Labour must fill the policy void on public services and put a focus on prevention

It is a mark of how much our public services have deteriorated that the famous pledges on which Labour fought and won the 1997 election now look laughably unambitious. Treating an extra 100,000 patients on waiting lists, reducing primary school class sizes and halving the time between arrest and trial for young offenders would barely touch the sides when there are literally millions waiting for healthcare treatment, teacher morale is in freefall and the justice system is facing meltdown. 

Something has clearly gone very wrong, and voters will have high expectations that a new Labour government will start delivering solutions fast. Indeed, the five ‘missions‘ Keir Starmer has placed at the heart of his electoral pitch look entirely unachievable without a properly functioning public sector. Delivering high growth, clean energy, good health and social care, safe streets and greater social mobility all require public services to escape their current state of permanent firefighting to focus on longer-term, stretching ambition.

The origins of the deterioration clearly lie in a decade of austerity and rising demand, compounded by the ongoing fallout from the pandemic. But there is a deeper issue at play – an intellectual void where a vision for the future of public services should sit. The Thatcherite approach, which tried to get public services to operate more like a market, finally died with the calamity that was the Lansley NHS reforms. The post-war settlement, which saw everything delivered by a state funded by healthy tax receipts, is equally deceased in an era of profound economic volatility. 

No new vision has yet emerged in Westminster to replace these two expired agendas. As a result, the public sector has lost any sense of long-term strategy. In its place is a bunch of increasingly incoherent, ad-hoc initiatives and interventions – the very “sticking-plaster” solutions that Starmer rightly decries.

Filling the vision void

A Labour government must fill this void as a matter of urgency. Rather than immediately launch a series of siloed plans for individual services, Labour should start with an agenda-setting white paper on the future of public services as a whole. This should acknowledge that the fundamental challenge now facing the public sector is a level of demand that is rising so fast it would outstrip new funding even if tax receipts were reliable and not subject to the UK’s uncertain economic performance. Any new vision for public services must address this challenge above all by shifting the huge resource ploughed into our public services towards greater efforts at preventing ill health, family breakdown, crime and long-term unemployment, rather than merely treating them when they arise.

Such a white paper would need to focus on three aspects of this prevention agenda. The first is to significantly increase the support available for use of early intervention and prevention. These techniques have been widely trialled across the public sector and were endorsed in the recent Hewitt review on the NHS. They work by allowing public sector workers to spot the initial signs of potential problems and offer help before they blow up into personal crises.

The second is to enable the widespread and rapid adoption of the community-powered approach to public services already inspiring change in some of the most forward-thinking parts of the public sector. This breaks with the old top-down model of service delivery and instead empowers and resources communities to take greater responsibility for their own health and well-being.

Finally, none of this can be divorced from the wider fight against the poverty and inequality that now characterises so much of our economy. The evidence is overwhelming that the chances of illness, family breakdown or involvement in crime rise considerably with the depth of poverty. Tolerating a welfare system and labour market that forces people into deprivation and insecure, low-paid work and then spending billions on our public services to mop up the resulting mess is not only inhumane but an irrational waste of money. A white paper that finally acknowledges this truth and makes decent welfare and work a key part of its public service reform agenda would be a major breakthrough.

And all of this needs to be underpinned by a recognition that such a complex and wholesale shift cannot be delivered by edict from Westminster. Local services need to be resourced and empowered to work very closely with the communities they serve to take forward this agenda in ways that make most sense for their unique local circumstances.

If the polls are right, Labour could win the next election with a majority as commanding as that secured in 1997. But Starmer will inherit a much deeper crisis in public services than that faced by Tony Blair. The mandate that comes with such a majority must be used early to end the chaotic, rudderless approach that is only deepening the crisis and instead set out a new, cross-governmental vision that can get public services back on track.