Select Committee on Public Administration Minutes of Evidence

Examination of Witness (Questions 660 - 679)



  660. I ask that question because it is only about five per cent of greasy spoon cafés in Blackpool that get inspected by the environmental health people. I ask that question because we are all horrified at what happened in Rotherham with the adulterated meat and poor old Rotherham Council spent about a million pounds tracking down these people that were passing off adulterated meat meant for the pet food market into the human food chain. I wondered whether there should be a national standard on that.
  (Dr Thomson) It is not an area I could claim any great expertise in. I do know there is a Food Standards Agency which I am sure will be looking at that and at what it considers to be appropriate regulatory frameworks.

  661. Are there instances where the Local Government Association are coming to you saying that they should have national standards for those particular services or is it all the other way, that central government is saying to the local government people where the national standards should apply? With national standards must come resources. You cannot say we are going to have the same standards in Cornwall, Somerset and Lancashire without underwriting them.
  (Dr Thomson) The flexibility on finance is increased with the new White Paper with the recognition that councils need to be able to serve their communities in flexible ways. Their reliance on grant is not as complete as perhaps it has been, so resources are important. My impression is that local government wants clarity in standards. Like anyone, if you are going to be assessed as good or bad, you want to know the basis on which that judgement is to be made.


  662. Is there a single place where we can go and find out about public service agreements, we have got this, we have got that, we have got national standards? Is there a compendium of all this so that we can go and turn them all up in one place?
  (Dr Thomson) I believe the report of the spending review on the public service agreements that are published at the completion of the review is a pretty comprehensive statement of the performance expected of public services.

  663. That is the PSA system, but there are many things now that are added on beyond that, are there not? It is a question of how these things all fit together. It is purely a factual question. If I want to see the whole gamut of targets, standards, everything, can I go and turn it up somewhere? Is there a book I can go and look at?
  (Dr Thomson) I think they all do follow from the PSAs that are at a high level and from there you can follow through. I am not aware of a compendium that embraces every single service across the country. I think it would be pretty thick and pretty hard to digest if you looked at it across the board.

  664. But is that not precisely one of the issues?
  (Dr Thomson) What would make it complex is that if you want local diversity some of those standards go down to a very local level and that is as it should be, but we perhaps at this level need to know those areas to which there is a clear national commitment to a set of performance targets.

  665. Does it matter that these consumers out there have not got a clue who provides services any more or what standards they are working to, and therefore who to punish if things go wrong and who to reward if things go well?
  (Dr Thomson) I think it does matter a great deal what the public knows and does not know. One of the commitments in the government's modernisation programme is that there should be greater transparency to the public about what they are entitled to and how they should access it. Certainly the local government modernisation programme very much talks about dialogue with local communities. I recognise too that the MORI polls on public understanding of service delivery show that people are not always aware. That is why a lot of public services are now placing more emphasis on informing the public better. A better informed public will make better use and access to services. If you look across government there is a lot of priority being placed on this at the moment.

Mr Heyes

  666. I want to follow on from the points that Gordon Prentice was making about local authorities. I am still a local authority councillor. I have not been a Member of Parliament for very long; I am still doing both jobs. The local authority that I am a member of was a best value pilot authority. We have had very good best value reports consistently. We passed our local authority Ofsted with flying colours, we have good SSI reports, we have promoted a customer oriented culture. We have been okay on all the performance indicators that we have been set to achieve. We have attracted very large sums by way of bidding processes all of which involved rigorous assessment of local authority capacity to deliver along with their partners. It would seem that that is an example of a well performing council. In fact it is Oldham Council, which was declared early this week to be a prime example of public service failure, where we had riots in the streets, where we have ghettoisation in housing and education, and we are a prime example of poor community leadership. There is a very clear contradiction there which I would welcome your observations on.
  (Dr Thomson) I would agree with the thrust of your point that community leadership must be the key aspect of how we judge the performance of local government. Local government is about places and how attractive and supportive those places are for people to live in and no judgement we make about their performance should ignore that.

