Making Sense of Entitlement

Recently-reversed entitlements such as the promise of free care at home and the scrapping of maximum hospital waiting times may have rung some alarm bells, but a new report from the New Local Government Network (NLGN) sees this as a positive move in the right direction and calls for a more devolved, locally-focused system for public service delivery.

NLGN’s latest paper, Making Sense of Entitlement, argues that the use of entitlements and guarantees to citizens replicates many of the problems of traditional performance targets and restricts the ability of services to focus on the needs of their local communities. It concludes that users would benefit and better outcomes could be achieved more efficiently if public services were subject to less central instruction, as long as the necessary safeguards of transparency, scrutiny and accountability to local citizens are in place.

Entitlements offering public service users a number of guaranteed commitments from public services were a prominent feature of policy under the previous government. They included:

• Maximum waiting times in the NHS
• Free care at home for older people and the disabled
• ‘September Guarantee’ offering all 16 and 17 year old school leavers a guaranteed place in education or training
• One-to-one tuition for all school children falling behind in English and Maths

However, the Coalition Government has already scrapped the ‘personal care at home’ bill and is proposing an end to ‘political targets’ in the NHS. Government spokespeople have also been at pains to emphasise that ‘those on the frontline know better than government ministers how to spend money’ in relation to one-to-one tuition.

NLGN’s report highlights the considerable evidence that uniform entitlements distort the priorities of frontline staff away from providing the best possible service, towards fulfilling specific entitlements at the behest of civil servants in Whitehall. Entitlements such as the NHS waiting times are also vulnerable to manipulation, for example holding A&E patients in ambulances so as to process them within the four hour maximum wait.

As such NLGN recommends that:

1. 1) Priorities and policy aims should be formulated on the basis of a negotiated agreement between central government and the local authority based on policy objectives and the needs of the local community. Drawing on the findings from the Total Place pilots, NLGN proposes that such a ‘Place Agreement’ should define clear service outcomes to be achieved locally and include additional devolution of funding and powers to meet these objectives.
2. 2) To provide the necessary safeguards, both central and local government should ensure that public service outcomes are clearly transparent and accountable to citizens. This should be done through a series of measures including e-transparency, an assessment system focused fundamentally on the citizen, and greater scrutiny from the local government family. Such a system will be the focus of NLGN’s forthcoming report in July 2010 on the ‘Future of Assessment’.
3. 3) Where the Coalition Government chooses to maintain or introduce future entitlements, that these should be broad and outcome-focused, rather than narrow and procedural, to allow local bodies flexibility to meet the needs of their community. The Policing pledge commitment to spending time on the beat working to agreed neighbourhood priorities is a positive example.
4. 4) Local authorities should be given greater responsibility for services such as healthcare and policing – strengthening joined up working and giving a cohesive democratic mandate to locally-responsive priorities.

Luke Hildyard, the report author said:

‘Fears of public services suffering as a result of the abandonment of entitlements are unfounded. Equivalently resourced services ought to be capable of producing better outcomes if they are subject to less central instruction, not worse. Provided the necessary safeguards of transparency, scrutiny and accountability to citizens are in place, public service users will benefit if the coalition’s move towards a more devolved, locally-focused system of public service management leads to the scaling down of uniform national guarantees’

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