Public Service Paradox: The Final Report of The Commission On Public Services in The North East

PublicServiceParadox
ThefinalreportoftheCommissiononPublicSector
ReformintheNorthEast
www.ippr.org/north
PublicServiceParadox
ThefinalreportoftheCommissiononPublicSector
ReformintheNorthEast
Contents
Aboutipprnorth ................................................................................................................... 2
CommissiononPublicSectorReformintheNorthEast ...................................................... 3
Acknowledgements ............................................................................................................... 4
Foreword................................................................................................................................ 5
Executivesummary................................................................................................................ 6
1.Introduction:TheNorthEastpublicservicesparadox ...................................................... 8
2.HealthintheNorthEast................................................................................................. 10
3.EducationintheNorthEast ........................................................................................... 14
4.CriminaljusticeintheNorthEast ................................................................................... 19
5.WelfaretoworkintheNorthEast .................................................................................. 21
6.TheeconomicandsocialcontextintheNorthEast ....................................................... 25
7.Thecurrentpublicservicereformagenda....................................................................... 32
8.TacklingtheNorthEastparadox ..................................................................................... 34
References ........................................................................................................................... 40
2 PublicServiceParadox| Aboutipprnorth
Aboutipprnorth
ipprnorth,theNewcastle-basedofficeoftheInstituteforPublicPolicyResearch,
producesfar-reachingpolicyideas,stimulatingsolutionsthatworknationallyaswellas
locally.Theseareshapedfromourresearch,whichspansthenortherneconomicagenda,
publicservicesanddevolution,aswellasastrongdemocraticengagementstrandwhich
involvesawiderangeofaudiencesinpoliticaldebates.
RegisteredCharityNo.800065
ThisreportwasfirstpublishedinNovember2009.
©ippr2009
3
CommissiononPublicServiceReform
intheNorthEast
ipprestablishedaCommissiononPublicServiceReformintheNorthEast,basedatippr
NorthinNewcastleuponTyne,in2007.TheCommissionwassetuptolookatthepolicy
challengesfacedinthereformandrenewalofpublicservicesembarkeduponby
successiveLabourgovernmentswithinthecontextofthedistinctiveneedsoftheregion.
TheCommissionacknowledgesthatmanyofthechallengesidentifiedinthisreport
couldwellapplytoanyregion,notjusttheNorthEast.Thatsaid,theNorthEast,with
itsuniquequalitiesandproblems,isthesubjectofthisreport,andourprimaryconcern
throughoutisthatregion’sapproachtodealingwiththeparadoxidentified.
TheCommissioners
TheindependentCommissiononPublicSectorReformintheNorthEastismadeupof
expertsfromallareasofinvolvementinthepublicservices.ItischairedbySirGeorge
RussellCBE,DeputyChairofITV.Itsfullmembershipisasfollows:
• SirGeorgeRussellCBE(Chair),DeputyChair,ITVplc
• DavidAlbury,independentorganisationalandpolicyconsultant,andformerPrincipal
Adviser,PrimeMinister’sStrategyUnit
• JoeDocherty,ipprnorthadvisoryboardmember,HomeGroup
• FionaEllis,formerDirectoroftheNorthernRockFoundation(until31March2009)
• MargaretFayOBE,Chairman,OneNorthEast
• RogerKelly,ChiefExecutive,GatesheadCouncil
• SeanPrice,ChiefConstable,ClevelandPolice
• BaronessJoyceQuin,formerregionalMPandMEP
• JamesRamsbotham,ChiefExecutive,NorthEastChamberofCommerce
• MarcusRobinson,Partner,PricewaterhouseCoopersLLPandipprnorthadvisoryboard
member
• JuliaUnwinCBE,Director,JosephRowntreeFoundation
• ProfessorGeraldWistow,VisitingProfessor,SchoolofAppliedSocialSciences,
UniversityofDurham
Allcommissionersareservinginapersonalcapacityandbringindividualexpertise.They
donotrepresenttheinterestsofanyorganisation.ipprnorthprovidestheSecretariatto
theCommission.
AftermuchlivelydebatetheCommissionreachedaconsensusaboutthemainthemes
identifiedinthisreport,butdonotallagreeonthedetailofeverypoint.
Previousoutputs
TheCommissionbeganwithareviewofsomeofthemainissuesandtrendsinpublic
servicesandpublicsectorreformintheNorthEastinrecentyears.Thisresultedinthe
publicationofAnAuditofPublicSectorReformintheNorthEast byJaneMidgleyand
SueStirling,September2007– availabletodownloadforfreefrom
www.ippr.org.uk/ipprnorth/publicationsandreports/publication.asp?id=556
AfurtherreportwaspublishedinJanuary2009:ProspectsforMoreLocal,More
PersonalisedPublicServices:ANorthEastperspective,byDuncanHiscockandSue
Stirling,availabletodownloadfromwww.ippr.org/ipprnorth/publicationsandreports/
publication.asp?id=642
4 PublicServiceParadox| Acknowledgements
Acknowledgements
TheworkoftheCommissionismadepossiblethankstofundingfromtheNorthernRock
Foundation,Humana,OneNorthEast,theJosephRowntreeFoundationand
NorthumbrianWater.
ipprnorthwouldalsoliketothankTonyDolphin,ProfessorDannyDorling,Sophy
Hallam,RichardHannah,LisaHarker,DuncanHiscock,MichaelJohnson,TessLanning,
GuyLodge,JaneMidgley,RickMuir,DanielNeilon,JohnPritchard,JoSandford,Sue
StirlingandBethanThomasfortheircontributionstothisreport.
KarlHallamwastheleadauthoronthisreport.GeorginaKyriacouatippreditedand
designedthereport.
Extensivedesktopresearchinvolvedareviewofcurrentrelevantliterature,whichiscited
asappropriateinthisreport.Dataanalysishasbeenaugmentedbytheuseofinnovative
mappingtechniquestohighlighttheparticularimportancetotheNorthEastofthe
inequalitiesnotonlywithintheregionbutbetweentheNorthEastandotherregions.
ThroughouttheprocesstherehavebeenregularmeetingsoftheCommissionitselfand
thisreportdrawsontheviewsandparticularexpertiseofindividualcommissioners.
5
Foreword
ThisreportisabouttheNorthEast.Theregionisveryclosetomyheart,asIwas
broughtupinGateshead,sowhenIwasaskedbyipprNorthtochairtheCommissionI
wasparticularlypleasedtoaccept.Itisaregionwithbothuniquequalitiesandproblems,
andourprimaryconcernthroughoutistheNorthEast’sapproachtodealingwiththe
challengeswehaveidentified.Thatsaid,anumberoftheissueswehavedealtwith
couldwellapplytootherregions,notjusttheNorthEast,andwethereforehopeitis
usefulthroughouttheUK.
Whenwesetout,beforethecreditcrunch,recessionandimpendingpublicspending
“moreflexibilityto
cuts,weknewourremitwasverybroadandweneverintendedtomakedetailed respondtolocal
recommendationsforindividualpublicservices.Whatwehavetriedtodoisidentifythe prioritiesandless
keychallengestheregionanditspublicsectorfaces,makesomegeneral
recommendationsonhowtheymightbeovercomeand,crucially,indicatewheremore
controlfromthe
detailedworkneedscarryingout. centrewouldlead
Theincreasedinvestmentinthepublicsectoroverthelastdecadehasdefinitelymadea tobetter,more
positiveimpactinthefourareaswelookedat:health,education,criminaljusticeand efficientservices”
welfare.Itisourviewthattheirimpactonlong-standingregionalissueswouldbe
greateriftherewasmoreofafocusonpreventionandengagingwithpeopleand
communities.Wealsofeelthatmoreflexibilitytorespondtolocalprioritiesandless
controlfromthecentrewouldleadtobetter,moreefficientservices.
Thereare,however,inourviewtwobigchallengestobeovercome– andthepublic
sectorhasabigroletoplayinthemboth– iftheNorthEastistothrive.Thefirstisto
maketheeconomystrongerandthesecondistodealwiththeconceptofwhoisin
chargeandaccountable.Weexplaininthisreportwhythesearecrucialissuesanddo
notprovideanswersonhowtotacklethem,butcallontheregionitselftoprioritisethe
formulationofideasforhowtodoso,howeverdifficultachallengeitseems.Thatiskey
tounlockingthepotentialthisregionundoubtedlypossesses.
IthankipprnorthandfellowCommissionersfortheirworkandbelievetogetherwehave
madeasignificantandtimelycontribution.
SirGeorgeRussellCBE
ChairoftheipprnorthCommissiononPublicServiceReformintheNorthEast
6 PublicServiceParadox| Executivesummary
Executivesummary
ipprestablishedtheCommissiononPublicServiceReformintheNorthEast,basedat
ipprnorthinNewcastle,in2007.TheCommissioncametogethertolookatthepolicy
challengesemergingfromthereformandrenewalofpublicservicessince1997,
particularlyinrelationtothedistinctiveneedsoftheNorthEastregion.
TheCommissionhasfoundthattherecordlevelsofinvestmentintheNorthEast’s
publicsectorhaveproduced‘high-performing’serviceswhichhavemitigatedsomeof
