procedures. We certainly didn’t too it by structural tinkering with a tried-and-tested model of municipal service delivery – in fact we brought services back in-house that private sector contractors had comprehensively screwed up.

I’m tempted to look at the one public service which commands respect from across the political spectrum: the Armed Forces. They don’t mess about with their structures all the time. The regimental system in the Army carries forward traditions that are up to 400 years old. When the Chiefs of Staff want different or better effects from the Armed Forces they don’t get it by antagonising all the producers – in their case officers and men. They get it by investing in more modern equipment, by recruiting and promoting the best people, by modernising their doctrine, and by brilliant training and retraining at every level from basic training to Staff College, but particularly at leadership level. When a crisis – a war – happens they have the organisational agility to improvise solutions to unexpected scenarios and threats. Leadership, equipment and esprit de corps are central to the success of the Armed Forces as the ultimate public service. Really successful state schools like Mossbourne Academy have the same characteristics: great leadership, great facilities and esprit de corps. The hospital I was in last year, the National on Queen Square, was successful for similar reasons. None of this requires constant reform of structures – it’s all about recruiting the right senior and middle leadership, creating the right organisational culture, and giving staff the best equipment and the best, constantly updated, training.

Unfortunately much public service reform was about importing values of individualism and the market into the public sector, and involving the private sector nearer and nearer to the frontline. I think this was ideologically a mistake because it weakened the character of institutions that should be important incubators of social democratic values. We should be as aggressive in promoting collectivist and egalitarian models of delivering services as the Tories are at dismantling them. We ought to have a situation where private sector companies are copying the brilliant management and quality of the public sector, and public sector leaders are seconded to help turn round industry, not vice versa.

Beware politicians saying they know the micro-answers to the way public services should be run. Unless they have actually been front-line public servants like Lord Darzi they usually don’t and would be better off setting objectives and letting the professionals work out how to get there.

I hope the next Labour government will focus on the standards of public services, and on developing the leaders, doctrine, equipment and highly trained and motivated workforce to make all of them world-beaters, rather than on “reforming” them. If we get back in we will inherit a depleted band of public servants who will be bruised and battered from Tory “reforms” and won’t thank us for another round however well intentioned.

I hope we won’t waste any more terms focused on sterile debates about “reform” that tend to have negligible benefits in terms of the quality of services.

As someone who was proud to be a Blairite I wish Tony had dedicated the second half of his premiership to the more immediate and politically resonant issues of greater equality and social justice, tackling crime and anti-social behaviour, and re-balancing our economy towards manufacturing so that the financial services crash would have had less impact.

Luke Akehurst also blogs here.

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