  667. The features of a well performing council that were listed under the proposals in the Local Government White Paper I guess would objectively rank Oldham Council as one that should have relatively more freedom with the loosening of central constraints that you talked about earlier, but the recommendations of the Ritchie Report into Oldham were that because of these failures of community leadership the response should be to send in mentors from the centre, Audit Commission advisers, consultants from the Improvement and Development Agency to give advice and help with capacity building. In fact, the form of the advice and recommendations are to do more of what Oldham has already done and apparently done successfully over the years.
  (Dr Thomson) I cannot comment on what advice has been given to Oldham in recent weeks. I would say that the framework on which local government will be assessed will include community leadership and will include the features that you are saying are important and that local communities will be judged upon.

  668. But is it not just more tinkering with managerial approaches, changing fashions? Best value was the fashion a couple of years ago and we did all that was required under that, and we are now being told that it was too prescriptive and that we need to introduce other measures. The system rolls on and a new fashion comes along and the local authority has to dance to the new tune. The real issue is about resources, surely. That is why local authorities like Oldham struggle. It is not about community leadership failing to follow the fashionable prescription. It is about resources. That is at the heart of it surely.
  (Dr Thomson) Some people are of that view. I do not think it is a matter of resources alone. Obviously resources are part of the picture. I think we have seen that throwing money at issues has not always solved the problems and there are good examples of some of the more deprived communities that attest to that. Best value requires authorities to be in touch with local people and very much strengthen the role of community leadership. I am certainly of the view that public services very often, because they are for the public, because the public value them and recognise them for what they mean, are serving their purpose.

  Mr Heyes: I will not push it too far because it is in danger of turning into a rant from me. I am quite edgy about the position this week, as you can probably tell. On that particular point, Oldham did a MORI poll on customer perception of the services and it produced extremely good results. The perception of community leadership was good. That is not a question; it is just an observation.

Mr White

  669. When you talk about being in touch with people is the problem not that it is the same people who are prepared to be involved with best value and you do not get to the people whose services you actually get at the end? Are we not in danger in what you are doing, change management, the whole thing, of getting to the same people who threaten to do it again and the chattering classes and so on without actually getting to the real thing?
  (Dr Thomson) I think everyone agrees that you need to find a whole range of ways in which the community can get involved with public services. It needs to be done at a local level and you need a strategy beyond the public meeting because that is a limited strategy for talking to people in the modern world. MORI polls are a strand but again there is a whole range of ways in which you can communicate with people in a modern world where there are lots of opportunities from telethons to the Internet, a whole range of modern ways of communicating.

Mr Lyons

  670. I should like to ask a question on the Health Service. If I were to go back to my local health board and say to them that the view of central government is, "You have to tailor and shape services for the public here", my view is that they would have me sectioned within about 20 minutes if they could. How can we change that? How can we make the reality at local level meet the theoretical drive?
  (Dr Thomson) I need to understand better what you think would meet with such surprise at the local level where you live.

  671. Let me give you one example. If I said to them, "We want local maternity services", they would laugh in my face, they would think I was off my head, because the drive all across the country—and I do not think it is any different in Scotland—is to centralise maternity. How do I deal with that?
  (Dr Thomson) I understand your point now. The need to serve the public is not inconsistent with mature and realistic understanding of how services can best be provided. I do not think it is impossible to meet what the customer wants at a local level and also for the customer to be informed about what is possible. My experience of dealing with local people around their expectations of services is that they do understand the reality of what resources are available, they like to be well informed about the best practice and on things like maternity services and other specialist health services, and I think the public always wants something local and convenient. They can be informed and persuaded by the information that demonstrates that better outcomes are to be had by providing services in a different way. I guess what I think you would recognise in the front line is that most people are trying to do a good job for people who come through the door and what they are frustrated by sometimes is that they do not have the systems or infrastructures or the modern ways of working that would make it easier for them to do that. I think there is always a wish for more resources at the front line. It would be a recognition of some of what I am describing, of it being important for excellent public services as well as a recognition of how there are still a lot of shortcomings to create the environments where people can work well and serve customers well.

  672. This is not just one example from where I live. It is across Scotland just now and certainly in major parts of England that people have had a local maternity service for over 100 years and are perfectly happy with that service—good, efficient, effective service, good medical service as well; no problems. Why should we centralise it? Why should we not keep it local when tens of thousands of people, the customers, say, "We want that to continue"? Why should we deny them that?
  (Dr Thomson) I do not know enough about the policy on National Health Service maternity provision.


