A Scottish Approach to Public Services? James Mitchell Enlightened Nation: Perspectives on Social welfare Friday 28 th November 2014 University of Edinburgh, South Hall Pollock Halls

…there come seven years of great plenty throughout all the land of Egypt: And there shall arise after them seven years of famine; and all the plenty shall be forgotten in the land of Egypt; and the famine shall consume the land…Genesis 41:29

Challenges/Opportunities DEMOGRAPHIC Over the next 20 years demography alone could increase expenditure on health and social care by 70 per cent: 1,042,00 pensioners in ,315,000 pensioners by 2035 FINANCIAL ‘…a long hard financial winter, which will require very difficult choices to be made about priorities’ Auditor General June 2010 INSTITUTIONAL ‘For a small country, Scotland has a plethora of institutions, including 32 local authorities, 23 NHS bodies, 8 police forces, 20 universities, 43 colleges, and over 1000 other public bodies.’ Independent Budget Review report July CULTURE/MINDSETS ‘We have observed inconsistencies and tensions between national targets and local outcomes which have constrained local partners’ ability to work together. These can stop people and organisations identifying and working towards shared outcomes, keep them and their resources in silos, and miss opportunities to improve local outcomes and efficiency.’ Christie Report July 2011

A Scottish Approach to Public Services? Reforms must aim to empower individuals and communities receiving public services by involving them in the design and delivery of the services they use. Public service providers must be required to work much more closely in partnership, to integrate service provision and thus improve the outcomes they achieve. We must prioritise expenditure on public services which prevent negative outcomes from arising. And our whole system of public services – public, third and private sectors – must become more efficient by reducing duplication and sharing services wherever possible.

Scotland in Europe Inge Kaul’s six governance requirements  Averting risk of dual failure  Correcting fairness deficits  Strengthening externality management  Promoting issue-focus and result- orientation  Recognising and promoting synergies  Active acceptance of policy interdependence

Holistic change required

CHALLENGES DEMOGRAPHIC Over the next 20 years demography alone could increase expenditure on health and social care by 70 per cent: 1,042,00 pensioners in ,315,000 pensioners by 2035 FINANCIAL ‘…a long hard financial winter, which will require very difficult choices to be made about priorities’ Auditor General June 2010 INSTITUTIONAL ‘For a small country, Scotland has a plethora of institutions, including 32 local authorities, 23 NHS bodies, 8 police forces, 20 universities, 43 colleges, and over 1000 other public bodies.’ Independent Budget Review report July CULTURE/MINDSETS ‘We have observed inconsistencies and tensions between national targets and local outcomes which have constrained local partners’ ability to work together. These can stop people and organisations identifying and working towards shared outcomes, keep them and their resources in silos, and miss opportunities to improve local outcomes and efficiency.’ Christie Report July 2011

‘There are known knowns ; there are things we know that we know. There are known unknowns ; that is to say, there are things that we now know we don't know. But there are also unknown unknowns – there are things we do not know we don't know.’ Donald Rumsfeld, US Defense Secretary February 12, 2002 Fourth type: Unknown knowns : Matters which we intentionally refuse to acknowledge that we know. Slavoj Žižek, Psychoanalytic philosopher

James Mitchell Academy of Government University of Edinburgh