The week in public services: 14th January 2020

This week: (missed) NHS targets; falling prison assaults; and five predictions for 2020

Christmas time is over, but it’s not been an especially news-heavy week in the world of public services. So, as usual, here are my five predictions for 2020. I got 2½ right last year — so treat with scepticism…

Five predictions:

1) The government will promise that every department a real-terms increase in its budget over the Spending Review…

The 2019 Spending Round promised that no department would see a real-terms cut in its budget in 2020/21. Currently, the indicative spending plan (promised way back in the 2018 budget) suggests that unprotected spending would see a slight real-terms cut after 2019/20, once you take protections to defence, international aid, schools, and the NHS into account. This means that at least some government departments without a settlement — Defra, MoJ, DfT etc. — would have had real-terms spending cuts.

But I don’t think this is viable. As the government has claimed it will end austerity and halted any further cuts to departmental budgets in the next financial year, it will find it difficult to reverse course.

2) …and the government will break its fiscal rules this year

This the flip-side of the above. The government’s fiscal rule for day-to-day spending — to run a balanced budget within three years — is already difficult to hit, given the unfunded commitments it has made (such as the promise to fix social care), and the likelihood that Brexit will means economic output and government revenues take a hit.

Without raising taxes, that suggests limited, if any, rises in spending for most other public services (given existing commitments to defence, international aid, schools, and the NHS), and scaling back some of the unfunded commitments.

But I think the government’s new electoral coalition now make it nigh-on impossible for them to retreat on their promises to end austerity and spend more on public services. When combined with their commitment to not raise income tax, national insurance or VAT, which hugely reduces their scope to raise more money to fund higher spending, I think the fiscal rule for current spending is going to get junked.

Of course, the government might just be less generous on spending than I predict above, making both this, and the above, prediction incorrect. We’ll know once the 2020 Spending Review is published.

3) Performance against the four-hour waiting times target in the English NHS will only start to turn around in May 2020

This winter has been particularly bad for the NHS in England. It’s become almost a cliche to point out that this month’s data has been the worst yet. So far, October, November, and December 2019 have all been new lows. It’s for a mix of reasons (flu, pension rules disincentivising consultants from taking on new work, lack of social care) but in previous years, performance normally turns around in the spring. The percentage of patients in major A&Es admitted, transferred, or discharged within four hours started to tick up again in April in 2016, January in 2017, and April in 2018. Given the scale of the decline this year, my guess is that things will only start to turn around in May (though I obviously hope this prediction turns out to be wrong).

4) The government will promise to turn the remaining 25% of maintained secondary schools into academies

Back in March 2016, the government was committed to making every school an academy by 2020. This was later quietly dropped while Nicky Morgan was still education secretary. But with Dominic Cummings — a proponent of academies when working as Gove’s SpAd — back and seemingly influential in №10, it wouldn’t be surprising to see this rise back up the agenda (even though the evidence suggests that converting maintained schools to academies makes no clear difference to their performance).

5) There will be fewer assaults on prisoners and prison officers this year than last

The number of assaults in prisons in England and Wales has risen every year since 2012/13 — despite an end to real-terms spending cuts in 2015/16, and prison officer numbers increasing after 2016/17.

As was the case with the initial spending cuts, there was always likely to be a lag between higher spending and more staff translating into safer prisons. A lot of experienced prison officers left during the initial spending cuts, meaning that new staff had less experience to draw on.

We already know that the second quarter of 2019 was the first time where prisoner assaults on other prisoners were lower than the equivalent quarter a year ago. While prisoner assaults on staff continue to rise, I think this year’s data should show a turning point for assaults across the prison estate.

Health and Social Care

A new report from the Nuffield Trust looks at what lessons we should draw from the health targets that were set in 2015. To ensure targets are effective, they think that targets needs to be: meaningful to staff; measurable; have political backing; and try to avoid over-optimism.

Which is timely, because December’s A&E waiting time figures for England were the worst ever (for the third month in a row). The Guardian is reporting that hospitals are having to redeploy nurses to care for patients in corridors.

I learned a lot from these great threads on Tom Forth and James Illman.

Children and Young People

An interesting updated House of Commons Library briefing on the Pupil Premium grant for schools finds surprisingly limited evidence that is contributing a reduction in the gap between outcomes for disadvantaged and other children — perhaps because there is no hard ‘ring-fence’ on the grant, as we pointed out last year. They also have a useful reminder out about what kinds of support children-in-need are eligible for.

Law and Order

Remember that Royal Commission on Criminal Justice the Conservatives promised during the election? Some commentary about the Conservative’s proposed suggests that prosecutors could be allowed to direct police investigations, akin to criminal prosecutions in Scotland.

Meanwhile, the new head of the National Police Chiefs Council, Martin Hewitt, has argued that 20,000 new officers are “not the answer to all the challenges we have around policing”. The council are particularly concerned about shortages of detectives and senior officers, who will be harder to recruit for.

Elsewhere in policing, a fascinating Transform Justice blog on police worries about reintroducing targets for number of arrests and cautions — and the incredible odd consequences of the ‘Offences Brought to Justice’ targets, which encouraged the police to arrest the easiest people to catch. Penelope Gibbs argues that “the challenge for the police is to find a way of proving their efficiency and effectiveness without the use of targets, in an era where so few reported crimes result in criminal sanctions”. This feels like a debate we’ll be having about a lot of public services over the next few years.

For more context, this Telegraph article rather worryingly finds that a private company providing neighbourhood policing to citizens — My Local Bobby — is now undertaking private prosecutions for theft and ‘minor’ crimes because the police do not have the resources to do so.

Moving on, a new report from the Crown Prosecution Service (CPS) Inspectorate has found that a shortage of prosecutors and experienced police officers left investigators “struggling to cope” with their obligation to disclose key evidence to defendants in trials. This really matters — failing to disclose evidence can stop a trial going ahead, or convict innocent defendants. The CPS have improved, however — even if from a low base.

In positive — if surprising — news, prison assaults are finally starting to fall — and the improvements haven’t just been in the 10 prisons which have been getting extra cash and staff. The Independent Monitoring Board’s annual report on Wormwood Scrubs prison has also found improvements in that prison over the last year, although they worry that “without sufficient numbers of trained and experienced officers to maintain [improvements], there is a significant risk that the improvements made to Wormwood Scrubs will be lost”.

In less good news, the Probation Inspectorate have published a report claiming that staff shortages and “insufficient professional curiosity” in the National Probation Service — the publicly-run part of the system which supervises the highest-risk offenders — are putting the public at risk

Russel Webster has written a really interesting summary of what the Justice Data Lab — a part of Ministry of Justice set up to analyse the effectiveness of re-offending schemes — has learned over the past six years. The Data Lab have struggled to find many schemes which show statistically significant reductions in re-offending, although 62 of the 237 schemes evaluated found a reduction in proven re-offending rates after one year. Mixed results — but always good to see evaluation!

Last but not least, this Guardian article looks at the rise of women committing violent crimes, and some possible explanations. This New Yorker article analyses the complexity of crime statistics, pointing out the age-old problem between crimes recorded by public sector organisations, and crimes reported by members of the public. In 2007, an influential US study found that removing lead from gasoline explained 56% of the reduction in recorded violent crime between 1992 and 2002. The researchers then ran again with reported crime rather than recorded crime. The result? No significant effect. A good weekend read.

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Graham Atkins

Graham Atkins

Senior Researcher @instituteforgov: public services, infrastructure, other things. Too often found running silly distances in sillier weather.