Public Services on Your Side

Britain faces a tough global downturn with public services in a better shape than ever before. Strong public services are essential to help people weather financial storms. Often, they are the last line of defence for families who need security and protection in uncertain times. But public services also change the long-term economic and social climate. Delivering radical reform in public services - and in so doing, changing the very nature of the state - will play a vital role in enabling the country to come out of the recession stronger and fairer. Excellent services will enable all individuals and communities, not just the privileged few, to grasp new opportunities for the future.

Building and rebuilding services

Since 1997 our public services have been transformed, helping create a richer, healthier, safer and fairer country. Substantial investment and radical reform has created and renewed the essential services that make our communities and economy resilient. Over the last decade, the most comprehensive measures of national economic performance, income per head - GDP per capita - has risen faster in the UK than anywhere else in the G7 - and social mobility - the chance for each generation of children to accomplish more than its parents - is now rising for the first time in 40 years.¹

People in conference We have consistently invested in and reformed the public’s services. Sure Start Children’s Centres are already helping 2.3 million young children and their families, giving every child a flying start in life. In England 15,000 schools are providing before and after school services and wider facilities to the community.² Every secondary school is being rebuilt or refurbished. More than 100 new hospitals and hundreds of new General Practitioner (GP) and primary care facilities have opened. Police numbers in England and Wales remain at record levels - with over 140,000 officers compared to 126,000 in 1997. Every community now has a neighbourhood police team. Jobcentre Plus has helped 3 million people across Great Britain back to work since it was created.

These are not just dry statistics. Each of these changes to services has changed people’s lives. The chance of being a victim of crime is now at its lowest level since the British Crime Survey began in 1981. For the first time in England nearly all out-patients start treatment at a pre- booked time of their own choosing, within 18 weeks of referral - compared to more than 18 months before 1997. More people are surviving disease, for example, coronary heart disease mortality has been reduced by 40% since the period 1995 to 1997. Young people are achieving better results than ever - with now nearly half (47%) of 15 year olds achieving five good GCSEs including English and maths.

All these achievements have happened whilst government cut back on waste and bureaucracy, actually doing better than expected against the high efficiency targets set for it in the independent Gershon Review - making over £26 billion of efficiency savings in the last three years.

A Quiet Revolution

This record of achievement in public services is the hard-won product of a decade of sustained reform.

In the first stage of work, clear national standards and targets drove up performance as investment was increased. As services were repaired and rebuilt, the next change was to revitalise them - to drive change from within - with more freedom, flexibility and incentives at the front line to push progress.

In this second phase, fewer, sharper targets and standards were demanded; new freedoms for front-line staff and institutions were coupled with greater choice and diversity for citizens, including from private and third sector providers. Funding for the voluntary and community sector doubled - from £5.5 billion to over £11 billion.

As the quality of public services has continued to improve, our ambitions have grown: the Government is determined to drive out low standards once and for all, and ensure that all public services can go from good to great - to be both excellent and fair for all.

In the last 18 months, progress on the ground has accelerated, with some of the biggest advances in public services since the Government took office:

In health, for the first time, two-thirds of General Practitioners’ surgeries are now open in the evenings, early mornings or at weekends. The number of self-governing NHS Foundation Trusts has increased by nearly 60%. More than half of all eligible acute and mental health trusts are now Foundation Trusts - with over 1.2 million citizens playing an active role helping to oversee them as ‘members’. The independent healthcare sector now provides more elective treatments and diagnostics. And in the year ahead, the NHS Constitution will enshrine a patient’s right to choice in NHS services.
In education, state schools are producing better results than ever before. Nearly twice as many academies have opened since spring 2007 than in all previous years; 133 are now open, with up to 80 more academies due to open by the end of 2009 and up to 100 more in 2010. Over 130 trust schools are now open, 450 more are in the pipeline, and almost all secondary schools - nearly 3,000 - now have a specialism. School chains have started and co-operative trusts with a clear parental voice have been announced. By this summer we will open the 3,000th Children’s Centre.
In policing in England and Wales, every community now has its own neighbourhood police team, with clear ways to contact it, and we have now cut all but one target for the police - the confidence of their local communities - allowing the police to work better with communities to tackle crime.
Overall, we have shifted significant power and responsibility away from central Government and into the hands of local communities and citizens. For example, we have reduced the number of targets for local authorities from over 1,000 performance indicators to just 35 agreed priorities in each area, allowing greater flexibility to join-up services around local priorities. We have invested in local services - up 39% since 1997 - and freed up £5 billion for local government.

Public Services in tough economic times

Stronger public services are never more important than in tough times; they play a crucial role in protecting opportunity and reinforcing responsibility, through the downturn and into the future.

