Your 2020

I’m in favour of the proposal but am concerned that localised government can be dominated by those groups and individuals with the most time, money and political clout. The last government introduced New Deal for Communities which became the most effective regeneration tool the UK’s seen, run by local communities working with council’s etc who HAD to cooperate with them

Matthew – I may be misinterpreting your point, but do you think that misunderstandings come from misrepresentations? Any data release needs context.

Better still, why not build the tools to allow people to interrogate the data like the decisions maker do (sorry, I mean should).

There’s a ‘What if the Daily Mail got hold of it’ argument about releasing data. Much of this data is already published, albeit hidden in PDF board reports. Who is better at holding public service to account – a splash-happy hack, or the thousands of citizens who will be affected by decisions based on this data?

If the diminishing numbers of journalists really took the effort enough, they could do ‘Bad Science’ on lots of already-available information. They (some – not all!) already do.

But what better way than to rebutt any misleading interpretations than by publishing the full facts? The best PR is honesty.

The business case has yet to be fully made, IMHO, about open data, but gut instinct and some very handy examples (OpenlyLocal at http://openlylocal.com/, Lichfield, data.gov.uk) tells me that it is a Good Thing.

This is the way forward to free up clinicians and wider carers time to focus on the most needy as the more IT enabled use alternative channels of communications. If works so well in many other industries why not in health care? However, we need to relentless focus to assure we do not disenfranchise those less able to influence through technology.
As a health service manager working with a vibrant and diverse community that has poor internet access and low IT literacy – especially amongst older community members there is a missing emphasis on how we use technology to map and build wider community assets and use activists to drive the change that better information can provide – how to create local networks and raise peoples desire for change. The way forward is also through helping communities understand what public service investments flow through them – the Total Place approach – and how they can work through this to change what investments are made on their individual and community behalves – to challenge commissioners to better align this to their needs. There is also a stretch agenda that potentially brings together local individual budget holders across health and social care as new investment communities able to come together and drive better value through the power of collective purchasing. This might make a great trial project. Do not forget the research base as we go – a lot of change requires evaluation and constant retuning to get right – this needs to happen in a managed framework.

Trust people to have good common sense and give them straightforward data in natural frequencies – “how many people will benefit from this intervention and in what ways” – instead of the “40% improvement in death rates” type gobbldegook that is most public statistics.

That’s not how to engage people. Bits of paper have been tried – & local councils do this sort of thing anyway. I fear active engagement menas people talking with people.

Dumb idea. How would an account tell you if something was good value for money or efficient or brilliant? We know how much we’ve paid in tax already.

In the 1990’s a valid discussion emerged in local authorities about how commercial providers might deliver public services more efficiently. This was possibly the beginning of “marketising” our view of local services.
Now we have got to the point where service standards and provision are now often decided along market lines, with great nervousness on the part of local authorities or others about expressions of general needs of society, or the common good. There is surely a role for good local leadership about provision. No amount of tweaking the delivery mechanisms will address this.

I voted yes but worry that the very organisation that’s putting these ideas forward is very elitist in itself – the trustees atc underline this

So how would it work? How would the £££ be divided up? How would you avoid unrealistic expectations? What if a small, powerful, but unrepresentative lobby determind how the co-op would work? Would it be used to cut staff or reduce their wages? How would terms & conditions of staff be affected? I think this is one of those proposals that looks superficially attractive, but the devil -and possibly real devil – is in the detail

Hospitals became Foundation Trusts a few years ago (kind of mutuals). The earth hasn’t shaken has it? – either in a good way or a bad way. This is chairs on the Titanic’s deck. The iceberg is funding.

Whilst I, largely, concur with the previous sentiments I would add that this proposal reminds me of a US healthcare insurance scheme. It would be interesting to know how this scheme would be administered. Are there proposals for augmenting low contributors? Has consideration been given to the possibility that those who contribute less, may actually require greater levels of intervention and therefore cost. Will those who contribute more be expected to pay those costs also? Too many known unknowns.

If public services are to be provided to people according to their means rather than their needs that is a very short step away from the privatisation of public welfare provision. It would allow for a tiered system of service provision in which those fortunate enough to have had a surplus of income to invest would have that advantage translated into a state guarantee of superior benefits. Great for the able bodied and ‘well positioned’ not so great for anyone less fortunate!

How do you ensure this scheme doesn’t discriminate against the more poorly paid, disabled, etc? It seems to me it risks entrenching economic and social divergence at a time when we need schemes that reduce them, especially at the lower end.

This is surely just another way of ensuring existing differences in wealth distribution continue to be reinforced. People have a fair degree of choice already about education (notably the better off who can afford to live in the right catchment area)and social care (direct payments). If we want this society to be fairer, we actually need to load these budgets towards the lower ends of the income scale.

