The need for quality in public service

I have commented before on the lamentable failure of parts of our public services to keep pace with demand, to recognise the big improvements in customer service elsewhere, and to tackle the high error rates they currently experience. I have been visiting some factories recently and seeing just how far the private sector is getting with high quality and reliability. Manufacturing is well advanced with total quality systems, as it has to be to stay in business. Firms use the Kanban techniques (cards or other devices triggering action when needed) first developed by Toyota in the 1950s to control inventory and work flows through the factory. They use Poka Yoke techniques, also pioneered by Toyota to prevent mistakes, by “idiot proofing” processes. Many now use a variant of Motorola’s 6 Sigma system pioneered in the 1980s for total quality management, training leaders to collect data, and manage continuous improvement. The only acceptable level of defective products leaving a factory is zero. Keen inspection and checking regimes aim to remove any failures or wrongly made parts. In order to cut waste and improve efficiency, the private sector is aiming for well under 1000 defective parts per million in what it does, and seeking to eliminate almost any that are not properly made first time. It is aiming to find them all and understand why they failed before any reach the customer.

Meanwhile the public sector stumbles on as if none of this had happened elsewhere. We accept large numbers of people contracting serious diseases in NHS hospitals, we put up with very high error rates in tax calculation and benefit assessments and allow poor performance in a whole variety of areas. Error rates can easily exceed 10,000 per million and in some cases like secondary infections in hospitals might reach much higher levels! In a well run supermarket queues are monitored and more tills opened up if the time you are waiting gets too long. If you hit Immigration and Customs at the wrong time of day you end up in a huge long queue which no one in government seems to care about. If you ring a private sector phone line there should be rapid response, with call monitoring, to make sure your call is captured and answered promptly. It is true that some of the less competitive large companies have poor phone in arrangements for some of their services, but a competitive business has to have a phone system which works well and is monitored to ensure speedy response. Compare that with the problems my constituents and others experience trying to get through to Benefit offices or the GP booking line, where delays can be huge and redialling on a regular basis a necessity if you to have any chance of getting through.

The defence of the public sector is that they are doing more difficult things than the private sector, so the same standards and techniques cannot apply. I do not accept that defence. The quality systems developed in the first instance for smart manufacturing could apply similarly to the public sector. Keeping the place clean is one of the first principles of good factory management – so it should be of a good hospital management. Modern factories in some industries have to be run to clean room standard, where tiny particles of dust and fluid have to be kept out of contact with the products. Ensuring a proper workflow, so that everything is done to the time required by the client and customer should apply to public sector customers as well. After billions of spending on IT the NHS still does not have a reliable and comprehensive system for ensuring smooth work flow to all hospitals in a way which guarantees speedy treatment to all patients.

There is nothing intrinsically more difficult about planning a benefit system than running an insurance company, nothing inherently more difficult about running a public hospital than running a private one, and nothing that more difficult in running an Immigration system than running an employment agency. The public sector needs to wake up, and wake up quickly, to how much better the best of the private sector has become., They need to understand the whole approach. Concentration on good work planning, managing quality and good housekeeping, are complemented by believing in the people in the business, giving them scope to be responsible for their own work and decisions about how it is done, and allowing people opportunity to develop with career progression and offers of suitable training. The best of the private sector is not afraid to admit mistakes and seek to remedy them. The best know they are not good enough and are striving to be better. The complacent will fail. We are in urgent need of some of the magic of total quality and full involvement of all staff in continuous improvement in public service. We need the leaders in public service who can do this hands on day by day crucial work, instead of writing more memos, demanding more resources and employing more management consultants.

14 Comments

  1. londonerr
    May 31, 2008

    What would a New Labour govt know of such things, John when the nearest they probably got to industry is to support a picket line in their student days? Plus to add insult to injury they have adjusted salaries upward in the public sector without achieving any of these modern necessary management controls and systems. It is a hard culture to change made harder by a no-firing culture for poor performance leading to an invincibility of sub standard and mediocre performers.

  2. Kit
    May 31, 2008

    Public sector fails because it lives in an environment devoid of competition. It is greed and the fear of failure that motivates people in the private sector. No number of "total quality" schemes or "leaders" will solve the public sectors problems. The only solution is to get the government out of the provision of services.

    I'm sorry to be cruel but this piece sounds as if it was written by NuLabour think tank wonk.

