Memorandum by the GMB Union (PSR 24)
The GMBBritain's General Unionwelcomes
the opportunity to submit written evidence to the Public Administration
Select Committee. The GMB represents approximately 200,000 employees
in public services, many of whom have had direct experience of
private sector involvement in service provision.
Principles and Strategy for Reforming Public Services
1. What should be the principles guiding
the reform of public services?
Quality, reliability, accountability and value
for money. It should also be about motivating and empowering public
service workers to do their jobs well.
2. Does central government have clear principles
and an effective strategy for reforming public services? Does
it need to have a strategy at all, or is it better to let public
bodies make their own arrangements for improving services?
There seems to be some confusion in government
thinking. There has been talk of the value of public services
and the public service ethos but also an ideological commitment
to increasing private sector provision of public services. Private
Finance Initiative procurement has, in the words of the Office
of Health Economics, been "artificially promoted". The
Government mantra has been "what matters is what works"
whilst PFI credits in local government for instance have meant
that local authorities have no financial alternative to outsourcing.
The GMB would like to see a level playing field between public
and private provision of services. A recent survey by the GMB
of our senior officer and chief officer members in local government
showed that over half believed that the Best Value regime was
a route to privatisation "regardless of quality of service."
The Government has been promoting change and
experimentation in the public sector whilst imposing strict national
targets in health and education and a rigid inspection regime
in local government. The GMB agrees that standard setting is an
important tool but believes that public service bodies should
be allowed more flexibility in delivering these standards and
operate within a financial regime which allows for alternatives
to outsourcing and PFI deals.
The GMB welcomes the Chancellor's recent statement
of commitment to a publicly funded NHS.
3. Do the devolved institutions and local
government have clear principles and effective strategies for
reforming public services? Could there be a role for strengthened
Local authorities should be allowed to develop
their own strategies for public service reform, however, the current
inspection and financial climate undermines this aim.
The GMB supports regional government provided
it has real legitimacy and democratic accountability. We believe
that regional government should take powers from Whitehall and
bring them closer to the electorate but should not replace local
government. Effective regional government would allow for better
co-ordination and planning of resources across regions.
What would be the consequences if there were
significant differences between the policies adopted by central,
devolved, regional and local government on public service reform
If devolved institutions have genuine powers
then this would be an inevitable consequence of local democracy.
This would be a positive opportunity to experiment with different
models and tailor policies to particular local needs and priorities
4. How do we know if public service reform
Effective consultation with service users and
the workforce. The achievement of rigid national targets alone
is not sufficient because concentration on targets alone can mean
that other service areas may suffer. Public service workers are
an untapped resource, and are not often enough fully involved
in service review and reform. They are inadequately empowered
to improve the services they provide. Public service workers are
also service users and therefore have a unique insight into the
effectiveness of provision and potential areas of improvement.
The Concept of a Public Service Ethos and the
Involvement of the Private Sector
This issue will be examined in the first part
of the inquiry.
Is the concept of a public service
5. Is there a public service ethos, and
how can it be defined?
Public service ethos can be defined as a desire
to contribute to the wider community. It is an ethos which seeks
reward from a sense of purpose in a job rather than just individual
financial gain. It is public service ethos which motivates low
paid GMB members such as care assistants and hospital ancillary
workers to continue with stressful jobs in often poor conditions
when they could be earning more working at the local supermarket
The primary purpose of any private company is
profitby their very nature, and company law, private companies
are required to put the interests of their shareholders first.
Railtrack is a prime example of a company which considered the
payment of dividends to its shareholders a higher priority than
investment in a safe and efficient rail network.
Private companies are increasingly involved
in school sponsorshipthe payback being that they can get
advertising materials for their products in front of schoolchildren
("Schools offer excellent opportunities. Not only are
they a high traffic sales generator, but students are some of
the best customers you could have." McDonalds Operations
manual). This is an anathema to the public service ethos.
The GMB is concerned that the public service ethos is being destroyed
by stealth. We believe it should be nurtured and encouraged rather
than subjected to cynicism.
6. How is the public service ethos different
from the private (or voluntary) sector ethos?
The voluntary sector ethos is similar to that
of the public sector. Many people join the voluntary sector in
a desire to "do something worthwhile" with their lives
and give something back to society. The GMB is not so naive
to believe that all public and voluntary sector workers are paragons
of virtue compared with those in the private sector. We do, however,
believe in the ethos of an environment where the one overriding
purpose is not the search for profit.
