Ministers mull over early results from Total Place

16 Feb 10
The first reports from 13 pilot projects provide a wealth of data. One thing is clear: public services focus too much on symptoms and too little on causes
By David Williams

16 February 2010

The first reports from 13 pilot projects provide a wealth of data. One thing is clear: public services focus too much on symptoms and too little on causes. David Williams investigates

Over the past year, the Total Place pilot schemes have captured the imagination of policy experts, mandarins and politicians of almost every persuasion.

The 13 pilots, launched last July, are now reporting their findings back to the Department for Communities and Local Government.

The schemes have essentially been mapping exercises, involving all agencies that provide services locally. Each has focused on crosscutting policy areas such as children’s health and wellbeing. Agencies across a county or around an economic hub pool data to find out exactly how public money is spent, and to identify how it could be used more effectively.

Even before any results emerged, the initiative had cross-party support and a buzz about it that belied its modest £5m cost to the DCLG.

The final reports were due to be handed in on February 19, and are expected to be incorporated into Chancellor Alistair Darling’s pre-election Budget. But the first results are beginning to emerge.

In Birmingham, where agencies chose to examine health, housing and crime, authorities discovered what corporate director of policy Jason Lowther described as ‘an excessive focus on symptoms rather than causes’.

Total Place data released to Public Finance shows that of the city’s total employment spending, benefits account for 93%, while less than 7% goes on interventions to help people into work.
On health, 96% of spending is on treating illness, while less than 4% is on keeping people well.

The report also underlines the disproportionate impact on public budgets of people with complex and difficult-to-tackle problems.

Children who are in care – who make up 2% of the city’s child population – cost  £35m a year while each of Birmingham’s 6,400 crack addicts costs £833,000 in wider ‘social costs’ over their lifetime, totalling £5.33bn in all. The city’s total annual budget is £7.5bn.

Another theme of the Birmingham analysis is incoherence. Evidence and cost-benefit analysis on drug treatment is either ‘not available or not used’, it says, while agencies focusing on the same individuals do so without co-ordination.

Although every £1 spent on drug treatment saves £9.50 in other costs, it still takes an average of six attempts over six years for addicts to kick their habits. This is despite recommendations from those using drug programmes that a more ‘holistic’ approach – which focuses on the complex needs of the individual, rather than simply treating the addiction – would be more effective.

Worst of all, the way central government funds local agencies provides a disincentive to better collaboration. Lowther makes the point that, although investment in early intervention for children and families saves £10 overall for every £1 spent, the council takes only a quarter of this – making it far less attractive than it should be.

The agencies are now vowing to adopt an attitude of collective responsibility for the city, and to develop a ‘budget for Birmingham’, co-ordinating their strategies to tackle stubborn underlying issues at the heart of the city’s social problems. But it says there are other barriers – for example, rules on data protection that discourage agencies from sharing information.

In Kent, Total Place has shown that accessing unemployment services could be greatly simplified. The final report had not been released at the time of writing, but Kent County Council’s member for corporate support services, Roger Gough, told PF that a third of the current total cost of administering an unemployment claim could be saved by simplifying the system.

Meanwhile, mapping the use of public buildings has revealed ‘tens of millions of pounds’ in potential savings. ‘That [percentage] is well into double digits,’ says Gough. ‘And we suspect it is quite a lot bigger because we haven’t taken into account Ministry of Defence land.’

He said the exercise has shown that: ‘If you have pressure on local bodies to achieve best value for themselves, that may not be the same as achieving the best and most efficient agglomeration of public sector assets.’

Gough acknowledges it would be simpler for central government to impose across-the-board cuts ‘in the time-honoured way’. But he believes the ‘time is ripe’ for Total Place and it has the momentum, and the vital Treasury backing, to be adopted more widely.

So does Andy Robinson, assistant chief executive at Leicestershire County Council. He cites the government’s white paper, Putting the front line first: smarter government, as evidence of a serious commitment to removing bureaucracy.

The full report from the Leicestershire Total Place pilot has yielded this illustrative nugget: it costs national, regional and local organisations £180m in overheads to spend the area’s £230m combined budget for economic development.

The principal focus of the county’s study was on the area’s drug and alcohol problems. It revealed that alcohol accounts for double the amount of serious crimes that can be attributed to drugs, and that the region’s 38,000 severe drinkers massively outnumber the 4,700 ‘problematic’ drug abusers. However, the area spends £4.9m on alcohol interventions, and £13.4m on drug misuse.

But John Tizard, programme lead for the Worcestershire Total Place pilot, says that local mapping can only get us so far. He calls for ministers to allow public bodies to account for savings ‘that go across agencies and across timescales, and across budget years. [Otherwise] the risk if you have less money is that agencies will want to invest in things that produce a result for themselves.’

Overall, the picture that is emerging suggests there will be few surprises in the Total Place pilots: just the pages and pages of striking raw data and calls for change that they were designed to produce.

‘It’s not a new idea but it’s an idea whose time has come,’ says Lowther. ‘It’s not completely novel but it has firmed up the evidence base, and it has created a momentum for change that I hope will be taken forward.’

But if the initiative is beginning to feel like a magic wand that can easily be waved to painlessly remedy the public sector deficit, one passage from the Birmingham report might give optimists pause.
Under the heading ‘delivering major cross-sector efficiencies,’ the report argues that multiple back-office functions ‘are luxuries we can no longer afford’. It resolves to ‘deliver radical cost savings through rationalisation in these areas’.

The report was sent to PF the day after Birmingham City Council published its 2010/11 financial plan, which included a likely cull of up to 2,000 posts.

Local unions are already gearing up to fight the plans. The completion of the Total Place pilots could well signal the start of a new era of efficiency and effectiveness in public services. But it could just as easily mark the beginning of a long and convulsive period of large-scale public sector reorganisation.

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