RESPONSE OF THE GMB TO THE PUBLIC ADMINISTRATION SELECT COMMITTEE INQUIRY INTO PUBLIC SERVICE REFORM

The GMB Britains General Union welcomes the opportunity to submit written evidence to the PublicAdministration Select Committee. The GMB represents approximately 200,000 employees in public services, many of whomhave had direct experience of private sector involvement in service provision.

QUESTIONS

Principles and Strategy for Reforming PublicServices

1. What should be the principles guiding the reform of publicservices?

Quality,reliability ,accountability and value for money. It should also be aboutmotivating and empowering publicservice workers to do their jobs well.

2. Does central government have clear principles and an effectivestrategy 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 improvingservices?

There seems to be some confusion ingovernment thinking. There has been talk of the value of public services andthe public service ethos but also an ideological commitment to increasing privatesector provision of public services. Private Finance Initiative procurementhas, in the words of the Office of Health Economics, been artificiallypromoted. The Government mantra has been what matters is what works whilstPFI credits in local government for instance have meant that local authoritieshave no financial alternative to outsourcing. The GMB would like to see a levelplaying field between public and private provision of services. A recent surveyby the GMB of our senior officer and chief officer members in local governmentshowed that over half believed that the Best Value regime was a route toprivatisation regardless of quality of service.

The Government has been promotingchange and experimentation in the public sector whilst imposing strict nationaltargets in health and education and a rigid inspection regime in localgovernment. The GMB agrees that standard setting is an important tool butbelieves that public service bodies should be allowed more flexibility indelivering these standards and operate within a financial regime which allowsfor alternatives to outsourcing and PFI deals.

TheGMB welcomes the Chancellors recent statement of commitment to a publiclyfunded NHS.

3. Do the devolved institutions and local government have clearprinciples and effective strategies for reforming public services? Could therebe a role for strengthened regional institutions?

Local authorities should be allowed todevelop their own strategies for public service reform, however, the currentinspection and financial climate undermines this aim.

TheGMB supports regional government provided it has real legitimacy and democraticaccountability. We believe that regional government should take powers fromWhitehall and bring them closer to the electorate but should not replace localgovernment. Effective regional government would allow for better co-ordinationand planning of resources across regions.

What would be the consequences if there were significantdifferences between the policies adopted by central, devolved, regional andlocal government on public service reform issues?

If devolved institutions have genuinepowers then this would be an inevitable consequence of local democracy. Thiswould be a positive opportunity to experiment with different models and tailorpolicies to particular local needs and priorities

4. How do we know if public service reform is effective?

Effectiveconsultation with service users and the workforce. The achievement of rigidnational targets alone is not sufficient because concentration on targets alonecan mean that other service areas may suffer. Public service workers are anuntapped resource, are not often enough fully involved in service review andreform. They are inadequately empoweredto improve the service they provide. Public service workers are also serviceusers and therefore have a unique insight into the effectiveness of provisionand potential areas of improvement.

The Concept of a Public Service Ethos and theInvolvement of the Private Sector

This issue will be examined in the first part of theinquiry.

Is the concept of a public service an anachronism?

5. Is there a public service ethos, and how can it be defined?

Publicservice ethos can be defined as a desire to contribute to the wider community. It is an ethos whichseeks reward from a sense of purpose in a job rather than just individualfinancial gain. It is public service ethos which motivates low paid GMB memberssuch as care assistants and hospital ancillary workers to continue with stressfuljobs in often poor conditions when they could be earning more working at thelocal supermarket

The primary purpose of any privatecompany is profit by their very nature, and company law, private companiesare required to put the interests of their shareholders first. Railtrack is aprime example of a company which considered the payment of dividends to itsshareholders a higher priority than investment in a safe and efficient railnetwork.

Private companies are increasinglyinvolved in school sponsorship - the payback being that they can getadvertising materials for their products in front of schoolchildren (Schools offer excellent opportunities. Notonly are they a high traffic sales generator, but students are some of the bestcustomers you could have. McDonalds Operations manual). This is an anathema to the public serviceethos. The GMB is concerned that the public service ethos is being destroyed bystealth. We believe it should be nurtured and encouraged rather than subjectedto cynicism .

