The current government is engaged in substantial reorganisations in many parts of the public sector. Frequently these changes are not following up on commitments made at the General Election. Some embody changes that were, indeed, explicitly ruled out. But I think we’ve now learnt the value of such commitments emanating from the mouths of politicians. Some might say zero. It would be fairer to say they are of indeterminate value – is this a commitment they are intending to keep or one being offered for short term electoral advantage?
The other day I was reading comments generated by a relatively positive blog post at Liberal Democrat Voice on the restructuring of the NHS. In a response to comments the author of the blog post noted the reform as “passing power from a national bureaucracy to locally accountable organisations”. That particular phrase is worth unpacking. It taps into the prevailing discourse that uses the term ‘bureaucracy’ as a pejorative. We’ve had governments for thirty years, influenced primarily by the simplistic nostrums of public choice theory, railing against the inefficiencies of bureaucratic administration and ‘red tape’, usually accompanied by a presumption in favour of marketization or some form of hybrid network structure. There is similarly a strand in the literature on private sector organizations that has described or prescribed – it is never quite clear which – the arrival of the post-bureaucratic organisation.
The term ‘bureaucracy’ is now shorthand for all that is organizational inefficient and out of control, remote and ripe for reform. Given ‘bureaucracy’ = ‘bad’ the statement by the blogger on LDV implies that the NHS organised nationally is undesirable. Whereas, framing provision at local level in terms of ‘organisations’ is rather more neutral. Even better, they are ‘locally-accountable’. That’s got to be a good thing.
It is quite possible I am over-interpreting that specific comment by that particular author. But I don’t feel that I misrepresent the thrust of much of this type of discussion. We can see moves to devolve responsibility for provision in the name of accountability and greater effectiveness across a range of policy areas. At one level, that is a good thing. If systems and services are more effective and more accountable when organised at a local level then it is sensible to organise them in such a way. But, unless one is adopting an entirely ideologically-driven approach to policy, it is not definitionally true that they will be.
For that to be the case would imply that there are no such things as economies of scale and scope, or that co-ordination costs are never better managed within an organisation rather than across an organisational boundary, or that there is no benefit to scale as offering countervailing power. It would imply that there is never benefit in strategic planning and co-ordination at broader spatial scales. Extreme versions of the localisation argument imply that there is no benefit or necessity for expertise and anyone can pretty much run anything if we give them control over it. While claims to professionalism can be overplayed, the idea that there is no such thing as organisational or managial expertise is nonsense. Nor would it be a sensible use of resources – applying notions of comparative advantage – for everyone to run things: take years to training as a doctor, but spend most of your time making planning decisions. Even if you’re a doctor who likes making planning decisions, it would be better to allocate the activity to someone with a stronger managerial skillset.
So it doesn’t take a rocket scientist to predict that as the aggregate planning systems and larger organisations in the NHS are dismantled the roles they perform will reappear as part of the staff complement required by groupings of GPs to run their bottom-up service. In fact, it is as likely that some GP groupings will hand these functions over to private companies offering ‘management’ packages to deal with all those organisational headaches – letting them get on with treating patients. Indeed that is already happening.
So the net result in such cases is that we have seen the substitution of private bureaucracy for public bureaucracy. To the extent that the private companies entering the market tend to be large multinationals then this will see an allocation of power over health care planning and management to unaccountable and anonymous private capital. No doubt many GPs will protest that these new NHS arrangements – with GPs apparently in charge, scrutinised by local authorities, buying services from contractors from the efficient private sector - makes things more accountable locally. All I can say is that such arguments are either a complete charade or they are based on a failure to understand how power and dependency in organisations operates.
It is useful to view this debate from the opposite perspective by looking at something like Jeff Madrick’s The case for big government. Madrick makes an impassioned plea to a US audience that the antipathy to federal government that is apparently deep rooted in the American psyche is in fact dysfunctional. It stops the US from taking advantage of those things that government can do well, organising on a more aggregate scale. In the way that other countries have done very successfully without collapsing under the deadweight of taxation. As a consequence, in his view, the US underachieves as a society.
The argument that bureaucracy is bad and we need to move beyond it is deeply frustrating. It is problematic at a number of levels. First, it has lost sight of the fact that bureaucratic organisation has advantages. When Max Weber spent so much of his time writing about bureaucracy he was not uncritical, but he could see that it brings considerable strengths to large scale organisation. These included standardisation, specialisation, impartiality, continuity, clarity of roles and merit-based career trajectories, a reliance on authority rather than charismatic power. The introduction of bureaucratic processes into public administration was an attempt to move beyond partiality, nepotism and the idiosyncratic use of discretion. One person’s red tape is another person’s robustly documented procedure which demonstrates probity and transparency.
Of course the ideal-type of the bureaucracy was not something witnessed in practice. And as an institution bureaucracy is not without problems. Nonetheless, bureaucracy has strengths as well as weaknesses.
Second, the problem with the argument is that bureaucratic organisation has proved extremely resilient. Despite a thirty year assault by governments across the developed world, abetted by a phalanx of management consultants peddling new public management, business process reengineering and the like, bureaucracy is alive and well.
Third, bureaucratic organisation is unavoidable – unless we’re aspiring to chaos. All organisations above the very smallest require rules, roles, clarity of communication, systematic record-keeping etc. That is as true of the ‘dynamic, innovative’ private sector as it is of the ‘moribund’ public sector. In fact, there are respectable arguments in the academic literature that as society becomes more diverse and public administration has to reconcile more complex competing claims there will be less agreement over goals, so agreement of fair process becomes even more important (as discussed by Olsen here, for those with access). That reopens a space for bureaucratic organisation, with its emphasis upon rules, impartiality and the scope for audit.
There are some very simplistic arguments about organisation and reorganisation kicking about at the moment. There continues to be a naive belief in the power of markets. And formal and informal network organisations remain the warm and fuzzy alternative. Large scale bureaucracy continues to be the bad guy, but the quality of thought about precisely how alternatives operate and by what criteria they have been – or even in principle can be – assessed as ‘better’ are not well elaborated.
That is by no means intended as an uncritical vote in favour of bureaucracy. It is fully possible to recognise that Franz Kafka captured something important about the impersonal and inhumane nature of bureaucracy in his masterpiece The Trial, without concluding that therefore it is a sensible strategy to persist with the illusion that bureaucracy can and should be done away with. There is good and bad bureaucracy. Avoiding the bad should not and cannot mean avoiding bureaucracy completely.
Public administration always has been a mix of hierarchy, market and network. One or other organisational logic may dominate both in practice and discursively. But dominance is never complete. And it is only temporary. Effective organisation is a judicious and non-dogmatic mix of the strengths of each approach. Everyone acknowledges we face challenging times. We need more sophisticated thinking on how best to organise, and how best to hold organisations to account.