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The Big Squeeze – The National Context

Explore the evolving landscape of Scotland's public services, detailing financial constraints, benefit changes, and income trends. Discover key strategies and practical issues to address reform and enhance service delivery.

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The Big Squeeze – The National Context

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  1. The Big Squeeze – The National Context Sarah Gadsden Improvement Service

  2. Scope • The wider environment: the new, the ongoing and the ugly • Christie and beyond • Focusing Reform • Practical Issues and Questions • Key Challenges

  3. The Changing Context • 12% real reduction in spend to 2013/14 • Extensive universal entitlements: travel; prescriptions; tuition fees; free personal care • High level of ‘failure’ demand: ‘preventable’ negative outcomes • Continuous freeze of local taxes

  4. The Changing Context • Substantial demand growth: demography, economic downturn, welfare reform etc • Over the next 15 years, Scotland’s public services will need to cope with additional demands in health, social care and justice amounting to more than £27 billion (NESTA) • If current models of care continue, the care of approx £4.5 billion will increase by £1.1 billion by 2016 and £3.5 billion by 2031 • Between 2008 & 2033, number of people aged 60 + is projected to increase by 50%; numbers aged 75 > will increase by 84%

  5. Benefits Changes • June 2010 Budget: £11Bn to be taken out of benefits spending programmes (further £7bn in CSR in Oct) • Key changes • Move to CPI from RPI for up rating • Migration from Incapacity Benefit to Employment Support Allowance • Reductions in Disability Allowance entitlements • Changes to Housing Benefits

  6. Benefits Changes: June Budget • Scottish LG Forum Against Poverty: Direct & Indirect cuts • Benefit ChangesPotential Loss (£m Scotland) • Housing Benefit 27 • Disability Living Allowance 260 • IB to ESA: 135 • Move from RPI to CPI 93 • Total £515m

  7. Position of Incoming Government • Clear prioritisation of NHS: 9% inflation + 4% demand growth means that cash protection alone will not work • Stimulating investment and growth: capital acceleration • The ‘covenant with the workforce’: no compulsory redundancy • Will preserve 32 council structure but…. • Initiating ‘partnership’ discussions with COSLA around Police, Fire and Health & Care

  8. Income and Demand Trends: TFG • Projection of income based on Spending Review • Projection of demand and costs on current trends (3 years) adjusted for demography • Based on current service models and arrangements • TFG: 2013/14 = £1.7 billion, 2016/17 = £2.8 billion • Income reduction = 48%; demand on current models = 52% • What happens if nothing else happens

  9. Scottish Block Finance & Demand 2009/10 – 2016/17 (% real terms)

  10. Initial Focus • Control the wage bill below trend: Pay strategy and workforce reduction • Maximise income: Tax collection, fees and charges • Drive value out of procurement: Share pressure with suppliers and contractors • Outsourcing of non-competitive provision • Drive value out of the asset base: Rationalisation; utilisation; co-location, etc. • Tighten eligibility and entitlement criteria: Prioritisation and targeting

  11. In Total This Gets Us…

  12. The reality of outcomes in Scotland • Many people in Scotland live very well by international standards: averages are not bad • The variation around the average is the issue: safety, health, learning, economic well being • Within Scotland: high clustering of positive outcomes and negative outcomes • Communities experiencing very poor outcomes on one domain experience them across others: clustering at neighbourhood level

  13. Focusing the Problem: Education and Learning

  14. The Fundamental Issue: Disparity of Outcomes

  15. Christie Commission • Reported in June • ‘Ethos’; ‘improved outcomes’; ‘sustainability’ • Major conclusions: • Need for whole system focus on outcomes • Acceptance of demand and ‘failure’ demand as key issue • Strengthening and deepening partnership: within and between sectors • ‘Localisation’ and ‘integration’ as route to reform; common public sector duty • Co-production: community capacity building

  16. Christie: Reform Should … • Support achievement of outcomes • Be affordable & sustainable within existing budgets • Strengthen accountability through democratically elected reps • Build services around people & communities needs • Empower front line staff • Support the local integration of service provision • Encourage prevention; tackle inequalities; promote equality • Improve transparency over plans; spending; performance • Streamline public sector landscape • Consistent with & support wider PS reform & improvement

  17. Reform: Practical Issues for FM • Ensuring the workforce can deliver – profile & capacity • Identifying opportunities to maximise income • Empowering employees to find solutions • Developing locally integrated services • Benchmarking Comparability Competitiveness • The appropriateness & sustainability of business models – Joint Ventures; Clyde Valley; Ltd Liability Partnerships

  18. Reform: Key Questions for FM Can you identify key steps for: • reducing costs, improving efficiency and enhancing productivity? • strengthening partnership working (with other public, private and voluntary providers)? • targeting resources to reduce failure demand and improve outcomes? • engaging public and service users with the changes that are necessary?

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