theworsteffectsofthecurrentrecession.However,such‘highperformance’,as
measuredbythevariousnationalauditingbodies,hashadlimitedimpactonclosingthe
gapinrelativeoutcomes.Whetherintermsoflifeexpectancy,entrancetofurther
education,orunemployment,theNorthEaststilllagsbehindotherregionsandthe
disparitiesbetweendifferentpartsoftheNorthEastremain.
Throughanalysisofthisapparentparadoxofhighperformanceandpooroutcomes,the
Commissionhasidentifiedthreeinterlinkedthemesunderwhichthepublicsectorand
theregionmustovercomechallenges,eachwithakeyrecommendation.
Theme1–Thebestservices
ThepublicsectorintheNorthEasthasbeenverygoodatdoingwhatcentral
governmenthasaskedittodo,butthishasnotnecessarilyallowedtheregion’sservices
enoughspacetotargetlocalpriorities.Thesectorcouldbesaidtobe hittingtargets,but
missingthepoint.
Thechallengeistoprovidethebestperformingpublicservicesthat:
•Aremeasuredbytheireffectonoutcomes
•Focusonpreventionoflong-standingproblemsintheNorthEast
•Respondtotheneedsofthepeopleoftheregion
•Engagelocalpeopleandcommunitiesandworkwiththemtosolveproblems
•Showabetterunderstandingofhowdifferentpeopleandcommunitiesmightmake
changesintheirbehaviourandhowservicesmightsupportsuchchange
•Areopentonewwaysofdoingthingsthroughandbeyondcutsinpublicsector
spending.
KeyRecommendation1:
ThatthepublicsectorintheNorthEastisgrantedgreaterfreedom,withina
frameworkofstrongeruseraccountability,toimproveitsownperformancewithmore
ofafocusonlonger-termoutcomesthanshort-termtargets.
Theme2–Accountabilityandfunding
ThepublicsectorintheNorthEasthasbeenverygoodatdeliveringonthewiderange
ofresponsibilitiesgivenitbycentralgovernment,buthaslimitedpowerstochangewhat
itdoestosuittheregion’sneeds.Thesectorcouldbesaidtohavelotsofresponsibilities,
butnotenoughrights.
Thechallengeforthepublicsectoristobemoreflexibleandresponsiveandto:
•LeadonthedevelopmentanewclearvisionforthefutureoftheNorthEast
•Haveleadershipthatisvisible,accessible,accountableandwiththepowertomake
changesneededtoachievethevision
7
•Increasetheproportionofregionalexpenditureraisedlocally,gainmorecontrolover
localpublicspendingandmovetooutcome-basedbudgeting.
•Bemoreproactive,openandinnovativeaboutovercomingrealandperceivedbarriers
tomakingtheregionsucceed.
•Beshapedbyandlinkedtolocalneedandopportunities.
KeyRecommendation2:
ThatthepublicsectorintheNorthEasthasgreaterfreedomoverpublicfinancesto
addresslocalneedsandprioritiesandtostrengthenanddeveloplocalaccountability.
Theme3–Theeconomy
HoweverwellthepublicsectorperformsintheNorthEastitcanonlydosomuchforthe
regionwheninrelativetermstheeconomyisweak.Despitesignificantimprovementsin
theregionaleconomytherearetoofewjobs;wagesaretoolowandthereissignificant
economicandsocialdisadvantage.Thechallengeforthepublicsectoristoensureits
activitycontributestowardscreatingajustandsustainableeconomyby:
•Creatingtheconditionsforincreasedemploymentandmoreequaleconomic
participation
•Creatingamorediverseeconomywithstrongerprivateandthirdsectors
•Providingservicesthatreducemultipledeprivationandinequalityinoutcomes
•Providingservicesthataddressthecausesofmultipledeprivation
•Promotingenterpriseandcontinuingtoattractinvestmentandemployerstothe
region.
KeyRecommendation3:
ThatthepublicsectorintheNorthEastshouldextenditsworkwiththethirdand
privatesectorstodevelopinnovativeapproachestoservicedeliverythatpromote
economicdevelopmentfocusedontacklingregionaldisparities,respondingtothe
recessionandpreparingforsustainablerecovery.
8 PublicServiceParadox| Introduction:TheNorthEastpublicservicesparadox
1.Introduction:TheNorthEastpublic
servicesparadox
After12yearsofinvestment,reformandimprovementinpublicservices,theNorthEast
stilllagsbehindotherEnglishregionsonseveralimportantmeasuresofsocial
disadvantage.Whiletheperformanceofpublicservicesshowssignificantimprovement,
thegapinkeyoutcomemeasurementssuchaslifeexpectancy,weeklyhousehold
incomeandeducationalattainmentbetweentheregionandtherestofEnglandhasnot
narrowed.Thereisanapparentparadoxwhereservicesaregood,outcomespoor.
TheperformanceofpublicservicesintheNorthEast–schoolsandcolleges,hospitals
andGPs,police,welfareproviders–hascomealongwayinthelastdecade.Thereisno
doubtthatthingshavegotmuchbetter,evenifthecurrenteconomiccrisishasremoved
someoftheshine.Positivetrendshavebeenvisibleinmanykeyoutcomesthatare
centraltoourchancesinlife,suchaslifeexpectancy,examresultsandfearofcrime.
Otheraspectshavealsoimproved.Hugeinvestmenthasledtothebuildingor
renovationofmanyschoolsandhospitals,andmuchhasbeendonetoaddresshigh-
profileconcernssuchashospitalwaitinglistsandclasssizes.
Yetforallthepositivetrendsthatcanbeidentified,whencomparisonsaremade
betweentheNorthEastandtherestofEnglandthepicturelookslessrosy.Acrossthe
publicservices,outcomesinmanyareasremainwellbelowtheEnglishaverage,and
oftenthegaphasnotnarrowedsignificantly.Furthermore,inequalitiesbetweendifferent
partsoftheNorthEastarestarkandforcertainoutcomesthegapisgrowing.Andthere
wouldappeartobeanumberofkeyissues–attainmentinEnglishandmaths,teenage
pregnancy,probation,forexample–whichareprovingparticularlyintractable.
Inmanyrespects,regionalinequalitiescanbeseenasafunctionofaregionaleconomy
thathassufferedseveraldecadesofdeclineandrestructuring.However,pooroutcomes
cannotsimplybeattributedtopoorinstitutionsorbeblamedonalackofinvestment.
Overthelastdecade,publicservicesintheNorthEasthaveconsistentlybenefitedfrom
above-averagespendingincreases.
Table1.1(p9)showscentralgovernmentspendingperperson(totalidentifiable
expenditureperhead)ineachEnglishregionduring2003–4and2007–8(thelastyear
forwhichactualfiguresareavailable).Inbothsetsofyearstheamountspentperhead
intheNorthEastwaswellabovetheEnglishaverageexpenditureperheadandbehind
onlyLondonamongtheEnglishregions.Thisfedthroughintothenumbersofpublic
sectorstaff:theNorthEastexperiencedthehighestincreasesintermsofstaffnumbers
relativetopopulationnumbers,forexampleinpolicenumberstoresidentpopulation
andpupil-to-teacherratios(HMTreasury2009).
Spendingcutsinthecomingyearsareinevitableandcouldthreatentheprogressthat
hasbeenmade.ArecentreportfromtheNationalEndowmentforScience,Technology
andtheArts(NESTA)suggeststhat‘thepublicserviceswerequirewillhavetodeliver
significantlybetterperformanceatsignificantlylowercost’(HarrisandAlbury2009:4).
Itisinthiscontextthatwenowexaminetheparadoxmorecloselybylookingatfourkey
areasofthepublicsectorintheNorthEast–health,education,criminaljusticeand
welfare-to-work.Foreachwebrieflyconsiderthechangesininvestment,performance
andkeyoutcomes.Wewillthengoontoconsiderthebroaderregionalsocialand
economiccontext.
First,anoteonmethodology.TheCommissionhasusedarangeofmethodstocollect,
analyseandreviewevidence.Thefirsttaskwastoestablishastartingpointandrecord
thechangesthatweremadeinourchosenfourkeyareasofthepublicservicesoverthe
firstdecadeoftheLabourgovernment.Thisledtotheproductionofipprnorth’sreport
AnauditofpublicsectorreformintheNorthEast (MidgleyandStirling2007).
9
Table1.1:UKidentifiableexpenditureonpublicorderandsafetybycountryand
region,perhead,2003–04to2007–08
Region 2003/04 Region 2007/08
(£perhead) (£perhead)
NorthEast 422 NorthEast 512
NorthWest 435 NorthWest 513
YorksandHumber 380 YorkandHumber 457
EastMidlands 333 EastMidlands 384
WestMidlands 367 WestMidlands 446
East 293 East 360
London 696 London 786
SouthEast 331 SouthEast 369
SouthWest 312 SouthWest 361
England 407 England 474
Scotland 361 Scotland 436
Wales 400 Wales 458
NorthernIreland 693 NorthernIreland 739
UKidentifiable 411 UKidentifiable 478
expenditure expenditure
Source:HMTreasury2009
TheCommissionwasdeterminedtocollectandrepresenttheviewsofallpartieswithan
interestinpublicservicereformintheNorthEast.Itannouncedanopencallfor
evidencefrompeoplewhousepublicservices,publicserviceprovidersfromallsectors,
communityorganisationsandresearchandadvocacyorganisationsintheregion.Expert
roundtablesinthefieldsofhealth,educationandwelfarereformwereheldandfurther
interviewswereconductedwithkeystakeholdersintheregion.Someoftheexamples
andintelligencegatheredthroughthesemethodsareinterspersedthroughoutthis
report.
10 PublicServiceParadox| HealthintheNorthEast
2.HealthintheNorthEast
Investment
TheproportionofBritain’sGrossDomesticProduct(GDP)spentonthecorepublic
servicesofhealth,educationandpublicsafetyincreasedfrom12.2percentin1997/98
to15.5percentin2005/06(Brooks2007,MidgleyandStirling2007).Thegreatwinner
washealthwhoseproportionofGDPwentfrom5.4percentto7.3percent.In2007/8
theNorthEastreceivedthesecondhighestamountofregionalexpenditureonhealth
perpersoninEnglandafterLondon.
Figure2.1.UKidentifiable 2003-04 (£ per head)

