Introduction
After a dismal decade, public service reform is in vogue again. In anticipation of a change of government, last week saw the welcome launch of the Demos Public Services Taskforce, one of several efforts underway to shape up a coherent public service agenda ahead of the General Election (also see recent work by IPPR and New Local). Collaborate’s founder and Chair, Lord Victor Adebowale, is one of five members of the Advisory Board, and I am pleased to be a policy advisor to the Taskforce.
This work is urgently needed. As set out in the Discussion Paper that accompanied the launch, there has not been a coherent public service agenda since the market-informed reforms of the Blair government, which feel profoundly out of step with where public services are today. Both citizens and public servants deserve a cross-cutting and cross-party consensus about the future direction of public services, not more piecemeal reforms and sticking plasters.
Starting with what we know
However, as the Demos paper also acknowledges, we should start from what we already know. We do not need to invent what has already been built on the ground all over the country. Places like Wigan, Gateshead and Barking and Dagenham (among many others) have innovated in response to the changing context and in the absence of a top down, imposed political agenda from central government. Their successes and ongoing learning are documented pretty extensively already in multiple publications over the past decade or more (1) .
We should instead focus our attention on what we don’t know, or don’t understand as well – both about this emergent practice today, and about the more distant horizons of public service reform that need new thinking and efforts to bring them closer.
So, as the Taskforce begins, I want to recap what we know, outlining the principles – or DNA – that already underpin the work of many people and places, and make the case that there is still a missing element from this work that needs more attention. In a short series of subsequent blogs I’ll offer thoughts about aspects of a future public service reform agenda which are less well developed on the ground, and would be usefully explored through the work of Demos and others.
The DNA of future public services
The innovations we have seen, and that are guiding the way into a new future, at their heart attempts to shift power towards people, building more reciprocal relationships with citizens and service users as equal partners in creating change. This is a critical move away from previous models of public service reform based on paternalism or market principles (2), and prompts us to rethink the goal of public services.
At Collaborate, we define this goal as ‘supporting human flourishing’(3). In simpler words – supporting and investing in people and creating the conditions for people to have good lives. This goal is deliberately different from a traditional view of services as ‘responding to need’ or providing choice in a market place, putting good lives at the heart of what public services are for.
So, what do public services that support human flourishing look like?(4)
Relational and personalised
Public services are about people. Outcomes are rarely the product of a transaction, they are the product of a collaboration and a relationship. A human-to-human conversation about what someone wants and needs, and what a good life would look like for them, requiring dialogue, listening, mutual understanding. Service users therefore must be understood as coproducers of value in their own right – people who have an active part to play in their lives, their outcomes, their communities, not ‘consumers’ of services.
This means we need people working in public services who treat people with human care, dignity and kindness, and services based on building human-human relationships, interactions and trust, not assessments and thresholds (see Mark Smith’s blogs on the public service reform work in Gateshead for good examples of this). Building relational public services requires us to liberate the kindness and intrinsic motivation of the workforce.
Strengths-based and holistic
As we all know from personal experience, we live complex lives with many factors that affect our quality of life, health and happiness, including income, job security, social and family connections. From the point of view of each individual, these factors are all interconnected, and yet public services and interventions tend to be designed around only one issue at a time, and often ignore the underlying factors entirely.
So public services must care about people’s whole lives, not just the presenting issue or biggest problem on someone’s mind that day. They need to be designed to be curious about and responsive to what’s under the surface, and care about what’s strong, and can be strengthened, not just what’s wrong, because people themselves hold part of the solution to the problems they face.
Preventative
Building on the broad goal of human flourishing, the public sector should invest in community development to help communities become stronger and more connected, active and resilient, and work collaboratively with the voluntary and community sector to support a vibrant civic and participatory economy in every community.
Building on these foundations, public services should act early, before problems grow. A shift towards prevention rather than reaction means working collaboratively across service and sector boundaries, sharing data and identifying those who need support the most and ensuring there are early help offers available, not turning people away until they meet the thresholds of need set out in ever more stringent eligibility criteria.