Today, public services are protecting millions of families and hundreds of thousands of businesses from the worst of the global economic storm. Extra support with job searching and free skills training is helping those across Britain who lose their jobs to get back into work; high quality advice and new forms of support are available all round the clock to families facing the threat of repossession, so that they don’t lose their homes just because they lose work or income; and increased help for families with children and pensioners is boosting household budgets when it is most needed.

When people need protection - and public spending can support the economy - it is not right to cut back on investment. This is why the Government has brought forward £3 billion of planned capital spending into the next two years, and boosted the resources available for public services and professionals, such as in Jobcentre Plus, who are on the frontline of providing support to people across Britain now.

But the acceleration of investment designed to protect families and businesses is also a once in a generation opportunity to accelerate the creation of the public services of tomorrow.

To build secure foundations for the future, the Government’s net investment in the public sector is projected to rise from £30 billion in 2007/8 to £40 billion in 2009/10.³ By contrast, in the early 1980s downturn public sector net investment fell in real terms from £16.1 billion in 1979/80 to £10.9 billion in 1982/83.

So we must be clear now about the kind of economy - and the kind of society - we want to see emerge from the downturn. That in turn tells us how government and public services must change. Reform must be reform with a purpose and our intent is ambitious:

To create a strong economy. Financial services will remain an important part of Britain’s future economy, but we must have growth across a wider range of key sectors. If Britain is to play a leading role in the key industries of the future - as we compete against rapidly developing countries of Asia and South America - from digital to pharmaceutical, from low carbon and advanced manufacturing to services, active leadership from government is essential. The potential prize is enormous - for example, independent research suggests that we could create an additional 400,000 jobs in the UK environmental sector in the next eight years - with a total of 1.3 million people employed in these sectors by 2017.⁴
To create a society of fair chances. Despite the downturn, globalisation offers more opportunity to more people. But it can also increase inequality and insecurity. As we set out in our New Opportunities White Paper, we believe that in this new world the job of government is more not less important, ensuring security for families whilst enabling people to be socially mobile.
To create a country of strong communities, underpinned by fair rules. As we set out in our statement Fair Rules for Strong Communities, we believe the irresponsibility of some can lead to insecurity for others. So people need to see that the rules are being enforced. Whether it is reckless behaviour in the bank boardroom or anti-social behaviour on the street, we will not tolerate a situation where some people break the rules and others pay the price. Government must be underpinned by an ethic of responsibility.

Delivering this vision tells us public services must continue to adapt and change. From the childcare and education that equips young people with skills for the modern world, right through to the care that means older people can lead active lives, public services are no longer simply a net to catch people in tough times. They help people shoulder their responsibilities and take up new opportunities.

Critical to the country’s recovery will be our education, welfare and skills systems helping millions re-train, build new skills, and ready themselves for new industries. New public institutions focusing on economic development - such as Regional Development Agencies - will play a vital role in fostering industries of the future in partnership with universities, colleges and schools. The evidence shows clearly that investment in high skills in a country boosts individual incomes and spreads the income distribution - increasing a country’s growth and competitiveness.⁵

Health and care services not only provide support when people need it - but also enable people to work and lead independent lives. And in areas of industry in which Britain has the potential to be a future world- leader, public services play a major role in Britain’s comparative advantage. For example, the National Health Service (NHS) represents one of the most important assets Britain has in competing on the world stage in the pharmaceutical and bio-science sector. Likewise, our universities are a major national resource in enabling Britain to compete in high tech, high value industries.

The challenges of tomorrow

With ambition clearly set, we must be clear about how the new global, digital environment around us, where people have new horizons, new expectations and new needs, must shape our vision of change.

A new economy. Beyond the immediate downturn, the world economy is expected to double in size in the next 20 years, creating up to 1 billion new jobs worldwide, often in new industries. Preparing for the new economy means investing in the education, skills, research and development that are our most important resource in a global market.
Powerful people. Everyone has something to contribute to public services. Services work better when they harness people’s interests, expertise and ambitions. Citizens also rightly expect more choice and control over their services. They also want to work in closer partnership with professionals, to get services personalised to their needs. As just one example, nine in ten people with care needs want to be involved in their services. Understanding people’s capabilities and behaviour better will be crucial to tackling some of the biggest challenges facing the country in the future - from obesity, to anti-social behaviour, to climate change. We know that schools that work with parents ensure better behaviour and results for pupils, while health services that give patients greater responsibility ensure people are better able to manage their conditions independently.
A digital age. Technology allows for innovative ways to do things. Information can be shared and good ideas can spread. Opportunities to communicate and collaborate through the internet have allowed for people to realise their capabilities. People don’t always need to be experts to understand, and they don’t need to belong to a big organisation to make change happen. This provides a major opportunity to move from old-fashioned consultation in government and public services and towards a genuine conversation with citizens and professionals. Communities both locally and globally can collaborate to innovate, shape and work around services.

