A critical juncture for public services: lessons from COVID-19 Contents

Chapter 6: Over-centralised delivery of public services

“Because of my age and health … I had a letter from the Government telling me that I should officially shield, but nothing happened … It was about four weeks into lockdown before I was actually recognised, only because I persisted … If I had kept quiet and done nothing about it, I have a feeling that I might have been completely forgotten.”

106.This is what Agatha Anywio, 76, from London, told us about her experience of the early days of the first lockdown.110 Her experience was not uncommon; we heard how the Government’s disjointed communications strategy with local and frontline services led many people to feel that they had been forgotten and left without support.

107.Debra Baxter said that local organisations would have been in a better position than national agencies to understand her situation and coordinate services around her needs: “I believe in local organisations and keeping things local, because what might work in one end of the country might not work in another.” 111

108.Rt Hon Michael Gove MP’s June 2020 Ditchley Annual Lecture made the case for the kind of devolution to the local level that Debra Baxter advocated.112 But the public service response to COVID-19 demonstrated that little such devolution has yet occurred. Witnesses maintained that central Government attempted to coordinate too many services during the pandemic. This chapter analyses the lack of integration between central Government and local service providers, and how this affected people using services during the first lockdown.

Poor central Government coordination and communication

109.We heard that frontline public service providers were often required to interpret and implement the Government’s public announcements on COVID-19 without prior consultation.113 There was no coordinated communications strategy across Government; local authorities often received divergent messages from different Government departments. Sarah Pickup, Deputy Chief Executive of the Local Government Association (LGA), told us: “Guidance came out in dribs and drabs. One of my [local authority] colleagues said it was like trying to construct a piece of Ikea furniture with a piece missing and the instructions being posted daily in bits and pieces.”114

110.NHS England’s Volunteer Responders Scheme, delivered in partnership with the Royal Voluntary Service, saw over 750,000 people sign up in just four days when it launched in April 2020. This was three times the original target. Volunteers were recruited to deliver medicines and equipment, drive patients to and from appointments and make regular phone calls to check on people isolating at home.115

111.However, the Institute for Volunteering Research wrote that such national-level attempts to coordinate volunteers had “limited impact, were not aligned to locally organised and coordinated responses and overall made a limited positive difference”.116 Witnesses also reported that the centralised structure of the NHS England’s Volunteer Responders Scheme meant that it took a significant length of time to respond to local volunteers, which diminished their enthusiasm to volunteer.117 In particular, the social care sector could have benefited significantly from the support of volunteers, who would have relieved some of the pressure on social care workers.

Public health

112.England entered the COVID-19 pandemic with a public health system that had both devolved and centralised components. The local system is led by directors of public health based in local authorities, who are responsible for a range of community and public health services in their area. This local network operates alongside Public Health England, a national executive agency of the Department of Health and Social Care (DHSC) which is responsible for health protection and improvement in England.

113.We heard that the national response to the pandemic largely depended upon centralised executive agencies and failed to use local resources effectively. The Association of Directors of Public Health (ADPH) pointed to the extensive experience of contact-tracing in local authority public health teams. But local councils and public health teams had little involvement in the design and delivery of NHS Test and Trace, the national COVID-19 contact-tracing service.118

114.Dr Jeanelle de Gruchy told us that her colleagues from central Government often failed to draw on local resources because they were unaware of the role played by local authority public health teams: “There was a really poor understanding and recognition of the role of the director of public health, the local public health system and indeed local government as a key partner in managing this pandemic.”119

115.This lack of understanding resulted in poor communication from the centre:

“If you do not know that directors of public health exist or what our role is, you are not going to communicate with us … in the first weeks we got nothing directly communicated to us, which put us—we have a statutory responsibility for our local populations on health—on the back foot in how announcements were made, how we were left to interpret and translate them into local areas. Bearing in mind that we were supporting and advising … care homes, schools and mortuaries, we were a bit in the dark in being communicated with.”120

116.Such poor communication and engagement, at least in the earliest stages of the pandemic, created a fragmented public health response. Directors of public health were often required to coordinate the different elements of the Government’s strategy—for example on PPE and testing—to ensure that they joined up across local health and care systems.121 Dr de Gruchy told us that many national initiatives such as the NHS Track and Trace scheme were “designed nationally in silos and landed locally. We had to knit [them] together.”122

117.COVID-19 has demonstrated that certain key public service functions are best delivered locally. These include the pandemic response of public health systems, the recruitment of volunteers and contact-tracing. To increase the resilience of public services in any future health crises, the Government must give more decision-making responsibility to its partners at the local level.

