Public institutions and governance

In (Climate) Emergency Break The Mould 

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Paul Joyce, Philip Whiteman and Jason Lowther

Cities must be at the heart of a successful response to the climate crisis. Hundreds of local authorities in the UK are acting responsibly by taking the climate crisis seriously, whether it is by setting net zero targets or proclaiming a climate emergency. But they will be hampered in their endeavours for a number of reasons, including the significant capacity constraints that contradict their aspirations, even though national government in the UK has also set a net zero target.  

Support for local government action could increase if government ministers listen to the recommendations of a report by the Rt Hon Chris Skidmore  Environmental Audit Committee (EAC) Chairman, who issued a report on  how the UK could better meet its net zero commitments.  It’s an impressive piece of work, reflecting over 1800 written submissions as part of the official Call for Evidence.  Central to its recommendations is the need for central government to empower regions, local government and communities to play a greater role.    

We should acknowledge that on some measures the UK is already performing relatively well on environmental issues, particularly in reducing greenhouse gas emissions.  The UK was placed joint second in Yale’s global Environmental Performance Index 2022, with Finland and behind Denmark.  It achieved the fastest improvement of the three countries (and third best globally) in the last decade. Between 1990 and 2020, the UK reduced emissions by almost 50%, driven in part by a reduction in the use of coal and toward natural gas and renewables.  Some of this success stems from historic decisions such as the 2008 Climate Change Act, which committed the UK to reaching 80% emissions reductions by 2050, and actions such as the introduction of a carbon price floor in 2013 and investments in solar and wind energy.   

It may become more difficult for the UK to keep performing well as new, more challenging actions are needed.  The EAC report is clear that local government is critical to developing and implementing the necessary actions, and that this requires a fundamental change in its relationship with central government.  We highlight four essential changes. 

First, simplify net zero funding arrangements.  The report is clear that “current central government funding arrangements are standing in the way of effective local action”.  The funding landscape is disjointed, unfair, and expensive for local authorities because of its complexity and reliance on short-deadline competitive bidding.  

Secondly, trust local government.  The report recognises that “to achieve a place-based, place-sensitive, locally-led transition to net zero, Government must place its trust in local leaders and communities to deliver”.   Analysis by UKRI found that a “place-specific” approach to decarbonisation costs 70% less and delivers 90% more benefits than one which is “place-agnostic”.  The report recommends a high-level framework and an agreement to close future partnership working between central and local government. 

Thirdly, allow local communities to determine their priorities and approach within the national framework.  The report recommends a new statutory duty on local authorities to take account of UK net zero targets.  Disappointingly, government is asked to back only “at least one” Trailblazer Net Zero city, local authority and community, with the aim for these places to reach net zero by 2030.   

Finally, align the planning system with net zero ambitions.  The current framework sometimes stands in the way of councils insisting on high standards.  And cumulative cuts to planning department budgets mean many councils lack the staff to deliver effective planning inputs quickly.  As the report says: “Reforming the relationship between central and local government on net zero will empower local authorities to deliver place-based, place sensitive action and unlock the high levels of local net zero ambition that we have across the UK. Unblocking the planning system and aligning it more closely with net zero will enable widespread pro-growth, net zero development” (p.189).  

In our discussions with local councils, we often find strong aspirations to address the environmental agenda.   To turn green aspirations into reality, we need city and town governments that are properly empowered and resourced to achieve this.  One of our concerns is that while the local authorities in the towns and cities are positive about cooperating with central government to promote sustainable development, their capacity is limited by comparison with European counterparts such as Sweden, Germany, The Netherlands, Norway, and Denmark.  In consequence, the centralised approach to public governance in the UK has produced little “depth” to sustainable development by public authorities.   Furthermore, we note that whilst may local authorities aspire to improve the environmental agenda, there is often a lack of specific or explicit connectivity to international targets, comparing less favourably to local authorities in other countries.

It is time to empower local government to become a powerful means of transformation of UK society, to give them much more fiscal autonomy, and to give them a strong mandate for sustainable development of cities and towns.  This needs to be effective not just for the biggest cities, but also for smaller cities and towns where the capacity is sometimes more limited.  Chris Skidmore’s report has recognised many of these issues, we now need to break the mould and give local government the mandate, capacity and collaborative approach it needs to succeed. 