    Reply: Far from it – I have proposed a number of schemes to introduce choice and competition in a wide range of former and present services – e.g. my plan to make every school an indepednent school, which has been an influence on the good proposals n ow coming from Michael Gove.

  3. Matthew Reynolds
    May 31, 2008

    The basic gist of your argument as I see it John is profit motive is a great way to deliver for a service user rather than neo-Soviet top down bureacracy . When it snows the schools run by LEA's close down while the shops that need peoples custom where the consumer is King more often than not stay open . In retail world we do not have the cushy pensions & long holidays not to mention the vast pay rises as doled out to those on the payroll of Gordon Brown's client state . We have to work & deliver what our service user wants while faceless bureacrats will be safe in their jobs even if they fail . In our railways , schools & hospitals you need to allow providers to make a profit or there is no incentive for the innovation needed to sort things out . In health & education you need decetralisation so that local solutions can be tailored to local needs . In transport more privately funded roads are needed to cut congestion while not adding to already high government spending . Why can we not have public-private railways as in many EU states that are superb rather than the rubbish that we have with Not Work Rail in the UK ? If you had locally elected police chiefs then they would need our support to keep their pay , perks , pensions etc – thus giving them a massive incentive to slash red tape , give politically correct social engineering a miss while getting the police onto the beat to use their powers to fight crime . Planning responsiblities need decentralising as much as possible so local councils can use the reciepts from council house sales to fund the necessary level of social housing in a way that local people . By ending QUANGO's & the ever pointless Local Government Ministry you could have really powerful local government that people would take a keen interest in because they would feel that local elections mattered if they thought that their councillors had the power to improve things . Would it not be nice if LEA's & Health Authorities just doled out vouchers to empower service users to get the best deal possible rather than just being vast , expensive bureacracies that stand in the way of progress while supplying non jobs to Labour supporters ? The scope to save money & devolve power is enormous – if done properly it could make our public services better by prudent usage of market forces and / or giving voters more power ( i.e. vouchers for schools or elected police chiefs ). My advice to David Cameron is don't let Nick Clegg occupy this territory first ! The trend in the UK is in the direction that I suggest – Gordon Brown will never ' get it ! ' Come on Tories what are you waiting for ? Why not capitalise on the anti-big government reaction going on ?

  4. William B.
    June 1, 2008

    There are, it seems to me, two aspects to the efficiency question.

    First, the system of operation must be one which is capable of being efficient. And, secondly, the people working within it must be managed in a way that brings out the best they can offer.

    I fear that in much of the public sector there are far too many examples of one or both sides of the equation being deficient.

    Too often the size of the administrative unit causes both the system to be inefficient and the staff to feel like insignificant cogs in a massive wheel with no incentive to try to improve the way their work is done.

    These problems can arise in the private sector too, but good management identifies and addresses them. But there is an additional factor in the public sector which is the stupefying "principle" that if a change is to be made in one place it must be made everywhere so that "equality of provision" exists.

    This is, of course, a nonsensical "principle" because external forces will always mean that identical services cannot be provided everywhere, but it is nonetheless a guiding light to those who believe that provision of services by the state is an end in itself.

    Never let it be forgotten that public services are delivered by people. Some are just time-servers but, I would suggest, the vast majority are dedicated to the work they do and want to do it well. If they have an idea for an improvement they want to be listened to and to know that their suggestion will be heard by open minds. Not only will it lead to good ideas being implemented cheaply and quickly (and then adopted by others who hear about it and think it will work for them) but the whole atmosphere in which people work will be improved (itself a significant contributor to efficiency).

    Keep things as local as possible and keep the staff incentivised, it works for business and it can work for the public sector too.

  5. Adrian Peirson
    June 1, 2008

    £100 Billion wasted on Quangos and non Jobs.
    http://tpa.typepad.com/bettergovernment/files/080

  6. Adrian Peirson
    June 1, 2008

    Add to this the Net £30 Billion we contribute to the Corrupt EU that cannot account for 80% of its Budget and hasn't had it's accounts sighed off for 13 yrs, When you consider our troops sent off to fight in Two wars on a Peactime budget I really do not understand why General Dannat does not simply Kick the Door in.
    http://www.livevideo.com/video/rclark23/1E8F485B9

  7. AlanofEngland
    June 1, 2008

    "They use Poka Yoke techniques, also pioneered by Toyota to prevent mistakes, by “idiot proofing” processes." Now this has given me an idea. Could we see Poka Yoke techniques used as part of MP selection processes? Just imagine knowing that prospective candidates have been Poka Yoked!!

