Stepping up the pace on care integration

The Scottish Parliament’s Health and Sport Committee has published a report on the forthcoming budget. UNISON Scotland gave written and verbal evidence to the inquiry.

The report highlights their ongoing concern over the absence of budget transparency, with specific reference to the new health and care integration authorities. There is no real breakdown of the £8.9bn spent by the IAs overall and they will not set their individual budgets until July next year, well into the financial year. The report gives several examples of how it is impossible to identify spending plans for specific services, with organisations forced to resort to freedom of information requests.

The committee also highlighted one of UNISON’s concerns over the budget, the double counting of social care funding in both NHS Scotland and local government. There also remains a misalignment of budget timescales between councils and health boards.

The lack of transparency means it is also difficult to see how integration funds are contributing to the nine national health and wellbeing outcomes. In evidence to the committee most IAs emphasised the difficulty in achieving linkages with expenditure. This is supposed to be a statutory duty!

There has been an informal push by some IAs towards direct funding. We set out UNISON’s objections to this in an earlier blog post.

The report welcomes the announcement about ending the 1% pay cap and rightly seeks assurances on funding the increase. They also highlight the cost of extending the living wage to sleepover provision. 

The report also calls for long-term budget planning, recognising that the short-term nature of the UK budget setting process hinders this approach. Delivering transformational change by shifting resources to care in the community will not be achieved in the current time frames. Support for investment in preventative spending also requires a longer time frame. Audit Scotland have produced a useful video clip that illustrates the challenges.

The report also highlights UNISON Scotland’s concerns over the potential cut to sports and leisure facilities if the Barclay Review is implemented without additional funding to councils.

Overall the committee is disappointed over the slow progress in integrating health and care services and the lack of transparency in budget allocations. They believe key outcomes such as shifting resources have been allowed to drift and clear leadership is required to deliver this.

Regulation is not 'Red Tape'

If the Grenfell tragedy teaches us anything, it must be that regulation is not 'Red Tape', it is an essential safeguard for a civilised society. Scotland has escaped some of the worst examples of deregulation, but we shouldn't be too quick to pat ourselves on the back.

The circumstances of the Grenfell Tower fire will be subject to a judge-led inquiry and it is clear that regulations and enforcement will be one of the issues to be considered. In Scotland, a change to building regulations in 2005 made it mandatory for builders to ensure that any external cladding "inhibited" fire spreading. The new regulations were introduced following a fatal fire in an Irvine tower block in 1999. The Building (Scotland) Regulations 2004 contains the mandatory regulation: "Every building must be designed and constructed in such a way that in the event of an outbreak of fire within the building, or from an external source, the spread of fire on the external walls of the building is inhibited."

This is the primary reason why no social housing tower blocks in Scotland have been found to have the type of cladding used at Grenfell. However, effective regulation is only part of the story, we also have to ensure we enforce those regulations. On this, Scotland is not doing so well.

A recent UNISON Scotland survey reveals that building control staff are short-staffed, overworked, stressed and long overdue a pay rise. Key findings from the survey show:

- Almost half (48%) said there have been budget cuts this year while one in five (20%) said the cuts had been severe.

- There are 56 less staff working in the Building Standards departments now than in 2010.

- The overwhelming majority (89%) feel their workload has got heavier in the last few years.

- Almost half (47%) felt they should spend a lot more time on site visits while just 13% felt they had the right balance between site visits and office time.

- 48% described morale as low, with over three quarters (78%) saying they don’t expect it to improve as a result of budget cuts, increased workload and lack of a pay rise.

The report reveals a dedicated workforce committed to ensuring that buildings meet the standards required, but who are under enormous pressure. They feel exhausted, undervalued and are struggling to deal with the demands placed upon them. Previous UNISON surveys of other regulatory staff, covering, food, consumer rights, planning and the environment, highlight similar concerns.

