If you’re even the slightest bit politically inclined, or you happened to have switched over to the leader’s debate on TV last week, the real ‘hot potato’ subject of note was the private sector outsourcing of NHS services. This is a common stick with which those more aligned with socialist beliefs beat the Conservatives (and by default right now the Liberal Democrats too), and it was highlighted and discussed at length.
But what do the public at large think about the idea of private sector outsourcing of our public services? Do people really care who collects their bins, who runs their GP surgery or the rail system so long, as they do a good job?
According to We Own It , a campaigning organisation that’s tagline reads “Public services for people not profit”, more than half of those who responded to their survey said unequivocally that they wanted more say in who runs our public services, creating a positive bias towards not-for-profits, and opening up service statistics and performance levels to public scrutiny.
I believe that it was Nick Clegg at the Leader’s Debate who responded to the implication that there was some sort of mass migration towards private sector outsourcing. He said how ridiculous this is because five years ago around 4% of the NHS services were run by private sector firms, and now it is 6%. Although that in itself is a 50% increase if these statistics are to be believed; observers will wonder what all of the emotive political language is about. There are some who believe that the current government are leading us down a slippery slope – and, if you read the We Own It campaign for a Public Service Users Bill, it is difficult to draw any other conclusion that they themselves are among them.
What is the Public Service Users Bill?
Essentially, what is being called for is more public (citizen) involvement in public services, cracking what is considered a ‘closed door’ system that locks the general population out of such decisions and leaving them in the hands of our elected peers. But, while all of this sounds great – wrestling control back from the perception of the profiteering private sector – isn’t this precisely the role that we elect our peers into local or central government to perform for us? Assuming that we’re going with the profiteering private sector narrative, here are the key issues the Public Service Users Bill would highlight.
1. Public consultation. Once a need for a public service is identified or validated, the public will be consulted about what they would want from that service. Essentially, every time a new service or a contract renewal comes up the public would be asked to contribute their thoughts on the subject – what do they want, what do they think is the best way of achieving it, and so forth.
2. To privatise or not to privatise, that is the question. The public should always be consulted on the subject of whether the identified service should be continued in-house or outsourced. This will, of course, determine who should take ultimate responsibility for the service levels of your public services – the local authority or a private company.
3. Public ownership first and always. Clear prioritisation should be given to the public sector, mutuals, charities or social enterprises to run public services because the selection process should be focused on ‘social value’. And public sector bidders should be required to always tender for public service contracts.
4. Contracts should be open to scrutiny. Once an agreement has been signed it should be available for all to review. Such openness should encourage fairer contractual terms and, where the successful provider was from a private sector provider rather than a public sector provider, a more transparent view of profit margins. Public sector organisations that provide ‘arms-length’ service delivery are already subject to this transparency.
5. Performance and financial information. Simple freedom of information enquiries and access to financial data and performance statistics would also mean greater accountability. Although the plan would be that under the bill this information is already published, thus avoiding the need for excessive FOI requests.
6. Right to recall. Any provider/supplier considered to be doing a ‘bad job’ can be removed from a relationship early if enough complaints come in about them – whether that is public or private sector. Smart KPIs would need to be very carefully thought through and their implications determined.
How realistic are the expectations of a Public Service Users Bill?
So, there is a view of public services utopia according to one campaigning organisation, but how realistic are their aspirations for us all?
Potential reservations about the Bill working in practice:
1. Publicly elected officials in charge of public service provision decisions. As I mentioned before, our electoral system is set up to give us the power over determining, among other things, who we feel are best suited to handling our public service provision decisions. We elect local and national representatives who will be in charge of these issues and as we live in a democratic nation we have the right, every few years, to change our minds and choose someone else if we feel they could do a better job. So the call to wrestle these decisions from our elected officials baffles me a little. If you don’t like the way your local authority or central government spends its budget, vote them out at the next opportunity. If you don’t like the way the national budget is being spent, then use your vote this May.
2. What makes the public at large a better decision-maker than the officials they elected? How many of your friends and neighbours know much about public sector outsourcing, the intricacy of public/private sector relationships, public sector procurement procedures, and so forth? Openness is one thing, but while you may feel well equipped to contribute to the conversation on whether public services should be best managed by public sector teams, are the public at large able to speak with an informed voice on the subject?
