The TaxPayers' Alliance - Better Government

Hospital hygiene

Reuters report today that the Lancet has condemned Brown's proposals to deep-clean hospitals and make all hospital staff wear short sleeves.  Their central contention is that he has neglected more important measures like making NHS staff wash their hands.

Some of the Lancet's criticisms are ill-founded.  The problem isn't that Brown is being too populist - the public are not fans of staff failing to wash their hands - or that keeping hospitals clean should not be a priority - they acknowledge that cleaning hospitals makes a significant difference to the spread of C. Difficile.  The problem is that once again the headline-grabbing simplicities of a politically managed health service will tend to distort activity towards big initiatives and away from small tasks like washing hands that can be more important.

Politicians need to stop trying to manage healthcare.

NHS fails the elderly

The Telegraph reports a study by the Healthcare Commission today showing a shocking series of failures in the NHS' treatment of older people:

"• Only five hospital trusts out of 23 met all of its standards on dignity in care

• 23 per cent of elderly patients said they had to share a room or bay with someone of the opposite sex

• Only 16 per cent said they had all the help they needed to eat

• 25 per cent of recorded patient safety incidents involving food and drink either caused patients harm or put them at risk

• 94 per cent of elderly patients claimed they were never asked their views of their care while in hospital."

The government response is limited to lame assurances that it takes the issue seriously and will make it a priority.  While there are broader questions that we should be asking as a society about how vulnerable older people are looked after that isn't the problem here.  This is another case of institutional carelessness in the NHS.

A system focussed on responding to political priorities instead of answering to patients is almost pathologically unable to think of the little things.  The NHS is too large for anyone, particularly inexperienced politicians, to really understand.  To get around that problem politicians use simple statistics.  These can't capture intangible basics like patient dignity and care.

Institutional carelessness leads to 84% of staff failing to wash their hands even after contact with an MRSA patient and 99 out of 394 NHS trusts failing to take basic steps to tackle infections like decontaminating reusable medical equipment.  This failure to ensure cleanliness kills thousands each year.  Now we learn that it leads to negligence, starving patients who need help to eat, and to abuse, the Healthcare Commission found patients are being left in soiled clothes or "forced to use lavatories or bedpans in front of other people".

It is becoming clearer and clearer that the NHS is institutionally careless to the point of real brutality.  Reform which puts real power in the hands of patients, rather than more political targets as promised by Brown and his Ministers at the Labour party conference should be an absolute priority.

An independent exam authority

The Telegraph reports that today Ed Balls will announce a replacement for the Qualifications and Curriculum Authority (QCA) that sets both the curriculum and the tests:

"He said: "There is an inherent conflict of interest in having one body that is both developing the curriculum and keeping the curriculum up to date with the modern needs of employers and learning, and at the same time having set the curriculum and set the tests, also reporting after the fact that standards have been maintained.

"And while I think the QCA has tried really hard to be robust and independent I just think that if you have an organisation with different functions that look like they conflict, you aren't going to win the highest level of public confidence.

"And that is why I think now is the right time to address this issue."

What's interesting is that the replacement will still have its senior officers appointed by ministers.  Those setting the exams will still owe their position to political favour.  Political priorities are the root cause of problems with grade inflation.  It might have been worth thinking about a system that is, instead, under the control of those who rely on exam results to differentiate between students - perhaps universities as Jamie Whyte proposed in the Times.

Private company to offer degrees

The Financial Times reports:

"A private sector company has been granted the power to award degrees for the first time, provoking complaints about the "privatisation" of education.

The news that a subsidiary of education company BPP has been given the go-ahead also suggests that universities could face stiff competition as the private sector moves in on their turf."

Private universities are nothing new, whether the great American institutions or Buckingham University here in the UK, but now the BPP College of Professional Studies has become the first company to gain the power to offer degrees.  This expansion of a university system accountable to the students who attend universities rather than politicians in Whitehall has to be a good thing.  It might force public universities to up their game as well.

