Best of the frontline bloggers (week ending 26th October 2012)

We love public and voluntary service bloggers. At their best, they capture the day-to-day reality of public services in a way that Westminster-commentators can’t – and they have the real expertise and insights we need to improve social policy. Here’s our selection of the best frontline blogs we’ve read this week. Do send us your suggestions for great posts we’ve missed – and those frontline bloggers we should follow in the future.

Welfare

A4E? Who are they? What are they about?

From The Big Picture

Posted on 23rd October 2012

“What are A4E up to next? Well according to David Cameron they would make an ideal company, along with our old friends G4S, to become involved in the process of Rehabilitation… The scheme will see firms such as G4S and A4e, along with charities and voluntary groups, offered cash incentives to put offenders back on the straight and narrow. We already give these companies enough money, and now we’re going to give them more? Do they have a proven track record?”

Retired and Angry, retired from the Metropolitan Police Service, examines the recent history of A4E – and doesn’t much like what he finds.

Carers

If it works, break it

From Ned Ludd Carer

Posted on 24th October 2012

“Surely, if the carers and service users find these services valuable, that should count for a lot. But in the world of cuts, they don’t care what works, what’s valuable. They just want the overspend caused by their own unrealistically low budget reduced.”

Ned Ludd, carer, gets angry when ambushed by his local council’s plans to cut personally valuable “getting a life services”.

Social care

People with dementia need an independent voice

From The Age Page

Posted on 25th October 2012

“For a variety of reasons, most older people are unable to complain or express a view on the type and nature of care they need or want to receive. Worst of all perhaps, most are unable to influence the quality of service they have every right to expect or how or where to lodge complaints, if they have any.”

Sarah Reed reflects on the ambitions in the Government’s dementia strategy, and suggests this means we need to ensure that those who struggle to speak for themselves can be heard.

Education

This much I know about…an alternative to the English Baccalaureate Certificate

From John Tomsett

Posted on 21st October 2012

“If Jeremy Hunt announced a backward-looking reform to appendix operations which would be hugely invasive and leave patients in hospital for a fortnight (such as I experienced in 1977), the medical profession would deride him. Why aren’t we deriding Gove over his EBC proposals, which are the educational equivalent?”

Headteacher John Tomsett argues that educationalists need to begin an urgent campaign to provide an alternative to the Government’s proposals for an English Baccalaureate Certificate.

Things to know about ED Hirsch and the ‘Common Cultural Literacy’ idea

From Laura McInerney (@miss_mcinerney) writing on lkmco

Posted on 23rd October 2012

“ED Hirsch’s ‘Cultural Literacy’ has become quite popular in England this week due to him featuring on a Radio 4’s Analysis and also being the subject of a blog by Daisy Christodolou, Managing Director of The Curriculum Centre. Hirsch is the man who wrote the book ‘Cultural Literacy’ which he followed by creating ‘Core knowledge‘ an age-ordered curriculum with an emphasis on facts that, if taught correctly, he argues will give children the most important cultural knowledge. But to understand his work it helps to understand its American context, as the reason for his popularity in the States is really quite different to the way his ideas are being framed in the debate here in England.”

In this post Laura McInerny describes Hirsch’s model of ‘cultural literacy’ and its roots in the US – and questions how appropriate it is for the UK.

Policing

Re-offending – ‘Payment by results’ will not work

From Inspector Gadget

Posted on 22nd October 2012

“I have read the PM’s plans for ‘payment by results’ in terms of the re-offending rates of prison inmates with interest. This will not work. A bit like trying to use the wrong gate, ministers need to listen to police on this one. I’m sure it will be shown to have worked, but it won’t work for the simple reason that these days, criminals only go to prison in the first place if they are persistent offenders.” 

Inspector Gadget argues that the use of payment by results won’t work to reduce re-offending. He speculates that this idea probably came from a think tank who in turn have been sponsored by an organisation with an interest in securing ex-offender rehabilitation contracts. Inspector Gadget argues that the most effective way to deter ex-offenders from re-offending is a lengthy stay in a closed prison, preferably far away from home.

‘Re-inventing the wheel’ or just ‘Strapping two u-turns together’

From MinimumCover

Posted on 24th October 2012

“I want us to be bold and imaginative about transforming policing and the wider criminal justice system to save time and money and deliver a better service for the public. These are the words of our ‘beloved’ Home Secretary which she used to describe her latest improvement to the way Police investigate and prosecute offences. This bold and imaginative move introduces the power for Police to independently charge a number of offences that currently require consultation with the CPS.”