Paul Joyce is an Inlogov associate.  Paul has a PhD from London School of Economics and Political Science. His latest book is Strategic Management and Governance: Strategy Execution Around the World (Routledge, 6 June 2022). He is a Visiting Professor in Public Management at Leeds Beckett University.

Philip Whiteman and Jason Lowther are Inlogov staff members.

Responding to National Populism

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Picture credits: https://www.spiked-online.com/ and https://unherd.com/

Jon Bloomfield

The playwright David Edgar and I have written a two-part essay for Byline Times which was published before Xmas. It focuses on the role of two distinct web-sites – ‘Unherd’ and ‘Spiked’- in shaping the debate on culture wars and promoting national populist ideas across British politics. Here is a brief summary of the essay, full links below.

So, now the dust is settling, what is the ideological future of the Conservative Party? With kamikaze supply-side Trussonomics so thoroughly discredited, will Rishi Sunak and his – relatively – big-tent Cabinet return to a 2020s version of Cameronian fiscal austerity? If so, what happens to the Johnsonian cocktail of high public spending and social conservatism which proved so palatable to the voters of the Red Wall? And what is the role of online ideologues – notably writers for the websites Spiked and Unherd – in the battle for the party’s soul?

British national populism has proved much more than just a short-term political tactic, unexpectedly successful in the Brexit referendum and re-conceived as an election-winner three years later. Like the free market ideologues of Tufton Street, national populists are organised into influential groups of intellectuals and political campaigners who have gained considerable reach into mainstream media. The role of The Spectator is well-known but this article focuses on the profound influence of two websites: Unherd and Spiked. 

What makes these sites so significant and successful is that many of their lead writers originate not on the right but on the mainstream and indeed the far left, and now promote ideologies that seem contradictory but – in practice – are increasingly allied.

The emergence of national populism has seen strange, paradoxical political alliances emerging within the two main political parties exemplified by the Red Tory and Blue Labour tendencies. Even stranger has been the ideological overlap between the website of a formerly Marxist, now right-libertarian think tank and the main online home of anti-liberal communitarianism. So why – on the issues that are tearing Britain apart – do Spiked and Unherd appear to be bedfellows?   

Both are prolific sites supplying a daily flow of political and cultural commentary. Spiked is an outgrowth of the  Revolutionary Communist Party (RCP), which developed an increasingly eccentric version of Trotskyism with its magazine Living Marxism. Launching the website Spiked in 2000, its cadres – including former RCP guru Frank Furedi, polemicist and now Brexit-supporting peer Claire Fox, and Munira Mirza, later to become Boris Johnson’s policy chief  – continued the RCP’s trajectory towards anti-statist, economic libertarianism while retaining its original Leninist discipline and capacity for harsh polemic. 

Unherd has more conventional origins within the Conservative party.  Its founder Tim Montgomerie set out its stall in Prospect arguing for a “social Thatcherism,” which would re-balance “from a conservatism of freedom to a conservatism of locality and security.” Montgomerie argued that within the Conservative Party “the magnetism of national sovereignty has finally overtaken the magnetism of free markets.” However, Unherd has also attracted former left polemicists, including ex-Labour-supporting, Prospect-editing journalist David Goodhart – now ‘Head of Demography, Immigration and Integration’ at the right-wing think-tank Policy Exchange; academic turned national-populist advocate Matthew Goodwin; trade union activist and anti-woke campaigner Paul Embery; and the ex SWP-flirting, Tory-convert vicar Giles Fraser. 

The reason for this unexpected cross-fertilisation of ex-Trotskyites, traditionalist Tories and communitarian, socially-conservative Labourites is their ideological alignment on many of the key cultural controversies of the day. A fervent commitment to Brexit and belief in the unreformed UK nation-state are central, but what gives the two platforms their raison d’etre is the consistent vitriol directed at the mainstream left and the new social movements that have emerged around it over the last few decades. A bitter animosity against social liberalism and a caricatured ‘woke’ left is their most distinctive, current and common thrust. Their ideas – particularly on multiculturalism and the ‘woke agenda’ – have been eagerly lapped up by the mainstream right-wing media. 