Christmas threatened by Union-Grinches

The Telegraph reports that the Unite union, which represents 12,000 Royal Mail managers, is threatening strike action over Christmas.  They are protesting plans to end the company's final salary pension scheme and replace it with a career average scheme.

Final salary schemes are in retreat across the economy as firms try to avoid the financial risk of massive future bills.  With people living longer company pensions just can't be as generous without putting firms, and future employees' well-being, at risk.  Most private sector firms are biting the bullet and closing final-salary pension schemes, limiting current and future employees' benefits.  The Royal Mail managers expect that the public sector is different - that politicians will prefer writing a big cheque at the taxpayers' expense to the PR risks of dealing with a strike.

There's another side to this story.  Next time someone tells you that we can't have the private sector provide public services because that will undermine the 'public service ethos' think of cases like this.  If workers in the public sector are kindly, self-sacrificing sorts, better people than you or me, why are they prepared to play the Grinch and threaten to ruin so many children's Christmas?

ORDER TODAY! - THE MUST-HAVE CARD GAME FOR ALL OCCASSIONS...

Political Trumps

The TaxPayers' Alliance has produced the must-have accessory for all rainy days and long trips: Political Trumps!

The cards include today's major political figures with Labour, Conservative, Lib Dem and minor parties all represented. 

Every politician has been rated on their media skills, scandal avoidance and integrity by a panel of political journalists, bloggers and think tankers.

Also included is their record: years of private sector experience prior to political activity, length of ministerial service and the frequency with which they shift from department to department.*

There are fascinating details of some of our most famous contemporary political figures on each of the 52 cards, plus the obligatory two jokers. 

The TPA cards are dual purpose, carrying both Political Trumps data and conventional playing card suits.  To play Political Trumps just match up politicians against each other on their different rankings and see how they compare.  Each player chooses a category and squares off with their opponent – if their card has a superior ranking, the player claims that card.  The winner is the player who collects all the cards in play.  Alternatively, just use the cards as a conventional novelty deck when you next play bridge or poker.

To order your pack of Political Trumps today, click the PayPal button:

Price: £3.99

(Cost including P&P is £3.99 per pack). Alternatively, send a cheque for £3.99 made payable to "The TaxPayers' Alliance" to 43, Old Queen Street, Westminster, LONDON, SW1H 9JA.

Highlights include:

1. The Kings of each suit are Party leaders (Brown, Cameron, Campbell, Salmond), but the Aces are a controversial selection.  The deck includes two jokers (Boris Johnson and Lembit Opik)
2. Tony Blair (Ace of Clubs), scores the highest on media skills, and Ed Balls the lowest. 
3. On integrity, the Labour MP Frank Field tops the rankings, and John Prescott has the lowest score.
4. On scandal avoidance, Ming Campbell is judged the safest pair of hands, and John Prescott (again!) scores the lowest.

When it comes to the facts, the cards reveal some fascinating (and little-known) truths about our high-spending, high-taxing political class:

1. Sir Digby Jones beats every other politician, with 30 years of private sector experience, compared to more than a dozen politicians who have 0 years of experience outside of politics.
2. The leader of the Democratic Unionist Party, the Rev. Ian Paisley, scores the highest on front-bench experience, leading his party for 38 years.

Overall, measuring points scored for media skills, integrity and scandal avoidance out of 300 the Political Trumps deck reveals:

• The Conservative Shadow Education Secretary – Michael Gove – comes top, with 248 points, followed closely by Nick Clegg, Frank Field and Alex Salmond (all 245 pts). Gove scores highly on media skills (82 pts), integrity (78 pts) and scandal avoidance (88 pts).
• At number 15 in the rankings with 221 points, the Prime Minister, Gordon Brown, beats the Liberal Democrat leader Ming Campbell (213 pts) and the Opposition leader David Cameron (209 pts). 
• At the bottom of the league, with a mere 117 points out of 300 is John Prescott, followed by David Blunkett (141 pts).

As well as being a bit of fun, Political Trumps also has a serious message. Public services are failing because politicians lack the management experience and subject knowledge that is needed to run large, complex organisations. Services will only become more effective and efficient when politicians stick to setting high-level policy and remove themselves from management.