6. How is the public service ethos different from the private (orvoluntary) sector ethos?

Thevoluntary sector ethos is similar to that of the public sector. Many peoplejoin the voluntary sector in a desire to do something worthwhile with their livesand give something back to society . The GMB is not so nave to believe thatall public and voluntary sector workers are paragons of virtue compared withthose in the private sector. We do, however, believe in the ethos of anenvironment where the one overriding purpose is not the search for profit.

Thevoluntary sector often acts as a powerful advocate for disenfranchised

ordisadvantaged groups in society. The private sector, understandably, only takesan interest in those it considers to be good potential customers.

In the private sector competitiondrives improvement if a customer receives poor service they look elsewhere.Large companies in the private sectorwould generally prefer not to have competition this is why competitors are so often boughtout. Cartels and monopolies have greatappeal for private companies. This is why anti trust and monopolies and mergerslegislation exists. To give the private sector a monopoly on a 30 year PFIcontract is the worst of all worlds customers are unable to shop around forschools or hospitals yet they will be run for a profit motive. Some areas ofsocial provision require accountability, and not merely accountability toshareholders this way only the wealthy have a voice and major stakeholdersare excluded.

Is a public service ethos necessarily a good thing? Can itbe an obstacle to the effective delivery of services to the public?

The GMB believes that a public serviceethos is positive. This ethos remains strongamong GMB workers in front line such asnursery nurses and homecare assistants. They often work extra hours , orrun marathons to pay for extra equipment for their hospital. If you ask our lowpaid NHS ancillary workers why they remain the common reply is because they want to work for theNational Health Service. This is one reason (amongst many others) why so manyof our members resent being transferred to private contractors.

A criticism often levelled at publicsector services has been a lack offocus on the customer and a lack of flexibility. This has to be seen in thecontext of declining resources, constant criticism, restructuring andreorganisation. Demotivation is hard to overcome once entrenched in anyworkforce. It has led to a bunker mentality in some areas. This is often causedby outdated management practices, blame culture and hierarchical structures.Every mistake made leads to an inquiry andresulting new procedures Services become process rather than outcomeled. These problems need to be addressed. Handing over services to privatecontractors may often seem an easy solution but the GMB does not believe thatit will produce the step change required for our public services. It will certainly not harness the idealismof many public service workers.

10. Would the creation of a single public service help apublic service ethos?

TheGMB does not believe that this would improve matters it would risk thecreation of a monolithic bureaucracy. There does, however, need to be moreco-operation between independent services one stop shops for housing andbenefit advice for instance.

11. Is it possible for profit-oriented organisations tomaintain the public service ethos?

Theproblem for private providers is that their primary loyalty is to shareholderinterests. Not for profit organisations aremore likely to retain public service ethos. Workers transferred to theprivate sector find conflicting loyalties andthey become isolated from other public service workers. When hospitalcleaners transfer to a contractor they are no longer part of the same team asother hospital workers. Council workers lose the sense that they work for thecommunity. This undermines joined up thinking by public sector providers andleads to fractured services. The GMB considers that profit-orientatedorganisations are less able to respond to changing service needs due to theprescriptive nature of contracting.

TheGMB would question whether private contractors would go that extra mile intimes of civil emergency or crisis. There have been reports from North DurhamHospital that doctors were forced to use ambulances move patients around thehospital because the PFI provider stated that this task was not included in theportering contract (Guardian 23 July 2001). Such situations can be put right(often expensively) but it illustrates the inevitable differences of ethosbetween private and direct provision.

Thepotential conflict of interest between the profit motive ethos and serviceneed were illustrated by the leader ofFalkirk council at a meeting of the Scottish Parliament Local GovernmentCommittee on 15 May 2001. He stated that the PFI contract to run schools inFalkirk had been expensive and had led to a number of problems concerning extracurricular activities and the out of hours use of school premises. He statedthere are additional charges for out of hours services at PFI schools andthat the PFI contractor has priority use of schools out of hours for profitmaking activities. On one occasion childrens luggage was left in the streetafter they returned from a field trip because they were not given access to theschool. The public service ethos which motivates teachers and other staff toengage in extra curricular activities has now been undermined by the profitmotive. The GMB believes that such scenarios will be replicated across theschool sector with the expansion of PFI.

12. What measures, if any, need to be put in place to ensurethat the search for profit does not undermine the public service ethos?

TheGMB would argue that when public services are run by for-profit organisations, purpose and ethos is inevitably changed. The purpose of acleaning contractor in a hospital is ultimately to make profit. The purpose ofan NHS cleaning team is to keep the wards clean. Four out of the five NHS Trusts that recently received redlights for poor cleanliness used private contractors for cleaning. One of thereasons given for this was that lines of management and accountability wereundermined by the use of privatecontractors.

