{"id":60,"date":"2012-02-16T14:22:03","date_gmt":"2012-02-16T14:22:03","guid":{"rendered":"http:\/\/www.thedissenter.co.uk\/?p=733"},"modified":"2012-02-16T14:22:03","modified_gmt":"2012-02-16T14:22:03","slug":"rebuild-rebalance-reform-reshape","status":"publish","type":"post","link":"https:\/\/www1.thedissenter.co.uk\/?p=60","title":{"rendered":"Rebuild, rebalance, reform\u2026 reshape."},"content":{"rendered":"

\"rebalance-reshape-reform\"<\/a><\/p>\n

The Northern Ireland Executive announced a Programme for Government 2012-2015, eventually, towards the end of 2011. Plenty to do. In fact, it reads as a massive \u2018to do\u2019 list.<\/p>\n

<\/span>Headline measurement will no doubt be against the more practical elements. All Housing Executive homes will be doubled glazed over three years, or they won\u2019t; either brucellosis will be eradicated by March 2014, or it won\u2019t; either\u00a0there will be no additional water charges, or\u00a0or there\u00a0won\u2019t.<\/p>\n

Elsewhere, the Executive has committed to spending money with broad outcomes. Once again money will be spent, or it will not.<\/p>\n

Then there are the more open points added to the list about producing strategies and plans: developing; implementing; monitoring; evaluating.<\/p>\n

There are lots of words used by way of framing the announcement of the Programme for Government \u2013 rebuild, rebalance, reform; lots of \u2018promote\u2019, \u2018develop\u2019, \u2018improve\u2019.<\/p>\n

Much of the \u2018to do\u2019 list reflects the mundane nature of administering against a fixed income \u2013 the block grant \u2013 with a bit extra from the rates. What the Programme for Government tells us it that Stormont has not risen much above basic administration: the equivalent of an English County Council under \u2018no overall control\u2019; no Party able to take on the mantle of leadership alone. A deal here, a compromise there, lack of major decision making, and very often a significant (if unobtrusive) role for the public servants in the absence of clear coherent direction.<\/p>\n

Frankly, why it took so long to produce this Programme for Government (PfG) is a bit of a curiosity. There is nothing that is startlingly innovative. Mostly off the Departmental shelf. Nothing in the PfG that could not be achieved, and most could be done to at least some extent if not in the entirety within the timeframe\u00a0– unlike last term<\/a>?<\/p>\n

Of course there are one or two items, perhaps more, that would hardly cause a crisis if they were not to be completed on time or at all.\u00a0 Is a plastic bag tax really necessary; what will be the impact on small retailers? \u00a37.2 million on an Obesity Prevention Framework seems a bit of budget largesse, when the finance belt should be capable of being tightened down a notch.<\/p>\n

The success of the construction of this PfG is that to pick on one aspect seems churlish, and to challenge it as a whole would be to demand the baby is thrown out with the bath water. The choreography of the announcement made it a big positive occasion of the hard-working united Executive, all in it together.<\/p>\n

And yet? thedissenter<\/strong><\/em> finds it hard to be enthusiastic. For all the words, it is not clear how, overall, this is a PfG that will rebuild, rebalance or reform Northern Ireland to become an open competitive\u00a0 economy that is driven by the innovation and enterprise of a wealth creating private sector: not that that was a stated purpose of the PfG. To do that the public sector would need to be smaller, more efficient, and more effective. Yes that will mean fewer jobs among those employed directly and those employed indirectly through the voluntary and community sector which with few exceptions isn\u2019t.<\/p>\n

Reducing the public sector is not even an agenda point within the Programme for Government:\u00a0that would require far more than the\u00a0sort of rearranging our public sector is so adept at managing.<\/p>\n

Reforming the public sector in Northern Ireland to make it smaller, leaner and more effective is a huge topic. It starts with thinking that the unthinkable is possible, and that the debate would be better starting sooner rather than later.<\/p>\n

So let\u2019s start with health.<\/p>\n

While PfG talks about transforming Health & Social Care, even though the budget essentially ringfences the Health part (accounting for a full 30% of the entire public spend). \u00a0This hardly provides an indication of the intention to transform. The Compton Report which was released following the announcement of the PfG was very worthy. It recommended a reduction in major hospitals to between 5 and 7. Probably 4 major hospitals are enough, supplemented by local \u201ccottage\u201d hospitals, services provided via GPs and truly preventative social care. To ensure hospital services are strategically managed, abolish the five Health Boards and place Hospital Services into one Authority, allowing hospitals to become independent as \u2018Trust\u2019\u00a0or even \u2018private sector\u2019, to include all major and \u2018local\/cottage\u201d delivery. Integrate this with a distinct\u00a0Community Health Services commissioning body within that Authority, to cover home care and GP services.<\/p>\n

There is no reason why Health resources and Social Services (non-health\/benefits)\u00a0could be\u00a0managed directly, Departmentally. Make the Health & Social\u00a0Care\u00a0Minister directly accountable for the two main services that matter to the public \u2013 effectively Chairman of the Boards \u2013 and charge the Assembly Committee with an enhanced oversight role.\u00a0 This increases accountability, hugely reduces management infrastructure, and opens the possibility to build effective partnerships with private sector providers and make optimum use of social finance.<\/p>\n

