Dead Ends: Austerity I

Hi, welcome to Dead Ends, a monthly podcast about how the world around us is designed and how it got that way. Ending mostly in. Isn't that interesting? I want half of your hosts, Sarah Drummond.

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Lou

And I, in the other half laid down. And this is the Dead End podcast from the Scott Lucas services, and we hope you enjoy the show.

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Sarah

This was such an interesting and big topic that we decided to turn austerity service design into two parts. So you are listening to part one. Let's get on with the show. Okay, so since we did our last podcast, we have a new government in the UK. I think for many people we know there's been this sort of eyes peeled emoji scenario.

00:00:47:22 - 00:01:14:12

Sarah

You know, those little peepers that people put on and say like, I'm watching you. That's kind of stalker ish. Like, I'm looking at what you're going to do or I'm interested in this thing. And I think a lot of people were involved in some of the industries that we work in and around, involved in digital and technology and policy, government and even designing private sector services have been like, what is this new government going to do when it comes to investment and things like that?

00:01:14:16 - 00:01:35:12

Sarah

And we were all, I guess, hoping for some kind of change to what we've been feeling over the last 14 years. And I'm not saying it all came crashing down because I obviously want to give a new government some time. But I guess when I read Novara media's headline which said austerity is back, baby, I sort of let out a really big sigh.

00:01:35:14 - 00:02:12:12

Sarah

And it was a report on the new chancellor, Rachel Reeves, that she had announced a series of austerity inspired sticking plasters, as they called it, axing 5.5 billion from budgets for what remains of this financial year, with a further 8.1 billion by 2026. And they said that the reason for doing this is that they'd made a discovery of 35.5 billion in unfunded government spending plans and I guess a sort of sense of hope, of a tide change of investment into industries and services and government.

00:02:12:14 - 00:02:31:21

Sarah

We maybe felt like it was a bit of a backstep and that there was more cuts to come. And I think the last 14 years have felt really hard for a lot of people. Services have either gone back to really skeletal operations or have been stopped entirely because of cuts have been made.

00:02:31:23 - 00:03:01:05

Lou

Yeah, I think we're all very sensitive at the moment to any kind of statement that might sound like we are moving back to the kind of beginning part of that 14 years of conservative government. and that's that sense of kind of hopefulness, of really willing us to be in a very different place, around how we invest in not just public services, but also in the economy, which is why I ended up writing a blog post earlier this month about austerity service design.

00:03:01:05 - 00:03:33:15

Lou

Because I think what's really interesting, when things change, as they did with the ending of 14 years of conservative government, is that you get to see how things are right now with more clarity. And that's certainly what happened to me. I started to realize that actually, progressively over a period of time, the idea of what service design has changed in that 14 year period, which makes up the bulk of certainly my career and probably a lot of people who are currently in the industry of designing and delivering services.

00:03:33:15 - 00:04:03:13

Lou

And we've gone from something that was, I think, probably mostly about thinking about the future, creating new services, making things better for someone, that to something that is now really about stopping bad things from happening and about thinking of services in the short term, saving money, stopping risks and that kind of thing. I've certainly seen this in my own career, but I also see it in what people are practicing out there now in the public and the private sector.

00:04:03:15 - 00:04:27:08

Lou

And there's a different type of service design that's been created by this economic environment, that we've been in for the last 14 years and has really affected actually how we work. And it's something that I started to think of as austerity service design. And if you haven't read the blog post that we published earlier on this month, feel free to pause and come back.

00:04:27:10 - 00:04:49:09

Lou

if all you can carry on listening, it's entirely up to you. But I will just quickly summarize what I mean by austerity service design. The sole purpose of austerity service design is to save money or raise revenue above and beyond delivering value to users. Its objectives are always short term, focusing on what is within reach quickly, not what would be the right thing to do in the medium or the long term.

00:04:49:15 - 00:05:13:20

Lou

There's little talk of investment, just as there's little talk of the future beyond the next quarter or transformation program end date. Things will always be better once we deliver the new website, CRM, or target operating model, or customer account. But that horizon never seems to come any closer, because austerity service organizations are always in a rush, doing too many things at the same time, with not enough people to do it.

00:05:13:22 - 00:05:34:24

Lou

You do not ask big questions in austerity service design, lest you try and boil the ocean. Projects are rigorously managed so that they are on time and within budget, but completely missed the point. Creating long term costs and impacts on society. In austerity service design organizations, funds might go down, but they try to do more with it so their corners are cut.

00:05:34:24 - 00:05:51:16

Lou

There's no time to think, time for research or time for design. They make mistakes and become ever more risk averse with each inevitable mistake. Every day the stakes become higher. The ability to do work successfully with less people, less time, and less budget creates ever increasing odds of failure.

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Sarah

I really recognize all of that. I think it's probably worth it. We take a bit of a look through. What do we mean by austerity? Where does it come from? Why did we get there? Because we don't really want to be there, do we?

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Lou

No, I mean, it's not the nicest description, is it?

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Sarah

Well, I think it's really interesting when you say not the nicest description. We could think of the meaning of austere as being a form of strictness, which in some sense in what we're going to talk about today is true. And when I looked up the word austerity, one of the synonyms was grimness, which in terms of what we've experienced over the last 14 years, it does feel pretty grim in what you've described.

00:06:29:16 - 00:06:39:15

Sarah

But the other primary meaning of austerity is difficult economic conditions created by government measures to reduce public expenditure, which also, I think you'd agree is pretty grim.

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Lou

Yeah. I mean, I did feel like I was reading a really horrendous kind of bedtime story there.

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Sarah

Yeah, it's not the kind of bedtime stories that I want to be read. I mean, I don't get bedtime stories read to me.

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Lou

I can, if you want, I will.

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Sarah

I'll put it on my my bedtime story list. Anyway, according to Mark Blyth, who was a Scottish American political economist, the concept of austerity emerged in the 20th century when large states acquired sizable budgets. Now, Blythe argues that the theories and sensibilities about the role of the state and capitalist markets that underlying austerity emerged from the 17th century onwards.