expenditureperheadon 2007-08 (£ per head)
healthbynationand UK
UK identifiable
identifiable expenditure
expenditure
region,2003–04to Northern
Northern Ireland
Ireland
2007–08 Wales
Wales
Source:HMGovernment2009 Scotland
Scotland
2003-04 (£
England
England
2007-08 (£
South
South West
West
South
South East
East
London
London
East
East
West
West Midlands
Midlands
East
East Midlands
Midlands
Yorkshire
Yorkshire and
and the
the Humber
Humber
North
North West
West
North
North East
East
00 200
200 400
400 600
600 800
800 1,000
1,000 1,200
1,200 1,400
1,400 1,600
1,600 1,800
1,800 2,000
2,000
UK
UK identifiable
identifiable expenditure
expenditure per
per head
head on
on health
health (£
(£ per
per head)
head)
Performance
Inhealthcare,performancehasbeenassessedannuallysince2005/06bytheHealthcare
Commission.The2007/08AnnualHealthCheck providedevidencethatthe23NHS
TrustsintheNorthEastwerealreadyperformingwellandhadcontinuedtoimproveover
thelastthreeyears.Twenty-oneofthe23trustswereratedaseither‘excellent’or
‘good’fortheirqualityofservicesin2007/08,upfrom18in2006/07,andnotrustwas
ratedas‘weak’.Similarly,17ofthe23trustswereratedexcellentorgoodfortheiruse
ofresourcesin2007/08,comparedwithsevenin2006/07,andnotrustswereratedas
weak.Forbothqualityofservicesanduseofresources,theNorthEasthadthebest
overallperformanceinEngland(HealthcareCommission2008).
SomepartsoftheNorthEasthavegaineddeservedrecognitionfortheirworkonhealth.
SouthTynesideCouncilisonlyoneofahandfulofauthoritiestowinBeaconStatusfor
itsinnovativeapproachtocross-agencyworkingindevelopingLocalStrategic
Partnerships.Forexample,itsHealthierCommunitiesStrategy2008–2020 putshealth
inequalitiesinacommunityandmulti-servicecontext(SouthTynesidePrimaryCare
Trust/SouthTynesideCouncil2008).
Outcomes
Accordingtothe2009BritishSocialAttitudessurveythepublicisnowmoresatisfied
withtheNationalHealthServicethanatanytimesince1984(Parketal 2009).Inthe
NorthEasttherehasbeenconsiderableprogressinimprovinghealth,butthehealthof
peopleintheregionremainsgenerallypoorerthaninEnglandasawhole.Theregionhas
theworstlifeexpectancyandthehighestratesofearlydeathsfromcancerandcoronary
heartdisease.Table2.1summarisesthemainhealthoutcomesandnationalcomparison.
11
Table2.1.HealthoutcomesintheNorthEastandcomparisonwithEngland
TrendsandstatisticsinNE Nationalcomparison
Lifeexpectancyincreasedbyapprox. Samerisevisibleeverywhere.NEstillhas
2yearsformen,1.5yearsforwomen someofthelowestlifeexpectanciesin
between1996–98and2003–05 England
SignificantfallinStandardisedMortality NEstillhashighestSMRinEnglandfor
Ratio(SMR)forcoronaryheartdisease coronaryheartdisease(secondhighest
1997–2005from194to113formen, formen)andcancer
191to121forfemales;similarfallfor
cancerrates
Fallinteenageconceptionratesfrom NEstillhashighestteenageconception
approx.57per1,000in1998to50 ratesinEngland
per1,000in2005
ReducinghealthinequalitiesisoneofthefivenationalprioritiesoftheNHSoperating
frameworkandalocalpriorityacrossservices.Despitetheincreasedinvestmentand
improvedinstitutionalperformance,theinter-regionalandsub-regionalinequalitiesin
theNorthEasthaveprovedhardtotreat.
TheCommissionhasfound,however,thattherearewaysofreducinghealthinequalities
thatcouldbeusedmoreintheregion.Forexample,roadsafetymeasures,suchas
enforced20mphlimitsinalloftheregion’sresidentialareas,wouldhaveasignificant
impactonreducinginequalities.Thisisbecausepeople,especiallytheyoung,frommore
deprivedneighbourhoodsaremuchmorelikelytoexperienceroadaccidentsthantheir
moreaffluentpeers(Graylingetal 2002).Introducingfreeschoolmeals,whichhas
provenpopularinDurham,wouldalsoreduceinequalityovertime–seeBox2.1.
Box2.1.FreeschoolmealsuccessinDurham
About90percentofCountyDurham’sprimaryschoolchildrenarereceivingfree
schoolmealsunderatwo-yearpilotschemetoprovidefreelunchestoallchildrenin
thecounty’s244primaryschools.
Therewasnear100percenttake-upatShincliffeCEPrimary,nearDurhamCity.
AccordingtotheDurhamTimes,‘HeadteacherJeanineLowessaid:“We’revery
pleasedwithhowit’sgone.Wefeelschoolmealsareabigpartoflearningandsocial
skills....Wewerewonderinghowquicklychildrenwhopreviouslyhadschooldinners
wouldtaketoit,buttheylovedit.We’vehadareallypositiveresponse”’(Tallentire
2009).
Themainaimistocutchildhoodobesityandboosthealth,but‘itcouldalsosavea
familywithtwochildrenatprimaryschool£17aweek–£1,300overthetrialperiod’
(ibid).
Source:‘FreeschoolmealsinCountyDurhamhailedasuccess’,byMarkTallentire,
DurhamTimes,8September2009
Lifeexpectancyrosebyapproximatelytwoyearsformenand1.5yearsforwomen
between1996–98and2003–05,buttheNorthEaststillhassomeofthelowestlife
expectanciesinEngland.Thevariationwithintheregionissignificanttoo–updated
figuresfor2005to2007formalelifeexpectancyatbirthvaryfrom75.0in
Middlesbroughto79.0inTynedale(OfficeforNationalStatistics2009).
Figures2.2and2.3illustratelifeexpectancyforallpeopleintheNorthEast.Thepaired
maps1 presentedinthisreportshowconventionalmapsontheleftandequalarea
1. Allthemapswerepreparedbythe
cartograms,otherwiseknownasdensity-equalisingmaps,ontheright.Acartogram SocialandSpatialInequalities
resizeseachterritoryaccordingtothevariablebeingmapped–throughoutthisreport, ResearchGroupatSheffield
Universityusingthemostup-to-
thatvariableispopulation.Figures2.4and2.5showthewholeregionwithlocal datedataappropriatetothetopic
authoritylabelstoassistwithidentification.Thelocalauthorityareawiththelowestlife ofeachmap.
12 PublicServiceParadox| HealthintheNorthEast
expectanciesintheregion(ondatafrom2004–06)isHartlepool(76.5years);the
highestexpectanciesareinBerwick-upon-Tweed(81.8years).
Cartogramsareusefulindemonstratingthefullimpactofinequalitiesbetweendifferent
2. Themapsthroughoutthereportuse
theborderspriortothe2009local
geographicalareas.Theyhavebeenusedinthisreportbecauseastrongfeatureofthe
authorityreorganisation,asdatais paradoxintheNorthEastistheinequalityinoutcomes,notjustbetweentheNorthEast
notyetreadilyavailableforthenew andotherregions,butwithintheregiontoo.Here,forexample,lookingatthe
authorities.
Life expectancy 2004-06 Life expectancy 2004-06
Figure2.2.Lifeexpectancyatbirth2004–6,all Figure2.3.Lifeexpectancyatbirth2004–6,all
people,NE people,NE
Datasource:OfficeforNationalStatistics Datasource:OfficeforNationalStatistics
Figure2.4.2 Map:NElocalauthoritylocator Figure2.4.Cartogram:NElocalauthoritylocator

