The odd relationship between less and more

Even I have to admit that the burdz mind is a scary place.  There is a constant swirl of questions on policy matters to which I, and no one else, seem to have the answer.

Scottish Labour reckons 13,500 jobs will be lost under this year’s local government settlement.  Is this necessarily by itself, a bad thing?  If the work these people used to do is no longer there, why should they continue to be employed to do nothing?  Of course, the removal of that work is what might well be the bad thing but is that necessarily so?

Take police funding, numbers and crime levels. Generally, police funding has been protected in this round of budgeting, largely due to it being ring-fenced and therefore, allocated separately by the Scottish Government.  Where police forces have identified shortfalls between government grant and their spending need – often, it is claimed, to keep services and police numbers at previous levels – local authorities will top up out of their funding allocations, taking money away from other services in the process.

But why is no one challenging the assumption that the police needs this money more than other areas?  Crime levels are down generally, although there are stubborn and worrying upward trends in violent crime.  Even the fear of crime is decreasing.  The Cabinet Secretary for Justice, Kenny MacAskill, regularly trumpets the Scottish Government’s success in this area.  So why do we continue to need more police, or at least, the same number of police as before?  Or is it – as is asserted – that the high number of police officers has resulted in those crime figures dropping?

There is an unhelpful trend in policy circles, now that the Scottish Government has committed itself to shifting expenditure away from just in time (or after the fact) intervention to acting early and therefore, preventing problems happening further down the line.  This approach clearly has implications for current services and fiefdoms with services and areas of expenditure at the wrong end of the spectrum at risk.  So everyone is now making a claim for what they do as amounting to preventative spending.  The police is no exception.  Investing in high numbers of police officers is preventative because it is resulting in fewer crimes – see?  Look at the figures, there is the evidence.

But in truth, that is spending at the wrong end of the spectrum.  That is waiting for problems to arise, for the circumstances which allow crime to flourish to continue unchecked and unaddressed, sitting back and watching the children who get themselves into “bother” at an early age graduate as full-blown potential adult criminals.  Surely, if we are serious about preventing things, the money currently spent on expensive police officers should be being spent on much cheaper health visitors, family support workers, nursery and classroom assistants, play workers and therapists who can stop the chain of supply, or at least try to.

Yet, these are the kinds of things being cut from many council and health board budgets.  Sarah Boyack was right to point out that women workers, in particular, are most likely to be worst affected by jobs going.  So here’s another question – why is it that women’s work and jobs are expendable when cuts have to be made, when men’s are not?

More questions, this time on health.  Why are health boards overspending despite having their funding protected?  The increasing cost of drugs is not a good enough answer, frankly.  Aren’t there cheaper ones available?  If not, why not?  And why are we continuing to spend so much on drugs in any event?  Significant progress is being made on tackling some of Scotland’s biggest health ills – cancer, heart disease and stroke.  So why then is having fewer nurses and doctors – as Labour is wont to decry – by itself a bad thing?

Surely, if we are all healthier and our wellbeing is improved, we need fewer health professionals to treat us?  Or is it because we have huge numbers of health professionals that we are all getting better?  But, of course, we are not all getting better.  In many deprived areas, the outcomes in terms of wellbeing and life expectancy are woeful.  Are we diverting resources into these areas – in serious amounts – to try and fix these problems, to address the huge inequalities that exist?  Are better off areas getting significantly less to spend as a result?  Of course not.

Yet, some of those areas with better health outcomes are highly rural.  Providing any level of healthcare costs more because of rurality and the lack of economy of scale in provision.  It is much cheaper to provide key services in high population areas than in low ones, where higher numbers of people can be provided for.  Have we managed to resolve this conundrum yet, beyond the time-honoured swing back and forth between centralisation and specialism, and localities and generalism?

This dichotomy exists all over the public sector.  There are fewer children, so why do we need more teachers, unless it is to invest in smaller class sizes, something most councils paid lip service to in the years of plenty and have now largely given up on, now times are lean.  Is the spend per pupil the same in well-off areas as in poorer ones?  Is universalism the right approach anymore if 20% of children are still being left behind, despite record levels of investment in education over the last thirteen years?

Local authority housing has, for many years, provided one of the best/worst examples of illogicality in expenditure.  Look at most housing revenue accounts over the last ten years and you will find a pattern of falling numbers of houses, reduced or at best, largely static maintenance budgets but increased spending on staffing and especially, management activity.  And rising rents to pay for it all.  The result?  Tenants paying more for less.

Admittedly, this was much more heightened when right to buy was at its peak, but the point is the mindset.  It is prevalent and redolent everywhere in the public sector.  Short term decisions are made, largely to preserve vested and self-interest, when what we need is strategic policy-making at all levels of government which applies resources, methodically and evidentially, to where and how they might be needed most and will have the greatest effect.  We’ve been promised shifts in the planning, design and delivery of services for years, yet now the chips are down, we’re getting the same old, panic driven, slash and burn approach to making cuts.  Yet, by and large, there is still “more” right across the public sector, even when it is required to tackle “less”.  Worst of all, is when there is “more” but “less” to show for it.

I told you my mind was a scary place, but one final question.  Isn’t it scarier still that key influencers and policymakers – politicians especially – aren’t asking questions like these and applying themselves to finding or working out the answers?

 

 

 

 

6 thoughts on “The odd relationship between less and more

  1. Burd, women’s jobs are most expendable because they are less likely to kick up hell,The jobs of GPs are least expendable because they are articulate and literate at defending their fiefdom and because the NHS is the national religion.

  2. All very good questions, some of which reminded me of a report I read recently from a group called GPs at the Deep End. It’s a group of the 100 GPs working in the most deprived areas of Scotland and it introduced me to something called the “inverse care law” which says that the people least in need of healthcare are likely to get the most of it. They made all sorts of good policy suggestions in their manifesto last year: we can but hope that some of them get accepted.

  3. When governments cut services, they look at what will have the least political impact, rather than what might actually be more beneficial in the medium to long term.

    What really gets my back up is when a minister speaks as though “nanny knows best”. You only need to look at Andrew Lansley to see what I mean.

  4. Burd flies into dangerous airspace and comes through with feathers resplendent.

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