The Week

The Week, 6 January 2023

Charlotte Pickles

We thought we would start 2023 as we ended 2022, with a special edition of the ‘The Week’ — this time looking forward rather than back. Parliament hasn’t even returned from recess (that will be Monday) and we’ve already had speeches from both the PM and the leader of the opposition. Nothing game changing, both on the vague side, but each providing some interesting insights into their respective worldview (Sunak a section on the importance of family, Starmer a focus on devolving power).

The coming year will be pivotal for both parties. You are all acutely aware of the state of, well, everything, so we won’t waste time reminding you. Suffice to say that 2023 needs to be a year of radical reform. We’ll be putting forward our own bold thinking to reimagine the State, and in particular our approach to health and care, and how government is run. Below, for each of those topics, you’ll find some key dates and things to look out for over the coming 12 months.

Framing all this will, of course, be the economic and fiscal outlook. Earlier this week the IMF warned that a third of the world economy will be in recession this year. Just before Christmas, the ONS informed us that the UK economy had actually performed worse than previously thought in 2022. 15th March will be the next fiscal event — the Spring Budget — and it’s hard to see how the Chancellor will be able to offer the sort of rabbits you might expect at this stage of the election cycle.

Reform has a big year ahead with an already packed events and research schedule. I am also delighted to welcome two new Reformers, Hash and Izzy, to the team.

Reimagining the State in 2023

Key dates for your diary:

📅 Early 2023: Community Wealth Fund launch expected

📅 February 2nd: One year since publication of the Levelling Up White Paper

📅 April 1st: New devolution deal and Mayor for North Yorkshire

📅 April: The APPG for Left Behind Neighbourhoods will publish the final report from its inquiry into levelling up

📅 Spring: Levelling Up and Regeneration Bill expected to receive Royal Assent

Levelling up, devolution, and the revivification of communities are emerging as a key policy battleground for the next general election, which means that in 2023 a serious conversation may finally get underway about the need to reimagine the State itself, rebalancing the strength of local and central government and resetting the relationship between state and communities.

2023 will see continued work on newly agreed devolution deals, as establishing combined authorities and mayors remains one of the key mechanisms of the Government’s levelling up project. A new North Yorkshire unitary council will replace seven existing district councils and the county council in April, paving the way for the election of the first Mayor of North Yorkshire and the City of York in May (if that region’s devolution deal is locally ratified).

So-called ‘trailblazer’ devolution deals, further expanding the powers of combined authorities in Greater Manchester and the West Midlands, are also expected to conclude negotiations this year, at which point we will learn whether arguments that these should include new fiscal powers and ‘double devolution’ for local authorities to shape local collaborations have been heard. More devolution deals are expected to come into force in 2024, including new powers for Suffolk, Norfolk, Cornwall, and North East England.

The long-awaited Community Wealth Fund — with £700m+ of funding from dormant assets — is expected to be announced ‘early this year’, per reports from Peter Foster in the Financial Times. More resources, by an order of magnitude, will likely be required to deliver on DLUHC’s 12 levelling up missions, which will be one year old in February, soon acquiring a somewhat firmer footing via the Levelling Up and Regeneration Bill currently in its second reading in the House of Lords. Nevertheless, the Community Wealth Fund would be a major achievement for the sector, and a very welcome shift from State-dictated spending to community-driven investment.

Reimagining Whitehall in 2023

Key dates for your diary

📅 Early 2023: Civil Service Governance and Accountability review expected

📅 June 15th: two years since publication of the Declaration on Government Reform

For those hoping for progress on civil service reform in 2023, we’re expecting Lord Maude — a veteran of Whitehall reform — to publish his Governance and Accountability Review, looking at how government makes decisions and how the civil service functions (as well as where it doesn’t). It is also meant to set out lessons from the pandemic response here in the UK and abroad. Exactly when this will be published remains unclear: it was supposed to be shared with ministers in September 2022. But given Lord Maude’s pedigree as a reformer unafraid to challenge the status-quo, here’s hoping for some bold recommendations early this year.

15th June marks the two year anniversary of the Declaration on Government Reform. This latest attempt to set the parameters of Whitehall reform focused on improving 3 ‘Ps’: people, performance, and partnership working. These were laudable ambitions. After all, who would oppose efforts to “avoid hierarchies slowing down action”, “put data at the heart of our decision-making” or “create more opportunities for Ministers and officials to discuss and hone policy collaboratively”? Progress on this has, however, been limited — perhaps Lord Maude’s review will kickstart efforts to deliver?

Other things to look out for this year… March will mark 10 years since Lord Browne (the Government’s first lead non-executive director) published Getting a Grip, highlighting the poor management of major government projects. Significant progress was made to improve delivery under Sir John Manzoni, but challenges remain — HS2 is set to go (even further) over budget — suggesting this may be a good time to review whether further ‘grip’ is needed. Also on the subject of delivery scrutiny, the Public Administration and Constitutional Affairs Committee’s inquiry into the role of non-executive directors (NEDs) concludes early this year, with the final evidence session just 11 days away. Reform’s leading NED nerd — who will go unnamed (Charlie Pickles) — is especially excited for this one.

Reimagining Health in 2023

Key dates for your diary

📅 March: Patricia Hewitt will publish her final review on oversight and governance of Integrated care systems

📅 March: the Department of Health and Social Care will publish an independent forecast of future health workforce needs.

📅July: the NHS turns 75

With our health and care systems in crisis, there will be little appetite for celebration in 2023. However, there are a number of big anniversaries this year: the NHS itself celebrates its 75th birthday, the National Institute of Health and Care Excellence (NICE) turns 25 and it is 5 years since the Department of Health tagged ‘Social Care’ to the end of its name (turns out that move didn't solve anything, quell surprise).

Two other anniversaries that might not be on your radar…

2023 marks 40 years since the release of Roy Griffiths’ report into management of the NHS. The Griffiths Report paved the way for the formalisation and strengthening of management within the NHS, finding that effective management is the linchpin of a high-quality health system. The trope that the NHS’s woes can be pinned on an over-abundance of faceless pen-pushers has become commonplace, but as Griffiths and sensible commentators ever since rightly point out, a *lack* of effective managers in the right place is a far more logical explanation of poor performance.

Griffiths also pointed out two core problems with approaches that may get us closer to explaining our current crisis — the tendency for local bodies to be given “directives without being given direction” and the insuffient devolution of power from the political centre to the operational frontline. Plus ça change…

Which brings us to our second anniversary — NHS England’s 10th birthday. This year, as the health service continues to restate its ambition to devolve responsibilities to local organisations, and as performance on virtually every indicator deteriorates, important questions will be raised about what the central body has achieved over the last decade. At Reform, we think its time to ask more existential questions about the centre and make brave decisions about where power and responsibility should rightly sit.