13
distributionoflifeexpectanciesontheconventionalmapcanbemisleading.Itshows
overhalftheregionashavinglifeexpectanciesofover79years.Onthecartogram,
whereanareaisdrawninproportiontopopulation,presentationofthesamedata
revealsthattheregionisdominatedbyareaswherelifeexpectancyisbelow78years.
Thecartogramthereforeprovidesamoreaccurategraphicalrepresentationofthe
experienceofpeopleintheNorthEast.
Therehasbeenprogressonotherkeyhealthmeasures,includingsignificantfallsin
StandardisedMortalityRatios(SMRs)forcoronaryheartdiseaseandcancerbetween
1997and2005,buttheratesarestilltheworstnationally.Thismaybelinkedtothe
NorthEasthavingthehighestestimatedlevelsofadultbingedrinkingandadult
smokinginEngland(AssociationofPublicHealthObservatories2008).Ratesofsmoking
inpregnancyandbreast-feedinginitiationaretheworstinEngland.Theregion’steenage
conceptionrateshavedecreasedto48.8perthousandunder-18s,butarestillthe
highestinEngland,wheretheaverageis40.6perthousand.
Figures2.6and2.7showwidevariationsacrosstheregion,withhigherratesdenotedby
darkershading.Again,thecartogramontherightgivesamoreaccuratepictureofthe
intra-regionalinequalities;itcanclearlybeseenthatthelowerteenageconceptionrates
arefoundintheleastdensely-populatedareasoftheregionandthereforetheoverall
regionalpictureisinfactconsiderablylesspositivethanwouldbesuggestedbythe
conventionalmappingontheleft.(RefertoFigure2.5toassistwithidentification.)
TheNorthEastalsohaspocketsofhighratesoflow-birth-weightbirths(under2500
grams),despitearegionalrateinlinewiththenationalnorm.Forexample,in
Middlesbrough,11.2percentofallbirthswerebelow2500grams,incontrastwiththe
nationalaverageof7.9percent(2005figures).
Insummary,thedatashowsthatthehealthsectorintheNorthEasthasreceivedhigher
thanaverageinvestmentandkeyagencieshavebeenassessedtobeworkingtoahigh
standardwhencomparedwiththerestofthecountry.Keyhealthoutcomeshave
improved.However,theNorthEastcontinuestolagbehindthenationalaverageina
numberofkeyareasandthereremainconsiderableinequalitieswithintheregionitself.
Under-18 conceptions, 2006 (per 1000) Under-18 conceptions, 2006 (per 1000)
Figure2.6.Under-18conceptions,2006,NE Figure2.7.Under-18conceptions,2006,NE
Datasource:OfficeforNationalStatistics Datasource:OfficeforNationalStatistics
14 PublicServiceParadox| EducationintheNorthEast
3.EducationintheNorthEast
Investment
TheproportionofBritain’sGDPspentoneducationrosefrom4.7to5.7percentover
thedecadefrom1997.InEnglandtheNorthEastregionwassecondonlytoLondonin
spendingperheadoneducationandtraininginboth2003/4and2007/8.
Figure3.1.UKidentifiable
UK identifiable expenditure
expenditureoneducation 2003-04 (£ per head)
2007-08 (£ per head)
bynationandregion,per Northern Ireland
head,2003–04to2007–08 Wales
Source:HMTreasury2009 Scotland
England
South West
South East
London
East
West Midlands
East Midlands
Yorkshire and the Humber
North West
North East
0 200 400 600 800 1,000 1,200 1,400 1,600 1,800

UK identifiable expenditure on education (£ per head)
Performance
Table3.1.2008CPAscoresforsingletierandcountycouncils
Council Authoritytype Directionoftravel Starcategory ChildrenandYoung
People’sservices
assessmentscore*
Darlington Unitaryauthorities Improvingstrongly 4star 3
Durham Countycouncils Improvingwell 4star 3
Gateshead Metropolitan Improvingwell 3star 4
districtcouncils
Hartlepool Unitaryauthorities Improvingstrongly 4star 3
Middlesbrough Unitaryauthorities Improvingstrongly 4star 3
Newcastle-upon-Tyne Metropolitan Improvingwell 2star 2
districtcouncils
NorthTyneside Metropolitan Improvingwell 3star 3
districtcouncils
Northumberland Countycouncils Improvingwell 4star 3
RedcarandCleveland Unitaryauthorities Improvingwell 2star 3
SouthTyneside Metropolitan Improvingstrongly 4star 3
districtcouncils
Stockton-on-Tees Unitaryauthorities Improvingwell 4star 3
Sunderland Metropolitan Improvingwell 4star 3
districtcouncils
Source:AuditCommission
*ServiceassessmentsarescoredontheLocalServicesInspectorateForumscale:
1=Inadequateperformance–belowminimumrequirements;2=Adequateperformance–onlyatminimum
requirements;3=Performingwell–consistentlyaboveminimumrequirements;4=Performingstrongly–wellabove
minimumrequirements
15
Primaryandsecondaryeducationistheresponsibility(throughChildren’sServices)of
localauthorities,whichappeartoservetheNorthEastwell.All12localauthoritiesinthe
NorthEasthavebeenverypositivelyassessedbytheAuditCommission’sComprehensive
PerformanceAssessment(CPA)3(seeTable3.1) .Themajorityareamaximumfour-star
ratedandallare‘improvingstrongly’or‘improvingwell’.Thechildrenandyoungpeople
elementsoftheratings,coveringeducation,aregenerallygood,too,butthemajorityare
threeratherthanfour-star.
Thereare,ofcourse,manyverygoodschoolsintheregionthatdoverywellinwith
considerableeconomicdisadvantageandsocialissues.Forexample,Shiremoor
PrimarySchoolinNorthTynesidewasrecentlynamedbyOfstedasoneof‘Twenty
outstandingprimaryschools:excellingagainsttheodds’,‘whichprovidegreatservice
tohighlydisadvantagedcommunitiesindifferentpartsofthecountry’(Ofsted2009)
–seeBox3.1.
Box3.1.ShiremoorPrimarySchool–NorthTyneside
‘Theheadteacher’svisionaryandunremittingapproachtocontinuallyimproving
teaching,learningandthecarethatpupilsreceiveisattheheartoftheschool’s
success.’(Ofsted2008)
Formerlyaminingvillage,thislargeTynesideestatereflectsconsiderableeconomic
disadvantageandsocialissues.MostchildrenwhoattendtheschoolareofWhite
Britishheritage,withfewerthan5percentfromminorityethnicgroups.Theschool
hasthevisionandcommitmenttomakelightofitsmanychallenges,responding
readilytotheneedsofitschildren–likeprovidinga‘second’breakfasttoprovidethe
fuelforlearning–andsustainingcloselinkswithbothparentsandtherangeof
serviceswhichoperateinthearea,includingpolice,firebrigadeandhealthservices
andlocalbusinesses.Pupilslovetheschoolandknowthattheadultswillsortoutany
problemstheyhave.
Perhapsthemostimportantvehicleforachievingsuccessistheapproachtakento
managingbehaviour,whichbeganin1990whenHelenCleggbecamethe
headteacher.Thisinvolvesstrongmoralpurposeaswellasbeingverypractical.Itis
basedongoodmanners,payingattentionandmutualrespect.Theschoolhas
developedclearandwell-establishedruleswiththechildren,accompaniedbyrewards
andsanctions.Thesearedisplayedprominently,explainedtoparentsand
demonstratedbystaff.Buttherewardsarenotwhatenablethepupilstobehaveso
wellsomuchastheschool’spositiveethosandengagingcurriculum.
Theschoolhasexceptionallywell-organisedmanagementsystemswherewhatneeds
tobedone,oraddsvalue,isdoneefficientlybystaffattherightlevelandwhat
doesn’t,isn’t.Staffmoraleatalllevelsisveryhigh;theyseethemselvesasfortunate
towork,withautonomyandenjoyment,insucharewardingsetting.Thelast
inspectionreportedteachers’enthusiasmforlearningasinfectious.Pupilslikebeing
expectedtodothingsforthemselves,whichbringsasenseofachievementandspurs
themontonewchallenges.
Source:quotedfromOfsted2009,p74.
Outcomes
EducationaloutcomeshaveimprovedintheNorthEast,butsomearestillpoorerthanin
Englandasawhole.Therearelowparticipationratesinpost-16educationand 3. TheCPAinspectionregimeforlocal
authoritiesistobereplacedfrom
significantinequalitiesinkeyoutcomesacrosstheregion.Table3.2belowsummarises November2009bythenew
someofthemaineducationoutcomesandnationalcomparison. ComprehensiveAreaAssessment
(CAA),whichwilllookacross
Despiteamodestchangetostaffnumbersinthemaintained(stateschool)sector,the councils,healthbodies,police
forces,fireandrescueservicesand
NorthEastenjoyssomeofthelowestpupil-to-teacherratiosforprimaryandsecondary othersresponsibleforlocalpublic
educationinthecountry.Duringtheprimaryphaseofeducation,resultsforschool services.Thenewregimewillwork
alongsidetheexistinginspection
childreninKeyStages1and2(undertakenatages7and11)areabovetheEnglish bodiesforhealthandpolice
average,withgirlsout-performingboys(whichisconsistentwithnationaltrends). services.
Table3.2.MaineducationoutcomesintheNorthEastandcomparisonwithEngland
TrendsandstatisticsinNE Nationalcomparison
Virtuallynochangebetween2000and2006atKS*1 KS1resultsinNEclosetonationalaveragein2000and
2006
ImprovementatKS2,atsamerateasnationalaverage KS2resultsinNEclosetonationalaveragein2000and
2006
ImprovementatKS3,mostlyatsamerateasnational KS3resultsinNEbelownationalaveragein2000and
average 2006
Increasefrom40%ofpupilsattaining5ormore %ofpupilsattaining5ormorepassesinNEincreased
GCSEpassesin2000to57%in2006 between2000and2006muchfasterthannational
average;attainmentnowmatchesnationalaverage
Onlyjustover40%ofpupilsachieve5GCSEpasses NEhadlowestachievementinEnglandinachieving
includingEnglishandmathsin2006 5GCSEpassesincludingEnglishandmathsin2006
*KS=KeyStage.Source:MidgleyandStirling(2007)
Primary-levelattainmentleadstotheexpectationthatsecondaryachievementshould
alsobehigh.However,thisisnotthecase:byKeyStage3(atage14)attainmentinthe
NorthEasthasdeclinedtobelowthenationalaverage.
GCSEresultshaveimprovedovertimebut,whenlookingatthepercentageofpupils
whoachievedatleastfiveGCSEpasses includingEnglishandmathsatgradeA*toC,
theregionstillperformsrelativelypoorlycomparedwiththerestofEngland.Figures3.2
and3.3illustratethatitisnotonlyinequalitiesbetweentheNorthEastandother
regionsthatareaconcern:persistentinequalitiesremainineducationaloutcomeswithin
theregion.Darkershadingshowsthattherearehigherratesofscoringfiveormore
gradeA*toCGCSEsintheNorthEast.Adjustedforpopulation,inthecartogram(Figure
3.3),itbecomesclearerthattheaverageattainmentacrosstheregionislowerthan
mighthavebeensuggestedbytheconventionalmap(3.2).
5+ grade A* - C GCSEs, Sept 2006 - Aug 07 5+ grade A* - C GCSEs, Sept 2006 - Aug 07
Figure3.2.5+gradeA*-CGCSEs,Sept2006–Aug Figure3.3.5+gradeA*-CGCSEs,Sept2006–Aug
2007(%),NE 2007(%),NE
Datasource:NeighbourhoodStatistics(ONS) Datasource:NeighbourhoodStatistics(ONS)
17
No GCSE passes, Sept 2006 - Aug 07 No GCSE passes, Sept 2006 - Aug 07
Figure3.4.NoGCSEpasses,Sept2006–Aug2007 Figure3.5.NoGCSEpasses,Sept2006–Aug2007
(%),NE (%),NE
Figure3.6.Attendanceatuniversity,2000–04(%),NE Figure3.7.Attendanceatuniversity,2000–04(%),NE
Datasource:Corver2005 Datasource:Corver2005
Figure3.4showstheareaswiththeworstratesfor‘noGCSEpasses’withthedarkest
shading.Thecartogram,3.5,illustratesthefactthatthehighest-achievingareasatGCSE
tendtobetheleast-denselypopulated,andthelowest-achievingtendtobethemost-
denselypopulated.Again,theaimofthecartogramistorepresenteducational
performanceacrosstheregionmoreaccurately,givingequalweighttoallstudents.
Participationratesinpost-compulsoryeducation(full-orpart-time)andwork-based
learningarelowerintheNorthEastthaninotherEnglishregions,contributingtowhatis
seenasa‘qualificationsdeficit’.Thepairedmaps3.6and3.7showthedistribution
acrossthisregionofthosegoingtouniversitybetween2000and2004.Thepopulation-
adjustedcartogram,3.7,moreaccuratelyportraystherelativelylowregionalattendance
ratesthanFigure3.6,theconventionalmap.
Thedeficitisfurtherillustratedbytheratesacrossallregionsofattendanceatelite
universities:1.8percentintheNorthEastversusanEnglishaverageof2.8percent
(Corver2005).
TheNorthEastcouldlooktoNottingham,whichhasfocuseditsLocalAreaAgreement
onearlyinterventiontotackleproblemssuchasthelong-standinglowereducational
performanceassociatedwithdeprivation.
Insummary,educationintheNorthEast,includingthefurthereducationsector,has
receivedhigherthanaverageinvestmentandthemajorityofkeybodieswithoverall
responsibilityhavebeenjudgedtobeperformingwell.Educationoutcomeshave
improved.However,theNorthEastcontinuestolagbehindthenationalaverageina
numberofkeyareasandthereremainconsiderableinequalitieswithintheregionitself.
19
4.CriminaljusticeintheNorthEast
Investment
TheproportionofBritain’sGDPspentonpublicorderandsafetyrosefrom2.1to2.5
percentoverthedecadefrom1997.OftheEnglishregions,theNorthEastwasbehind
onlyLondonandtheNorthWestinspendingonpublicorderandsafetyinboth
2002–03and2006–07.
Figure4.1.UKidentifiable
UK identifiable expenditure 2002-03 expenditureonpublic
2006-07
Northern Ireland orderandsafetybynation
Wales andregion,perhead,
Scotland 2002–03to2005–07
England
South West
South East
London
Eastern
West Midlands
East Midlands
Yorkshire and Humberside
North West
North East
0 100 200 300 400 500 600 700 800 900