  8. Derek
    June 1, 2008

    I generally agree with advocating commercial best practice to the public sector. However, all too often the public sector seems to use this as an opportunity to operate a 'Wendy House' version of business. Merrily they appoint CEO's and plaster logos and mission statements over everything whilst rarely delivering any improvement in efficiency.

    Measuring the efficiency improvements is part of the problem as well. It always reminds me a bit of quantum theory. When you try and look at something and measure it, ie with excessive targets (that become an end in themselves) and box ticking bureaucracy, the perfomance monitoring process itself has a, often deleterious, effect on the outcome.

  9. adam
    June 1, 2008

    i think the problem is the culture among politicians at the top.
    What is needed is real leadership and management skills. For the last ten years we have had the self styled progressives who are more interested in grand visions and legacies and destroying what already exists and replacing it with something new, just for the sake of it.

    That is not really what the job is about. Managing what already exists properly seems to be considered too dull.

  10. adam
    June 1, 2008

    Privatising things creates its own problems which politicians choose to ignore.
    Railway Stations are clearly not private property, they are public places. However station employees are now forced to accost and threaten people who dare to film or use photography without permission on "private property."

    Perhaps the much loved consultants can be brought in to teach techniques.
    Staff morale and efficiency is about more than
    just private ownership.

  11. mikestallard
    June 1, 2008

    William B has, I reckon, got to the heart of the difference between public and private provision. "Never let it be forgotten that public services are delivered by people. Some are just time-servers but, I would suggest, the vast majority are dedicated to the work they do and want to do it well. "
    The trouble with Public Service is that people are seen as units of production.
    My own thinggy is education: Thus we need "27 teachers" with "graduate Status." Lunch times, meanwhile are "manned" by "dinner ladies". Schools are measured by their rolls.
    As any fule no, teachers can be very good or very bad indeed. Motivation is all in the learning process. Adolescents, especially, need a LOT of tlc. But the state is not bothered.
    Look at all these statements about how much money has been pumped into the system and how many more teachers we now have and how many more examination successes (of course, if the examinations themselves have been devalued).
    One of the wisest things you said was to liberate schools from the dead hand by freeing them up to be what they are – places where learning takes place under dedicated teachers and with motivated pupils.

  12. steve-roberts
    June 2, 2008

    Well, said John. The private sector has been steadily improving, by using better techniques and proving them in the marketplace, which will reliably support better, quicker, cheaper and reject the rest. Government services, not exposed to this discipline, languish decades behind. We have to recognise that today's government does far too much. Stripped back to the few necessary functions, it would have a better chance to do them tolerably well, especially if it could genuinely adopt best practice (including statistical process control, theory of constraints, to add to your list) instead of the cargo-cult parody we endure today.

  13. NigelC
    June 2, 2008

    As a district councillor I am always disappointed when I ask how officers are going to tackle necessary process improvements. They have no methodology or structured approach. They fail to adopt approaches used in the private sector for decades. A fundamental culture change is required
    Why is it that councils can contract out waste collection, leisure provision, parks maintenance and most delivery services at lower cost than in house delivery? The inefficiencies in the public sector have to be tackled one way or another

    Reply: Yes, they do. Please work with your colleagues to challenge the complacency of officers on your Council.

  14. Sam Pepson
    June 3, 2008

    There's a lot of good stuff, both in what you've written and in the responses. But I'm surprised no-one has mentioned the excellent book by John Seddon that was published a couple of months ago, Systems Thinking in the Public Sector. This Daily Telegraph review by Philip Johnston on 23 March gives the flavour. http://www.telegraph.co.uk/opinion/main.jhtml?xml

    It's only by adopting radically different thinking about the delivery of public services that serious savings and improvements can be made. I'd love to hear that David Cameron has a team considering and developing Seddon's ideas. They will be difficult enough to implement anyway anyway, given the prevailing culture in the public service unions and civil service and media frenzy over any "post-code lottery" . But if he waits till he gets to Downing Street there's just no way it will ever happen.

    People can always argue that radical ideas might scare the voters – so it's obviously tempting to put them in the "too difficult" tray. But if the Conservatives are serious about making real changes (as I still hope, despite my scepticism), they really need to be working on ideas like this – even if they don't want to say so yet.

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