Measuresneed to be put in place to ensure that private contractors do not have theopportunity to increase their profits by cutting the terms and conditions ofstaff, or hiring new staff on worse terms and conditions than staff transferredfrom the public sector. This is the reason why the GMB, together with otherpublic service unions and the TUC are supporting the adoption of a new fairwages resolution to guarantee that all workers involved in the provision ofpublic services are entitled to decent terms and conditions. There is nothingmore damaging to the public service ethos than the creation of two tierworkforces and the perception by public service workers that their pay, holidayand pension entitlements are being cut to pay for increased dividends forshareholders.

13. Can lessons be learned from the experience of privatesector involvement in public services in other countries?

Othermajor European countries such as Germany and France have historically differentstructures for health provision for instance than the UK. The role of theprivate sector in their healthcare systems is greater than in the UK but thesignificant difference is that there has historically been more publicinvestment in healthcare. The Conservatives have recently been saying thatpublic spending on health in the UK is broadly comparable with that in Franceand Germany, the difference in investment in health is made by the privatesector. This is clearly untrue. In 1997, according to OECD figures, public spendingon health was 5.8% in the UK, 7.1% in France and 8.3% in Germany as aproportion of GDP.

Inboth France and Germany private healthcare acts as a top up for the better offmembers of society. In July this year it was reported that Germedic, a Germanprivate health company, were marketingtheir services to British Health Authorities in order to take patients on NHSwaiting lists. Newspaper reports at the time claimed that the German healthcaresystem has 20% overcapacity to fill. In August the GMB National Officer forHealth visited Stuttgart to look at the German health system. She was told byhealth workers there that overcapacity is a feature of German privatehospitals. In some areas Germans are waiting for treatment whilst private hospitals look to fill their sparecapacity with profitable patients from the UK or Norway. It is not surprisingthat nearly 80% of Germans believe that the Government should be responsiblefor providing healthcare (EU Opinion poll).

InFrance, although the quality of healthcare is excellent, there is far greaterhealth choice in wealthy areas because private hospitals will only openwhere there is a good client base. Divisions in access to healthcare accordingto wealth are becoming an increasingsource of concern and is a weakness of a system of a public private mixedmarket. All emergency treatment in France is undertaken at public hospitals.The GMB spoke to the Federation Hospitaliere de France in September this yearwho told us that France would never allow private sector management of publichospitals because of their crucial role in providing emergency and long staytreatment. It is also worth noting that healthcare in France is not a freemarket - co-operation between privateand public hospitals is tightly regulated by regional government to help plan healthcare provision.

TheGMB believes that the UK can learn a great deal from countries such as Franceand Germany but is no evidence that these countries have high standards becauseof the role of the private sector. Sweden has high health standards and thehighest percentage of health care workers in the EU. The private sector,however, plays a very small role in the Swedish health sector.

Swedishhealth authorities have experimented with private sector management ofhospitals. It should be noted, however, that in Sweden it is consideredessential that that local councils (who have responsibility for health) retaincontrol of the hospital buildings as a safeguard against underperformingcontractors. There is far more accountability in this system than under theBritish Private Finance Initiative. Even so, the Swedish Government passedlegislation in response to public concern which bans the private sector frombeing involved with the operation of emergency hospitals.

14. Do private sector people working in and aroundgovernment, including secondees, task force members and others, undermine thepublic service ethos? Are special measures needed to regulate their activitiesand prevent possible conflicts of interest?

Thereis a danger of conflict of interest where private sector people have influenceon government policy decisions relating to public service reform. There shouldadequate guidelines surrounding the employment of civil servants by privatecontractors when civil servants have been involved in policy in this area.

TheGMB believes that vested private sectorinterests have too much influence over government policy in this area. Theprivatisation of the Treasury PFI task force to create Partnerships UK has meant that PFI contractors such as Jarvisand Serco have direct influence ongovernment promotion of this policy through their part ownership of PUK. TheGMB believes that PFI has effectively been a means by which taxpayerssubsidise private companies with little independent scrutiny or open debate.

