The Conservatives and the state: A new perspective?
There is a deep rooted myth that has taken hold of the Conservative Party in recent decades, based around the role of the state. Amongst others, Thatcherites, classical liberals and libertarians have all denounced the public sphere and bowed down to the private. This idea seeped into the Labour consciousness and was epitomised under Blair – with many on the left complaining about this historical trend. We seem now to have reached a balancing point in most levels of government where services are contracted out to the private sector via a tendering system that aims to use competition to deliver near-optimal results, whilst checked by politicians.
Whilst it is common knowledge that this may not be a perfect settlement for some on the left, who value renationalisation rather than contracting when delivering public services, One Nation Tories, compassionate conservatives etc. should also see a problem in the hagiography surrounding the private sector and the denunciation of the public. The post-Thatcherite consensus has left our ruling class wary of criticising the private sector for its numerous mistakes, believing that a ‘hands-off’ approach is the price paid for efficiency. This view is fundamentally misguided, and will be shown to be so through a case study below. Although there are numerous cases of inefficient practices in the public sector (see Cabinet Secretary Francis Maude’s recent government cuts for easy examples), when it comes to local government contracting out services there seems to be a dangerous, and ironically wasteful, move towards efficiency for efficiency’s sake.
This post will look at Mears, who are contracted out by Liverpool City Council/NHS to provide care to elderly and disabled patients, varying from visits for food preparation and cleaning to ‘sit ins’ to 24 hour care. Through my sister, who has been working there for over 6 months, I have been able to get first and second hand experience of how the organisation is run. Obviously, I wouldn’t be writing this blog if I was impressed by Mears – I am not – but it has given me a new appreciation of how the state can be used by Conservative to generate better public service delivery.
Just to give you a background to the main problems I’ve found working for Mears, I’ve made a handy little list below.
- This job requires staff to travel from house to house usually on foot. Often rotas will be given out which demand a staff member makes a long journey between houses (say, 1 mile in many cases) in a superhuman time (10 minutes).
- On numerous occasions staff have been sent to a patient only to find that they have gone on holiday, died, or already had a visit that day.
- Fail to remember what days have been booked for holiday, then call up and expect staff to cover.
Poor organisational skills
- Failed to pay staff numerous times, or paid too much/little. This problem is so well known that a rival care provider uses ‘accurate and punctual wage payment’ as a way to entice experienced care workers.
Lack of respect for staff
- It has been known for managers to lie to staff about the number of jobs that need covering, the distance required to travel or the time it will take to complete a visit, in order to get staff to agree to cover a shift.
These issues may sound like general staff complains, but the lack of attention shown to Mears’ employees is causing systemic problems. Staff turnover is very high, resulting in a constantly overstretched workforce (my sister often starts work at 9am and finishes at 9pm) and almost consistent adverts in the Job Centre database. Of course, these issues encroach on patient care in a number of ways, including poor care from new recruits and the added stress of patients having to allow new workers into their home, when familiarity would be preferred. Taxpayers also lose out, since service delivery costs are increased via ‘training on the job’ reducing workers’ efficiency and the administrative costs of searching for and bringing in new staff.
Proponents of the free market/night-watchman state would argue that competition for contracts would reduce the inefficiencies within Mears and result in improved service delivery – but this patently has not been the case. Instead, what we have is a blind focus on lower costs which is detrimental to employee conditions, which in turn impacts on the customers (patients) and the taxpayers.
It is here that Tories should stand up and embrace the state – if I was doing a bad job in work, I would expect my boss to tell me, and set corrective targets to ensure the problem didn’t reoccur. The state should do the same. It could do this in a number of ways;
- By setting high standards that companies must adhere to for the benefit of staff (overlooked due to the search for ‘efficiency’) Mears would be forced to address the systemic failures in the company. This however would rely on the state addressing what areas are problematic, adding an unnecessary level of bureaucracy to the process.
- Instead, local government should have a more holistic approach to the tendering rounds, including ‘staff satisfaction’ as a key target, as well as more obvious things such as cost, levels of patient care etc. This could be measured by a third party survey, or one issued by the state, or even done online – but the point is that it would provide an incentive for companies like Mears to pay more attention to the needs and opinions of their workers. Indeed, acting or improving upon the survey results could also form a key part of the contract or be a condition for reapplication or the continuation of the contract.
Critics have often argued that if the state applies too many conditions or drives too hard a bargain there would be no incentive for companies to apply. This has always seemed like a strange objection, since those who forward a night-watchman state argue that the profit motive, which is lacking in the public, is what makes the private sector so bloody brilliant. Broadly speaking, if there is profit to be made then business will fill the gap.
To conclude, the Conservatives need to move away from the idea that the state is an evil that can only get things wrong. A smaller state? Maybe. But certainly a more demanding one. As the case of Mears shows, efficiency isn’t always efficient, and lower costs aren’t always better value. The state can and should step in and demand better – just like any other employer would.