Principles of Reform

Last year we set out our three principles for public service reform over the decade ahead: citizen empowerment; a new professionalism; and strategic leadership.6 This document shows how those principles will be translated into practice for the coming years.

Empowering Citizens

Excellent public services put people first, investing power in the hands of citizens and communities. This matters because greater power over public services gives people greater control over their lives. This demands an active government distributing not simply resources but power - information, entitlements and control - to people.

People do not expect public services to solve all their problems. They understand that parents have to parent, patients have to prevent health problems escalating, and everyone must play fairly by the rules. But they do expect public services to be on their side: fitting around their needs and lives, giving them security, control, information, and letting them know what they are entitled to. Empowering citizens means closely matching rights with responsibilities in public services.

For citizens this means:

Personalised services, which fit around people’s lives and needs, backed by clear entitlements to services and guarantees of standards of, for example, what people can expect from their local police, schools, or the NHS. This means people being able to work more closely with professionals, even one-to-one, as well as accessing services such as childcare and General Practitioners at times and in settings that suit them. And it will be backed by clear information about the performance of local services, so that people can see clearly whether those entitlements are being met.
Greater choice and control, such as through personal budgets which let people choose the care which best meets their needs.
An information revolution, designed to put the power of information within easy reach so that people can exercise control and shape their services. This includes open-source, real time data on the performance of services. It also means having the ability to feed back to services and share comments on issues with other patients, parents and local residents.

A New Professionalism

We know that in the end what matters most in public services is the relationship at the front line: between adviser and jobseeker, teacher - or teaching assistant - and pupil, nurse and patient, and social worker and family. Public services that are personalised to the different needs, capabilities and ambitions of individuals and local communities, have front-line professionals and local services with the space, the skills and the power to respond. In turn, it means services and institutions having the freedom to work more closely together, and with third and private sector providers, to deliver local people’s priorities. In this way we will make public services more sensitive to local places - not only recognising that places are different and need different solutions, but also unlocking the energy and creativity of people on the front-line.

The value of public service - the power of people coming together to support each individual - is also reinforced in tough times. This is as true for the head teacher as for the dinner lady; the care worker as for the doctor. The improved quality of public services and greater opportunities to personalise and lead services are attracting the brightest and most dedicated into, and back into, public service. As just one example, Teach First, through which people teach in some of the toughest schools is one of the biggest recruiters of Oxbridge graduates.

For public service leaders and professionals this means:

New freedoms for local communities and service leaders - including ways for local leaders to work across services, and with the private and third sector to achieve results for local people.
New freedoms for professionals to lead, run and personalise services - including more opportunities to manage the services themselves and act as lead professionals, joining up services and funding streams around citizens. As Lord Darzi’s review has demonstrated in the NHS, we need to put professionals at the heart of policy-making on public services.
Boosting skills and attracting talent - we will be more ambitious than ever in attracting the brightest and best into our public services, and will support an increasingly professional workforce, especially those working in the most challenging circumstances.
Professionals leading innovation and efficiency - giving front-line workers the power to identify and cut unnecessary bureaucracy, and the support they need to innovate and improve services.

Strategic Leadership

All these changes mean that the role of government itself has to change over time. We know that it is the effectiveness not the size of
government that counts. And the global recession has brought home that effective governments must be able to adjust quickly, innovate and play new roles in the face of new challenges.

Just as a strong government is required to steer the economy through the global recession, it is also the case that a responsive state should withdraw from areas in which it is no longer required.

Now more than ever government must prioritise its interventions and secure the greatest possible efficiency for every pound of taxpayers’ money it spends. As we redouble our efforts to reform and renew our public services, it is vital that we are bolder in our efforts to strip out waste, improve productivity and sell off public assets that the state no longer needs to own. The Government will set out proposals on these issues at the Budget.

