Why and how do municipalities merge? A view from the cognitive perspective

[Photo: https://www.linkedin.com/pulse/mental-virus-flipside-covid-pandemic-dr-abha-bhartia/%5D

Dr. Veronika Vakulenko

Among all public sector reforms initiatives, those appearing on the municipal level are the most tangible. This is because in modern democracies citizens can observe and (if willing to) trace changes in, for example, city planning, local infrastructure, education and many other spheres. Let’s be honest, everyone likes to visit a clean park, modern library, drive perfect roads or celebrate an opening of a new school. Meaning that local governments need to use financial recourses on creating a comfortable place for all to live in. However, it becomes rather common that local governments are not able to balance their budgets, due to a higher per capita spending, lower public service provision, or limited infrastructural capacity, which is the case particularly for smaller rural areas.

Seeking to improve local financial condition, many countries worldwide launched local government reforms, which still remain on the top of agenda among academia and practitioners. Pursuing mainly the objective to enhance local financial efficiency and quality of local public services, the reforms can vary from contractual inter-municipal cooperation to mergers or amalgamations. Mergers are the most drastic reforms as they require alterations of territorial boundaries, changes in administrative responsibilities and routines, and adjustment of financial management practices, all of which affects significantly the lives of citizens.

Several European countries, e.g., Finland, Switzerland, Ukraine, selected to implement voluntary mergers, allowing local governments to celebrate the freedom in deciding whether to initiate the territorial reform. While some municipalities recognized merger’s benefits (i.e., improvement local governments’ economic condition and quality of local public service delivery), others resisted merger. In this situation, it becomes interesting to approach municipal amalgamations from a dynamic perspective to understand behaviour and interactions between different actors, which can result in diverging reform outcomes.

In our recent study published in open access at Local Government Studies, we use an interdisciplinary concept of cognitive style, to explore the psychological aspect of mergers. By mobilizing cognitive literature, we could take a closer look at local actors’ behaviour, to argue that a merger is not a simple ‘marriage of convenience’ of local actors to increase their economic efficiency. Rather, it is a complex cognitive process, which requires local actors’ mental work in taking decisions and creating (or not) a new merged municipality. Thus, a final decision “to merge or not to merge” depends not only on financial benefits, but also on the way local actors perceive and process information about financial incentives and how they operationalize their decisions.

In a story of two neighbouring local governments in Ukraine studied during 2015-2019, we approached two local political leaders, who were drivers of changes on the local level. By studying very carefully their behaviour and actions, we found that their initial perceptions of merging were completely the opposite. While the first one was viewing this as an opportunity and was able to convincingly explain the need and future benefits of this change, as well as introducing new practices to engage local citizens. Despite several other local actors were supporting this initiative, the second leader was acting in a discouraging way and always emphasized risks for their community, which in the end resulted in collective inaction.  To summarize, new interdisciplinary approaches can be used to better understand the success stories or failures of municipal mergers. Cognitive theory in public administration has a significant potential in this field as well as implications for practice. As our case showed, better mapping the sceptics and addressing perceptions of local leaders before initiating voluntary mergers could facilitate better results from territorial reforms.

Dr. Veronika Vakulenko is an Associate Professor at Nord University Business School, Norway. Their research interests include interdisciplinary public sector accounting research; budgeting and financial management in local governments; national and supra-national public sector audit; reforms particularly in the context of developing countries.

The Winding Stair: half a century of local government

Sir Rodney Brooke

Image: https://talesoftimesforgotten.com/2019/12/18/no-medieval-staircases-werent-designed-to-give-right-handed-defenders-an-advantage/

My memoir, The Winding Stair, chronicles over half a century of my service in local government, a period which coincided with the decline in the importance and independence of local government as well as the biggest social changes since the industrial revolution. As a local authority chief executive, I experienced these changes at first hand.