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Sarah

It's grounded in liberal economics, its view of the state and sovereign debt as deeply problematic. Life traces the discourse of austerity back to lots of kind of different writers and social, cultural political theorists of the time, including John Knox, theory of private property and derivative theory of the state. David Hume, these ideas about money and the virtue of merchants, and Adam Smith's theories on economic growth and taxes, but on the basis of classical liberal ideas, austerity emerged as a doctrine of neoliberalism in the 20th century.

00:07:48:04 - 00:08:18:17

Sarah

Here in the UK, austerity gained its own status, and I would kind of call it like a sort of proper noun status. The last 14 years have been dubbed as the inverted commas United Kingdom's government austerity program. So it's actually a thing that is shaped and has form to it. In 2009, the term age of austerity, which had previously been used to describe the years immediately following the Second World War, was popular, ized by Conservative Party leader David Cameron and future Chancellor George Osborne.

00:08:18:19 - 00:08:42:19

Sarah

The term at the time lacked the negative associations that would develop over the course of the following decades, and was somewhat synonymous with prudence. In his keynote speech to the Conservative Party Forum in Cheltenham on the 26th of April 2009. Cameron declared that and I quote, the age of irresponsibility is giving way to the age of austerity and committed to end years of what he characterized as excessive government spending.

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Sarah

I think what's really sad about this is when you start to kind of go over the evidence for this in ten, is that they didn't really do that much formal research on the impact of the cuts in services and the public when adopting this approach of austerity. But this led to some pretty grim outcomes across loads of different sectors, loads of different domains.

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Sarah

And, you know, just.

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Lou

One example.

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Sarah

Between 2007 and 2017. Museums suffered a 13% reduction in funding, resulting in the closure of at least 64 museums between 2010 and 2019. And whilst museums are free of charge, in order to broaden the demographic of visitors and provide universal access, many museums have had to resort to privatization in order to accommodate budget cuts. The emergence of austerity and subsequent cuts to local government funding caused other similar cultural services to close, including libraries, which included nearly 800 public libraries since the launch of austerity in 2010.

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Lou

Yeah, and I think what's really interesting about, some of the areas that were most dramatically, hit by this policy is that they are the ones that to some extent to that government at the time seemed somehow optional. You know, reading and culture, you know, things that perhaps, maybe we could do without and hopefully you can hear the, the sarcasm in my voice when I'm describing that.

00:10:12:11 - 00:10:38:17

Lou

Interestingly, just before the general election, Ada Edith Marion published a really brilliant article, in The Guardian, long reads about the role of libraries in local communities. Now in 2024. And in it, she described libraries in this absolutely wonderful, phrase. And I will read it to you. They are informal Citizens advice bureaux, a business development center, a community center, and a mental health provider.

00:10:38:19 - 00:10:59:05

Lou

It's an unofficial, sure start center, a homeless shelter, and literary and foreign language learning center, a calm space where tutors can help struggling kids, and asylum support provider, a citizenship and driving theory test center, and a place to sit all day and stare at the wall. If that's what you need to do without anyone expecting you to buy anything.

00:10:59:07 - 00:11:26:15

Lou

And it's such an expansive and telling story about all of the things that are now crammed into these flexible spaces of libraries. and it's really telling, actually, about the types of functions that they're now performing that don't have anywhere else to go. And she goes on to basically say this really explicitly. She says, you know, when there is nowhere else to go, said one library staff member, this is where they come.

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Lou

And I guess the question is, what happens when those close? Yeah.

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Sarah

The cuts from this Doherty program really cut deep into all corners of public and civic life, especially when you take away those last spaces that people could go. And there's knock on effects elsewhere. You know, in some ways we might say it's really positive that we saw more voluntary run services get up and running in the charity and civic sector.

00:11:50:07 - 00:12:21:11

Sarah

But actually, I think this is really people propping up people who really need support and help of a system that is not doing it for them. You know, for example, the number of people using foodbanks has increased. I'm not even going to try and do the maths in lifetime ten fold, 24, 30 fold. in 2008 to 9, there was just under 26,000 people registered as using different forms of foodbanks for people providing food, essential supplies to those who need them the most.

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Sarah

When they surveyed this in 23 to 24. That number had jumped to 3.2 million people. I mean, you don't even really know how to respond to that, right?

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Lou

No. Well, I mean, what it makes me think of is, is the fact that a lot of those, food banks and other places are not just providing food as well. You know, they're often providing, bedding and personal hygiene. And, you know, we've also starting to hear about schools providing mattresses for kids as well. So, yeah, it's not just food that people are struggling with.

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Lou

It's kind of basic necessities.

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Sarah

I think that's really important to just say when you look across all the different types of data with what people are being supported with, it's not that this is new. Voluntary services have always existed. Supporting people in need has always existed, you know, through lots of, old, older charities, and funds. However, the number of people accessing those types of services has increased dramatically in this period of austerity.

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Sarah

We wanted to talk about today's the age of austerity, when it was launched, came hand-in-hand with the concept that was called Big Society. So the Big Society was a social political concept of the first 15 years of the 21st century, introduced by David Cameron and his administration. Just for context, anyone who's not really from a UK political background, David Cameron was the leader in am I right in saying this 2010.

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Lou

And he's a prime minister?

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Sarah

Yeah, the Prime minister, he got into power in 2010. So David, like I know him, David Davey.

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Lou

David I mean, there is a biography of him called Call Me Dave. So maybe you can go. Dave.

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Sarah

Dave, the Prime Minister first outlined his theory of the Big Society project and why it was his answer to, and I quote, broken society as leader of the opposition. So prior to him getting into power in his speech at the Conservative Party conference in October 2009, he stated, and I quote. So no, we are not going to solve our problems with bigger government.

00:14:21:00 - 00:14:44:05

Sarah

We are going to solve our problems with a stronger society, stronger families, stronger communities, a stronger country, all by rebuilding responsibility for the kind of details emerged of this promise of some kind of big society. In his Hugo Young lecture in November 2009, when he called for, and I quote against state action to make the Big Society project a reality, he said.

00:14:44:07 - 00:15:07:11

Sarah

Our alternative to big government is not no government. Some reheated version of ideological laissez faire. Our alternative to big government is the big society. But the big society is not just going to spring to life on its own. We need strong and concerted government action to make it happen. We need to use the state to remake society at a high level across kind of three main policy areas.

