Thursday 16 May 2013

Government responds to the Boyle Review

This time last year, I was preparing to start work on the government's independent review into barriers to choice in public services.  My pencils were sharpened, my only suit pressed, my plans not quite formulated.

I eventually reported to the Cabinet Office and Treasury in January, and the result has become known - rather embarrassingly, but this is the way they do things in government - as the Boyle Review.  It received an unexpectedly enthusiastic response from the Cabinet Office ministers, and from Danny Alexander at the Treasury who had been so involved in commissioning me.  I went away relatively confident that the government broadly agreed with my approach and proposals.

Before I go on, let me just say what that approach was.  The core of the review was to get out there and talk to the users of services, and find out about their experience of 'choice' - and check what I heard with a major poll - and reach some conclusions:
  • First, that the bureaucratic barriers to choice remain powerful if you are less confident or articulate; and if you want something slightly out of the mainstream then there is inequality present in the scope of choice available to everyday people across the UK.
  • Second, people, especially the disadvantaged, need information and advice on what choices are available to them, yet often this proves problematic. Some people do not easily have access to the internet and this makes it even harder to find out what choices are available, and they also want face to face advice to make sense of it; 
  • Finally, the kinds of choices people think they are getting are often not what they are being offered in reality, and there is a need for more flexibility in the way services are delivered.
The last one was really key to it.  Competition has a place in public services - there is no reason why people should put up with poor services - and so does online information.  But choice needs to be so much more than that, if it is going to provide people with the services they want - it needs to provide a series of levers that allow for service flexibility.  

I called that 'broad choice' to distinguish it from the narrow, formal choice that the system has been struggling to provide so far.

So I'm pleased that the government's 'initial response', published today, is so positive.  I'm glad they use words like 'enlightening'.  I'm pleased they have supported seven out of ten of my recommendations - though this slightly obscures the full truth, which is that some of these were happening anyway and some have been agreed by especially careful wording and are not really quite what I meant, as they must know.  Such is the world of government, and I understand that.

I am pleased that they agree with my proposal about publishing information comparing the performance of schools achieving the best outcomes for free school meal children.
I'm glad they have accepted the 'co-production' recommendations about social care assessments, which are now in the Care Bill - more on that another time.

I'm particularly glad that they have agreed that there will be an advisor to the Prime Minister who will "champion broad choice across public services and work across departments and services to tackle barriers to choice."  

I take this to mean that they accept my basic premise that choice needs to be broadened out if it is going to be (a) meaningful and (b) effective.  It rather depends on who they appoint, of course.  I know who I want them to appoint (and I'm not going to ruin their chances by naming them here).

Where I am disappointed, it is because the whole thrust of the review, and so many of the conversations I had with service users - not to mention the poll findings by Ipsos-MORI - suggest that, for a good third of people using services, online information simply isn't enough.  So, although online information is important, face to face contact is absolutely vital if everyone is to get the kind of choices they need.  

I proposed a way forward which evidence suggests would also save money: extending the growing role of peer support volunteers into giving signposting and choice advice.  This is what they say:

"We will explore how to take this recommendation forward including expanding existing programmes; improving awareness of peer support programmes and looking at how we work with mentors and volunteers."

That isn't a no, but it isn't quite a yes, yet.  I am assured that they are looking at the best model for taking this forward, so we shall see.  But this is a vital reform, merging the co-production and the choice agenda, which would do more than anything else to bring choice - broad or narrow - to the whole population.

I won't be the only one to detect a defensive note in the response.  This reveals, perhaps, how nervous some departments were when the review began.  But there is no need to be defensive.  The government was brave enough to commission me to see what was really happening on the ground - people's real experience of choice.

The difficulties I found won't be solved overnight, and everyone understands that.  But my impression is that the narrow choice agenda, which requires a huge infrastructure of watchdogs and competition institutions, may have got as far as it is going to for a while.

I believe in choice, and choice beyond simply encouraging competition - not just because it is good for service users, but because flexibility is good  for public services too.  Sclerosis is expensive.  

Whether my review will turn out to have found a way to revitalise the choice idea depends on what happens next.  Watch this space...

More on my review (please ignore terrible picture of me) in Civil Service World interview.  See also coverage back in January.

No comments: