News from the CIPFA conference, held in Bournemouth on June 1214 Regulators must promote innovation

21 Jun 07
Public sector regulators should promote a 'culture of curiosity' among service providers, the Audit Commission's chair, Michael O'Higgins, told delegates.

22 June 2007

Public sector regulators should promote a 'culture of curiosity' among service providers, the Audit Commission's chair, Michael O'Higgins, told delegates.

Previewing the new Comprehensive Area Assessment regime's lighter touch approach, O'Higgins argued that a key role for regulators will be to encourage innovation among service providers.

'We need to provide more than just protection,' he said. 'Central government has to allow local government the freedom and flexibility to respond to local user preferences and to innovate. This must all be reflected in our assessments.'

Reducing the current number of, sometimes ill-defined, performance indicators would be 'quite a challenge', he said. He welcomed moves in the Local Government and Public Involvement in Health Bill to do this and to give councils more freedom to set targets.

O'Higgins also noted that the 'CPA-lite' Departmental Capability Review regime for central government was still 'under-developed', particularly when it came to the follow-up improvement process. Ministers were notably sensitive to criticisms of their departments, particularly with a reshuffle looming, he said.

In the same session, Stephen Thornton, a non-executive director of the NHS foundation trust regulator, Monitor, criticised the 'unhealthy focus on compliance and minimum standards' emerging from the Department of Health's reconfiguration of the health inspectorates.

These things are important for patients, said Thornton, who is also chief executive of the health care policy charity, the Health Foundation. But regulators also need to 'encourage and incentivise continuous quality improvement, and improve capacity'.

Some senior civil servants not up to the job, says Whitehall delivery czar

Some senior civil servants are not qualified to perform the tasks required of them by ministers, according to the man leading the review of Whitehall capabilities.

Ian Watmore, head of the Prime Minister's Delivery Unit, told CIPFA delegates on June 14 that the Departmental Capability Review process had revealed a mixed picture on leadership. 'We find that there are some really outstanding leaders in the civil service. But on the other hand there are people who are square pegs in round holes& somebody with a particular expertise wrongly placed in a different job,' he said.

'One thing that came across quite strongly was that civil servants at the highest level were not particularly strong at people management. There is now a huge effort to correct [that].'

His comments will fuel the debate around Whitehall's skills amid lingering accusations that the civil service is the last bastion of the 'generalist' mandarin with few specialisms applicable to modern public services.

Cabinet secretary Sir Gus O'Donnell, in partnership with the Treasury, is co-ordinating Whitehall's Professional Skills for Government programme. That aims to update senior staff skills by developing service delivery expertise, for example, as well as generic management experience.

But O'Donnell recognises that the result of improved skills will take time to filter through.

Watmore, whose DCR teams have now reviewed 15 departments, was also critical of the role played by Whitehall boards in developing the 'world-class' public services demanded by the public.

'Whitehall boards were not always functioning as you would expect a board to in a big organisation: in terms of being aligned across all parts of the organisation and regarding the weakest part of an organisation as a problem for them all and not just for the board member responsible for it,' he said.

But the first set of DCR follow-up assessments had revealed improvements. 'I'm beginning to see the green shoots of improvement a number of the boards are remarkably better than they were a year ago,' Watmore said.

The time is right for town hall devolution, think-tanks agree

Local government should be at the heart of public services reform but politicians must find ways to make town halls more accountable for any extension of choice and contestability, two think-tank chiefs have warned.

Speaking to delegates on June 14, the leaders of the centre-Left Institute for Public Policy Research and the centre-Right Policy Exchange reached a consensus over the need for a greater devolution of powers from Whitehall to town halls.

But both men warned that local government must be reconfigured to commission more services from agencies, private and voluntary sector providers.

IPPR director Nick Pearce said he believed that the high watermark of centralisation by British governments had passed.

'The next ten or 20 years could be very good for those committed to local government. Central government has learnt that it can't pull levers and simply expect things to change: you need to empower intermediate governments with decision-making locally,' he said.