The voluntary sector often acts as a powerful
advocate for disenfranchised or disadvantaged groups in society.
The private sector, understandably, only takes an interest in
those it considers to be good potential customers.
In the private sector competition drives improvementif
a customer receives poor service they look elsewhere. Large companies
in the private sector would generally prefer not to have competitionthis
is why competitors are so often bought out. Cartels and monopolies
have great appeal for private companies. This is why anti trust
and monopolies and mergers legislation exists. To give the private
sector a monopoly on a 30 year PFI contract is the worst of all
worlds"customers" are unable to shop around for
schools or hospitals yet they will be run for a profit motive.
Some areas of social provision require accountability, and not
merely accountability to shareholdersthis way only the
wealthy have a voice and major stakeholders are excluded.
Is a public service ethos necessarily a good
thing? Can it be an obstacle to the effective delivery of services
to the public?
The GMB believes that a public service ethos
is positive. This ethos remains strong among GMB workers in front
line such as nursery nurses and homecare assistants. They often
work extra hours , or run marathons to pay for extra equipment
for their hospital. If you ask our low paid NHS ancillary workers
why they remain the common reply is because they want to work
for the National Health Service. This is one reason (amongst many
others) why so many of our members resent being transferred to
A criticism often levelled at public sector
services has been a lack of focus on the customer and a lack of
flexibility. This has to be seen in the context of declining resources,
constant criticism, restructuring and reorganisation. Demotivation
is hard to overcome once entrenched in any workforce. It has led
to a bunker mentality in some areas. This is often caused by outdated
management practices, blame culture and hierarchical structures.
Every mistake made leads to an inquiry and resulting new "procedures".
Services become process rather than outcome led. These problems
need to be addressed. Handing over services to private contractors
may often seem an easy solution but the GMB does not believe that
it will produce the step change required for our public services.
It will certainly not harness the idealism of many public service
10. Would the creation of a single public
service help a public service ethos?
The GMB does not believe that this would improve
mattersit would risk the creation of a monolithic bureaucracy.
There does, however, need to be more co-operation between independent
servicesone stop shops for housing and benefit advice for
11. Is it possible for profit-oriented organisations
to maintain the public service ethos?
The problem for private providers is that their
primary loyalty is to shareholder interests. Not for profit organisations
are more likely to retain public service ethos. Workers transferred
to the private sector find conflicting loyalties and they become
isolated from other public service workers. When hospital cleaners
transfer to a contractor they are no longer part of the same team
as other hospital workers. Council workers lose the sense that
they work for the community. This undermines joined up thinking
by public sector providers and leads to fractured services. The
GMB considers that profit-orientated organisations are less able
to respond to changing service needs due to the prescriptive nature
The GMB would question whether private contractors
would go that extra mile in times of civil emergency or crisis.
There have been reports from North Durham Hospital that doctors
were forced to use ambulances move patients around the hospital
because the PFI provider stated that this task was not included
in the portering contract (Guardian 23 July 2001). Such situations
can be put right (often expensively) but it illustrates the inevitable
differences of ethos between private and direct provision.
The potential conflict of interest between the
profit motive ethos and service need were illustrated by the leader
of Falkirk council at a meeting of the Scottish Parliament Local
Government Committee on 15 May 2001. He stated that the PFI contract
to run schools in Falkirk had been expensive and had led to a
number of problems concerning extra curricular activities and
the out of hours use of school premises. He stated "there
are additional charges for out of hours services at PFI schools"
and that the PFI contractor has priority use of schools out of
hours for profit making activities. On one occasion children's
luggage was left in the street after they returned from a field
trip because they were not given access to the school. The public
service ethos which motivates teachers and other staff to engage
in extra curricular activities has now been undermined by the
profit motive. The GMB believes that such scenarios will be replicated
across the school sector with the expansion of PFI.
12. What measures, if any, need to be put
in place to ensure that the search for profit does not undermine
the public service ethos?
The GMB would argue that when public services
are run by for-profit organisations, purpose and ethos is inevitably
changed. The purpose of a cleaning contractor in a hospital is
ultimately to make profit. The purpose of an NHS cleaning team
is to keep the wards clean. Four out of the five NHS Trusts that
recently received "red lights" for poor cleanliness
used private contractors for cleaning. One of the reasons given
for this was that lines of management and accountability were
undermined by the use of private contractors.