InOctober the government announced the creation of a strategic partneringtaskforce to provide support to local authorities on developingpartnerships. Out of 27 members of the taskforce, 24 come from the privatesector. Members include contractors such as Amey, CSL and Hyder Businessservices as well as KPMG who have benefited enormously from consultancy in thePPP area. This again represents powerful vested interests involved in policydevelopment.

TheGMB does not believe that the Government should commission any more reports onthe effectiveness of the Private Finance Initiative from consultants thatthemselves receive financial gain from the policy.

15. Many companies are becoming increasingly aware of socialand ethical issues. Does this make them more suitable for work in partnershipwith the public sector, or does it make no difference?

Somecompanies have a distinguished record of social responsibility such asRowntrees and Boots, but they are very much the exception in the UK. The quotefrom free market economist Milton Friedman if businessmen do have a socialresponsibility other than making maximum profits for stockholders, how are theyto know what it is? sums up the attitude of many British companies towardssocial responsibility. Currently only 4.7% of the total charitable donations inthis country are given by business (UK Voluntary Sector Almanac).

Private companies do not get involvedin public service contracts for charitable reasons or out of any sense ofsocial responsibility they do it for profit. Balfour Beatty, a major PFIcontractor, announced this year that its operating profit from buildingmanagement and services increased by 57% largely as a result of PFI. PFI appealsto such companies because it offers long term contracts with predictablemargins and little risk. Social and ethical issues are irrelevant topartnerships. An investigation by Health Service Journal (13 may 1999) showedthat building contractors are expecting returns of up to 20% a year on theequity stakes they hold in (PFI) project companies. The GMB considers thatthis is unacceptable, especially since PFI is often subsidised by the taxpayer.

The fact that there has been concernthat the public sector needs to enhance its procurement skills illustrates thatcompanies contracting for public services will always seek to negotiatecontracts which will maximise profit it would be nave to expect any otheroutcome.

16. Do the views, motivations andattitudes of public sector workers differ from those in the private sector?Does any difference in motivation have an effect on the delivery of publicservices?

Research conducted by Hay managementconsultants for the Cabinet Office has shown that for complex and senior jobs,base pay rates in the wider public sector are roughly 25-30% below thecomparable private sector rate (Strengtheningleadership in the public sector, PIU March 2001). Such workers are evidentlymotivated by something other than monetary gain.

The GMB does not believe that theattitudes of our public service members automatically change when they aretransferred to private contractors. Demotivation is caused, however, by theuncertainty of the transfer process and by the cuts in terms and conditions andpension entitlements that are so often a consequence of such a move. Motivationis further undermined by the creation of a two tier workforce.

GMB members in the homecare sector whofind themselves transferred to private contractors consistently complain thattheir ability to give quality time to clients is undermined by stringent rulesconcerning the amount of time they are allowed to spend on each job and thelevel of support that they are allowed to give.

Private contracts are usually tightlyspecified and service level agreements written in stone. The GMB believes thatthis stifles innovation and flexibility in public service workers.

The Government has ambitious plansconcerning public service reform it is essential that the workforce feelempowered and motivated to deliver the step change in service quality demandedof them.

17. There is conflicting evidence as to whether the publicis in favour of private sector involvement in public services (MORI polling,June 2001). What in your view is the truth about public attitudes?

Weoften hear that the public do not care who provides the service as long asits provided. The GMB believes that this is to miss the point. Our argumentis that there is little evidence that improvements in service standards will bedelivered by the private sector and that there is no public will forprivatisation to be expanded . An opinion poll conducted by MORI for the GMB inAugust 2001 showed that for 65% of respondents the involvement of the privatesector in public services was an important factor in their voting intentions.The GMB does not believe that Labour was re-elected this year because thepublic wanted more privatisation.

Theelectorate rarely if ever are given the opportunity to choose whether servicesare outsourced or not. No matter which political party controls a localauthority the Best Value process and the local government finance regime willencourage outsourcing. It would be ridiculous to claim that the privatisation process is driven by thedemocratic process it is driven by persistent lobbying by private companiesat national and international level for government to open up lucrative publicservice markets. The people of Islington and Lambeth who received evictionnotices because their housing benefit had not been paid did not vote for the takeover of housingbenefits by a private contractor.

