The government's approach to public services prompts many questions. But one thing is clear: this is about markets over human needs, and competition over co-operation.
Ideology overrides evidence at every turn in this week's Open Public Services White Paper. It promotes competition and individual choice where there’s clear evidence that co-operation and shared responsibility work best. It wants to open up public services to free markets, yet every day brings further proof of market failure. It is trying to turn the welfare state into a supermarket where we can all go shopping for services. But you can’t reduce the means for meeting human needs and aspirations to so many goods on a shelf.
A discredited market model
1. Whatever happened to the good ideas in the ‘big society’ story, where ‘we are all in this together’, sharing resources and helping each other? This White Paper wants individual choice and competition to be the main drivers of public services – a market place where individuals buy and sell their wares, which is quite the opposite.
2. Southern Cross crashed because its financial model couldn’t cope with rising rents and public spending cuts for older people. This is not an isolated error by a ‘rogue’ provider, but a symptom of endemic market failure. How on earth can opening up services to more market competition address this problem?
‘Fair access for all’ or ‘to those who have shall be given’?
3. There are fine words about inequalities leaving our society ‘less free, less fair and less united’. But where’s the substance? How can the motley collection of ‘fair access’ measures outlined in the White Paper match its fine rhetoric about ‘tilting the playing field to ensure fair opportunities’?
4. Providers and commissioners are to be held accountable - and services improved - through customer ‘choice’ and ‘voice’ and by more ‘transparency’ of performance data. People who are better educated, better off and better connected have louder voices and are better placed to navigate information and make choices that bring them real benefits. So how will these measures help to reduce inequalities?
Quality: a race to the bottom?
5. Public services are to be opened up to a diversity of ‘any qualified’ providers, but is ‘qualified’ good enough? Where’s the guarantee of quality for the service user? Will a new regime of ‘minimum standards’ launch a race to the bottom? How can a cash-strapped regulator like the Care Quality Commission, which has clocked up some spectacular failures in its short life, begin to police the vast multiplication of providers we are encouraged to expect?
6. The aim is to promote more ‘payment by results’, which can only be achieved if actions have direct, measurable consequences. What’s a ‘result’ and who decides? Where some services are concerned, a good result is that nothing happens for a long period of time. Is there a danger of boiling down services to quantifiable outputs that do nothing sustainable to improve people’s lives?
Where’s the money?
7. Where are the new, funded policies for reducing inequalities? The aim is to decentralise power to the ‘lowest appropriate level’ and to hand over control of services, wherever possible, to individuals or neighbourhood councils. Control over what? Services that are no longer adequately supported by public spending – like libraries, parks, recreation and leisure, child care, adult education? Does this simply mean that ‘the people’ will be left to cope with the consequences of deep cuts in funds for the services they come to control?
8. There will be more personal budgets for health and social care. The White Paper says ‘responsibility for using funds wisely… rests with the individual’. Will these individuals also be liable for the consequences of forthcoming cuts in the budgets they hold?
A missed opportunity?
9. The White Paper says ‘there is a huge appetite for people to get directly involved in the delivery of the services they use’. Yet why is there nothing to encourage or support the development of co-production (which means equal and reciprocal partnerships between service ‘providers’ and ‘users’ for defining needs and designing and delivering services)? This can tap into a range of human resources, to enable people to help themselves and each other.
10. Co-production should become the standard way of getting things done, as nef has argued consistently. But it must go hand in hand with measures to make sure everyone can get involved. And – although it can achieve ‘more for less’ in the medium and long term – the move towards co-production needs upfront investment and sustained public support. What’s more it’s not a market mechanism. Is this why the White Paper has missed the best opportunity it might have had for transforming public services?
This article is cross-posted with thanks from the New Economics Foundation.