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Public sector, private profit

The edition of Channel 4’s Dispatches shown last night presented a nightmarish picture of negligent staff and inefficient services within the NHS. There will be deserved anger at the staff who were shown to be at best neglectful, and at worst downright guilty of serious misconduct regarding the patients in their care, and I would hope that appropriate action is taken against them. But are they the problem or merely a symptom of the destructive impact the encroachment of the private sector on the public sector has had?

In an earlier post I pointed out the irony of David Cameron’s claim that the public sector is the ‘enemy of enterprise’. Having worked in the public sector for the last 15 years I can say that it is in fact the increasing influence of private sector practices and methodology within public services that has brought us to the place we are today, where demoralised and disenfranchised staff fight to continue to provide a decent service in the face of relentless cost cutting exercises and slavish adherence to meaningless and trite targets set by central government.

In order to administer the never ending quest to hit targets a whole new breed of manager has appeared and proliferated. Interested only in being seen to be achieving and window dressing the real issues, these are professional managers rather than vocational – where it used to be that senior managers would have worked their way up and have a good working knowledge of their field, we are increasingly seeing the top jobs taken by the new breed who appear to be more focused on managing spreadsheets and reports rather than addressing the day to day reality of providing essential services. We now have a whole level of senior management which is over resourced and disconnected from the ‘shop floor’.

It is often the case that the targets set detract from the real work that needs to be done, the ‘less important’ (non-targeted) work is neglected in the face of the threat of draconian punishments should management not be able to produce the reports showing them in the best light. These in turn are fed up the ladder and eventually some junior minister will proclaim that rigorous standards have be set and maintained, and aren’t we a good little government? Meanwhile, back on the ground floor, staff are reaching burn out and service users are being told that they’re being treated grandly while experiencing the opposite.

You may think that experienced and valued staff would be able to approach senior managers and offer their own view on how the plethora of new procedures and targets should be implemented, after all, they’re surely in the best position to see what impact these will have on the day to day operation of their service? Again in my experience the new style of manager pays only lip service to consultation and will often implement major operational changes with no consultation whatsoever, and without any concern for either the needs of the staff or the overall level of service provided. Try and suggest that perhaps things could be done differently, or that your experience shows possible problems on the horizon, and you will be tagged as a troublemaker and threatened with disciplinary action. I’ve seen it happen all too often.

We saw in last night’s Dispatches the reaction by a senior manager when the methodology and policies he and his fellow managers pursue were questioned – he petulantly turned tail and refused to be interviewed any further unless members of staff were present with the grievances he had been told about – he knew that wouldn’t happen despite any number of assurances regarding the lack of repercussions for any ‘whistle blowers’.

And so we end up with public services full of people wanting to help, wanting to do what they’re being paid for, but instead caught up in the politics of being seen to be doing the right thing while keeping costs down. Is it any surprise that standards fall, that previously attentive staff members start to make mistakes or, worse, even stop caring about their work. Of course, this does not excuse the minority of slackers you will find in every job, but it’s not as simple as blaming those on the front line for poor service.

The whole target culture was introduced under Tony Blair’s neo-liberal government, a government almost as much in thrall to the market as its supposed enemies on the right. Ministerial offices began issuing dictats to their respective services ordering that costs be cut and key performance indicators (KPIs) be met. At this time I noticed in my own organisation a marked increase in the numbers of senior managers and consultants being drafted in to achieve these targets. Billeted high above the action, they would pore over reports and spreadsheets and implement strategies that wouldn’t work at which point they’d look at more spreadsheets and reports. Absent from all this were the views of the staff on the frontline – a huge resource of knowledge and experience is going to waste.

The notion of targets and cost cutting as applied in the private sector simply does not translate to public services. One is responding to markets, the other is responding to the needs of the population – these two things are not compatible. And now Cameron wants to further entrench private sector values (and companies!) within our services: the needs of the public will have to be weighed against the needs of the shareholders, and we’ve seen the results of that particular battle within the privatised utility and transport companies.

Cameron’s claim that public spending is to blame for our financial malaise and we need to slash and burn in order to save ourselves is of course a game of smoke and mirrors. Figures show that the treasury is spending 30% less on debt interest than in 1997 despite all the coalition scaremongering. Where Labour used the notions of ‘best value’ and efficiency to start the incremental privatisation of public services, this government is using the smokescreen of debt to introduce the interests of big business and the markets wholesale into areas where there may be easy profit to be made, but it will be at the cost of services that we hold dear.

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