Social care is pointing the way towards the use of working in partnership to deliver public services that prevent crisis by focusing on early, targeted help, says MV's Emmet Regan. A version of this article was first published in the MJ.
The recent Budget has provided the financial road map for public services over the coming Parliament. We know there is an inherent tension between the fiscal envelope and the dire state of public services. We also know that funding alone, albeit much needed, will not improve outcomes. Thought must now turn to how public services can be improved and how outcomes can be transformed after a decade of challenges, be that rising demand or increased complexity. What can be an approach for the current challenges we face?
We now have the opportunity to leave the mantra of choice and competition behind and to embrace both partnership and prevention as the roadmap of public service reform.
During previous periods of reform, policy makers have looked at different ways of reforming public services from the use of targets and top-down approaches formed from the techniques of new public management to the use of the market. Whitehall looked to pull central leavers to deliver local outcomes. Decades of under-investment have hollowed out that option, leaving it unavailable. There is now an inability to will something centrally and expect a coherent local delivery strategy, be that in welfare, social care or criminal justice.
It has become expressly clear that approaches such as the use of the market have failed to address those deep-rooted challenges since the turn of the century. One only needs to look at output from the Competition and Market Authority's report into children's social care placements to understand some of the major failings of the market. It stated that ‘a lack of placements of the right kind, in the right places, means that children are not consistently getting access to care and accommodation that meets their needs and that the largest private providers of placements are making materially higher profits, and charging materially higher prices, than we would expect if this market were functioning effectively'.
At the core, the underlying logic of the use of the market was its ability to effectively allocate resources using competition and choice as tools to do that. From water to social care, competing with ourselves for public necessities does not provide competition, merely it facilitates a race to the bottom with an illusion of choice.
We now have the opportunity to leave the mantra of choice and competition behind and to embrace both partnership and prevention as the roadmap of public service reform. We must work in partnership to deliver public services focused on early, targeted help to prevent crisis.
The Local Government Association (LGA) highlighted this focus in Doncaster, saying: ‘During the pandemic, the council successfully modelled and piloted perinatal mental health visiting roles which had been evaluated with positive outcomes'.
The LGA went on to highlight how Doncaster has built a sense of trust with its providers and created a space for flexible, customised service delivery which has been particularly crucial in maintaining the quality and efficiency of new birth visits. There are other emerging examples across social care where we can see the power of partnership and prevention coming to the fore.
The Department for Education is currently supporting several local authorities to re-imagine the delivery of children's social care in a new way. One of those areas is Dorset. In the Family First for Children Pathfinder ‘the partnership is underpinned by a shared culture, language and set of values and is committed to working together and with children, young people, and their families'. This is done by putting children and families at the heart of everything they do, including how they develop and shape services.
With the arrival of a new Government and clarity on the underlying financial position, now is the time to reimagine public services, consigning competition and choice to the history books, and renewing focus on citizens to aid prevention and doing that in partnership with them and the wider public sector family.
For more on Mutual Ventures' work on public services reform click here.
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