Within the Sunak government, in their various ways Kemi Badenoch, Michael Gove and Suella Braverman are all signalling their wish to return to the national-populist ‘culture wars’ agenda. Like their counterparts in Europe and the US, the national-populists want to roll-back the advances that have been made in the past 50 years. The likes of Spiked and Unherd are crucial propagandists in this battle. In particular, these two sites have mounted a consistent assault on progressivism on the major social and cultural issues of the day: climate justice, feminism and anti-racism. On three of the great social issues of our era – climate change, women’s inequalities and structural racism and discrimination – the editorial lines of Spiked and Unherd are marching in lockstep, deploying similar arguments and even phraseology, to minimise the issues or to deny that there’s any problem.

National-populism has its own logic. Mobilising ethnic nationalism; arousing fears about race and religion; attacking social liberalism; overtly or covertly promoting the ‘Great Replacement’ conspiracy theory. All lead in just one direction.

This is a moment for liberals, progressives and the Left to wake up. 

It’s time for them to draw on their own history and re-build the alliances that have led to so much social and economic progress in the past.  In the more variegated, less homogenous world of 21st Century capitalism, finding the ways to navigate common ground between movements and build cross-class alliances is more important than ever.

The provocations of Spiked and Unherd stand in the way. At a moment when the hard-Right is showing a readiness to indulge in racist and nationalist politics reminiscent of dangerous eras of the not-too-distant past, it is time for progressives to prioritise unity, rebuild alliances which have done so much good in the past, and direct their firepower at their main opponents.

Red Tory to Blue Labour – How Spiked and Unherd are Keeping National Populism Alive – Byline Times

Fighting Back Against National-Populism – Byline Times

Jon Bloomfield has been involved with the EU’s Climate KIC programme for over a decade, helping to develop educational and training programmes and experimental projects which help companies, cities and communities to make effective transitions to a low carbon economy.

Local government should welcome Gordon Brown’s private bills proposal

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Phil Swann

Streamlined access to local legislation must be available to help struggling councils to improve rather than rewarding those that have already done so, writes a PhD candidate in central-local government relations at INLOGOV and former director of Shared Intelligence.

In 1926 Winston Churchill, then chancellor of the exchequer, successfully opposed a private bill promoted by Bristol Corporation to establish a municipal bank in order to stop “all kinds of incompetent town councils”, particularly “socialistic” ones, from running banks. He did so despite the fact that the bill was supported by his Conservative colleague and former mayor of Birmingham Neville Chamberlain, who argued that Birmingham’s municipal bank had encouraged thrift and home ownership.

It is interesting to reflect on this dispute (not the last between these two political Titans!) in the context of the move by Gordon Brown’s Commission on the Future of the UK to promote the use of private bills by local councils. Raising the prospect of “the great cities of England” exerting similar powers to the Scottish and Welsh governments, the commission recommends a new, streamlined process enabling councils to initiate local legislation in parliament. This, the commission argues, would give councils an ability to secure the powers they need and to have a direct relationship with Parliament.

Evading centralising tendencies

It is undoubtedly the case, as the commission argues, that private legislation provided a vehicle for innovation in Victorian local government in the face of the social, economic and physical impacts of the industrial revolution. 

The genesis of public health lies in local legislation as does the creation of public utilities to provide gas, electricity and public transport. It was the ability of local corporations to promote private legislation that fuelled Joseph Chamberlain’s ambition to turn Birmingham Corporation into “a real local parliament”. Private acts were also used by enterprising councils to evade the centralising tendencies of successive governments in the second half of the 19th century.

It is also the case, however, that by the inter-war period private legislation had become a feature of the tensions in central-local government relations rather than necessarily being a solution to them. The resources and ambition required to draft and promote private legislation reinforced a growing divide between “advanced” or “progressive” councils on the one hand and “backward” or “penny-pinching” councils on the other hand. This reinforced differences between the major cities and smaller towns and rural areas. The widespread use of private legislation also contributed to the ad hoc and complex structures and powers of Victorian local government.

