With ministers now scrutinising reports from the 13 Total Place pilots, Michael Burton reports from a recent MJ/NSA conference on Total Place
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The Pilots have completed their work and handed in their homework to the CLG. But this is far from the end of the project. Indeed, Total Place is hardly on the starting blocks.
A similar message was delivered at a recent Total Place conference organised by The MJ, and conference partner, Neil Stewart Associates.
Sir Michael Bichard, executive director of the Institute for Government and chair of the Total Place high level officials group, said: ‘Total Place is not about structure, but nor is it a marginal, fleeting initiative.
‘There’s a tendency to move on to a new idea before we’ve finished the old one. We can’t do that with Total Place. It’s not just another initiative. It marks a shift in the way we work.’
Initial feedback from the 13 pilot submissions shows there is clearly huge scope for both savings and improving services, especially when dealing with families and individuals.
Sir Michael joked there were so many different agencies dealing with vulnerable families that the latter ought to be given a free appointments book.
But his serious point was that the system is ‘pretty well dysfunctional’ and, he added: ‘The pilots have shown too many people are receiving poor, unco-ordinated services which do not meet their needs. The money is not well-managed and agencies do not act together.
‘We are failing to deliver on major social policy objectives.’
The health sector has often been criticised for not being signed up to Total Place. But Mike Farrar, another conference speaker and chief executive of NHS North West, called it ‘a fantastic opportunity’, and ‘a natural evolution of where we’ve been heading’.
Birmingham City Council chief executive, Stephen Hughes, said Total Place was a way of dealing with the difficult, persistent social problems and focusing on ‘the whole family and individual’ rather than different facets.
He calculated early intervention with children and young people could save £400m in Birmingham for an upfront investment of £42m. Every £1 spent on treating drug addicts would yield £9.50 savings. Just two families in the city involved in gangs cost the taxpayer over three generations £37m.
He said spending cuts were ‘a mixed blessing’, as ‘they have galvanised our thoughts’. He added: ‘Intellectually, we understand about public spending cuts, but not emotionally.’ And he continued: ‘The more ring-fenced budgets, the more inefficient the outcomes. Ring-fencing doesn’t work.’ Asking himself whether there could be a single budget for Birmingham, he replied: ‘Without any changes in legislation, we could get 90% of the way there simply by willpower, but the barriers are enormous.’
Since it would take 10 years for the Government to sort out debt, then public finances should be allowed to plan over 10 years, he said.
Catherine Staite, director of the Office for Public Management, said too many interventions by various agencies ‘were outcome-free, which is a shocking waste of money and effort’.
Gareth Davies, managing director, local government, for the Audit Commission, talking about the CAA process said alcohol was a serious national problem, especially in the context of health, crime and young people, and was ‘an important theme for public policy’.
Westminster City Council chief executive, Mike More, described Total Place at the conference as ‘not an initiative, but a whole system approach’. He also stressed that Total Place could only work if accountability, investment and return were aligned.
As a local example of Total Place in action, he outlined the council’s family recovery programme. The council estimated there were 40 families in the borough with extreme ASB problems, of which 35 were likely to involve care proceedings, at a staggering cost of £93,000 each.
One multi-agency team was set up to deal with each family, drawing together all the various agencies. The result was that 78% of the families were sent on parenting courses, 39% reduced their ASB, 50% saw improved school attendance, and yet, with an improved service, there was a drop in costs, expected to reach £89,000 over three years. w