I do not think it is right for the state to take my money and then take away my choices. How I support my family and how I educate my children are deeply personal issues. As long as they are safe, the state should give me back my money so that I can make choices that reflect my faith. I do not want my children to go to schools full of Godless pupils and deviant teachers.

In theory, this sort of thing is a good idea. But the devil is in the detail. What levels of funding could you actually devolve, to make this worth while doing? How would you ensure that the local democracy was actually democratic & not captured by a particular vociferous or powerful group? How would you avoid narrow local interests impeding wider interests? I think there is an argument for devolving decisions to prperly defined local communities, but with some very clear constraints & rules designed to prevent abuse & chaos

Graham
I agree that because we havent got local accountability right so far, we shouldnt give up on it. And I also agree that localities are the right level for ‘co-production’ etc to flourish.

But im worried about the different capabilities of people to ‘co-produce’. Would local government be any better at making sure that the people who need the most support in this respect actually get it? It would take a serious boost in capacity.

I would like to see it, but im not convinced that when local budgets are squeezed, there is a strong case that LG’s can keep the best people around to make this happen.

Lets discuss!
Thierry

Edwina / Thierry,
I believe the current set up of local participation is dreadful. However that’s not an excuse to give up. I suggest we change it. There are multiple reasons why it’s busted.
However the concept of accountability for SOME services being devolved to local will develop the so needed ‘responsible citizenry’ which is a pre-requisite to “co-” design/delivery/production of public services – that ultimately makes them more tailored to needs and cheaper.
Am always up to argue this point!…
Graham

Yes – but! If you devlove greater accountability to local authorities, you can’t at the same time bellyache about postcode lotteries. The trouble is, too many people want to have their cake and eat it, local flexibility when it suits, no divergence in standards when it doesn’t. You also need to reinvigorate local government. At present electoral turnout in local elections is so abysmal, the results are probably undemocratic. I’d go for devolving a lot more powers & having elected mayors (& possibly banning candidates from any political party from standing, so you get local councillors who are both local & independent)

Nobody will vote in elections unless the people elected have the power to actually do something. I’ve read that local authorities only have control over 5% of their expenditure, and that the rest has strings from the centre. What are we so afraid of?

I agree with this. Its bad for citizens because it reduces democratic engagement to a once in a blue moon decision with a great deal of distance between citizens and their representatives. There are BIG questions about how local democracy could be invigorated enough to legitimise stronger local govt, but they are how questions, not if questions – social engineering from the top-down hardly ever works, and its a fallacy to believe that central solutions are producing uniform outcomes anyway.

I agree. But I believe you ened the Information Commissioner to take an active monitoring role in ensuring data isn’t misused.

I think that if citizens use public services it is not asking much in return for them to allow some information about how they used them to be shared, especially if they can say no if they really want to.

I would be very concerned about the form in which data was published, especially if this data were intended to help the public make decisions about which services to access. Often, data is presented in confusing and misleading ways, or does not really tell us anything useful. But the majority of us are not used to or good at interpreting quantitative data, so we must rely on it being presented in a neutral manner by the very people who collect the data and who may have an interest in presenting it in a certain way – those who deliver the services.

There cannot be a single approach here. Social security needs to discourage dependency & encourage work and the improvement of people’s skills – otherwise the UK economy is going to lag more and more behind our competitors (both new & old). On the other hand, the NHS should continue to provide care free at the point of delivery for most ailments. It’s vital that education remains free – certainly up to University. I’d also argue for reducing the cost of all tertiary education in all areas where the UK economy needs the skills.

The public services will over the next decade need to move beyond its paradigm of strong support for “ability” and “opportunity” that enabled “robustness” in public policy and move on to supporting people from cradle to grave with help for “motivation” to strengthen “resilience” amongst the significant proportion of the community (possibly up to 30% in the UK) who are not seriously driven even by extrinsic motivation let alone intrinsic motivation. The problem that those advocating this reform face is that too often co-production messaging sounds to up to 70% of the population something like Norman Tebbit talking about his father getting on his bike. The messaging and engagement for co-production therefore needs to be segmented to address all levels of motivation and contain considerable elements of empathy. This may require significant retraining of public services staff (some of which, through “institutionalisation” as a result of low levels of autonomy and a culture of low-self-efficacy) to become change-makers not just in their working lives, but with the local communities they also reside in.

Firstly I agree with Emily. The voting is off. Can’t tell if my vote went yes or no and I wanted to say NO. I disagree with blanket statement saying post-war public services are wrong. How can Utopia be wrong? But real needs must be identified (does EVERYONE really need child benefit?) and abuse of the systems must stop.

The basic principles are good. Any civilised society must provide decent education and national health services for all. It’s what’s happened after that which must be looked at… plus eternal vigilance.