Getting into the top universities

The Sutton Trust reports (PDF) that state school pupils do not have the same chance of getting into top universities even if they have the same grades as a student from a private school.  It is important to understand that this doesn't necessarily mean that the universities are discriminating.

There is plenty of evidence that state schools are teaching to the test.  That instead of equipping students with the broad range of skills they need to progress in further education and work they are focussing too much on exam results that boost the league tables.  This means that, with a given quality of exam results, a privately educated pupil - where parental pressure provides an incentive for schools to provide a broader education - will have a more diverse set of skills and will usually be better prepared for university.

Not Me Guv Government

He's to blame

Do you remember "joined-up government"?

No, don't scream. Labour's slogan said that government under the hopelessboomandbust Tories operated in silos- they would join it up again to servethemanynotthefew.

You remember that?

The real world has turned out to be a tad more problematic.

For one thing, just bunging everything together under one roof doesn't automatically remove the silos. The dysfunctionalnotfitforpurpose Home Office was an excellent example of that, as was the multi-role internally conflicted DTI (eg see this blog). A giant wobbling blob is no substitute for realistically defined objectives, and an honest alignment of power with responsibility.

But worse than that, Labour in power has actually dismantled some of the joined-up structures that had previously operated quite successfully. New half-baked quangos have taken powers and reponsibilities out of government departments, often resulting in important bits dropping down the cracks in between. The result is Not Me Guv Government, a perennial issue in PAC investigations of public sector disasters (see many previous blogs- including this one on the shambles of NHS nursing staff).

And now we have a real humdinging classic- Gordon Brown's 1997 decision to split responsibility for the financial stability of our banks between the Bank of England and the FSA.

Previously, the whole responsibility had been in the hands of the Bank. And overall they'd done a pretty good job- Britain hadn't seen a run on a High Street bank since 1425... well, OK, not since Victorian times.

But Brown/Balls decided they knew better. For reasons that have never been entirely clear- and which were strongly opposed by the Bank in 1997- they hived off responsibility for regulating banks to the FSA. The problem was, the FSA was not given a cheque book to shore up wobbly banks if the need arose. The cheque book (aka emergency last resort lending) was left with the Bank.

Now, just a decade later, this new untried stucture has failed its first big test. We've had a bank run that has undermined confidence so much the taxpayer has been made to write a blank cheque guarantee. And goodness knows when and how we'll be able to retrieve it.

What happened was that when it came to the crunch, Brown's tripartite "memorandum of understanding" between the Bank of England, the FSA, and the Treasury broke down.

According to the memorandum, in the event of a crisis:

"Each authority would:

assess the situation and co-ordinate their response within the framework agreed with the other authorities. The form of the response would depend on the nature of the event and would be determined at the time; and

where possible and desirable to facilitate a solution to a problem, and hence reduce risks to wider financial stability, encourage negotiations between third parties whose agreement might be beneficial for the reduction or resolution of the issue, in its area of responsibility." (para 16)

But what on earth was supposed to happen if the three authorities couldn't agree? This morning the FT reports:

"Recriminations... started in earnest... when it emerged that the Financial Services Authority had repeatedly urged the Bank of England to intervene in order to avert a crisis of confidence.

FSA officials and senior banking executives had in recent weeks pressed the Bank to widen the types of collateral it would accept when lending to financial institutions, people familiar with the matter said.

But the Bank refused, arguing that this would promote moral hazard by offering banks and their shareholders a bail-out without punishing them for taking excessive risks."

Pre-Brown and Balls, doubtless there would have been similar arguments around a table inside the Bank of England. But at the end of the day, everyone would have understood they were accountable to one boss- the Governor. And that boss would have been accountable not just for overall macro-financial stability, but also the micro business of staying on top of individual banks.

Instead of which, despite the fact that page one of Management for Dummies says you should only ever have one boss, Labour's tinkering reformers threw out the tried and tested, and set up a new untested structure designed for delay, indecision, and turf conflict.

Not Me Guv Government.

And just like with everything else, we taxpayers foot the bill.

