On Sunday the Liverpool Echo had yet another of its articles warning about the Council’s financial problems which was both timely and accurate but although stating the problems gives no hint as to what the solutions to those problems might be.
There are three facts which the Echo, Council and all public sector deliverers will have to grapple with over the next 5 years:
- There will be no more money from the Government. Liverpool will not be a Tory priority. Any additional spending for the North will be ruthlessly spent by the Tories on those areas which they gained from Labour in the General Election.
- The likelihood is that that there will be less money. There will be no Brexit dividend and the opposite will apply. A reduction in the Country’s revenues will lead to a decrease in the tax take which means that the Tories will not be able to keep the promises about sending on services which they have sprayed around the Country.
- There is a lot of money that will still come in to Liverpool but so much of it is wasted. This is not an attack on the Council although there are a lot of examples of Council waste. It is a criticism of the way that successive Governments have totally failed to join up service delivery in an effective way.
Social care does not link effectively to health care; education does not provide the knowledge or skills needed by employers; our universities undertake vast amount of research that adds little value to our City; the Police concentrate on catching criminals because social service departments are unable to stop children moving into crime; the DWP keeps people who want to work not working etc. etc. etc!
All this means that just doing less of the same will not work. The Council must reiterate and firm up its offer to Government to take the lead within our City of joining up the public sector into one coherent whole in which people and their problems are not passed from department and department.
This is not just about saving money or using it more effectively. It is about providing every Liverpool resident with better services. Let’s just take one example of this the interchange between health care and social care.
The first problem is that people do not understand the difference between these and why should they? Why are some inevitable conditions of ageing dealt with by a social care route which must be paid for whilst others are dealt with by a health route which is free? The second problem is that many people have both health and care problems and a spend a great deal of time shuffling through different agencies. The third problem is that the shuffling costs the public sector time and time is money. The fourth problem is that this creates gaps in service as the lack of system means that some people’s needs go unmet. Lastly, the binary system means that no one organisation takes responsibility for changing the system and its cultures to deliver services around the need to deliver one continuum of services to service users.
This lack of system is hugely expensive. At any one time more than 10% of hospital beds are occupied by people, usually elderly, with no clinical or medical need to be there. In most cases people do not want to be there but want to be at home where they could be looked after by their family or friends. A hospital bed costs £550 a day. Our system with budgets in silos and targets set from the centre is unable to move money around over time to provide a better and cheaper service.
Lib Dems don’t want the Council to take over these, or any other services, but we do want the Government to allow the locally elected council to take the lead in working with the people of Liverpool to decide the local outputs and outcomes which will mean that every single penny that the Government gives us can be more effectively used.
Local councils can create the partnerships needed to deliver the locally agreed priorities. They can move money upstream within the system to prevent many social and health problems. They can have a coherent view of the local strengths, weaknesses, opportunities and threats.
Above all they can be accountable to the local electorate in a way that the Government cannot. Because the councils would take over a leadership responsibility for services that people can actually relate to, they can be judged more easily. A national pledge to spend an extra 2% here and 1% there simply gets lost. A local pledge to do something about a service which people will either use themselves or will be used by a friend or relation is much easier to check on.
The challenge has already gone out from the Council meeting in September to the Government making an offer to take over the leadership role for local service delivery. This will not involve a costly reorganisation with redundancies and new jobs and structures which would take time to organise.
This is about priorities and outputs and outcomes which would be delivered by existing organisations but in a way which saves cash and gives a better service. Only blind prejudice would make the Government turn down such an offer. This is a Tory Government which, in theory at least, claims to want to get value for taxpayer’s money. Liverpool has made an offer for a system change which will deliver this. Only blind prejudice would prevent the Government from taking up this offer.