Co-producing public services could save billions, says government czar

21 May 2014

Public service users working alongside professionals could save taxpayers billions each year, a new report from CentreForum suggests.

Written by the government’s independent reviewer of public services David Boyle, the report sets out ways that ‘co-production’ of services can be applied more widely in health, housing, social care and other contexts.

Co-production is described as “the type of service delivery model that the father of the welfare state, Sir William Beveridge, envisaged six decades ago”. But the report says the way public services have evolved in Britain has precluded it from being widely applied.

“Co-production denies that professionals are the only people required to do practical things”, writes Boyle. “It also denies that everything necessary for support – whether in health,education or social care – can be paid for. Both of these were understood very well by Beveridge, but have been sidelined in the UK, and disastrously so.”

Examples of co-production already in practice include citizen justice panels, co-operative nurseries as well as time banks, where people offer services to members and can choose services they would like in return.

The report says that there are clear social benefits from producing services in this way. It argues that service users, their friends and families, are able to build a much broader range of activities and gain the respect that goes with being “equal partners”. 

In addition, the report finds that there are significant savings to be realised through co-production. Research has identified that it could cut NHS costs by at least 7% (£4.4 billion) a year and potentially up to a fifth.

David Boyle said:

“The great divide in public services, between exhausted professionals and their clients, who are expected to stay passive to make them easier to process, is corrosive and hugely wasteful.”

“The key issue in public services is how to unleash the huge resource that is represented by service users, their families and their neighbours, to make the system more human and more effective.”

Scots deserve facts when voting on independence, says think tank

14 May 2014

Think tank dubs SNP’s independence plans “unrealistic” and urges Westminster to table legislation for further devolution and a federal UK

The Scottish National Party’s blueprint for an independent Scotland has huge holes in it, a new report from CentreForum warns.

The think tank says that the SNP has been unrealistic in projecting what will happen if Scottish people vote for independence this September.

It urges the UK government to seize the initiative by tabling legislation for further devolution in the event of a “No” vote.

Toby Fenwick, CentreForum research associate, said:

“The SNP can’t fulfil key promises it has made because its plans don’t add up. Scots have a right to know the facts when voting on their country’s future.”

“The UK government should seize the constitutional initiative by putting forward legislation for further devolution and a federal UK.”

The CentreForum report ‘Scottish independence: an economic and political appraisal’ reaches the following conclusions.

On North Sea oil: With declining North Sea oil revenues and a 2016 budget deficit of more than 5%, Scotland faces difficult choices. The SNP’s proposed “oil fund” will require a combination of higher taxes, more borrowing and/or spending cuts. Yet the party has pledged to keep taxes the same and maintain a big state, posing serious questions over how the funding gap can be filled.

On financial services: It is inconceivable that British legislation will allow the Bank of England to act as lender of last resort for an another country’s financial sector. With Scotland’s financial sector having liabilities of 1254% GDP, the risk is simply too big for the Scottish government to take on. The financial services’ exodus that will follow a ‘Yes’ vote will leave a blackhole in Scotland’s revenue base. There are currently 97,000 financial services jobs in Scotland.

On retaining sterling: The potential costs to the UK taxpayer of a Scottish bank bailout mean that currency union with Scotland is a practical political impossibility. There is no evidence that it is in the interests of the rest of the UK to enter one.

On national debt: The SNP’s stated response to the UK deciding against currency union is to dump an estimated £143 billion* of national debt on England, Wales and Northern Ireland. But defaulting will damage Scotland’s relationship with the rest of the UK and make borrowing much costlier. Contrary to what the SNP says, an independent Scotland will almost certainly take its share of the national debt which is equivalent to £27,000 per person.

On EU membership: While long term EU membership is likely, an independent Scotland will have to apply post independence. It will take 24-36 months to gain membership, and the UK’s opt outs will not be available. Losing tariff free access to the EU for an indefinite period of time will be disastrous for Scotland because 65% of its exports go to the rest of the UK.

NOTES

* £143 billion is Scotland’s population proportionate share of the projected UK national debt in 2016/17

Ageing alone launch

29 April 2014

Launch of CentreForum’s Report ‘Ageing alone: loneliness and the oldest old’ Committee Room 4, House of Lords, Westminster, SW1A 0AA

Speakers

  • James Kempton, Associate Director, CentreForum
  • Caroline Abrahams, Charity Director, Age UK
  • Rt Hon Norman Lamb MP, Minister of State for Care and Support

The afternoon of the 29 April saw the launch of CentreForum’s report ‘Ageing alone: loneliness and the oldest old’ at the House of Lords. The launch was chaired by James Kempton, an associate director at CentreForum and the report’s co-author, and attended by leaders and innovators in the voluntary and community sector, and politicians and policy makers in both central and local government. 

James Kempton began by outlining the twin social and economic costs of loneliness. He stressed that loneliness is not only a painful emotion for older people, but also has a demonstrable impact on their health. Helping people to alleviate their loneliness, therefore, not only enhances their general quality of life, but can also improve their health and wellbeing, reducing health and social care costs in the process. 

The over-85s are more severely affected by loneliness, with almost half reporting that they feel lonely most or some of the time. Moreover, with rising life expectancy we need to pay attention to the issues for this age group which is set to double in the next 20 years. Despite this, tackling loneliness is not being regarded as a key public health priority.   There is strong evidence that community-level activities provide a good social return on investment, but it is essential to develop a sufficiently robust evidence base to persuade Health and Wellbeing Boards to direct funding towards tackling loneliness. 