00:15:07:11 - 00:15:32:05

Sarah

It aim to give communities more powers. So look at a form of localism and devolution. Encourage people to take an active role in their communities. So looking at volunteerism, transfer of power from central to local government support, the development and increase of co-operatives, mutuals, charities and social enterprises and to open up government in a way. So start publishing government data and be more transparent.

00:15:32:07 - 00:16:08:21

Sarah

And I think it's really important, as we kind of go through where Big Society came from, is to call out, first of all, that it wasn't call me Dave's, you know, strategy and his government's strategy alone. It builds on a wealth of traditions and ideas about strengthening communities, civic action and co-ownership of public services. As big society was emerging in government through Cameron's politics and speeches, a select committee got together and did a call for evidence on where and how a big society could be delivered, and kind of scratching their heads on what does this actually mean in practice?

00:16:09:02 - 00:16:48:02

Sarah

And the early part of this report that was published, which we'll share in our show notes, was that this was not necessarily a new concept. It was linked with the ideas of some central major religions, with the Bishop of Leicester suggesting it has resonance with a vision for a society that is profoundly Christian. the commitment to open up public services to mutuals and cooperatives links the Big Society project to the co-operative movement, which was first established in Rochdale in 1844, where 28 working class men in Rochdale in England established the Rochdale Equitable Pioneer Society, which was the first modern co-operative business.

00:16:48:04 - 00:17:18:07

Sarah

The Big Society also had roots in the theory of social capital, most notably espoused by the Harvard sociologist Robert Putnam, whose seminal 1995 essay Bowling Alone identify the reduction in the number of Americans taking part in communal activities, causing a decline in social interaction and civic engagement. Pitman defined social capital as the fabric of community life. He lamented its decline in the USA and the development of what he called a widespread tendency towards passive reliance on the state.

00:17:18:12 - 00:17:40:24

Sarah

There's loads of other things that were mentioned in the select committee report, but ultimately I'm saying it's really not a new idea, but it felt quite ideological as well. Then, aside from me giving you a history lesson on where Big Society began, the committee shared concerns about the practical implementation of the concepts. Big society was a big branded idea strongly held at the center of Cameron's government.

00:17:41:01 - 00:18:07:12

Sarah

The forward to the coalition agreement, which was an agreement signed between the conservative government and the Liberal Democrats, who came together to form a government in 2010. In the UK. It said at the start of this agreement that and I quote, Big Society Project has the potential to completely recast the relationship between people and the state citizens empowered individual opportunity, extended communities coming together to make lives better.

00:18:07:14 - 00:18:19:01

Sarah

And that the Prime Minister's description of Big Society was his mission in politics, and has pledged to fight for it every day because the Big Society is here to stay. This sounds good, right?

00:18:19:02 - 00:18:32:05

Lou

I think what's really worth noting here is that it really, really sounds like the government at the time was properly working itself off into a froth about how exciting a big society and, austerity was.

00:18:32:08 - 00:19:05:18

Sarah

I remember around this time that there was actually a buzz, this sort of renaissance of local importance, of a volunteering spirit and a sense of openness coming back, a focus on community empowerment and importance. Even in the committee's evidence base were letters from folks like the British Humanist Association applauding the focus on communities. They said, and I quote, that the general position is that government and others should recognize the value of communities where people of all different backgrounds and beliefs engage and work with each other for the benefit of everyone.

00:19:05:19 - 00:19:30:08

Sarah

And there was letter after letter saying, well, this is good. I mean, we fundamentally agreed the principles, behind it, but most letters then followed up with really important questions on the practicals of Big Society, for example, had the promise of setting up mutuals, of delivering public services led by staff would happen when maybe some of those people didn't have experience of running businesses or handling large budgets.

00:19:30:11 - 00:19:56:03

Sarah

Coming back to the Bishop of Leicester again, in his evidence in the committee report, he said that yes, whilst the church is definitely happy to step up into volunteering where it's needed, they cannot be an alternative to public service provision across the piece. They cannot deliver the professional exam, they cannot deliver the resources, they cannot deliver the standards, they cannot deliver the consistency and they should not be expected to.

00:19:56:07 - 00:20:20:08

Sarah

Beyond the short lived buzz and general sense of agreement into the ideological principles of a big society. I think the reality set in alongside that, this really felt like a gimmick, that promotion of big society was a cover up for an incoming program of austerity, where budgets would be slashed, services would be closed, and an expectation that volunteers and the public would just step up to fill in those cracks.

00:20:20:10 - 00:20:53:04

Sarah

As we saw the skepticism spread across the news at the time. We're not fooled by the Big Society Council gimmick. The Essex County Gazette standard in 2011, even a decade on in the New Statesman, Tom Lloyd Bridgman wrote, the language of community power is often used to paper over the cracks of ten years of local austerity, and coming right back to the committee review of Big Society, they stated that there is little clear understanding of the Big Society project among the public, and there was confusion over the government's proposals to reform public services.

00:20:53:06 - 00:21:23:18

Sarah

In particular, the ambition to open up public services to new providers has prompted concerns about the role of private companies, which have not thus far been adequately addressed by ministers. Now, this report was 2010 to 2012 asking these questions and 14 years on, we're looking back and going, what happened? And if, like Rachel Reeves and Novara media said in their headline, austerity is to continue, what will that mean for our services?

00:21:23:20 - 00:21:46:20

Lou

So you found a really great paper from the Institute for government, which has got seven ways in which austerity, actually fundamentally effective public services. And I think we should go through that list, and have a look at them, because sometimes this can feel like a really academic discussion of removing money from public services and sort of displacing that responsibility to the wider public sector.

00:21:46:20 - 00:21:59:21

Lou

It's really hard to see, actually, what did austerity really fundamentally do to public services? So we're going to go through that list one by one, and we're going to talk about why they were potentially problematic. Yeah.

