House of Commons - Public Administration

Select Committee on Public Administration Twelfth Report

4 Entitlements to public services: Public Service Guarantees

38. Perhaps the most significant aspect of the Citizen's Charter programme was the creation of individual charters for public services. These charters set out the levels of service provision that the public could expect to receive—allowing people to be clear about what they were entitled to, and making it clear to service providers the standards they were committed to meet. In this way, as the Public Service Committee observed in its report on The Citizen's Charter, the charters set a minimum framework of standards for a range of public services.[43] There were 42 charters, ranging from the Passenger's Charter and the Tenant's Charter to the Parent's Charter and the Jobseeker's Charter. One example, the Taxpayer's Charter, is replicated below.

The Taxpayer's Charter (1991)

You are entitled to expect HM Customs and Excise:

To be fair

by settling your tax affairs impartially
by expecting you to pay only what is due under the law
by treating everyone with equal fairness

To help you

to get your tax affairs right
to understand your rights and obligations
by providing clear leaflets and forms
by giving you information and assistance at our enquiry offices
by being courteous at all times

To provide an efficient service

by settling your tax affairs promptly and accurately
by keeping your private affairs strictly confidential
by using the information you give us only as allowed by the law
by keeping to a minimum your costs of complying with the law
by keeping our costs down

To be accountable for what we do

by setting standards for ourselves and publishing how well we live up to them

If you are not satisfied

we will tell you exactly how to complain
you can ask for your tax affairs to be looked at again
you can appeal to an independent tribunal
your MP can refer your complaint to the Ombudsman

In return, we need you

to be honest
to give us accurate information
to pay your tax on time

39. The charters were designed to ensure the public were aware of and able to claim their rights or entitlements to public services. In this chapter, we look at the idea of entitlements to specified levels of public service provision more generally. Since the Citizen's Charter, there have been other expressions of this idea. Our predecessor Committee recommended a form of public service entitlement in its Choice, Voice and Public Services report. The proposed set of entitlements were to minimum standards of public service provision, and were termed 'Public Service Guarantees' (PSGs):

…it should be possible to devise a developing set of Public Service Guarantees (PSGs) which may apply either nationally or locally and which would be pledges of services being provided to a minimum standard. They would:

support policy outcomes;
be precise as to the level of service to be expected (e.g. an operation in six months, or a passport in six weeks);
have a clear statement that the service could be delivered by a provider of the user's choice; and
clear arrangements for redress in the event of failure.[44]

40. Specifying people's entitlements to public services can promote service improvement as well as empowering service users. Age Concern told us that:

41. The Government has announced several recent initiatives that draw on the idea of entitlements or rights to public services. The most high-profile of these is the draft NHS Constitution, which "sets out commitments to patients, public and staff in the form of rights to which they are entitled and pledges which the NHS will strive to deliver".[46] The Government explicitly acknowledges the debt that the draft NHS Constitution owes to the original Patient's Charter.[47] Other charters that were conceived as part of the Citizen's Charter programme, including the Courts Charter and the Taxpayer's Charter, have been revised and revived already or are in the process of being so.[48]

42. In this part of the Report, we consider in greater detail some of the issues that would be raised by the creation of Public Service Guarantees, or entitlements to minimum standards of public service provision. We examine first the form that entitlements to public services should take. We then consider some of the issues that would arise out of creating such entitlements: universal minimum standards of provision and local responsiveness; rights to public services, responsibilities on service users, and resources; setting levels of entitlement; empowering people to take up entitlements; and enforcement and redress.

Creating entitlements to public services

43. In creating Public Service Guarantees, the first issue is to determine the form of entitlement. The original Citizen's Charters varied considerably in their length and content, and contained different types of promises to service users. According to the Public Service Committee, the 1991 Patient's Charter contained the following distinct types of commitment:[49]

i. Formalisation of best practice relating to, for example, standards of catering and accommodation;

ii. Statutory entitlements, such as access to medical records and informed consent;

iii. Targets, such as waiting times for treatment; and

iv. Broader policy objectives, such as the promotion of community support.

44. As the Public Service Committee pointed out, this inconsistency ran the risk of confusing the public about the nature of their entitlements to public services:

45. The Public Service Committee went on to say that departments and agencies were often vague as to which of their promises were to be regarded as binding guarantees requiring redress or compensation if not met. It recommended that charters should make clear the rights that are capable of being enforced.[51] Similarly, our predecessor Committee proposed that specific entitlements to service provision be set out, with a statement of redress arrangements if standards were not attained.[52] We recommend that there should be clear, precise and enforceable statements of people's entitlements to public services. These should be in the form of Public Service Guarantees, as proposed by our predecessor Committee. The Guarantees should specify the minimum standard of service provision that service users can expect, and set out the arrangements for redress that apply should service providers fail to meet the standard promised.

