When reading about and talking to people about reforming public services I quite often hear statements along the lines ‘if we carry on doing what we’ve always done we’ll get the same results as we always have’. A similar thought comes through in discussions around innovation and taking risks: that many people and organisation default to the do nothing option because it is the safe thing to do.
In every case I’ve heard those sorts of phrases I agree with the sentiment: that we need to do be brave and do things differently if we want to get better results from public services. But I do want to challenge a part of the underlying logic: that the status quo is a safe option or will keep delivering the same result.
I don’t doubt for a second that in a stable system doing nothing and carrying on with business as usual is a safe option. But the current environment for public services of rising demand, changing expectations and declining real terms public spending is not stable. And stability is not likely in the foreseeable future. Even if spending cuts end in 2018, demand pressures look set to outstrip projected increases in public spending until at least 2025. In a report for WPS 2025 I quantified this gap between funding and demand as being around £2.6 billion in Wales by 2025, depending on how the economy goes and a few other factors. There will be a similar gap in other countries facing fiscal and demographic pressures.
In that report, we concluded that given this squeeze ‘there is no low risk do nothing option’. The ‘do nothing’ option of trying to do the same thing really means trying to get a declining workforce to deliver the same level and quality of services in the same way to an ever growing number of service users. It just does not add up. Something has to give.
If we try to do business as usual in this environment where we are likely to see things ‘give’ is outright cuts to some services, declining levels and quality in others and staff burnout. The ‘do nothing’ option poses huge risks that we will end up doing harm to service users and to our communities.
We are facing a scenario where every option, including doing nothing, carries risks. Transforming services comes with no guarantees of success. The WPS2025 report suggests an approach to transformation based on preventing demand in the first place, and managing the demand that is not prevented more effectively. It is a co-productive model built around focusing on outcomes, and whole systems methods to re-shape services around what matters to service users. The excellent RSA2020 report on demand management reflects the same kind of thinking about the direction for public services. But as that report acknowledges, the evidence and business case is tentative. Adopting these kinds of approaches comes with risks as well.
The challenge for public services is what kinds of risks to take. To try to reactively tackle the risks of a managed decline or to be brave and take some managed risks in a positive effort to do things differently and get better results. I know what position I’d rather be in. In some cases there will be failure and things may not be perfect. But as an excellent speaker at a seminar I recently attended pointed out: it is OK to start with an imperfect service and refine it as you go along and it is OK to fail. But make sure you fail fast, learn the lessons quickly, dust yourself off and keep trying.
The views expressed here are my own!