Prevention is better than cure in public sector reform

SO ARE you getting the retro vibe? IMF bailouts and public sector strikes dominate the news. The echo of decades past is unmistakable. But here’s a modern twist – a report on the necessity of urgent and long-lasting reform of public services chaired by Campbell Christie, a former General Secretary of the Scottish Trades Union Congress, and his committee including major businessmen such as Jim McColl of Clyde Blowers alongside people such as Pat Watters of the Convention of Scottish Local Authorities (Cosla). The coherence and consensus in their report deserves attention as the Westminster government and the trade unions dig in for a long and destructive dispute.

For what the Christie Commission – set up by the Scottish Government in 2010 – has delivered matters hugely. There has been no shortage of critics rushing to decry this report as another failed exercise which produced no specific proposals and lost itself in the usual impenetrable language of management consultancy. I disagree. Such criticism comes from misunderstanding the process of reform, misunderstanding the role of government and missing the opportunity for Scotland to become a leader in delivering quality, efficient, targeted local services in a manner that is both efficient and accountable.

It starkly frames the problem: “The pressure on budgets is intense and public spending is not expected to return to 2010 levels in real terms for 16 years. In addition, new demographic and social pressures will entail a huge increase in the demand for public services. The economic downturn will also intensify and prolong demand. Unless Scotland embraces a radical, new, collaborative culture throughout our public services, both budgets and provision will buckle under the strain.”

The problem is immediate and is worsening. We can either address those pressures or they will ultimately break the system. It is in many ways the greatest challenge facing the Scottish Government today. It isn’t sexy, doesn’t command headlines and, if pushed, the man in the street might hazard a guess that the Christie Commission recently played Glastonbury. But ignore this problem now and it will scar Scotland for generations.

The report makes no specific recommendations in relation to health, education or any other specific public service. Nor should it have. Instead, it takes a more systemic approach – an intelligent attempt to chart a course through a hideously complicated world of duplication and waste. That starts with key principles, like insisting local services are built around people rather than imposed by top-down government. Or that matching of actual need to provision as opposed to imposing a uniformity of approach is the key to winning public confidence. Or that we should concentrate on prevention – in other words to focus upstream on reducing demand on services. Those aren’t just platitudes – for example it is estimated 40 per cent of all spending on public services is on interventions which could have been avoided by prioritising a preventative approach. That is an eye-watering number. It also amounts to an admission that the state provision of services is wrongly configured and inappropriately focused. The scale of that failure is not the fault of any party, council or organisation. It is the price of policy driven for generations by piecemeal remedy. This isn’t about someone carrying the can, rather it is a chance to start again and rethink how and why we receive the range of public services we do.

This process has another major advantage – the proposed radical change is being driven from within. This is not an ideological government imposing its will on an unsuspecting public and running into the inevitable conflict with unions and local authorities. This is change championed by those who know the problems, by people who deliver the services. The strength of this report is precisely because it is a shared agenda. Unions and local authorities in particular have shown leadership and courage in promoting this report.

In truth, this debate is happening all over the world. But Scotland, as a small wealthy nation, has a chance to be radical. Small nations can implement internal reform much more effectively than larger ones. Moreover, whilst the economic times are harsh, and the need for reform is urgent, no one is suggesting a withering of the state or an attack on those in need. Quite the opposite – this is a chance to marry the necessary drive for efficiency with the public sector ethos. This is about fusing our much-trumpeted social compassion with an aggressive programme for ending the inefficient allocation of increasingly scarce resources. We do so not to cut services, but to protect them.

Bizarrely, the Commission has been criticised for passing responsibility for policy development and implementation back to the government. That is the correct approach to have a cohesive and holistic approach. The Scottish Government has welcomed the report and announced a cabinet sub-committee. I’m not sure that’s sufficient. Given the importance of this issue, I don’t think many would complain about the appointment of a junior minister to drive reform. Delivering a successful programme – one championed by the public sector as well as hard-pressed taxpayers – can be a lasting achievement of this SNP government. This report doesn’t provide all the answers, but it certainly tells the government where to look.