46. Some commitments to provide minimum standards of provision already exist in a variety of public services. Many of the most prominent ones occur in health, such as commitments on GP appointment and hospital treatment waiting times.[53] The Department of Health has, since 2004, promulgated the Standards for Better Health, which outline 24 core standards that apply to all NHS care.[54] We welcome the Government's existing efforts to set out people's entitlements to minimum standards of public service provision, as expressed in a number of targets and core standards. In developing a set of Public Service Guarantees, we would expect the Government to consolidate these existing commitments.

47. The process of developing a set of Public Service Guarantees would be a continuous one, starting with the entitlements that exist now. New entitlements—for example, entitlement to respite care—could be added as necessary, resulting in a continually evolving set of Guarantees. Drawing together existing entitlements in one place would give public service users a powerful tool to help them claim their rights to public services. It would also assist in identifying where it would be desirable to spell out new entitlements. We envisage the creation of a set of Public Service Guarantees that could be put in the hands of public service users. This would, in effect, form a citizen's handbook of entitlements. The set of Guarantees would be a progressively evolving document that is able to adapt to changing need and attitudes about entitlements to public services.

Universal minimum standards of provision

48. Public Service Guarantees that are based on minimum standards of service provision would apply universally. The Guarantees would, therefore, serve as the basis for all service users to claim their right to an agreed minimum level of service. In this way minimum standards could promote fairness in public service provision, as acknowledged by the Government's recent report Excellence and Fairness: Achieving World Class Public Services.[55] Likewise, all service providers would be clear about what was expected from them in terms of acceptable levels and standards of service to be provided. In this way, Public Service Guarantees can serve a useful purpose by evening out the inequity of 'postcode lotteries' of service provision, as Age Concern suggested to us.[56]

49. We recognise there is a concern that minimum standards set the bar too low, encouraging service providers to satisfy the bare minimum rather than striving to achieve the highest standards. David Bell explained to us his view on such matters as the former head of Ofsted:

50. He went on to say that minimum standards need not pose a barrier to diversity of service provision:

51. In a related vein, the Metropolitan Police Authority told us that:

52. This addresses in part the concern of many that centrally-set minimum standards, if imposed inappropriately, could stifle responsiveness to local or specific circumstances. The Audit Commission, for instance, told us that:

53. In the foregoing discussion, we have assumed that the minimum standards to be set are the 'right' ones. If they are not, there is a danger that the imposition of inappropriate minimum standards could result in the kinds of unintended or perverse consequences that have, on occasion, plagued public service targets.[61] One example that is also relevant for our purposes was given to our predecessor Committee during its inquiry on government targets. It concerns the effects of a commitment on waiting times for eye hospital appointments for new patients, as compared to those waiting for follow-up appointments:

54. It is clear that service providers would need to anticipate any potential adverse or perverse consequences of setting entitlements to minimum standards. On balance, however, we believe that the benefits of guaranteeing minimum standards of service provision—clearly setting out the entitlements to public services that people could claim, and the standard of service expected of public service providers—justify taking this approach. The point of national minimum standards is not to bring about uniformity of service provision, but to set the minimum acceptable level and quality of public service provision that should apply to all. We believe that minimum standards are therefore an appropriate basis on which to formulate Public Service Guarantees.

Rights, responsibilities and resources

55. Given that all governments will face a situation of finite resources for public service provision, entitlements to public services cannot be unlimited. The Public Service Committee observed that one difficulty with the charters under the Citizen's Charter initiative was that they were not linked to decision making about the resources required to meet the entitlements: "The Citizen's Charter has helped to create expectations of service. It is not its role to provide the resources to deliver them".[63]

56. It is important that discussions about the level of entitlements contained in Public Service Guarantees occur with a degree of realism about the funding of public services. We have couched our proposal for Public Service Guarantees in terms of entitlements to the minimum acceptable standards of public services, which might help to avoid some of the problems that could be raised by setting unrealistically aspirational entitlements. In addition, differing levels of resources may be required to enable communities or services in different circumstances to meet universal minimum standards, as noted by the Audit Commission:

57. A related issue is that of the responsibilities owed by users of public services, as the corollary to their rights to services. Some of the original Citizen's Charter service charters, such as the Taxpayer's Charter cited earlier, listed the responsibilities expected of service users as well as the rights granted to them. The Government has recently announced a number of initiatives that pick up on this idea of responsibilities as well as rights to public services. The draft NHS Constitution contains a section on the responsibilities of patients and the public, such as obligations to follow courses of treatment agreed with clinicians and to register with a GP practice.[65] A new draft Taxpayers' Charter updating the rights and obligations of taxpayers, a clearer expression of the responsibilities expected of those receiving welfare benefits, and the broader debate around the Bill of Rights and Responsibilities are other instances of this new emphasis on duties owed by citizens and public service users.[66]