Funding for local service delivery

118.We heard that past public expenditure reductions following the global financial crisis had hampered service delivery at the local level. Anna Round, Senior Research Fellow at IPPR North, a think tank, pointed to “local authorities having come from a long period of extremely constrained funding”. This retrenchment, she argued, had left local authorities poorly equipped to deal with the pandemic: “Financial austerity over a long period … has had the knock-on effect on staffing and the amount of resources and assets that local authorities have to work with” in dealing with COVID-19.123

119.While central Government had promised more funding since the onset of the pandemic, it had not always been forthcoming. Jessica Studdert, Deputy Director of the New Local Government Network (NGLN), a think tank, claimed: “Local government was told early on by the Secretary of State that it could spend whatever it takes to get needs met in communities, but there has since been a significant rowing back of that early commitment.”124 She said that although £3.2 billion had been allocated to local government during the pandemic, “the overall costs of outlay of the service response and lost income for local authorities” were estimated at “about £10 billion to £13 billion”.125

120.Jessica Studdert contrasted the experience of local government with that of the NHS, which had “its costs met in full. Trusts have had their deficits written off, unquestioningly. That puts a public service in a much more secure place to be able to plan for the future.” Nick Davies, Programme Director at the Institute for Government (IfG), a think tank, compared the funding received by organisations working at different levels of public service delivery, arguing that solving this disparity would be key to the reform of public services after COVID-19.126

121.Witnesses criticised central Government for providing only short-term funding. The NLGN decried the “UK Government’s growing tendency to fund local authorities with random one-off short-term single-issue funding pots” which do not “aid local strategic planning” of the kind needed to deal with crises such as COVID-19, and “take resources away from local authorities by requiring them to bid for the money and report on how it is used”.127

122.The NLGN contended that the pandemic had underlined the need for local government to “secure [a] long-term funding settlement to remain sustainable in its current form”. A “multi-year funding settlement” would allow local authorities “to plan strategically and make the best decisions for their residents and area while stepping outside central Government’s shadow”.128 Jessica Studdert argued that the current funding model made planning difficult:

“Cuts to its funding, and a lack of certainty over the future of its funding, makes it much harder for [local government] to plan, to have a four-year investment plan in the area, to collaborate with other services, and to think about how to do things differently and innovate.”129

123.The current model embeds the lack of integration of public services that has been exposed by COVID-19. This “disjointedness will be embedded much more if we do not put local public services on a much more sustainable footing”, Jessica Studdert told us.130

124.One solution would be to permit local authorities to balance budgets over multiple years, which according to the NLGN “would give them some breathing space to recover from the financial impact of COVID-19”. “This is something the Chancellor of the Exchequer can already enable at the national level, but is currently not allowed at the local level,” the NLGN noted.131

125.Eamonn Boylan, Chief Executive of the Greater Manchester Combined Authority, sought a “relationship with Government that did not consistently have cliff-edges in it”. He said:

“I have a cliff-edge on public transport funding on 4 August. I have no idea what will happen to public transport funding in Greater Manchester after that point. We are continually working on relatively short-term budgets for relatively short-term competitive processes in order to move forwards to make strategic priorities. That needs to change.”132

126.The year 2021 will be important in the development of devolution in England. The Government has committed to publishing a white paper on English devolution133 and eight out of 10 devolved mayoralties are due to hold elections.134 The next chapter describes how giving more responsibility to local public services and communities paid dividends during the first lockdown. In Chapter 12 we outline how the devolved administrations have worked with local government during the pandemic. The Government should study their experiences as it considers granting more powers to the local level.

127.It is clear that the underfunding of local services in recent years left them ill-equipped to deal with the resource pressures of the COVID-19 pandemic. For too long Government has prioritised services delivered from the centre, when many of the services that people use every day are organised at local level. The pandemic offers an opportunity to rethink how central Government funds and supports local services.

110 Q 136

111 Q 144

112 Cabinet Office, ‘“The privilege of public service” given as the Ditchley Annual Lecture’ (1 July 2020): https://www.gov.uk/government/speeches/the-privilege-of-public-service-given-as-the-ditchley-annual-lecture [accessed 20 October 2020]

113 Q 19

114 Ibid.

115 Written evidence from Richmond Group (PSR0029)

116 Written evidence from Institute for Voluntary Research (PSR0014)

117 Written evidence from Locality (PSR0074) and Dr Chris Cocking (PSR0033)

118 Written evidence from Association of Directors of Public Health (ADPH) (PSR0069)

119 Q 35

120 Ibid.

121 Written evidence from Association of Directors of Public Health (ADPH) (PSR0069)

122 Q 37

123 Q 14

124 Q 12

125 Ibid.

126 Q 9

127 Written evidence from the New Local Government Network (NLGN) (PSR0039)

128 Ibid.

129 Q 12

130 Ibid.

131 Written evidence from the New Local Government Network (NLGN) (PSR0039)

132 Q 39

133 Andy Bounds, ‘Plans for further English devolution shelved until next year’, Financial Times (30 September 2020): https://www.ft.com/content/e1e2c392-a2e6-4ac5-9f0e-51e2926b1785 [accessed 20 October 2020]

134 House of Commons Library, ‘Coronavirus: how might devolution in England be affected?’, (11 May 2020): https://commonslibrary.parliament.uk/CORONAVIRUS-how-might-devolution-in-england-be-affected/ [accessed 20 October 2020]

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