Post-war local government attempted to tackle the problems of deprivation. Increasingly the emphasis shifted to the problems of affluence. The three post-war decades saw rising living standards, falling inequality, greater freedom and expanding welfare provision. The following decades saw the opposite. The belief that problems would be solved by spending more money evaporated.

Public expectations rose with the decline of faith in post-war remedies, such as urban motorways, multi-storey flats and town centre redevelopments. Communal services were privatised. Ministers introduced innovations before any assessment could be made about the effectiveness of their precursors. Rather than tackle a problem, governments changed the structure of the agency dealing with it. Responsibilities of the state were transferred to the private sector. An underclass of casual workers was created. My local government career placed me in the middle of these changes and my memoir chronicles them.

In my youth local authority chief executives were great men. Among them knighthoods were ten-a-penny. [Not one serving local government officer now has a knighthood]. The London train would be held for the county chief executives, who traced their authority to the Courts of Quarter Sessions for which they were responsible until 1972. They would expect the Permanent Secretary of the Ministry to call on them when they went to London.

The Councils they ran were fundamental in the life of their residents. During my service I was central to some of the most newsworthy issues of the day. I

  • prosecuted for riot;
  • was the last person ever to be responsible for reading the Riot Act;
  • was responsible for the construction of the last municipal reservoir before water supply was stripped from local government in 1974;
  • warned Bradford City football club of the danger before 56 fans burnt to death in front of the TV cameras;
  • enabled the inquest into the notorious death of Helen Smith in Jeddah;
  • challenged the police belief in Wearside Jack’s claim to be the Yorkshire Ripper;
  • refused Willie Whitelaw’s secret request to sack the West Yorkshire Chief Constable over his failure to catch the Yorkshire Ripper;
  • as emergency controller for Yorkshire in the event of nuclear war, was to shelter in an underground bunker in the Pennines before emerging when Geiger counters showed that it was safe;
  • discovered that three Westminster cemeteries had been sold for 15p;
  • found the press camped on the lawn of our house when I resigned before Dame Shirley Porter began her Homes for Votes gerrymandering – which resulted in her being surcharged £42.5m.
  • acquired a knighthood, a CBE and decorations from France, Germany and three other countries.

Sir Rodney Brooke worked for Morley Council (1955-62); Rochdale Council (1962-63); Stockport Council 1963-73; West Yorkshire County Council 1973-1984 (Chief Executive 1980-84); Chief Executive of Westminster City Council (1984-89); Secretary of the London Boroughs’ Association 1984-90; and Secretary of the Association of Metropolitan Authorities (1990-1997). He remains involved with local government on a non-executive basis.

The Winding Stair is available online or from booksellers at £13.99. ISBN 9781838489977

Theresa Stewart: Leader, Lord Mayor, Councillor and Mother

Chris Game

A few months ago, in blogging about ‘Women in West Midlands Governance’, I noted that in 1975 – not special, simply the year that had prompted the blog – 21 or 17% of Birmingham City Councillors had been women. They included “Theresa Stewart … a future Leader of the Council, Birmingham Lord Mayor, and wife of a Professor John Stewart”, who himself was, of course, for nearly 30 years an INLOGOV Professor, and builder, shaper and almost embodiment of the institution it would become.

There was no cause to mention in that blog that Theresa Stewart had in fact died, aged 90, during the first year of Covid, in November 2020. It did, however, mean that the City Council’s formal Thanksgiving Service for the Life of Honorary Alderman Theresa Stewart – Birmingham (Labour) City Councillor (1970-2002), its so far only female Leader (1993-99), and Lord Mayor (2000-01) – was indefinitely postponed.      

From a purely personal viewpoint, but also arguably more generally, it was one of the more fortuitous Covid postponements. As a work colleague of her husband, Professor John Stewart, I knew Theresa for nearly four decades, including as one of their countless serendipitous chauffeurs.

However, had the Council’s commemoration event not been Covid-prevented from being held relatively soon after her death, I’m not sure it would necessarily have taken the informal, inclusive, family-led and, yes, appropriately celebratory form that it eventually did. Or indeed that I – and possibly even the Clarion Singers’ delightful ‘socialist choir’ – would necessarily have made the invitation list.  