Joined up
For too long, public services have been designed based on an outdated paternalistic model that is less ‘what you need and want’ and more ‘what we can provide’. They are arranged more for the convenience of bureaucrats, different tiers of government, funding streams and so on, than for service users. Instead, in order to provide all the help people need without having to repeat themselves multiple times, services must remove the burden of navigating complex service structures from individuals. This could include organising around communities or geographies that work for residents and stronger facilitate relationships and collaboration between staff from different organisations. And where that’s not possible, ensuring that services communicate and collaborate across service boundaries – housing department with social care and health; SEND with schools and so on – pulling in and coordinating support from people and services that can help.
Adaptive
It feels glib to say everyone is different, but our current services often act as if that isn’t true, with one size fits all pathways and practices that are deployed and scaled without considering the huge variations in context. In reality we know that what works for one person may not work for another. Support needs to be tailored to the individual, with the flexibility to adapt based on what we’re learning about what’s working and what needs to change. This applies at the level of individuals and to whole services, requiring changes to commissioning and procurement practice.
As a Director of Adult Social Care said to me recently, how could the service that works at the start of a 5 year contract still be working as effectively at the end, if it hasn’t been able to change along the way? People who work in public services need to be able to learn, invite feedback, and adapt in response.
At Collaborate, we have previously summarised all these principles in terms of the following shifts in public services (5):
Equitable
However, to this fairly familiar list of principles, I would like to add one more: Equitable. It seems to me that for all the work already undertaken in this area, the importance of these principles and all the progress made on the ground, our thinking about shifting power between services and service users, organisations and beneficiaries still has some way to go.
Every time I’ve ever heard Collaborate’s founder, Lord Victor Adebowale, talk about public services, he’s talked about the moral imperative of addressing the ‘inverse care law’: the principle that the availability of good medical or social care tends to vary inversely with the need of the population served (6). The principle of universal access to publicly funded services remains a critical foundation of our social settlement, but it is fairly obvious that universal access alone does not create equitable outcomes. I think there is a lot of lingering fuzzy thinking about fairness when it comes to public services – for example the fears of postcode lotteries puts the focus on access rather than outcomes, and the “computer says no” use of thresholds which assumes procedural justice is the best path to fairness.
The principle of equity on the other hand points us in a different direction. It helps us see that people need very different things from public services, and therefore that public services need to offer very different things, reach out in different ways, provide different sorts of help, collaborate in different ways – that greater equity in terms of experience and outcomes comes from greater flexibility and diversity of approach. It’s also about making different choices, redirecting resources to those who face the biggest disadvantage.
In some ways this principle is already well baked into public services, and in others it feels like a radical challenge to some long-held beliefs. The shift towards relational, strengths-based, adaptive approaches requires a much sharper understanding of structural inequality and power dynamics between public services and citizens than is usual today, not to mention change to public sector workforce and training approaches and recruitment, and the building of much greater cultural literacy and competency among the workforce. It is also about values, and our societal care and focus on people for whom public services have to work – those at the sharp end of the inverse care law.
Perhaps the real shift in thinking from New Public Management to future public services then is one from efficiency to equity. I think we need to focus more on why equity should be at the heart of how we think about public services, and what the implications of this would be in practice. This is an area that requires much more attention and exploration in public service reform work going forward.
Further horizons of public service reform
I hope this has been useful as a summary of what we already know – and don’t know – about public service reform today, and which areas of this emergent DNA need more work. In the next pieces, I want to explore the aspects of this reform agenda that are less well developed and understood, and where we should be putting our attention through the Demos taskforce and other work. I intend to explore:
1. How we bring this emerging future into being
The work that is giving us hope and direction exists in pockets, often perilously. The real work needed urgently is to establish how this unevenly distributed future can be nurtured and supported everywhere so it becomes how public services work.
