My sister lives in the Netherlands. I saw her at the weekend. She’s planning her return to the UK, and so our conversation inevitably turned to “the state of the UK”. To my surprise, the first thing she raised was the parlous state of Local Government. It’s not a topic that usually cuts through to the general public. Has it got that bad?
The slant that I take on this topic (and all others to be fair) is different from most people’s. I’m Alice Watson, part of the team that created the ScrutinyCounts app, which provides easy access to parliamentary debates. So every day I use the app to check what’s been said in the House, and I dip into any debates that look of particular interest.
And as luck would have it, recently (1st Feb 2024) there was a debate about Local Authorities in Financial Distress. And a few days before that there was one about Somerset Council’s difficulties, and the week before that there was one about Transparency in Local Government, and the week before that there was one about the potential merits of the Four Day Working Week….and the list goes on. There isn’t a shortage of topical content.
People groan when I say I read Parliamentary Debates. They assume they are like PMQ’s (a pet hate of mine), which they aren’t.
Here’s a quote from the recent debate about Local Authorities in Financial Distress. It’s a reply from a Labour MP (Clive Betts) to a Conservative MP (Bob Blackman):
It’s a cheering thought. Cross party select committees working collaboratively to explore problems and find solutions.
And what else did I learn from the debate? That the woes of some councils are self-inflicted, but not all. That the various mixed pots of funding available to councils makes for a patchy funding pattern geographically. That the three main spending challenges are Social Care, Special Educational Needs, and Homelessness.
There are two big benefits to reading a parliamentary debate on this (and any other) topic. Firstly, you get to read all sides of the political argument, which is good for the soul regardless of where you sit politically. And secondly, you get a sense of how different regions are affected. By way of example, Bradford’s problems stem from the high cost of Children’s Services in the Borough. The Trustees running Children’s Services have demanded a sum equivalent to about 50% of the council’s budget. Very different from the much-reported Equal Pay claims at Birmingham.
There are hundreds of other topics that are equally interesting and relevant to people who spin in the world of Local Government. On 11th January 2024 there was a debate about SEND Provision and Funding. As is often the case, MP’s volunteered personal stories which adds conviction and context to their contributions. Read this quote from David Davis (Conservative) about his granddaughter, Chloe:
I won’t try and precis this, or any other debates here. Because with every precis, comes editorial judgement, and the whole point of ScrutinyCounts is that we don’t edit, summarise, filter or distort. We have created summary charts that enable you to navigate quickly to items that are of interest. Then you click through to the original debate and text. Our screen designs are optimised for speed reading so you can jump to contributions that interest you, and scroll up and down fast.
So what did I say to my sister about the parlous state of Local Government? I told her not to believe everything she reads in the news, but to look on ScrutinyCounts, read about it for herself, and make her own judgement!
Alice Watson is a Director of Hinc Ltd, the provider of the ScrutinyCounts mobile app. Having trained as an Engineer (Bath Uni), she established Porge (a data insight company), which she successfully grew and subsequently sold. ScrutinyCounts is her latest chapter. It sprung from her belief that people need an easy way of following politics, undistorted by echo chambers or soundbites. More information about ScrutinyCounts can be found here – https://www.scrutinycounts.co.uk/ or follow us on Twitter/X @ScrutinyCounts
The decision to create a new public body to inspect and regulate local authorities is a recognition that it was a major mistake, made by David Cameron soon after he became Prime Minister in 2010, to abolish the Audit Commission. At the time, many of us thought that the government would come to regret it. It is much easier to reform an existing body that to create a new one.
The Office of Local Government will be a Departmental body within Michael Gove’s Department of Levelling Up, Housing and Local Government’.[1] It will not, as was Audit Commission, be an independent public body. That leaves it wide open to the criticism that it is an extension of the process of central government bossing local government. The point has already been made in an influential report from the Institute of Government.[2]
OFLOG has already published what it calls draft “metrics” (or performance indicators) for some of the main services.[3] The Audit Commission began identifying performance indicators soon after it was created in 1983. It published its first comprehensive set of indicators for local government in 1992. In 2001 it instituted a process of Comprehensive Performance Assessments for every council, eventually based on more than 1,000 indicators. It used these, along with some qualitative assessments which attempted to assess a council’s ability to plan in advance and respond to crises, to give each council a rating on a scale of 1-5. In 2007 this was simplified, with just 214 indicators and a streamlined assessment where seven separate inspectorates worked together.[4]
This experience showed that there were fundamental problems. Performance indicators give providers very powerful incentives to change their behaviour. But they also give them powerful incentives to game the services, often by increasing spending on aspects that are measured and lowering it for those that are not.
