Well we knew it was going to be tough but the Comprehensive Spending Review has probably presented those of us working in the public sector with challenges even greater than expected.
1. Public sector cuts are long term – and permanent
Cuts in public expenditure are not just here for the next few years whilst the government claws back the mounting public debt. Taps rarely get turned back on big time, even as election mechanisms. So many of the cuts and changes taking place now are likely to become enshrined in our working practices – the age of austerity will not emerge as the age of plenty.
So do we cut wherever possible, moan about it for as long as possible, claim that we were always pretty good anyway and just try and get through this crisis? Well, no because this crisis will result in permanent change, not temporary interruption.
2. Rationalising back office systems and new working
As Dean Shoesmith writes in the Public Sector People Managers’ Association blog ….
“Many of us have been gearing up for this for some considerable time – and in my two boroughs (Sutton and Merton) respective transformation programmes are well on their way, recognising that we need to get on and make difficult decisions quickly – not only to meet new budget constraints but also to assist with effective employee engagement (dithering will not pass muster in my view).”
Bradford is one of the pilots for the Total Place initiative – focusing on how public sector organisations can work together to facilitate real efficiencies. The principles behind this tend to be driven by the rationalisation of back office systems such as procurement, IT, HR and physical locations. These are fine in as far as they go and are by no means easy to develop/implement. Bringing together education, health, council and emergency services systems is challenging! But if developed in an incremental, inclusive and sensitive manner, there are opportunities for some serious economies.
But should this be the limit of our ambitions? Like it or not the coalition government and its Big Society say we need to go further. It’s about redefining front office as well as back office, promoting real change. We need to approach this in a spirit of openness and creativity. Some of us might not like the fact that Primary Care Trusts are being replaced by GP commissioning bodies. We might not like Michael Goves’s new focus on moving educational control away from councils to individual schools. But once the juggernaut starts rolling it is difficult to hold it back.
3. Opportunity to customise our public services?
So we might as well use the “opportunity” to reflect on how we run our public services. Is there a case for real change?
Take the health service for example. At Bradford University School of Management I develop a number of programmes for health service managers. What we are starting to focus on is the patient (or customer) journey. There has historically been a tendency to work vertically rather than horizontally – recommendation from GP, communication with consultant, communication from outpatient clinic to patient via GP, a consultation with consultant – providing the operating schedule does not get in the way – and then the journey through different hospital interventions, quite possibly ending with council social services.
As both the health service and councils get squeezed, post operative responsibility could become a natural battle ground. Ward or convalescent home – which side will pay? The patient thinks about one process – getting well – not two (or more) systems.
What about education? I am a governor of a large comprehensive and academy status is a serious agenda item. Here we are being encouraged to think “them” and “us”. Autonomy could mean more money and more freedom. But will semi independent status for the best schools contribute towards a two tier system? Good schools will often cite wasteful council activity. But will two systems necessarily work and what replaces academies if they don’t deliver?
Fiona Millar of the Local Schools Network argues that partnerships between schools would be a good thing – but we can do that without academy status.
4. Public sector
What we need is for forward thinking public sector organisations to think customer/patient/student/tax payer and how, together, they can contribute to an improved front as well as back office. Weaknesses in the current system will be better tackled in partnership.
In parts of Bradford (for example diabetes care) we are starting to see consultants venture out into the community, recognising the customer journey, creating a closeness of consultants to their communities, focusing on prevention as well as cure – joined up thinking.
Real change in the public sector needs a joined up thinking approach, a willingness to question current vertical processes and the strength of purpose to move the existing boundaries to a better, more sustainable position. Are we prepared to go that way? Do we have the courage? Can we afford not to?