Although a coherent national public services agenda will be helpful, this is not about central command and control, however tempting this might be to a new government. Instead it’s about finding ways to enable and facilitate local leaders to bring reforms out of marginal pockets of innovation and into the mainstream. It requires changes to the role of central government, more devolution, new forms of accountability and regulation, support for learning across places and services, and investment in local leadership and capacity building.
Tempting as it is to describe the above as a ‘new model’ for public services, this is to miss a crucial part of how new approaches have been created on the ground, in response to local contexts, through experimentation and learning. Arguably what matters more is method, not mode: DNA that can be expressed in different ways in different contexts. So I suggest we think about the future of public services as guided by this core set of principles that should guide local leaders in thinking about what matters, resisting the temptation to describe it as a prescriptive model they can adopt.
So: a top down, centrally-driven and mandated reform agenda might not cut it!
2. From public services to services to the public
We need to significantly widen our thinking about public services to encompass services we rely on as a society, delivered across all sectors, public, private and the thousands of voluntary, faith and social organisations that are at the heart of our communities.
Understandably, so much of this work focuses on publicly-funded and people-focused services that sit within(or are commissioned by) the public sector – local government, NHS, and so on – but we should think much harder and more radically about public goods – all the things that people need and rely on and which contribute to human flourishing. Many of these are in the private sector today, and the public sector is – unaffordably and unsustainably – picking up the pieces of private companies’ failures to prioritise and provide public value. Greater shared purpose and collaboration across sectors for public (and environmental) benefit is where the new frontier of public service reform is today.
3. What sort of society do we want to be part of?
Finally, underpinning all of this is the fundamental thing that no one ever talks about in debates about public service reform: values.
By values I mean the intangible but critical beliefs about society, human relations and connections that we should be putting at the heart of a future political project. Care, connection, love, belonging, respect. If these things are what we want to feel in our lives, and what keep us healthy and happy, then all the above needs to be about how these values are embedded. Ultimately, the future of public services is really about the future of our society, and we should be clear that building post-neoliberal society, economics, government and public services are all part of the same project.
I offer these blogs as provocations at a time of opportunity for fresh thinking and new attention on public services. Collaborate plans to organise a series of discussions next year about each of these themes, hopefully building our understanding of each, and ensuring these insights are contributing to the Demos work too. We welcome your thoughts and feedback, and look forward to these discussions.
Please do let me know your thoughts at [email protected].
Thanks for reading!
With thanks to Elle Dodd, Dawn Plimmer and Jeff Masters for their comments and input to this piece.
(1) See for example: Hilary Cottam’s Radical Help, Collaborate CIC and Toby Lowe’s work on Human Learning Systems, the work of the 2020 Public Services Commission
(2) New Local’s work on the Community Paradigm is a good history of different approaches to public services, and Toby Lowe and Annabel Davidson Knight offer a good critique of the limits of New Public Management in A Whole New World — Funding and Commissioning in Complexity
(3) Public Service for the Real World, published by Collaborate, CPI & other partners: https://www.centreforpublicimpact.org/assets/documents/hls-real-world.pdf?__hstc=45853115.7db57e85893e336892cf8b8e3eed6e7d.1701706812456.1701706812456.1701959951800.2&__hssc=45853115.1.1701959951800&__hsfp=1553784269
(4) These principles build on the work of too many to mention here, but I would like to highlight the pioneering work of Wigan Council, with whom Collaborate are currently working, Mark Smith in Gateshead, Chris Naylor (previous CEO of Barking and Dagenham Council), the many leaders of Greater Manchester’s public service reform work, and Henry Kippin, now CEO of the North of Tyne Combined Authority, as well as the policy work of Collaborate, New Local, Demos, IPPR, Hilary Cottam and others.
(5) Manifesto for a Collaborative Society, Collaborate CIC, 2020
(6) This principle was proposed by Julian Tudor Hart, https://en.wikipedia.org/wiki/Inverse_care_law#:~:text=The%20inverse%20care%20law%20is,the%20history%20of%20The%20Lancet.