In the background to the budget and subject to discussion since have been proposals for efficiencies in the public sector. Sir Michael Bichard and others undertook a review of the potential for savings across government and at a local level through more collaborative working (http://www.hm-treasury.gov.uk/vfm_operational_efficiency.htm). Much of it reads like so many reports written in the past thirty years. History suggests the ‘potential’ savings identified will be hard to realise. But nobody asks the key questions. Why has it been so difficult in the past? What makes anyone think it will happen this time?
There is one interesting proposal: the idea of Total Place – the mapping of public spending at a local level for all public agencies and departments. An exercise in Cumbria identified spending of more than £7bn in the county. When viewed in those terms, the failures of public services seem less associated with a lack of resources and more about what is done with them. Of that £7bn, a large proportion is committed to infrastructure etc, but the possibilility of avoiding overlaps and using the money more effectively is an attractive one that has been argued for for some time (twenty and more years). But again, why has it not worked before? Have the technical difficulties been overcome? Is there the authority, leadership and capacity at a local level to do anything with the information? Without wishing to be unduly pessimistic, I remain to be convinced.
Some recent television programmes present uncomfortable images of our public services. Recently, Channel 4 have started to broadcast Hospital, a documentary series. The programme made depressing viewing but, on the whole, staff seemed to be doing their best in difficult circumstances. However, one consultant in A&E appeared, to me at least, highly judgemental of her clientele. She was doubtless under pressure and had seen many changes in her lifetime, but she seemed to have lost any empathy or compassion. Her views were given some prominence in the programme and tended to give a more begrudging, unfriendly image of the service.
Last night, BBC’s Panorama looked at the home care sector. So far from professional, the staff were poorly paid, harassed by their managers and under trained. It made for truly depressing viewing.
The contrast, however, was the ITV programme on Holloway Women’s Prison. We normally associate prisons with brutality, deprivation of liberty, lack of care etc… But not here. Women with long criminal records, most often associated with drugs, were treated pretty well, on the whole. A number of inmates clearly found structure inside that was absent in the outside world. Staff showed some understanding and empathy towards others who were violent and abusive, including towards staff.
In many ways, the episodes I saw suggested a clearer sense of vocation and of purpose was evident in this one prison than in the two settings more normally associated with care. A more challenging programme or piece of research might ask why? What is it about the settings in which people, not much different one from the other, were working that hindered or enabled them to act with a degree of compassion?