Our Progress paper on ‘reform in an age of austerity’ was intended as a positive contribution to the debate on the centre-left about how to reshape United Kingdom public services for the future. The responses to the paper from Philip Collins, Paul Corrigan, Jon Cruddas, Rick Muir, Imogen Parker, and Ben Lucas each illuminate why this debate is of such fundamental importance for the modernising left ahead of the next general election.
Since 2010, Labour has been at some risk of falling into a strategic trap set by its opponents with the aim of portraying Labour as a party of bureaucratic incompetence and vested interests, incapable of standing up for the needs of the modern ‘citizen-consumer’. The danger was that Labour focused on positioning itself against the last Labour administration, instead of looking forward, determining how to upgrade and improve public services in an age of relative austerity.
The argument recounted by critics of the Blair-Brown years is that there was too much choice and not enough voice in New Labour’s reform agenda. Too much private sector and too little mutual sector. Too much focus on reform at the expense of those working in the public sector. Too much self-interested consumerism and too little focus on affirming the values of community and citizenship. Each of these observations may contain a kernel of truth, but a critique of past decisions does not amount to a serious policy. Labour has maintained strong leads on which party is best placed to run the NHS and schools since 2010, but the resonance of health and education has steadily declined with voters according to Ipsos Mori. The party has to again make these issues part of the battleground of British politics.
This does not mean that the previous Labour government got everything right: far from it. The 1997-2010 administrations were hampered by disagreement at the very top of government about the appropriate direction of ‘reform’, as the battle over NHS foundation hospitals in 2003-4 underlined. At times, there was a fundamental confusion of means and ends; ‘reform’ appeared to be the overarching goal, without any coherent vision of how key public services would affirm distinctive social democratic values. There was a ‘one size fits all’ managerial approach where a set of generic ‘reform principles’ were imposed on diverse public service institutions, from primary health services to local police command units. The mantra of treasury-imposed edicts and ‘PSA targets’ demoralised public service professionals, exacerbating the egregious centralisation of power in England, the unintended consequence of devolution to Scotland and Wales. Moreover, Labour accepted too readily the New Public Management model inherited from the Thatcher era, fragmenting services and promoted monopolistic private sector provision.
Nonetheless, it ought not to be forgotten that the last Labour government committed unprecedented investment in schools and the NHS, greater than any post-war administration. Indeed, the party transformed the climate around public spending. Margaret Thatcher’s first white paper in 1980 declared that high levels of public spending were the cause of Britain’s relative economic decline. By the early 2000s, lack of investment had been firmly established as a major driver of the UK’s economic and social under-performance. Moreover, by the time Labour left office in 2010, satisfaction rates were at record levels in the English NHS. However, framing a more nuanced and sober assessment of Labour’s record is only the first step towards developing a serious plan for the future.
It is clear that there are new priorities in public services which were barely evident in 1997. The extent of the fiscal challenge hardly needs restating. Demographic change, population ageing, entrenched social inequalities, innovation in medical technologies, rising demands for knowledge and skills, and so forth, emphasise the growing structural demands on public provision. These are unlikely to disappear any time soon. Reformers are right to emphasise the importance of collaboration between providers, underlined by a ‘whole systems’ approach defined around coherent ‘care pathways’.
However, the central question for the next 10 years is whether Labour is capable of taking forward the battle for popular control of public services, as articulated by Aneurin Bevan in the late 1940s who argued that for any party of the left, the purpose of winning power is to give it away. The fight for popular control of state-funded services has been one of the great battles of post-war British politics. The 1945 government has path-breaking achievements to its credit not least the creation of the NHS in 1948, but too often it conceded veto powers to professional interests. The Labour governments of the 1960s and 1970s largely ducked the reform challenge, while post-war Conservative administrations were characterised by astonishing complacency about the condition of the public realm. The Thatcher revolution was portrayed as a crusade to restore individual rights to users in the public sector, but in reality marketization and privatisation denuded citizens of control. As such, the battle for popular control goes on – an enormous opportunity for a revitalised party of the centre-left.
In contemporary Britain, major areas of service provision are characterised not by too much choice and control, but too little. Access to a GP surgery, especially in our major cities, is but one example. Another is decent schools in areas of persistent educational disadvantage. Too few pupils in deprived areas have access to a high-quality school place, a major inhibitor of social mobility. Labour must have an agenda to remedy these ills if it is to succeed in office after 2015.
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Patrick Diamond is lecturer in Public Policy at Queen Mary University of London and vice-chair of Policy Network. He tweets @patrickdiamond1
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