Wales and England should learn from each other’s approach to public services rather than argue over ideology
Prime Minister David Cameron’s recent criticisms of public services in Wales understandably provoked some debate, including Malcolm Prowle’s article in April’s PF, ‘Bottom of the class’.
Sadly, the war of words from across Offa’s Dyke on public services reform has become more a battle about ideology than about what works. At the heart of the issue is which model of reform is best – collaboration or competition? The problem with ideologically driven reform is that it presupposes that there is only one answer. If the only tool you have is a hammer, you treat everything as if it were a nail.
Prowle claimed that health and education services in Wales were lagging behind those in England. But comparing performance across the two nations is difficult, especially in the NHS. The latest King’s Fund monitoring report shows the English NHS is coping with efficiency targets but performance is mixed and difficult to compare from one period to another because of seasonal effects. In Wales, the NHS required an additional £103m in 2011/12 but this year is expecting to break even.
A measure of how joined up NHS and local government are is the rate of Delayed Transfers of Care. The King’s Fund tells us that these numbers are ‘stable’ in England. In Wales, there is a steady decline, despite the fact that the Welsh NHS lacks the protection given to English budgets.
Prowle is right in one respect, that we focus too much on statistical nuance to argue one way or another. This is not helped when politicians use performance management as a blame game rather than as an evidence base for improvement. What we need are holistic approaches to reform and measures that tell us how well that system is working, end to end. These approaches will be crucial in delivering the vision of Sustainable Social Services set by the Welsh Government, and they can build on a number of initiatives across Wales. The Gwent Frailty Project, for example, is already providing joined-up health and social care in the community and thereby reducing the pressure on acute, hospital-based services.
In education, local government acknowledges that the system as a whole is underperforming. As Prowle says, Wales is not doing as well as England or our counterparts in Europe. David Reynolds, professor of educational effectiveness at Southampton University and senior policy adviser to the Welsh Government, has argued that Wales’ decline in performance relative to England is linked to the burgeoning funding gap between the nations, thought to be around £620 per pupil.
This is only part of the story however, because what has been lacking in our education system is a grip on good performance management data and standards in schools. The performance of council education services has also been variable. Reports from the Estyn schools inspectorate show that councils such as Denbighshire have transformed their schools and are determined to improve even further. However, in other local authorities, commissioners have had to step in. The Welsh Government now has a School Standards Unit, run by a former council education director, which is producing analysis to inform this debate.
We need to turn the curve on school performance. There is now a relentless focus on performance data, improving standards and concentrating on the three strategic priorities of the Welsh Government: literacy, numeracy and breaking the link between poverty and educational attainment. We are working to bring every school and education authority up to the standard of the best.
It is a massive challenge, not least in an austere and increasingly worrying financial climate. The chilling predictions in the Institute for Fiscal Studies’ Green Budget are well read in Wales, while demands for public services are unceasing. Also lurking on the horizon is welfare reform, which is being hurried through on a madly ambitious timetable. Its impact on the most vulnerable in society is a potential train crash.
But back to the main question here: collaboration or competition? As a former Chinese leader said, it doesn’t matter whether a cat is white or black, as long as it catches mice. The approach to public service reform needs to be pragmatic and flexible, designed around the needs of citizens, not organisations, and to deliver better outcomes with less money. Mutual learning across nations would perhaps assist this rather than a war of words. Chairman Mao called it the ‘principles of peaceful coexistence’.
Steve Thomas is the chief executive of the Welsh Local Government Association