Significantly these trends were reflected in the justification for increasing central government intervention in local politics. In the 19th century there was a shift in ministerial focus from corruption to efficiency and action to bring “backward” councils up to the standard of the “progressive”. The first half of the 20th century saw a financially driven move to rein in the most innovative councils and drive improvement in the poorly performing ones. The dispute between Churchill and Chamberlain over the Bristol bank bill is an example of this.

Clause acts and adoptive acts

Despite these warning notes from history, the ambition of the Brown commission to enable local leaders to have access to a streamlined process to initiate local legislation should be welcomed. Many of the problems that emerged when private legislation was a common feature of local government could be overcome if it was explicitly seen as a way of testing new legislative powers prior to wider adoption – genuine pioneering.

Two other legislative devices deployed in the Victorian period could help to secure this approach if they were refreshed alongside a revival of local legislation. The first device is a clauses act, the prime example being the Town Improvement Clauses Act 1847. It brought together the provisions most commonly inserted in and effectively deployed through local legislation. Clauses acts, each of which would relate to a particular service area or initiative, would both streamline the legislative process and avoid unhelpful adhockery.

The second device, which takes this a step further, is the adoptive act. This is a piece of legislation which has been through the parliamentary process but which comes into effect only when it is adopted by individual local authorities. Acts of this type could make powers that have been successfully adopted by one authority available to be adopted by others without requiring local drafting or taking up parliamentary time.

Earned autonomy?

One other issue which requires attention is whether there should be a link between an ability to initiate local legislation and a council’s perceived performance. A sustained thread running through central-local government relations since the 1830s is the view that that councils should not benefit from new powers or responsibilities until they have met certain conditions or achieved a certain standard.

Joseph Chamberlain, who made extensive use of private legislation in Birmingham, took a different view. In 1877 he argued that “whatever the defects” of a council “I defy you to make a better one for the place except by gradually increasing its functions and responsibilities and so raising its tone.” No earned autonomy for Chamberlain!

If the increased use of local legislation is to help achieve the ambition set out by Brown and his commissioners, it is essential that streamlined access to local legislation is available to help struggling councils to improve rather than as a reward for having done so.

This article first appeared in the Local Government Chronicle on 13th December 2022.

Phil Swann is researching a PhD on central-local government relations at INLOGOV

Professor John Stewart: the nation’s teacher of local democracy

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Jason Lowther

Everyone in or with links to the Institute of Local Government Studies was saddened this week to learn of the death of Professor John Stewart, who from 1966 developed Inlogov to focus on UK local government and made an enormous and lasting contribution to the development of local government, local governance and public administration scholarship over several decades.

I had the good fortune to meet John last year when, following the death of his wife, Councillor Theresa Stewart, he kindly offered his research library to the department.  We had a lovely afternoon recalling the earlier days of Inlogov, developing the first courses, contributing to the insightful Layfield Commission on Financing Local Government, travelling all over the country to review training and development needs in hundreds of councils, and leading thinking on the sector through articles in both the scholarly and professional journals. 

John was a strong advocate of local government as community leadership at the heart of a vibrant democracy – rather than a mindless channel of central government’s directives or a mere provider of various local public services.  He and his co-authors often led the thinking in key areas.  In the 1970s, he promoted the development of corporate planning and management in local authorities bringing synergy to the various service areas.  In the 1980s, he asserted the value of the public good in the face of New Public Management’s push to convert public service into private consumption.   He argued that developing Quangos for specific services was creating a late twentieth-century version of the fragmented local public service world of the Victorian era.  In the 1990s, he challenged the narrow consumerist Citizen’s Charter approach and instead asserted the importance of citizens’ rights, participation and accountability.

In 2014, John published his reflections on the past four decades in local government.  He argued that the problems facing the economy, society and the environment need effective local responses:

Local government can draw on its own and its citizens’ ideas and aspirations, but this genuine localist approach cannot be achieved in fragmented and imperfectly accountable structures over-controlled by central government. The lesson of the last 40 years is the need for a learning government that welcomes diversity. All can learn from the relative successes and failures of diversity, whereas too often centralism builds uniformity from which all that may be learnt is general failure.