00:21:59:21 - 00:22:39:06

Sarah

So this list is from austerity in public services lessons from the 20 tens written by Stuart Hoddinott, Matthew Freight and Thomas Pope. The first up is holding down wages. Now wages account for the majority of spending in most services, particularly in public services. Direct staff costs account for 64% of hospital spending, 80% of school spending, and for instance, when there's a change in wages, it can have a big impact on total public spending across the board, 1% reduction in pay equates to saving of 2.4 billion per year for the government, so pay freezes were obviously put into place.

00:22:39:10 - 00:22:40:18

Sarah

I mean, casting aside.

00:22:40:20 - 00:23:17:22

Lou

The obvious issues to deal with the fact that services are made of people and the happier, more respected those people are, the better your service is going to be. That just get that out there. There is a really big problem with this approach. When you compare it to our expectations around particularly digital service delivery, because what happens is, you know, if you create a great, accessible, usable digital service, then you end up with more of the kind of simple cases essentially going through that process.

00:23:17:22 - 00:23:48:13

Lou

Right? So all of the people who have simple issues and simple questions and things that they need to get done go straight through that digital service. And on the other side, you never, ever speak to them. What happens, though, is the better your digital service becomes, the more complicated your casework is. So essentially, the people who are now phoning you, who are contacting you through email and, you know, kind of webchat or whatever other channel you've got now have much more complex situations that need to be dealt with.

00:23:48:15 - 00:24:09:12

Lou

So actually, the people who are doing that kind of user support, customer customer support, whatever you want to call it, need to be much more skilled and much more empowered and therefore probably better paid, also certainly more empowered to be able to deal with that situation. So the two fly in the face of each other, really.

00:24:09:14 - 00:24:37:05

Sarah

And I mean the obvious one is then there are strikes, and strikes mean that staff don't show up, which means that services don't run. And, you know, we've seen a serious amount of striking from ambulance, you know, drivers, paramedics to doctors in recent years, fire brigades, you know, like we've seen a whole bunch of striking even the Royal College of Nursing who have never strike before rebalancing recently for the first time in its history about whether they should strike or not.

00:24:37:05 - 00:25:06:02

Sarah

This means that services don't run. So that kind of links to the next one, which is cutting staff. And as with cutting wages, if we make a 1% reduction in staff numbers, that can also equate to a saving of around 2.4 billion per year for the government. And between September 2009 and May 2013, the NHS, as one sectoral example, cut the number of managers and senior managers by 30 and 31% respectively.

00:25:06:04 - 00:25:36:10

Sarah

By 2018. In the policing sector, officer numbers were down 14% on 2010 levels, equating to 21,000 fewer officers. We saw it in the prison sector as well, with a reduction of about 26% of its officers between 2010 and 2015. And, you know, if we go back to the sort of NHS numbers, what this means is that we can struggle to do things like discharge patients from hospitals into social care due to staff shortages.

00:25:36:12 - 00:25:51:12

Sarah

And we know that that's having an impact because of evidence from patient surveys over the last decade show increasing public frustration and difficulties in getting things like GP appointments or satisfaction with different forms of hospital and care services.

00:25:51:12 - 00:26:18:09

Lou

Yeah, I think what you're saying there is, is really interesting because those cuts are not being done universally. They're very often in operational areas and they're not in every single service. So although one service might be totally fine because it's made some cuts, it's creating problems further downstream or further upstream in other organizations. I think what's really interesting is if you take this, you know, kind of point around cutting staff numbers and staff wages together.

00:26:18:09 - 00:26:44:08

Lou

What you see is really short term, savings. And if you look at actually the numbers of the civil service, you know, before and after austerity, you know, around 2010, there was about a 20% reduction in the number of civil servants. But actually that has increased year on year since 2016. And the civil service is now larger than it was at the start of austerity.

00:26:44:08 - 00:27:10:10

Lou

So it's been a bit of a weird, kind of yoyo diet, I suppose, for kind of numbers of particularly civil servants. And we've also seen an increase in the seniority of staff as well, which kind of makes sense when you think about it, because if you can't hire people and you can't pay them more, you can't give and pay rises, you just end up promoting people and you sort of end up promoting them away from those kind of frontline jobs.

00:27:10:12 - 00:27:31:20

Lou

But I think what's really important here is that, you know, where where you see massive reductions in staff, particularly in operational areas, all you're going to see is an increase in waiting times. And that is not cost neutral because particularly in things like health or adult social care, those sorts of kind of big public sector areas, longer waiting times mean obviously changes to people's health changes.

00:27:31:20 - 00:27:51:03

Lou

Their social situation, which may end up being more serious when you then come round to dealing with that person. And I think even in just a casual way, you know, we're now all so used to phoning up any service public or private sector and hearing, you know, we're dealing with exceptionally, large call numbers, but we just take that for granted now.

00:27:51:03 - 00:28:12:04

Lou

But the demand has well outstripped the ability for any organization to deal with it. But that is a deliberate choice that we've made as organizations to reduce the number of people who are providing customer support. and we'll get to this later. But that reduction in support has affected people unevenly.

00:28:12:06 - 00:28:34:20

Sarah

Yeah. And we get, in this sense, more inexperienced staff filling those gaps in the workplace and in experience, perhaps in skill set, but also in terms of experience of actually being on the job, you know, running that service, learning the patterns of how it works, learning how to navigate it and make it work for people. And so we see that causing a challenge in service delivery.

00:28:34:20 - 00:28:53:23

Sarah

And, you know, just is a kind of statistical example. The number of prison officers with fewer than five years experience increased from less than a quarter to more than half between 2010 and 2022. So that's 22% to 52%. So we have an inexperienced staff bill trying to fill those gaps.

00:28:54:00 - 00:29:07:06

Lou

Yeah. And when you think about the recent headlines there's been even in the last few weeks actually about massive overcrowding in prisons. Combining that then with less and less experienced staff is is a real recipe for problems.

00:29:07:08 - 00:29:27:24

Sarah

So that moves us quite neatly on to number three, which is pushing staff to work harder. So, you know, speaking with my budgets evening hat on, this is a great one because if you increase the productivity of staff, even just by 1%, it comes back to that same figure again of 2.4 billion, which means we need for your staff to deliver the same thing.