PS- for more backgound on bank regulation and financial stability, see this paper by Prof Charles Goodhart.

Britain falls in international education league tables

The Times reports another international comparison that shows failure in British education.  It uses exam results which there is good reason to think significantly overestimate standards in British schools due to pupils being taught to the test.  The real picture could be much worse:

"The results show that Britain has plummeted to 22nd of 29 countries, from 14th place 40 years ago, despite its pupils attaining ever-higher grades. They raise fears that an underclass is emerging, increasingly unsuited to the job market as manual work declines and competition grows from abroad.

While 97 per cent of South Korean students were awarded the equivalent of five good GCSEs, only 73 per cent of British exam candidates achieved the same results. They were surpassed by those educated in the Czech Republic, Slovakia, Australia, Canada, Ireland, Scandinavian countries and much of Western Europe."

In an article for the Telegraph Daniel Hannan sets out the solution; how we can bridge the gap between the quality and choice available to those who can afford it and the poor standards faced by everyone else:

"Look more closely at the countries that provide match-funding for private schools. Denmark, Sweden and Holland are, in most regards, precisely the kind of egalitarian societies that Left-wingers admire. Private schools are nothing special there, because all parents can take their financial entitlement to any school they wish.

Couldn't we do something similar here? Not a full-scale voucher scheme, but a legally enshrined opt-out, entitling parents to the £6,000-odd that would be spent on their behalf by their local education authority. Millions more would suddenly be able to afford private education and, as happens in Scandinavia, state schools would have to raise their game to retain customers."

Restrictive surgery hours costs business £1 billion every year

The Times reports a new survey showing the cost to Britain of time off to visit the doctor.

"The Confederation of British Industry said yesterday that the cost to the economy caused by restricted surgery times and problems booking appointments was more than £1 billion. The CBI argues that patients should be able to register at more than one surgery so they could visit a doctor close to where they work, as well as near their homes, to speed up treatment."

This is the kind of problem that could easily be solved by freeing public services from political management and making them accountable to their customers like any other business.  Then any business that could deliver healthcare at more convenient times would make more money, out-compete its rivals and force them to meet the public need for treatment outside of office hours.  By contrast, we have had to wait for a new government initiative with an eye-catching proposal to put surgeries in shops and will have to hope it doesn't wind up in the long grass once the headlines have faded and ministerial attention has moved on.

Public see little prospect of improvement in the public services

The Financial Times reports a decline in the numbers expecting improvements in the public services:

"On public services generally, those who believe things will get worse outnumber those who believe they will get better by 22 percentage points, against 13 in May."

The public are probably right.  Politicians don't yet appear ready to get out of management.  Until they do better public services will prove elusive.

Even in the areas where the public do expect improvement, education for example, they are likely to be disappointed.  While increased spending may yield some improvement no serious rise in standards will take place without the kinds of reforms that have been successfully tried elsewhere, Swedish school vouchers for example.

The belief that politicians' promises to improve public services are meaningless is at the root of public distrust in political leaders.  Only if politicians get themselves out of management might they really be trusted again.

The problems with the Happy Planet Index

Informed sources think that something along the lines of the New Economics Foundation’s Happy Planet Index is going to be recommended in the Conservative Quality of Life group report this Thursday.

The purpose of the Happy Planet Index is to create a measure that captures a society’s ability to produce what we really want, long and happy lives, from what we have to work with, natural resources.  To support it you have to accept two key propositions:

First, you have to accept that happiness economics properly captures true human aspirations and needs.  Second, you have to accept that resource efficiency is the proper standard to hold economies by.

Both of these should be an absolute anathema to a conservative and the Conservative Party.

Happiness economics isn’t the reliable policy tool that the New Economics Foundation makes it out to be.  It is based on one key observation, which Lord Layard is most famous for advancing, that average happiness doesn’t increase along with national income.  As Helen Johns and Paul Ormerod pointed out in a book published by the Institute of Economic Affairs it isn’t only national income that happiness doesn’t correlate with, it’s also public spending, longevity, income equality, even levels of depression and almost any other variable you care to name.  As the iea authors point out this implies that either happiness can’t be created through social policy or it isn’t a reliable measure.  Either way it is toxic to the NEF’s view that improving happiness should be the primary goal of social policy.  “State control with a smile”, as Corin Taylor described happiness economics in The Business, cannot be justified empirically.