The former UK coalition and Conservative governments promised a “bonfire of red tape” with a “one-in-two-out” rule governing new regulation. In Scotland, there is a more measured approach in the Regulatory Reform (Scotland) Act, but much of the language around this legislation was similar.  Too much emphasis on supporting business and not enough on compliance. 

On food, Scotland has abandoned the visual inspection of some animals in abattoirs and Food Standards Scotland want to go further in abandoning independent meat inspection. Environmental health officers have had to scale down their inspections of food premises due to staffing cuts. Deregulation of planning has long-term consequences in both built and natural environment, even if the consequences of poor decisions or regulation can take years to emerge.

A big focus for Tory deregulation was health and safety. 137 people were killed at work last year, but this figure is dwarfed by the numbers of people dying of work-related illnesses, including at least 5,000 a year who lose their lives to asbestos-related cancers. The Hazards Campaign estimate that around 50,000 people die each year due to past poor working conditions of heart and lung diseases and work cancers,” They argue that the government’s obsession with cutting “red tape” really meant abolition of regulations which protect workers. 

Sensible regulation is something we all take for granted. We assume that someone is checking that the food we eat and the goods we buy are safe. Increasingly, that is simply not the case and sadly it will be a tragedy like Grenfell that causes governments to rethink the merits of light touch regulation. It is local government in Scotland that has borne the brunt of austerity cuts and the salami slicing of regulatory departments is not well understood.

An effective state that protects its citizens needs people in order to actually function. If there aren’t people in central government to proactively revise and update regulations and in local government to effectively enforce them, that is a state failure.

In 2015 the New Economics Foundation (NEF) concluded its major investigation into deregulation that had been unfolding behind the scenes in Whitehall for years. They called the final report ‘Threat to Democracy’ – because that is exactly what it is. NEF makes the point that regulations protect us from bad businesses (as well as, in principle at least, bad finance).  It is absolutely our democratic right to demand the ability to make those rules, and see them properly enforced.

It remains to be seen whether a chastened Government will, post-Grenfell, retain its deregulatory zeal. Last year NEF also warned that Brexit would only increase this deregulation drive. The Great Repeal Bill threatens to give ministers the power to strike swathes of social and environmental protection from the post-EU statute book.

Grenfell might at least result in a pause on further deregulation, but what we really need is for the mindset around regulation to change. In future, we need a greater appreciation of the role of those who uphold regulatory standards and ensure that both central and local governments have the resources to keep all of us safe.

Police Scotland, Reform Scotland and reforming Scotland’s policing

Mon 25 July 2016

We don’t often say nice things about Reform Scotland. They have a tendency to favour minimal public services, the play of the free market handing things to the private sector, all a bit grimly Thatcherite for our tastes. Upon hearing that they have published a new report, reaction in these parts is more likely to be “Oh dear” rather than “Oh really”.  So when we looked at their latest publication about Policing in Scotland – it was a pleasant surprise to see that it made a great deal of sense.

The report is a précis of the evidence Reform Scotland are submitting to the Scottish Government’s consultation on Policing priorities for Scotland. They chime admirably with many of UNISON Scotland’s own observations and criticisms of Policing in Scotland over the last three years.

We have been highly critical of the way Police Scotland has been set up and run over the last numbers of years.  Centralisation, an arbitrary target for uniformed officers and a demand for cash savings have not delivered the police service that Scotland deserves.

Reform Scotland agree with us that the (thankfully now dropped) 1000 extra officer target has done policing no favours. They are also critical of the ‘one size fits all’ model of policing priorities that UNISON members have been reporting since the setting up of Police Scotland.  They attribute at least some of this to the removal of any local authority role in the governance of Police Scotland and the weakness of the Scottish Police Authority(SPA).     

These are concerns we have expressed repeatedly –  not least the weakness of the SPA. This quango  lacks the capacity to hold Police Scotland to account in any significant sense,  with local engagement a particular failing.

