Civil Service Live
Public Services in the future
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The government needs to pay more attention to the mass of knowledge held by front line staff and help release their innovative ideas, a minister has said.
Cabinet Office minister Ed Miliband was speaking to hundreds of civil servants on Wednesday, the second day of Civil Service Live, after hearing about the work of a number of public service workers and social entrepreneurs.
Calling for a real change of culture, the minister said it was not just civil servants who had to change their behaviour.
“This does also mean ministers listening more, understanding more, the front line,” he added, telling the audience that there needed to be a greater tie up between policy and delivery.
“We need to find a better way in which the organisation and the distribution of power between the centre and the front line makes possible innovation,” he said, and called for the public sector “to be more willing to take risks”.
The minister had earlier quizzed a panel of front line staff about their own experiences, including Simon Duffy, managing director of In Control, a service which helps social care users take control of their own care budgets.
Duffy said personalised budgets could cut the cost of an individuals care by as much as half compared to traditional, usually institution-based treatment, with early figures indicating an average per capita reduction of 10 per cent.
A total of 114 out of England’s 150 local authorities had already signed up to the scheme, with around six per cent of the country’s one million social service users either taking advantage of either personalised budgets or its precursor, direct payments.
The initiative, Duffy said, allowed greater personalisation, creating “a more equal relationship” between the user and provider and brought benefits such as greater efficiency, reduced costs, and encouraging new users to access services.
“Everyone in an organisation can make a contribution and can have ideas, and often the best ideas, about how the organisation can improve.... My sense is that we are not good enough at tapping into that.”
Ed Miliband, Cabinet Office Minister
The biggest problem In Control faced, he continued, was people’s fear of something that was new. “Even a system that is clearly dysfunctional and not working very well gives people some security,” he explained.
And, on questioning from Miliband, Duffy warned against rolling out such innovations too early. “It would worry me if this got sold into some sort of reform of the NHS,” he said.
From right within the public sector, Knowsley Borough Council’s family learning manager Keith McDowall talked about the various programmes in place to help children and parents get more involved with the education system.
This was helping the hard to reach people that the government was focused on, although he emphasised that commitment was needed to overcome longstanding issues of confidence and trust in parents who may not have had a good experience of education themselves.
McDowall also told Miliband that the success of programmes such as his were often difficult and complex to measure the success of, and emphasised that targets such as key stage results would not always reveal the true benefit.
Government needed to be “a little bit creative and not just look for he numerical outcome”, he explained to the minister.
From health, Jo Prichard, managing director of nursing service Central Surry Health Care, said the organisation’s 18 months as a co–owned social enterprise had resulted in “doing things that are having a real impact on patient care”.
Waiting times for physiotherapists had been reduced from 16 to four weeks, while those for wheelchair services were down from nine to two months.
But more than the benefit for clinicians and patients, it was the effect on her own workforce that was also important.
The resulting change of culture within the organisation had resulted in a “release of energy” with staff being “motivated and excited” and an end to a “system where everything had to be signed off by three tiers of management”.
Decision making, including budget decisions, were being delegated instead to local teams, she said, while ideas and innovations, such as that for a new clinic, no longer had to be filtered through line managers and were coming to fruition in just a few months.
Miliband said he “100 per cent” agreed with what Prichard was saying, adding that there was a lesson for ministers “about the need for greater flexibility at the front line”.