Public service reshuffles risk obstructing much-needed change

John FitzGerald: Reorganisation can be successful but requires a targeted plan

Former minister for health Mary Harney: showed real leadership in reorganisation of cancer services, in spite of significant local opposition. Photograph: James Horan/Collins

Former minister for health Mary Harney: showed real leadership in reorganisation of cancer services, in spite of significant local opposition. Photograph: James Horan/Collins

 

The transfer of responsibility for climate change in 2016 from the Department of the Environment and Local Government to the former department of communications had unintended consequences. While there were reasonable theoretical arguments for making this move, the necessary reorganisation of departments seriously delayed the development of a progressive climate change policy as the new department tried to build its expertise in the area.

In addition to the loss of skills and expertise, the experience of decades of chopping and changing departmental titles and functions is that the act of reorganisation itself absorbs much of the attention of those making the change, leaving little time or energy for normal business.

The establishment of the HSE, and its successive internal reorganisation into different regional units is a prime example. Eight health boards, briefly 11, were abolished without a clear plan to replace them.

The HSE first set up four regional divisions, then broke up into 32 local health offices, then into the present nine community health organisations, and is now about to be reshuffled again into six regional units.

It’s not just the public sector has problems with major organisational change – just look at the bizarre break-up of the proposed Nissan-Renault merger.

To be successful, a major reorganisation needs to have a clear rationale and objectives, be well-planned and executed with leadership and skill.

All too often, reorganisation has been seen as a magic bullet to deal with a policy problem, and then executed without a proper implementation plan. Even if reorganisation is the right solution, change management is a delicate art. In general, ministers would do well to steer clear of taking on such changes and concentrate on providing policy direction.

Ministerial leadership

One example of successful change, backed by strong ministerial leadership, was the reorganisation of cancer services into eight regional centres of excellence. Given strong evidence that cancer centres with a critical mass of patients and a range and depth of expertise saved lives, Mary Harney showed real leadership in driving this change through, in spite of significant local opposition to losing a cancer service down the road. The result: more people remain alive today.

The lesson that centralised, high-volume services with skilled and expert staff in fewer centres yields better outcomes holds true across many other health disciplines. Given our propensity to elect local hospital candidates, and to dislodge those who favour reform, it will take real political courage for the incoming government to apply the lessons of the 2007 cancer strategy to a wide range of other clinical areas. But there could be real payoffs in reducing deaths and long-term incapacity.

Tackling health, housing and climate change will absorb enough energy without getting sidetracked

Political ideas, values and choices matter. We expect government and individual ministers to set strategic direction. If we don’t like what they do, or the policies they pursue, we can replace them at the next election.

A real strength of our system is that we have an impartial public service to advise ministers on broad policy options, and to work on the details of policy and its implementation. Successive external bodies, from the OECD to the troika, have rated the quality of our public service as high.

Public good

While our public service has the task of implementing government policy, they also have a duty to alert ministers where they perceive that policy may risk contravening the public good. A clear separation of political and Civil Service roles is important. Ministers should leave the management of the department and the administration of schemes to the professional civil servants. Civil servants should not get so close to ministers that they risk losing objectivity and impartiality.

The “cash for ash” disaster in the North shows the danger of civil servants getting too close to ministers or their special advisers. In Northern Ireland, the continued churn of civil servants from job to job contributed to the debacle. Across the system, there was also a common view that funds from the mainland should be maximised, and a neglect of the obligation to ensure value for the public money involved.

Dominic Cummings, having delivered Brexit, is now turning his attention to disrupting the UK civil service in ways which could make it more subservient to temporary political needs. Fortunately, in this election there is no suggestion of plans for a similar assault on this important bulwark of our democratic institutions. Neither are candidates mooting any major administrative reorganisations.

Tackling health, housing and climate change will absorb enough energies of the incoming government, without getting side-tracked into further reshuffling.

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