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Last updated: 08 November 2008
I would like to start by thanking the Young Foundation, NESTA and the National School for Government for organising this event. I think anyone who is interested in the way the public sector works and delivering the right things for our society has to think that innovation is incredibly important.
I am going to talk less about the ‘how do we do it’, because partly I want to hear from you, and I think you have heard lots of people talking about this.
I just want to say something briefly about where I think we are in terms of the public service debate and what are the ends, the objectives for public services, to which I want innovation to be put. Then I am going to suggest some sort of areas of innovation which people can perhaps respond to.
I think the first and most obvious thing to say, and I think it is important because it is something easy to forget when we talk about the very difficult challenges that we know we face in public services, is how far we have come. You are probably used to ministers talking about all the achievements. I am not going to do that but I do think it is important. In 1997 if we take the NHS for example, people would have questioned the very viability of the National Health Service in the form it was. That doesn't happen any more, and there consensus about the form of the NHS pretty much across the public. That is a tribute to the work of public servants in the last ten years and the transformation that they have brought. The interesting thing about that is that it does mean that the challenges can change, and in a way we can be more ambitious about some of the things that we want to achieve.
In health, for example, from what I have learnt in the last ten years is, yes it is important to deliver on shorter waiting times; we are heading towards 18 weeks as a maximum waiting time for people and that can change people's lives in all kinds of very beneficial ways. But to have a transformative effect on people's lives today you need to deal with a whole set of other problems. Take chronic disease, for example. In order to address that challenge you cannot just deliver it through public service professionals, through government, you also have to deliver it through users themselves – through individuals themselves being empowered to cope with their own conditions. I suppose that is the thing, most of all, that I have learnt in the last ten years: if you want to have a really transformative effect on people's lives, yes you need efficient and well run public services, but as part of that you need empowered users and empowered communities.
I had better just say what I mean by that because empowerment is not a great word. So what does it really mean to people? I want to talk about three aspects of empowerment which seem to me to be important to us.
The first is the most basic thing. When we think about a public service, do we think of the user at the centre of the service? Do we orient the service around the user?
One interesting example to give you is something I know a little bit about, the Pension Service. The Pension Service in Britain has been transformed in the last few years by a woman called Alexis Cleveland who is now in the Cabinet Office. She turned it from a service that was meeting its targets in various ways but actually was not delivering good service to pensioners, partly because the Pension Service didn't know its customers; didn't really understand what their needs were; didn't really, in a way, respect them. She has transformed it.
And one interesting thing about is that the assumption we might all have about pensioners is that they would love to trek into offices, have face to face contact with people and so on to discuss their things. Well that turned out not to be the case at all. When she got to know the customers of the Pension Service, actually they wanted a telephone based service and a service that wouldn't take six weeks to sort out their pension and they wanted a service that was joined up so it wasn't just the pension, it was the pension credit associated with it and Council Tax Benefit and Housing Benefit too. That is what she has started. I think that is about respect: is the purpose of the service built around the citizen.
I suppose the first challenge in public service is how do we get public services across the board to put the user at the centre and show respect for them, show that they are the most important thing about the service. We have made progress in this in the last ten years but I would say there is further to go. We can discuss the various different means that we have at our disposal – choice for users, voice for users, the role of professionals – and discuss the different ways in which we can do that. The first base for me is empowerment.
The second component is personalisation. The service is centred around the user, but does is understand the individual needs of particular users? Is it is oriented around the particular, specific needs of a user?
What is an example of this? If you think about what is happening in social care and individual budgets in social care, that is not just the service that is generally oriented around the users, it is finding a specific way in which users can be in control of their service themselves. That, to me, is a fantastic innovation. It has helped disabled men and women, particularly with specific needs, to design the kind of packages that they want to see.
The interesting thing about personalisation for me is it is partly about individuals and decisions individuals make but it is also about communities and the decisions that communities make. So take youth services, for example. I am a passionate advocate of better youth services, partly again because of my experience as a Member of Parliament, but we haven't invested in them properly for about 40 years. Part of the problem also is we haven't heard the voice of young people when designing those services, so we are starting to pioneer ways in which young people themselves can express their voice. These are services that are inherently collective, they can't be personalised to the specific individual but they can be personalised around groups of young people.
So the issue of personalisation to the individual and the community is a second very important aspect where we need to work on innovation.
The third point I want to make about empowerment, which is the most difficult point of all it seems to me, and the area where we have got furthest to go, is how we recognise that public services are different from private services in one crucial respect: the contribution that the individual makes to the service and to their outcomes, is absolutely as important as the contribution made by the service itself.
What do I mean by that? When you go to a supermarket you choose your items, you pay and you leave. It really is about delivery. I want to take on for a moment this word delivery because delivery suggests a sort of Post Office model. You sit in your house and you wait for the envelope to come through the letterbox. That is not the way in which public services transform peoples lives. If you take chronic health, if you take the challenges in education, they will only make the difference if kids themselves feel engaged in the service and feel they make a contribution to transforming things for themselves and also parents. One of the best predictors of educational outcome is that the parents are engaged in the service itself. I think this is a huge challenge for government and for service providers. How do we convince people that, yes it is partly about providing a good service, delivering a good service, but how do we also convince them that their contribution is equally, if not more important, in determining their life chances and their outcomes?
I see this as an MP for a former mining constituency, where the jobs used to be provided by the public sector in the coal mines, the leisure used to be provided by the public sector because it was built around the coal mines and housing used to be provided by the public sector. There is a real sense of the provision comes from the public sector and less of the sense of people being empowered to change their lives themselves. I think, in a way, this is the most profound challenge we face because it needs a change in government rhetoric and the way we talk about public services and people's role in public services.
It also takes you to an absolutely crucial point which is the role of professionals, not just as people who deliver services but people who navigate people through services and empower them. That is what lots of the best public services are doing on the front line and it is something we need to do a lot more of.
So they are the three challenges: respect, tailoring to people and convincing people they could make a contribution to the service. I think they are the three of the big challenges we face to creating empowered users and empowered communities who can really transform their own lives and the lives of people around them.
I hope that that gives you a sense of where I see the priorities. Innovation across public services is an absolutely crucial part of that and I hope that is something we can now get into discussing.
Thank you very much.