Public services are lacking a clear overall vision but now is the time for our political discourse to rise to the occasion and provide us with a blueprint for reform says Emmet Regan. This article was originally published in the MJ.
As we enter the final phase before the next General Election, questions are beginning to arise as to what a vision for the future of our public services looks like.
We know that the status quo cannot continue with decreasing funding alongside increasing demand and complexity. The cost of living crisis is asking fundamental questions of how citizens use and engage with public services alongside a backdrop of significant industrial action.
Currently, there are no compelling visions for what the future could look like emerging from our political discourse. We are mired in a discussion that is backward-looking, focusing on political rhetoric, missed targets, and increasing backlogs. These issues are important to the debate but with no clear map to future reform, we are unlikely to reach that destination.
How can it be that, within the wider political debate, there is not an emerging framework for how we deal with our future challenges? There is no clear plan for how we move beyond the last few years to focus on a domestic reform agenda that is much needed.
We stand on the precipice of immense change with huge possibilities yet the debate about our public services is focussed on targets and statistics. We run the risk of both missing the target and missing the point. Now is the time for clarity of thought and bold action.
Our public services deserve to be prioritised in the national debate. Key to the success of any future Government is a clear mandate from the public to deliver a reform agenda. Without clarity of what our future public services should and could look like, we are unlikely to see the change we need.
There are competing Labour Party missions focused on the economy and the NHS and Conservative Party pledges focused on reducing inflation and stopping ‘small boats’ arriving from northern France. Where is the vision for the future of our public services that draws together the great challenges and opportunities of our time?
Public service reform is sclerotic; service users are seen through the lens of the NHS or the social care system but not as a citizen who uses multiple services. While Whitehall maintains a siloed approach there is no clear direction of travel in terms of reform or how services should come and work together.
The British Medical Association conducted recent research with the latest figures for March 2023 showing that around 7.33 million people waiting for treatment with nearly 3.3 million of these patients waiting over 18 weeks.
Understandably, day-to-day focus is on Covid backlogs whether that be in the NHS or the criminal justice system but this has come at the cost of not being able to focus on the immense challenges that are either here or coming down the line. The use of AI will fundamentally change not just individual services but the way we govern and the way we are governed.
Now is the time to think big but also look at the work already happening across the country in local authorities, local places, and regions. Here are some of the key themes that can act as a framework for the debate and the planning that must happen urgently.
Decision-making: Where and how are we making decisions that impact people’s lives is vital to the impact of those services. Whitehall has long dominated as the pre-eminent arbiter of how public services are delivered. We must go further and deeper in terms of devolution but not stopping at the town hall, moving into communities and community institutions to develop local decision-making tools and empowering local ownership.
Meaningful integration: For too long, we have talked about the integration of services without defining effective parameters. Understanding how data can be used in a different way to make more decisions in real time and trusting local partners to share will be crucial for meaningful reform.
Co-production: Without involving the people who use public services, the risk remains that a proposed solution works on a whiteboard but not in real life. We have seen the value, time and time again for involving service users in the process of reform. Last year, the work of the independent review of children’s social care was greatly strengthened by several panels of care experienced families and young people informing their work.
Perspective: Understanding that not everyone will have the same perspective on how services should be shaped and changed. Bringing together groups, being aware of their own perspective whether that is staff, services users, or other stakeholders can only add value to the reform agenda.
Now is the time for our political discourse to rise to the occasion and provide us with a blueprint for reforming our public services over the coming years. We must be bold, look forward and build on what is happening up and down the country.
People who rely on public services deserve to have a clear articulation of what the future holds. As Martin Luther King said: ‘Life’s most persistent and urgent question is, “What are you doing for others?”’
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