A new IPPR report 'The Relational State' argues that we need to radically reconfigure our public services so they are better able to tackle the complex challenges we face, and meet changing public expectations.
Public service reform has relied too heavily on the use of bureaucratic and market-based tools (primarily in England) that are ill-equipped to deal with a growing range of complex problems, from chronic disease to long-term unemployment. This report sets out a new agenda for public service reform – one that is better able to deal with this complexity, by devolving power, connecting services and deepening relationships.
The two predominant methods by which government has sought to run public services – bureaucracy and markets – are both predicated on assumptions of a relatively simple world in which most problems have a small number of causes which interact in a linear fashion. Such problems – how to collect the bins, for example, or reduce hospital waiting times – can be very effectively tackled by top-down plans and simple market incentives. The difficulty is that public services are increasingly expected to tackle a growing range of ‘complex problems’ – examples of which include antisocial behaviour, chronic ill-health, large numbers of young people not in education employment or training (NEETs), and long-term unemployment. Such problems consume a growing proportion of public expenditure. They have multiple, non-linear and interconnected causes that feed off one another in unpredictable ways, and are precisely the problems that the governments of all the advanced economies struggle to address effectively.
The IPPR report recommends five big steps at national level:
• A decentralisation of budgets to local authorities and city-regions to unlock innovation, improve responsiveness and break down silos.
• Allowing greater pooling of funding, so that services can take a ‘whole person’ or ‘whole area’ view.
• Enabling greater integration of professionals into multi-disciplinary teams.
• Greater frontline autonomy combined with accountability for outcomes achieved, such as through the publication of performance tables that rank providers.
• Expanding new collaborative infrastructures such as school chains, so that providers can share knowledge and learn from innovation.
The report also sets out measures to ensure that at the individual and community level, the relational state means deep relationships instead of shallow transactions.
Ed Miliband’s recent speech on public service reform covered similar ground. While the Scottish Parliament is legislating for greater integration of health and care services through the Public Bodies (Joint Working) Bill, it retains strong centralising provisions that fall a long way short of the ideas in this report.