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SeanworthSean Worth, a former Downing Street Special Advisor, is starting a new project for Policy Exchange. Follow Sean on Twitter

I have said today in an interview with the Guardian that we have to keep up the pace of public service reform. Not just to bring in the charities, businesses and technology that will at last make them more innovative and effective.  But because, given the spending restraint services face, and the continually rising demands on them, public services are too important to see wither. Reform is vital.

Iain Duncan Smith, Andrew Lansley, Michael Gove, and the Prime Minister himself, have made heroic reforming strides already. They, and the Blairite reformers before them, deserve great respect for the slog involved. But there are a raft of other service areas throughout central and local government that urgently need the same attention.

Paul Goodman rightly points out that the big issue at the next election will be the economy and that should be the Government’s focus. I agree – but believe the economy and public services will be inextricably linked.


In what are now only a couple of years or so to the next election, we of course expect the economic course we’ve charted to produce stability at least; the start of growth preferably. But the human costs of the structural economic weaknesses this government inherited – huge skills deficits, a culture of worklessness in too many communities, an unbalanced economy – are still being exposed and the fall-out borne by our public services.

I have said that the big problem is, regardless of the financial urgency, or the public demand, this country is too reform-averse. Commentators have mused that this is currently due to the civil service. Or that there isn’t enough political drive. Or that coalition crushes the required zeal…

But the real problem is much longer term: the fact that services are largely held under trade union control and bringing in alternative providers or new technologies, however brilliant, is a threat to that. It’s the reason so much political capital is required to change anything, and in turn why reform has been too-seldom attempted.

I worked in politics long enough to respect robust debate. But something has changed in the last two years. The propaganda put about by some unions is becoming much more militant, twisted and nasty, and organised on a much vaster scale.

Something I experienced, walking in town with my family in Berkshire: a leaflet thrust in my hand about how the Tories (no mention of the Libs; that would dilute the message) want to privatise the NHS, tear up services and put families at risk. Other parents were being handed these patent lies that could scare people stiff; a business, charity or political party could land in serious trouble using such material. The organiser of a nearby campaign stand gave no response other than that the material was produced ‘centrally’. There were, of course, huge amounts of this false propaganda being spread in very well-funded and coordinated campaigns, underneath more measured media appearances by “doctors’ leaders”.

I’m not advocating censorship at all, but we have to stand up more strongly to it for what it is. But also, the biggest missing voice in the debates over reform are actually people themselves, and the new providers and innovators who could help transform services. We need to hear much, much more from them if reform is to succeed.

That’s why I’m starting a new project at Policy Exchange – to help provide exactly this voice, some new ideas, and some concrete recommendations for making policy progress. We’ll be asking all sorts of interesting questions about how to improve public services with much more charity, business and technological innovation. 

Given their experience, I think the unions could actually make a really positive contribution to this. I respect their role and their heritage, but the debate really has to be better. And I hope tomorrow’s planned strike by doctors in demand of £68,000-a-year pensions is called off – because to get the result they want, the unions will have to disrupt patient care, which for that cause is inexcusable.

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