From time to time, society is forced to shift its position and adapt to changing circumstances. It is of course the job of Government to bring these changes about fairly, but more than anything else, it must be honest and declare its real agenda – how much of the current strategy would still be happening without such a large debt, purely out of political dogma?
I have just a few pragmatic perspectives on this:
1. When the public sector has a function that is not performing the way it thinks it should, it creates another function to either monitor the first one of take on part of its workload. If this doesn’t work, it will overlay another audit-type operation. It then wonders why its costs run out of control. In the private sector, the approach is more logical and efficient – if something is not working properly it gets mended.
2. This attitude can only be due to the poor quality of management available and the false assumption that more mediocrity is a substitute for “good”. Outsourcing piecemeal to the private sector is likewise not the answer, as the outsourced service will only ever perform to the same standard as its “customer”. The task of managing an outsourced service is different, but no easier than an in-house operation. One thing is for sure – responsibility & accountability for the quality of the service delivered can NEVER be outsourced.
3. Occupational health is not a new branch of medicine; it is simply looking at an individual’s condition and abilities from a slightly different angle. It does not therefore need an army of newly qualified specialists and an entire educational infrastructure; just perhaps some retraining around expertise that already exists. Why are GPs so incapable and why must they remain that way forever?
4. One of the main justifications for a change in approach is absenteeism rates of c 7% (allegedly). This may be true in the public sector, but I have never worked anywhere where it has exceeded 3%, below 2% if you take out the individuals whose illness is indisputable – short or long term. This can be achieved with fair, but diligent and consistent management.
5. It has recently said that GPs have no incentive not to sign people off work – no incentive that is other than a responsibility to act in accordance with the Hippocratic Oath. Why does everyone need an incentive to do their job correctly? The Government’s starting assumption with the sick and disabled is that they are all fraudsters and it appears it has a similarly dim view of GPs. They must stop judging others by their own duplicitous standards.
6. There has to be a definition of “work” and the Government must describe clearly what it proposes to subsidise (through benefit payments of one kind or another) and where it will draw a line. For example:
a. To what extent will it help an individual return to their profession? When and against what criteria will it abandon this in favour of finding any job?
b. Within a) to what degree will it reflect the characteristics of particular job markets – some are very much tougher than others?
c. How long a term view will it take? E.g. would it bear with someone who could return high income tax payments if found the right employment longer or press them into any menial, low paid job?
7. The Government has knowingly & dishonestly amended (i.e. toughened) WCA criteria on the basis that workplaces generally are now far more accommodating than they were and have been developed such that they are considerably less demanding (at least physically) than ever before. The clearest example is the statement that the modern workplace no longer requires either bending & kneeling, which is why this test has been removed from the WCA.
This assertion is based on nothing other than an assumption that employers have responded to various layers of legislation in a particular way – it is based on no empirical evidence whatsoever. The assumption does however suit its purpose very well.
8. In behaving disingenuously, the Tories do not just damage their own party; they damage the reputation of Westminster as a whole. Government must at all costs retain integrity and be constantly monitored against the Civil Service code of ethics and it is down to the other political parties to ensure this comes about.