Labour leader Ed Miliband made his first foray into the world of public services policy this week, giving the Hugo Young lecture on the subject. Key among the principles set out by Miliband was that public service users must be empowered to make changes to local public services, that users should have better access to information about public services, and that old cherry on the top of any public sector reform speech worth its salt: greater devolution of policy-making to put users closer to this process. In practical terms, Ed advocated that no local services, from welfare to education and health, should be commissioned without local consultation, and that he would legislate to ensure this process was mandatory across the country.
Whilst it can be argued that this Government has looked to impose its ideology on the welfare state without due regard to service users, this has not been the case in education and health. In the health sphere, in particular, Health Secretary Jeremy Hunt has driven wide-ranging reforms in response to The Francis Report into poor care at Mid Staffordshire NHS Trust, many of which Miliband looks to build on in his proposals. Hunt has empowered health service users by giving them a range of information regarding health services, including through the introduction of Ofsted-style ratings, ‘named GPs’ accountable for a person’s care throughout the system, and the creation of ‘Fundamental Standards of Care’ to which a provider must adhere, which include measures to ensure that patients are fully involved in decisions taken about their care and that providers have appropriate systems in place to respond to, and act on, complaints.
Originally an ideological centrepiece of his brother, Ed Miliband is undoubtedly (well, at least he is now) a believer in the value of community organisation, and has talked many times of how he believes that better bottom up activism in his own party will be intrinsic to a Labour victory in 2015. Indeed, many of the proposed reforms build on work being undertaken by Labour-run councils – most prominently in Lambeth, Manchester and Newham. Through recent policy announcements – see the 50p tax rate, the energy price freeze and pledges on future housebuilding – Miliband has looked to be the champion of these communities against what he sees as free market excess, using the power of majority opinion to both set the political agenda, and look to form a tightened web of regulation around these policy areas.
However, as seen with the last community gimmick – the ‘Big Society’ – empowering people to make a difference is just the start. If ‘people-power’ is to really take off, then a whole range of stakeholders have to buy into the vision, from power-hungry Junior Ministers keen to make a mark in their respective policy portfolios, to members of the public expected to give up their own time to help shape the public services in their local areas. Ed’s speech gave little in the way of substance as to how he will incentivise all parties to buy into his vision, and will instead fall into the criticism faced by Michael Gove over his academies programme that only the ‘pushy parent’ type will look to be involved in such schemes.
Given the somewhat unworkable nature of Miliband’s proposals, this author believes that we will most likely see a form of the ‘muscular localism’ championed by Communities Secretary Eric Pickles, in which people-power is fundamentally guided by regulatory principles set by central Government. Shadow Health Secretary Andy Burnham has already set out this approach in his wish to repeal this Government’s competition laws in the health service, stating that a future Labour Government would seek to guide commissioners towards the NHS as “preferred provider” when seeking providers for health services.
Further, if he is to truly succeed in setting the agenda on public services, such a heartland for Labour traditionally, he will need to link his guiding principles to reforms proposed in education, welfare and health, namely: a teacher re-evaluation system to raise standards in schools; a Jobs Guarantee to replace the Work Programme and the repeal of the Health and Social Care Act.
Not only this, Ed also needs to build a fully incentivised system for everyone to build in to his bottom-up vision. It is no good simply expecting people to help reform public services because they feel compelled to do so. It is a much easier sell on the economy and energy – want to see your boss get taxed more? Sure you do! Want your energy bill frozen? Of course you do! Lower house prices? Why not. Such vague Cameroonian and Blairite messages as delivered on Monday are all well and good as a starting point, but for the electorate to truly buy into Miliband’s vision, they need something that they can get their teeth into.