Why ambitious digital transformation is key to reforming public services
The UK is one of the birthplaces of parliamentary democracy. Our models of government and governance have been an asset (think of the number of companies that incorporate in the UK and list on the LSE, or the popularity of the English legal system). Our home and foreign civil service is widely respected (at least, outside the UK). But our institutions are now decades, if not centuries out of date. The home of democracy is now home to a crisis of confidence in democracy, especially amongst the young.
A chasm has opened up between citizens’ experiences in their day-to-day lives and their interactions with public services. The on-demand economy means millions can expect their groceries to arrive on their doorstep within an hour of an order and for their future orders to be optimised to their preferences and needs without any further interaction. Yet anyone accessing social care services can be expected to fill in a mountain of paperwork and wait months for care to commence.
The gap is clear in attitudes towards transformation too. The language of “Backlog Britain” itself is instructive. For many, the backlog in public services involves a series of discrete tasks to be ticked off. But for technologists, the job is never done. For all the legitimate criticisms, there is something inspiring in Facebook’s “the journey is only one per cent done” or Amazon’s emphasis that it is only at “Day 1”.
This matters, not only because British people deserve world-class public services; but also because people’s experiences with their government affects trust in institutions and ultimately in democracy.
These are not new discoveries. The UK was one of the first countries to recognise the importance of digitalising public services, establishing the Government Digital Service (GDS) in 2012. This model has been much admired and replicated in other countries. But despite some landmark achievements (like the award-winning GOV.UK), the UK’s digital transformation agenda has run out of steam.
GDS’s philosophy was to make delivery the strategy - to start with a manageably-sized problem and show, not tell, that it was possible to design and deliver a better service. It’s succeeded in doing this for many services, some of which are rightly recognised as world-class (passports, Lasting Power of Attorney, driving licences).
But to truly reform government, this approach needs to be paired with a deep understanding amongst political leaders of what the technology revolution means for citizens’ needs and government’s priorities. Chipping away at specific problems whilst leaving the core services and institutions unreformed can only ever amount to marginal improvements for citizens; and without sustained political backing, even this becomes exponentially more difficult.
The May and Johnson governments saw GDS abandon some of its most valuable projects. The Verify function was an ambitious effort to provide a means for UK citizens to prove claims about themselves in a wide range of public and private sector contexts. But it ran into the sand due to lack of political backing, to be replaced with One Login for Government for public services, and the Digital ID Trust Framework for the private sector - both still works in progress. Likewise, GOV.UK Registers (an attempt to establish canonical sources of data to underpin service design within government), and the commitment to publishing performance data for all government services have fallen by the wayside.
The relatively new Central Digital and Data Office (CDDO) should bridge the gap between GDS’s work putting in place high quality digital services, and the political strategy of designing and running systems - teams, departments, bodies, funding sources - in the optimal way to support the agile design and maintenance of those services. But it has yet to fully find its feet in this role - its new strategy includes an aim to “embed digital approaches and cross-functional teams into policy design and delivery”, but gives less detail as to how the capabilities required to deliver this will be developed, especially amidst 91,000 civil service job losses .
There is no shortage of talent, adaptability or creativity in the public sector. During the pandemic, public services switched to online delivery, with considerable success: most schools were eventually able to continue teaching online, and GPs held consultations by phone and video calls. The NHS App has been a particularly impressive achievement: now with over 25 million users, more than 10 million repeat prescriptions ordered and in excess of 140 million Covid-19 passes generated. Recent work shows that the public are now more confident in engaging with public services online as a result.
But this was in spite of, not thanks to, the central systems in place - for instance despite numerous philanthropic efforts, it took nine months to get laptops out to all schools. Since then, little effort has been made to bank the learnings and potential efficiency gains: conversely, the government has castigated GPs for continuing to see patients remotely and put pressure on them to return to face-to-face consultations.
Developing a tech-inclusive approach to reforming public services is crucial to help the UK recover from the pandemic, which has deprived school children of years of education, and seen NHS waiting lists surge to an all-time high. The conversation about public sector reform has focused on a narrow set of arguments around more or less spending, higher or lower public sector debt, a bigger or smaller civil service. While investment is certainly needed following decades of austerity, the hard truth is that in the long term, no amount of spending will be sufficient to overcome the quality-scale challenge. We need to radically rethink how we meet citizens’ needs.
