More for Less!

The Rt Hon David Gauke MP

Friday 17th February: As Britain’s public services face rising demand, The Rt Hon David Gauke MP*, the Chief Secretary to the Treasury, explains in Politeia’s Winter Address that improving productivity and efficiency are part of a wider strategy for success in the 21st Century.

So often, political debate on [the future of Government services] is reduced to sheer weight of numbers. Are we spending more than we did before? Are we spending more than the opposition are saying they would spend? Are we spending more than other countries are spending?

The answers to any of these questions will only take you so far. The question we should also ask is not just how much, but how well we are spending that money. It is in that spirit I am leading a Government-wide drive to make our public services more productive—quite simply to get more for less. That might sound idealistic. Even simplistic. But unless you think Government services are already running like clockwork, and offering our taxpayers perfect value, I think you will agree that there is plenty of scope for us to improve how we operate. And I am not someone who subscribes to the view that the only way you can do so, is to throw money at the problems. That is not how businesses operate, and it should not be how governments operate either.
Instead, we should make a relentless effort to become ever smarter, ever more productive, and ever more efficient in the future. That is why I am working with all my Cabinet colleagues to look at how we do so – and we have set ourselves a target of saving the taxpayer £3.5 billion by the end of this Parliament. It can certainly be done.

Just look at the gains to be made in our Health Service alone – the Carter review has identified that by working more efficiently we can save £5 billion pounds a year by 2021. A recent Radio 4 documentary highlighted how we are raising productivity in the NHS. It gave a good insight into just how much room for improvement there is – for both the patient, and the taxpayer. One example came courtesy of orthopaedic surgeon, Professor Tim Briggs, who is also the National Director for Clinical Quality and Efficiency in NHS Improvements. Just looking at hip and knee replacements, he found standards varied wildly across the NHS – whether that was in how much any given hospital spent buying the joint replacements, the different rates of infection or the varying patient outcomes and costs of mistakes and litigation. By making changes to share best practice, whether in treatment or procurement, he showed we could not only raise care, but reduce costs – freeing up of millions of pounds to be used elsewhere. In fact, he reckoned the money saved just from getting infection rates down to the level of the best performers, would be enough to pay for around 50-60,000 more such knee or hip operations – for the same amount of money. That is a staggering figure and I am pleased to say he is now looking at what we can do in 30 other specialities, including diabetes and heart surgery.

This is exactly the kind of approach we can and should be taking across our public sector as a whole. Improving productivity and efficiency must become embedded in the culture of our public services if we are to meet rising expectations and cope with the long-term fiscal pressures. And that is why I am inviting experts from across our society – from within the public sector, from academia, 3rd sector organisations, and businesses – to look at how we can reform the ways in which we work, put our workforce to best use and invest in the technology and systems that will raise our productivity to another level.

*The Rt Hon David Gauke MP is Chief Secretary to the Treasury and this extract is from his Winter Address to Politeia.