Identifiable expenditure on public order and safety (£ per head)
Performance
AnnualpoliceperformanceassessmentsarecarriedoutbytheHomeOfficeandHer
Majesty’sInspectorateofConstabulary(HMIC).TheNorthEast’sthreepoliceservices
(Cleveland,DurhamandNorthumbria)wereallreportedtohaveimprovedtheir
effectivenessintacklingcrimein2006/07,andfurtherreductionsincrimelevelswere
notedinallthreeareasin2007/08.Greaterpublicsatisfactioninallthreeserviceswas
reportedin2007/08.ClevelandandDurhamwereratedas‘performingwell’intheiruse
ofresources,whileNorthumbriawas‘performingstrongly’.Thethreeserviceswerealso
deemedtoallbemeetingstandardsfortacklingmajorcrime,deliveryofcitizen-focused
policingandneighbourhoodpolicing(HomeOffice2008).
Thewiderinfluenceoftheperformanceofthecriminaljusticesystemindetermining
well-beinghasbeenrecognisedlocally.Anexampleisintheframeworkofmeasuresof
well-beingdevelopedbyHartlepoolMindinconjunctionwiththeLocalStrategic
Partnership(HartlepoolPartnership2008).Thisframeworkincludesbothobjective
measuressuchastheassaultwithinjurycrimerateandsubjectivemeasuressuchasthe
percentageofpeoplefeelingsafeafterdark.
Outcomes
Thepicturefortheregionisbroadlymorepositiveforcriminaljusticethanfortheother
measuresdescribedsofar,buttherearesomeareasofconcern.Table4.1below
summarisesthemaincriminaljusticeoutcomesandthenationalcomparison.
ResidentsoftheNorthEastarelesslikelytoliveinfearofburglaryandviolentcrime
thanthoseelsewhereandcrimerateshaveinfactfallenconsiderably.Theregion’s
criminaljusticeagenciesin2006hadthehighestrateofdetectionandsanctioned
detection(reportedcrimeleadingtoprosecution)ofanyEnglishregion.Thepolice
forcesintheNorthEast(in2006)enjoyedthehighestlevelsofpublicconfidenceofany
20 PublicServiceParadox| CriminaljusticeintheNorthEast
Table4.1.CriminaljusticeoutcomesintheNorthEastandcomparisonwithEngland
TrendsandstatisticsintheNE Nationalcomparison
Fearofcrime(burglaryandviolentcrime)dropped FearofcrimeinNElowerthaninmostregions;downward
considerablyfrom2001to2006 trendsimilareverywhereexceptLondon
Over50%ofpopulationconfidentthatlocalpolice NEamonghighestconfidenceinpoliceinEngland
force‘doingagoodjob’ (withSouthWestandLondon)
Only41%ofpopulationconfidentthatcriminaljustice NEhaslowestconfidenceinEngland(withNorthWest)
system‘effectiveinbringingpeopletojustice’ thatcriminaljusticesystem‘effectiveinbringingpeople
tojustice’
region.However,thecriminaljusticeagenciesexperiencedsomeofthelowest
expressionsofpublicconfidenceintheireffectivenessinbringingpeopletojustice.
TheNorthEast’srecordonyouthoffendingismixed.Therearelowlevelsofcustodial
andcommunitysentencingforyoungoffenders,andlengthsoftimebetweenarrestand
sentencingareaverage(attargetlevel).However,youngoffendersintheregionfalling
underthesupervisionofYouthOffendingTeamsareamongthecountry’sleastwell
supportedinterms,forexample,ofensuringtheyareineducation,trainingor
employment(MidgleyandStirling2007).
Onefactorinthepublic’slowlevelofconfidenceintheeffectivenessofthecriminal
justiceagenciesintheregionisconcernaboutanti-socialbehaviour.Lookingatpublic
perceptionofanti-socialbehaviouracrosstheregion,theconventionalmap,ontheleft
ofFigure4.2,showsthatcomparedwiththenationalpicturetherearebelievedtobe
highlevelsofanti-socialbehaviourinallthreepoliceforceareasintheNorthEast.Areas
withthehighestperceivedlevelsareshadedmoredarklyandthemapsshowthatthe
mostnegativepublicperceptionofbehaviourisintheClevelandforcearea.
ThecartogramontherightinFigure4.2isinaslightlydifferentformtoprevious
examples,butthesizeoftheareasonthecartogramisagainadjustedforpopulation.
Thecartogramillustrateswhatmightbeexpected–thatitisthemoredensely-
populatedforceareaofClevelandthatsuffersfromthehighestperceivedlevelsofanti-
socialbehaviour.
Figure4.2.Perceivedhigh
levelofanti-social Northumbria
behaviour,Englandand
Wales Cumbria
Source:BritishCrimeSurvey Cleveland
2006–07 Lancs
N.Yorks
Insummary,theNorthEasthasreceivedhigherthanaverageinvestmentoncriminal
justiceandthekeybodiesaregenerallyperformingwell.Mostrelevantoutcomeshave
improved.Theparadoxinthisareaofpublicserviceisthelowconfidenceintheabilityof
theregion’sagenciestobringpeopletojusticedespitelowfearofcrimeandafairlyhigh
levelofconfidenceinthepolice.
21
5.Welfare-to-workintheNorthEast
Investment
Thepictureforwelfare-to-work4 againshowstheregionisreceivinghighlevelsof
resources,butspendinginthisareaismuchmoredemand-ledthanotherservices.Of
theEnglishregions,theNorthEastreceivedthehighestspendingperheadon
employmentpoliciesandsocialprotectionin2003–4and2007–8.Thisreflectssome
ofthelowesteconomicactivityratesinthecountryandisanareaofspendingthatis
likelytoseeunwelcomegrowthduringtherecession.
Table5.1.UKidentifiableexpenditureonemploymentpoliciesandsocialprotection,bycountryandregion,per
head,2003–04to2007–08(£perhead)
Region, Employment Social Total Region, Employment Social Total
2003–04 policies protection 2007–08 policies protection
NorthEast 75 2,909 2,984 NorthEast 81 3,336 3,417
NorthWest 63 2,769 2,832 NorthWest 66 3,237 3,303
Yorks/Humber 61 2,551 2,612 Yorks/Humber 61 2,959 3,020
EMidlands 46 2,375 2,421 EMidlands 45 2,805 2,850
WMidlands 60 2,563 2,623 WMidlands 61 3,088 3,149
East 37 2,269 2,306 East 38 2,708 2,746
London 65 2,637 2,702 London 59 3,082 3,141
SouthEast 33 2,200 2,233 SouthEast 32 2,641 2,673
SouthWest 37 2,515 2,552 SouthWest 36 2,942 2,978
England 52 2,507 2,559 England 51 2,953 3,004
Scotland 56 2,860 2,916 Scotland 55 3,306 3,361
Wales 60 2,908 2,968 Wales 69 3,401 3,470
NIreland 91 3,052 3,143 NIreland 93 3,670 3,763
UKidentifiable 54 2,572 2,626 UKidentifiable 54 3,025 3,079
expenditure expenditure
Performance
Forwelfare-to-work,regionalorlocalauthorityleveldataofproviderperformanceis
noteasilyavailable.TheDepartmentforWorkandPensionsdoesmeasure
satisfactionwithavarietyofservicesoffered,includingJobcentrePlus.Nationally,
thevastmajorityofJobcentrePluscustomersreportedthattheywereeither
‘satisfied’or‘verysatisfied’withtheoverallservicethattheyreceived(Johnsonand
Fidler2007).LevelsofsatisfactionintheNorthEastwerearoundthenational
average.Therearesomelocalexamplesofinnovativepractice;seeBox5.1forone
(p21).
AnotherexampleisSunderlandCityCouncil’sNorthernWayWorklessnessPilot,
which‘engagedwithover280employers,practitionersandclientsandusedservice
4. Helpandsupportforpeopleof
designmethodstomapthepublicservicesneededtohelpdisadvantagedindividuals workingagetogetajobandstayin
outofunemployment’(HMTreasury2009c). work
22 PublicServiceParadox| Welfare-to-workintheNorthEast
Box5.1.TheAcumenCommunityEnterpriseTrust
TheAcumenCommunityEnterpriseTrustissaidtobeanexampleofbothamore
personalandlocalapproachtoworklessness.Itwasestablishedin2003andbeganits
workinEastDurhambutnowworksinotherareasoftheNorthEast.KateWelch,
Acumen’sChiefExecutive,arguesthatinthedisadvantagedcommunitiesinwhichit
operates,manypeoplearefarawayfromemployabilityandarepoorlyservedbythe
standardprogrammesofferedbyJobcentrePlus.Acumen’sclientsoftenstartwith
multipleproblems,includinghealthproblemsandlowself-esteem,anddonotbelieve
thattheycanchangetheirlivesandfindsustainableemployment.Helpingthesepeople
backintoworkrequireslong-termengagementthatbuildstrust.‘Ifwecangivepeople
theself-confidenceandself-esteemtostepuptothemarkandsay“actually,Icoulddo
somethingmorewithmylife”,that’samuchbetterwayofworking’,saysKate.
Acumenaimstomeettheneedforpersonalised,localandjoined-upservices.Itsays
thatsupportmustbetailoredtowardstheneedsoftheindividualifitistobetruly
effective.Everythingitdoeshasstrongrootsinthelocalcommunity.Thisistoensure
thatpeoplecanseerealisticroutesintoemployment,andbecauseAcumenbelieves
thatthisisthebestwaytotackleculturesofunemploymentanddependency.Kate
Welchsays:‘It’sthecompletelyworklesshouseholdswhereyoustruggle.Ifyouhave
sustainedworkgoingoninthelocalcommunity,andyougettoonepersoninevery
family,thenbitbybityoustarttogetsomethinghappeninginfamiliesthatchanges
thewaypeoplework.Itdoeswork,butittakesalongtimeandinvestment.’Finally,
Acumenpromotesajoined-upapproachthatbuildsstronglinksbetweenother
agenciesandprogrammes,includingpublic,privateandvoluntarysectororganisations.
Welcharguesthatallsectorshavesomethingtogive,buttheywillonlybeeffectiveif
theyareintegratedandworkinginunison.
Acumenhashelpedthousandsofpeoplebackintoemploymentorself-employment
overthepastfiveyearsthroughcommunityengagement.Ithasalsoestablisheda
numberofsocialenterprisesattheheartoflocalcommunities.Inthecontextofthe
recession,suchsocialenterprisespotentiallyofferanimportantpathwayforpeopleto
developworkskillsandgainconfidence,ensuringthattheycanstillfollowatransition
backtoworkeveninaneconomicdownturn.
Source:Commissionroundtableonwelfare,25March2009
Outcomes
Beforetherecession,economicactivityrateshadimprovedintheNorthEast,butstill
laggedbehindtherestofthecountry.Table5.2summarisesthemainwelfareoutcomes
andshowsthenationalcomparison.
TheNorthEasthadexperiencedsignificantincreasesineconomicactivityratespre-
recession,withcorrespondingdeclinesinunemploymentratesandclaimantcounts.But
theregionstillhadsomeofthelowesteconomicactivityratesandhighest
unemploymentandclaimantcountratesinEngland.Unemploymentratesandclaimant
countsregionally(andnationally)arerisingrapidlyinthecurrentdownturn.Thelatest
figuresshowaclaimantcountof7.3percent(Dolphin2009).
Table5.2.Welfare-to-workoutcomesintheNorthEastandcomparisonwithEngland
TrendsandstatisticsintheNE Nationalcomparison
Unemploymentratefellfromover9%in1997tobelow UnemploymentratestillhigherinNEthaneverywherein
6%in2005(thoughstartingtoriseagainfrom2008) EnglandbutLondon,thoughgaphasreduced
Claimantcountratefellfromnearly6%ofworking NEclaimantcountstillhighestinEngland(withLondon
agepopulationin1997tojustover3%in2006 andWestMidlands),thoughgaphasreduced
Figures5.1and5.2showregionalemploymentandunemploymentratesin2008and
illustratetheNorthEast’sproblem.Lightershadingindicatesloweremploymentinthe
firstmap(5.1).Darkershadingindicateshigherunemploymentinthesecondmap(5.2).
23
Figure5.1.Employmentrates,England,Scotlandand Figure5.2.Unemploymentrates,England,Scotland
Wales,2008 andWales,2008
Datasource:AnnualPopulationSurvey(ONS) Datasource:AnnualPopulationSurvey(ONS)
Figure5.3.IncapacityBenefitclaimants,%of Figure5.4.IncapacityBenefitclaimants,%of
working-agepopulation,2006 working-agepopulation,2006
24 PublicServiceParadox| Welfare-to-workintheNorthEast
Thepictureatsub-regionallevelismixed.Figures5.3and5.4aboveshowdarker
shadingforhigherratesofworking-ageIncapacityBenefitclaimants.Lowerclaimant
ratesseemtopredominateintheconventionalmap(5.3),butthoseareaswithhigher
claimantratesarealsothemostdensely-populatedandsothecartogram(5.4)givesa
moreaccurateindicationofthetrueimpactacrosstheregion.
JobgainsthroughparticipationinJobcentrePlus’sNewDealprogrammeareamongthe
lowestinthecountryforalltargetgroupsexceptdisabledparticipantsandthosewho
havelong-termunemployedpartners(butnumbersarerelativelysmallifcomparedwith
otherNewDealtargetgroups).TheNorthEastalsostillpossessesthesecondhighest
rateinEngland(afterLondon)ofchildrenlivinginworklesshouseholds(Midgleyand
Stirling2007).
Tosummarise,theNorthEastisspendingalotofmoneyonwelfare-to-workandthe
relevantbodiesappeartobeprovidingareasonableservice.TheNorthEastdoesstilllag
behindonkeyoutcomesandtherearenotableinequalitieswithintheregion.The
paradoxofhighperformanceandinvestmentversuspooroutcomes,asseeninother
areasofthepublicsector,doesnotapplyinquitethesamewaytowelfare-to-work.
Spendinginthisareaofthepublicsectorislargelydemand-led,higherspendingbeinga
reflectionofhigherunemployment.Investmentinwelfare-to-work,therefore,cannotbe
seeninexactlythesamelightasinvestmentinhealthservicesoreducation(though
elementsofhealthandeducationspendingareofcoursealsodemand-led).Thewelfare-
to-workoutcomesobservedarelessdirectlyrelatedtopublicspendinginthisarea,and
morelikelytobeareflectionofthewiderproblemsfacedbytheregionintermsofits
economyandrelatedlevelsofpovertyanddeprivation,whichweturntointhenext
chapter.
25
6.Theeconomicandsocialcontextinthe
NorthEast
Publicservicesplayacrucialroleinthelifeofeverycitizenandcommunity,but
theyareonlyone,albeitveryimportant,determinantofwhetherapersonleadsa
goodandfulfillinglifeorwhetheraplaceissuccessful.Totakeabroadexample,
