Public Service Reform

Kevin McLean

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Public service reform

Introduction 3 stages of public service reform Better outcomes Improved, but not yet world class Long term challenges A new approach to Public Service Reform Lessons from the last 10 years

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Since 1997, there have been three stages of reform in public services

Choice and contestability Minimum standards

1997 2001 2005 2009

MajorInvestment

Quality Below average Above averageWorld class

Public Service Reform

Improving

Stage 1:

Stage 2:

Stage 3:

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Stage 1: Establishing minimum standards

Significant increases in funding after the first 2 years Increased numbers of doctors, teachers, nurses Creation of central targets to drive improvement Tougher intervention in failing organisations: schools,

hospitals, and local authorities Setting high minimum standards in health, education and

social care Unravelling the internal Market in the NHS

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Stage 2: introducing choice and contestability

Extension of quasi-markets in health, education, social care, social housing and offender management

Increased diversity of provision in education through more specialist schools, faith schools, independent academies and encouragement for new entrants

Creation of NHS Trusts and Foundation Trusts, creating more independence and autonomy in the NHS

Increased role for commissioning of services in criminal justice, education, children’s services and health & social care

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Stage 3: Achieving world class public services

Citizen empowerment New Professionalism Strategic leadership from government

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These reforms have had significant impact on performance

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Public services have improved significantly, although many are not yet world class, and we face some long term challenges

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Performance

Students achieving level 4 or above at KS2 (%)

For example, in education, investment and reform over the last 10 years have delivered significant improvements

English

Mathematics

Science

1996 1998 2000 2002 2004 2006

2006 target

Education

Investment

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Significant extra investment • Government expenditure on education

has increased rapidly (CAGR of 8.3% between 1998 and 2004) and is growing faster than in many of the largest OECD economies

• Significant new investment in school buildings and equipment

Radical reforms• National Strategies for literacy and

numeracy• Specialist schools and academies• Choice and flexibility of curriculum

pathways in 14-19 agenda• Every Child Matters agenda etc.

Current performance around average in international league tables

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However, despite these improvements public services are still not world class (1)

England

Scotland

Education

The latest worldwide league table of child reading achievement puts England in 19th and Scotland in 26th place.

Source: PIRLS 2006 International Report

Singapore

New Zealand

Northern European

Children’s achievement in reading

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Despite these improvements public services are still not world class (2)

Health & social care

In a combined index of satisfaction with health care and social services, from 2004, the UK is ranked 10th out of 28 European countries.

Source: EFILWC Health and care in an enlarged Europe 2004

UK

Eastern European countries

Spain, Ireland, Italy

Northern European countries

Index of satisfaction with health and social care services

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Despite these improvements public services are still not world class (3)

Justice

Victim satisfaction with police response in the UK is just above the European average.

Source: EUICS 2005 Burden of crime in the EU

UK

Measure of victim satisfaction with policing

Average

Denmark

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Public services face a number of long term challenges. Trends in long term conditions and obesity will increase pressures on health employment and welfare services

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Public services will continue to strive to meet rising public expectations about customer experience, access to services and how services adapt to their needs

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Public services will face simultaneous pressure for greater productivity/efficiency, and improved quality of service

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Public services also face immediate challenges created by the credit crunch, the recession, and the pressure on public finances

Speed of change Volume challenge Contradictions...... Confidence

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In response to these challenges, the government set out a set of principles for public service reform, published in Excellence and fairness in 2008

Citizen empowerment

New professionalism

Strategic leadership

Excellence and fairness

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In response to these challenges, the government set out a set of principles for public service reform, published in Excellence and fairness in 2008

Citizen empowerment

New professionalism

Strategic leadership

Excellence and fairness

Personalisingthe relationships between

citizens and frontline professionals

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In response to these challenges, the government set out a set of principles for public service reform, published in Excellence and fairness

Citizen empowerment

New professionalism

Strategic leadership

Excellence and fairness

Personalisingthe relationships between

citizens and frontline professionals

Giving citizens more control means that risk and responsibility are

shared

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In response to these challenges, the government set out a set of principles for public service reform, published in Excellence and fairness

Citizen empowerment

New professionalism

Strategic leadership

Excellence and fairness

Personalisingthe relationships between

citizens and frontline professionals

Giving citizens more control means that risk and responsibility are

shared

Increasing autonomy from the frontline, greater accountability to the user, and responsibility

for efficiency/productivity

Translating the principles into policies and system reforms

Citizen empowerment

New professionalism

Strategic leadership

Excellence and fairness

Individual budgets The power of information

Peer support, mutual aid and self help

Recruiting the brightest and the best

Bottom up efficiency programmes

Funding and support for innovators

Optimise preventative spending

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The Excellence and fairness approach to improving public services is being implemented in a range of different government strategies

The NHS Next Stage Review put professionals at the heart of the policy-making process

From the Neighbourhood to the National, a Green Paper on policing, contains proposals to empower citizens to hold their local Police to account

Communities in Control sets out new duties to involve users of services and help them shape services

No One Written Off, the welfare Green Paper includes proposals to modernise the provision of training and welfare and devolve more decision making

Children’s Plan: One year on, outlining policies for 2009 which will provide every child & young person with the best start in life.

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The lessons of public service reform

Targets and command and control can produce short term improvements, but reduces the capacity of systems to continuously improve

Targets can create perverse incentives Targets and prescription undermine local innovation and leadership and

reduce local discretion of professionals Too many targets too many initiatives We have learned effectively from other OECD countries including Sweden,

Australia and the US Choice can be introduced in ways that enhance rather than exacerbate

inequality Choice has been seen as an attack on professionals and local leaders Choice is not the only way to empower citizens - greater control and

stronger partnerships with staff are equally important There are limits to the benefits of individual choices and plenty of examples

of the need for collective choice

Questions?

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There are many innovations that demonstrate that personalised public services can deliver better productivity and value for money

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Personalised public services are an essential resource for meeting Britain’s long term strategic challenges

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