Overhauling our rural services
What does the future hold for rural services such as healthcare, transport, village shops, pubs and post offices? That’s a question that sits at the heart of the ‘public services reform’ agenda – the responses to which are going to have very real consequences for rural people and places. Jessica Sellick investigates.
With budget allocations for 2011-2012 completed and in the process of being implemented, the effects of the financial plans outlined in 2010 Comprehensive Spending Review are becoming tangible. According to the Local Government Association (LGA), councils were handed one of the toughest public sector settlements and will face a total funding shortfall of about £6.5 billion between 2011 and 2013.
In July 2011, the government published the Open Public Services White Paper. This sets out a new approach to delivering services which aims to ensure that everyone has access to the best public services. Moving away from an “old-fashioned, top-down, take-what-you-are-given model”, the White Paper aims to give people more control over the public services that they receive and open up the delivery of those services to new providers:
Too many of our public services are still run according to the maxim ‘the man in Whitehall really does know best’. Decades of top-down prescription and centralisation have put bureaucratic imperatives above the needs of service users, while damaging the public service ethos by continually second-guessing highly trained professionals. The idea behind this view of the world – that a small group of Whitehall ministers and officials have a monopoly on wisdom – has propagated a lowest common denominator approach to public services that implicitly favours the wealthy by allowing them to move to find pockets of excellence or to opt out altogether. Our vision of open public services turns this presumption on its head and places power in the hands of people and staff, with additional power or incentives to help boost those who would otherwise be disadvantaged in the marketplace (pages 7-8).
The White Paper contains five principles for modernising public services: (i) increasing choice, (ii) decentralising power, (iii) diversity/opening up public services to a range of providers, (iv) fair access and (v) accountability to users and taxpayers.
Significantly, the White Paper was launched on the day that Southern Cross, then the UK’s largest residential care home provider with 752 homes, walked away and handed the keys to all of its homes back to the landlords. The situation left many of 44,000 people employed by Southern Cross, often on the minimum wage, facing an uncertain future and some Councils (having sold off their stock of placements and with already stretched budgets) having to step in to help pick up the ‘tab’. So where does all this leave us? In a ‘prices versus people’ calculus? From top-down approaches to bottom-up individual, neighbourhood and community owned delivery solutions? From a controlled and closed to competitive and open ‘marketplace’? What might an open services approach look like, warts and all, and what are some of the implications for rural communities? I offer three points.
Firstly, amid a desire to deliver ‘better public services for less money’, what do we actually mean by ‘public services’ and how can they be delivered ‘for less’? The White Paper, for example, references ‘core services like policing, schools and the NHS’, should be free at the point of use. Within the current activities of the Rural Communities Policy Unit (RCPU) at Defra, ‘access to services’ cites shops, pubs, bus services, post offices and village halls as being “the lifeblood of thriving rural communities” with RCPU seeking to work with partners to empower community enterprise to maintain these services.
In parallel, in March 2011, the Department for Communities and Local Government (DCLG) began a cross Government review of statutory duties placed on local authorities by central government. A key purpose of the review was to build a comprehensive list of duties – now totally 1,294 duties – and to consider removing old, unnecessary and outdated duties. Take ‘public’ libraries as an example: the Public Libraries & Museums Act of 1964 sets out a statutory duty for all local authorities to provide a library service, but no ring-fenced cash comes through the government grant support for local authorities to provide such a service; it often ends up being principally supported by the local council tax. In the current climate when local Councillors have to weigh up the way stretched cash is to be distributed, libraries become part of a range of statutory services, some of which are viewed as critical and some which are ‘life and death’. At its most extreme, we have seen some Councils weighing up these decisions and seeking to emulate budget airlines such as easyJet by charging citizens extra for ‘premium’ services that it had provided for free. Such a no-frills approach, whilst possibly reducing the bill for taxpayers, has very real consequences for citizens in that it restricts what services people get automatically. On the one hand, the outcomes of the DCLG consultation could encourage Councils to be even more accountable to local residents by releasing them from the grip of top-down micro management. On the other hand, it is questionable to what extent any reduction in responsibilities could assist Councils in making funding cuts.
