Wednesday’s Autumn Statement arrived on a wave of publicity,
pre-announced gambits & commentariat predictions. But for those of us expecting or being
encouraged to expect more detail on English devolution proposals the actual
statement failed to live up to the hype.
The Chancellor made an early reference to the “Northern powerhouse” that
excited some social media speculation, but beyond a summary of proposals for
Greater Manchester & a reference to English Votes for English Laws the
subject didn’t progress beyond Mr Osbourne’s pledge that “my door is open to
other cities who want to follow” the
example of Manchester. Reform of stamp
duty took the limelight, & reform of English democracy retreated to the
sidelines.
The coverage following Wednesday has (Stamp Duty excepted)
centred around the analysis that the continued long term public sector spending
plan detailed in the Autumn Statement will lead to the lowest proportion of state spending
since the 1930s. A further £15billion
reduction in Whitehall
spending over the first two years of the next Parliament have been promised
(subject to voters’ agreement, of course) under the slogan of “Savings and
reform”. This section of the statement
is worth quoting in full:
“We’ve shown in this Parliament that we can deliver spending
reductions without damaging frontline public services if you’re prepared to
undertake reform.
Crime is down.
Satisfaction with local government is up.
Savings and reform.
We will do exactly the same again.”
All of which is perhaps unsurprising. Data sourced by the IFS and reported by The
Economist illustrates the percentage change in Whitehall departmental
budgets between 2010-11 and 2014-15, with Local Government reducing by around
25% and Communities by 45%. And yet
protection remains and grows for certain areas, especially the NHS.
If we go along with the old saw about the NHS being the
closest thing England
has to a religion, then National politicians appear to be devout
believers. The Chancellor announced a
further £2billion every year (yes, every year) to frontline NHS services,
alongside £1.2billion investment in GP services. And who could disagree with more acute care,
more nurses, more Doctors, more NHS?
Labour, who see the NHS as their trump electoral card, certainly
couldn’t & so promptly announced that the extra £2bn announced by the
Chancellor would be added to the £2.5bn they had already pledged should Ed
Miliband become Prime Minister.
This NHS arms race between the political parties is a key
electoral theme, & as such can be seen as an entertaining parlour game. Instead of tanks & rocket launchers parading
across Red Square, perhaps our political leaders dream
of columns of ambulances & paramedics marching along The Mall. But it does obscure and ignore some of the
biggest (actual, real) challenges facing our society, our population’s health
and future development.
People working within & outside public services know the
issues we face: an ageing population that is living longer but enduring more
long term illnesses; significant issues with obesity, diabetes & other
limiting conditions; longer working lives & the requirement for skills
development, re-training & innovation; the shortage of quality affordable
housing, & so on. From the Marmot
Review onwards every analysis of current and future demands on the state has
identified the importance the wider, or social, determinants of health &
wellbeing. The importance of prevention,
of changes upstream to reduce future impacts of these issues is commonly
accepted. The problem is the very people & organisations that have the
potential to at least assist in meeting these challenges in the future are
currently being slowly strangulated & the focus remains on the last port of
call, the already overstretched & buckling Health service.
None of which is to say that reform & savings are not
required across the whole of the public sector.
Most of my colleagues & acquaintances understand the need for
change, & believe the days of largesse are deservedly over. The newer generations entering the public
sector workforce are bringing with them a greater emphasis on creativity,
problem solving & inventive solutions, unburdened by concerns over
tradition, hierarchy & political ideology.
What they require is an environment that provides the freedom to innovate,
collaborate & genuinely re form how the public sector might operate,
unhindered by ring fences & political groupthink. The sacred cow of NHS funding illustrates the
barriers that remain between the present & future forms of the public sector.