The birth of the White Paper on public service reform was a tortuous business — but, now it’s been out for several months, the government is keen to make the most of it. David Cameron is launching an ‘updated’ version today, with a few new proposals contained therein. He also has an article in the Telegraph outlining those ideas, including the one that seems to be getting the most attention: draft legislation to give people a ‘right to choose’ their public services.
It feels like both an important and potentially inconsequential moment all at once. Enshrining choice in the laws of this land is a powerful symbol that people shouldn’t have the state’s idea of ‘good’ foisted upon them. But it’s also doubtful what this will actually mean in practice. One fear is similar to that surrounding the Brown/Miliband ‘guarantees’: that it would create a legal minefield out of rights and infringments, so dangerous that people would fear to tread on it. It’s also worth noting that the NHS constitution already contains ‘rights’ to choose GP surgeries, which GP you’d like to see, which hospital you’d like to be treated at, etc, etc — and with an uncertain effect on actual outcomes.
And there are wider concerns too. Do people want to choose? Do they have access to the information that underpins choice? What if they don’t? The coalition are, to their credit, trying to think around these problems, as Cameron’s announcement today of ‘an independent review that will specifically look at how we can extend choice to the most disadvantaged in our society.’ But, then again, so did Labour. They released a paper in 2005 — Improving Services, Improving Lives — which dealt explicitly with many of the same questions.
Fact is that choice is one of the most powerful ideas around when it comes to delivering public services. But choice, proper choice, also depends on so many external factors — from broadband infrastructure to the everyday politics of local government. Today, Cameron is giving us a welcome statement of intent. Filtering that intent down through the bureaucracy, and to the public, will be a different matter entirely.
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