MinimumCover welcomes reforms to charging powers – but questions whether Theresa May can call these proposals ‘bold’ or ‘imaginative’ when they return powers that the police used to hold previously.

If you’re a frontline blogger, do send us your latest blogs on policy issues or posts from the past that you’re particularly proud of, and they could be included in next week’s round-up. Get in touch with us at: info@guerillapolicy.org or via Twitter @guerillapolicy and @guerrillapolicy


How outsourcing can reduce real choices for people using services

In recent posts we’ve been exploring the tensions between two competing Government agendas – for so-called ‘open public services’ and ‘open policy-making’. Choice is supposed to be a central part of the Government’s agenda to open up public services to greater competition in order to improve outcomes, quality and efficiency. In this post we explore three ways in which outsourcing can actually reduce real choices for people using public services.

You might have missed it, but in June the Cabinet Office announced an independent review led by David Boyle into the barriers to choice in public services. The review is looking to address the factors that prevent people from understanding and exercising the choices available to them in a range of public services. But the review does not address another pertinent question: how ‘open public services’, especially outsourcing, can reduce real choices for the public.

Firstly, there is no getting away from the impact of the cuts, which are creating poor choices for users of public services. For example, local councils are due to make cuts of about £2 billion to adult social care budgets between 2011-13, with £890 million coming out this year alone as part of the Government’s deficit reduction programme. Outsourcing services to non-public sector providers is seen as the main way to reduce costs.

Take this example: domiciliary care services (care in the home), much of which is outsourced, is one area that has borne the brunt of cuts. Hourly rates for dom care have dropped in some parts of the country to as low as £10-12 per hour. From a provider point of view, the only way to make these contracts work financially is to increase the volume of customers and reduce costs. Given that the majority of cost is staff time, this means becoming a minimum wage employer and reducing staff terms and conditions – a move that many charities and private sector providers are (being forced into) making. It also means cutting the time allocated for care visits to under 30 minutes and sometimes to less than 15 minutes.

Rationing of social care has also meant the things that people want to choose – for example social contact or help with domestic duties such as housework, shopping and gardening – are not available unless they can afford to pay from their savings. According to Age UK 33% of older people report feeling lonely, with this figure increasing to half for those aged over 80. It’s obvious that a 15 minute visit doesn’t leave time for a conversation.

Outsourcing based on price is bound to affect quality. A review into choice and competition in public services by the OFT found that competition based on price alone is likely to lead to a deterioration of quality. This is backed up by the results from a survey conducted by the National Care Forum of 40 social care providers this week, which showed that the social care workforce is rapidly ageing, and that there has been a hike in staff turnover rates. Given the unsociable hours and low pay, social care does not tend to be an attractive career option for young people. 46% of care staff are aged 46 or over, whilst turnover rates for domiciliary care for older people has climbed to almost 28%.

Secondly, information about services available is fragmented. It is well documented that advocacy, information and advice services are withering on the vine as a result of the cuts. Yet good quality information and advocacy support are integral to supporting choice. Information about providers is hard to find with services such as Find Me Good Care, Shop4Support and the Good Care Guide in their infancy. The Government has been reluctant to invest in services such as these – the Social Care Institute for Excellence has invested their reserves into Find Me Good Care instead. Providers have also been agnostic about these services as many of them find business through word of mouth or local authority referrals. Yet without adequate market information, real choice for service users will be undermined.

The views of service users are not always well understood or captured by services. Take another sector as an example: 11,000 pupils are placed in out of authority special schools at an annual cost of £572 million. A review of this market by the Audit Commission found that young people were rarely asked for their opinions or offered choices. Instead, choices are made by parents and professionals, not the young person themselves. Many young people want to be placed nearer to their family but the concerns of their parents tend to take precedence.

Thirdly, the ‘bigger is better’ approach to outsourcing is reducing real choices for people. The outsourced public services market is maturing around a group of large providers who are increasingly too big to fail. The Government is ever more reliant on providers such as Capita, Atos, A4e, Serco and G4S, who alone have the scale and funds to absorb the risks associated with this ‘bigger is better’ approach to outsourcing. A4e now delivers services across welfare to work, adult social care, information and advice and offender management. The dominance of these providers crowds out small charities and providers who cannot compete on a level playing field, which again reduces choice for service users but also commissioners of services.

