23 June 2006
Prime Minister Tony Blair this week initiated a crucial phase of his third-term public services reforms – a wide-ranging review of private and voluntary sector capabilities across health, social care, welfare and local government.
As Public Finance went to press, Blair, Cabinet Office minister for the third sector Ed Miliband, and health minister for care services Ivan Lewis were due to launch a major review and a Whitehall unit designed to improve services by expanding and assisting providers outside the public sphere.
The review, announced by Blair at a Future Services Network conference on June 22, but led by the Department of Health, will assess how the NHS, local government and potential private and voluntary sector partners could deliver future 'community equipment' needs, such as wheelchairs and housing modifications for people with disabilities. Around £500,000 has been set aside to fund the review of a market worth £220m.
'The aim is for local authorities to have an unprecedented degree of choice in how they deliver vital equipment… that is essential for people coping with difficult circumstances,' Blair's office said.
Number 10 believes that the charity and voluntary sector, through existing relationships with 'hard to reach' groups, already has the capacity to deliver improved services at lower cost than direct public investment.
Lewis claimed that improved procurement and delivery of community equipment would also reduce costs by 'reducing… unnecessary residential care or acute care admissions'.
Blair was due to tell delegates that central and local government's use of the voluntary sector to deliver services has been 'one of the most profound and lasting changes' to public policy since he came to power.
But in a reference likely to irk critics who perceive the initiative as 'soft privatisation' towards voluntary groups and social corporations, Blair was due to say he would go further.
'If there are barriers to this collaboration, then we will remove them. If there are rules that prevent private and third sector bodies bidding fairly against the public sector, we will change them,' he was to warn.
A spokeswoman for Number 10 later confirmed to PF that this included potential adjustments to public contracts in health and social care, for example, to make them more flexible and to encourage provider diversity.
To assist in the creation of that environment, Lewis was set to launch the DoH's Social Enterprise Unit.
The Whitehall-based body, he said, would 'encourage social enterprises to involve staff and service users in designing and delivering services tailored to meet people's needs and… achieve greater value for money'.
A Cabinet Office spokesman said that Miliband's role was to ensure that there was 'a clear and consistent framework, across all departments, for delivering services through the third sector'.
Miliband is considering standardising government-partner contracts, partly to ensure that minimum standards are built into future delivery models.
He will also monitor value-for-money assessments across the third sector, although individual departments must ensure that new ventures deliver the cost-effective services sought by Blair. A Treasury review of third sector finance, due next year, will also inform these assessments, the Cabinet Office said.
Referring to the fledgling 'co-production' agenda – the idea that public service users contribute to the design of services – Miliband said: 'The third sector is uniquely positioned to make sure that local users experience public services that are specifically designed to meet their needs.'
It is, he argued, often in a better position to innovate to deliver services and possesses more intimate knowledge of the 'hard-to-get' groups that the government's third-term welfare reforms, for example, have targeted.
But Dave Prentis, general secretary of Unison, questioned whether transferring responsibility for delivery would improve matters.
'The problem with the existing service is that it's under-resourced and there are huge shortages of occupational therapists, so switching to a different type of provider is not the solution.
'It's wrong to think that the private sector has all the solutions with no evidence, no facts. Decisions about the NHS should be based on evidence, not on conjecture. We want something a bit more visionary and a clear plan of where we are going.'
PFjun2006
