A human agenda for public services
Liberator magazine, April 2008
Spring is here. The winter which has frozen the intellectual veins of UK liberalism is beginning to thaw at last.
The first swallow came in the form of the Reinventing the State book. There were a few voles glimpsed during the Lib Dem leadership election. But finally we have green shoots: at long last, a real debate about Liberalism and public services – and it’s really thanks to Liberator.
For goodness know how long, we have been iced into a stale debate – if it can be called that – between those who feared too much market influence and those who feared too little. It never amounted to much more than that. Dipping into it provided a genuine whiff of the 1970s, as redolent as flared trousers: it was more like a debate between Starksy and Hutch.
But we are moving at last towards a genuine Liberal critique, and about time too. Most general elections are dominated by debate about public services and – since we have only managed to contribute a handful of bright ideas on this in the past decade – it is hardly surprising that voters say they don’t know what we are for.
What carried that real whiff of spring was Simon Titley’s leader in the last edition of Liberator. He said that the real division in the party was now about what it means to be human. “Are we primarily partners, parents and relatives; friends, neighbours and colleagues?” he asked. “Or do we define ourselves more in terms of the things we buy?... Do the Liberal Democrats envisage a society of active citizens or supplicant consumers?”
That is exactly the right question (though I might quibble with the use of New Labour-speak like ‘active citizens’). My only criticism was that this was an editorial fired in the direction of only one camp in the debate between Starsky and Hutch.
It was intended as a critique of the market position, and it was a good one. But it implied no similar critique of their opponents: those who believe that all people’s needs can be met by the old professional institutions of local government, or their equivalent.
The same critique wasn’t applied to those who believe that, as long as people are elected to run our public services, nothing else needs to change.
Simon identified the wrong-headed wing of the debate with those who subsume these human relationships within economic relationships, with the idea that people are individual consumers faced with a series of passive choices.
That is right, but he missed out the other side of the argument. Because that reduction of people into dependent supplicants is not confined to those can see no further than narrow consumer choices in public services; it is alive and well among those who don’t believe in choice at all – who are quite happy that people should be grateful but passive recipients of services defined by the local state.
Because, in practice, the wrong-headed idea that we oppose is not confined either the private or the public sector. It is an insidious combination of them both – the idea that people are defined narrowly by their needs, and should be administered by giant agencies part-public, part-private, by huge databases and remote call centres.
This is the new centralised supplicant state, and Simon was absolutely right that it is the heart of a new Lib Dem critique of public services. Not because the supplicant state is too public sector, or too private sector – it borrows from the worst of both – but because it is deeply alienating, deeply inefficient and deeply ineffective.
The point is that there is a more fundamental problem about our public services, which has nothing to do either with investing more or selling them off: they are grinding to a halt.
They are doing so because of the massive inefficiencies of centralisation, the disempowering targets and the externalities of giant organisations. They are doing so because centralisation causes sclerotic bureaucracy that tries to exclude the vital human element – the very element that actually makes things happen in schools and hospitals. And they are doing so because they refuse to share responsibility with their clients, preferring them passive and silent.
This is the real story of public services under Gordon Brown, and you can see it everywhere:
- The patients of factory hospitals who never see the same doctor twice, one in ten of whom will suffer real harm from hospital mistakes or viruses.
- The new claimants who have to hold on so long at the call centre on their pay-as-you-go mobile phones just to make a claim that it costs them £35.
- The probation officers with 600 clients each, who wonder how they can possibly build transformative relationships with any of their ex-offenders.
- The A&E nurses who know what the patients in front of them need so urgently, but who have to go through more than 20 pages on their IT system before they can help each of them.
- The public service managers who struggle to manipulate their expensive recruitment IT systems just to make sure the people they know would be best get interviewed.
- The teachers who knows what they need to say in their pupil’s report, but have to choose from a series of approved phrases in their approved report-writing system.
Politicians see these problems of course, but it is up to us as Liberals to stitch them together, articulate them as one problem – because that’s what they are, exactly as Simon Titley said: because they are all the result of inefficient centralised systems downgrading human skills.
What we need to do next is to put the important implications of all this into words, in such a way that it is political, and at the heart of the Lib Dem message:
It means the central problem of public services is no longer how they should be paid for. It is centralisation, giantism, bureaucracy and the deliberate excision of human skills from frontline services – all of which are common to public and private alike.
It means we have an explanation why, despite all the money spent on services in more than six decades since the Beveridge Report, the five giants he set out to tackle – Ignorance, Squalor, Disease, Want, Idleness – are still alive and well. Because those key relationships between doctors and patients, teachers and pupils, probation officers and clients, are what actually makes things change. Without them, everything grinds to a halt in a flurry of output targets that make it appear that progress is being made.
It means that the problem of public services is certainly about the absence of democracy. But this is democracy in its broadest sense – not just because they are run by appointed boards rather than elected ones. Lib Dems have been slow to understand the breadth of the localism agenda of localism because they are fixated on elections. These are important, of course, but they are only part of the battle. There remains a question of how services are organised once those directors are elected, whether they are sharing responsibility, bringing in volunteers, making change possible and permanent.
It means that the same critique can be applied to private corporations, as our monopoly watchdogs doze on the job, allowing our communities to be captured by increasingly monopolistic supermarkets (presided over by intrusive IT systems and security guards watching you from platforms by the door). That is why there are only a couple of remaining waste contractors who are expected to fulfil nearly every local government contract, removing all the leverage that competition used to give to councillors and local people trying to squeeze a better and more efficient deal.
It means that there are enormous implications for the costs of public services. Institutions which don’t work, or only deal with symptoms and ignore causes, or which cause massive externalities because they try to remove human contact, are vastly more expensive to run than they should be. The issue is no longer how to raise more money to make public services work, but how much more could be done if they were local, human and effective.
This last point is the most important, because it indicates a political way out of the current impasse, which forces us to get embroiled in arguments about raising taxes just to demonstrate political commitment to education and health.
Instead we have the outlines of a new, coherent critique that public services cost vastly more than they should, and achieve far less than they should. Because centralised bureaucratic services don’t work, they lead to Teflon education and training, health spending which keeps people unhealthy, regeneration spending which leaves people exactly where they were before.
We now need an achievable political programme that could achieve a credible switch from sclerosis to genuine change.
We could then believably embrace the traditional Liberal campaign slogan of thrift, which allows us to explain this massive seizing up – and combines it with a wider critique of Brown government.
Look at the record so far, just on the headline white elephants. Nuclear clean-up (£73bn, just for existing waste), Iraq (£5-7bn so far), NHS computer project (£12bn so far), replacing Trident (£20-70bn), ID cards (up to £18bn).
Just add that up and work out how we could change people’s lives – if we had face-to-face public services, run by human beings who ware employed because they had initiative and leadership skills, and could use IT systems without being ruled by them.