00:29:27:24 - 00:29:54:07

Sarah

And we've probably heard this so many times in services, which is do more with less, but it's not easy. And we see this play out in loads of different services that many of us are familiar with. For example, in schools between 2010 and 2021, the pupil to teacher ratio roles in both primary and secondary levels from 20.4 to 20.6 and 14.8 to 16.7, respectively.

00:29:54:09 - 00:30:19:09

Sarah

This is despite research showing that smaller class sizes are more beneficial to pupils, as teachers can better focus on smaller groups and teach more flexibly in adult social care. The early part of the last decade saw a rise in the number of local authorities commissioning home care visits in much shorter allocations, so asking staff to do their visits within 15 minutes rather than 30, 45 or 60.

00:30:19:11 - 00:30:40:24

Sarah

This means that carers were being forced to do the same amount of work in less time, which in turn led to higher levels of unmet needs for users. And this is really important when we think about service design, that the targets that you set for people around allocated time to support people are parts of your service design. So austerity is driving those.

00:30:41:01 - 00:31:03:07

Lou

yeah. And productivity is such an attractive but also red herring of a metric. Right. Because it looks great on paper. You know, we're seeing more people, we're teaching more children, we're doing more with less. But are you actually doing more? Because often those metrics are not included. You know, whether or not we're actually meeting our outcomes is not something that we're measuring in that situation.

00:31:03:07 - 00:31:36:11

Lou

So yeah, it looks great, but we don't know whether or not those things are effective anymore. and I think there's really, you know, there's pushing staff to work harder, often comes along with a misunderstanding of what more efficient actually looks like. And this kind of doing more with less mentality is actually really, really damaging because I think what we're not seeing in organizations is a reduction in the size of the portfolio or in delays in any work or, you know, really in a different approach to prioritization at all.

00:31:36:13 - 00:32:03:16

Lou

What we're seeing is actually the same amount of work being done in less efficient ways. and so we're seeing more work being outsourced with no long term commitment around the support of that service. we're seeing work being done with part time teams. So they're stretched across multiple different services. We're also seeing teams being taken off of live services to be moved on to new product development, new service development.

00:32:03:18 - 00:32:32:18

Lou

And we're seeing as a result, of course, you know, an increase in staff churn. And I'd also say, you know, an increase in that, that, you know, kind of mental health crisis really, that we're starting to see amongst people doing these sorts of roles because they're being asked to do things that just, you know, kind of, quite simply are not possible or not the right thing to do.

00:32:32:20 - 00:32:54:19

Lou

Hi, it's new here. Time for a short ad break. When we're not podcasting, we run the school, look at services that helps people and organizations learn how to design and deliver great services. We teach courses and service design how to get by and for your work and what makes a good and a bad service. So if you want to know more about that and to sign up to one of our courses, check out books services.

00:32:54:21 - 00:33:26:10

Sarah

So now for a more physical kind of example. Number four is cutting public service capital spending. So we're talking here not about operational expenditure, which is the money that goes into continuously running our services, but actually the capital money that goes into setting that thing up or investing in expanding or improving it kind of quite significantly. And in this sense we could mean buildings or equipment, but we can also talk about some things that might feel slightly less intangible, but that is our digital infrastructures as well.

00:33:26:10 - 00:33:48:16

Sarah

And this is a really obvious one, which is just don't put some capital works onto that building. If we don't spend that, we'll save some money. But it can have quite a big impact on our services, but not nearly so as acutely in the short term as it is in the long term. So short term is a really great, effective strategy for austerity.

00:33:48:18 - 00:34:23:11

Sarah

For example, between 2013 and 2019, NHS providers cut spending on equipment such as MRI scanners and some of the money intended for capital investment was also diverted to meet the spending pressures instead. So we can say don't buy that equipment that will just plug our budget for running our service as it is right now. Furthermore, in hospitals, you know, if we keep not undertaking capital expenditure, surgeries cannot be carried out in theaters that like things like air conditioning and equipment, reduces the throughput of procedures.

00:34:23:11 - 00:34:48:00

Sarah

And the Health Foundation actually found that aging infrastructure and repairs backlog is harming productivity, having negative effects on patient care and safety, and is hampering medical staff ability to deliver optimal care. So when we don't undertake the capital expenditure that's needed to keep our services, you know, running well, the physical stuff, it can have a really big impact on those service outcomes.

00:34:48:19 - 00:35:17:05

Lou

Yeah. Really good point. I mean this is probably my my favorite topic. what is classified as capital expenditure and what is classified as operational expenditure. And I think part of the problem is that we literally categorize every single thing we do to particularly digital services as capital expenditure, as if we are going to spend it once and then we can do the transformation, and then that money will not need to be spent anymore.

00:35:17:05 - 00:35:40:04

Lou

And of course, that is not true. you know, the internet is not going to be done. and then we can forevermore forget about it. You know, that's just not the way the technology and change works. And, you know, when I say austerity service design is risky, I really, really mean it. I have been involved in so many business cases where, you know, you have to put everything in capital expenditure.

00:35:40:04 - 00:35:58:12

Lou

You have to say, you know, like, where are you going to do this change once? We're not going to commit to having long term teams because otherwise your business case wouldn't be approved. And I used to work with, someone who says favorite catch phrase was the only reason why we're doing transformation is because we never did any continuous improvement.

00:35:58:14 - 00:36:27:02

Lou

And it has always stuck in my head ever since. Partially because it's so, unhelpful at the time to the person who's listening to it. And I've never seen anyone take this well, because of course, you know, like saying that they should go back in time and do continuous improvement so that they're not there is entirely unhelpful. But the problem is that we are doing this repeatedly now, and, you know, we're changing something once we leave it for 5 or 10 years before we ever look at it again.

00:36:27:04 - 00:36:52:20

Lou

And then surprise, surprise, we need to spend more money transforming that thing because we didn't do any continuous improvement to it. But the the issue is, of course, that doing nothing is not neutral. You know, technology changes, user behavior changes. And if our services stand still, essentially they're going backwards slowly, but they're going backwards and so, you know, in a lot of organizations you hear this kind of rebuttal of, well, you know, we can't be like Google.

