Public Service Reform Kevin McLean
Mar 28, 2015
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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