As well as research, John developed a strong teaching capacity in Inlogov.  He created residential courses, held at Wast Hills House outside Birmingham, which had been given to the University by the Cadbury family.  It was adapted as a residential facility with 25 bedrooms and a range of teaching rooms.  These courses became the essential preparation for local government officers with ambitions to become chief executives.  Much of the work on the courses was in small groups, which led to many lasting friendships between future senior local government officers and chief executives across the country – providing an essential support network for those in these tough roles.  The Local Government Training / Management Board later commissioned John to visit almost all English local authorities and many in Scotland and Wales, assessing their capacity and recommending approaches to develop this further.

In addition to his remarkable 36-year writing partnership with LSE’s late Professor George Jones, John nurtured and collaborated with successive generations of scholars including Bob Hinings, Royston Greenwood, Stewart Ranson, Rod Rhodes, Kieron Walsh, Chris Skelcher, Steve Leach and many more.  A few weeks ago, I invited some of his former colleagues to contribute some reflections for a potential collection of some of John’s works.  I was delighted by the speed and warmth of the responses, typical examples including:

“John was the nation’s teacher of local democracy. He was a remarkable man, a gifted and inspiring leader at the Institute and across local government”

“John Stewart was the most significant British thinker on local government in the last half of the twentieth century. He was the key influence on several generations of local government workers”

“He argued that the narrative that users of public services should be treated as self-interested customers ignored their role as citizens with a wider interest in the welfare of their community”

“His wonderful insight helped so many people to be massively more effective than many of us thought possible”

“The most negative thing I ever heard him say about an idea was ‘I don’t think we can make that a priority’”

“I’ve not known such intellect, such tolerance, generosity and encouragement from a mentor. This must have been the same for many who have come under his giant but gentle wings”

“John and George [Jones] formed a partnership whose writings proclaimed the case for local government for almost forty years. They were doomed, like Cassandra, to have their warnings ignored. But John’s influence on the management of local authorities endures.”

Outside his professional life, John was a loving husband, father and grand-father.  Following his death this week, his grandson Henry published a lovely thread on Twitter outlining some of John’s achievements and recollections from friends and colleagues. 

It is immensely humbling to inherit the guardianship of one of John’s creations, Inlogov.  I will close with another quotation, from my colleague Emeritus Professor John Raine this week:

His legacy in shaping the policy and practice agenda of local government in the UK, as well as on the development and sustainment of INLOGOV as the premier research and teaching centre for local governance, will surely endure.

Jason Lowther, Director – Inlogov

25th November 2022

Voter ID – in theory, practice and mirrors

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Picture credit: https://www.electoral-reform.org.uk/why-the-governments-mandatory-voter-id-plans-are-a-terrible-idea/

Chris Game

“ID cards for polls are nothing more than suppression of voters” – D Butler. I’d forgotten precisely when and where I first read this pronouncement – May 2021 in The Times, as it turned out – shortly after the Government’s Elections Bill, now Act, was published. But I certainly remembered it.

Partly the phrasing, as personally I’d have gone for “nothing less than”, if I was hoping to galvanise readers into outraged protest. The seriously striking bit, though, was obviously the author.

Since first becoming fascinated by elections and electoral studies – thanks initially to Prof Richard Rose at the Univ of Manchester, then the late Prof Tony King at Essex – there has only ever been one D Butler in that file of my academic consciousness. Populariser of the Greekish word ‘psephology’ for the study of elections, and original authority figure in the BBC’s General Elections coverage: Nuffield College, Oxford’s Sir David Butler, who died earlier this month, aged 98.    

I knew him – distantly, but sufficiently to know he’d never have uttered anything resembling that strongly opinionated opening sentence – and, of course, ’twas not he. Rather, as I almost immediately realised, it was Dawn Butler: recent candidate for Deputy Labour Party Leader and, it so happens, MP for the London Brent constituency in which I first voted – shortly before she was born.

All of which might have excused a quickish blog return to the contentious Voter ID issue – within weeks of its last coverage – even if it hadn’t once more been prominently in the news this past fortnight, with Parliament finally getting its first full sight of the Government’s Voter Identification Regulations and the Electoral Reform Society leading the call for a parliamentary inquiry into its implementation.