As it was, though, the Thanksgiving took place over an early June lunchtime in the so-called Banqueting Suite in the Council House home of the City Council in Victoria Square. And yes, there were socialist anthems, food, and much non-alcoholic and cross-party mingling after the ‘Service’ itself.

Moreover, the enforced delay allowed the celebration to be highlighted by the formal unveiling – by the Stewarts’ daughter, Selina, and grandchildren – of the portrait commissioned to celebrate their mother/grandmother’s unique contribution to Birmingham’s civic life.  I say ‘portrait’, but the Council seem commendably to prefer ‘artwork’, as I’d guess does Michelle Turton, the Birmingham-based illustrator who created it.  

It should by now be viewable in the Council House’s (Dame) Ellen Pinsent Room – thus renamed in 2018 after the city’s first female (Liberal Unionist) councillor, who, like so many of Birmingham’s subsequent women councillors and MPs, was elected by Edgbaston voters, as a Liberal Unionist in 1911.

The formal rededication of the former committee room had been undertaken by then Honorary Alderman Theresa Stewart in 2018, and both, pleasingly, are now among the 30+ exceptional ‘Pinsent Room women’ – from Olympic heptathlete Denise Lewis to Nobel Prize winner Malala Yousafzai – whose achievements are celebrated in Louise Palfreyman’s fascinating 2018 book, Once Upon a Time in Birmingham: Women Who Dared to Dream.

As already indicated, the commissioned portrait was a kind of double bonus of the Covid postponement – in its own right, but also in its directly involving younger generations of the Stewart family, always at the heart, in every sense, of Theresa’s exceptional life of public and political service.

Not primarily, on this occasion, her lifelong work for, obviously, the Labour Party; or even the almost countless other causes for which she influentially campaigned – hospital standards, the Birmingham Pregnancy Advisory Service (which she founded), family allowances (going to mothers), CND, the miners’ strike, and indeed, just about every aspect of social services and education.

No – for arguably the most striking feature of Theresa Stewart’s ceaselessly active, seven-days-a-week, public life is that already alluded to: that it was totally interwoven with her family life – her immediate and extended family of 17 grand- and great-grandchildren and counting.   

The other obvious feature is that it was very largely focused on ‘local’ government. Exceptionally large-scale local, given it was Birmingham, but, while turning the initially marginal Billesley ward into pretty safe Labour, she resisted most of what must have been regular opportunities to at least consider Westminster – at a time, pre-1997, when under 5% of MPs were women.

Things have progressed, somewhat. Paulette Hamilton’s recent Erdington by-election win increased Labour’s women MPs to 52%, but the Commons total is still barely one-third and the proportion of mothers significantly lower still.

Which is why ‘Dirty Mother Pukka’ – aka Walthamstow Labour MP – Stella Creasy recently launched her VoteMama UK campaign, modelled on the US VoteMama movement. Its MotheRED grants of up to £2,000 are as timely as ever, at least helping – in the absence of maternity rights for MPs – to cover campaign childcare costs and encourage more mothers to stand for Parliament.

Early indications are that even these modest subsidies are attracting particularly single mothers and BAME (Black, Asian and minority ethnic) women. Yet one more worthy cause which Honorary Alderman Theresa Stewart would undoubtedly have backed with enthusiasm.

Pictured: Emeritus Professor John Stewart; Selina Stewart; C’llr Brigid Jones,
Deputy Leader, Birmingham City Council

If anyone would like to see a copy of the Service ‘programme’ – with summaries of Theresa’s life and Council record, and the tributes by Baroness Estelle Morris, Steve McCabe MP, Deputy Council Leader Brigid Jones, and Sir Michael Lyons – a small number are available via [email protected]


A version of this blog appeared in the Birmingham Post on 30th June – https://www.pressreader.com/uk/birmingham-post/20220630/textview

The role of scrutiny in navigating our new health and care economy

Picture credit: https://www.gponline.com/deadline-extended-gp-access-cover-england-brought-forward/article/1456385

Cllr Ketan Sheth

Mortality rates during the pandemic laid bare the health inequalities that exist across the country. Behind these figures lie human stories and grieving families that should remind us of the urgency and importance of understanding and addressing these inequalities.