Here are some high-profile examples:
The Police. Former senior police officer Rodger Patrick, in a pathbreaking PhD thesis at the University of Birmingham[5], showed how the West Midlands and other Police Forces gamed the statistics used to assess them: not recording many crimes, increasing clear-up rates by giving favours to criminals who confess (who might or might not have committed the crimes), moving police to parts of the city where the crimes committed can be dealt with relatively easily, and even creating what they claimed was evidence. Crimes were reclassified to reduce the apparent number of crimes in targeted areas.
Hospitals. Bevan and Hood used data from the National Audit Office to show that an unexpectedly large number of patients arriving in in accident and emergency departments were assessed just before they had waited four hours – thereby not contributing adversely to the per cent who waited longer. One way of doing this was not to record those waiting outside in ambulances or inside on trolleys. Another was to create Informal registers of people on long-term waiting lists, not putting many of them onto the official lists.[6]
Schools. OFSTED ranks schools as Outstanding, Good, Requires Improvement, and Inadequate. A poor score on any part of the assessment will prevent a school from being recorded as Outstanding. This became very public after a primary school headteacher took her own life when her school was downgraded for failing in its child protection arrangements while scoring highly in nearly all the other parts of its assessment. This case has led to increased awareness that a single judgement on a complex organisation such as a school can often be unfair or misleading when a school is strong in some aspects but less so in others.
These are not the only kind of problem. Another issue is that what is achievable will often depend on the history and geography of a place. Thus an area with many rail stations, or with very wide roads where bus lanes can be created, will find it easier to achieve targets for public transport. Or a city which is a regional centre will have a history of supporting local arts organisations, more so than a district which is not.
The third problem is that there is often duplication with other inspectorates: the Care Quality Commission, Ofsted, the Planning Inspectorate, Police and Crime Commissioners, and many others. Should OFLOT trust these, and not duplicate their work? Or should it follow the practice of the Audit Commission in its later years and work jointly with them, with associated extra costs and hassle?
We illustrate the issues with longer comments on one service, planning, where OFLOG has already produced detailed proposals.[7] I wrote about this in 2007, and the proposals I discussed then are almost identical to those proposed now.[8] These will judge the effectiveness of planning in an area by the number of planning applications dealt within a target number of days, and the percent of applications overturned after appeals. This does not recognise that the most important work is done well before an application is formally submitted, when an applicant or agent starts talking to officials in the planning department. This may well throw up problems with transport or access; lack of proposals for green space, community facilities or shops; environmental issues about trees or wildlife; and disagreements about densities. The Council will want as many units as possible on a site, and for an application to meet its requirements for social and affordable housing. Moreover, drawings are often inaccurate, computerised images misleading, surveys loaded to favour an application, and designs poor. Good quality advice can make a big difference. But if an application is submitted before these matters have been properly researched, or do not meet the council’s prescriptions (especially for affordable housing), it has to decide whether or not to take it to its committee recommending rejection, or to wait for a more comprehensive submission to arrive. The easiest way to meet these targets is for councillors to approve every planning application uncritically.[9] Developers frequently try to renegotiate targets for social and affordable housing units, on the basis that they cannot afford them. But with only very limited other funding for this type of housing, they are essential almost everywhere. This kind of stand-off will no doubt continue unless and until land values decline to the point where developers can both meet the targets and make money.
In short, the OFLOG draft targets for the planning function are a missed opportunity. What is needed is powers to refuse planning applications that do not include relevant evidence or meet the prescriptions set out in a council’s local plan without wasting the time of the Planning Committee. And targets which explicitly recognise the value of design and quality, and the need for social facilities and open space.
These issues are not confined to planning. At a time of austerity which especially affects the funding of local government, there will inevitably be many situations where councils are struggling to deliver services of the quality that they would like. In such situations, inspectors do not contribute much by pointing this out. Rather they need to act as advisors, or expert external friends, who assist councils making the most of what they have.
Andrew Coulson was an INLOGOV staff member for 25 years. For 14 of those years he was also a Birmingham City Councillor where for a time he was a member of the Development Control Committee as well as the Cabinet Member for Regeneration.
