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Yorkshire Post - 2006
What have these two statements got in common? No 1: “They don’t answer letters. They don’t even read them I think. They just generate a generic response, wait a few days, then send a standard reply. Nobody seems to be in charge and making a complaint is like piddling in the wind-you’ll get a letter from another poor sod who has no idea what has gone on before.”
No 2: “There will be less bureaucracy, more money to invest in front-line services and better care for patients.”
The first quotation is the most printable part of a message from a constituent- the first e-mail waiting for me in the office last Thursday- relating his experiences with the Government’s policy on tax credits. The second was – no surprise – the Department of Health explaining the advantages of its programme of merger of ambulance services.
They illustrate two of the abiding characteristics of this government: the rushed introduction of schemes before they are capable of being “delivered” (to use one of the Government’s favourite words) and the mania for merger of organisations in the interests of increasing “capacity.”
These issues will form a major bit of the not-yet-departing Blair legacy.
Let’s start with the rushed roll-out of schemes. There are two particular examples of this- glorious, technicolour, all-singing and dancing cock-ups (not a Government expression.) The bigger, in sheer size, was Gordon Brown’s tax credit programme. There is not an MP in the land who will not have seen the following sequence of events: application followed by total silence; overpayment of claim; letter from the Inland Revenue blaming the recipients for not realising they had been overpaid; a schedule for repayment (or, in some cases, ignoring the over-payment.)
This was Gordon Brown’s brainchild. The bulldozing Chancellor can never be told he is wrong. He will not take criticism. The Treasury has been drained of the will to offer constructive advice and his political courtiers are there to applaud.
For the Government’s second great shipwreck we are indebted to Mrs Margaret Beckett. She negotiated a reform of the notorious Common Agricultural Policy- and it was a good reform. Then came implementation. She was determined to stamp her signature on the transformation. For England (never forget that much Government policy only applies to England in this age of devolution) she chose to introduce the most complex variant of the new scheme, in the shortest possible time-scale, which means introducing tens of thousands of new claimants at a time when the delivery machinery had been re-organised and the IT systems were known to be clinging on for dear life.
This was a decision in search of a disaster – and it didn’t have far to look. The result has been a melt-down in the system of making farm payments, a cash-flow crisis across the countryside and the desperate resort (too late) of making partial payments.
Farmers in Scotland, Wales and Northern Ireland, where administrations chose a much simpler system, have, in general, had their full entitlement for months.
Let us leave aside the problems the NHS has had in absorbing the increased cash the Government has decreed, not least because of the Government’s utter inability ever to get an estimate of cost even approximately right and turn to structures. Size rules, OK.
The Government has just announced the merger of Patient Care Trusts – the bodies which set local health care strategies and commission services. Yorkshire and the Humber comes down from 34 to 14. Serving a population of 765,000 North Yorkshire will have the country’s third biggest trust after Hampshire and Surrey. A single ambulance trust will serve the whole region.
Charles Clarke, recently sacked as Home Secretary, was set to ram through Police mergers in the interests of creating “capacity.” Yorkshire is to get a single force. Fire and Rescue services have already been regionalised. Army regiments have been amalgamated to increase capacity and flexibility.
The planned elected regional assemblies for Yorkshire and the North-West may have been abandoned and the proposal for the North East went down to a thumping defeat at the hands of an electorate which thought that “more politicians” was not the answer to any conceivable problem they might have had but the relentless drive towards bigger units goes on.
Of course not all the logic should be dismissed. There is a case for aligning health and social services within the same boundaries (the main argument for PCT re-organisation) provided that management remains absolutely committed to local identity and action. There was also a case for the re-organisation of regiments, however cack-handedly the Government went about it.
But capacity is not the only virtue. Flexibility, responsiveness to local needs, maintaining strong roots in local communities and being accountable to them are also hugely important. For services like the Police, health and planning this is particularly true. The costs of alienation would be huge.
The Government talks about devolving powers to local communities – to local organisations in the voluntary or faith sectors or neighbourhood activists. Double devolution is the buzz-word: from Government to councils and from councils to localities. Yet it is all the time creating ever-larger and more remote bureaucratic structures. Like so much else with this government the impatience for action has too often overruled the concern for efficient delivery.
Ask the harassed mother with her forms for family credit. Ask the over-drawn farmer living off the tolerance of the bank manager. Inquire of the hospital administrator who has been told he must “live within his means” and pick up the pieces for the Government’s innumeracy.
Couldn’t a government minister ask just one more question as D-Day for yet another “roll-out” approaches: will it work?
© Yorkshire Post
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