Measures need to be put in place to ensure that
private contractors do not have the opportunity to increase their
profits by cutting the terms and conditions of staff, or hiring
new staff on worse terms and conditions than staff transferred
from the public sector. This is the reason why the GMB, together
with other public service unions and the TUC are supporting the
adoption of a new fair wages resolution to guarantee that all
workers involved in the provision of public services are entitled
to decent terms and conditions. There is nothing more damaging
to the public service ethos than the creation of two tier workforces
and the perception by public service workers that their pay, holiday
and pension entitlements are being cut to pay for increased dividends
13. Can lessons be learned from the experience
of private sector involvement in public services in other countries?
Other major European countries such as Germany
and France have historically different structures for health provision
for instance than the UK. The role of the private sector in their
healthcare systems is greater than in the UK but the significant
difference is that there has historically been more public investment
in healthcare. The Conservatives have recently been saying that
public spending on health in the UK is broadly comparable with
that in France and Germany, the difference in investment in health
is made by the private sector. This is clearly untrue. In 1997,
according to OECD figures, public spending on health was
5.8 per cent in the UK, 7.1 per cent in France and 8.3 per cent
in Germany as a proportion of GDP.
In both France and Germany private healthcare
acts as a top up for the better off members of society. In July
this year it was reported that Germedic, a German private health
company, were marketing their services to British Health Authorities
in order to take patients on NHS waiting lists. Newspaper reports
at the time claimed that the German healthcare system has 20 per
cent overcapacity to fill. In August the GMB National Officer
for Health visited Stuttgart to look at the German health system.
She was told by health workers there that overcapacity is a feature
of German private hospitals. In some areas Germans are waiting
for treatment whilst private hospitals look to fill their spare
capacity with profitable patients from the UK or Norway. It is
not surprising that nearly 80 per cent of Germans believe that
the Government should be responsible for providing healthcare
(EU Opinion poll).
In France, although the quality of healthcare
is excellent, there is far greater health choice in wealthy areas
because private hospitals will only open where there is a good
client base. Divisions in access to healthcare according to wealth
are becoming an increasing source of concern and is a weakness
of a system of a public private mixed market. All emergency treatment
in France is undertaken at public hospitals. The GMB spoke to
the Federation Hospitaliere de France in September this year who
told us that France would never allow private sector management
of public hospitals because of their crucial role in providing
emergency and long stay treatment. It is also worth noting that
healthcare in France is not a free marketco-operation between
private and public hospitals is tightly regulated by regional
government to help plan healthcare provision.
The GMB believes that the UK can learn a great
deal from countries such as France and Germany but there is no
evidence that these countries have high standards because
of the role of the private sector. Sweden has high health standards
and the highest percentage of health care workers in the EU. The
private sector, however, plays a very small role in the Swedish
Swedish health authorities have experimented
with private sector management of hospitals. It should be noted,
however, that in Sweden it is considered essential that that local
councils (who have responsibility for health) retain control of
the hospital buildings as a safeguard against underperforming
contractors. There is far more accountability in this system than
under the British Private Finance Initiative. Even so, the Swedish
Government passed legislation in response to public concern which
bans the private sector from being involved with the operation
of "emergency hospitals".
14. Do private sector people working in
and around government, including secondees, task force members
and others, undermine the public service ethos? Are special measures
needed to regulate their activities and prevent possible conflicts
There is a danger of conflict of interest where
private sector people have influence on government policy decisions
relating to public service reform. There should adequate guidelines
surrounding the employment of civil servants by private contractors
when civil servants have been involved in policy in this area.
The GMB believes that vested private sector
interests have too much influence over government policy in this
area. The privatisation of the Treasury PFI task force to create
Partnerships UK has meant that PFI contractors such as Jarvis
and Serco have direct influence on "government" promotion
of this policy through their part ownership of PUK. The GMB believes
that PFI has effectively been a means by which taxpayers subsidise
private companies with little independent scrutiny or open debate.
In October the government announced the creation
of a "strategic partnering taskforce" to provide "support"
to local authorities on developing partnerships. Out of 27 members
of the taskforce, 24 come from the private sector. Members include
contractors such as Amey, CSL and Hyder Business services as well
as KPMG who have benefited enormously from consultancy in the
PPP area. This again represents powerful vested interests involved
in policy development.