  673. We are back to delivery again.
  (Dr Thomson) Obviously there is a central theme here. The public does not always find change easy, just like some members of staff do not find change easy. Some of the challenge that we are describing is both providing some leadership when there are new and better ways of doing things, provided the leadership explain when and how we need to advance in that way, as well as being tuned into what people needing the service want. Balancing that is the job of the public service.

  674. So you are giving me the okay to say that you are telling them in the department that we can keep it local?
  (Dr Thomson) If you read, as I am sure you will, the NHS Plan, its implementation produced a document called Shifting the Balance of Power which was produced this summer, which was very much about devolution. The recent Health Bill commits the Government to devolving 75 per cent of NHS funding to primary care level and that is quite a radical devolution for the Health Service. It has not yet become a reality because, as we know from making a commitment to delivering, it takes time but certainly the intention is devolution.

  675. I keep telling them things can only get better but they do not seem convinced. My second point is this. In this very room a few weeks ago I came along to a session organised by the Royal College of Nursing. There were nurses from all over England and Wales, lots of very excellent nurses, and I thought, "I must speak to as many people as I can and get a feel for what is happening in the Health Service in England". It was a quite consistent story that hardly a week would pass when there was some new arrangement, some change. I said to them, "What is wrong? Do you not agree with it?" They said, "No. Quite simply it prevents us from working and improving patient care. We want change but we do not want it to be our work every day, every week, every month. We want to look after the patient and this is an obstacle to working with the patient. Can you as a politician not do something about that?" I said, "I wish I could." How do we square that, that on the ground there is no real relationship, that change is slow and we are trying to help people, motivate them, encourage them, and they just see it as nothing other than an obstacle to them providing improved health service to the patients? How do we get round that?
  (Dr Thomson) Certainly we need to communicate what the purpose of the changes is and how it is going to make the service to the public improve. That sounds quite simple but it is not an easy task, something that is a huge task for something the scale of the NHS with its 1.2 million staff. There is, from the conversation with your nursing colleagues, obviously still a job to be done. It is part of the communication task that government is recognising: the focus on delivery should not be about continual initiatives. When you are committed enough to the proposals faced in the ten-year plans there is a consistent commitment to delivering those. That should provide a greater consistency and sense of continuity than perhaps there has been in the past.

  676. I should tell you that I have tried to say to them to help them with that, "Look; the Government are pumping millions into the Health Service", and all the nurses want is leaders here to help them get on with their work. Another point is this. You make a great deal of communication, which is quite important in my view. But does that not also give a responsibility to listen to what people have to say about the service they provide?
  (Dr Thomson) No, I think that does come with a responsibility to listen.

  677. So how do we listen to the people in the Health Service? How do we do that structurally?
  (Dr Thomson) I believe that most NHS organisations will have arrangements for listening to their staff and also increasingly for listening to patients' experiences as well. You need to listen to both.


  678. Do you think there has been an initiative overload?
  (Dr Thomson) Many people working in public services have complained of too many initiatives, but that reflects the impatience and lack of commitment to change perhaps. This agenda of delivery is trying to bring those two experiences together, a commitment to deliver, primary objectives, but to do it in a way which is more continuous, more consistent and not leading to a feeling of being overwhelmed.

Annette Brooke

  679. Is there not a danger that with this initiative we have to remove shortages of teachers and nurses and so on, this is a big bang effect rather than a gradual change and that it could actually be that what we might have to go through might just be too painful?
  (Dr Thomson) The improvement and retention of key staff is obviously important to successful services. The statistics are sometimes saying a number of things at once. I think when you see the concern about shortage of teachers that is also in part because there has been a real increase in the number of teaching positions because of the increased investment that there has been in education and it is the same with nursing and GPs in the Health Service. As you invest so you need to expand capacity and the shortfall becomes more clear. Just this week the Education Department announced a net increase of 10,000 teachers within the last three years which was in advance of the target they set for themselves. It is important that there are programmes in place to attract people into the professions right across public services.

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