00:36:52:20 - 00:37:27:10

Lou

We can't be like Apple, you know, unless of course, you are listening from those organizations, in which case you can be like Google, we can be like Apple. But to a certain extent, we don't really get a choice, because actually organizations that do have money, regardless of who that, that organization, is, if they are out there in the world and they, you know, are setting the tone for the expectations that users have of their services like Apple and Google arguably do, then we kind of have to meet those expectations.

00:37:27:10 - 00:37:51:07

Lou

You know, it's really difficult for us to not meet those expectations, you know, and particularly if we don't have the money to be able to, to do that. So it puts us in a really difficult situation where, you know, those expectations about technology changes without our control. but, you know, we also don't necessarily have the money to be able to meet those, those change expectations and that change technology.

00:37:51:07 - 00:37:52:15

Lou

So it's really difficult.

00:37:52:17 - 00:38:11:04

Sarah

Yeah. This is a really interesting one, particularly when it comes to capital expenditure into digital stuff. A lot of my work back in the old days of running a agency was that there would be, you know, a clear budget for us and or another agency to come and build something for them, you know, to research, design, test it.

00:38:11:06 - 00:38:46:22

Sarah

And I guess the question I would always ask was, so where's the budget for the, you know, continuity of that, where's the budget to hire some skills or to develop some skills in-house to keep running that thing and developing it? Because technology does not stop needing to be fed. It's a core part of infrastructure. So when we see the austerity strategy of don't make any capital expenditure, it's not just bricks and mortar, it's managing our data, it's our servers, it's the skills and the staff that we need to keep running that thing.

00:38:46:24 - 00:39:14:23

Sarah

And that's always been a challenge for me, just generally away from just austerity strategies. But in service design, which is we've got some CapEx budget, but we don't have any operational budget considerations then, because that to a lot of organizations is super unknown. Like they don't like the risk of not knowing what the operational expenditure is. So you're kind of dealing with a double edged sword there really, both in terms of organizations fear of additional operational expenditure, but also then austerity don't spend any more money.

00:39:14:23 - 00:39:16:17

Sarah

So double edged sword there.

00:39:16:19 - 00:39:54:18

Lou

Yeah. And gosh I mean this is a really difficult topic isn't it. Because I think what's really fascinating about the timing of all of this is particularly in a government context, austerity literally collided with agile, multidisciplinary, user centered service delivery. And that if you do it well, it is not cheap. you know, technically there will be longer term savings to your overheads of maintaining very large, legacy technology or, you know, huge amounts of customer complaints or people failing to casework all of those problems that we know are solved by better service delivery.

00:39:54:20 - 00:40:16:16

Lou

But having a full multidisciplinary team on your service for the lifetime of that service, when you have multiple services is a big expense. And I don't know that we necessarily, thought that through, in terms of the cost saving that we expect from digital services.

00:40:16:18 - 00:40:45:10

Sarah

I think that's really interesting. But actually something that you were saying around not thinking about the long term comes into the next one, which is number five, cutting preventative and early intervention services in favor of more acute and statutory services. Now it's when we say the word preventative and early intervention services. What we mean are interventions or services that are intended to improve outcomes in the medium to long term by tackling the root causes of various problems.

00:40:45:12 - 00:41:18:03

Sarah

You know, for example, things like early medical screening, reducing the need for serious surgery later on, or early intervention crime prevention schemes, keeping more people out of prison. You know, you can look at a whole variety of different preventative services that help people, not have more needs later on. And cutting those services is really politically attractive and cost effective because those savings are immediate cut that service, save X million pounds.

00:41:18:05 - 00:41:44:14

Sarah

And while those are immediate benefits, these diffuse and accrue over a long period of time. But it's very difficult to stand up to them because it can be very hard to quantify. So some examples of where we've seen cuts in the last 14 years on preventative services is things like the Truss government announced that it intended to scrap plans to tackle obesity, and that was to include its Tackling Obesity plan, which was set to cost 100 million.

00:41:44:16 - 00:42:15:01

Sarah

The government in the 20 tens cut other preventative services. One of the key ones was in children's services, where spending on Sure Start centers and youth services fell by 68.9% between 2010 and 2021. However, this proved something of a false economy, with spending on children's social care rising by 34.9% over the same period. Similar, the spending on the Supporting People program, which was a service designed to allow vulnerable people to live independently.

00:42:15:03 - 00:42:40:10

Sarah

That fell by 79% in real terms between 2010 and 2020. In the same period, spending on homelessness services increased 115%. Many of the preventative and early intervention services that existed at the beginning of the 20 tens have already been cut deeply. The result is that the proportion of budgets spent on acute demand led and statutory services has increased.

00:42:40:12 - 00:43:02:03

Sarah

When many of these cuts were first implemented, there was not an obvious short term worsening in outcomes. Children who did not go to Sure Start centers did not immediately require child protection services, and an underinvestment in preventative mental health services did not instantaneously translate into greater pressure on police to deal with mental health crises. However, the medium to long term outcomes are now being felt.

00:43:02:03 - 00:43:31:22

Sarah

There was 25.6% more looked after children in 2021 than there were in 2010, and police now report spending more time dealing with mental health incidents. You know, I'm spitting out facts here and percentages and data and it's very, very difficult to directly correlate an increase in statutory services with the reduction of preventative services. But I do think overall, holistically, the data speaks for itself.

00:43:31:22 - 00:43:32:05

Sarah

Yeah.

00:43:32:05 - 00:43:58:09

Lou

I mean, it's it's literally like a scale, isn't it, with every single one of these examples, you know, we've stopped spending on one side of it and then we spend astronomically more on the other side of it. And I think what you see here in all of these examples is basically just displacement to more expensive services. Cutting preventative and early intervention services can also have an impact on those macroeconomic outcomes that we're trying to get to as a society.

00:43:58:11 - 00:44:29:01

Lou

and it will be really difficult actually, to square any of these, policies with a government's ambition for improved growth. If you've got people who are suffering all of the negative consequences that you've just described there. So, you know, as my granny would say, you know, you're essentially just cutting off your nose to spite your face if you're cutting in preventative services and you're spending more in those acute or statutory or enforcement services, in comparison.

