Study Establishes that People-User-Based Public Service Strategy Could Save Billions

locality-logoEdinburgh       Riding on the train from Stafford to Edinburgh, I started reading a pamphlet produced by Locality, the big UK nonprofit.  The title, “Saving Money by Doing the Right Thing,” had caught my eye sitting on a literature table at the training conference.  The upshot was a contrarian, but in our experience accurate and corrective analysis of the current failures of public services to actually fulfill their purposes of providing services to the public, as opposed to serving their internal bureaucracies, metrics, and filling their subcontractor’s pockets.

The bulk of the report was based on the work of a Locality partner, Professor John Seddon and a consulting operation he directs known as Vanguard.  He and his team over several years have collected exhaustive piles of data tracking the interactions of users with government and private outfits providing services.  By following a people centric matrix on services rather than a provider centered approach they found some interesting things in England, which also resonate with our experiences in the US, Canada, and other large countries in the throes of neo-liberalism and government retractions.

The report’s findings included the following:

·         Overall demand for public services has not risen.  What has risen is what they call “failure” demand, which is artificial demand caused by not doing the right thing for the person at first contact.  What used to be labeled as mere paper-pushing is now people-pushing, and because of the redundancy of contacts, the delays, and the constant evasions is pushing people away from the help they need and mischaracterizing fundamental problems.

·         They identified an interesting process where “points of transaction” for service users are “in practice referral rather than action points,” creating an “assess to refer” dynamic rather than an “assess to act” or solve process which forces users to “bounce around from one agency to another until a decision is made.”

·         They advocate a solution “focused on purpose, not outcomes,” arguing that “better outcomes are a consequence of effective intervention” for the service user, rather than the service provider.  Pointedly, they argue that “outcomes-based management…drives dysfunctional behavior, fosters cheating and hides failure.”

Amen!

What does it all mean going forward if providers of public services rethought their approach?   It actually saves a huge amount of money if you fix a problem rather than repetitively continue to push it downstream.  The Vanguard folks estimate the savings in England alone would be 16 billion pounds which conservatively would translate into about $26 billion in dollars, which just might be something hard pressed governments would notice!   For example in health care and human services in one data crunching exercise after another they found:

“…a ratio of 75.25 per cent waste to value.  It took 400 hours of work to deliver 100 hours of value.  Meanwhile, just 5 per cent of the population consumed 50 per cent of the resource ….”

This is part of the rationale we’ve been arguing for our Citizen Wealth Centers as well, by creating advocates and representatives who would be able to intervene in the process and inject themselves like wrenches into the bureaucratic machinery, we could force them to finally deliver real services to low-and-moderate income constituents.  It was refreshing to stumble onto an excellent analysis that dared to look at the facts and punch holes in the myths of subcontracting, “economies of scale,” and service cutbacks to find that reworking the system could fix real problems for real people by embracing the people, rather than pushing them down the road or burying them in the bureaucracy, and, save money while solving more problems in the process.

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