In Brent, an ethnically diverse North West London borough, we recently set out to do just that.

Systems thinking

We know that Brent residents, who are from ethnic minority communities, disabled, or who are in poverty, experience significant health inequalities; but what does that look like in practice? How are our healthcare systems contributing to and/or compounding inequality? And what can be done to resolve this challenge?

Usually, GPs are the first point of call when someone is not feeling quite right. They ought to help everyone to access timely and safe healthcare. Therefore, reviewing access to GP services is critical and we decided to focus a dedicated scrutiny task group for eight months to report.

By giving ourselves time to understand this complex area in detail, we developed a deep comprehension of the landscape we were going to scrutinise. Patient voices are at the heart of our work, and we worked closely with Brent Healthwatch to ensure those from communities that have been under-represented in these conversations in the past, as well as those experiencing the worst health outcomes, were able to articulate and share their experiences.

Also, the task group held a number of evidence sessions over the course of six months, which were attended by stakeholders across Brent’s health economy. This included council officers, local commissioners and service providers.

All of this enabled the team to make a number of practical recommendations to  Brent Council and NHS partners.

Our work focused on three pivotal areas: Demand, Access and Barriers

With the dynamics of our healthcare and well-being landscape changing locally as well as nationally, it is more vital than ever to ensure all our residents have equality of access and consumption of healthcare services.

We found repeatedly that some groups of patients experience significant, and unnecessary, barriers, specifically:

• Patients of low-income

• Patients with a disability

• Older patients

• Patients whose first language is not English

• Children and young people

• Refugees and asylum seekers

• Patients who cannot access digital technology

Knowing this, GP services must seek to reduce and resolve the barriers experienced by patients, with a focus on deprivation, ethnicity, disability, and other protected characteristics as described in the Equalities Act 2010, if we are to execute our duties under the Act.

We recognise that rising demand, changing patient expectations and workforce retention issues continue to place pressures on primary care. Therefore, it is essential that the NHS continues to plan for this and uses the expertise of healthcare professionals across the system.

The digital transformation to healthcare, brought about by the pandemic, although helpful to some, introduced additional barriers for other people and communities.

In acknowledging the varying levels of ease in which patients access GP service, we strongly believe an access and treatment standard ought to be developed. This will ensure that Brent residents experience consistent and high levels of service: whether their requests are routine or urgent, focused on physical or mental wellness; or made via the telephone, online or in-person.

Our work has been conducted in the spirit of cooperation and partnership, and particularly, we look forward to continuing our dialogue and work with our partners across Brent’s health economy to evolve our shared vision of GP access across Brent.

Cllr Ketan Sheth is Chair of Brent Council’s Community and Wellbeing Scrutiny Committee

Can drama “Help” social care?

Jason Lowther

Photo credit: https://www.youtube.com/watch?v=5Z2ufAl2lko

Fresh from winning the Grand Jury Prize at the Banff Rockie Awards on Monday, Channel Four’s drama Help was yesterday nominated for Best Drama in the Edinburgh TV awards, with its lead actor Jodie Cromer also nominated for Best Actor.  The drama was one of the most watched on the channel, bringing to millions of viewers the plight of care homes and their residents during the pandemic.  Whilst the Help storyline is fictional, it is based on hard and devastating facts.

In my view, Help could be criticised for its farfetched ending and sometimes unsympathetic rendering of the care home manager, however its characterisation of care home staff and residents is both caring and revealing.  Clearly emotionally affected researching the programme, writer Jack Thorn said: “hearing the stories of those at the frontline, having people break down in tears on zoom in front of us has been incredibly moving and galling”.   