Commercial confidentiality often means thatthe full implications of PFI projects remain hidden to the public. The 900million land deal associated with the Edinburgh Royal Infirmary PFI projectonly became known after a civil servant leaked the details to the press. WhenKidderminster hospital was downgradedto help finance Worcester Royal Infirmary local residents certainly didcare electing anti PFI councillors to their local council and Dr RichardTaylor as their MP in protest. PFI continues at Worcester illustrating that thepublic have no say in privatisation issues. The same can be said for the LondonUnderground PPP project which continues despite the opposition of the majority of Londoners. It is fatuous tospeak of conflicting opinion poll evidence in these matters when the publicclearly have no real influence on these matters.

18. If there are to be rules regulating private sectorinvolvement in public services, should they apply also to, for example, thevoluntary sector? Should there be less stringent regulation where profit is notinvolved?

Aprivate care home should have the same standards expected of it asvoluntary sector or local authority care home. The Care Standards Billaddressed such issues and was welcomed by the GMB. There should be a properregulation framework for all public services whatever the provider.

ACCOUNTABILITY ISSUES

19. What kinds of accountability are most effective?

TheGMB believes that the best kind of accountability is that oflocal democratic scrutiny and choice. We believe that this is being underminedby wholesale privatisation of services. Average turnout at local elections isdeclining and currently stands at only 30%. This is partly due to a longprocess of reductions in local authority powers and increased central controlof local government. With the expansionof PFI there is a danger that councilswill only have to meet once every 30 years to renegotiate contracts.

TheGMB also believes that there should be more service user and workforceinvolvement in service reform and improvement. The Local Government Act 1999gives local authorities a statutory duty to consult service users. The GMBbelieves that a similar statutory duty to consult the workforce would send apowerful signal that employee involvement is taken seriously in publicservices.

20. Is there sufficient coherence in the accountability arrangementsfor public services?

Thereneed to be more effective mechanisms for accountability in public services.This was well illustrated by the inquiry into the deaths of children at BristolRoyal Infirmary. There needs to be a greater push for internal accountabilityand a move away from old fashioned hierarchical structures which prevent nonmanagement staff from having adequateinput into mechanisms for improving services.

21. Is there too much accountability, or too little?

TheGMB believes that there is too little accountability in the reform of publicservices. Traditionally the ultimate accountability has been local politicians,to their electorate. With the involvement ofthird parties (contractors) the public are now one step further removedfrom the service in terms of accountability.

This years Audit Commission report onWelsh Public Services (Better Value Wales) stated that private sectorcontributors claimed that the Welsh public sector had a pre-occupation withdirect control over the way in which public services were delivered. (Para 4.8Doing business in Wales). The GMB believes that this direct control is aneffective tool of local democracy, and as the experience of housing benefitshas shown, a far more effective way of delivering a service.

22. Does the new pattern of public service provision requirenew forms of accountability?

Theprovision of public services by private contractors automatically creates aconflict of accountability between service users and shareholders. For privatecompanies shareholders will always come first. One way to deal with this issueis through the creation of not for profit trusts or have companies owned bylocal authorities themselves. There arealready a number of arms length companies and Leisure trusts operatingin local government.

23. In the Government's overall programme of public servicereform, is the need for accountability to Parliament and to other bodiesproperly taken into account?

Recentevents concerning the attempted removal of a few respected members ofParliamentary Select Committees suggests that there is not enough commitmentfrom government for proper scrutiny of public service matters. The GMB believesthat up until now there has not been real debate on the use of the PrivateFinance Initiative and a lack of proper research from public bodies whichdemonstrates that it provides either value for money or improved services. TheGMB does not consider that reports commissioned from private companies withvested 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 measuresshould be put in place to ensure better accountability?

TheGMB believes that more independent information should be made available to thepublic on the expansion of the use of the private sector to deliver publicservices. This is particularly the case in relation to the Private FinanceInitiative. Justification for PFI has variously been given as the need to keeppublic spending off balance sheet (this has now been discredited), value formoney (no independent evidence that this is the case), and the need to bringprivate sector management skills into public services (private contractors arehiring in expertise from the public sector in any case). The fact thattaxpayers have not been given a clear, consistent rationale for this expensivescheme suggests serious lack of accountability.

TheGMB particularly welcomes this Select Committees inquiry into public service reform.

25. Does the growth in private involvement in publicservices threaten to reduce public accountability?

TheGMB is concerned that private sector service providers are insufficientlyaccountable for the services they provide. We have already submitted to thisselect Committee evidence relating to Capita plc and the cancellation of itscontract with Croydon LBC. Capita required a guaranteed base payment whetherthey provided an adequate service or not which Croydon would not accept. Capitahave also threatened legal action against Lambeth LBC if their failing benefitscontract was terminated and ITNet. threatened legal action against Hackney LBCafter it was dismissed from that benefits contract.

