By stewartb

A detailed and wide ranging ‘stocktake’ of UK government funded public services has just been published by the Institute for Government (IfG) with the Chartered Institute of Public Finance and Accountancy (CIPFA). Termed the ‘Performance Tracker’, this is an annual publication which in 2023 is covering the state of nine services – general medical practice, hospitals, adult social care, children’s social care, neighbourhood services, schools, police, criminal courts and prisons.

Source: IfG/CIPFA (30 October 2023) Performance Tracker 2023 – Government is stuck in a public service performance doom loop. (https://www.instituteforgovernment.org.uk/publication/performance-tracker-2023)

The report is focused on Westminster government actions and on public services for England: the services are all in areas of devolved responsibility. Nonetheless, the assessment has relevance for Scotland.

To state the obvious, Scotland, its government in Edinburgh and the resourcing of its public services do not function within a fully independent nation-state distinct from the rUK. The Scottish Government can make a better (or worse) fist of public service delivery – and often does the former. However, the subordinate nature of Scotland’s place in the UK, limiting powers available to resource services to address evolving needs and wants of citizens, means that the state of public services in England have spillover consequences for the other UK nations.  This is most crudely evident in the size of the so-called ‘block grant’ but other ‘dependencies’ are impactful on Scotland’s resource development more generally, including but not limited to the reserved matters of immigration, trade and energy.

There is only one nation in the UK whose government has ALL POWERS to effect the performance of the public services for which it is directly responsible, England. The ‘Performance Tracker’ report exposes how government in Westminster is performing, Candidly, Scotland may perform marginally better but it cannot buck sustained trends of underinvestment by government in the UK/England leading to decline and failure whilst still within the Union.

Key findings and conclusions from the IfG/CIPFA report summary are reproduced below, with my emphasis. (There are further detailed insights into the state of Westminster’s governance of England in chapters dedicated to each of the service areas.) As you read through the catalogue, recall that it is highlighting the legacy of Westminster governments that a majority of voters in Scotland have often had the good sense to reject … but yet still get!

Overall conclusions:

• ‘The public is experiencing first-hand the consequences of successive governments’ short-term policy making, with decades of under-investment in capital having a serious impact on the productivity of public services’.

• ‘All the services covered in this report, with the sole exception of schools, were performing worse on the eve of the pandemic than a decade earlier. The situation was particularly dire in prisons, hospitals, general practice and adult social care. But they are performing even worse now.’ 

• ‘Teachers, nurses, doctors and social workers work in crumbling and cramped building and many services are experiencing a full-blown workforce crisis.’

• ‘the government risks getting stuck in a doom loop – with the perpetual state of crisis burning out staff and preventing services from taking the best long-term decisions.’

• ‘All this is the result not just of the pandemic, clearly disruptive though that was, but also of decisions taken over the course of many years and different administrations.’

And on future prospects:

• ‘The situation after the end of the current spending review is worse still’

• ‘the government’s spending plans from April 2025 onwards – which Labour have also committed to – will likely mean that all services other than children’s social care could be performing worse in 2027/28 than on the eve of the pandemic and in most cases services were performing worse on the eve of the pandemic than they were in 2010.’

On NHS England:

• ‘Hospitals are doing substantially worse on all major performance metrics’
• ‘The elective waiting list continues to grow, reaching 7.8m in August 2023, up from 4.6m on the eve of the pandemic’ and ‘the elective waiting list reaches a new record high every time figures are published’
• ‘an ever-shrinking number of GPs’
• ‘The proportion of registered nurses with less than five years’ experience rose from 19.3% in March 2019 to 25.5% in March 2023’. 

The IfG report explains that on NHS England: ‘Performance is worse in some services despite substantial spending and staffing increases. In hospitals there were approximately 13% more doctors and nurses in March 2023 as compared to March 2020, yet many areas of activity have not returned to pre-pandemic levels.’

However, on capital spend on health services which impacts productivity:

• ‘since 1970 there have only been two years in which the UK did not spend below (often much below) the OECD average; today the NHS has half as many CT scanners per head of population as the OECD average’.
  