Caroline Abrahams, Charity Director of Age UK, who sponsored the report. also stressed the need to reframe loneliness as a public health priority, pointing to the centrality of social connectedness in equipping older people to lead happy and healthy later lives. Society should be cautious about thinking technology could be a universal remedy for social isolation. Community action, she argued, often had the most material impact on older people’s later life experiences, this may be particularly so for the over-85s. 

Caroline also made the point that the effectiveness of local projects often depends upon outstanding individuals. She highlighted the need to encourage social entrepreneurship, and foster effective and sustainable local infrastructures at times of public funding constraints. Lastly, Caroline stressed that the purpose of such community interventions was not to impose solutions on older people, but rather to create the conditions within which older people can help themselves and each other. Successful local services enable older people to forge friendships and enjoy each others’ company, and thereby (re)construct their own social networks. 

Norman Lamb MP, Minister of State for Care and Support, welcomed the report, and thanked both CentreForum and Age UK for producing it. Isolation among older people was gaining prominence as a critical issue –as people live longer and extended families disperse. The minister shared some of his personal experiences of shadowing a care worker around West London, and how struck he had been by the narrowness, boredom and loneliness of many of many older service-users’ lives. He also discussed the significant benefits that reconnecting older people with their local community could bring about. Citing two organisations which he had encountered – the ‘Penwith Pioneer’ (linked to one of the case studies in the CentreForum report, the Newquay integrated care pathway) and ‘Friends and Neighbours’ in Sandwell – he discussed how both projects had recorded significant reductions in older people’s dependency (in terms on their reliance on social care and the frequency of their admission to hospital) as they experienced greater companionship and community integration. 

A number of issues were raised in general discussion by the people attending the launch, including the stigma around loneliness. Getting vulnerable people to access services was a challenge given the reluctance many felt to even admit to feeling lonely.  This was especially true of men. There was also support for one of the key findings of the report about the importance of organisations acting as “brokers”, joining up potential volunteers with older people in their community. This was felt to be a crucial role, as there was strong evidence that people were keen to get involved but wanted to do so through a structure that that gave ‘permission’ rather than approach older people informally or directly as might happen in less disconnected communities.

There was a gap to be bridged between what commissioners and academics considered robust evidence and what was appropriate to collect at a community level.  Professionals and practitioners needed to develop a shared understanding of what good data and good local practice looked like. While useful, the randomized controlled trial was not necessarily right for evidencing the value of local interventions. One contributor challenged the research sector to change its own culture, and broaden its definition of admissible evidence from numerical, quantitative data, to more qualitative and narrative evidence.

Many of the organisations represented were already actively engaged in collecting and disseminating data in order to prove the efficacy of their work in tackling loneliness and in that way building a more robust evidence base. The minister acknowledged the importance of strengthening the evidence base for interventions that tackled loneliness and encouraged community projects to evaluate their impact in this way. 

Report by Vicky Pearce

New build nuclear: Big returns for French and Chinese governments at Brits’ expense

8 May 2014

The private financing behind the Hinkley Point C nuclear power station will cost British consumers £12.4 billion more over 35 years than government backed procurement, a new report from CentreForum suggests.

The think tank says the absence of government investment will result in an additional bill of at least £15 a year per UK household for a generation while the taxpayer underwrites double digit returns to French and Chinese nationalised industry.

Need for new build nuclear

82% of Britain’s existing nuclear generation capacity is due to be decommissioned by 2023 – more than half of the UK’s low carbon energy supply.

To meet the UK’s climate change targets and provide security of supply, new build nuclear is considered essential to the UK energy mix. CentreForum believes that state subsidy is appropriate given the risks associated with new build nuclear.

However, its report maintains that both the financing model and the selection criteria for the Hinkley Point C project are flawed. It says that there should have been a public auction to secure the minimum subsidy level with a viable public sector comparator.

The company created out of the comparator could have looked like Network Rail, operating at arm’s length from government – but unlike Network Rail, would be able to pay back its debts, CentreForum says. 

Achieving cost effectiveness

The report suggests that the assessment criteria for new build nuclear in future should include the differential costs of grid connections and realising the value of government owned nuclear sites.

It says that there are savings to be made from burning the UK’s 140 tonne plutonium stockpile rather than continuing to store it.

Further savings could be achieved by “transmuting” existing nuclear waste to make it easier to store, the report adds.

Toby Fenwick, CentreForum research associate and report author, said:

“New nuclear is essential for low carbon energy. The question is how to provide it in the most cost effective way. Decisions taken under the last government will result in expensive electricity that will cost British consumers more than £12 billion more than is necessary over the next 35 years. UK consumers deserve better value.”

“Operating as a Network Rail style arms length organisation, a public operator is best placed to provide the competition required to get the best price for the low carbon nuclear power we need.”

“Getting rid of the 140 tonne plutonium stockpile will save us £40m a year in storage costs and £500m to build a new storage facility. It is important to build the most efficient plutonium burning option into the selection process for future nuclear power plants.”

NOTES TO EDITORS

The CentreForum report ‘UK new build nuclear power: delivering best value’ by Toby Fenwick can be viewed here.