Anthony Browne, director of Policy Exchange, said that local authorities had, in the past, acted as a 'roadblock' to reforms.

'Some local education authorities, for example, tried to prevent other types of schools opening up because they view them as competition to the schools that they control and they want to maintain their empire. It's important for local government to work with the reform agenda and not against it.'

Primary care now ready for radical reform

The structure of primary care services is likely to change radically as the NHS continues to change and evolve, a former senior health adviser to the government told the conference.

Paul Corrigan, who is now director of strategy and commissioning at NHS London, provided delegates with a comprehensive round-up of the major health reforms of the past decade and the rationale behind them.

He said for example that the traditional GP model of small partnerships was being challenged.

'There has been an inequality of access [to primary care services] and we need to intervene in those poor areas,' Corrigan told the conference on June 14.

Securing a greater diversity of public sector suppliers was one of the major elements of NHS change, he said, adding that the provision of independent sector treatment centres and foundation trusts was providing just that.

'One of the most alarming things about going into the Department of Health in 2001 was that the secretary of state owned the nation's hospitals,' he said. 'There's no possibility of constructing real, local change if the plant is owned by Whitehall.'

Despite the rapid change brought about by the creation of primary care trusts and the introduction of the payment by results hospital funding system, there was still near-universal agreement on the principles underpinning the NHS, Corrigan stressed.

'Nobody is seriously suggesting there should be changes to the funding and delivery of the system,' he added.

Localism is not the answer, Clarke argues

Former Conservative chancellor Kenneth Clarke has warned that localist models of public service provision might allow ministers to evade responsibility for failures.

Clarke told Public Finance that he was not a great believer in new localism because it could 'get to a level where a minister can say he is not responsible for anything'.

He also warned that localism, which is now espoused by all the main political parties, could lead to wide variations in service provision. 'It gets to a point where you end up with a postcode lottery and the public won't accept a lot of local variation,' he said.

Earlier, Clarke told delegates that localism would still leave central government answerable to the electorate, while slowing the pace of reform.

'The health secretary would soon find himself being chased about a shortage of bedpans in Grimsby,' he said. 'I also don't think much would change locally, because you would have to wade through local opposition and everything would be saved by local campaigns.'

However, Clarke did call for drastic cuts in targets and less prescription for managers of frontline services.

'What we need is people who have a sense of ownership and know what's required, in tune with national priorities,' Clarke added.

TUC points the way to reform

Government and the unions need to work towards a 'new model' of public service reform, according to the Trades Union Congress's head of organisation and services.

Tom Wilson described the reform agenda as 'a chaotic mishmash' that threatened ten years of progress on public services.

There were three main problems: constant reorganisation, leading to staff demoralisation; the lack of any real consultation; and blind faith in the private sector. Markets and contestability were seen as panaceas but there was little evidence to back this view up. The problems with city academies, private prisons and the Private Finance Initiative showed the limitations of contestability.

In contrast, the TUC proposed a partnership approach that would empower users and staff, and strengthen procurement.

Third sector offers public extra value

Public bodies that view commissioning as simply shopping around for the cheapest price miss out on the vital extra value third sector bodies can bring to services, the head of the Association of Chief Executives of Voluntary Organisations has said.

Speaking on June 13, Stephen Bubb cited a council that switched its meals-on-wheels contract from the voluntary sector to a cheaper private sector outfit that delivered frozen meals once a week in bulk.

'It was very efficient& but the council had forgotten that at least a third of older people who receive meals on wheels don't want the meal, they want the contact,' said Bubb. 'But that's what the council lost, so they provided a seriously worse service for older people. Those volunteers were the early warning system for many frail and vulnerable people, but the person arriving from the private sector company wasn't picking that up.'

Welcoming the move by some authorities to consider wider issues when awarding contracts, he said: 'It isn't just about value for money, because you have that wider role in guaranteeing economic and social wellbeing.'


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