Increasingly, government’s role will be:

Setting standards and entitlements - and then getting out of the way - central government must ensure that the priority outcomes people expect are delivered, and delivered fairly. This demands oversight of services, but not always direct delivery. We can and should allow local leaders and managers greater freedom on how they achieve these outcomes. Fewer, simpler targets, such as a single target of confidence in policing, make a reality of this ambition - enabling the police to focus on local priorities. This approach frees the centre to focus harder on services which fail to deliver acceptable minimum standards; for example, National Challenge advisors in England are helping to turn around underperforming schools. We cannot and will not tolerate low standards of services.
Driving productivity - at a time when families and businesses are tightening their belts it is more important than ever that the Government ensures that investment is targeted on frontline services and that there is more resolve than ever on improving efficiency and value for money.
Driving innovation - innovation will be a major route to achieving services which are both more efficient and empowering for people. This means not only more freedoms to the frontline of services, local areas and professionals - but changes in the way the centre works. The Civil Service must work harder to foster innovation, and ensure that the experience of delivery is shared from those at the front-line to those at the top of government. This must be backed up with more transparent, accountable civil service, and a central government that not only consults, but holds a real conversation with the public and front-line public service leaders and workers.

In summer 2008, we set out our approach to empowering citizens and fostering a new professionalism in public services, driven by a more strategic centre of government, in Excellence and Fairness: Achieving World Class Public Services. Since then changes in the global economy have made our ambition for world class public services for all only more important. 2009 will be a year of accelerating progress on the ground.

Citizen Empowerment in practice

For patients and people with care needs, we will:

offer many more people with long term conditions a personal care plan – with 15 million people offered plans by December 2010 – and legislate to enable patients to hold new personal health budgets, where they want to, for their long-term and chronic care;
offer an estimated 1 million people a preventative health check free on the NHS over the next twelve months;
enshrine the principles and values of the NHS in the NHS Constitution. This includes entitlements, such as the right to all NICE (National Institute for Health and Clinical Excellence) recommended treatments;
extend GP access – with around three quarters of GP practices open in early mornings, evening or at weekends, and open around 135 of the planned 152 new GP led health centres open eight to eight, seven days a week by the end of the year;
provide new opportunities to comment on, review and hence reshape NHS services through the NHS Choices website, including the ability to comment on and review your GP practice; and greater investment in adult social care enabling those who are eligible, and those who want one, to have a personal budget.

For parents we will:

better guarantee basic standards in schools – National Challenge advisers will work with head teachers in 440 schools to drive up standards, so that by 2011 no child will go to a school where fewer than 30 per cent of students get five good GCSEs including English and mathematics. We expect that 50 of the poorest performing schools, in some of the most deprived areas of the country, will be turned into either Academies or Trusts;
provide better information on how their child and their child’s school is doing, through timely and frequent communication covering achievement, progress, attendance, behaviour and special needs. This will be available through a range of routes, including online, for children in secondary schools by 2010 and children in primary schools by 2012;
deliver the 3,000th Children’s Centre by the summer, to serve up to 2.4 million young children and their families;
open up to 80 more Academies in 2009, and up to 100 more in 2010;
extend free child care places to disadvantaged two year olds, to reach 23,000 children in summer 2009 – and with all Local Authorities delivering free places by September; and
have a childcare price and quality comparison website up and running by early 2010. This website will include parents’ views on childcare providers to help other parents make the best choices for their children, and drive improvement in quality.

For children and young people we will:

personalise learning, such as through extending one-to-onecatch up tuition for those falling behind, reaching 140,000children between the ages of 7 and 14 in each of Englishand maths from September 2009, up from 36,000 in the 2009spring and summer terms;
ensure every secondary school pupil has a Personal Tutor that knows them in the round and supports their progress by September 2010; and
develop new innovative models of alternative provision for disaffected pupils, including through the use of private sector providers, so that all pupils are supported to make progress, and challenging behaviour in the classroom by a minority does not disrupt the teaching of everyone else. We have 12 pilots using the expertise of partners such as Rathbone, Barnardo’s, the Prince’s Trust, and Kids’ Company.

For jobseekers we will:

invest £1.3 billion in maintaining and extending Jobcentre Plus – so that anyone who loses their job can access help and support from the first day they become unemployed;
invest half a billion pounds to provide additional and more personalised support for all those unemployed for over six months, including ‘golden hellos’ – incentives of up to £2,500 for employers to recruit and train unemployed people;
extend an integrated employment and skills service, to help 100,000 people get qualifications and back to work by 2010/11;
extend the provision of counselling and support for those have been made unemployed, through accelerating the talking therapies programme.

For those who want to raise their skills we will:

provide a free skills audit for anyone losing their job who wants one;
provide over a quarter of a million apprenticeships for the first time ever and a new dedicated National Apprenticeships Service to support employers and apprentices; and start trialling Skills Accounts across all regions in England from September 2009, to enable people to access the most appropriate training for them.

For victims and those at risk of crime we will:

strengthen national standards for local policing through Policing Pledges in every area;
improve information, with new crime maps for all areas accessible through Directgov from March 2009 – we estimate up to two million people will access crime maps this year;
give local people an opportunity to have a say in the justice system, such as how Community Payback operates in their area and through a community prosecutor approach; and
provide more personalised support for 35,000 young victims of crime.

