So what are we to make of the public service reforms promised in the much anticipated white paper? Cameron describes them as the most profound since the creation of the welfare state. Critics say the reforms, or at least the public statements made about them so far, lack coherence. What is going to change then? The state monopoly on services will come to an end, says Cameron. I’ve spent most my career working in social care and, believe me, the state is far from having a monopoly over the provision of those services – and it is no bad thing. But there is clearly a lot more of this to come. There is much excited talk, for instance, about the creation of new social enterprises, co-ops and employee owned mutuals.
Cameron’s new head of policy development Paul Kirby wants to ‘shift decision-making about solving the fiscal problem from Whitehall to the millions of people who produce and consume public services’. He also wants to see the end of block contracts and budgets based on historical spends, and more ‘payment by results’ and budgeting decisions delegated to individuals and communities. But is any of this especially new? Polly Toynbee warns of Pickles’ ‘anti-public shock troops’ bent on invading a rather idyllic sounding public sector: a ‘precious, civilising embodiment of our best collective endeavours’. While the cuts will no doubt do their damage, these reforms are only the latest in a long line of ‘modernising’ initiatives aimed at public services.
Indeed, it all sounds very New Labour to me. Which is perhaps why, as Toynbee rightly points out, Labour find themselves ‘conflicted by a hundred quandaries’ in opposing them. But there is also a real nervousness in the coalition – particularly in the ranks of its junior partner – about how the reforms will be received. The last thing they want is to be accused, as they are being, of privatising public services. Far from the proposed public service reforms revealing Cameron’s ‘runaway ideology‘, as Toynbee has it, the botched NHS reforms point to an absence of conviction and a profound loss of nerve in government.