Themost beneficial contract for a private sector provider would be one where theyhave guaranteed long term income with little accountability or consequence offailure. The GMB believes that there should be an independent inquiry into thetype of contracts that public bodies are signing up to and mechanisms put inplace to ensure that contractors arealways fully accountable to the client body.

TheGMB believes that the expansion of the Private Finance Initiative will fatallyundermine the democratic accountability of our public services. PFI contractsare by their nature too long and inflexible to allow for changing localpriorities and service needs.

26. Do the demands of commercial confidentiality threatenthe accountability of public services when the private sector become involved?

Thishas proved to be the case in a number of PPP projects. The secret land dealassociated with the Edinburgh Royal Infirmary PFI project has been previouslymentioned under question 17 . The secrecy surrounding the Ernst&Youngreport on the London Underground PPP is a prime example of commercial confidentiality being used toundermine public accountability.

Service Users and Public Service Reform

27. Does the Government's public services reform programmehave sufficient focus on users and consumers of those services?

TheGMB believes that service users have to struggle to make their voice heard onpublic service reform issues, the examples of Kidderminster hospital and theLondon Underground PPP were given earlier.

TheGMB agrees with the government that the focus of health reform should bepatients and that the focus of education reform should be pupils. Our emphasison the importance of decent terms and conditions for public service workers hasled to accusations that we represent vested producer interest. The Prime Minister himself has said that I don'tbelieve that that is the way to provide a better service, to reduce the termsand conditions of the staff. And I just think that's obvious (Guardianinterview September 2001)

TheGMB does not believe that the interests of users and consumers of publicservices and those of public service workers are mutually exclusive. We wouldlike to be given the opportunity to work in partnership with the government inbringing UK public services up to standards of excellence currently the termpartnership is almost entirely usedin the context of the private sector. The GMB does not believe that the PrivateFinance Initiative is partnership itis a straight commercial transaction.

Theevidence of the Private Finance Initiative so far is that there is too muchfocus on the needs of the private sector provider and not enough on serviceconsumers the earlier example of the effect of PFI on extra curricularactivities in Falkirk (question 11) is an illustration of this .

TheGMB recently had the opportunity to view aspects of private contractor bids forNewcastle City Councils schools maintenance PFI project. One contractor statedthat we understand and share the authoritys view that a best value serviceis about quality, efficiency and competitiveness which consults and takes intoaccount the views of the client. By client they meant the council there wasno mention of service users.

28. If not, how can the position of users and consumers bestrengthened?

Usersand consumers need to be given real choices about options for service provision not told that the only way to provide investment in services is to use theprivate sector. There must be mechanisms to ensure that the needs of serviceusers 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 publicservices?

Userrights can be a useful tool for promoting accountability.

30. If so, how could these rights be exercised in practice?

Possiblythrough the imaginative use of service level agreements especially whereservice users are a regular clientele such as in care homes and schools. Thestatutory duty placed on local authorities to consult service users could beextended to all public service areas.

31. Could the Citizen's Charter/Service First approach befurther developed?

Thefundamental flaw with the Citizens Charter and similar initiatives is that they tend to measure response, ratherthan quality of response. An example of this would be that a phone help linemay hit a target of response within 6 rings, but this does not measure thequality of the response given. Such targets are common in unimaginative servicelevel agreements and frustrate staff whilst doing little to improve servicequality.

TheGMB believes that there needs to be more emphasis on service user feedback as a measure of quality and less onthe achievement of statistical targetmeasures.

32. Are complaint/redress systems for public service usersadequate and effective?

Thiswill vary between local authorities and public service bodies. One of theweaknesses of private service provision, especially over long term contracts isthat it creates separate lines of accountability, encouraging both client andcontractor to blame each other when things go wrong (as was the case withLambeth LBCs benefits contract). It seems self evident that if a member of thepublic was to complain to their local councillor about services provided by aPFI contractor then the councillor will have far less influence on that servicethan if it was directly provided by the council. This will especially be thecase if the contractor is performing to the strict terms of its servicecontract.

Movesby the government to abolish Community Health Councils in the NHS do notinspire confidence in their commitment to service user rights and adequateredress systems.

30November 2001