The Elections Act requires voters, from next May, to produce photo ID at UK Parliamentary and most English local elections. And now, a mere six months or so later, we – and the local election officials required to implement them – finally have the Government’s list of acceptable forms of ID and proposed guidelines governing initially next May’s council elections: Coronation permitting, in most English councils – though not Birmingham, to save you checking.

The guidelines run to just the 344 pages, taking effect probably in January. Leaving already pressured election officials with minimal time (and as yet undetailed costs, beyond a ‘ballpark’ £180 million per decade) to process and issue electoral identity documents for those who gradually discover they don’t have acceptable forms of photo ID. Plus the near certainty that at least some would-be, and quite likely upset, voters will be turned away at their polling stations – which could add to the fun for the small army of volunteer poll workers.

At which point I should indicate my personal viewpoint. Instinctively – and certainly predating Birmingham’s own 2004 embarrassment of six Labour councillors getting elected through what was judicially described as a “massive, systematic and organised” postal voting fraud campaign – I’ve long broadly supported, in principle, stronger election integrity rules in general and photo voter ID specifically.

And I have recounted in these columns the reactions of some of my overseas students to the frankly casual ID confirmation procedures they’ve observed when accompanying me to the polling station. Their surprise at the staff’s indifference to whether I’ve brought my poll card identification; and almost shock as I ‘helpfully’ point on the register to what I claim is my name and address.

So why my support in principle for photographic ID – as well as nowadays that of a substantial majority of voters themselves and the conditional backing of the independent Electoral Commission?  Simples!  Elections are the engines of our democratic system. They should be seen by all as important, and that perceived importance is diminished by not having visibly more robust voter identification procedures – like virtually all other ‘democratic’ nations.

On the Crime Prevention Research Center’s database of Europe’s nearly 50 such countries, “only the United Kingdom” does not require government-issued photo voter ID to vote in national elections.

Correction!  Not the UK, just GB. Northern Ireland introduced voter ID nearly 20 years ago, and now has numerous forms of acceptable photographic ID – including, as well as passports and driving licences, a free Electoral Identity Card, plus senior, disabled and blind persons’ ‘SmartPasses’.

Since when, the Electoral Commission has found that, far from prompting polling day protest riots, voters’ confidence that elections are well-run has steadily increased to at least match the levels in other UK regions[1]. The demonstrable message has been not that we elsewhere in the UK are uniquely virtuous and trustworthy – though even Ministers concede that fraud levels are minimal, if not invariably seen as such. Rather, it’s that for us – and successive Governments – voting has been seen as less big a deal than, say, collecting a parcel at a post office.

Until now, that is, following a decade of quite dramatic change in the voting behaviour of particularly our 18 to 24-year-olds. Their turnouts are invariably lower than the average, but still high enough to hurt. In the 2010 General Election these mostly fledgling voters split equally across the Conservatives, Labour and Lib Dems, roughly 30% for each. By 2019, almost overlooked in the Conservatives’ overwhelming win, it was Labour 52%, Conservatives 28%, Lib Dems 11%.

That’s what evidently prompted the rush – not ‘personation’ or fraud, which for polling station voting are acknowledged as negligible. Rather, a possible early General Election campaign in which the Conservatives don’t start way ahead of the field. It also explains why the apparently generous range of 21 acceptable forms of ID is clearly weighted towards the better paid and over-60s. Older Person’s Bus Pass, Oyster 60+ card, Freedom Pass (66+), Scottish National Entitlement Card (60+), etc. – all welcome. Those particularly applicable to younger people, like Student ID cards or Railcards, remain “unacceptable”, as in the original legislation.

Yes, as in Northern Ireland, free ‘Voter Authority Certificates’ will be available – including online – and a public awareness campaign will remind you and your selfie to apply in time.  And no, none of this remotely approaches the legalised voter suppression we saw in some of this November’s American state elections. But – to coin a dreadful cliché – it’s from the same partisan playbook.

As are the £1.3 million-worth of 40,000 mirrors and privacy screens – one of each per polling station – that desperately cash-strapped councils must provide to check on would-be voters with religious face coverings. But they may well prove worth a blog of their own sometime before next May.

