The latest publication from the Centre for Policy Studies arrived today: “Freedom for Public Services” by William Mason and Jonathan McMahon. Better services at lower cost, and more fulfilling jobs for public servants, are quite possible.
As ever, this CPS report is intelligent, brief, clear and insightful. The sheer scale of central regulation is shocking even as one who has begun to study the situation. Consider for example the list of regulators for the NHS:
- The Healthcare Commission
- Strategic Health Authorities
- The General Dental Council
- Payment by Results (The Audit Commission)
- The National Patient Safety Agency
- The National Clinical Audit and Patient Outcomes Programme
- The Commission for Social Care Inspection
- The Mental Health Act Commission
- The National Institute for Health and Clinical Excellence
- The Health and Safety Executive
- The Medicines and Healthcare Products Regulatory Agency
- The Clinical Negligence Scheme for Trusts, part of the NHS Litigation Authority
- The National Commissioning Group
- and the Department of Health itself
Furthermore, healthcare professionals are individually regulated by, variously, medical schools, Royal Colleges, the Postgraduate Medical Education and Training Board, the General Medical Council and other professional organisations.
As you would expect, the paper makes a number of practical recommendations for simplification, efficiency and greater accountability in health and in the other public services, including the police, local government, schools and higher education. One summary point is particularly telling:
Central control is not working. Leading politicians of both main parties recognise that public services in the UK today are too large and complex for effective central management. In particular, David Cameron’s advocacy of the post-bureaucratic age is based on the premise that freedom of information can “make possible a new world of responsibility, citizenship, choice and local control.”
I recommend the report.