The GMB does not believe that the Government
should commission any more reports on the effectiveness of the
Private Finance Initiative from consultants that themselves receive
financial gain from the policy.
15. Many companies are becoming increasingly
aware of social and ethical issues. Does this make them more suitable
for work in partnership with the public sector, or does it make
Some companies have a distinguished record of
social responsibility such as Rowntrees and Boots, but they are
very much the exception in the UK. The quote from free market
economist Milton Friedman "if businessmen do have a social
responsibility other than making maximum profits for stockholders,
how are they to know what it is?" sums up the attitude of
many British companies towards social responsibility. Currently
only 4.7 per cent of the total charitable donations in this country
are given by business (UK Voluntary Sector Almanac).
Private companies do not get involved in public
service contracts for charitable reasons or out of any sense of
social responsibilitythey do it for profit. Balfour Beatty,
a major PFI contractor, announced this year that its operating
profit from building management and services increased by 57 per
cent largely as a result of PFI. PFI appeals to such companies
because it offers long term contracts with predictable margins
and little risk. Social and ethical issues are irrelevant to "partnerships."
An investigation by Health Service Journal (13 may 1999) showed
that building contractors are "expecting returns of up to
20 per cent a year on the equity stakes they hold in (PFI) project
companies." The GMB considers that this is unacceptable,
especially since PFI is often subsidised by the taxpayer.
The fact that there has been concern that the
public sector needs to enhance its procurement skills illustrates
that companies contracting for public services will always seek
to negotiate contracts which will maximise profitit would
be naive to expect any other outcome.
16. Do the views, motivations and attitudes
of public sector workers differ from those in the private sector?
Does any difference in motivation have an effect on the delivery
of public services?
Research conducted by Hay management consultants
for the Cabinet Office has shown that for complex and senior jobs,
base pay rates in the wider public sector are roughly 25-30 per
cent below the comparable private sector rate (Strengthening Leadership
in the Public Sector, PIU March 2001). Such workers are evidently
motivated by something other than monetary gain.
The GMB does not believe that the attitudes
of our public service members automatically change when they are
transferred to private contractors. Demotivation is caused, however,
by the uncertainty of the transfer process and by the cuts in
terms and conditions and pension entitlements that are so often
a consequence of such a move. Motivation is further undermined
by the creation of a two tier workforce.
GMB members in the homecare sector who find
themselves transferred to private contractors consistently complain
that their ability to give quality time to clients is undermined
by stringent rules concerning the amount of time they are allowed
to spend on each job and the level of support that they are allowed
Private contracts are usually tightly specified
and service level agreements written in stone. The GMB believes
that this stifles innovation and flexibility in public service
The Government has ambitious plans concerning
public service reformit is essential that the workforce
feel empowered and motivated to deliver the step change in service
quality demanded of them.
17. There is conflicting evidence as to
whether the public is in favour of private sector involvement
in public services (MORI polling, June 2001). What in your view
is the truth about public attitudes?
We often hear that "the public do not care
who provides the service as long as it's provided." The GMB
believes that this is to miss the point. Our argument is that
there is little evidence that improvements in service standards
will be delivered by the private sector and that there is no public
will for privatisation to be expanded . An opinion poll conducted
by MORI for the GMB in August 2001 showed that for 65 per cent
of respondents the involvement of the private sector in public
services was an important factor in their voting intentions. The
GMB does not believe that Labour was re-elected this year because
the public wanted more privatisation.
The electorate rarely if ever are given the
opportunity to choose whether services are outsourced or not.
No matter which political party controls a local authority the
Best Value process and the local government finance regime will
encourage outsourcing. It would be ridiculous to claim that the
privatisation process is driven by the democratic processit
is driven by persistent lobbying by private companies at national
and international level for government to open up lucrative public
service "markets." The people of Islington and Lambeth
who received eviction notices because their housing benefit had
not been paid did not vote for the takeover of housing benefits
by a private contractor.
"Commercial confidentiality" often
means that the full implications of PFI projects remain hidden
to the public. The £900 million land deal associated with
the Edinburgh Royal Infirmary PFI project only became known after
a civil servant leaked the details to the press. When Kidderminster
hospital was downgraded to help finance Worcester Royal Infirmary
local residents certainly did careelecting anti PFI councillors
to their local council and Dr Richard Taylor as their MP in protest.
