Published on 24 October 2017
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10 November 2017
Last month a powerful review of the NHS in Northern Ireland pointed to the importance of political leadership in public service reform. The BBC reported that NHS performance was deteriorating because, in the absence of devolved government, no one was taking the tough decisions about changes in services and budgets. One commentator said: “In the last nine months we’ve had no government in Northern Ireland. We’re in a political vacuum. This system reverts to keeping the show on the road, and any ideas about transformation or change are simply mothballed.”
The State of the State launched in Belfast this week and the joint Deloitte / Reform report made the same point (“policy decisions that require ministerial approval have not been taken. That could come at an opportunity cost for Northern Ireland, especially where public sector reform stagnates and decisions that could save money are not taken”). In my presentation at the launch, I argued that the argument applied to Westminster almost as much as to Stormont.
There are certainly areas of real energy and progress across government, from Liz Truss’ interest in public sector innovation to Brandon Lewis’ focus on technology in regard to the border to Sam Gyimah on prisons reform. An overall sense of direction is however lacking. Neither the Prime Minister nor Chancellor have given a major speech on public services which would bring Ministers’ efforts together. There is a sense that decisions on public services are being taken on a tactical and political basis – just to “keep the show on the road” – rather than on principle. Examples of this would be the public sector pay debate after the Election and the debate on NHS spending ahead of the Budget.
The lead recommendation of The State of the State is that the “momentum of public sector reform needs to be re-energised”. Here are three reasons why that is likely to happen.
First, the 2017 Election showed how important the public services issues are to voters. What was supposed to be a Brexit Election actually turned on NHS, schools and police funding and on social care. There is a great incentive for politicians to return to these issues. Some argue that Ministers should ignore domestic policy because Brexit is absorbing all their bandwidth but it is hard to defend that view.
Second, public service reform has so much to say to the prevailing political mood of disenfranchisement, loss of control and exclusion from economic opportunity. As Justine Greening is showing, reforms to education, health, employment and welfare speak directly to this themes.
Third, the political challenge, which is a real one, is to balance citizens’ wish to move beyond the emergency-style “austerity” post financial crisis with the ongoing difficulty of the public finances. Productivity, based on reform, remains the best way to achieve this.
The forthcoming Budget is a great moment for the Chancellor to give his sense of direction.
Andrew Haldenby, Director, Reform