[1] Department for Levelling Up, Housing, and Communities and Office for Local Government Understanding and supporting local government performance. Policy Paper, July 2023
[4] Andrew Coulson “Targets and Terror: Government by Performance Indicators. Local Government Studies Vol.35, No.2 pp.271-81, 2009
[5] For a summary, see Rodger Patrick,“A web of deceit: Police Crime Statistics for England and Wales”, in John Eterno, Arvind Verma and Eli Silverman (eds) How Countries Count Crime: An Exercise in Police Discretion Taylor and Francis, 2022, pp.170-219
[6] Bevan, G and Hood, C “What’s Measured in What Matters: Targets and Gaming in the English Public Health Care System”. Public Administration Vol.84, No.3, pp.517-38
[7] Office for Local Government Next steps for OFLOG and draft metrics, October 2023, pp.5-7
[8] “Don’t Forget the Politics in Planning”. Local Economy Vol.22 No.3, pp.223-6
[9] “Targets and Terror: Government by Performance Indicators.” Local Government Studies Vol.35 No.2, 2009, p.279
No man is an island entire of itself: every man is a piece of the continent, a part of the main;
If a clod be washed away by the sea, Europe is the less, as well as if a promontory were,
As well as any manner of thy friends or of thine own were.
Any man’s death diminishes me because I am involved in mankind,
And therefore, never send to know for whom the bell tolls;
It tolls for thee.
John Donne
When every week seems to bring news of yet another major failure of governance in a local authority, some members and officers in other councils will be fearful that the same fate will befall their own council before too long, while others will be confident that all will be well for them.
Councils need both strong rules, about finance and behaviour and strong public service values. Constant vigilance and honest collective self-reflection are vital to ensure that decision makers are independent, transparent, accountable, behave with integrity, have a sense of shared purpose and focus on outcomes. Ask yourself – are our informal and formal governance arrangements fit-for-purpose? If not, where might the weaknesses lie? Look at your structures. Are your Constitution, Codes of Conduct and Standing Orders up-to-date? Is your organizational structure robust? Are your s151 officer and Monitoring Officer on the senior management team and do they report directly to the Chief Executive? Then look at your systems. Are decision making processes clear? Can projects be started without the right sign-off? Can officers exceed their authority without consequences? Last, but by no means least, take a long hard look at organizational behaviour. How do leading politicians and officers respond to being challenged? Is bad behaviour rife but undiscussable?
It’s important to avoid complacency. Most of the members and officers leading and managing councils that have failed to uphold the best standards of good governance either thought what they were doing was fine, or that they could get away with it. Sometimes those who are part of an organization are the last to notice how the patterns of weak governance and bad behaviour, which have become so familiar that they cease to be noticed, will eventually lead to their downfall. Even when officers can see that their council is not going to able to balance its books or manage its risks, it can be difficult to speak up if members do not want to listen and it can be career limiting when a bullying culture prevails. Although statutory officers have statutory powers and duties, they are will not be protected from retaliation if they are perceived to be raining on the parade of colleagues and members who, because of ambition or political expediency, have lost sight of what good governance looks like. The statutory protections that attach to senior roles are not proof against bullying or actions amounting to constructive dismissal. The power imbalance between members and officers remains significant because while members may lose positions of power, or even their seats, officers risk losing their livelihoods and even their careers.
Those members and officers who consider themselves safe from failure may take some guilty pleasure from the failure of another council, especially if its run by another party. Councils have been encouraged to compete with each other for funding and kudos, so perhaps it’s natural to feel that the standing of better run councils goes up when the reputations of failing councils go right down. That’s a big mistake, for two very strong reasons; failure of one local authority reduces public confidence in local government as whole and it gives central government convincing reasons for not delegating resources and power to a local level. For all that we refer to ‘sovereign’ councils, no council is ‘an island, entire of itself’ and the failure of one diminishes all. When we open the LGC or MJ, to see for ‘whom the bell tolls’ we should hear the message that ‘it tolls for thee’.
Catherine is a researcher, consultant and coach who specialises in strengthening leadership, improving governance and supporting senior politicians and managers. She is an independent consultant with Darlingburn, a small consultancy practice and is working with Grant Thornton on local government audit, specializing in governance. She was the Director of the Institute of Local Government Studies (INLOGOV) at the University of Birmingham from 2011 to 2017.
If local councils and the NHS do not work together as trusted equal partners, our residents are the ones that lose out.
In Brent, our local communities were among those most affected by the first and second waves of the Covid-19 pandemic, with the local hospital, Northwick Park, making the national headlines having been caught in the eye of the storm, which acutely demonstrated the terrible impact of health inequalities on real lives.
We are, of course, particularly reliant on our NHS partners to provide emergency services, planned elective care, and a full and complex mix of outpatient and specialist services, including mental health and community services.
Likewise, NHS staff are reliant on local councils (and other local partners) playing their part in delivering a seamless patient pathway, that can go from a first GP visit right through to a tailored social care package.
Delivering high quality, equitable health services take detailed planning and a solid grasp on the needs of local communities.