Reform Scotland’s proposal is for representatives from every council to sit on the board of SPA, and councils to be involved directly funding the police. Specifically they suggest monies to come from central and local government on a more or less 50/50 basis.  At this point the proposals are starting to reach the point that civil servants in Yes Minister would describe as ‘ambitious’.  Having 32 local authorities represented with whoever else needs  to be accommodated would make for a pretty big board. And local government funding is arguably under enough uncertainty at the moment. But nonetheless whether or not these ideas represent the ideal solution, their can be little argument that Police Scotland needs a more local approach and better funding.

The other thing this report shows is that criticism of the current set up is coming from all parts of the political spectrum, and on a similar range of issues.  Time for a change.

See also UNISON Scotland website Police page:
http://www.unison-scotland.org/service-groups-and-sectors/police/

and our latest briefing on Police Best Value:
http://www.unison-scotland.org/2016/07/06/briefing-079-bargaining-police-best-value-july-2016/

Christie Commission - Five Years On

In the flurry of post-Brexit excitement it was welcome to hear the First Minister remind Parliament that it must not distract from the business of government. Indeed the Deputy First Minister started the process of public service reform with the publication of his Education Delivery Plan.

I spent yesterday in Edinburgh at the Holyrood conference on public service reform with a focus on how the Christie Commission report has been implemented in the five years since its publication.

My own contribution largely set the scene, starting with the challenges facing public services in Scotland today. They are remarkably similar to those identified by Christie, although if anything even greater. Austerity cuts have gone on longer than Christie predicted, largely because of the failure of austerity economics - creating the longest recovery from recession on record. Austerity cuts have not been equally applied with local government bearing the brunt of cuts. I also showed that NHS spending is perhaps not as encouraging as headline figures imply.

Scotland’s deep-seated inequalities remain largely untouched and recession has hit the most vulnerable hardest. Demographic change has only partially been alleviated by increased migration and even that is under threat by Brexit.

Christie had much to say about the role of the public service workforce in delivering reform. However, with 31,000 fewer devolved jobs, 87% of them coming from local government, the capacity to contribute is massively reduced. As UNISON and other surveys show, a demoralised, ageing workforce has been largely forced to abandon the preventative work Christie promoted. Instead, reverting to the statutory minimum, and sometimes not even that.

Of the main Christie recommendations, conference participants felt that progress had been limited.

On Outcomes, we have a nice website and some fine statements of policy intent, but politicians still emphasise inputs. As the Head of CIPFA pointed out, the main SNP manifesto commitments were on spending or staff numbers, without any explicit link to outcomes. A fault not limited to the SNP!

There remains considerable support for the concept of preventive spending. There was a decent case study from the Fire and Rescue service where fire prevention has reduced fires by 40%. However, generally there was frustration over the barriers to preventative spending. Most obviously, that spending in one area might reduce the demand on another without giving any credit to the originating budget holder. The silos that Christie sought to bring down are very much in place.

It’s not that the ideas are not out there. A good example of this is a paper on preconception care written by Dr Jonathan Sher. Christie highlighted the importance of early intervention and this research shows us a way ahead.

Another Christie recommendation was for greater public service integration. Efforts are being made to achieve this in the key health and care field, but there is considerable scepticism that this will work. There are some good examples of progress out there and we heard from the Youth Talk initiative in Edinburgh that not only brought services together, but also is an excellent example of the bottom up service design Christie championed.  

I pointed to some themes of public service reform, most of which have championed centralisation and ministerial direction over the principles set out in Christie. The Deputy First Minister’s Education Delivery Plan, launched yesterday, sadly risks looking like more of the same. When ministers are in government for a long time, the temptation to grasp the levers of change and direct from the centre is strong. However, as friend who worked in Tony Blair’s Delivery Unit reminded me recently, it just doesn’t work. 

COSLA President David O’Neil made a strong case for local democracy, which is right in principle. However, we need to develop this further into practical ideas that can deliver better-integrated services that focus on delivering positive outcomes and preventing poor ones. It is easy to find fault in government plans, but it is more constructive to develop workable alternatives, before the latest avalanche of directives, targets and inspectors roll all over local innovation.

