Examination of Witnesses (Questions 360-375)
PROFESSOR MICHAEL BARBER, DR WENDY THOMSON AND MR GEOFF MULGAN
THURSDAY 11 JULY 2002
360. We have not currently got a war on, have we?
(Professor Barber) That is true. That mentality of planning and organisation flowed through, as you very well know, in the late 1940s.
361. Our deepest suspicion until recently has been that the Prime Minister is trying to create a presidential office and he needs lots of people to do this but I have rather changed my mind and my current suspicion is that the head of the Civil Service is actually reining the whole thing in after all and the plan to have a Prime Ministerial office has changed somewhat. Do you have any view on this?
(Dr Thomson) I think Andrew Turnbull's paper makes clear the way he sees the role of the centre of government supporting the Prime Minister and the Cabinet and that is the key role of the centre of government.
(Mr Mulgan) It has been suggested there has been a big change here but I do not think there has. In my case, previously I reported to the Prime Minister through Sir Richard Wilson, now I report to the Prime Minister through Sir Andrew Turnbull. There is no change of the principle there. The Cabinet Office continues to support the Prime Minister and the work of Government as a whole.
Sir Sydney Chapman
362. Following the last election there were three central units, there are now to be six. Surely no matter how you streamline your functions it is a recipe for more bureaucracy and more distance from effectiveness.
(Professor Barber) That is not quite an accurate account of what occurred. The e-Envoy's office existed before, the OGC existed before, the function that Alice Perkins will head on human resources and so on exists now. What Andrew is doing is bringing those functions together around the corporate structure which, as Wendy said a few minutes ago, is very close to what major corporations and other large organisations, like local authorities, have in their management structures. There is no creation of new units in Andrew's proposal, what there is is a step forward in the co-ordination of a set of existing functions.
363. You mentioned the National Health Service and you are all involved in one way or another. I am old enough to remember when the National Health Service came into existence in 1948 it was expected that the cost would be £400 million a year and the forecast was made that actually it would cost less and less because the health of the nation would improve. It is easy to laugh at that now. In fact, in the first year it cost £700 million and it went from a £700 million per annum cost in 1949 to £7,000 million in 1979 and it has rocketed ever since. The present Government has increased resources and I think you got about £42 billion in 1997. If there is any area where blue sky thinking is required surely it is in the health of our nation. Is it your honest judgment that we can actually deliver a better health service to the people of our country using the same present structure?
(Professor Barber) I will answer and then Geoff will come in on that. There is no doubt that the challenge of delivering health care at the level of quality that people have come to expect is a huge challenge ahead of the National Health Service but all my learning about that over the last year would suggest that they are really beginning to put the reforms in place, they are getting the capacity to deliver established, they are making progress on delivery. You asked for an honest judgment. I think they are doing a terrific job and there is every reason to expect that they will rise to that challenge over the next three or four years and we will see the difference.
(Mr Mulgan) This has been an area where there has been rather a lot of serious blue skies work in the last year or two: Derek Wanless looking at demands on the health service, Adair Turner working for the department and the Strategy Unit looking at the other side of the coin in terms of supply. Rightly or wrongly, the pretty clear conclusion has been reached that changing the structure of funding is not the answer which some people think it might be and is neither desirable nor necessary to deliver the health outcomes which the Government and the public want. That said, there is a great deal that can be done to improve the way in which the Health Service works, all sorts of new ways of using technology, using IT, better diagnosis, better prevention, better public health, all sorts of things which could be done to deliver better outcomes but essentially within a comprehensive, universal structure.
364. Obviously we are all thankfully living longer, I am told, and there are going to be more and more new treatments invented and introduced, very expensive ones, and matching that is a higher demand for better service. I certainly would not call it from the sublime to the ridiculous but surely it was realised pretty quickly that the targets madeI am sorry to talk about targets but they are importanton waiting lists was a pretty disastrous commitment for the Government to make, was it not? Not because whether or not it was achieved but whether or not it was achieved the whole Health Service was skewed to try and deliver the right answer. Many people on both sides of the House were pointing out at the very early stages that it is not the waiting lists, but the waiting times. This is not trying to score political points but just to say who sets the targets? Obviously the politicians set them and they set them to achieve them so they actually set pretty modest targets. Am I being too cynical to say that?
(Professor Barber) I think the Government has actually set itself a range of targets, many of which are very ambitious actually. I think I would say that you are being too cynical when you say that, yes.
Sir Sydney Chapman
365. Just one final question. I think, Mr Mulgan, you were a co-founder of Demos, is that right?
(Mr Mulgan) Yes.
366. Mr Jake Chapman, the author of a recent pamphletno relationwas being rather critical and was arguing the central units are "mostly rewriting departmental policy with little idea of the impact on the ground". How would you actually respond to Mr Chapman because he has been pretty critical? He talks about too many advisers.