In Brent, we have seen increasing levels of partnership working with the local NHS trust. Collaboration is made easier because London North West University Healthcare NHS Trust (LNWH) shows a refreshingly genuine commitment to gaining a deep appreciation of the views, concerns, and perspectives of our local populations. This is reflected in the development of the trust’s new five-year strategy.
In addition to undertaking vast analysis of public health, demographic and other data relating to our communities, LNWH sought engagement right from the start. The trust co-created a strategy with the help of almost 900 local community members and 40 representatives from local authority and partner organisations. Over 2,300 staff also contributed, many of who live locally and reflect the diverse population of our local communities and are frontline NHS staff who know all too well the importance of good partnership working.
I hosted one of the open forums for the trust where the local residents had an opportunity to say what they felt should be the trust’s priorities. Working in partnership with local communities and improving the quality of care came out as key themes.
This is not surprising. In Brent, our communities experience significant health inequalities when compared with regional and national levels. Local councils like Brent can only provide so much support to address these issues, so we must work with NHS partners to combat health inequalities right across our health and social care system. Indeed, we are now seeing an increased trust present at place-based and neighbourhood meetings.
One of the biggest challenges facing LNWH is the level of emergency activity. As a local council, we must work collaboratively to address systemic issues like this that the trust cannot resolve alone. Indeed, the emergency pathway is a key touchpoint for the most deprived people in Brent and partnership working presents us with a real opportunity to connect them earlier with more appropriate support in the community.
The trust’s discharge processes are perhaps the most reliant on partnership working — the NHS isn’t just its hospitals. It’s vital that we work collaboratively across organisations — the rest of the local NHS like GPs, district nursing, mental health and social care — to help the trust improve the flow of patients through its hospitals.
LNWH has called its new five-year strategy ‘Our Way Forward’. It sets out a welcome commitment to local authorities, communities, and people. We must take joint responsibility for Our Way Forward, because by working together we will forge a far better health outcomes for our residents than we can alone.
Cllr Ketan Sheth is Chair of North West London Join Health Scrutiny Committee
Black History Month creates a moment when we can step back and reflect together, as well as individually, on the immense contribution of Black, Asian and minority ethnic communities whose rich history, culture, and experiences, have shaped Brent and beyond.
The NW London Joint Health Scrutiny Committee comprises 8 NW London boroughs. As Chair, I know we simply could not function without the dedication, the skills, and above all, the compassion that thousands of people from our diverse communities contribute to the NHS, day in and day out.
The difference this makes to all our lives, is immeasurable. Black History Month affords us an opportunity to acknowledge and thank them for the important work they do: their continuing contribution to the care, the culture, the shaping, and well-being of Brent.
The colour of someone’s skin should not determine how they are perceived, considered, and treated – positively or negatively – but the impact of the pandemic has highlighted many disturbing features of inequality in our communities. Many of these problems are not new. They have existed for far too long.
Black, Asian and minority ethnic communities are more likely to be affected by life-changing diseases like diabetes, prostate cancer, and sickle cell than people from other backgrounds. Living in less-affluent areas, they are more greatly affected by poor housing as well as poor air quality from the busy urban roads that run through their neighbourhoods. There is a big gap in life expectancy between richer and poorer areas irrespective of race, but these communities are disproportionately affected.
To tackle these inequalities, the North West London Integrated Care System is launching a joint initiative between the local NHS and NW London boroughs, which will seek to build real understanding of what matters to our residents, how we can work with them to remove barriers to health equality to deliver healthier neighbourhoods and better outcomes.
This initiative is the first tangible benefit I have seen emerge from the new Integrated Care System, which has health services and local authorities coming together to address many of the challenges that impact our well-being. That is, health and care services, employment, education, housing, and the environment we live in.
We might perhaps reflect for a moment on the work of the great poet, James Berry OBE, who never avoided the difficult issues of injustice in history, or in the present, but always sought for mutual understanding. His poem, “Benediction,” stresses the need for us truly to hear one another, and truly to see, and through so doing, to understand. He said:
Thanks to the ear that someone may hear
Thanks to seeing
that someone may see
Thanks to feeling
that someone may feel
Thanks to touch
that one may be touched…
Black History Month is a reminder to us to truly hear and see one another, to celebrate our heroes and tell the stories that, for so long, have been hidden or forgotten. It is also a reminder that the evils of the past have resonance today, reflected in the impact of poverty and institutional racism that many in our communities experience as part of their daily lives. Ultimately, it is an opportunity to continue to learn, understand and come together to pull down these barriers and build healthier and fairer neighbourhoods.
Cllr Ketan Sheth is Chair of Brent Council’s Community and Wellbeing Scrutiny Committee
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
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