In a country the size of Scotland it is reasonable to have common national standards, data and staff governance provisions. Local services can then be integrated in real communities of place, without the bureaucracy and fragmentation that localism can create. There is a halfway house between centralism and localism, but it needs to be developed.

Five years on from the Christie Commission, we may not have delivered a focus on outcomes, prevention, integration and engagement; but they remain the principles that should underpin reform. The challenges facing public services are even greater today, so we should make a greater effort to find workable solutions.  

Changing public services

Public service reform could be one of the defining issues of the coming Scottish Parliament session.

I was speaking at the 'Leading Change in Public Services' conference at Queen Margaret University in Edinburgh today. An international gathering of academics and practitioners on this issue. There is some very interesting academic work being done on this issue across Europe that should inform our debate. My task was to set the scene by outlining public service reform so far in Scotland, likely new directions and some alternative approaches.

The challenges is the easy bit to describe. Public services are being savaged by austerity economics, and in Scotland, has largely been dumped on local government services. The chart below demonstrates this in financial terms.

The workforce numbers show this even more dramatically. A staggering 87% of the public sector job losses in Scotland since the crash have been in local government.

Job losses and finance are the biggest challenges, but not the only ones. We also have demographic change that is increasing demand on council services, particularly social care. Poor economic performance is also increasing demand as is the need for public services to respond to climate change. However, underpinning all this is Scotland's deep seated inequalities. As the Christie Commission highlighted five years ago, failure demand accounts for around 40% of public spending in Scotland. 

The financial pressures are likely to get worse. There is about another £1.5bn of revenue cuts to come for Scotland in the current UK spending plans. The Scottish Government is not planning to use many of the new powers to take Scotland in a different direction to austerity. The tweaks to the higher rate tax bands and the Council Tax will mitigate the cuts by around £350m less £60m cost of cutting APD, unless as I hope, the opposition parties combine to stop this. Given the NHS spending commitments, it seems pretty clear that local government (less perhaps education) will continue to bear the brunt of cuts.

Apart from job losses, the impact on the workforce can be seen in UNISON Scotland's monthly 'Damage Series' of reports. Almost all staff groups comment on the salami slicing of services, the juggling of plates to the extent that many of them are now crashing. Just doing the statutory minimum, and often not even that, while abandoning much of the preventative work that they value and is so important if we are to tackle long term problems. It shows up in sickness absence, particularly stress and violence, and in a demoralised workforce with declining morale. We should also pay more attention to the ageing workforce and the lack of young people coming into public service.

Five years ago I was working on the Christie Commission report. It called for services to be designed from the bottom up with greater user involvement. The report argued for preventative spending and a focus on outcomes. It also called for more integrated working, breaking down the silos and even going as far as looking at the 'one public sector worker' concept.

While almost everyone agreed with the principles set out in the report, delivery has been mixed, as I set out in an article last year. While the essential Scottish public service model remains intact, we have greater centralisation, ministerial direction and a new approach of quangos directing policy, even when delivery remains local. In my experience, the longer ministers are in office, the stronger the temptation is to direct services from the centre, reinforced by the civil service culture.

The SNP manifesto points to a programme for the new government that envisages significant structural change. Reviews are promised of the structure of health boards and councils. New regional education bodies with more finance going directly to schools. There are also proposals to allow community councils to run some services and 1% of council budgets devoted to community budgeting. 

This could lead to fewer health boards, which might work for acute services, but not for primary care. Of course they are subject to the new integrated joint boards with social care. If this form of joint working doesn't deliver greater joined up working, then the pressure to make them formal structures and the employer of staff will grow.

With education and social work going elsewhere, leisure and housing has already largely gone arms length, you are left with rump local authorities. They could be left to wither on the vine or merged, with decentralisation schemes that give communities a larger say in how the few services that remain are delivered. 

