Examination of Witnesses (Questions 340-359)
PROFESSOR MICHAEL BARBER, DR WENDY THOMSON AND MR GEOFF MULGAN
THURSDAY 11 JULY 2002
340. I know also that you cannot predict the future, I understand that, but can you see clouds on the horizon, for example? In your blue skies thinking did you figure that unless more money and more resources went into towns like Oldham there was going to be trouble? Does anything like that come out of your blue skies thinking?
(Mr Mulgan) There are all sorts of things we can be fairly certain of which will be big challenges for any government in ten or fifteen years time around knowledge, education, human capital, a more open global economy, adjusting to demographic change, new science, new health and so on. There is a fair amount that can be known about the likely future of different towns and cities. There is a lot of research work which does precisely what you just described there, trying to identify which places or regions are most likely to grow fastest, which are the ones which are likely to face problems. It is not our job in the centre specifically to be looking across the map of the UK and making predictions about different areas. I think that is a good example of where government does need to build up and improve its capacity to spot challenges on the horizon. One of the things which we felt was by the mid-90s that capacity in British Government had become very thin, thinner than it had been twenty or thirty years ago, which meant that often things happened that were experienced as crises or as shocks when they should have been prepared for. This Government has tried to build up capacities to avoid that happening. We are one of them and the Civil Contingencies Secretariat in the Cabinet Office is another one focused on more specific disruptive challenges that the UK may face. I think many of the departments are now building up their own capacities to look ahead, to think through different scenarios that the future might bring rather than just muddling through or acting day-to-day or just responding to events. I think this has to be good for the country, it has to be good for Government that a long-term perspective is brought to bear complementing the focus on delivery and implementation as well.
(Professor Barber) Coming back to what is nearer to the present, in the delivery planning we are asking departments to manage risk, to think about risk management, which is the short-term of the longer term that Geoff is talking about.
(Dr Thomson) And in the work we are doing we expect departments to recognise this as not just policy making but essentially having the forward strategic capacity within their own operation. That is the way of the future.
341. When is the report coming out that you are doing on ethnic minorities in the labour market? Has that been published?
(Mr Mulgan) It has not been published, but it should be coming out fairly soon.
342. I have said on many occasions that I think one of the big challenges facing us is getting Muslim women into the labour market. Have you any thoughts on that?
(Mr Mulgan) Earlier in the year we published a very extensive interim report from the project on ethnic minorities in the labour market which if you have not seen it, I will send to you and recommend. I think it is the most detailed, thorough analysis of what is a very, very complicated picture of the economic experience and performance of different minorities in different regions, very different experiences often between men and women within different minorities. It was trying to bring a much more sophisticated and nuanced view of the situation than perhaps had been the case in the past. We are now working through the policy implications of that analysis. As I say, I hope we will be publishing the results of that fairly soon.
343. One final point just going back to the discussion we had earlier about targets and who decides what the targets are. Whatever happened to the People's Panel, the Focus 5000 Group and so on? Is it still out there lurking in a corner somewhere?
(Dr Thomson) I do not think it is lurking. It came to the end of its cycle just this spring and we are in the process of finalising its final report. When Ministers have considered it, it will be published. We are doing extensive work, as I think you can see in the notes that I submitted, with departments on customers. The People's Panel has shown its success in spearheading what now is becoming normal mainstream government business which is asking people quite extensively what they think of the service they are getting and what they would like in the future.
344. Just on one of the points that you made at the end on risk management. There is a view among academics that one of the problems we face in public services is we have nobody who has any expertise on risk management, so how do we turn that around in some way?
(Mr Mulgan) We have been doing a review on risk in government which is in its final stages and which is trying to address and bring together some of the issues that Michael and Wendy have mentioned about how to bring a more systematic approach to the management of risk into the public sector. Some of that is about specific projects, big IT projects and programmes where I believe there was a fair case that there was not sufficient risk management in the past and this became quite costly for the public purse. There is a range of other issues, including risk to the public, and how we manage what is said to the public about issues like MMR or other risks of that kind. We have tried to bring that together looking at what is best practice in business, in other governments around the world. This is an issue that is being looked at in detail in Australia and Canada and many other governments and there are important lessons we can learn from them. We are looking at what that implies in terms of processes within departments and training, which would be the focus of your question, so that it becomes much more part of the general development of all civil servants that they understand risk and how it is managed in both senses of the word, both anticipating or planning or preventing negative risks but also, where appropriate, taking positive risks where there is a potential gain for the public sector in doing that.
