There are those who tried to convince us that improved efficiency would be enough to deliver the budget saving in the public sector. They were wrong and we now see rationing in the form of increased waiting times in the NHS, tighter eligibility criteria in social services and service reductions as libraries, day centres and swimming pools are closed.
Now some people are claiming improved customer care is the answer. All we need to do is get better at identifying and delivering what our customers want. If we simply listen more we would waste a lot less time and money on providing service that people don’t want and we would have fewer complaints.
Of course good customer care makes good business sense. Of course the public sector wants to shake off the “take it or leave” image of old. And of course doctors and social workers are keen to distance themselves from the professional knows best culture. So yes, we need to get better at listening to people and finding out how they want their services delivered.
Only it’s not quite as straightforward as that in the public sector. Just for a moment let’s pretend the private sector has sorted this problem, that the utilities, the banks and the train operators have developed sophisticated and effective ways of listening to their customers and adapting their services in response. That call centres are a fast and easy way to do business, that computers don’t automatically generate threatening standard letters and that the member of staff at the other end of the phone doesn’t keep repeating “but the screen is telling me such and such”.
How does this solve the problem of getting home help to help you into bed when you want as opposed to when they are available? How does this help you deal with opposition from neighbours to opening a home for people with learning difficulties? And how does this work when local people voice their opposition to plans to close their local hospital or library or day centre or want their bins emptied weekly?
Simply put, customer care is not the knight in shining armour for this situation. On its own, it is not enough, especially when times are tough.
Whose fingerprints are on the backstabbing knife?
Cynthia Bower must have really upset some one at the DH. She does have a reputation of speaking her mind. The head of a public service knows they are in trouble when the Guardian quotes their salary as if earning over a certain amount of money should ensure the organisation you head has no problems. I would have thought it was the other way round.
Then there is the attempt to rewrite history, success is turned into failure. “You know that scandal that happened, well they were involved”. As if the DH would appoint someone to a top job in the NHS if they were not absolutely convinced they were placing the safeguarding of all patients in the NHS into a safe pair of hands.
Finally there is the implied character flaw. In this case deception, we are informed that the CQC mislead Parliament by producing a report for the DH which claimed an inflated number of inspections and reviews. We are given no explanation as to why the CQC revised the figures, only that they have “admitted” doing so.
Am I the only one who suspects that it is not as straightforward as this? People rarely risk lying about the facts but the DH frequently asks for figures to be recalculated excluding this or including that or using a new definition to clarify the difference between a visits to homes as in a visit to register, a visit to inspect or a light touch inspection which doesn’t involve a visit.
I am suspicious of the motives of the Guardian article because there is no attempt at analysis of the political and organisational context. The merging of several inspection organisations resulting in a prolonged period of disruption and loss of experienced staff. The subsequent restructuring which demoralised staff by forcing them to apply for their own jobs. The efficiency drive which saw a significant reduction in posts. Whilst at the same time the government of the day imposed performance targets that distorted priorities. These circumstances are not unique but neither is the belief that there are ministerial finger prints all over the back-stabbing knife. Just as there were for the head of immigration.
I don’t know what is worse: that journalists swallow this, or that they expect readers of the Guardian to as well.