3. Does the public care enough? Does the average person really care who picks up their bins once a fortnight or who takes care of their roadside maintenance and so forth? Of course nobody wants to wake up to rubbish scattered across their street, but as long as someone competent is in charge to ensure that everything keeps on turning, does the average person really want to involve themselves in the million and one decisions, big and small, that go into developing a competent public sector service delivery strategy?
4. Clarity and early service termination. There are strict guidelines that currently protect both service provider and client regarding the process for exiting a service delivery partnership earlier than planned. Of course, many public sector relationships are created to last for many years and an early exit could be financially and reputationally traumatic for both parties. This includes the possibility of a painful transition period that could significantly adversely affect service provision and, therefore, the recipients of the service: the public at large.
Central to the smoothest possible exit from a service provision relationship is clarity of purpose. This clarity starts with what you were asking your provider to supply in the first place, what the expected service outcomes were to be, what their advice was at the outset and where you stand right now in the scheme of things.
The clarity is essential as part of the agreement between client and provider – whether in-house or a third party private or public sector provider. It is difficult enough to come to an agreement when you have a dedicated in-house team determining all the many facets of a relationship. If you then add into the mix a public consultation (usually more than one), you add many more voices and opinions that may or may not be fully formed and quantifiable in nature.
The more voices the less clarity, the less clarity the more ambiguity there will be in the contract and delivery expectations, and the more ambiguity there is, the weaker any case for early service termination will be.
Put simply, if you cannot clearly tell your provider what you expect from them and ensure it is quantified, it becomes more challenging to say that they were not achieving your expectations. Without a clear strategy and these quantified service delivery objectives being in place, it is an unfair and inequitable position to put your provider into.
Five steps to adapt the Public Service Users Bill into a workable solution
We’re not suggesting that the Public Service Users Bill is a solution that we recommend in its current form. I still believe wholeheartedly that with the right support and controls, our current system provides the most freedom to deal with local delivery issues, but if we had to adopt a Public Service Users Bill then it would require certain fundamental changes to be more practically workable in our experience:
1. Quantify ‘what good looks like’. Detailed in-house research needs to be conducted into the demands and aspirations of the service provision to create a picture of what the ideal (but affordable) outcomes would be, should the best provider (whether in-house or private/public sector outsourced) be selected and everything go according to plan. This is the end goal that everyone will need to keep in mind, not only when selecting a provider, but throughout the relationship as a key directional tool to determine performance measurements. Costs involved need to ground such outcome expectations as the frugal nature of public sector service provision these days must also be recognised.
2. A better informed public make better decisions. Rather than holding open consultations without specific guidance and context, we feel that any members of the public who wish to be involved in the process must first understand the financial ramifications, legal boundaries, EU Procurement issues, service level, employment and local economy impact of their decisions on in-house or private sector bids. Ramifications such as the compromises that may need to be made in other areas of public service provision, should budgets be strained on particular areas of public service that are under consultation.
3. Early piloting of services. A greater number of voices creates greater risks. Essentially, just because more people want it does not make it the right decision; it is all the more important to trial any service provision and report back on the impact of the test. Due diligence will require such a pilot system in a controlled environment with the monitoring and reporting of outcome-aligned smart KPIs.
4. Contract for outcomes not inputs. A focus on the goals of the service is important. Effort does not always equate to results and the outcomes that you determined based on thorough pre-contract research and analysis to evaluate ‘what good looks like’, are your best measures of the success of your relationship. Contracts should clearly and quantifiably determine expectations and milestones along the way so performance can be measured, penalties enforced or rewards allocated to ensure the right behaviours are encouraged.
5. Your contract is not a finite thing. Contracts are all too often seen as immovable objects, but they need to be as flexible as your relationship requires them to be. An evaluation and reshaping programme should be set in place from the outset which at least every six months looks at the practicalities of existing clauses and milestones and the reality of the environment in which the parties are working. Public feedback and performance analysis that is evidenced based will then help to reshape a contract to realign expectations and redirect efforts.
The idea of more public involvement in public service provision decisions is a popular political mantra for some parties in this coming election, so expect it to be used quite often in the run up to this spring’s big event. The inevitable discussion in the media this creates will only boost the efforts of, and potentially support for organisations like ‘We Own It’ and their Public Service Users Bill. But whether it will cause genuine change will only be evident over time. Without some serious refinement, this concept and others like it are more likely to add cost and complexity to an already strained system rather than markedly improving it.