Another idea that cannot be sustained is that resource efficiency is the standard economies should be held to.  As the NEF suggest we do have a limited stock of natural resources, however, other resources such as human time and ingenuity are also only available in limited quantities.  Both environmental and human resources have the capacity to be used in alternative ways and produce returns both now and in the future.  Deciding how those resources should be used and which it is more important to use efficiently is a job the market does very well.  Let’s think about that in more concrete terms, with a historical example:

At the beginning of the twentieth century Britain was far more resource efficient than the United States.  We used less raw cotton for each yard of cloth produced, less coal and iron ore for each tonne of steel.  However, we used far more skilled labour.  This was the result of us having more skilled labour, as we had been an industrial nation for longer, but less natural resource, as we did not have the big resource endowment of the US.  The market prioritised resource efficiency in Britain but efficient use of skilled labour in the United States.  Resource efficiency is not an unqualified good.

The Happy Planet Index is based upon assumptions that classical liberals, conservatives and the Conservatives should all be opposed to:  An understanding of what people really want and need based upon the opinion of “experts” rather than preferences of those concerned and an ignorance of the capacity of market mechanisms to prioritise the efficient use of different scarce resources.

There is a simpler, more intuitive, rebuttal though.  Leaving aside tiny Pacific Islands the number one ranked country in the NEF’s index is Colombia.  One of the worst ranked is the United States.  Where would you rather live?

The answer is obvious.  Thousands risk death each year attempting to get from 38th placed Mexico to the 150th (out of 178) placed United States.  This is just one way that people clearly reveal their preference for a higher standard of living.  I’m sure the New Economics Foundation can blame this on some kind of false-consciousness.  The reality is that it illustrates that the free-market economies and resulting high living standards that the NEF deride are people’s real priorities.

Police chief calls for the abolition of targets

Ian Johnston, the president of the Police Superintendents Association, is denouncing Whitehall crime-fighting targets as a "shambles":

"He maintains that performance targets set in Whitehall are preventing senior officers from giving the public the policing they want.

They have no credibility within the police and do nothing to improve the public's perception of crime, he will argue.

Senior officers say they should be given more discretion to set their own priorities based on the needs and wishes of local people."

Does anyone still seriously believe that the complex problem of controlling crime can be understood from desks in Whitehall?  So long as local forces have to respond to the priorities of a central government that can only understand what is going on with clumsy targets that miss the true picture of crime and then analyses it from a perspective not shared by most of the population.

The only way to improve things is to give senior officers more discretion and then make sure they have to listen to local people through elected police chiefs.

Specialist schools fail to raise standards

From the Telegraph today:

"Almost every comprehensive in England has been turned into a "specialist school" - receiving thousands of pounds in extra money every year to champion particular subjects.

Under the scheme, schools specialise in technology, art, sport, languages, business, maths or science.

But a study by academics at Cambridge and Staffordshire universities concludes that the schools are "no more effective than other state schools".

This is an example of how attempts to create choice without allowing genuine freedom from political management fail.  Specialist schools are well-funded but respond to the priorities of politicians rather than parents.  To see rapid improvement thanks to new schools and the pressure they have put on existing schools to act on the priorities of parents and compete for their vouchers look to Sweden.  There school choice has been a massive success, the evidence can be seen in this paper for Reform, and remains exceptionally popular.

Britain lags in quality of life index

Yesterday the Telegraph reported that a new Economist index will reveal Britain lagging behind other countries of similar income in the quality of life it affords its residents.  The difference has a lot to do with our underperforming public services.

While in the private sector we lead the world in attracting international investment in the areas the public sector takes primary responsibility for we have crowded roads and low life expectancy.  Politicians have failed while private sector firms have suceeded.  This has to strengthen the case for moving more personal services that can be provided by Civil Society out of political control.