publicservicespolicymayhavesomeeffectontheimpactofandrecoveryfromthe
currentrecession,butglobalfactorsmaybemoreinfluential.Publicservicesand
servants–teachers,doctors,policeofficers–arealltooawareofthisandvery
oftenhavetotackleproblems‘downstream’thataregenerated‘upstream’inthe
widereconomyandsociety.
Forexample,weknowthatchildrenfrompoorerhouseholdsareseriously
disadvantagedbeforetheyhaveattendedtheirfirstdayatschool–andinmany
casesevenagoodqualityprimaryandsecondaryeducationcannothelpthem
catchupwiththeirbetter-offpeers.Wealsoknowthathouseholdincomesarethe
bestpredictorsofpeople’sgeneralhealth.Inplaceswherethereispersistentand
inter-generationalpoverty,outcomesareboundtobeworsethaninmore
prosperousareas.ItisthereforeessentialthatweunderstandNorthEastpublic
servicesintheirwidereconomicandsocialcontext.
TheNorthEast’seconomy
WhiletheNorthEasthasseenrisingprosperityinthelast12years(temperedby
thecurrentrecession),theregioncontinuestolagbehindtherestoftheUKin
economicterms.Thestandardgovernmentmeasureforeconomicperformance
acrossthedifferentregionsisusuallyGrossValueAdded(GVA)–thecontribution
totheeconomyofeachindividualproducer,industryorsectorintheUK5.Onthat
measuretheNorthEast’srelativepositionworsenedbetween1990and2005:in
1990theNorthEasthadaGVAperheadthatwas82percentoftheUKaverage.
By2005thishaddroppedtojust78percent–thelowestofanyEnglishregion
andevidenceofadecadeandahalfoflowerthanaverageregionalgrowth.GVA
perheadintheNorthEastin2006was£15,200comparedwith£19,100fortheUK 5. GVA+taxesonproducts–subsidies
asawhole. onproducts=GDP
Table6.1.Rankingofallindicators,byregionandnation,2006
Region Productivity Income Employmentrate
NorthEast 7 12 10
NorthWest 9 7 8
YorksandHumber 10 9 6
EastMidlands 5 6 4
WestMidlands 8 8 7
EastofEngland 3 3 3
London 1 1 11
SouthEast 2 2 1
SouthWest 4 4 2
Wales 11 10 9
Scotland 6 5 5
NorthernIreland 12 11 12
Source:Economic&LabourMarketReview2009,fromONSdata.
Notes:Dataforproductivityandincomeisprovisional.Employmentrateisforpersonsofworkingage,includingfemalesaged16to
59andmales16to64
26 PublicServiceParadox| TheeconomicandsocialcontextintheNorthEast
TheOfficeforNationalStatistics(ONS)hasrecentlylookedatthemeritsoftheuse
ofawidersetofmeasuresofeconomicperformance,includingproductivity,income
andemploymentrate.Table6.1aboveshowstheregionalrankingsbythreedifferent
measures.Itshowsamoredetailed(andcomplex)picturethanthatgivenbyGVA
figuresalone;theNorthEastcomesbottomofthenationalleagueforincomes(asit
doesforGVA),andnearthebottomforemploymentrates.Itsproductivityranking,
however,isjustbelowhalfway.
TheONSsaysthat‘Usingacatch-allindicatorcannotaccountforthevarying
regionalperformancesonproductivity,incomeandlabourmarketissues’(Economic&
LabourMarketReview2009:7).TheNorthEastisoneoftheregionsthatdisplayed
thelargestrankingdifferences.
TheONSalsocomparedthethreefactorsovertime,concludingthat:
TheNorthEastexperiencedarelativeimprovementonincome
andemploymentfrom2000to2006,whileproductivitygrew
moreslowlythantheUKaverageandthereforedeclinedin
relativeterms.Theemploymentratehasrelativelyimproved,
whichalignswiththeregion’shouseholdincomeperhead
havingrelativelyincreasedfromitslowlevel.Therelative
declineinproductivityfrom2000to2006alongsidearelative
improvementinemploymentratescouldreflectpeopletaking
jobswhicharelessproductiveintermsofGVAperhour
worked,reducingtheproductivityrelativetotheUKaverage.
(Economic&LabourMarketReview 2009:8)
WhiletheONSworkshowsthattakingabroaderlookattheNorthEast’seconomic
performancegivesamoremixedviewthanexaminingGVAalone,theoverallpicture
isstillpoor,evenbeforetheimpactoftherecession.Thislowerthanaverageregional
economicperformanceispartlyalegacyofrelativeeconomicdeclinethroughthe
1970sand80s,duringwhichtheregion’straditionalindustries(coalmining,
steelmaking,shipbuildingandheavyengineering)shrankordisappearedcompletely.
Thesheerconcentrationoftheseheavy,mass-employmentindustriesintheNorth
Eastmeantthatthisregionwashitharderthananyotherbytheirdecline,andits
economicpositioncomparedwithotherregionsthereforedeteriorated.
Duringthe1990sandbeyondtheNorthEastregionaleconomysufferedfromthe
continueddeclineinmanufacturing,whichfellfrommakingup30percentofthe
region’sGVAin1989tojust19percentin2004.Thishasmeantalossof100,000
manufacturingjobsinthelast25years–jobswhichtendedtobeatthehigher-
skilled,higher-wageendofthelabourmarket(Johnson etal 2007,Midgleyand
Stirling2007).
Demographicchanges
Themanufacturingdeclineofthelatetwentiethcentury,whichasdescribedhitthe
NorthEastparticularlyhard,wascloselytiedtoalossofpopulationfromtheregion.
Inmorerecentyearstherehavebeensignificantchangesinthemake-upofthe
populationoftheNorthEast.Betweenthe1991and2001Censuses,theproportion
ofpeopleintheNorthEastbornoutsidetheBritishIsles(theUK,Irelandandthe
ChannelIslands)rosefrom1.87percentofthepopulationto2.67percent(a42per
centchange).Thisremainsasmallproportion,however,andalowonecomparedwith
otherUKregions(Kyambi2005).
Accordingtothe2001Censusdata,thedistributionofthenon-British-Isles-born
populationisdisparateacrosstheregion,withthelowestproportionsinEasington(1
percent),Derwentside(1.2percent)andtheWearValley(1.3percent)andthe
largestproportionsaroundthecity-regionofNewcastleuponTynewhere6.4percent
ofthepopulationwerebornoutsidetheBritishIsles(Pillai2006).
In2007aPolicyExchangereportlookedattheeconomicperformanceinanumberof
northerntownsincludingSunderlandandsuggested,‘Itistimetostoppretending
27
thatthereisabrightfutureforSunderlandandaskourselvesinsteadwhatweneed
todotoofferpeopleinSunderlandbetterprospects’(LeunigandSwaffield2007:
31).Thereportwaswidelycondemnedatthetime,withtheSunderlandEcho
respondingrobustlywith‘GoSouth?Nothanks!’(Robertson2008).Thesuggestion
thatWearsidersgiveuponSunderlandandmovetotheSouthEast,evenpriortothe
creditcrunch,mayhavebeen‘idioticandignorant’asthelocalMPputitintheEcho,
butitdoesatleastgiveanindicationofsomeofthestructuralchallengesfacedby
theregionaleconomy.
RecentmigrationfromEasternEurope,particularlyfollowingthe2004roundof
EuropeanUnionenlargement,andthesubsequentreturn(acceleratedbythe
recession)ofsomeofthosemigrants,hasfurthercomplicatedthepicture.Recent
ipprresearchhasshownthat‘mostimmigrantsspendlessthanfouryearsintheUK
andsuchshort-staymigrationisincreasing(itdoubledbetween1996and2007),
largelyasaresultofanincreaseinthenumberofforeignstudentsandoftemporary
labourmigrants,particularlyfromtheEuropeanUnion’(Finchetal 2009:3).Thenew
diversityandvolatilityinthepopulationtrendsperhapsposeparticularchallengesto
theNorthEast’spublicservices,whicharerelativelyunusedtoadaptationtosuch
demands.
ItisimportanttonotethattheNorthEastmanufacturingstoryisnotexclusivelyone
ofdecline.Therehasbeenrecentgrowthinmicroelectronics,oilandgas,
biotechnologiesandtheautomotivesector(predominantlyNissan).Rayovac,for
example,ahearing-aidmanufacturerbasedinWashington,TyneandWear,isaworld
leaderwitha70percentmarketshareinEuropeand55percentglobally.
Developmentssuchasthese,andthecontinuedstrengthofchemicalsand
pharmaceuticals,contributestronglytoapositivebalanceoftradefortheNorthEast
region–acontrastwiththenationalpicture.TheUniversityofTeessideisbuildingon
thisregionalstrengthandhasdevelopeda‘SciencetoBusinessHub’,designedto
helpmorethan100smalllocalbusinessesaccessthelatestresearchandbestpractice
inthespecialitychemicalssector.
SomehaveidentifiedgreatpotentialfortheNorthEasttoexploititsnaturalassets.A
recentreportfortheSmithInstitutehighlightedtheoffshorewindindustry(Tomaney,
ed.,2009).TheNorthEastregionhasboththerightlocationandrelevantskillsand
experienceasaconsequenceofitshistoricstrengthsinshipbuilding,oilandgas,
aerospace,offshoreengineeringandchemicals.
Therearealsomovestoboosttheregion’stourism.Athirdofthelandisdesignated
eitherasaNationalPark(NorthumberlandandpartoftheNorthYorkMoors)oran
AreaofOutstandingNaturalBeauty(NorthPenninesandtheNorthumberland
Coast).TheregionhastwoWorldHeritageSitesinDurhamCathedralandHadrian’s
Wall.
Despitethesesuccessandopportunities,privatesectorgrowthremainsachallengein
theregion,whichsuffersfromalowerbusinessstockthanthenationalaverage
(althoughVAT-registeredbusinessstockdidgrowatarateabovethenational
averagebetween2002and2007)(Clarke2009).Figure6.1,nextpage,showsthe
nationalcomparisonforVATregistrations,withlightershadingforlowerrates.
AnotherissueisthattheNorthEasthasbecomeincreasinglydependentonthe
publicsectortosustainemployment,andtoagreaterdegreethanthenational
average:32percentoftheregion’semploymentbaseisinthepublicsector,
comparedwith27percentnationally(NERIP–StateoftheRegion2008, citedin
Tomaney,ed,2009).SomethinkthatthesizeoftheNorthEastpublicsectoritself
accountstosomeextentforlowlevelsofentrepreneurshipintheregion.However,as
theippr’sNorthernEconomicAgenda project6 hasshown,thepublicsectorisnot
especiallylargerelativetothesizeofthepopulationandthereislittleevidencethat
itcrowdsoutprivatesectoractivity(JohnsonandReed2008).Theremaybea
problemthattherelativelyhighlevelofpublicsectorwagescomparedwithwagesfor 6. Seewww.ippr.org.uk/
medium-to-highskilledworkersintheprivatesector(asdiscussedinMrinska2007) ipprnorth/research/teams/project.a
sp?id=1837
mightdetermovementofemployeesfromthepublictotheprivatesectorandso
Figure6.1.NewVAT
registrationsper10,000
people,2007
Datasource:Departmentfor
Business,Enterpriseand
RegulatoryReform
restrictprivatesectorgrowth,butthiswagegapisinitselfareflectionofthe
weaknessoftheprivatesectorandsooflabourmarketcompetitionintheregion.
Rightlyorwrongly,itwouldappearthatpublicserviceinvestmentmaybeakey
reasonwhyoveralleconomicweaknesshasnotledtoanincreaseininequalitiesanda
worseningofoutcomes.
Povertyanddeprivation
Reflectiveofthiswidereconomicstory,theNorthEastremainsEngland’spoorest
region.Ithasthehighestproportionofhouseholdslivingonlessthan£100perweek
inEngland.
Figure6.2showsthenationalcomparison,withlightershadingdenotinglowest
incomes.
Figures6.3and6.4,p30,demonstratethatthereissignificantinequalityinincomes
acrosstheregion.Lightershadingdenoteslowerincomes.Thecartogram,6.4,once
moregivesanindicationofthepredominance–hiddenbytheconventionalmap–of
lowerincomes.
In2006/07theNorthEast(alongsideYorkshire)hadthelowestmedianhourlywages
ataround£9.80perhourinEngland–andthesameistrueforfemalemedianwages
–andthisisonlypartiallyoffsetbyalowerthanaveragecostofliving(Johnsonetal
2007,MidgleyandStirling2007).
29
Figure6.2.Grossdomestic
householdincome(GDHI)
perhead,2006,England,
ScotlandandWales
Datasource:OfficeforNational
Statistics
“ThebigissuefortheNorthEasthasbeenaboutaddressinginequalities,despitethe
goodworkthat’sgoneon,andwehavesomegoodincreasesinemploymentrates
andeconomicactivityrates.Westillhavethesameplacesthathavethesame
problems,andalotofthatisaboutshort-termism.Onceyou’veestablished
somethingthat’sstartedtowork,youneedtohaveitsustainedandworkinginthe
rightkindofwaytohaveimpact,becausethesearenotproblemsthathappened
overnight,theseareproblemsthathappenedoveralongperiodoftime.Therefore
thesolutionsshouldbeoveralongperiodoftime.”
Delegate,Commissionroundtableonwelfare,25March2009
The2007EnglishIndicesofDeprivationrepresentsthemostrecentnationaloverview
ofdeprivation(CommunitiesandLocalGovernment2007).TheIndicesusethenew
IndexofMultipleDeprivation2007,whichisbasedonthesmall-areageography
knownastheLowerSuperOutputArea(LSOA).LSOAshavebetween1000and3000
peoplelivinginthem,withanaveragepopulationof1500.Theseareasaremostly
smallerthanwards,thusallowingidentificationofsmallpocketsofdeprivation.The
IndexofMultipleDeprivation2007containssevendomainswhichrelatetoincome
deprivation,employmentdeprivation,healthdeprivationanddisability,education
skillsandtrainingdeprivation,barrierstohousingandservices,livingenvironment
deprivation,andcrime.TheNorthEastistheregionwhichhasthegreatest
Weekly income 2004/05
Figure6.3.Averageweeklyhouseholdnetincome Figure6.4.Averageweeklyhouseholdnetincome
estimate(equivalisedafterhousingcosts),NE estimate(equivalisedafterhousingcosts),NE
Datasource:Aggregatedfrommodel-basedestimatesatMiddle Datasource:Aggregatedfrommodel-basedestimatesatMiddle
SuperOutputArea(MSOA)level,ONS2004/05 SuperOutputArea(MSOA)level,ONS2004/05
45 % in bottom quintile % in top quintile