00:44:29:03 - 00:45:00:19

Lou

And actually, you know, if you look at early years education, that can massively improve, you know, skills acquisition throughout someone's life, not just in early childhood. likewise, providing secure housing can really improve people's health, education outcomes and even mortality. so, you know, we often see kind of this connected, knock on effects from investment in those preventative services, not just in the direct area of, you know, support that, that that person might find themselves in.

00:45:00:19 - 00:45:30:20

Lou

Also, preventative services are much cheaper to run as well. You know, we're stating the obvious here, but taking someone through a smoking cessation service is way cheaper than the current NHS bill for smoking related cancer, for example. and finally, finally, a really important point on this people from disadvantaged backgrounds are much more likely to rely on the benefits from preventative services and cuts to these sorts of services.

00:45:30:20 - 00:45:39:08

Lou

Over the past decade have had a disproportionate negative impact on social inequality. And that's a really important aspect of this.

00:45:39:10 - 00:46:01:11

Sarah

And let's talk about then not just preventative services being scrapped, but the services that I've held on for dear life. You know, number six is reducing scope of services and triaging based on time and energy and, you know, reducing the scope of services. We're seeing some that are really down to the most skeletal model of what they should be running.

00:46:01:11 - 00:46:23:02

Sarah

And often signposting people off to other places to get more help and them arriving. Essentially, what you talk about in the book Dead Ends because they can't support those people, but they're still just about running. You know, I've worked with organizations where I've helped them set up new functions of services, new features, and of help them develop financial models to keep that in place.

00:46:23:02 - 00:46:50:24

Sarah

And over the last, you know, ten years, those services have stayed in place. But over the last few years, some of them have been scrapped because of further cuts, because of seen as non essential, because there is no budget line for that service or that part of the service. And what this then means is we see a bit of a knock on effect of some services starting to charge for parts of it where it was previously a completely free service.

00:46:51:01 - 00:47:21:09

Lou

Yeah, yeah. And I think this is a really this is a really big one. This reduced scope of a service because, it's often something that we do really unconsciously. We don't necessarily talk about it, but we just don't really want as many people using the service because it's very expensive to provide. And actually, yeah, much like, previous points of, you know, displacing people to other services, that's what we find when we, increase the kind of strictness of the triage of our services.

00:47:21:12 - 00:47:59:11

Lou

And I think what's really interesting about this is the reducing the scope of your service provision will much like the, you know, kind of previous point that we were talking about, essentially just push people to other services that are probably more expensive. So, you know, for example, cuts to social care will definitely increase demand for primary and secondary care, as that user's condition worsens, for example, and ultimately, when a user of any kind of service cannot get access to the services they're looking for through the formal official channels, essentially they will go elsewhere for that support.

00:47:59:12 - 00:48:20:17

Lou

You know, that need for support, that need for the service doesn't go away. So they end up, you know, going to things like payday loans to Citizens Advice Bureau. They turn up at libraries, they turn that up at A&E Jobcentres we see them and ambulance calls, you know, in the court system essentially with, with displacing those needs to places.

00:48:20:19 - 00:48:55:11

Lou

that are potentially much more expensive for us as an organization to deal with, much less effective for that user, much more difficult. But I think the really important thing about reducing the scope of our services is that we often do this with very little accuracy about who exactly we are triaging in, and who exactly we are aiming to triage out of our services, and we use methods like hiding our phone number or our contact form, or shutting off physical touchpoints to our service, or simply just not investing in making that service easier to find or clearer for our users.

00:48:55:13 - 00:49:28:05

Lou

So that essentially we manage the demand of that service with a really, really blunt tool. And to be perfectly frank about this, what we end up with is rather than triaging the people who need that service the most into the service, we triage against it. So actually we end up with only the people who have the most time, the most determination, the most civic literacy in our service, and the people who really, really need to use it end up elsewhere, which is obviously not what we are aiming for.

00:49:28:05 - 00:49:55:04

Lou

But as I said, it's because we don't really have a lot of accuracy about this method of triaging in our service. And I think what's also really important here as well is that it's a vicious cycle, because the less we invest in our services, the more expensive they will be to run, the more we will need to triage, and the more we'll end up in the situation where we end up with the people who essentially have the most determination.

00:49:55:04 - 00:50:01:22

Lou

Using that service. yeah, the cycle repeats itself. So it's not a it's not a great tactic, is my review.

00:50:01:24 - 00:50:26:03

Sarah

I mean, none of them are good tactics at all. No, none of them are good tactics. And if it's not clear already, we're not advocating for anyone to do these were. But I think what's really helpful is to actually name these just like we're naming austerity service design. So you can see these tactics in place and how they mold and shape what it is that we are designing and how we are delivering services.

00:50:26:05 - 00:50:58:16

Sarah

And the final one isn't about depletion or cutting back or changing the service necessarily, but it's about finding new revenue sources for those services. And developing new sources of revenue, or increasing revenue from existing sources can help to offset any reductions that are coming in terms of funding for your service, and might allow you to either a continue to retain your existing level of provision, or at least at the very least, keep that service somehow alive.

00:50:58:16 - 00:51:26:22

Sarah

And it can actually be more politically appealing to central government to place responsibility for raising revenue on local government rather than raising headline tax rates. Right, like nobody wants to turn on, you know, a political announcement saying we're going to raise tax and, and the knock on effect that this has had this mean that we've seen quite a lot of services start to find parts of them to be paid for by users where they previously were not.

00:51:27:01 - 00:51:59:01

Sarah

So the report estimated that the UK government had reduced grants to local authorities by 18.6 billion between 2010 and 2020, which is a 63% reduction in real terms. That is huge. A huge reduction. And local authorities, apart from doing some of the things that we've just talked about and cutting critical services or dramatically having to reduce them, partially offset this reduction through a combination of raising council taxes, which we've all felt, and charging more for services.

00:51:59:01 - 00:52:23:24

Sarah

So we'll see some of those charges come into things that we might have previously not been charged for. If you want to get a new bin, you might have been free before, but now you have to pay for it. If you want to make a planning application, the cost of that might have gone up. There's lots of different things that have maybe slowly crept in that we haven't noticed that essentially have become like using a private sector service that you have to pay for.

