LGC’s essential daily briefing.
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A cynical hospital trust leader remarked in September that the NHS had been “perfectly designed for the needs of the people that work in it”.
Whether Nick Hulme, chief executive of the Ipswich Hospitals NHS Trust and Colchester Hospital University NHS Trust, was right or wrong, the working patterns of staff have an inevitable impact on any organisation, and too much poor customer service is attributable to systems designed to suit staff rather than users. This is true for any organisation, including local government.
It is that thought that is spurring Greater Manchester CA to reorganise the region’s public services around neighbourhoods of 30,000-50,000 residents, building them “around the unique and diverse needs of its people and places, not the policies of fragmented service providers”.
The aim is to integrate staff from different policy areas working in the same neighbourhood through co-location, better information sharing, and pooled budgets. The hope is that the new model will free up frontline staff by devolving power and better allocating scarce resources.
In this, as in much else for local government, Greater Manchester is proving a pioneer of the integration agenda. Among officers and councillors across the UK there is broad backing for joining up services, but this city is making it happen.
Andy Burnham (Lab), the mayor for the combined authority, is thus right to describe this as “a big test for devolution”, the cause for which he is one of England’s poster boys. Cities are by their nature hubs of variety, and tailoring policies to neighbourhoods is a logical extension of devolving power to cities and regions.
But logical or otherwise, the plan comes with risks.
Restructuring is by nature highly disruptive – and not always in the positive sense favoured by Californian IT entrepreneurs. The complex governance and duties found in public services make the hardship of reorganisation even more pertinent to local government than in business.
Integrating parts of an organisation also often involves separating other bits, as managers in other sectors could tell you. The music is turned on for one round of musical chairs, and when it stops those sitting nearer to one another are better connected at the expense of former neighbours now halfway down the hall.
Such restructurings are often prompted by a genuine lack of co-ordination, or as a radical solution to perceived existential threats. Local government is familiar with both. As Jon Rouse, chief officer of the Greater Manchester Health & Social Care Partnership, puts it: “The complexity of the challenges our communities face, combined with significant pressures on resources, mean that we can’t respond with the same thinking and the same ways of working as we’ve always done.”
This is a natural reaction to the cuts which risk leaving Britain’s most vulnerable without the basics that make life bearable. Yet reformers, especially radical ones, should always be aware that the status quo, however unappealing, may be better than any alternative. The coming months and years will determine whether Greater Manchester passes Mr Burnham’s “big test”.
Jimmy Nicholls, features editor