Choice is nothing new of course; successive governments have embraced it as a way to improve performance across a range of public services, and in one sense the current Government under its open public services agenda is only continuing this trend. But after nearly 30 years of promises of increased choice – often to be achieved through increasing amounts of outsourcing – many of the actual choices available to the public seem less and less appealing. The one choice we don’t seem to be being offered is the political choice to challenge this agenda – for the users of services and the professionals who deliver these services not to be subject to imposed ‘choice’, but rather for them to be able to determine together how services can be improved and for policy wonks to get out of their way. Perhaps the Cabinet Office could add this type of choice to its review, if it is allowed to.


How does outsourcing constrain open policy?

In the previous two posts we have asked if there is a tension between two competing Government agendas – open public services and open policy making. In this post we set out fours ways in which the current approach to outsourcing of public services can stifle open policy.

The ongoing saga surrounding the role (or more often, the non-role) of G4S in providing Olympic security has again highlighted that important aspects of outsourced public services – including performance and contract terms – are often hidden from public view behind a wall labeled ‘commercial in confidence’. This has significant implications for open policy, in at least four respects.

Firstly, outsourcing sometimes obscures performance. The Government’s flagship Work Programme is a case in point. This £5 billion programme has been heralded as a radical approach to reducing long-term worklessness. It uses a payment by results approach where providers are paid on achievement of outcomes. Providers have the freedom to decide how they will deliver the service without prescription from government (often called a ‘black box approach’). The problem is that effective transparent scrutiny is difficult because providers are not able to share data about what is working and what isn’t. They are required to sign comprehensive contracts, which prevent them from sharing performance data unless it is already in the public domain. Providers must also not attract ‘adverse publicity’ from their media work or face consequences if they do. Charities and media commentators have questioned this but ministers have refused to change this.

Rather than protect the policy in its relatively early stages, this has only served to intensify the questions as to whether the Work Programme is working effectively. Various charities are pulling out of the programme or going bankrupt, raising concerns about the viability and sustainability of the policy. Data leaked to Channel 4 News indicated that only 3.5% of individuals referred to A4e are securing a job outcome. The way the Department for Work and Pensions has released performance data about the programme has made it difficult to effectively scrutinize the policy overall, a view shared by ERSA – the welfare to work trade body.

Secondly, where public services are not provided by the public sector, this can result in data no longer being available to public policymakers. Francis Maude has argued that data belongs to citizens and not the state, but this hasn’t been reflected in all contracting processes. In a recent Q&A on open government Vicky Sargent from Socitm pointed to cases where council contact centres have been outsourced and the data about enquiries is no longer available to the council because it was not explicitly included in the contract. Vicky rightly argues that retaining the right to data from outsourced systems is critical.

Thirdly, what this reflects is that different providers are treated differently when it comes to transparency. Local Government departments are required to publish all expenditure above £500 as well as salaries of senior officials.  Similar rules apply to Whitehall departments but the same rules don’t apply to outsourced service providers. The Freedom of Information Act also doesn’t apply to private and voluntary sector providers, even though it would if the same services were delivered in-house. This inconsistency in applying transparency rules between services delivered by the state and those by the private/voluntary sector means that we are seeing ‘black holes’ open up in public service commissioning, to the detriment of public accountability.

Fourthly, this situation is likely to undermine the greater use of evidence in policymaking, for example Sir Jeremy Heywood’s desire to see a social policy equivalent of NICE that could issue social policy ‘kitemarks’ for particularly effective and proven approaches. How could such an approach be adopted consistently across public services? Knowing what works and what doesn’t could help the Government in its ambition to increase social investment in areas such as long-term worklessness, but this is unlikely to be realized if we aren’t able to analyse the performance data, costs and timescales across all programmes whoever provides them.

Transparency and scrutiny is not a luxury, rather it is essential if we are to understand whether policy is working and if it isn’t, how it could be improved. We need to understand the impact of public expenditure and whether it represents value for money. We need to make informed decisions, based on evidence, about existing and future policy. Policy will be weaker if a substantial part of the evidence base is hidden behind a veil of supposed ‘commercial confidentiality’. At stake is whether outsourced services are still ‘public’. If public money is being spent in the public interest, then surely how this money is spent should be transparent.

As we suggested in the previous post, the current situation has allowed a further serious problem to develop, of which the G4S fiasco is just one outcome – the emergence of a small, very powerful but somewhat unaccountable group of providers who have significant interest in public policy stemming from their role in delivering a range of public services from prisons, welfare to work, hospitals through to schools. Given their size and scope, independent and transparent analysis of the activity of these providers is essential if we are to scrutinize how this investment is spent and to what effect. Any future social policy equivalent of NICE surely requires a stronger and more secure foundation than this – something we will address in a future post.

We will be looking at each of the issues raised in this post in more depth in future blogs.  Please tell us what you think.