Westminster Scotland Wales London Northern Ireland European Union Local
ePolitix.com

 
[ Advanced Search ]

Login | Contact | Terms | Accessibility

Rt Hon John Redwood
Home
Biography
Constituency
Campaigns
Contacts
Links
Articles
Press Releases
Speeches

Wokingham

Rt Hon John Redwood
Articles

Too much spending can damage your health

If money be the food of public services, spend on. We have excess of it. The banquet has been laid before us. Health, education and the law may gorge at the table until they are replete. The government promises that the public sector is going to be brought to life by a glut of new money.

It won't be like the other times since the war when state munificence failed to satisfy, they say. Always before either the table was not fully laden or it was the wrong kind of food. This time it will be more money with reform. No pound will be wasted.

Listening to minister after minister announcing record funding and making all sorts of promises it was possible to dream sweetly. Will we at last be able to have treatment or operations whenever needed? Will the tube trains run on time and would the carriages be clean? Will the crime rate drop, the policemen come on television to praise the Home Secretary and local Councils purr contentedly at just how much cash they had sloshing around? Could this be the free lunch so admired by some politicians?

Outside the House of Commons and the hothouse studios of Westminster it already looks very different. In the same week that we heard of spend, spend, spend the London Underground workers went on strike, complaining of underfunding of their public service. Local authority employees downed tools and said they were bottom of the queue for more cash. They saw no sign of a slap-up rise coming their way. My local Primary Care Trust, recently established under government orders at considerable expense to supervise our local GPs, told me that their money will be cut back. Apparently the government thinks we only need 63 GPs in my district, not the 76 we currently have. Local firemen say that they cannot afford to live on their present pay. The Mayor of London has taken the London Underground and the government's public-private partnership to court, claiming it will not work. Consignia (just call me The Post Office) is trying to charge us £728 to have our mail delivered on time. My local Council is pouring over £2.5 million of spending cuts to try to balance the books.

So which view is right? Is the government correct to tell us now the money fest is on and all these scenes of budget cuts, strikes and public sector unhappiness will soon be a thing of the past? Or are the public sector lobbyists right, that despite the money, my local GPs, Council, firemen and rail system are still starved of cash?

I fear the government is soon to discover that stuffing the public sector with money may give it indigestion. The public sector now has an ability to spend huge sums on management, bureaucracy, advice and reorganisations. It seems to find it difficult to recruit, retain and motivate the service providers we need. Just this week there are hundreds of very expensive jobs on offer that will make little or no difference to the hospital waiting lists or the crime rate.

The newly established National Patient Safety Agency seeks a deputy Director for £49,000 to £57,000 a year to “improve patient experiences” along with an Assistant Director for Information Services at £38,000-£44,000 and an Assistant Director Human Resources for £40,000 to help out. Maybe a few more nurses would have done the job better. The main patient experience that needs improving is access to medical treatment in a timely way. It's not more spin doctors we need but medical doctors. South Gloucestershire is keen to recruit an Economic and Social well-being Team Leader at £40,000 a year - probably a good enough salary in South Gloucestershire to promote the economic and social well-being of the lucky recruit. The newly formed Social Care Institute for Excellence is offering £85,000 plus attractive benefits for a Chief Executive.

Now you get a different picture. There will be a huge expansion in the army of networkers, co-ordinators, managers, auditors, advisors, and business consultants. There will be less available for the extra nurses, teachers, doctors and policemen we do need.

Worse still, the people who serve the public will continue to feel let down. They will see so much of the money going on the army of invigilators and second guessers, as they struggle to do the difficult jobs in health, law and order and education. There will have to be pay increases. That will eat up quite a lot of the extra money available. Public sector cost inflation is already running at 6.5% and may rise further as the money finds its way around the system.

There is some switching of money underway, from the more affluent to the less affluent parts of the country. This is a strange decision given the way the less affluent parts already rightly receive much more, and given the big increase overall. The better off places may have less need for public service, but they experience much higher costs in providing it. A truly national service like Health should recognise this.

The government is unsure of its attitude towards trusting local people or centralising the services. They will set up targets and monitoring at national level for schools, sometimes working with the Local Education Authority but on other occasions overruling it or even changing its management. There will be many a muddle and dispute about who does have the power to change the Head teacher at a school, who has the power to move in and sort out a failing school, and who is ultimately responsible if a school continues to do badly.

It's the same in Health. The government is spending a lot of money on reorganising local health management into new Health Authorities and Primary care Trusts, only at the same time to set more and more targets and make more and more decisions from the centre. In the case of both of these two services it would be cheaper and better to decide whether it was being left to the localities or whether the centre was taking over. We are paying twice for two systems that will live uneasily together.

Gordon Brown's great experiment in Ten Year Plans, money with strings and giving the public sector more than it dared ask for, will unfortunately fail to deliver the improvements we want. There is too little trust of the patient and the student or parents, too little choice in the system to make the service providers accountable to the people who matter, the people who use the service. Without such choice and accountability no army of auditors and second guessers, however big and well paid, will succeed in making it all work. It will be bigger, dearer, patchier and even more distorted by bureaucratic priorities and political necessities.

Those who can afford to drift to private health care and education will continue to do so. The rest, far from feasting at the banquet will feed off the leftovers and be bitterly disappointed. The big social divides remain will remain. This week has been notable for the contrast between the joy of politicians making it Christmas for the public sector, and the impact on the public as we struggle with the long waiting lists, the transport chaos and the uncollected rubbish.