PLC Public Sector reports:
The government’s 2011 public services White Paper, Opening Public Services, advocated a greater role for the service user in choosing and controlling the way that they receive public services. This built on policies introduced by the previous government (for example, relating to direct payments). The momentum behind the approach has continued to grow throughout the term of the current government, culminating most recently in the government commissioning an independent review by David Boyle into the barriers to choice in public services. The report findings were published in January 2013.
Choice and control seem set to remain central to government policy through to the next election, with May 2013 seeing the:
- Government reinforcing this message in its latest update on the White Paper.
- Welcoming of David Boyle’s findings in the government’s initial response to his review.
- Publication of a new “Choice Charter“.
This post looks at the key points to note in these latest developments.
White Paper update
The update on the White Paper focuses on the government’s achievements to date, highlighting the following developments:
- Individual services. This includes expanding the Academies programme and introducing Free Schools; devolving the NHS budget to clinical commissioning groups; introducing pilots for greater flexibility on GP registration; consulting on the expansion of personal health budgets to more than 50,000 patients in receipt of NHS Continuing Healthcare; and introducing a cap on reasonable care costs.
- Neighbourhood services. Introducing the Community Right to Challenge; a business rates retention scheme; community budgets; directly elected Mayors and Health and Well Being Boards.
- Commissioned services. Introducing payment by results. In the update the government commits to further expansion in this area in rehabilitation services, international development and skills/work programmes.
- Diversity of provision. Providing for innovative funding structures such as social impact bonds and providing support in this area through initiatives such as Big Society Capital and the Social Outcomes Fund; and the ongoing development of public service mutuals spinning out from the public sector.
- Enabling open public services. Creating the new What Works centres; establishing the Commissioning Academy and the roll out of new digital platforms and strategies.
Government’s response to the Boyle Review
In its initial response, the government has welcomed David Boyle’s report. The response includes a table of responses from the government on some of the specific recommendations made in the report. These responses highlight how important the Care Bill will be in delivering the policy goal of increased service user choice, with the government highlighting that the Bill will place duties on local authorities to:
- Provide an information and advice service that will, among other requirements, provide sufficient information to enable a person to make plans for their future needs for care and advice.
- Promote a diverse, high quality and sustainable market so that people have a variety of services and providers to choose from.
The response acknowledges that it will be up to local authorities to determine the best way to execute the second of these new duties. A key concern must be that, at a time when it has been confirmed that Eric Pickles is again among the first Secretaries of State to sign up to new cuts in revenue, imposing an obligation to create a market may be a task that some local authorities will not be best placed or resourced to carry out.
Choice Charter
Finally, the government has also published a “Choice Charter”. It aims to ensure that people have a clear understanding of the choices available to them; that services providers are held to an ambitious standard; and that users know how to seek redress when those expectations are not met. The Choice Charter will sit above a series of individual Choice Frameworks setting out the specific choices available in NHS care, social housing, school education, funded early education and adult social care.
The Charter contains four key messages to service users. They:
- Can have a say in how a public service is provided to them.
- Will be given the opportunity to take up and exercise the choices available.
- Will be given clear, accessible and high-quality information and advice to inform their choices.
- Have clear avenues to complain if they do not receive the choices they are entitled to.
While it may be easy to dismiss initiatives such as this as little more than government marketing, providing details in one place of all aspects of service user choice in a particular area could play a role in promoting the take up of these options. However, one concern must be that this does not immediately present itself as the solution to one of the key problems highlighted in David Boyle’s report; the more disadvantaged a service user is, the less likely they are to engage and exercise the options available to them.