Technology has the power to deliver the transformational change needed in our public services - by changing not just how we design and deliver solutions, but how we understand and characterise the problems.
The chief benefit of the Internet is the ability to exchange near-limitless volumes of information, almost instantaneously. The friction associated with communicating has evaporated. This has two implications for policy and public service design:
Firstly, as GDS have demonstrated, it makes it possible for public service designers and owners to gather granular, real-time data on the performance and impact of their services, testing and implementing incremental improvements constantly.
But data can also be shared amongst service users, empowering them to engage with service providers from a position of knowledge. To have innovative, effective public services, we have to somehow combine autonomy among front-line experts with accountability. Peer-to-peer health data sharing would open up an evidence base for patients on the range of care pathways and outcomes that are typical for someone in similar circumstances. Pairing this kind of tech-enabled transparency with measures to increase choice - for instance, breaking the link between geography and school choice - would expose service providers to powerful incentives to improve.
If we can get these things working, it reduces the need for Whitehall command and control and frees up space for professionals to innovate, while holding them to account for the results.
Secondly, it allows policy makers to take into account a far greater volume and diversity of inputs than ever before when setting the strategic and policy context that determines what services are provided, how and to whom. If adopted widely, this could lead to better, fairer policy by countering group-think and capture by special interests, and drawing on expertise that may otherwise not be accessible.
But it also provides a means of democratic participation, many more fora in which citizens can express themselves, with some reasonable expectation of being heard. Setting up a National Citizens Service, using prediction markets, and increasing the transmission surface between government and citizens using social media would all help here.
Using more sophisticated, higher-frequency means of understanding citizens' concerns and preferences should give political leaders the confidence to make bolder reforms to key elements of public services, taking full account of the potential of technology to improve outcomes. This doesn’t mean digital-only, but a differentiated approach. In many cases, exploiting the efficiencies generated by new models of delivery creates savings that can be reinvested in reaching out to those that need public services most, ensuring no-one in need is left behind.
In education, this means embracing the potential of hybrid and remote learning to help improve outcomes without increasing staff costs in schools. In healthcare, it would mean drawing together our individual health data to improve health care delivery and sharing this data through trusted research environments to turbocharge research. We should also fundamentally shift our approach towards preventative healthcare.
It also involves challenging long-held beliefs and providing infrastructural services to citizens. A combination of digital identity and smart contracts technologies could safely and securely deposit urgently needed monies to citizens the minute a new policy is enacted. This would require political champions for such new approaches, and explaining why new technologies for digital identity are often safer and more secure than the current, siloed and paper-based model.
Leading digital governments like Estonia and Austria are now making the leap from “good” to “great” by moving to highly personalised, proactive services. This can make services both more accessible (those that need them, get them automatically), and more efficient (only those that need them are targeted).
One case in point in the UK is tax credits: over a million households are yet to claim £2,000 a year of tax-free child-care payments. Nearly one million households are not claiming pension credit, worth nearly £3,000 a year. Either the policies are targeting the wrong people, and better data and targeting would fix this, or the services are so difficult to access that those in need are missing out.
But in order to deliver this value to citizens, government institutions need to be able to seamlessly and securely share data amongst themselves. The UK’s lack of a functioning digital ID is hampering efforts to do this.
Rethinking public services requires reforming our institutions. Alongside reforms to frontline services, progressive leaders should overhaul government digital capacity. This means making the civil service better by recruiting and retaining highly skilled civil servants, ensuring they are more competitively remunerated; removing barriers to interchange between the private and public sectors; and rewarding innovation and risk-taking.
Political leadership is needed to make this a reality. This means engaging with debates about data-sharing, and joining up services around citizens - not ducking them, or reverting to a defensive, anti-innovation stance. Politicians need to respond to the public’s legitimate concerns, and also articulate the prizes at stake: better health service delivery and clinical research; more tailored, targeted services which are cheaper and easier to navigate.
There is a current of public opinion that is optimistic about technology (and sees a role for it in public services), which at present has no political representation, as leaders tack towards easy anti-Big Tech rhetoric or generalities about the power of private sector innovation. Politicians also need to recognise that digital transformation is costly and at times - indeed oftentimes - will fail. But that is the price of progress.
Finally, political leadership in this new digital age means creating an environment where the best digital, data and technology experts want to work for public services. That will happen if - or indeed, when - they see a vision of the future of digital government which is compelling and ambitious.