My two favourite parts of the programme (no spoilers) are the endless recorded message of a hopelessly over-run “NHS 111” call centre in the background for several minutes, and Jodie Cromer’s wrenching speech to camera (1:34 on the video) demanding “…underlying health conditions, eh?  When did all lives stop being worth the same?”  The programme ends highlighting some stunning research findings: 40% of Covid deaths in the early pandemic (from March to June 2020) were in care homes; the average wage of a care home worker is £8.50 per hour; whilst government provided 80% of PPE needs for the NHS, it only met 10% of adult social care’s needs. 

This last claim is based on the National Audit Office analysis published in November 2020, which found that the adult social care sector received approximately 331 million items of PPE from central government between March and July (10% of their estimated need) whereas NHS trusts received 1,900 million items sent to NHS trusts (80% of estimated need).  Whilst both fell significantly short of what was required, there is an apparent imbalance here.  Data collected by the Care Quality Commission (CQC) showed that, throughout April and May 2020, more than a fifth of domiciliary care providers had no more than a week’s supply of PPE. 

This situation was well known to the Secretary of State, not least because the LGA and the Association of Directors of Adult Social Services wrote stating “we continue to receive daily reports from colleagues that essential supplies are not getting through to the social care front-line. Furthermore, national reporting that equipment has been delivered to providers on the CQC-registered list does not tally with colleagues’ experience on the ground”.  Nevertheless, in a scene included in Help, during a Downing Street press conference on 15 May, 2020, Mr Hancock said: “right from the start, it’s been clear that this horrible virus affects older people most. So right from the start, we’ve tried to throw a protective ring around our care homes”, repeating in the House of Commons on 18 May that “we absolutely did throw a protective ring around social care”. 

Understanding the human costs of these central government failures is difficult, with the effects on staff, residents and their family impossible to measure objectively.  Help does a good job in illustrating some of the pressures on care staff and the pain of relatives unable to visit dying residents, made all the more poignant now that we know some of the behaviour during the pandemic of senior central government actors such as Hancock’s affair and Johnson’s multiple parties forensically examined in Sue Gray’s recent report

Perhaps the most basic measure is in human lives.  Last year researchers used the national death registry of all adult (aged ≥18 years) deaths in England and Wales between January 1, 2014, and June 30, 2020 to compare daily deaths during the COVID-19 pandemic against the expected daily deaths.  They estimated that during the early pandemic, about 26,000 excess deaths (almost half of the total excess deaths) occurred in care homes and hospices.  This is likely to be an underestimate since early in the pandemic, testing of suspected cases was available only in the hospital, whereas routine testing of staff and residents in care homes was not implemented until May 2020.

The latest ONS statistics, issued in February 2022, suggest that since the beginning of the coronavirus (COVID-19) pandemic, there have been over 274,000 deaths of care home residents (wherever the death occurred) registered in England and Wales; of these, 45,632 involved COVID-19 accounting for 17% of all deaths of care home residents. 

Intriguingly, The Lancet reported in March that “COVID-19 has had a disproportionate impact on the mortality of care home residents in England compared to older residents of private homes, but only in the first wave. This may be explained by a degree of acquired immunity, improved protective measures or changes in the underlying frailty of the populations.” Meanwhile, last month the Care Quality Commission finally published data on deaths in each care home during the first year of the pandemic (April 2020 to March 2021).

Whatever the precise figures, it’s clear that adult social care residents and staff were badly let down by central government, far from the Secretary of State’s “protective ring” narrative. This despite the best efforts of care managers, local commissioners and councils discussed in Luke Bradbury’s blog here last week.  Help does a fantastic job of showing the impact of these critical central failures – and recognising the incredible work care staff did in such difficult circumstances with so little financial reward.

Collaborative management in the face of government response to COVID-19? Evidence from care home staff and stakeholder experiences in West England.