345. The reason I am asking this is there is a related question on health and all three of you are actively involved in that in some way or another. We have this strategy, we have moved from waiting lists to waiting times, and we have had different explanations about why we do that, but at the end of the day we want to see improvements in health. There is a slight contradiction as far as I can see. In PPP or PFI most of the health projects will ask for less consultants, less nurses, less staff, less beds, so why would you want all of that when you are trying to force an improvement and deliver an improvement at the end of the day?
(Professor Barber) First of all, we do want to reduce waiting times and we also want to improve health outcomes and the Department of Health has priorities, for example, in relation to coronary heart disease and cancer which are straight health outcomes as well as reduced waiting times. One of their big challenges over the next phase is building up capacity both in terms of the physical infrastructure but also staff and a range of different means for doing so are being built into their planning and taken forward. The PFI programme is part of that build up of capacity, it is a programme that seems to be delivering improvements in capacity in exactly the way that we would want.
346. You would surely accept that it is reducing capacity in lots of areas?
(Professor Barber) I am not in a position to comment area by area but overall the hospital, and in fact wider health service, capacity has been built up very significantly over the last few years and the build up of capacity is accelerating over the next two to three years.
347. So you could give me a list of PFI projects where we have an increased number of beds, increased number of nurses and so on?
(Professor Barber) That level of detailed question would be better directed to the Department of Health. There is no doubt at all about the overall progress in terms of developing capacity, both human capacity and physical infrastructure.
(Dr Thomson) And there are new ways of doing things. Capacity does not always have to be in the same form, so part of the developments Michael was describing also includes PFIs, things that are not just building things that are hospitals but diagnostic treatment centres, walk-in centres and new forms of health care that are more convenient for the patient as well as more economic.
348. I am trying to put it in context and thinking at the same time we are working with nurses in general in the UK and probably more people leave than join. Recruitment and retention is a major problem. What do you say about that as a group?
(Professor Barber) The number of nurses working in the health service has been growing very significantly over the last year, the data shows that in the Department of Health's statistics.
349. So retention is still a major problem?
(Professor Barber) Retention in all of the public services needs to be considered. You do not want a zero turnover, you want some turnover, but you should always be looking at retention of staff as well as recruitment of them. In terms of nurses, recruitment and retention are going rather well at the moment.
(Dr Thomson) It is one of the areas that we are looking at because it is such an important strategic area for a public service that this would be a first choice career for more young people as they are seeking jobs, undergraduates coming through. There is evidence over a very long period of time that it is less often a first career choice for graduates. That is a trend that I think with this recent commitment to investment and reform and expansion of public services we can expect to see reversed.
350. On health again in terms of the delivery of health, trusts and health boards have been told "this is what we are after, this is what we are looking for at the end of the day", but if I am a trust chief executive I may well tell you that I am meeting everything you are asking and I might just fabricate the figures. How do you know that I am not doing that?
(Professor Barber) I was at a conference of NHS chief executives three days ago and they certainly welcome the focus on delivery in the health service, they certainly welcome the sense that they are part of a national transformation of the health service, and they certainly conveyed the impression to me of rising to what is an immense challenge ahead following the Budget. That is the background. The reforms that Alan Milburn announced at the time of the Budget about setting up an independent commission which is going to publish a report, not just nationally but area by area, go to the heart of what you are saying. That is his anticipation of that. All the evidence we get when we check the health service data against, for example, Audit Commission data which exists on the health service as well, suggests that the data certainly at a national level is pretty reliable and that people are very straight-forward about the data that they are putting in.
351. So how do we have reports of fabricated figures then?
(Dr Thomson) Because they were found really. The Audit Commission does audit the figures within a given health trust and the NAO does it at a national level. Obviously when one or two cases are found they are a cause of public concern but the fact that they are found reflects the fact that there are quite extensive systems to identify them.
352. I am reassured by the fact that the Audit Commission finds them but what worries me is that nobody locally will whistle blow and say "these figures are a fabrication". That must be of concern to all of us surely.
(Professor Barber) I think the changes in the way that the data is going to be collected and presented that Alan Milburn has announced will help but I would want to emphasise, as Wendy has, that we are talking about a very small minority.