PFI continues at Worcester illustrating that the public have no
say in privatisation issues. The same can be said for the London
Underground PPP project which continues despite the opposition
of the majority of Londoners. It is fatuous to speak of conflicting
opinion poll evidence when the public clearly have no real influence
on these matters.
18. If there are to be rules regulating
private sector involvement in public services, should they apply
also to, for example, the voluntary sector? Should there be less
stringent regulation where profit is not involved?
A private care home should have the same standards
expected of it as voluntary sector or local authority care home.
The Care Standards Bill addressed such issues and was welcomed
by the GMB. There should be a proper regulation framework for
all public services whatever the provider.
19. What kinds of accountability are most
The GMB believes that the best kind of accountability
is that of local democratic scrutiny and choice. We believe that
this is being undermined by wholesale privatisation of services.
Average turnout at local elections is declining and currently
stands at only 30 per cent. This is partly due to a long process
of reductions in local authority powers and increased central
control of local government. With the expansion of PFI there is
a danger that councils will only have to meet once every 30 years
to renegotiate contracts.
The GMB also believes that there should be more
service user and workforce involvement in service reform and improvement.
The Local Government Act 1999 gives local authorities a statutory
duty to consult service users. The GMB believes that a similar
statutory duty to consult the workforce would send a powerful
signal that employee involvement is taken seriously in public
20. Is there sufficient coherence in the
accountability arrangements for public services?
There need to be more effective mechanisms for
accountability in public services. This was well illustrated by
the inquiry into the deaths of children at Bristol Royal Infirmary.
There needs to be a greater push for internal accountability and
a move away from old fashioned hierarchical structures which prevent
non management staff from having adequate input into mechanisms
for improving services.
21. Is there too much accountability, or
The GMB believes that there is too little accountability
in the reform of public services. Traditionally the ultimate accountability
has been local politicians, to their electorate. With the involvement
of third parties (contractors) the public are now one step further
removed from the service in terms of accountability.
This year's Audit Commission report on Welsh
Public Services ("Better Value Wales") stated that "private
sector contributors claimed that the Welsh public sector had a
pre-occupation with direct control over the way in which public
services were delivered". (Para 4.8 "Doing business
in Wales"). The GMB believes that this direct control is
an effective tool of local democracy, and as the experience of
housing benefits has shown, a far more effective way of delivering
22. Does the new pattern of public service
provision require new forms of accountability?
The provision of public services by private
contractors automatically creates a conflict of accountability
between service users and shareholders. For private companies
shareholders will always come first. One way to deal with this
issue is through the creation of not for profit trusts or have
companies owned by local authorities themselves. There are already
a number of arms length companies and Leisure trusts operating
in local government.
23. In the Government's overall programme
of public service reform, is the need for accountability to Parliament
and to other bodies properly taken into account?
Recent events concerning the attempted removal
of a few respected members of Parliamentary Select Committees
suggests that there is not enough commitment from government for
proper scrutiny of public service matters. The GMB believes that
up until now there has not been real debate on the use of the
Private Finance Initiative and a lack of proper research from
public bodies which demonstrates that it provides either value
for money or improved services. The GMB does not consider that
reports commissioned from private companies with vested interests
in PFI (such as Price Waterhouse and Mott MacDonald) constitute
independent analysis by government bodies.
24. If the answer to the above question
is no, what measures should be put in place to ensure better accountability?
The GMB believes that more independent information
should be made available to the public on the expansion of the
use of the private sector to deliver public services. This is
particularly the case in relation to the Private Finance Initiative.
Justification for PFI has variously been given as the need to
keep public spending "off balance sheet" (this has now
been discredited), value for money (no independent evidence that
this is the case), and the need to bring private sector management
skills into public services (private contractors are hiring in
expertise from the public sector in any case). The fact that taxpayers
have not been given a clear, consistent rationale for this expensive
scheme suggests serious lack of accountability.
The GMB particularly welcomes this Select Committee's
inquiry into public service reform.
25. Does the growth in private involvement
in public services threaten to reduce public accountability?
The GMB is concerned that private sector service
providers are insufficiently accountable for the services they
provide. We have already submitted to this select Committee evidence
relating to Capita plc and the cancellation of its contract with
Croydon LBC. Capita required a guaranteed base payment whether
they provided an adequate service or notwhich Croydon would
not accept. Capita have also threatened legal action against Lambeth
LBC if their failing benefits contract was terminated and ITNet
threatened legal action against Hackney LBC after it was dismissed
from that benefits contract.
