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If public services aren’t radically reformed, the new healthcare levy may be in vain

September 18, 2021

Like most Conservatives, I support today’s Health and Social Care Levy Bill with some reluctance. Personal contact with the care system as well as that of my constituents made clear to me that more funding is part – but only one part – of any long-term fix. In particular, my heart goes out to the millions of unpaid caregivers who stoically provide cover for (when not actually falling through) the cracks in the system as it stands today.

Nor should we get carried away. The UK remains one of the lowest tax countries in the G7, and the choice at the next election will still be between a Conservative Government which raises taxes as a last resort out of necessity, and opposition parties who never see a question to which the answer is not to spend more of other people’s money. Margaret Thatcher increased taxes when required, before going on to reduce taxes and instigate reforms that unleashed Britain’s growth for decades to come.

Conservatives’ real concern – and my own greatest fear – should be if the new Levy turns out to be in vain. So far, it has to be said, the omens are not good. Rather than a ‘long march’ towards a radically overhauled, streamlined modern state, we have the ‘slow shuffle’ of public sector employees back to their desks.

Publicly funded salaries and pension are a privilege, not a right, and a growing pile of my correspondents are making the link between their own personal experience of the state – the delayed driving licence, slow motion planning application or a growing waiting list for a continuing healthcare or childs educational assessment – and the relative responsiveness of the private and public sectors. It was a different era but, the last time the UK tried to reconcile growth and prosperity with a three-day working week in 1974, things did not end well.

As we put the crisis stage of the pandemic behind us, it is therefore critical that we do not lose sight of, or the zeal for, the radical reform of government that is required. Only by changing the machine itself can we change what it delivers for the people of Britain. The normal clock speed of government is far too slow; memorably likened to the dream where you try to run but your feet will not move.

During the pandemic a heroic effort by all concerned overcame this. The epic recent Afghanistan evacuation was another similar example. But you can’t run the British state by constant exception management. Delivering our popular and bold programme will require better instrumentation, clearer goals and new ways of working.

Without near real time data, Ministers are forced to drive not just in the rear-view mirror but using a backwards-pointing telescope. One example, the latest NHS workforce statistics are only available for April: whilst we may shortly be dealing with the impact of a difficult winter, the NHS will be telling us how many staff it had back in the midst of summer.

The excellent Commission for Smart Government recently published actionable proposals for reform. It also identified the risk that the scale of the task might encourage leaders to put the intricacies of systemic reform to one side. Tired Ministers heading towards mid-political cycle and with busy in-trays may not have the energy or the freshness for the challenge.

One lens on a future reshuffle could be to inject a little more grit into the oyster. The current Spending Review is an opportunity that should not be missed, but such exercises rarely end up in the true zero-based scrutiny of departments and their operating model that real reform requires.

This Government has everything going for it. Clear leadership, an ambitious programme and political fuel in the tank in the form of a large majority. But the yardstick of long-term political success is real action impacting the real lives of citizens across the UK. To achieve this, reform is a necessity not a luxury.

Andrew Griffith MP is founder Chairman of the Campaign for Economic Growth and was a board director at Sky for 11 years and a senior non-executive director of Just Eat.

This oped was originally published on ConservativeHome on 14 September 2021.


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