(Mr Mulgan) As I said earlier, Mr Chapman worked in the PIU, was very useful to it and is on record as saying that the work he did there on resource productivity and energy was an absolute model of how policy should be done, very analytical, very evidence based, very open and very strategic and using people like himoutsidersto provide advice. The heart of his pamphletwhich I wonder if people have readand some of the commentary on it does make you wonder whether it has been read, is a rather serious proposition about how policy makers should use systems thinking approaches to understand the complexities of the modern world. I would actually commend it to everyone to read. They are certainly methods which we have tried using in our own work to understand complex policy issues. There are one or two sentences in the whole thing about central units and the ones you quoted which do not have much relationship to the rest of the argument and on which we could have an interesting discussion. I actually think the bulk of what he is writing about is more interesting than that and more important for government and quite a challenge to a Civil Service and policy makers, most of whom were not brought up with any of those skills and tend to therefore see things within a single discipline or within a single silo or without a sufficient number of dimensions.
I actually encouraged him to write the pamphlet, I may say, so I feel some responsibility for this.
367. For the record, I have not read the pamphlet myself, I have been relying on reports.
(Dr Thomson) Even if the reports were accurate and they may not entirely be, I have also read the pamphlet, some of the ways that are being described as working are actually the very ways that we are bringing to government. The idea of policy being delivered through to the public as a sort of end-to-end process that depends on complex systems is exactly the approach that we are taking working with departments. To help people understand that you do not look at institutions, you look at how policy will be delivered to the public through to the front line and that is done through systems. We do it by talking to people who work in those systems. Our work has been based on hundreds of encounters with people who are actually providing public services and we set up regular surveys with them. Even were the accounts to be accurate I think you could safely say that the way these approaches are being introduced in the centre of government is quite different.
(Mr Mulgan) Not to labour the point, in our projects we talk to people who are involved in delivery on the ground and involve them in project teams, we try to see the whole thing as a system, rather than acting as a small group sitting in an ivory tower in Whitehall dreaming up solutions and imposing them on a passive set of people involved in delivery, which sometimes was perhaps the model in the past. I think we have moved far beyond that.
(Professor Barber) I have not read the pamphlet but I would like to confirm that the Delivery Unit has not rewritten a single departmental policy during its existence and it does not intend to do that. What we do is help departments with their capacity to deliver. I am confident that if you talk to the Secretaries of State or the Permanent Secretaries from the departments we work with that they would endorse that view.
368. As one of the people who has read that pamphlet, I was impressed with it. On your PIU report, one of the criticisms of it is that you repeat paragraphs and you are not as focused as the image you just presented. Why is that? Take the data privacy one that has just come out.
(Mr Mulgan) Can you repeat the question, I did not quite catch that.
369. In the data privacy PIU report there were lots of paragraphs repeated and it was not quite as focused as the impression you were giving a few moments ago. Why is that?
(Mr Mulgan) My apologies if our editing quality has declined. We are trying to make all of our reports shorter, amongst other things. We have just had some visits from people from around the world who said that report is the benchmark which a number of other governments are now using to understand both the issues of data sharing privacy but also the policy solutions which arise from them.
370. Just to point out for clarification, I think the PIU has a high reputation. We are into the last few minutes, if I could do some pooling together and then reasonably brief questions and brief answers. Picking up Sydney's question, health is a very good example here for a number of reasons. First I want to observe where did the health plan come from? It did not come from you, it came from Gordon's man. The Treasury got a man to write a report according to the debate and set health policy for the period ahead. That is an observation. The question is is there a plan B? What if it does not work, Sydney's question? Are you people doing a plan B? We went to the Netherlands a couple of weeks ago and we heard the most distinguished health expert in the Netherlands tell us they thought we had missed a big opportunity in not moving over to a social insurance system. Is there a plan B in the drawer?
(Professor Barber) Let me not quite answer your question. The first thing I want to say is the NHS Plan which was published in 2000, and then a further update was published at the time of the Budget, is described as the reform programme for the NHS and that is being consistently pursued and my job is to help the Department of Health and the NHS deliver successfully plan A.
(Mr Mulgan) The Wanless Review and the work which we have been doing in the Department is essentially assisting the Department. The Department developed the ten year plan. The Department has the expertise on health policy and health strategy. We, as bits of the centre, can help them, can bring in outsiders to give different insights but the underlying work of all of these reviews is done by officials at the Health Department. It is not imposed from outside. Each of these different reviews has worked very closely together. As we were saying earlier, good practice in all policy now is to have the risk management built in so you do not relentlessly follow a single plan with no contingencies, no way of responding if things go wrong. In many respects the Health Department has been well ahead of understanding that. For many years they have done much more sophisticated scenario planning, contingency work and mitigation than most other parts of government.
