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Rachel Joyce: We can cut costs and protect vital public services

Joyce_rachel Dr Rachel Joyce is our PPC in Harrow West. She has been an NHS doctor for twenty years and has worked as a director of a PCT. She also has two children who are in the state schooling system.

I fully support the notion that we should “live within our means” and George Osborne is right that we should not be looking to increase public sector debt any further. We are uniquely poorly equipped for this recession, and according to the OECD, likely to therefore fare worse than other G7 countries. This means we need more prudence in the management of the public purse.

The Labour party cannot manage anything effectively – their top-down, gimmick-ridden and target oriented policies by their very nature waste resources, whether it be manpower or financial resources. Their large projects such as the NHS IT system, identity cards or defence procurement offer the usual Labour triple whammy of loss of personal and professional freedom, overall failure to achieve the original objective and runaway costs. I agree with Andrew Haldenby’s article that reform of public services is essential to ending the boom and bust of public services. 

The one thing however that Labour can do effectively - is spin. They will be putting forward the charge of “Tory cuts” and unless we are able to tackle this head-on, this will damage us.

Most of my colleagues in the NHS and other public services are dedicated staff who have witnessed in their time important or vital services cut or not funded – often due to an apparent shortage of money. We have seen local hospitals and GP surgeries close, class sizes that are too large, teacher shortages, and police that don’t have time to record, let alone investigate many crimes. They fear public sector cuts and what they may mean for vital services.

These same public sector colleagues and the public would also be the first to agree there is significant waste in public services – not just of money, but also of professionals’ time. In the NHS the main problem is bureaucracy, mostly caused by targets. These same people would like to vote for a political party that will allow professionals to get on with the job, serving the public rather than the politicians. They would like to live in a country that is responsible, and lives within its means. But they need some reassurance before they give us the public purse.

If we just stick to the purity of the ideology of reform, we will not be providing enough specific detail to provide the reassurance that the public and professionals need. We need to reassure the public that there will be savings in wasteful projects and bureaucracy, but at the same time the public need minimum guarantees to exemplify that we are still serious about having high quality public services.

My suggestions to start with are:

  1. No reduction in front line numbers of doctors and nurses;
  2. Keeping our pledge on single bed availability to reduce the costly burden of Hospital Acquired Infections;
  3. Class sizes kept to a maximum of 30 in infant schools;
  4. No reduction in overall teacher numbers;
  5. Keep our pledge for thousands more health visitors – vital to tackle social breakdown and the issues raised with the Baby P case;
  6. An increase in the numbers of social workers (with better support for these staff in tandem with social reform);
  7. No reduction in police officers, and an increase in the time they spend on the beat;
  8. Honouring the Military Covenant and ensuring our soldiers are properly equipped;
  9. Keeping our pledge on apprenticeships and training;
  10. An improved investment in science and technology skills training – at university and higher education level.

There are countries that spend less on health and education, but have better results than us. We can guarantee front line services whilst saving money. Most savings can be achieved by scrapping big projects and poor procurement, abolishing most targets and bureaucratic rules, and by welfare reform alongside high quality training. If we give examples of how we will save money alongside examples of how we will provide high quality public services, the public will vote for the change they want and need.


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