Giving People Opportunity to Choose - Public Services

The historical context for the current debate on public service reform goes back at least as far as the creation of the modern welfare state in the years after 1945. This saw the establishment of a broad and long-lasting consensus that whole areas of activity, previously in the private sector, should now be regulated or directly owned by the state in the public interest to secure both efficiency and equity. Variations to the post-war model of provision of public services have tended to involve either target-setting, benchmarking and performance-related pay; or competitive tendering and external contracting for defined, often stand-alone, services ranging from cleaning to IT. Both of these approaches are now well established as part of public service reform. The Committee has in the past few years examined many aspects of this reform, including the culture of performance targets and league tables.

The third variant, less developed but increasingly important in the debate on the public services, is choice, often defined as giving individuals the opportunity to choose from among alternative suppliers, whether or not entirely within the public sector. The choice that often matters most to those who are more reliant on the provision of good local services is the ability to make decisions which have a direct and immediate impact on the quality of their lives. It is clear that if choice is to succeed it will have implications for the Government’s wider objective of containing costs and increasing the efficiency of the public sector. For choice to be effective we found it was necessary to ensure additional capacity in the appropriate places. This not only comes at a cost, but expanding a successful school or closing a hospital cannot be an immediate, or even a practical, response to user choice. The complementary point was made that choice without “voice” is much less effective. As David Miliband MP, when Schools Minister, said “choice and voice are strengthened by the presence of each other: the threat of exit makes companies and parties listen; the ability to make your voice heard provides a tool to the consumer who does not want to change shops, or political parties, every time they are unhappy”.

Established methods of recording user satisfaction, handling complaints and offering redress are far from satisfactory. More care and more imaginative consideration need to be given to making such ‘voice’ mechanisms more effective. We therefore propose the development of a measurable and comprehensible Public Satisfaction Index. It is concluded that if users of the public services have the right to choose they should also have the right to expect a guaranteed minimum level of service. A choice between several poor schools or hospitals is no real choice at all. We commend the idea of ‘Public Service Guarantees’ which build on service standards schemes, such as the Charter Mark, which already exist. Public Service Guarantees would articulate the expectation of good customer service and provide the means to ensure that they are met by providers.

Three services where the debate on choice is especially lively were examined —health, secondary education and social housing—but it is believed that much of the analysis can also be applied more widely.

Choice, Voice and Public Services; House of Commons, Public Administration Select Committee, fourth report, 2004/5