An ice-chill of austerity for public services

So NHS top dog, Simon Stevens, has unveiled his bold plan for The Next Five Years. And very sensible it seems. And hard. In fact, has there been a more challenging plan for the NHS in its history? That plan will also impact local and central government services too so it’s worth a quick read even if you’re not working in the NHS.

The plan is designed to appeal to patients, the industry and government. Encouraging the NHS to “think at all times like a patient and act like a taxpayer” is a bold strap line and one we will hear a lot of I’m sure.

The election next May will likely again use the NHS as a political football. But this time, maybe, in a different way. Yes to the usual affirmation by the British people of the unique importance the NHS plays in the life of the nation. And yes to the usual “safer with us than them” we expect of politicians. It’s their job.

But a key difference will be the backdrop of future austerity and the impact that will have on all public services. The Office of Budget Responsibility (OBR) will play a crucial role in this election. As it says on the tin, the OBR’s role is independent from government. It can be (“will be” is perhaps going too much) an “honest adjudicator” of the to-be-expected claims and counter-claims. OBR projections of public spending make grim reading. There is no magic pot we can use after the election is over.

Simon Stevens’ projection of a £22 billion shortfall is a wake up call to the NHS and the rest of public service. The “rest” is more fragmented so there is not a common voice to express such a Big Bang number. But a quick read of the OBR’s output and projections should send a tingle up the collective spine of all public sector managers.

This is a threat we all need to meet head on. We need to make sure what we do is the best, the most relevant and the cheapest we can provide. And we need to start now, not wait until the Summer of 2015. Not delivering on that challenge and waiting for the knock of austerity is to ask for trouble.

In the NHS, the £22 billion shortfall will be met by more focus on prevention, more redesign and more focus on sustainability. All of which sounds positive. But all will impact on locally and impact on you.

Public sector managers need to go indoors and pull on a woolly jumper – the ice-chill of austerity is coming your way.

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