40
35
30
25
20
15
10
5
0
on
st
ds
t
r
ds
st
d
be
es
es
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an
Ea
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r th
idl
h
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h
En
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M
tM
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No
So
&
So
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ire
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Yo
Figure6.5.PercentageofLSOAsinthemostandleastdeprived20percentof
LSOAsinEnglandontheIndexofMultipleDeprivation2007,byregion
Source:CommunitiesandLocalGovernment(2007)
31
IMD 2007 average of SOA scores IMD 2007 average of SOA scores
Figure6.6.IndexofMultipleDeprivation2007 Figure6.7.IndexofMultipleDeprivation2007
scores,NE scores,NE
percentage(34.2percent)ofitsLSOAsthatfallinEngland’smostdeprived20per
cent,followedbytheNorthWest(31.8percent)(Figure6.5).
Inthepairofmaps6.6and6.7,darkershadingdenoteshigherlevelsofdeprivation.
Theapparentcorrespondencebetweenthedeprivationmapsandthevarietyof
outcomeswelookedatinthepreviouschaptersisobvious.Itseemsthereisa
significantcorrelationbetweenpooroutcomesinlifeexpectancy,under-18
conceptions,educationalattainment,participationinhighereducation,perceptions
ofantisocialbehaviour,economicinactivityandhighlevelsofdeprivation.Thiswill
notcomeasasurprisetomany,buttheanalysisprovidedinthisreportservesto
emphasisehowdominanttheinfluenceofdeprivationisforsomuchofthe
populationintheNorthEast.
Thesocialandeconomiccontextoutlinedabovebeginstoexplaininparttheparadox
ofincreasedinvestmentandimprovedservicesandyetweakregionaloutcomesand
intra-regionalinequalities.Therecessionandcutsinpublicspendingwillnothelp.
Therestofthisreportlooksatthecurrentpublicservicereformagendaandwhya
newapproachmaybeneededfortheNorthEasttomeetthechallengesitfaces.
32 PublicServiceParadox| Thecurrentpublicservicereformagenda
7.Thecurrentpublicservicereform
agenda
WhenLabourcametopowerin1997thecountry’spublicserviceswerewidelybelieved
tobeperforminginadequatelybecauseofmanydecadesofunder-investment.Thisview
wasreflectedinopinionpollsatthetime,whichshowedthatthepublic’sfirstpriorities
weretoimprovethequalityofhealthandeducationservices.Overthelast12yearsthe
Labourgovernmenthassucceededinputtingpublicservicesatthecentreofpublic
debateandgovernmentaction.
TheGovernment’sbasicapproachtopublicservicesduringthistimehasbeenoneof
investmentandreform.Itdidnotwanttoincreasetheamountofinvestmentifitcould
notbeconfidentthatitwouldbewellspent.Broadly,therehavebeenthreephasesof
publicservicereformsince1997:
•Phase1focusedontop-downinitiativesfromthecentre,withtheexplicit
introductionofclearnationalstandardsandtargetstodriveupperformance.
Examplesincludetheintroductionofnumeracyandliteracyhoursinschools.
•Phase2attemptedtodrivereformthroughtheuseofchoice,competition
mechanisms,andthediversificationofserviceproviders(involvingagreaterrolefor
theprivateandvoluntarysectors).Examplesincludepatientchoiceinhealthandthe
creationofAcademyschoolsineducation.
•Phase3hasprioritisedpersonalisation7 andcitizenempowerment.Examplesinclude
reformofGPs’openinghours,thepromiseofone-to-onetuitioninschools,and
individualbudgetsinsocialcare.
Phase4,currentlytakingplace,continuestobuildonthethemeofpersonalisationand
citizenempowermentbutalsostressestheneedtodevelopanewrelationshipwiththe
publicsectorworkforceandalessprescriptiveandmorestrategicroleforWhitehall.Most
recentlytheGovernmenthassuggestedthattargetsandcentraldirectionshouldbe
replacedbyasetofcitizenentitlements(HMGovernment2009a).
KeyissuesfortheNorthEast
AnumberofgeneralobservationshavebeenmadeabouttheGovernment’sapproachto
publicservicereform.Belowwesummarisesomeofthekeyissuesthatmayberelevant
totheparadoxwehavedescribedinthispaper.Someofthesehavebeenacknowledged
inthemostrecentCabinetOfficereportonthetopic,WorkingTogether:Publicservices
onyourside (HMGovernment2009b).
•Recordlevelsofinvestmentinpublicserviceshavenotyieldedequivalent
improvementsinoutcomes,particularlyintermsoftacklingtheunderlyingcausesof
socialproblems.Toooftenthestategetsinvolvedafterproblemsarise,insteadof
focusingonearlyinterventionandprevention.Policiesdesignedtochangebehaviour
remainintheirinfancy.
•Therewassomethingofa‘mixandmatch’approachtomodernisation.Labour
attemptedtoreformpublicservicesbyusingacombinationofatraditional
‘command-and-control’model,withadditionalmarketreformssuchasgreater
contestability.
•Powerwasconcentratedatthecentreandnotsufficientlysharedbetweendifferent
tiersofgovernment,notablywithlocalgovernment,andthepublicservices,andtheir
users.Despitesomelocalistinitiativesinrecentyears(forexample,areductioninthe
numberoftargets)Labourintensifiedthepost-wartrendofcentralisation,andlargely
failedtoencouragepluralistanddecentralisedsolutions.
7. Servicesthattreattheirusersas
individualsinaresponsivemanner,
•Reformtendedtoconcentrateonthefrontline–forexampleschoolsandhospitals–
aswellasbeingsensitivetotheir ratherthanreformtoWhitehallandcentralgovernment.Consequently,thecentrewas
needsandpreferences. onlypartiallyreformed.
33
•Partsofthepublicserviceworkforceandprofessions,especiallyinhealth,became
disenchantedanddisillusionedwithtop-downreform.Governmentdidnotdoenough
tolistenandlearnfromthefrontline.8
•Notenoughhasbeendonetopersonalisepublicservicesaroundtheuser(for
example,intermsofharnessingtheopportunitiesprovidedbynewtechnology),orto
empowercitizensmoremeaningfully.
•Significantemphasiswasplacedonthechoiceandcompetitionagendawithouta
clearaccountofthecircumstancesinwhichquasi-marketsaremostlikelytogenerate
improvements.BritishSocialAttitudesdatasuggeststhatthepublicsupportsgreater
choice,especiallyinhealthandeducation,butappearstohavelittleenthusiasmfor
theseservicesbeingrunbyprivateorvoluntarysectororganisations(ipprandPWC
2009).
•Publicservicereformtendedtoconcentrateonstructures,notrelationships.Reform
wasoftentoomechanical,tootop-down,andthereforefailedtofocuson
understandingandimprovingtherelationshipsbetweengovernment(nationaland
local),services(public,private,thethirdsector,andtheworkforce)andcitizens,
communitiesandusers.Gettingtheserelationshipsrightiscrucialtoimproving
outcomes.
ItisimportanttonotethattheConservativePartyhasstartedtosetoutsomeofits
thinkingonpublicservicereform,whichisshapedbytheideathatsocietyisenteringa
‘post-bureaucraticage’.Attheheartofthisagendaisadesiretoredistributepowerfrom
thestateandgovernmenttoindividualsandcommunities.Itrejectstop-downcentral
control,arguingthatthestate‘crowdsout’innovation,andadvocatesmuchgreater
involvementofsocialenterprises,voluntarygroups,andtheprivatesectorinpublic
servicedelivery.Thisthinkingalsoincludesideasforpolicingandeducationwhichclaim
toenhancelocalaccountabilityandempowerprofessionals.
Atanippr/PriceWaterhouseCoopersLLPeventforthejointproject‘theSmarterState’10,
LiamByrneMP(atthattimeMinisterfortheCabinetOffice)andtheConservative
MichaelGoveMP(ShadowSecretaryofStateforChildren,SchoolsandFamilies)laidout
theirviewsanddebatedpublicservicereform.Inmanyrespectstherewasagreementon
theneedforasmallerstate,empoweringcitizensanddevolvingpower.Therewasless
agreementonhowthisshouldbedoneandGovesaid,inrelationtolocalauthorities:‘the
lastthingwewantisareturntomunicipalism’.
InrelationtotheparadoxintheNorthEast,thecurrentproposalsforpublicservice
reform,therecessionandassociatedspendingcutsthrowupmorequestionsthan
answers.Forexample:
•Howisitpossibletodecentralisepowertoindividualsandcommunitiesandguarantee
equity?
•Isitpossibletoensurethatchoiceoperatesinawaythatisfairtoall–won’tsuchan
approachcreatehighlevelsofsegregationalonglinesofsocialclass?
•Istheresufficientcapacityinthirdsectororganisationstocopewiththepressuresof
extensivepublicservicedelivery?Willgreaterinvolvementleadtomorebureaucracy?
•Isthereapublicappetiteforempowerment?Forexample,doparentshavethetime
andinclinationtosetupschools?
•Aretheresuchthingsas‘smartcuts’?Canperformanceimprovewhenspendingis
decreasing? 8. SeeNationalSchoolofGovernment
(2009)forlatestproposalsonthis
Theapparentparadoxandunansweredquestionsarisingfromthecurrentproposals issue.
suggestthat,ontheirown,thereformagendasandspendingplanssetoutbythemain
9. www.ippr.org/uploaded
politicalpartieswillnotbesufficienttoclosethe‘outcome’gapintheNorthEast.So, Files/pressreleases/2008/smarter_s
whatelsewillberequired?ItistothesechallengesthatweturntoinChapter8. tate_launch.pdf
34 PublicServiceParadox| TacklingtheNorthEastparadox
8.TacklingtheNorthEastparadox
TheCommissionhasfoundthattheNorthEastregionhashigh-performingpublic
servicesandsomeofthehighestper-capitapublicinvestment,butsignificantlyhigher
levelsofdeprivationanddisadvantagecomparedwithotherEnglishregions,exacerbated
bygreatintra-regionaldisparity,whichhasnegativeimplicationsforoutcomes.This
chapteridentifiessomeofthekeychallengeswebelievethesectormustovercometo
tackletheparadox.
ChallengesforthepublicsectorintheNorthEast
TheCommissionhasidentifiedthreeinter-linkedthemesunderwhichthepublicsector
andtheregionfacechallenges.Foreachthemewehavemadeonekey
recommendation.
•Theme1:Deliveringthebestservices.ThepublicsectorintheNorthEastishitting
centralgovernmenttargets,butmissingthepoint.
•Theme2:Accountabilityandfunding.ThepublicsectorintheNorthEasthaslotsof
responsibilities,butnotenoughrights..
•Theme3.Ajustandsustainableeconomy.Thepublicsectorcanonlydosomuchfor
theNorthEastasthestateoftheeconomyisabarriertoprogressintheregion.
AllthreeplayaroleintheparadoxandtheCommission’sworkhasfoundthat
overcomingthefirstchallengeofdeliveringthebestserviceswillnotbepossibleuntil
morefundamentalchangesaretackledregardinghowwecurrentlymanageregional
accountability,fundingandeconomicdevelopment.
Thebestservices
ThepublicsectorintheNorthEasthasprovedtobeverygoodatdoingwhatWhitehall
hasaskedittodo.Earlierchaptersofthisreportillustratehowtheregion’spublic
serviceshaveconsistentlyhitthetargetsthathavebeensetforthem.Thefactthatwe
havenotseenarelativeimprovementinoutcomessuggeststhattheywerenotalways
therighttargetsfortheNorthEast.Thishasbeenpartlyacknowledgedthrough,for
example,movestowardsLocalandMulti-AreaAgreementsandComprehensiveArea
Assessments.OurworkssuggeststhatpartsoftheNorthEasthavebeguntomakegood
useoftheseinitiatives.Butwewouldarguethatmorefundamentalchangeisrequiredif
theregionistotackletheparadox.
ThepublicservicesintheNorthEastneedtobe measuredbytheireffecton
outcomes.Judgementoftheperformanceof,forexample,theregion’shealthservice
shouldreflectfactorslikelifeexpectancy,heartdiseaseandhealthinequalities.At
themomentperformancemeasurementshighlightedearlieraretoofocusedonaccess
to,andqualityof,resources.Ifthesefactorsimprovetheycanmasklackofprogress
onoutcomes.
Takingtheexampleofhealth:healthinequalitiesonlynarrowwhenavarietyofhealth
and‘non-health’interventionscombine.Figure8.110 illustratesthepoint.Publicservice
performanceismainlymeasuredinthetoptier,withalittleinthesecondandlessinthe
third.Thethirdtierrepresentslifestyle,includinglevelsofsmokinganddrinking,andthe
fourthisenvironmental,includinghousingandpollution.
DavidAlbury,anex-PrincipalAdviserinthePrimeMinister’sStrategyUnit,saysthatthis
isareflectionofa‘producer-driven,medicalised,hospital-centricsystem’.Someargue
thatthecurrentapproachisaslikelytoincreaseasreduceinequalities,despitethe
10. ThankstoDavidAlburyforthe
Government’sbestintentions.
allowingtheuseofthisdiagram
basedononehepresentedata Itwouldappearthatnewmeasuresofpublicsectorperformanceareneededwhichare
Commissionroundtable. lesscentrally-drivenandmightincludewell-beingandhappinessovertimeaswellasthe
35
Figure8.1.Publicservice
Access,quality interventionsand
andresources performancemeasurement:
ofhealthcare healthinequalities
Screeningearly,
intervention&diagnosis
Lifestyle:smoking,diet,exercise,alcohol
Socialcapital
Environmental:housing,income,pollution,work
“Untilrecently,inrelationtoPCTs[PrimaryCareTrusts],andnow,overwhelmingly,in
relationto90percentoftheresourcesthatarechannelledintotheNHS,there’s
nothingthatwouldincentivisethebulkoftheNHStofocusitseffortinawaythat
wouldreducehealthinequalities.Indeed,perversely,thechasingofrealperformance
againsttraditionaltargetsmayadverselyaffecthealthinequalitiesthroughallsortsof
marginaldecisionsthataremade.”
Delegate,Commissionroundtableonhealth,19March2009
collectiveperformanceofthesectoragainstregionaloutcometargets.Thisleadstothe
nextchallenge.
Thepublicsectorneedsto focusonpreventionoflong-standingproblemsinthe
NorthEast.Toomuchofthetime,publicservicesaretreatingsymptomsandnotthe
causeofproblems;reactingnotpreventing.Theearlieranalysisshowsthisinallfourcase
studyareasanddemonstratestheinevitabilityofthatbeingthecasewhen,forexample,
thecriminaljusticesystemismeasuredonitstoughnessoncrimeandnotthecausesof
crime.Inthecontextoftheimpendingcutsinpublicspendingandthewayfundingis
allocated(whichweturntolater)thisisahugechallenge,buttheCommissionhas
foundthattheNorthEastlagsinareaswhereithasbeenbehindforaverylongtime.
Twoareasthatseemtostandoutfromourpreviousanalysisareattainmentinmathsand
EnglishandaccesstoFurtherEducation.SomewaysthattheCommissionbelievesthat
theregioncouldmakeprogressintheseareascouldbeto:lookatproactivelabour
market(jobcreation)strategiesalongsidesupply-sidestrategies(welfare-to-work),and
