We're (not) all in this together

The Open Public Services White Paper is out. It commits to a vision of public services where decision making and funding are devolved to the lowest possible level, the market reigns supreme, choice and competition are positive features to be encouraged in public services and the door to public services is swung wide open to ‘’the best possible provider’’.

Critiques will no doubt emerge from all corners. For me, the most worrying aspect of the White Paper is its intent to put markets and competition over collaboration and partnership in the delivery of public services. As always, the devil is in the detail, so let us take one of the few specific examples used in the White Paper to explore what marketisation and competition might mean.

The government’s commitment to extending personal budgets from social care across to health, Special Educational Needs (S.E.N.) provision, and housing related support is one move which embodies its desire to devolve funding and decision making to the lowest possible level – that of the individual citizen.

Personal budgets have the potential to give people much more control over what type of support they receive, and how. When done well, with self directed support and a strong role for the state in facilitating support, they can be transformative in their impact, particularly for groups of people who have long been disempowered, and had little or no choice and control over the support they receive.

There are some big risks with extending the policy though which have not been properly considered, and these risks are made even more worrying as the move to extend personal budgets across to other sectors comes before the first major evaluation of the pilot programme has even been completed.

The first risk is whether devolving funding also means the state is relinquishing responsibility for basic provisions and entitlements? What is guaranteed and what is not? Most of the current evaluations of personal budgets are taking place while there is a core state infrastructure in place. Will people have to use their budgets to replace this once it is gone? Secondly, are we happy to transfer all risk and responsibility to the individual? By giving someone their ‘pot’ of cash do we wash our hands of their welfare and hope they make the best of it? Third, how will individuals fare against the powerful providers of care services in the open market? What if someone uses their budget to buy a place at the next Southern Cross? The costs of the almost certain market failure may be too big for individuals to bare and the government must be clear on what it will do in the case of market failure.

 It is the focus on markets and competition that suggests to me many people may be left atomised, unsupported by their peers and by professionals and left to passively purchase services as and when the market develops. Mutual aid, self help, collaboration and co-operation are all values which would enable the policy of personal budgets to offer genuine choice and control, bringing people together – not individualising them.  Yet these values are conspicuously absent from the White Paper.

Cameron talks of modernisation as a necessity to avoid ‘’wasting opportunities’’, but this White Paper represents the biggest opportunity missed yet. Where is the mention of co-production? Quite simply, services are more effective when people and professionals work together to get things done, pooling resources, time, knowledge and capacity. In a time of limited resources it makes sense to combine and combat the intractable social, economic and environmental problems we face, not to divorce them.  

What will hindsight have to say about the White Paper? Possibly that we weren’t all in this together, but were in it against each other, competing for every single slice of the pie.