58. The argument that service users should fulfil certain responsibilities recognises that public services are provided in the context of limited resources, which need to be used efficiently and effectively. Bernard Herdan put forward the view that efficient and fair service provision warranted placing obligations on people claiming their rights to public services:

59. In evidence to us, the British Medical Association also declared itself in favour of specifying the responsibilities of service users (in this case, patients) as well as rights:

60. Interestingly, the evidence we received did not address whether people should lose their rights to public services if they failed to uphold their responsibilities. This is a question the Government is starting to weigh up as it begins to set out formulations of rights and associated responsibilities such as the NHS Constitution. The Prime Minister, in a recent appearance before the Liaison Committee, outlined his view on the matter:

61. Rights or entitlements to public services do not exist in a vacuum. If Public Service Guarantees are to be credible, they must reflect the reality that there are limits to the resources available for public service provision. This means that discussions about the nature of entitlements to public services must explicitly take into account the resources available to fulfil those entitlements. It also suggests that people need to be made aware of the responsibilities arising out of their use of public services, as a concomitant of their rights to publicly provided services.

Setting levels of entitlement

62. Setting entitlements to public services will often be a difficult task, as it will involve making political judgements about the standard of service provision to be guaranteed to all service users. As we have seen, it also depends on wider considerations such as the funding of public services. User groups such as Breakthrough Breast Cancer and Mencap told us that it was important to set entitlements that have the legitimacy of being based on the views of service users. This could be done by, for example, examining data on complaints about services and through genuine consultation (i.e., before a minimum standard of service is set rather than after).[70]

63. The National Consumer Council (NCC) suggested that entitlements should be quite simple to develop, as service users will know what matters to them when they receive a service. The NCC drew an analogy with the service provided by supermarkets:

It should be relatively straightforward to develop a set of minimum standards for public services. Consumers are fundamentally consistent in what they need: a service that delivers what it is meant to deliver, with staff who have the appropriate skills and competencies, and where communication is effective. Through working with their customers Tesco has developed a model based on the five aspects of supermarket experience that are critical to customers:

the aisles are clear
I can get what I want
the prices are good
I don't want to queue
and the staff are great.[71]

64. The NCC's approach takes us some, though not all, of the way. While it may be relatively simple to identify people's broad preferences, translating these into tangible entitlements is a trickier task—particularly when resource implications are factored in. To take the Tesco example, it is not obvious how Tesco translates a broad statement such as "the prices are good" into a firm commitment about the level of its prices relative to competitors' (although the existence of 'price guarantees' suggests it is possible). In public services terms, a comparable example might be how a generalised preference such as "I want to see my GP quickly" gets transformed into a quantifiable commitment such as the 48 hour appointment waiting time target.

65. Despite the difficulties of formulating precise entitlements, the overall point about the need to base entitlements on people's preferences is clear. It is a useful discipline to require public service decision makers to think about what is most important to their service users, and to build entitlements and commitments to service levels around these views. We believe that the process for setting Public Service Guarantees must genuinely involve service users if the Guarantees are to reflect accurately what users want from public services.

Empowering people to take up entitlements

66. Once entitlements have been set, the emphasis shifts to encouraging people to take them up. One of the strongest user-focused elements of Public Service Guarantees is the active role they would give to service users to claim entitlements to minimum standards of service. The New Economics Foundation told us that this aspect of Public Service Guarantees effectively created a form of bottom-up accountability for good service provision.[72] Similarly, Age Concern described to us how people would be empowered by entitlements to specified standards:

67. This fits with the Government's emphasis on "empowering citizens", as set out in its recent statement of its vision for public services and, more generally, in the proposed draft Community Empowerment Bill in the 2008-09 draft legislative programme. The Government has said that it wants to:

empowering citizens

Introducing entitlements to public services in the form of Public Service Guarantees would be a powerful addition to the measures the Government has already outlined for empowering the people that use public services.

68. Nonetheless, the current reality appears to be that there is low public awareness of existing entitlements to service levels. As we noted earlier, many minimum standards of service provision exist already (such as waiting time targets and the core standards that apply to all NHS care). In discussing the Department of Health's Standards for Better Health, the Healthcare Commission told us that in its view:

69. Service user groups such as Shaping Our Lives and Age Concern agreed that awareness of existing service level standards needed to be raised. Age Concern, in particular, proposed concrete steps to communicate the core health standards more widely. This might, for example, involve making information on the standards available in relevant health and care settings—putting it in the waiting rooms of doctors' surgeries, or including it with hospital appointment letters.[76] Many minimum standards for public service provision exist already, but public awareness of these standards appears to be very low. We recommend that, across all public services, the Government should make a systematic effort to publicise and communicate these standards as an initial step towards enabling people to claim their entitlements to minimum standards of service provision. Public Service Guarantees, if introduced, would also need to be publicised widely.