makebetteruseofexistingpowerstotaketheleadonpilotinginvestmentin
preventativeapproacheswithmedium-termsavingsassociatedwiththem.
.
“Thedifficultyisalwaysthatwhatarereallysensibleinterventions–weknowthat
interveningtherewillsavemoneyoverthere–theonlyproblemisthatit’s
interveningintheeducationsystemwhenthesavingistothePolice,orit’s
interveningatthelocalauthoritylevelwhenthesavingistothehealthservice,and
actuallythey’renotcashablesavings,anyway.There’salotofworkthatneedstobe
done,whichagainitseemstobeisnational(thoughwemighttryandpilotsomeof
thislocally).It’sabouthowyouenablethoselong-termpreventivestrategiestobe
putinplace.”
Thesemeasuresrequireanewkindofinteractionbetweenusersandproviders,leading
ustothenextchallenge.
Thepublicsectormustrespondtotheneedsofthepeopleoftheregionandengage
localpeopleandcommunitiesandworkwiththemtosolveproblems.Toooftenthe
publicsectorgetstrappedintotryingtosolveproblemsforpeopleandcommunities,
ratherthanwiththem.Thiscanmeanthatalotofenergycangointoconsultingonand
developingunsuccessfulsolutionstothewrongproblems.Thisisnotsatisfyingforthe
passivereceiverofservicesortheprovideranditisnotefficienteither.
Theregion’spoorrecordonteenagepregnancycouldwellbeanareawhereamore
responsiveandempoweringapproachcouldyieldbenefits.Thisrelatestoanissuethat
hasbeenofgreatinteresttotheCommission,namelythepersonalisationofservices.
Duringtheinvestigationoftheissuesrelatingtopersonalisationitbecameapparentthat
manypeopleintheregionfeltthattherewasaparticularproblemwithengagementin
theNorthEast.Thesuggestionisthatpartoftheexplanationoftheparadoxisthatthe
region’spublicserviceshaveperformedbestwhererecipientsarepassiveandworst
whereengagementisrequired.
“Ifyouhavealowsenseofefficacy,thepersonalisationagendaisactuallyyour
enemy.…Mostofusfacedwithachoicearequitehappytoengagewiththewhole
intellectualbusinessofchoice–tellmeaboutthisone,tellmeaboutthatone.But
therearequitealotofpeoplewhodonotevenwanttobeginthatdiscussionwith
theirGP.”
Delegate,Commissionroundtableonwelfarre,25March2009
Thisleadstothenextchallenge.
Achallengefortheregion’spublicsectoristodevelopserviceswithabetter
understandingofhowdifferentpeopleandcommunitiesmightmakechangesintheir
behaviourandhowservicesmightsupportsuchchange.Ifthepublicsectoristobe
measuredbyitseffectonoutcomes,throughgreaterpreventionandmoreeffective
engagement,thenthesectorneedstobebetteratunderstandingbehaviour.Behavioural
changeisincreasinglybeingrecognisedasaprerequisiteforpositivesocialchange,but
todatepublicservicesandgovernmentpolicyhavenotbeenverygoodatrecognisingit.
Itisthoughttobeparticularlyimportantinregionswithhighlevelsoflong-term
disadvantage,liketheNorthEast.Thechallengeistodeterminewhichchangesare
requiredandhowbesttobringthemabout.Thepublicsectormustworktowardsa
sharedunderstandingwiththeirusersofwhatneedstobedone,whyitneedstobe
done,howitcanbestbedoneandwhen.
“Wedostartfromaservicemodel.Wehadadiscussionrecentlyabout
breastfeeding…It’sallaboutthecontentoftheservice,it’snotabout‘let’slookat
thisfromthepointofviewfromthosewhosefirstinteractioniswiththemidwife’,
there’sawholeapproachtotherelationshipbetweenthemidwifeandthemother.
Butnoneoftheanalysisaboutwheretoinvestwasaboutwhatdoweknowabout
thecontextualbarrierstobreastfeeding,whatgetsinthewayofevenanexhortation
ofbreastfeedingbeingresistedbythemother.”
InSouthTynesidetherehasbeensomeworkinvolvingbehaviouralpsychologistsin
regenerationprojects,whichisthesortofinitiativewewouldliketoseedevelopandspread.
Afurtherchallengeforthesectoristobeinnovativeandopentonewwaysofdoing
thingsthroughandbeyondthecomingcutsinpublicsectorspending.TheNorthEast
mustnotjustlooktosurvivingtherecessionandimpendingpublicspendingcuts.Some
haveevenoptimisticallysuggestedthatifinnovationisembracedthenregionslikethe
NorthEastwitharelativedependenceonthepublicsectorcouldbestrengthened.
37
Ina2009reportNESTAacknowledgedthat,inthecontextofjoblossesandpublic
spendingcuts,suggestingthattheeconomiccrisisoffersopportunities‘mightappear
crassandnaïve’,butwithoutinnovativeresponsestotherecession‘ourpublicservices
willbeover-stretchedbytheshort-termdemandsofthedownturnandoverwhelmedby
thelong-termchallengesofthefuture’(HarrisandAlbury2009:4).
MatthewTayloroftheRSA11 suggeststhatifthepublicsectorweregivenmorefreedom
toinnovateduringthisdifficultperiodthenregionsliketheNorthEastcouldseereal
benefits:
Aspublicservicebudgetsgetsqueezedthetemptationforcentral
Governmentwillbetotieeverythingdown,promisingthat
budgetsandservicelevelswillbemaintainedintheareasthe
publicseemstocareaboutmost.Butsuchanapproachwouldbe
disastrous,leavingservicemanagersandfrontlineworkersno
roomorincentivetodothingsdifferently.Currentlyitisassumed
thattheareasthatwillbemostbadlyhitbypublicservice
retrenchmentarethose–liketheNorthEast–whichhavethe
highestproportionoftheirlocaleconomyinthepublicsector.But
ifthesqueezeleadstonewwaysofthinkingandworkingit
couldbethoseareasthatseethebiggestadvancesinoverall
productivity.(Taylor2009)
TheCommissionbelievesthatinnovationisnotaluxury,itmeansbeingopentodoing
newthings,doingthingsdifferentlyandstoppingdoingotherthings.Innovationmeans
connectingwithdifferentorganisationsinnewways,beingambitiousandmotivatedto
change.Forexample,wehaveidentifiedparticularproblemsinrelationtoperceptionsof
thecriminaljusticesystemandprobationservices.Itmaybethatmoreinnovative
approaches,suchasrestorativejusticeschemes,mayimprovepublicperceptioninthese
areas.
Thepublicsectorneedstofosteracultureofproactivityandinnovation,developanew
approachtoriskandgivepermissiontofrontlineworkerstoworkwithuserstodefine
andsolveproblems.Theregion’spublicsectormustlearntoweighuptheshort-term
risksassociatedwithinnovationagainstthelong-termriskofallowinglong-standing
problems,whichunderpinthepooroutcomes,togounaddressed.
However,someoftheinnovativethingstheyneedtodotomovetowardsofferingthe
bestservicestothepeopleoftheNorthEastarenotcurrentlypossible.
KeyRecommendation1:
ThatthepublicsectorintheNorthEastisgrantedgreaterfreedom,withina
frameworkofstrongeruseraccountability,toimproveitsownperformancewithmore
ofafocusonlonger-termoutcomesthanshort-termtargets.
Accountabilityandfunding
TheCommissionsetoutwithakeeninterestintheroleoflocalisationinthereformof
theNorthEast’spublicsector.Inourcasestudieswehaveseenthatwhatthesector
doesandhowitdoesitislargelydictatedbyWhitehall.Wealsoseethatmostofthe
moneytodoitwithcomesfromLondontoo.Thiscreatesbothrealandperceived
restrictionsontheabilityoflocalservicestodirecttheireffortstolocalpriorities.Italso
createsconfusionaboutaccountability.Thesectorcouldbesaidtohavelotsof
responsibilities,butnotmanyrights.
ToovercometheparadoxthepublicsectorintheNorthEastneedstobemore
flexibleandresponsiveandtodosomustleadonthedevelopmentofanewclear
visionforthefutureoftheNorthEast.Thisvisionneedstoreflectthechallenges
frompoint1(‘thebestservices’)above.
11. TheRoyalSocietyforthe
Todevelopsuchavision,theregionmusthaveleadershipthatisvisible,accessible, encouragementofArts,
accountableandwiththepowertomakeschangesneededtoachievethevision. ManufacturesandCommerce
“Indealingwith[theDepartmentforWorkandPensions]overmanyyears,they’re
extraordinarilyblindtodifferencesupanddownthecountry.Theydesignnational
policiesandthenprettymuchapplythosenationalpolicieseverywhere,OKwitha
littlebitofdevolveddelivery.IfyouworkyourwaythroughtheWhitePaperon
WelfareReform,there’shardlyamentionofplaceinthere,yetactually,upanddown
thecountry,there’shugevariationinthesheerscaleoftheproblemwe’redealing
with…intheNorthEastofEngland,you’vegot155,000adultsofworkingageoutof
thelabourmarketonincapacitybenefit,that’sfractionallyunderoneintenofall
adultsbetweentheagesof16andstatepensionage.Thatisastaggeringnumber,yet
therearelargeswathesoftherestofthecountry,inSouthEastEnglandforexample,
whereit’stypicallyjust2or3percentofalladultsofworkingages.”
Delegate,Commissionroundtableonwelfare,25March2009
TheCommissionwouldarguethatovercomingtheotherchallengesoutlinedhereis
contingentonmakingprogressinthisarea.Forexample,additionalchallengeswe
haveidentifiedaretheneedtogainmorecontroloflocalpublicspendingand
movetooutcome-basedbudgetingandincreasetheproportionoftheregion’s
expenditurethatisraisedlocally.Ifthisweretooccur,forexamplethrough
hypothecatedgreentaxes,andlocalleaderswereseentobetheonesdecidinghow
tospendmoremoneythathascomestraightfromlocalpeople,thencitizenswould
bemorelikelytowanttoknowwhothoseleaderswereandhowtheycouldgetridof
themiftheydislikedwhattheyweredoing.
Ifprogresswasmadeonregionalaccountabilityandfunding,publicsectorleaders
wouldstillhavethechallengeofbeingmoreproactive,openandinnovativeabout
overcomingrealandperceivedbarrierstomakingtheregionsucceed.Somehave
arguedthatthereisaregional‘cultureofdependency’andlowaspiration,
particularlyamonglow-incomegroups,buttherearesomepartsoftheUKwhere
somelow-incomegroups(forexample,certainethnicminoritygroups)appearto
buckthetrend.ThiscouldsuggestthatthecharacteristicsoftheNorthEast–with
itslong-termdisadvantageandlowerethnicdiversitythanotherregions–maymake
theproblemmorechallenging.
Somewouldarguethatmakingjudgementsastowhetheraspirationsareloworhigh
missesthepoint.Asstatedearlierwethinkengagingcitizensandcommunitieswillbe
crucialiftheregionistochangebehavioursandimproveoutcomes.Thebasisof
successfulengagementisworkingfromwherepeopleareandthroughreachingan
understandingofandnurturingtheiraspirations.Thiscouldbeparticularlyimportant
withregardtothoseworkingwithyoungpeopleandineducation.
“Youngpeoplemayhaveaspirationsbutparents,carers,otherswhoaregiving
advice,mayletthemdown.Actually,ifyougoandtalktoyoungpeople,they’vegot
realisticandquitestrongaspirations,butthosearebeingdampenedbyadultsinthe
region,whetherthatbeparents,carers,advisers,whoever,whoaresaying‘actually
I’mnotsureyoucandothat,I’mnotsurethat’savailableintheNorthEast’.”
Delegate,Commissionroundtableoneducation,27March2009
Anotherchallengethatfollowsonfromtheaccountabilityandfundingissuesisaround
theneedfortheregiontoensurethatpublicsectororganisationsareshapedandlinked
bylocalneedandopportunities.ThereisnoreasonwhyWhitehallshoulddetermine
whichlocalagenciesshouldbecreatedoraxed.Iflocalleadersareaccountablefor
deliveringonpriorities,thentheyshouldhavethepowertodeterminethebestwayof
doingso.
KeyRecommendation2:
ThatthepublicsectorintheNorthEasthasgreaterfreedomoverpublicfinancesto
addresslocalneedsandprioritiesandtostrengthenanddeveloplocalaccountability.
39
Theeconomy
Themapsinthisreportshowthatwheredeprivationishighest,outcomesarealmost
alwayspoorer.ThecartogramsalsoshowthatthereisalotofdeprivationintheNorth
EastandliketherestoftheUKitisanunequalplace.Thissuggeststhatattheheartof
theanswertotheparadoxistherelativeweaknessoftheNorthEastregionaleconomy.
Economicdisadvantageisapowerfulbarriertogoodoutcomesforpeopleandplaces.
SomemeasuresofpovertyhavefallenintheNorthEast,buttheymayriseagaindueto
therecession.Untilpovertylevelsdropsignificantly,gapsinoutcomesbetweenother
regionsandwithintheregionaregoingtobeverydifficulttoclose.
TheCommission’sworkhasshownthatthepublicsectorhasakeyroletoplayinthe
developmentofajustandsustainableNorthEasterneconomy.Overcomingsomeofthe
challengesinthechaptersabovewillhelp,butthepublicsectormustalsofacethe
challengesofhowtocreatetheconditionsforincreasedemploymentandmoreequal
economicparticipation.Itmustworkouthowtoworkwithpartnerstocreateamore
diverseeconomywithastrongerprivateandthirdsector.Anexamplefromour
analysisofanareaforactionisthelowwagesintheregion.
TheCommissionbelievesthesectormustfacethechallengeofprovidingservicesthat
reducemultipledeprivationandinequalityinoutcomes.Thiscouldmeaninitiativeslike
anacross-the-boardcommitmenttoreduceinequalityorauditingtheimpactof
decision-makingonthemostdeprivedcommunitiesandpeople.Aswellasreactingto
deprivationthesectorshouldlooktobeprovidingservicesthataddressthecauseof
multipledeprivation.ipprnorthislookingfurtheratthisissuethroughanewproject,
‘MakingCityRegionsWorkforDeprivedCommunities’andinvestigationataregional
level.RecentworkbyWilkinsonandPickett(2009)saysthat‘moreequalsocieties
almostalwaysdobetter’.
OnewaytotackledeprivationisbytheNorthEast’spublicservicesplayingtheirpartin
continuingtopromoteenterpriseandattractinvestmentandemployerstothe
region.Commissionersbelievethatthereispotentialforthedevelopmentofa‘green’
technologyspecialismfortheregionandthedevelopmentofoverarchingregionaljobs
targets.TheCommissionwouldalsoliketoseeinitiativessuchasthecreationoflocal
authoritypartnershipstoprovidebankingtosmallbusinessesintheregion.
KeyRecommendation3:
ThatthepublicsectorintheNorthEastshouldextenditsworkwiththethirdand
privatesectorstodevelopinnovativeapproachestoservicedeliverythatpromote
economicdevelopmentfocusedontacklingregionaldisparities,respondingtothe
recessionandpreparingforsustainablerecovery.
40 PublicServiceParadox| References
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Figure2.1.UKidentifiable 2003-04 (£ per head)

Life expectancy 2004-06 Life expectancy 2004-06

Figure2.4.2 Map:NElocalauthoritylocator Figure2.4.Cartogram:NElocalauthoritylocator

Yorkshire and the Humber

0 200 400 600 800 1,000 1,200 1,400 1,600 1,800

Yorkshire and Humberside

0 100 200 300 400 500 600 700 800 900

Weekly income 2004/05

45 % in bottom quintile % in top quintile

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