Structural change is notoriously difficult and expensive. Organisations go into limbo while preparing for it and then spend years sorting out the new bodies. In the current financial climate it could be argued that is simply analogous to shifting the deck chairs on the Titanic. 

At today's conference I didn't offer a prescription for a different approach, but I did suggest some principles that we might consider in the debate to come. 

First and foremost, we should not simply roll over and accept austerity economics. Public services play an important role in tackling inequality, in part, as the OECD has observed, by mitigating the gross income inequality in the UK. We should recognise the value of proportionate universalism while targeting resources on preventative spending.

While centralisation is not the answer, that doesn't mean that in a small country there isn't a case for national frameworks. These could set out common standards, data sets and proportionate scrutiny. In particular, UNISON has long argued the case for a national workforce framework that would include common staff governance standards, training and start to break down the silos and make it easier for staff to move between services. I am personally increasing attracted to a longer term goal of the one public service worker with common terms and conditions, although I recognise that this has its challenges. Apart from facilitating integration, it would also reducing the significant costs associated with constantly reinventing the HR wheel.

Having national frameworks then enables greater localism, freeing up local democracy to focus on integrated service delivery rather than fragmenting services on the outsourced English model. This could be based around real communities; towns and discreet urban areas, with community hubs providing a base for most public service delivery. Services can then be designed with service users and staff, adopting system thinking principles, rather than the dead hand of the one size fits all approach.

Austerity may be the defining feature of public service delivery in Scotland, but we shouldn't let it define the sort of Scotland that we want. Public services play a central role in that vision and it is right that we take a considered look at how they are best delivered.

Building better public services

Public service reform should be built from the bottom up through local democracy rather than centralisation. However, no reforms will be effective unless they are fully funded.

I have written a number of articles recently on the broad issue of public service reform. In this blog post I will attempt to knit them together to illustrate a theme around local democracy and fair funding.

In the journal 'Scottish Policy Now' I set out an overview of progress with the Christie Commission recommendations on the future delivery of public service. While there has been progress, I argue that on local design, preventative spending and workforce strategy; Scotland is missing out on real opportunities.

In a column in The Scotsman, I focused on a specific Christie recommendation - the importance of engaging staff and service users in the design of public services. Four years on, we still have centralisation, ring-fencing and top down targets. I also point to the systems thinking author John Seddon's latest book that clearly sets out the evidence for a different approach. If managers and politicians actually followed through a citizen's request through their systems they would be horrified. Some of these issues are also highlighted in UNISON Scotland's latest survey of staff working in transactional services.

Local government has borne the brunt of austerity in Scotland an issue I explored in an article in the Morning Star this week. Four out of five jobs lost have been in councils and ConDem austerity has been exacerbated by the regressive Council Tax freeze. While finance is vital, my main theme was that councils must act as strong local voices. All too often they are the passive administrators of cuts.

Finally, we return to funding public services. I contributed a chapter to the latest Red Paper publication on the implications of Devo-Max for Scotland's public services. I understand the case for independence, I might even have voted for it myself, but Devo-Max or Full Fiscal Accountability would be a disaster for public services in Scotland. I explain what Devo-Max is and the main criticisms of it. Put simply, devolved administrations want relatively stable income and expenditure. UNISON and other unions said this long before the oil price crash sharply illustrated the point. Since I wrote this chapter, the IFS has updated their calculations based on the SNP manifesto proposals and they would deliver huge cuts in public services and jobs. Barnett may not be perfect, but abandoning it is a huge gamble.

Having said that, this doesn't mean we should accept the limitations of the Smith Commission proposals. In the same Red Paper chapter I set out how we could improve public services with further devolution. Progressive federalism is right for Scotland and the rest of the UK. Labour should also be bolder on ending austerity.

The general election is obviously vital for public services, primarily to end Tory austerity. However, wider consideration of public service reform will not go away and most of those difficult decisions are made in Scotland.