It can cost around \u00a3500 per week for an elderly person to stay in a nursing home when good quality home care would allow a proportion of them to stay at home for longer for \u00a3100 week. On average a week in hospital costs \u00a32,000: if demand could be cut by 10% though better home care and support for chronic conditions by GPs and their practice nurses, the saving is huge. Better for the patient, and better use of scarce resources.\u00a0 There are private investors who are interested in this sort of change.<\/p>\n

The fact that \u00a3 millions may have been magically found for the Education budget <\/a>over the next so many years distracts from the fact that we have too many schools and too many teachers because there are too many empty desks.\u00a0 Perhaps the new ESA will start to look at this, though the educationalists who lurk around the idea of a single authority are obsessed with selection, which again distracts that there are too many young people arriving at second level education unable to read or write.<\/p>\n

There needs to be a much more coherent approach to commissioning at all levels of education provision \u2013 and this must include a significant role for the private sector. Schools should be allowed to make a profit to be reinvested in the school –\u00a0 as is permitted in Sweden. \u00a0This is not an ideological point. If there is a belief in the need to move away from over-reliance on public sector jobs we need the private sector engaged and informing curricula at all levels \u2013 primary through to post-grad. \u00a0That might be particularly relevant to vocational courses at Further Education Colleges, which again need only have a single oversight board: do we really need the separate institutions, with their own administrative infrastructures?<\/p>\n

Eleven\u00a0or fifteen Councils\u2019 is not even a question.\u00a0 Increased powers to Council would logically mean decreased powers and purpose for Ministries at Stormont. So there are two realistic options: 1) let Stormont do it all; 2) elect no more than five Councils to provide a consultative and representative role in planning, tourism and delivery of local services commissioned by the centre, and to provide members for the now regional bodies for health, education, and central services.<\/p>\n

It would be easy enough to create five Councils from existing council boundaries or by using the parliamentary constituencies as building blocks (3 contituencies per Council). Apart from the obvious economies of scale this much\u00a0smaller number of Councils rebalances the \u2018Belfast and then everyone else\u2019 nature of a larger number of Councils. All support services could be pooled, such as finance, ICT, human resources. A single waste management authority could be tasked with assuring competitive services in waste management, while taking a wider view of collection through to disposal \u2013 where services are contracted by Councils entirely to the private sector.<\/p>\n

The Northern Ireland Housing Executive has had its day. Retain commissioning responsibility by the Minister, with the close involvement of the Councils. Open the management of the existing NIHE housing stock to the big Housing Associations from the mainland: for one to take the entire stock would be to create a cosy monopoly, so the stock should be split into three, and not necessarily within specific geographical areas. \u00a0This opens the possibility of better management of public finance, and introducing private developers as part of a consortium approach to new development.<\/p>\n

We are well and truly quangoed. Look at the list. Ask, seriously, what does\u00a0such or such a body\u00a0do for the money it spends? All \u2018rights\u2019 Commissions could be put into one. With a minimum wage, why do we have an Agricultural Wages Board? Why is there a River Agencies Board in DARD and not with Environment?\u00a0 Why do we need a Strategic Waste Board?\u00a0\u00a0Why do we need a Strategic Waste Board and a Waste Management Board within the one department, neither of which have the capacity to provide the services of the Waste Programme Steering Group?\u00a0\u00a0Why have a separate ESA and Library authority? We only need one Health\/Social Care commissioning body. Let the hospitals become Foundation Trusts or similar, with private sector partners if they wish, and let them run some community services if that is a natural extension of their role and successfully compete for those commissions from the Community Health budget. Make the GPs take more responsibility and move them away from the prescription and \u201csign-off\u201d culture.<\/p>\n

To move forward on economic development\u00a0there needs to be a close audit of Invest NI and the NITB. \u00a0A smaller \u2018commissioning\u2019 body could take responsibility for developing the overall strategy and then contracting with others to provide development services in sectors. NITB should be a subset of a new INI \u2013 tourism development is a driver for economic growth not just a nice way to run expensive marketing campaigns.\u00a0 Step forward the Chamber of Commerce, Federation of Small Businesses, NI Retail Trade Association for growth strategy partnerships. Fewer local Councils could play a much more effective role in delivering services at a local level, particularly on local business engagement and support.\u00a0Perhaps the big consultancies such as PWC, Deloitte, or more specialist investment consultancies could be commissioned to support and grow specific talent pools or business clusters.\u00a0Less public sector bureaucracy and more private sector engagement, and so say all of us.<\/p>\n

Finally, for now, and presuming that the rebuilding, rebalancing and reforming energy translates in to a reshaped and reimagined Stomont,\u00a0reduce the Departments at Stormont down to six at most. There will still be a need for bodies like a Health Commissioning Agency, ESA, INI but these allocated to specific departments for accountability and review by Assembly Committees. The six could be:<\/p>\n