Are you brave enough to cede control of services?
Updated: Mar 30, 2021
Emmet Regan argues that public service bodies need to cede individual organisational control in order to ensure greater collective control over the services they provide within the wider public service system. A version of this article appeared in the MJ on 13 March – click here.
The fallacy of public sector control is that although public servants and elected members oversee and operate our public services they are not fully in control of those services. Without fully understanding the concept of control in relation to public services, we cannot ensure their long-term stability and viability.
The recent news from Northamptonshire County Council demonstrates the acute nature of the financial challenge the public sector is facing. The growth of new delivery models and new organisational structures from Accountable Care Organisations (ACOs) to children’s social care trusts provides a shifting landscape of responsibility, ownership and delivery for our public services. The collapse of Carillion has also raised questions about future models of contracting and the use of the private sector to deliver public services. All of this evidence points to the need for radical reform. Unless we tackle the issue of control, we cannot deliver meaningful change.
First, we need to understand who is in control of our public services. The two guiding influences on our public services are the concepts of demand and supply. Demand, simply put, is the needs of public service users, namely the patient and the pupil. The element of supply is the services provided to those users. This definition, albeit a crude demarcation, goes to the heart of the debate on how we reform our public services and how we understand the issue of control.
Without managing the demand for a public service, there can be no real control of that service. Yes, there is oversight and operation but that does not equate to control. Demand for a service directly impacts the budget for that service and this budget is directly correlated to the activity undertaken, which is demand-driven.
Control cannot be exercised without the ability to influence supply and demand. This is a challenging notion but one which is crucial in understanding whether ceding control to other stakeholders and organisations can provide more control.
We see examples time and again where public services such as the police and the NHS come under pressure because they cannot control their demand. The silo nature of our public service infrastructure does not allow for meaningful collaborative action. Issues such as mental health and domestic violence will not be solved by a singular agency but by a rather concerted effort across the pubic service family.
If we accept that control cannot be gained by a singular organisation, how can we address the issues of control?
In reality, this means the bravery to embrace partnership working and surrender organisational autonomy and control to ensure our populations are served by collective leadership and delivery. We are beginning to see the green shoots of this in areas like the West Midlands and Greater Manchester. This collaborative behaviour should be the rule, not the exception.
Public services face three key challenges: a reduction in public spending, increasing demand and rising complexity. Over the past 30 years, people’s lives have become more integrated, more complex and they are living for much longer. The architecture of public services has not kept pace with these changes and the linear nature of these services has been overtaken by how people actually live their lives and access public services. The pupil or the patient has more computing power and information in their smartphone than government had for generations.
In order to ensure greater control, organisations must work together and reflect the way people live their lives. Public services work best when they work in harmony with each other. Sharing outcomes, budgets and leadership is the only way to address this.
How many leaders will be brave enough to cede control in order to gain control?