 

Savings Halved

The two articles published yesterday on the “ground breaking initiative” in the west midlands in the west midlands give a slightly different spin on the project. The councils’ press release regarding their “innovative commercial company” which will ”drive economic growth service integration and trigger millions of pounds in savings” is full of gushing praise: they are “marking a milestone” as three councils and the police and fire services have signed a formal agreement to set up a company to manage their property assets. This is the first time public sector organisations have joined together to form a private company apparently.
We are told that this new venture will deliver gross savings of £58million over ten years. Now you are already thinking that’s only about a million a year per organisation (assuming the savings are evenly spread) and what are the upfront costs that are being invested in the hope of this promised bounty? No details included in that release.
Interestingly on the same day the local government chronicle also commented on the project. Here we find out that the One Public Estate Project had originally claimed it would save £110.7m last July: so predicted savings have already been halved. The Department for Communities and Local Government has supported the project with £150,000 for a feasibility study and the Transformational Challenge Fund for 2014-16 gave £400,000 for the design phase. Herefordshire Council was original included but has now dropped out.
It will be interesting to see what the actual savings end up as.

Strengthening local democracy

Fifty years of centralisation hasn't solved Scotland's biggest challenges, so let's try strengthening local democracy.

That's the conclusion of the final report of the Commission on Strengthening Local Democracy. It argues that the level of inequality remains intolerable after years of centralisation and has left us with huge social and financial costs. They also identify a link between the absence of strong local democracy and the prevalence of inequalities. It is communities that empower governments at all levels, not governments that empower people.

The report starts by making the case for local democracy. Put simply, they argue that strong local democracy means putting local people in charge of their own lives, and leaving national government to focus on outcomes for the whole of Scotland. They do recognise the countervailing forces of centralisation - consistency, efficiency and public support. As others have put it, one person's postcode lottery reflects another's local circumstances.

The Commission has identified seven principles that they believe provide a powerful basis for renewing Scottish democracy. They have also concluded that the evolution of Scotland’s democratic system across the past 50 years has more or less undermined or inverted all these principles, albeit often with good intentions.

It's recommendations start with the need for a fundamental review of the structure, boundaries, functions and democratic arrangements for all local governance in Scotland. They recognise that calling for another review might appear a bit inadequate, but it requires a bottom up engagement on a scale that is outwith the scope of this Commission.

They do however point to different approaches in different parts of Scotland, in particular, between cities and more rural areas - no one size fits all solutions here. They strongly oppose the 'supersizing' of councils and suggest that 60 to 80 councils might be the way forward. This would bring Scotland more in line with the rest of Europe. It should also consider bringing the array of services currently delivered by national quangos under local democratic control, through a 'right to challenge' national delivery. This would also enable councils to connect services more effectively. Where this isn't practical, councils should have the power to veto the local plans of national bodies.

Unsurprisingly, they identify the lack of local fiscal powers as the biggest limitation on local democracy. They recommend that local government should have full local control of the whole suite of property taxes and a general competence to set and raise new taxes, subject only to not duplicating taxes already set elsewhere. This chimes with the Scottish Parliament's call for a cross party approach to council finance and UNISON's own approach.

Another interesting recommendation is making Ministers undertake ‘subsidiarity impact assessments’ on national policy and legislation, as a way of restraining the drift to centralisation. This is balanced by a duty on councils to support and resource community participation in all local decision making about tax, spend and service delivery priorities. This means deliberative engagement, not just more consultation. As they say, language is important here. The report captures this as the choice between ‘ceding’ power and ‘seeding’ power. In other words it is about subsidiarity, not decentralisation.

The report also discusses how the role and powers of local government could be embedded in the constitution, as is the norm elsewhere in Europe. In particular, the European Charter of Local Self Government should be put on a statutory basis within Scotland.

