One of the often-quoted benefits of digital transformation is the improvement in the ways government departments interact with citizens and business. Departments aim to use the same systems and shared data to avoid time consuming and repetitive tasks. But the reality often falls short of expectations. So, in this blog I take a look at why cross-cutting activity is rare and how digital platforms might help.
Why are public services so siloed?
The current departmental structure brings together and manages most areas of government business through a top down, vertical management structure. This approach is highly effective in delivering many of the government’s key priorities. It provides a single, clear line of accountability and keeps tight control over resources.
However, vertical structures also have many disadvantages:
First, issues or problems which straddle departmental boundaries are neglected. Budgets tend to be allocated on a departmental basis rather to policies that cross boundaries. And mechanisms for reconciling conflicting priorities are weak.
The result is that policy makers can take too narrow a view of the issues. They fail to look at problems from the perspective of the user. And they focus on what is easiest for government to supply, not what makes sense to the service user.
Second, departments also fail to recognise that local authorities have separate lines of accountability to local voters and may not share their priorities. So, departments tend to be overly prescriptive, in specifying the means of delivery as well as the ends.
And third, there are real obstacles to effective cross cutting working on the ground. It involves complex relationships and lines of accountability. Costs tend to fall on one budget while the benefits accrue to another. If appraisal systems are incapable of identifying and rewarding a contribution to a successful cross cutting project, the risks are one way.
So how do we join up government?
My experience is that cross cutting interventions work best when government makes clear their priorities and when champions at Ministerial and Permanent Secretary level (and / or chief executive and senior management team in local government) have a lasting effect on behaviour.
Also, with these supportive conditions, the adoption of digital technologies will enable cross-cutting work. For example, emphasis in UK government is now quite rightly focussed on how digital can support business transformation through, for example, the creation of shared components (such as Verify, Pay and Notify) and common workplace tools . The common link is, of course, information technology: co-ordination involving multiple providers that both depend on compatible IT systems and common data collection and architectures.
But perhaps just as significantly, digital approaches can promote dialogue with citizens and service users.
There are two aspects to this dialogue. First government needs to provide digital channels for information and views to reach them, which are not constrained to departmental silos – people and organisations should not have to tailor their views to fit Whitehall’s structure. People often want to be involved in shaping services, particularly at a local level, not just choosing between them. Open source methods that involve users in designing services have become commonplace in business and have always been common in civil society.
And second, government needs to shift the quality of the relationship between citizens and the state, so services are shaped around the individual’s needs rather than being too standardised. The commitment to make services more personal can mean little more than having someone – a teacher or a doctor – to talk to face to face. But it can mean a different curriculum and programme for every pupil. Or a different pattern or modular options of care for every patient.
Where are we see the benefits of joined-up government?
The harbingers of the future can be found where governments face the most intense pressures. This includes the increasing incidence of chronic conditions, as an ageing population and changes in societal behaviour are contributing to a steady increase in common and costly long-term health problems. Mental illness is equally significant, accounting for over 30% of all GP consultations and 50% of follow up consultations.
As a result, in the UK we now spend over £24 billion on disability and incapacity benefits for over 3.5 million working age people.
Chronic and other complex conditions are not easily administered or treated either through a traditional clinical lens or prescriptions. Much of the care is provided by families and friends and is too expensive to be provided by formal structures and by highly paid doctors. Most of the most important knowledge about how to handle these long-term conditions resides with other patients rather than just doctors.
So, part of the answer lies with giving people control over how money is spent and support structured to meet their needs. This means giving service users direct power over money and new structures of advice, often through simple but powerful online platforms/
At its best, these approaches bridge the bottom-up and top-down, paying attention to the worlds of daily experience rather than seeing people as abstract categories. Networks and platforms can help the state track behaviours, highlighting ‘what works’, and make it easier for people to band together and take control of their care.