_______________________

A slightly publisher-edited version of this blog appeared in The Birmingham Post, 17th November – https://www.pressreader.com/uk/birmingham-post/20221117/textview

[1] Examples from the Electoral Commission’s ‘Winter Tracker’, Jan/Feb 2022:

   “Elections are affected by fraud/corruption?”  Total agree: 37%; W Midlands 37%; NI 30%.

Those “not confident that elections are well run: Some people have difficulties registering to vote”:                                          
Total agree: 20%; W Midlands 18%; NI 10%.

Chris Game is an INLOGOV Associate, and Visiting Professor at Kwansei Gakuin University, Osaka, Japan.  He is joint-author (with Professor David Wilson) of the successive editions of Local Government in the United Kingdom, and a regular columnist for The Birmingham Post.

Integrated Care Boards – a new frontline in localism?

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Jason Lowther

As the government once again kicks down the road decisions on vital reforms and funding for social care, local areas are establishing the Integrated Care Boards which will lead the new Integrated Care Systems (ICS), bringing together the NHS, local government and partners to plan and deliver integrated services to improve the health of the local population.  Building on the progress made since many public health responsibilities transferred back to local government in 2013, this is a great opportunity to address the determinants of health and issues around health inequality.  Might ICSs at last lead to an effective local voice in our over-centralised, top-down healthcare system?

Each ICS is supposed to plan at three levels: the neighbourhood (an area of around 40,000 people), the ‘place’ (often a LA area), and the (ICS) system (covering around 2 million people).  Working at the neighbourhood level is likely to be somewhat informal, often using a social prescribing approach and developing multi-disciplinary teams including third sector partners.  The approach to ‘place’ looks set to vary between areas, with some ICSs devolving significant responsibility (and funding) whilst others centralise these at ‘system’ level.  Meanwhile at ‘ICS system’ level, Integrated Care Partnerships (joint LA and health committees) will develop an Integrated Care Strategy to meet the assessed health and social care needs of their population identified in the Joint Strategic Needs Assessments and Wellbeing Strategies prepared by local Health and Wellbeing Boards.

Beyond the formal planning process, the success of local ICSs will partly depend on the quality of local collaborative (managerial and political) leadership – across statutory partners and with the third sector.  It will be a tough job to balance the priorities of the national health service and issues of local places, but many local authorities will be able to offer helpful experience , for example from moves to more networked governance approaches.

The National Audit Office recognises the potential but appears dubious on current prospects.  Last month it published a review, Introducing Integrated Care Systems: joining up local services to improve health outcomes, finding:

“NHSE has a detailed regime to monitor performance against core NHS objectives but … it is less clear who will monitor the overall performance of local systems, and particularly how well partners are working together and what difference this new model makes…“

The report notes that, whilst government is asking ICSs to set out local priorities and make progress against them, there is no protected funding and few mechanisms to ensure this happens.  This leads, as the NAO politely puts it, to “a risk that national priorities, and the rigorous oversight mechanisms in place to ensure they are delivered, crowd out attempts at progress on local issues”.  The report also identifies five “high risk” elements of effective integration: clarity of objectives, resourcing, governance and accountability (such as how ICSs will function alongside existing local government Health and Wellbeing Boards and how accountability differences between NHS and local authority bodies will be resolved), and the capacity to balance priorities other than national NHS targets. These urgently need to be addressed if ICSs are to begin to meet their potential.

At one of Inlogov’s “Brown Bag Lunch” discussions earlier this month we agreed on the importance of issues around how ICSs develop, particularly in terms of developing effective system leadership and planning, collaborating with community organisations, and links to wider devolution processes. I’d be interested to hear about experiences in local areas as these develop. 

Jason Lowther is the Director of INLOGOV. His research focuses on public service reform and the use of “evidence” by public agencies.  Previously he worked with West Midlands Combined Authority, led Birmingham City Council’s corporate strategy function, worked for the Audit Commission as national value for money lead, for HSBC in credit and risk management, and for the Metropolitan Police as an internal management consultant. He tweets as @jasonlowther

Picture credit: National Audit Office