Enforcement and redress

70. Putting standards in the form of Public Service Guarantees indicates that there is a direct form of accountability involved—people should be able to claim redress if the relevant standard is not met. This would, in practice, require an effective enforcement mechanism to support individuals seeking redress. As the Parliamentary Ombudsman put it to us:

Once standards have been set and accepted, bodies should not seek to avoid the consequences of failure to meet them. Clear standards must be matched by clear accountability.[

71. The Audit Commission told us that: "Standards in public services can in many cases be regulated and enforced voluntarily by the providers themselves".[78] The Government signalled in its recent report on the future of public services that it would give greater powers to service providers to address poor performance where that resulted in the failure to meet minimum standards:

The Government is clear that its priority must be to eradicate such underperformance, as recent announcements have demonstrated.

The Department of Health recently announced proposals to ensure that when a hospital or other health care provider falls below acceptable standards new powers will be used to turn them around, including by bringing in new management.
The new National Challenge programme sets out how local authorities will work with schools where attainment is low. This has been combined with greater freedoms to build new academies, merge schools or deploy excellent head teachers to help struggling institutions.

72. We welcome the steps the Government is taking to ensure that service providers have the necessary powers to secure high standards in public service provision. What is also necessary, however, is for there to be a strong, independent enforcement mechanism to bring into line those organisations that do not meet standards. One suggestion has been to make the Ombudsman responsible for enforcing public service entitlements, as occurred in relation to the original Citizen's Charter service standards:

73. The formulation of entitlements as Public Service Guarantees, to be enforced by the Ombudsman, avoids some of the difficulties that could arise if justiciable rights to public services were to be specified. We are in favour of an enforcement mechanism based on the Ombudsman's powers to seek redress for maladministration, rather than on requiring public service users to go to the courts. Securing rights to public services through a legal process is likely to be complex, expensive and off-putting for many users. Public Service Guarantees are hence more likely to achieve their aim of empowering public service users if they do not become the province of lawyers.

74. There would need to be a body dedicated to enforcing Public Service Guarantees so that, in practice, public service users were able to secure their entitlements. We believe that this would logically fall within the Ombudsman's remit, since the failure to meet promised minimum standards would result in complaints about 'maladministration' on the part of public service providers. The Ombudsman would also be well-placed to enforce Public Service Guarantees because of her wide-ranging remit over all public services and considerable experience in securing redress for those that have suffered from poor administration.

75. Ensuring that there is appropriate redress should standards fail to be met is key to effective enforcement. In the past, the Government was largely concerned with the issue of financial redress. It was reluctant to pay financial compensation when standards set out in the individual service charters were not achieved, as the Charter Unit guidance on redress makes plain:

76. In order to fulfil their function of guaranteeing service levels, Public Service Guarantees must outline the redress—financial or non-financial—due to users when specified minimum standards are not met. This should be made clear in the form of the Public Service Guarantees themselves. The precise nature of the redress will depend on the circumstances, but the Ombudsman's Principles for Remedy set out the broad approach that should be adopted if entitlements are not met:

77. For entitlements to minimum standards of public services to be effective, there must be robust enforcement and redress arrangements in place. Measures to remedy any failure to meet promised standards should be spelled out clearly in the form of the Public Service Guarantees themselves. Redress should be made in a fashion appropriate to the circumstances of the particular entitlement, and should aim to restore individuals to the position they would have been in had the standard been achieved in the first place.

43 Public Service Committee, The Citizen's Charter, para 10 Back

44 Public Administration Select Committee, Choice, Voice and Public Services, para 242 Back

45 Ev 167 Back

46 Department of Health, The National Health Service Constitution: A Draft for Consultation, p 2 Back

47 Ibid, p 13 Back

48 HM Courts Service, Courts Charter, http://www.hmcourts-service.gov.uk/infoabout/courts_charter/index.htm;HM Revenue and Customs, HM Revenue and Customs and the Taxpayer: A New Charter for HMRC and its Customers, June 2008 Back

49 Public Service Committee, The Citizen's Charter, para 40 Back

50 Ibid, para 41 Back

51 Ibid, para 41 Back

52 Public Administration Select Committee, Choice, Voice and Public Services, para 242 Back

53 Department of Health, The NHS Plan, Cm 4818-I, July 2000, p 101 Back

54 Department of Health, Standards for Better Health, July 2004 Back