The most beneficial contract for a private sector
provider would be one where they have guaranteed long term income
with little accountability or consequence of failure. The GMB
believes that there should be an independent inquiry into the
type of contracts that public bodies are signing up to and mechanisms
put in place to ensure that contractors are always fully accountable
to the client body.
The GMB believes that the expansion of the Private
Finance Initiative will fatally undermine the democratic accountability
of our public services. PFI contracts are by their nature too
long and inflexible to allow for changing local priorities and
26. Do the demands of commercial confidentiality
threaten the accountability of public services when the private
sector become involved?
This has proved to be the case in a number of
PPP projects. The "secret" land deal associated with
the Edinburgh Royal Infirmary PFI project has been previously
mentioned under question 17. The secrecy surrounding the Ernst&Young
report on the London Underground PPP is a prime example of "commercial
confidentiality" being used to undermine public accountability.
Service Users and Public Service Reform
27. Does the Government's public services
reform programme have sufficient focus on users and consumers
of those services?
The GMB believes that service users have to
struggle to make their voice heard on public service reform issues,
the examples of Kidderminster hospital and the London Underground
PPP were given earlier.
The GMB agrees with the government that the
focus of health reform should be patients and that the focus of
education reform should be pupils. Our emphasis on the importance
of decent terms and conditions for public service workers has
led to accusations that we represent "vested producer interest."
The Prime Minister himself has said that "I don't believe
that that is the way to provide a better service, to reduce the
terms and conditions of the staff. And I just think that's obvious"
(Guardian interview September 2001).
The GMB does not believe that the interests
of users and consumers of public services and those of public
service workers are mutually exclusive. We would like to be given
the opportunity to work in partnership with the government in
bringing UK public services up to standards of excellencecurrently
the term "partnership" is almost entirely used in the
context of the private sector. The GMB does not believe that the
Private Finance Initiative is partnership - it is a straight commercial
The evidence of the Private Finance Initiative
so far is that there is too much focus on the needs of the private
sector provider and not enough on service consumersthe
earlier example of the effect of PFI on extra curricular activities
in Falkirk (question 11) is an illustration of this.
The GMB recently had the opportunity to view
aspects of private contractor bids for Newcastle City Council's
schools maintenance PFI project. One contractor stated that "we
understand and share the authority's view that a "best value"
service is about quality, efficiency and competitiveness which
consults and takes into account the views of the client."
By client they meant the councilthere was no mention of
28. If not, how can the position of users
and consumers be strengthened?
Users and consumers need to be given real choices
about options for service provisionnot told that the only
way to provide investment in services is to use the private sector.
There must be mechanisms to ensure that the needs of service users
are put before profit. There needs to be more openness, consultation,
public access to information and accountability.
29. Should user rights be established in
relation to public services?
User rights can be a useful tool for promoting
30. If so, how could these rights be exercised
Possibly through the imaginative use of service
level agreements especially where service users are a "regular"
clientele such as in care homes and schools. The statutory duty
placed on local authorities to consult service users could be
extended to all public service areas.
31. Could the Citizen's Charter/Service
First approach be further developed?
The fundamental flaw with the Citizen's Charter
and similar initiatives is that they tend to measure response,
rather than quality of response. An example of this would be that
a phone help line may hit a target of response within 6 rings,
but this does not measure the quality of the response given. Such
targets are common in unimaginative service level agreements and
frustrate staff whilst doing little to improve service quality.
The GMB believes that there needs to be more
emphasis on service user feedback as a measure of quality and
less on the achievement of statistical target measures.
32. Are complaint/redress systems for public
service users adequate and effective?
This will vary between local authorities and
public service bodies. One of the weaknesses of private service
provision, especially over long term contracts is that it creates
separate lines of accountability, encouraging both client and
contractor to blame each other when things go wrong (as was the
case with Lambeth LBC's benefits contract). It seems self evident
that if a member of the public was to complain to their local
councillor about services provided by a PFI contractor then the
councillor will have far less influence on that service than if
it was directly provided by the council. This will especially
be the case if the contractor is performing to the strict terms
of its service contract.
Moves by the government to abolish Community
Health Councils in the NHS do not inspire confidence in their
commitment to service user rights and adequate redress systems.