Balancing the books – efficiencies, no-frills and co-payment

According to the media today, Wednesday’s budget will include £15billion of efficiency gains in 2010/11 to assist in balancing the public sector’s books. While any impetus to get more out of public spending is welcome, we need to remember that there are allsorts of issues with how efficiencies are measured. Moreover, if it is not possible to get “more for less”, we will all get “less for less” – the kinds of cuts seen so often through the 1970s, 1980s and 1990s.

Perhaps “no-frills” public services are inevitable – even if they are no one will admit it this side of an election. One thing that I am fairly sure about is that we will see more “co-payment” – that’s the jargon for users paying something towards the cost of services. (There was discussion of this as part of the Blairist approach to public service reform but it largely faded away with the arrival of Brownism - apart from in the NHS where the issue developed its own momentum due to NICE decisions.) We’ve got co-payment in higher education already. Where next? Or rather, where after the next election?