2 Tackle social injustice by letting the best provider provide

The public service ethos is about promoting equality of opportunity for all citizens. Public services are meant to be universal and support the aspirations of all, but those most in need of support often cannot access them. One-size-fits-all services struggle to react effectively to people's differing needs and do not provide the tailored, timely services that are needed by the wide range of households in Britain today. Diversity of provision will drive a culture of continuous improvement and harness new technology to build more responsive public services.

The public is open to this idea. A CBI/YouGov poll in September 2006 found that almost 60% of people surveyed had no problem with private sector companies providing public services, as long as they were of high quality and free at the point of use.6 Harnessing such providers through competition can deliver on social justice goals by giving choice to users and encouraging innovation and continuous improvement. For example, independent providers are already:

Improving living environments for local people. One company delivers social housing management services in Edinburgh. In 2002, the council was experiencing problems within one area of the city. It suffers from social and economic deprivation, and a combination of low incomes and standards of educational achievement, with high crime rates and unemployment compared to other parts of the city. The social housing service that was being delivered did not meet people's needs. After the private provider won the contract to run services, the quality of life for residents was enhanced through consistent improvements to the neighbourhood. One local resident said of an environmental clear-up:"65 tonnes of rubbish was removed… they cut all the hedges and removed graffiti. It was fantastic."

Helping people back to work. Another provider delivers employment services to the long-term unemployed in some of Britain's most disadvantaged communities through an Employment Zones contract. So far it has helped more than 76,000 people back to work, of whom 80% stayed in work for longer than twelve months.7 Success is linked to developing an outcomes-focused contract, which incentivises staff and jobseekers through a tailored recruitment pathway, using dif ferent management strategies and real financial incentives for staff.

Getting young people off to the best start in life. In education, just over half of children leave school without english and maths at C grade, the benchmark for competence in the three Rs. This is unacceptable and blights young people's employment and life opportunities. To challenge this, in 1999 the management of nine failing LEAs identifed by OFSTED was outsourced. The private sector providers appointed turned around performance to the extent that the proportion of pupils gaining five or more GCSE A*-C grades increased by more than three times the national average from 2000-2005. In the London Borough of Islington the partnership established in April 2000 saw the borough's 5+ A*-C GCSE results increase significantly from 26.5% in 2000 to 47% in 2006.⁸ Yet this valuable programme has been allowed to stall, with partnerships reserved for a few areas, and good practice not being spread.

Improving access to health services. A lack of GPs is a particular problem in many deprived urban areas. To address this, Primary Care Trusts (PCTs) have used outside providers to supply healthcare in such areas. In East London, Barking and Dagenham PCT has signed a deal with a private provider to run a 7,000-patient GP practice and a 100-patient-a-day walk-in centre, targeted at areas of particular need. Other boroughs have followed suit. In Tower Hamlets, the PCT commissioned one firm to provide a walk-in centre offering local residents easy access to primary healthcare services without an appointment. Since it opened, surveys show 97% of patients have found the care provided to be good or excel lent. The provider has exceeded contractual requirements by having a GP present in the centre at all times, rather than the hours specifed in the contract. It has also established links with other local services, such as ambulance and A&E, which help ensure patients receive the most efficient and appropri ate treatment.