10 March 2022
Diary of a Corbynista
Public Service Reforms
by Don Urquhart
Under the tenure of Jeremy Hunt the Health Service went into reorganisation mode. Clinical Commissioning Groups (CCGs) would administer budgets. Local people would be consulted about how it would all work. So in 2013 I went to a meeting and was put on a table to be presented to, largely by well-dressed management consultants who in appearance contrasted starkly with the predominantly scruffy bunch of pensioners before them. Another thing the consultants had in common was their passion for the Health Service and the ability to confuse with Powerpoints and spreadsheets. In the midst of all this was a talk by a young doctor who presented clearly with informative flipcharts how public services should be working. Every resident would have a single point of contact who would sympathetically route people to the service they needed and manage the solution of whatever problems they had. On our table we had to discuss what we had seen and fill out questionnaires. I told my group how impressed I had been by the young doctor’s spiel. I was gently guided away from this by our table’s apparatchik (there was one per table) who pointed out that it would be ludicrously expensive.
And, of course, it didn’t happen. The CCG’s continued as a Management Consultants’ wet dream and are due to be subsumed into Integrated Care Services in 2022.
I was reminded of the meeting by Chris Naylor’s programme on Radio 4, The Case for Public Service Reform about integrated public services and how well they worked in Barking & Dagenham and Wigan. It was a powerful sell job and worth listening to if you are concerned about our public services, particularly with austerity ramping up.
Several wise people took us through the history of welfare since the war. The Welfare State was apparently conceived as a trampoline. Most people would be in work and thriving and would soon bounce back. In practice it became a safety net for millions who rely on benefits for survival.
Chris Naylor had been the CEO of Barking and Dagenham Council and he told us of the improvement in the quality of services there through implementation of the single point of contact approach advocated by my young doctor for the Health Service.
Council Officer Darren Rodwell explained that the watershed was the BNP winning 12 council seats in 2006. Services had to improve and the strategy adopted was to merge 24 services into 1 department called Community Solutions.
Chris Naylor also expressed great enthusiasm for the achievements of Wigan Council under the guidance of Donna Hall CBE, who had adopted a similar approach, done wonders in cutting costs while improving the lives of employees and customers.
To find out more I looked up an interview she had given to The King’s Fund just before she retired from the Wigan job in 2019. She acknowledged that it had been difficult to educate council staff away from departmental silos and budgets. But naturally she talked up Wigan’s achievements.
Chris Naylor’s programme had an interview with the mother of a young man whose life had been transformed by being accepted as the member of a community in The Hamlet , an inspirational Wigan success story.
So I was a bit disappointed when looking up reviews of public services in Barking and Dagenham and in Wigan which were very negative.
Chris Naylor is now a director of Inner Circle Consulting advising on public service reform.
Professor Donna Hall CBE is Chair of a think tank called New Local advising on public service reform.
I have asked them both for feedback.