371. Let me try another tack. I am sorry for the abbreviated questioning. It comes again from the same direction. Listening to some of this I am reminded of Richard Wilson, who you heard here before, who was trying to tell us about politics. The one thing that is missing from all of this is politics. What politics does is blows plans out of the water every day. This is clear. Health was not a priority issue when this Government came in. It absolutely was not. We have not got time to debate it but it was not. Robert Winston did an interview for the New Statesman one weekend and said that the health service was crap based upon the experience of his mother and that caused 24 hours of headlines, the Prime Minister was bounced on to the Frost programme where he was forced to make a commitment about the amount of spending. That was not a strategic decision, it was a response to politics. If you look at what is happening in Europe now, there is the sweeping away of centre left governments, not because they were once successful, they were magnificent technocrats, they were wonderful managers, they were doing all the things that you people are interested in doing, but what they were quite unprepared for was the change in the political weather and the politics of identity appearing. There is no Strategy Unit in the world that would get hold of that. That reconfigures the whole political agenda. Is there not a mismatch between this kind of technocratic fixing approach and the world of politics as it actually is?
(Professor Barber) Let me start on this. This is a fascinating question to raise towards the end of the session and we could debate it for a long time. I recognise exactly what you are saying. One very important part of politics is that politicians, governments, make commitments to deliver certain outcomes and our job in the Delivery Unit is not to do the politics of that but, once the commitments are made on key priorities, to do everything we can to help those responsible to deliver those outcomes. Of course in the real world, however good the planning the real world will impact and politics will move on. Bringing that consistency to the priorities, to the key commitments, is our contribution to helping the Government deliver. There is a very clear connection between the politics and the Delivery Unit in its work.
(Dr Thomson) I think it is interesting that on some days the presence of such expertise is thought of as politicising the Civil Service whereas today it is characterised as technocratising it. Coming from Quebec I pride myself probably on leaning more towards the latter than the former, it is quite a strong French initiative. But anybody who works at the top of government has learned that the link between politics and management is a fact of life in the public service. Supporting what Michael was saying, being blown off course by events is probably the single greatest threat to governments, so trying to manage one's way through that with all your forward looking and risk managing capacities in place but also keeping your eye on the ball, that is bound to help politicians steer a course.
Chairman: Maybe we need a blown-off course by events unit.
372. Stormy skies.
(Mr Mulgan) We are servants of the government of the day. Ministers have to decide. Ministers have to respond to what the public wants. Ministers have to be ready to respond to events. Our job is solely to provide them with materials and advice, with strategies which they have to make judgments on. If we become too purely technocratic we are probably not providing very good service and we, in my unit, always have a sponsor Minister attached to every project to ensure we do not become too detached from the realities of everyday politics. Equally, our understanding of strategy is not a purely technocratic one. Strategy also involves communication if you cannot explain what you are trying to do to the people working within the public services and the wider public then it is unlikely that the strategy is going to succeed.
373. I am almost done. There was reference made to the Public Finance magazine and I was struck by a sentence in there which said "As a rule, the more the centre of any government builds up permanent capacities, the more it risks duplicating what departments should do and undermining rather than building their capacity" and yet the Prime Minister wants to have a bigger, stronger centre of government and you are saying that.
(Mr Mulgan) I am saying the UK starts with a very small centre. If you visit most other European countries or the US you will see large centres, many more people than there are in the heart of the British Government. We are small units working, I hope, in a relatively lean way and, as we have been emphasising again and again this afternoon, trying as far as possible to build up the capacities of departments because we operate in a departmental system of government. If we were ever to become too big, too rigid, too fixed, we would probably no longer be serving the Government as best we can.
374. But it is not part of the developing centre, it is a hit and run squad that comes in and gets out, nifty.
(Professor Barber) I think Geoff is right to draw attention to that risk and we have been talking about risk management, we should manage that risk. We need to know that is a potential risk with any step forward and then avoid it. When in our tracking of the data and milestones and so on a problem arises, as problems always will in the real world, we do not say as a Delivery Unit "right, we must solve that problem", we say to the department "can we help you solve that problem" and that philosophically is crucial to avoiding the risk that Geoff draws attention to in the article.
375. We are on the cusp of a new Spending Review. Is there any way of finding out what happened to the original one on the target and performance side? It was said then that all these targets were going to be met. There were reports coming out from the Lib Dems last week saying they have not been met. Who pulls all this together? We were told that there were going to be sanctions for non-achievement of targets. Before we embark on a new round should we not have some pulling together of what we have learned so far to see what we did achieve?
(Professor Barber) I think you should look at the White Paper that the Treasury publishes when the Spending Review comes out.
Chairman: Could we thank you very much for that. I think we have had a very, very interesting session that has fed into a number of areas that we are interested in. I think, probably this excludes certain Members of the Committee, we are all in this together, as it were, and if it does not work we are all in the frame. Thank you very much for coming and talking to us in the way in which you have.
3 Note by Witness: Some of the ways that the pamphlet suggests we work are actually the very ways that we do work in Government. Back