Luke Bradbury

Picture credit: https://socialvalueportal.com/support-national-effort-covid-19/resources/news/social-value-in-action/support-national-effort-covid-19/

As a student on the MSc Public Management course at INLOGOV and having worked part-time in care for a number of years, I felt my final dissertation project was an opportunity to investigate the impact of COVID-19 on adult social care and the implications of government intervention. The works of organisations such as SCIE (Social Care Institute for Excellence) have already shown that inaccurate government guidance – combined with years of underfunding – resulted in the sector being ill-prepared for dealing with a pandemic and that care policy and practices had to rapidly adapt to unforeseen circumstances with limited support.

This case study aimed to explore this in the context of two care homes in West England during the early months of the pandemic. It was also interested in the role of collaborative management between care homes and their surrounding communities including local authorities, charities, businesses etc. ‘Collaboration’, in this context, took some influence from Helen Sullivan and Chris Skelcher’s conceptualisation of a collaborative agenda governing the (often mutually) beneficial cooperation between different public bodies and community agencies. One might consider how care homes may have banded together with their own local communities to ensure they still had the means to provide quality care in the face of COVID-19. Indeed, recent research by Fiona Marshall et al. has shown that, where government support was scarce, many care homes formed resource networks with external stakeholders such as local businesses, dentists, veterinaries, and domiciliary care agencies to source vital materials including personal protective equipment (PPE), electronics, toiletries, bedding and even food.

This study used semi-structured interviews and recruited five participants via a combination of snowball and non-probability purposive sampling. This included two deputy care home managers representing two different care homes in West England as well as a carer, a local parish councillor, and a co-owner of a local chemicals firm. The latter two participants were recruited as active members of the local community for one of the two participating care homes (or ‘external stakeholders’). Thematic analysis and grounded theory-based coding was then used to interpret the data.

The analysis firstly uncovered a strong dissatisfaction with the central government response to COVID-19 amongst all participants. Care staff spoke about how the implementation of the Coronavirus Act forced them to take on extra patients from hospital without an effective COVID-19 testing system in place and that inconsistencies between government guidance and company policy led to confusion amongst managers. Practices were forced to adapt; for example, adhering to stricter infection control measures and taking on extra care duties such as virtual GP consultations. External stakeholders also spoke about how these circumstances encouraged some level of collaboration within the community and a desire to assist local care organisations; for instance, a parish council was enabled to collaborate with the local chemicals firm and local school to source PPE such as goggles and hand sanitizer which could then be distributed to care providers.

Despite this opportunity to establish a resource network, collaboration between the two care homes and their surrounding communities was not evidenced as Marshall et al. had found previously. This was attributed to two main reasons. Firstly, resource dependency was less prevalent because effective internal management within both care homes meant they already had a sufficient supply of PPE. As one of the deputy managers recalled, the manager for her home made the decision to stock up on PPE and to lockdown early, therefore minimising the spread of the virus. The second reason was down to external circumstances that aided both care homes. Since both operate within rural areas of West England, they occupy less densely populated regions than care homes within inner city locations and therefore surrounding transmission rates remained relatively low. The implication is that locality largely eliminated the need to establish support networks with external stakeholders because they were not experiencing the same level of devastation seen in many other care homes. This was corroborated by staff who felt ‘fortunate’ compared to what they were seeing on the news.

These findings indicate the importance of effective management but also the extent to which contextual circumstances may or may not have necessitated collaborative networking between care homes and their surrounding communities during the early months of the pandemic. Whilst collaboration was less necessary here, the background coordination of parish council and local actors to produce a ‘safety net’ of resources did highlight the potential of localised collaboration and intervention in times of crisis. Perhaps, had such coordinated localised governance been enabled within the surrounding communities of less fortunate care homes, they may have been spared some of the devastations of the pandemic. Regardless, there is certainly a strong call for greater support towards the care sector for government and policymakers to consider – particularly in terms of clearer guidance, increased funding, and enabling localised governance to support care organisations.

Luke Bradbury graduated from the MSc Public Management in September 2021.