Public services are dying a slow death, but what comes next? Lord Adebowale and Henry Kippin set out a vision for a move towards “services to the public” – a vision that requires us to re-think the needs of citizens, the reality of a mixed economy, as well as the relationship between citizens and the state

Adebowale, Lord

Kippin, Henry

LSE Research Online

4/19/2017From public services to “services to the public”: the threeelements of contemporary welfareblogs.lse.ac.uk /politicsandpolicy/services-to-the-public/Public services are dying a slow death, but what comes next? Lord Adebowale  and Henry Kippin set outa vision for a move towards “services to the public” – a vision that requires us to re-think theneeds of citizens, the reality of a mixed economy, as well as the relationship between citizensand the state.Public services as we know it are dying. Squeezed by austerity, overwhelmed by demand andsubsumed by Brexit, there is little-to-no chance that we will reach 2030 with a set of servicesthat are analogous with those we experience today. Top-level data tells the story. The Institutefor Fiscal Studies estimates that one in ten councils have already cut adult social care spendingby a quarter. Figures from NHS Providers suggest that an extra 5.2% of cost pressures will needto be absorbed during 2017/19 on a 1.3% increase in funding over the same period.But this is not just about austerity. Over the longer term, demographic change, increasinglycomplex needs, and a recalibration of the relationship between growth, public spending, andsocietal wellbeing will change the picture even more. The Joseph Rowntree Foundation, forexample, estimates that over half of families classed as living in poverty have a family member in work. TheresaMay’s notion of people ‘just about managing’ barely covers it.We are entering the slow death throes of William Beveridge’s vision of public services as things to invest in andcelebrate. His famous report, published in 1942 as a blueprint for the post-war welfare state, responded to what hecharacterised as the ‘five giants’ of ignorance, want, disease, idleness, and squalor. His ‘comprehensive survey ofsocial insurance’ developed in response set the basis for the post-war welfare settlement. And whilst the very notionof a fixed national settlement might today be misplaced, the lack of a high-level discussion about our rights,responsibilities, and relationships with each other as citizens is lamentable. We should be angry about this. But thenwe need get on with defining and building what happens next.The future should be defined by a subtle but important shift: from public services, to “services to the public”. As weexplore in our forthcoming book, this signifies a much broader range of public goods, reflecting both thecontemporary needs and wants of citizens, and the reality of a mixed economy in which the public sector cannotdeliver better outcomes on its own.Beveridge himself would recognise this if we could transport him to 2017 Britain. His contemporary ‘giants’ mightinclude social isolation, inequality, chronic low-level mental health, poor aspiration. He would recognise that the roleof Tesco, Vodafone, Ladbrokes or the high-street banks is as important to the root causes of wellbeing as health orsocial care services. He would recognise that, as the old assumptions about place, work, gender, politics andtechnology have changed, so should the way we think about welfare and the relationship between citizens andstate.We need to start doing the work now to define what tomorrow’s services to the public will look like. The mix ofspecialist, personalised, clinical and social will need to look different: quite possibly costing the exchequer less; verydefinitely blurring the artificial lines between economic growth, public service reform and community development. What links rich, poor, young and old is the need for bespoke services that are enabling and valuable – yetCollaborate and Ipsos MORI research from 2014/5 suggested that only around 15% of people say they consistentlyfeel they have influence on the services that are provided on their behalf. This is the reality of taking back control.1/3Early evidence for the shift we articulate can be seen in policy areas like accountable care, inclusive growth andintegrated local services – all of which seek to bend sector lines and reorient services around place. In places likeSuffolk for example, the interdependence of business, public services and communities is a base principle ofcounty-wide reform plans.  In Greater Manchester, the focused care model (originated in Oldham) is changing theway general practice works at scale – much more proactively addressing the wider determinants of healthinequalities. In South Yorkshire, Sheffield Money has been established to reduce downstream service demandthough disrupting the high-street loan market with a state-backed alternative.Tomorrow’s public service settlement must take these examples and push their logic further, addressing someshibboleths on the way. We might do this along three principles:The first is that welfare is good for you. It might challenge a few lazy Benefits Street-style stereotypes, but we needto start redesigning welfare as something for everyone; as a means by we support each other to build the countrywe want to be a part of. Experiments in universal basic income or what the economist Diane Coyle recently called‘universal’ should be seen as parts of a broader movement that emphasises the role of services to the public associal investment in our future competitiveness and growth.The second is that services should be collaborative by default. The waste inherent in our silo-based public servicesystem is phenomenal, meaning that things like children’s centres are shut whilst established institutions stagger onas the wider world shifts towards agile working. So we need a new presumption: requiring us to justify whereservices are not being delivered in collaboration, with central government playing a more effective role learning,sharing, and diffusing practice.The third is that good leadership is place-based. Accepting the reality that social problems are often systemic, andthat even the best institutions cannot operate in splendid isolation forever. Health and social care is the clearestexample of this. We are already seeing good hospitals skewered by the Care Quality Commission for what are2/3whole-system problems (like nursing shortages). The success of Sustainability and Transformation Plans will hingeon whether organisational leaders can create effective coalitions for change across a place; understanding how theworld thinks and feels outside of their service lens.The sociologist Richard Sennett famously talked about “the capacity (of people) to collaborate in complex ways”. We need to transpose his comment about human nature to the organisational challenge within public services. Woody Allen said that “I’m not afraid to die. I just don’t want to be there when it happens”. Well, where publicservices are concerned, it’s happening already. Let’s make sure that we are here for the rebirth too.______About the AuthorsLord Victor Adebowale  is Chairman of Collaborate CIC.  Henry Kippin is Chief Executive of Collaborate CIC.   Image credit: johnhain Pixabay/PublicDomain3/3

From public services to “services to the public”: the three elements of contemporary welfare

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