Burnham – who provides public services really does matter.Posted: August 16, 2013
Coverage of Andy Burnham’s recent Guardian interview has concentrated on his exhortation to Labour to shout louder and his view that the window for serious policy making will close sooner rather than later. Less attention has been paid to some interesting policy comments that emerged in the course of the interview.
He is I think the first Labour spokesman to recognise openly that New Labour’s approach to public sector reform got it wrong. He referred specifically to what he describes as a failure to champion comprehensive schools and went as far as anyone is likely to in disassociating himself from the academies programme.
On his own patch, health, he recognised he had himself done things he now regretted. Talking of letting the private sector into NHS provision he said: “It’s like a genie out of the bottle thing, isn’t it? You can let it out so far, but once the market takes a hold on the system it will destroy what’s precious about it.”
It was a fundamental principle of New Labour that it doesn’t matter who provides a service like health, social care or education as long as it remains free at the point of use. There was an assumption that private sector DNA was needed to sort out the inefficiencies of public provision and that competition, either directly or through tendering, is a positive force.
It is though becoming increasingly clear that it does matter for two fundamental reasons. One is that private firms in the end operate in their own self-interest. The bottom line is what can they get away with and still make a profit rather than what is the best service they could provide with the resources they have. So we have an increasing number of examples of failure by the major outsourcing firms – SERCO and Cornwall’s out of hours service, G4S and the Olympics and the fat cats of EAct Academies.
The second reason is that splitting up public services amongst multiple providers is an obstacle to the kind of integration that is increasingly essential to efficient service delivery. The RSA Academies Commission found that collaboration between schools to provide for challenging and vulnerable pupils is vanishing in many areas as each school puts its self- interest first. In health, creating integrated care pathways covering primary, community and hospital care will become increasingly difficult as services are broken up and each part answers to different corporate demands – coming soon no doubt from across the Atlantic as US healthcare companies move in.
Yet somehow every failure is seen not as an example of a systematic problem but as an unfortunate exception to the rule. In the Guardian recently John Harris set out in more detail than is possible here examples of the dreadful behaviour of SERCO in a wide range of contents. (http://www.theguardian.com/business/2013/jul/29/serco-biggest-company-never-heard-of). In that article Margaret Hodge also began to recognise that New Labour set this hare running. But she also rightly said that “this government should have learned from our mistakes”. She went on to say “What is becoming really clear to me … is that the Sercos, the A4s, the G4Ss, the Capitas – they’re good at winning contracts, but too often, they’re bad at running services.” Some of us might say where have you been for the last 20 years, but late repentance is perhaps better than nothing.
None of this is an argument for monolithic state monopolies which can be just as bound up in their own self-interest as providers rather than putting the needs of service users first. But it is an argument first for not fragmenting services and second for refusing to use organisations that have not an ounce of public sector ethos in their make-up. There should be a space for third sector organisations and for worker or user co-operatives. But only in the context of intelligent commissioning that makes sure that they are really serving the public interest.
When Andy Burnham says “we had been building a policy that said it doesn’t matter who provides healthcare as long as it’s free at the point of delivery. But I’m saying it does matter” it is a significant break with the recent past. And it’s not just about healthcare.
But it’s only a start – we have yet to see any evidence of this point of view being taken up more widely and it could easily disappear as the conventional wisdom re-asserts itself and the lobbyists set to work. There is still a great deal of work to do – if only because we have yet to see the same kind of mea culpa on education.