  

On local government in England:

• ‘Seven local authorities have issued a section 114 notice – effectively signalling ‘bankruptcy’ – in the last three years, compared to just one in the first three decades that the measure existed. Other councils have warned they may follow suit.’
• ‘Cuts to local government funding at the start of the 2010s have forced local authorities to make their own cuts in response – usually falling on unprotected responsibilities like neighbourhood services. Even statutory services such as adult social care have become more closely rationed. Fragility has become a defining characteristic of today’s public services.’ 

More on social care:

• ‘In children’s social care, workforce numbers are falling for the first time, resulting in a record vacancy rate’
• on adult social care” ‘there has been little progress in reducing unmet and under-met need.’ 

On education services:

• ‘Huge problems exist in teacher training: around 30% fewer trainees started postgraduate teacher training in 2022–23 than the government thinks were needed, based on trends in pupil numbers and other factors. ‘

On the justice system in England:

• ‘prisons are at bursting point, with inmates routinely being held in police cells to deal with overcrowding and the justice minister even considering ‘renting’ cells in other countries.’
• ‘The crown court backlog is at a record high, reaching 64,709 cases in June 2023, compared to just 40,826 in March 2020. However, accounting for the greater complexity of cases in the backlog, which now includes a disproportionate number of jury trials, the ‘true backlog’ is now equivalent to 89,937 cases.’ 
• on capital spending in the decade before the pandemic: ‘The worst hit was the Ministry of Justice, where annual capital spending averaged less than half the real-terms spending in 2007/08.’ 

On public sector pay:

• ‘Public sector pay freezes and below-inflation pay rises in the 2010s fuelled dissatisfaction with pay that this year, amid high inflation, erupted into the worst public sector strikes for decades’
• ‘The government’s approach to strikes – particularly its refusal to negotiate on pay for months – likely extended their duration and thus the level of disruption caused to public services’.

On capital investment:

• ‘Public service performance has been weakened by underinvestment in capital’ and ‘the decade before the pandemic saw particularly deep cuts to the capital spending of the departments overseeing the services covered in this report.’
• ‘Governments have underinvested in capital across all public services for more than half a century, leaving GP surgeries, hospitals, schools, courts and prisons that are not fit for purpose.’ 
• ‘The pandemic is no longer having a meaningful direct impact on the performance of public services. But their ability to bounce back from the shock of Covid has been severely hampered by historic underinvestment in capital – that is, buildings, equipment and the like.’
• on maintaining public sector infrastructure: ‘Across hospitals, schools, criminal courts, prisons and the road network the maintenance backlog now totals £37bn.’  

What is the English government’s excuse?

The IfG/CIPFA’s assessment of failings in capital investment by successive UK governments ‘over more than half a century’ brought to mind this from an article in the Guardian dated 1 November 2023 on criticisms of the Scottish Government: ’The report, by Gordon Brown’s Our Scottish Future thinktank, which has close ties to Labour, says much-needed reforms to public services and economic investment have been hampered by short-term decision-making and an unrelenting focus on referendums and elections.’

There is indeed a strong case for ‘much-needed reform’ in Scotland – of our constitutional status! And there is a big issue around ‘unrelenting focus on referendums and elections’ – it is that Scotland’s right to a referendum is being denied as mandates obtained at (bothersome) elections ignored.

The IfG/CIPFA’s Performance Tracker provides yet more evidence that historic claims of being ‘Better Together’ in this Union and of ’UKOK’ are now without merit, if they ever had any! And with every year that passes within this Union, the opportunity costs burdening us, our children and grandchildren mount.

Note on credentials

The London-based think tank, the IfG describes its mission as follows: ’The Institute for Government works to make UK government more effective through rigorous research, open discussion and fresh thinking.’ A charity, it claims to be independent, non-partisan and to work with all political parties. Its board, chaired by Lord Sainsbury of Turville, consists of well-connected Westminster and Whitehall establishment figures from across a fairly broad political spectrum. As such, its research output in a UK/England context is worthy of attention.