When public services have to do more with less and cater to the needs of the communities they serve may be its time to look at participative public services says Niamh Gallagher from Demos as he discusses a new report to be published early next year.
We are on the cusp of a potential transformation in the welfare state and public services, a transformation that is even more fundamental than the introduction of compulsory, competitive tendering and markets since the 1980s. This transformation comes from making people active participants in designing and delivering services that meet their needs, not just passive recipients. A forthcoming Demos report, Participative Public Services, looks at this shift, and describes how it can be achieved.
Participative public services are based on the idea that by supporting people to make realistic plans for the services they need, and devolving budgets to them so that they have more control in commissioning services to deliver on plans, we can turn people into innovators and investors, devising better solutions for them, with spin-off positive effects for those around them. And this kind of approach delivers benefits for the wider system too – making it possible to deliver more personalised, effective, tailored solutions, to create more lasting value, at the same cost, to more people.
The current system is under considerable strain – an ageing population and the growth of long-term health conditions are slowly wearing away the ability of traditional top-down, professional service delivery models to respond to real and changing need. Now, as politicians battle to win over hearts and minds on public services, policy makers are being encouraged to think about new, more economic and sustainable, solutions.
Here, social care is leading the way. In Control - an organisation pioneering the use of individual budgets for people with learning and physical disabilities, and increasingly those with mental health conditions and older people – is proving, day by day, that putting resources in the hands of individuals leads to better outcomes. Local authorities implementing In Control give individual budgets, based on rigourously calculated resource allocation. People are freed to develop their own support plan, commission their own services, and manage their own risk.
The benefits of this approach are striking. Individuals are better able to negotiate deals, solutions are more tailored to them as they commission a wider range of services, and their care is more joined up – based on fitting together formal and informal support. They report a greater sense of control over their own lives, and describe better, more trusting, relationships with local authorities and service providers. In Oldham this has transformed social care, and in other authorities - Essex, West Sussex and Hartlepool among them – it is set to radically transform individuals’ experience of services in the next few years.
But a change like this is not without risk. Issues of equity, economics and fraud are often cited in opposition to this radical new approach. Participative Public Services, published by Demos in January 2008 will address these risks, approach associated challenges, and outline the benefits a shift towards Participative public services will bring.
Competitive compulsory tendering (CCT) introduced market tendering in order to deliver the same services more efficiently. Put simply, people who used to be consumers of publicly provided services became consumers of services provided by private suppliers. CCT was based on the assumption that the private sector would have more efficient ways to deliver existing public services – a straightforward shift from public to private. The shift we advocate is more radical by far. By allowing people to develop their own solutions and generate innovation there is a fundamental change in the role of citizens and consumers. As empowered and engaged participants devising solutions, individuals and their families deploy their knowledge, resources and motivation, generating better outcomes for themselves and those around them. This is participative public services.