The Week

The GEek 31 May 2024

Patrick King
Senior Researcher

This week, we’re bringing back a long-time favourite of subscribers to the Week … the GEek (a special edition of our newsletter spotlighting all things public services from the General Election campaign trail).

With the Conservatives and Labour both ruling out increases in any of the ‘big three’ revenue-raising taxes — income, NICs and VAT (together worth more than 60% of a government’s tax take — the key question is “how would an incoming government fix the foundations of public services that are increasingly struggling to fulfil their core functions?”.

In some areas, the ‘Reform Fairy’ may be able to sprinkle some magic and make progress at relatively little cost (planning reform being an example cited by Labour). Clearly, though, addressing other challenges will require significant investment, and so the focus should be on ensuring every pound achieves its greatest possible impact (thankfully, a paper we published last year, Efficiency Mindset, sets out how the civil service can prioritise this).

In either case, delivering transformative change relies on a machine that can effectively execute the government’s priorities.

As recent Reform research has argued, this includes ensuring the very best talent wants to work in Whitehall, with opportunities to rapidly progress. And that for a small number of hyper-ambitious goals, or ‘missions’, the civil service can work in different, more agile ways, supporting innovation across society, and ultimately achieving a step-change in outcomes.

We were therefore delighted to see that government’s wash-up of parliamentary business included a response to PACAC’s inquiry on performance management in the civil service which cited many of the recommendations made in our paper ‘Making the Grade’. This follows John Glen’s speech at our flagship Whitehall conference earlier this month, announcing these reforms. In particular:

  • Ensuring that underperformance in monitored and addressed;
  • Having leaders in each department who are accountable for effective performance management; and
  • Ensuring that comparable performance standards are applied across government.

For an incoming government wanting to implement these ambitions, and attract exceptional talent, the paper provides 25 detailed recommendations of what would need to be in place.

Onto our read…

This week our friends at the Nuffield Trust published a helpful explainer on where the NHS budget goes. They highlight the importance of taking into account not only headline funding increases (3.1% annually in real terms, from 2013-14), but also how these increases are shared by frontline services.

The conclusion? Despite a consensus that prevention should be the north star of health policy, funding hasn’t followed rhetoric. Spending on NHS acute services has grown “much faster” rate than other services (4.4%), with the largest decrease seen in the value of the public health grant (falling in real-terms by 21% between 2016-17 and 2022-23), while primary care spending, as a share of total healthcare spending, has remained static — and funding for community pharmacy, optometry and dentistry have all shrunk.

As commentators have this week pointed out, an incoming government will face big choices on the balance of taxation and spending. But alongside this, understanding and addressing the fundamental reasons why funding continues to flow towards services that have failed to turn the dial on whole-system outcomes will be just as important. Watch this space for Reform research on how government can prioritise spending well in primary care.