353. I had better not be too specific but I had the head of one public service organisation just last week, in fact in his sector one of the most successful delivery organisations, explaining to me and drawing a graph to make a point to show me that it is inconceivable that the figures that are being reported for this service can be anything like true. All that has happened is that performance measurements have been modified to produce a story that has to be told in order to get the next dollop of money. That is just an example. Let us go back to the specific question. When you talk to people who are delivering public services in a variety of sectors and you ask them some of the questions that we have asked you about perverse consequences and so on they can readily produce examples and what is funny is that when we ask you these things you sit as the experts in all this and you cannot.
(Professor Barber) You disguised your example extremely well so it is quite hard to comment on precisely what your example represents there. When there is a big process of transformation and change going on in any given service, and I will disguise it as well, you are going to get different views, different perspectives from within the service. I was answering was the question from John Lyons about the reliability overall of the national data and the value of targets in delivering outcomes andthis is important as wellenabling the Government to be held to account for the expenditure of public money in a way which is making progress or otherwise against these key objectives.
354. Can I just try and understand how you guys work together. You live in buildings that I have been familiar with in the past and I can remember when there was a Prime Minister and a Policy Unit, they would talk a lot and have a fundamental trust in the relationship. The Prime Minister would go into the Policy Unit and meet with them and it worked quite well. Then there was an interim period when units grew and flourished and all the rest of it and finally Andrew Turnbull brought us last week the most sketchy diagramwe asked him to flesh it out a little bitwhich effectively showed the home Civil Service is now in charge of reform strategy and there is a reform strategy post to be filled, and I am sure you are not interested in political structures but I dare say it might be important to you, and somebody is going to be there and there are going to be the five units, the hybrid unit and the Treasury. It all seems rather complicated to me. Do you all sit close to each other? Are some of you in No.10, some in the Cabinet Office? How does it work?
(Professor Barber) You do not really want us to give you the addresses of our offices? That is the problem of thinking what details to provide. We see each other a lot. We have access, as my colleagues said, to the Prime Minister from time to time. We are going to be part of Andrew Turnbull's team. We will build on the informal team that has been working very well that Geoff described a few minutes ago. I think that the team will be a very strong team actually meeting very much what you said in your report in April 2001 for the Cabinet Office remit. The reform post is not another bit of line management on the organogram it is off to the side because that is what Andrew Turnbull wants to lead on personally. I think he described that to you last week. I think that we will be a strong team with a much clearer remit driving forward delivery and reform in all the different ways that we reflect that.
(Dr Thomson) I think the structure outside government is a fairly common one. If you look at the centre of a lot of modern organisations you will see a strategic capacity, performance management capacity, HR, organisation development capacity, some sort of partnership function. ICT is probably the most strategic resource for the service sector, the retail sector, at the moment. It is a pretty common structure really. It may not have been in the centre of UK government but I think it is probably present in most big corporations and probably in a lot of governments.
355. Can you just tell us why is this reform strategy, albeit important, on this little stalk? What is it going to do that you do not do because you do reform as well?
(Dr Thomson) The specific responsibility that Andrew Turnbull has taken is for Civil Service reform and my office will be leading on public service reform and ensuring that the relationship between those two is an effective one.
356. I would be interested to know where you are all based. Are you in No.10?
(Dr Thomson) We (myself and Professor Barber) share an office in No.10 and we share a building across the road so we are fairly co-located if you are really interested in it.
357. That is as it will stand?
(Dr Thomson) Until the next Cabinet Office accommodation strategy which you know as well as we do is a pretty continual process.
(Mr Mulgan) We do not have quite such wonderful accommodation as this. It is the case that bits of the centre are dotted around Whitehall. My team is in Admiralty Arch. Thanks to walking distance, e.mail, meetings and so on co-ordination happens very well. I think it is about as simple a structure as you could imagine for the heart of something as complicated as a government.
358. The Committee was reminded last week that Mr Attlee made very substantial changes to the government without delivery units and Harold Macmillan built hundreds of thousands of houses without a single unit to help him.
(Mr Mulgan) If you look in detail at the structure of government in the 1940s it was incredibly complicated.
359. We were told they had committees of civil servants, this was pre the think-tank. They just impressed their will on the department.
(Professor Barber) During the war when Attlee was Deputy Prime Minister they fixed the price of fish daily from central government. It was a very different era with an awful lot of centralised control in a way that was quite different from now.
(Mr Mulgan) Micro management.