00:52:24:01 - 00:53:01:04

Sarah

And a larger percentage of net transport expenditure now comes from income generated by parking fees increasing from 17.3% to 23.7% between the mid noughties, 2016 and 2020. But all of these additional costs in our services to be able to use them has a knock on effect. The Royal Pharmaceutical Society did a study with pharmacists. 90% of respondents had seen cases where patients decline some of the medicines on a prescription due to cost, and more than a quarter said that they had saw this happen often.

00:53:01:06 - 00:53:26:18

Sarah

And so the types of medicines that we're talking about being declined include those for things like blood pressure inhalers, pain relief, statins and other mental health orientated prescriptions. And as we've just been talking, when we don't prevent stuff, we have bigger costs later down the line. So monetizing and charging for products of services often means that people won't use them.

00:53:26:18 - 00:53:32:18

Sarah

And it might not even it might. It does disadvantage people that might need them the most.

00:53:32:20 - 00:53:54:18

Lou

Yeah, absolutely. And I think it's it's really telling that those prescriptions that are being declined all are the, you know, kind of to some extent the preventative, elements of health care. Right. and that is really, really, that's going to have a massive impacts, isn't it? I think, you know what I also picked up on what you were explaining.

00:53:54:18 - 00:54:18:16

Lou

There was that massive reduction in local authority budgets came along, you know, at the same time, slightly after this promise to devolve a massive amount of power to local authorities. And if we took all that budget away now, I'm not an expert in this, and I don't want to oversimplify it. And I'm sure there are people listening who can have a much more nuanced discussion about local authority budgets.

00:54:18:16 - 00:54:43:02

Lou

But I think this is a really interesting and quite obvious contradiction in terms when you start looking and looking at it in that way. But I do want to go back to this source of revenue aspect here, because on the one hand, like in some instances, yes, we've seen organizations diversify our pay closer attention to, you know, kind of customer service in order to either charge higher amounts or do different things.

00:54:43:07 - 00:55:07:07

Lou

But this particular aspect of encouraging other sources of revenue, particularly in the public sector, has had incredibly grim results. According to a study by the local government authority, 1 in 5 local authorities say that they will have to declare themselves insolvent in the next 15 months and at the time of recording this, six had already there may be more.

00:55:07:07 - 00:55:33:05

Lou

It's quite difficult to actually keep track of this so much so that the New Statesman has actually created a bankruptcy tracker to check in on how many local authorities are essentially going bankrupt. So their budgets were cuts. They were asked to fill a hole with investments in commercial developments that, you know, sometimes never happened. In some instances, they've invested in things that didn't actually exist.

00:55:33:05 - 00:56:01:03

Lou

There are many of those stories out there. And like I said, I'm not an expert in this. But, you know, one thing I think we can probably all agree on is that it's very difficult to make good long term strategic financial decisions when you are in a financial panic at that moment in time, and regardless of whether or not you're an individual or an organization, you know, investment takes time, patience, and really importantly, carefully careful thinking.

00:56:01:05 - 00:56:22:04

Lou

You do not make it big investment in a rush or in a panic. And without too much of a sweeping statement. Here is I know all of those situations of those different local authorities are different, and, you know, it's hard to apply this to, you know, kind of the private sector or central government or any other situation because they are all very different.

00:56:22:06 - 00:56:50:22

Lou

The real issue here, I think, around austerity service design, is that we're expecting essentially panicked organizations to make long term decisions. That is really, really difficult to do. and of course, we're going to end up making bad decisions in that kind of a situation, and the problem will exacerbate itself. So this is, I think, one of the most difficult double binds about austerity service design is that it really is a self-fulfilling prophecy.

00:56:50:22 - 00:56:57:12

Lou

You know, the the more panicked we are, the worse decisions we will make. You know, the more that will then create panic.

00:56:57:12 - 00:57:24:00

Sarah

Yeah. It feels like we're just put a lot of sticky plasters on all the problems that are a result of all the different tactics of austerity and strategies to services that we've discussed from, you know, making cuts on capital expenditure, reducing the scope of services, freezing pay, reducing staff, asking them to do more, creating new revenue sources. You know, going through this list, we are both nodding along.

00:57:24:00 - 00:57:44:04

Sarah

I know you can't see this as we're doing this, thinking of times when we've been asked to do that and from our training when we've heard people express it, that it's there. So Greece, as service designers, and I think the question that I'm left sitting here with is, if we have done all of this already, where will we be asked to go next?

00:57:44:06 - 00:58:07:09

Sarah

What will be the next step for service design? Greece? It kind of feels like the next thing is just like, automate it, stick in a chat. But that's become the next solution. But technology cost money and everything already feels quite broken. So with companies both public and private on the brink, will there be anything left for us to design?

00:58:07:11 - 00:58:11:01

Lou

I mean, I there is absolutely no way that I can answer that question.

00:58:11:03 - 00:58:12:21

Sarah

I might have got us a dead end before.

00:58:12:23 - 00:58:22:05

Lou

Know, but it's too soon, too soon. Because I think there's still things to say about this. I mean, of course, if you're listening and you're like, well, that's the end of the story, then you can choose to stop listening.

00:58:22:06 - 00:58:23:23

Sarah

Don't worry, there is hope coming.

00:58:24:00 - 00:58:26:05

Lou

There is hope coming at the end of this podcast.

00:58:26:07 - 00:58:52:11

Sarah

Thanks so much for listening to part one of austerity from the Dead Ends podcast, brought to you by the School of Kid Services. If you'd like to listen to part two, it's available now on our website. If you go to Good Services Dead Ends podcast, you'll find us there. We're also available on Spotify and Apple Podcasts and if you want to get in touch with us, just head on over to the website and come and say hello.

00:58:52:17 - 00:59:31:09

Sarah

We hope that part two is slightly less grim, and a little bit more hopeful about how we can start to maneuver our design in the right direction post austerity. See that in part two.

podcastdeadends

Sarah Drummond http://sarah-drummond.com/

Dead Ends: Austerity I

In our fifth episode of Dead Ends we've broken out into a two parter. In part one of episode five, we talk austerity, Big Society and the tactics of austerity service design.

Dead Ends: Austerity II

Dead Ends: Vernacular