For local residents we will:

provide new online performance maps of local services allowing people to compare their area with others from May 2009, so that they can put more pressure on their local councils to improve services;
support community groups to run local buildings themselves, supported by the Asset Transfer Unit, benefiting an estimated 300,000 people; and
offer greater choices over housing, through the extension of choice-based lettings to all local authorities by 2010.

New professionalism in practice

Across the public service workforce we are fostering a new professionalism.

In health we will:

look at freeing nurses and midwives to lead improvements through the Prime Minister’s Commission on the Future of Nursing and Midwifery; and
give high performing hospitals more autonomy through the expansion of NHS Foundation Trusts (FTs), with around 25 new FTs in 2009, subject to Monitor approval, which will mean more than half of all trusts will be FTs.

In education we will:

provide teachers with the opportunity to take a new Masters Degree in Teaching and Learning, with an ambition of 4,000 – 5000 participating in 2009/10;
enable 500 of the most disadvantaged schools to use £10,000 ‘golden handcuffs’ to recruit and retain excellent teachers, benefiting up to 6,000 teachers every year;
work with our social partners and Transition to Teaching to develop new routes into teaching, including a new fast-track route from September 2009 for talented career switchers and graduates moving into teaching – taking six rather than the current 12 months to complete;
introduce a new Accelerate to Headship scheme in September 2010, to offer up to 200 outstanding individuals a fast track career pathway to senior leadership within four years; and
improve Intitial Teacher Training – designing a diagnostic tool to systematically screen applicants for skills including empathy, communication and resilience, and pilot it with a range of Initial Teacher Training providers, for possible national roll-out to all providers.

In policing and the criminal justice system we will:

free police from all national targets bar one – public confidence in policing;
reduce red tape, freeing up the equivalent of 2,500 – 3,500 officers over time, including around 690,000 hours on form filling alone; and
introduce new ways of managing offenders, with lead professionals co-ordinating different agencies to reduce reoffending and improve efficiency.

In welfare services we will:

give personal advisers in Jobcentre Plus greater discretion to personalise support, benefiting up to 80,000 jobseekers.

For the third sector we will:

provide greater support through the downturn, such as a £15.5 million fund which will support community groups in areas most at risk of increasing deprivation; and
explore new opportunities for public service professionals to establish social enterprises, as we aim for our goal of increasing the sector’s workforce by 25,000.

For local government we will:

free local leaders to join up and tailor services and economic strategies across local areas, including a further six Multi Area Agreements in the coming year and introduce agreements with at least two city regions where cities increasingly take control over their own economic destiny.

Strategic Leadership in practice

Across Government Departments we will:

focus on just 30 high level outcomes, rather than micromanagement;
deliver £35 billion of value for money savings, equivalent to £1,400 per household, that we will be able to allocate to frontline services, and further efficiency savings to come in Budget 2009 including through selling assets and sharing IT and other back office services between different organisations;
deliver greater accountability of the civil service by introducing a new ‘scorecard’ setting out departmental performance against government priorities and the hunting out and ending of waste. It will also assess how well departments promote innovation and learn from the front-line;
open up information on service performance to the public and hold a series of new online engagements with the public and professionals;
involve front-line professionals at every stage of the policy making process to be given greater weight in the training and development of civil servants; and
provide greater support for innovation, such as the new NESTA Public Services Innovation Laboratory.

Notes

Blanden, J, Machin, S, Up and Down the Generational Income Ladder in Britain: Past Changes and Future Prospects, 2008
As part of this government’s agenda to harness the energy and innovation of communities at a more local level, we have devolved significant powers to the Scottish Parliament, the Northern Ireland Assembly and the National Assembly for Wales. As a result of this devolution the people of Scotland, Northern Ireland and Wales have devolved administrations and legislatures with real power to make local decisions that reflect the needs of their particular communities and respect their traditions. Delivery of public services is in some cases the responsibility of the Government across the whole of the United Kingdom, or of Great Britain, for example Jobcentre Plus. In other cases it is the responsibility of the respective devolved administration concerned. While this document highlights common values and themes that run across our communities, many of the areas of policy delivery highlighted focus on England.
HM Treasury, Pre-Budget Report 2008, Stationary Office, 2008. Public Sector net investment is a measure of capital spending net of depreciation.
Low Carbon Industrial Strategy: a Vision, HM Government, 2009
Hanushek and Wößmann, The Role of Cognitive Skills In Economic Development, Stanford University, 2008

HM Government