While the Commission's recommendations will take some time to deliver, they helpfully suggest ways in which we could start the journey now. Community planning, decentralisation schemes and other local initiatives offer a way forward to embed a different approach to developing local democracy. The powers already exist to do much of this. However, we need to take the opportunities of additional devolution or independence to ensure that we don't simply swap Holyrood for Westminster. Scotland is few people's definition of local.

In conclusion, the report argues that communities across Europe have enjoyed the benefits of strong local democracy for decades. Scotland must be no different. Real change can create a vibrant new democracy for this century and a stronger, more equal society.

I would argue that there is much in this report that will be welcomed by those who support genuine local democracy. It gets the balance right between recognising that democracy doesn't end in the council chamber and the rather woolly community development approach that risks capture by unrepresentative interest groups. I suspect many will find the lack of firm recommendations in key areas like structure and finance frustrating. However, there is a direction of travel on these issues that is consistent with some well thought through principles. What stands out from the report is the clear articulation of the case for local democracy. It is welcome for that alone.

Connecting and deepening public service delivery

Three years ago the Christie Commission reported on ‘The Future Delivery of Public Services’. It was a landmark report that set the direction for reform in Scotland and some core ideas have spread into wider UK thinking on the subject.

I wrote an article in last Friday’s Scotsman that reviewed progress with some of the Commission’s key recommendations. It was a mixed scorecard, with centralisation and insufficient focus on the workforce being the main delivery problems. Government legislation all too often largely ignores the workforce component of service delivery, giving the impression that services are delivered by robots. There is no workforce strategy that creates a framework to stop everyone reinventing the wheel in every service change. The Christie "one public service worker" concept is nowhere to be seen.

A number of Christie concepts can be seen in an interesting IPPR paper, "Many to many: How the relational state will transform public services". While the analysis focuses on English public service reform, the analysis is very similar to Christie.

The authors argue that top down delivery might be appropriate for transactional services, like bin collection. However, other more complex problems require a relational engagement between staff and service users - one that provides continuity and a deeper relationship. Care, early years and maternity services are good examples of this. They also require a cross cutting response from teams drawn from different delivery partners, breaking down the service silos. This was also a key recommendation in the Christie report.

This table explains the differences between transactional and relational services.

While I largely agree with the point they make about relational services, I would disagree that transactional services are best provided with limited differentiation. Christie highlighted the work of systems thinking that show that bottom up design works here as well, albeit in a different way to relational services. Public service users are not always the well connected citizens they might be.

As ever, solutions are more difficult, particularly at time of service cuts. The authors argue for two big reform moves which they call ‘connect’ and ‘deepen’.

First, at the system level, the relational state means managing public services as interconnected systems. This means a decentralisation of budgets to local authorities and city-regions. There should be greater pooling of funding, so that services can take a ‘whole person’ or ‘whole area’ view using integrated multi-disciplinary teams. These teams would get greater frontline autonomy with systems that encourage them to share knowledge and learn from innovation.

Second, at the individual and community level, the relational state means deep relationships instead of shallow transactions. This means linking service users with lead professionals with whom they can develop a relationship over time, such as the same care worker in their home. Professionals would be allocated to neighbourhood-based patches with a single point of contact for users. On the collective level, institutions would be designed in ways that strengthen relationships between citizens and enable them to tackle shared problems together.

The paper gives many examples of where this approach has been adopted in practice. There are parts of the solution, such as the use of league tables, that don’t appear consistent with the overall approach. However, much of this analysis would be familiar to the Christie Commissioners who travelled Scotland to look at similar best practice.

Finally, the paper looks at the political challenges, persuading politicians at the centre to ‘let go’. There is also the cost of building these deeper relationships, although the paper shows how this can be more cost effective in similar ways to the preventative spending concept championed in the Christie report. There is also the challenge of engendering greater civic participation, creating the space for people to help themselves, or co-production in Christie terms.

Three years after the Christie report it is interesting to see others reach similar conclusions. The IPPR report has clearly been influential in Ed Miliband’s thinking around public services. Scotland starts from a different place, but there is much common ground on the best way forward.

 

 

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