In terms of how you deliver public services for less, in August 2011 the Young Foundation published a Paper ‘Productivity in UK public services – what went wrong? What could go right?’. The document proposed that if reductions in education and health spend are not to lead to damaging consequences, action has to be taken in three key areas: (1) taking evidence and analysis on ‘what works’ more seriously, (2) empowering staff and tapping into wider resources, and (3) adapting financial and organisational structures. The Paper concluded that it is essential to allow front-line professionals to show what can be done. But many frontline professionals are grappling with reduced resources (budgets and staff). For example, research by Age UK has revealed how cuts of 8.4% are expected in older people’s social care this year. Based upon responses from 139 Councils, Age UK found net expenditure on older people’s social care to be falling from 2010-11 to 2011-12 by £610 million; net annual expenditure per person to be declining from £864 in 2010-2011 to £791 in 2011-2012; and only 1.148 million of the 2.9 million people over the age of 65 needing care currently receiving support from their Council. A survey by the Papworth Trust found the replacement of Disability Living Allowance with Personal Independent Payment (PIP) means some disabled people will no longer have enough money for everyday essentials like food and transport.
With the Statistical Digest of Rural England 2011 finding life expectancy to be higher for people born in rural areas compared to urban areas, and figures from the Department for Work and Pensions (DWP) suggesting almost 1 in 5 people will live to see their 100th birthday, how can public services for young people, the sick, disabled and older people be provided and funded? It is already clear that not all the cuts can be achieved through stripping out back office functions (e.g. IT, administration, human resources etc). A policy briefingprepared by the former chief constable of Gloucestershire Constabulary last month found that police authorities had been given insufficient time to implement cuts and that 16,000 police officer posts may be lost. These figures and forecasts become more problematic when you consider the additional cost (the premium) of delivering public services in rural areas.
On the ground, often far removed from these policy and funding decisions, RSN Members have provided us with a plethora of examples of both public services that are under threat in their locality and how they are finding innovative ways to try and save them from the axe: from a scheme led by bus operator East Yorkshire Motor Services to appeal for voluntary payments from pensioners entitled to ‘free’ travel to save a threatened service from closure to the newly launched County Connect transport system in Northamptonshire.
With no agreed upon list of public services used across central government straightforwardly accessible, for me, this opens up a dialogue around finding out what (public) services are important to rural communities’. Should some services be considered more essential than others? What do rural communities think the minimum requirements should be? To what extent do they think public services should be free at the point of delivery? How much do the public services that rural communities need and aspire to have cost and how might these be funded and delivered? Importantly, this dialogue means taking seriously how public services cover what rural communities feel is needed rather than reverting solely to thinking in terms of what is already provided.
Secondly, what does a more open market-based approach look like for rural residents, voluntary and community groups and public sector organisations? It is important to acknowledge just how much rural residents already do (often informally and on an ad-hoc, responsive basis) to support their local community. Whether they would want to become more active partners in the planning and delivery of rural services is in doubt. The Rural Insight Survey 2011, for example, canvassed the views of more than 1300 rural residents and stakeholders across England. The Survey found many respondents lacked the enthusiasm to deliver actual services: “some of these services (e.g. transport support, help for elderly) are or could be provided to an extent by the community as an addition to services provided by statutory bodies, but not to a level that would be an effective replacement for current levels of ‘formal’ service provision”.
The White Paper aims to open up public services to a range of providers. On the one hand, this presents opportunities to ensure that public services are tailored to individual and local needs rather than being viewed as something ‘done to’ people. It also means (in theory) a greater role for voluntary and community sector organisations and private companies. Again, RSN Members have provided us with countless examples of rural communities that have set up and sustained social enterprises around a variety of public and community activities. Going forward, the White Paper challenges us to think again about the role of the marketplace. For local authorities looking to commission services, how will the procurement process work? How can we ensure that charities and voluntary and community sector organisations are not there as (what one journalist described) as “bid candy”? For successful providers, what provisions will be made in the contract to monitor performance and check they have the requisite health and safety, risk assessment and safeguarding procedures in place? What is the role of the end user in this process and how can they make an informed decision between different providers? Interestingly, one of the consultation questions contained in the White Paper is: ‘how do we ensure a true level playing field between providers?’
Thirdly and finally, what do references around ‘fair access’ in the White Paper actually mean? For as there is often a premium in delivering services in rural areas, and given the distance rural residents are already travelling to access some services, will open public services really provide a certain level of service for rural dwellers (on a par with their urban counterparts)? The White Paper itself signals that the government’s forthcoming ‘Rural Statement’ (expected Autumn 2011) will include measures to help tackle these issues.
The example of Southern Cross serves as a powerful reminder of what can happen when a market based approach to delivering services goes horribly wrong. If putting people first is to remain the mantra of public service delivery, now more than ever we need to simultaneously consider how public services can cost less but be even better from the perspective of rural residents.
Jessica Sellick is a rural practitioner at Rose Regeneration. She can be contacted by email jessica.sellick@roseregeneration.co.uk or telephone 01522 521211.