Spending more is no guarantee of success – the impact of 20 years of devolution on public services across the UK

With just one week to go before Scottish and Welsh elections, a new Institute for Government report, published today, has revealed big differences in the performance of public services across England, Scotland, Wales and Northern Ireland over the last two decades.

Since their creation in 1999, the devolved governments have chosen to fund and run public services in very different ways. While the way they also choose to compile data is a real obstacle to comparison, our report Devolved Public Services: The NHS, schools, and social care in the four nations reveals the extent to which public service performance has diverged across the UK from 1999 to the start of the coronavirus pandemic in 2020. All the devolved nations spend more than England but all three have higher rates of treatable mortality – deaths that could be prevented through timely and effective health care interventions – and by 2018 all three had lower maths and science results.

Spending per person in Scotland and Northern Ireland is 29% higher than spending per person on comparable services in England, and 23% higher in Wales. Scotland spends the most per person on health and schools – and also has the most doctors, nurses, teachers and care workers. But this is not matched in performance.

The biggest differences are in education. The IfG paper reveals that:

• As of 2017/18, Scotland spent 9% more per pupil than England but Scottish pupils achieved significantly lower results in international PISA maths and science tests.
• Welsh pupils consistently achieve lower scores in international tests than pupils in the other three nations.
• By age 15 Welsh pupils’ reading ability is now about six months’ worth of schooling behind pupils in the other three nations.

There are also striking differences in health performance, with the report showing that:

• In March 2020, almost 40% of patients on waiting lists in Northern Ireland had been waiting longer than a year just to get an appointment – compared to only 0.1% of patients on waiting lists in England.
• In March 2020, the median waiting time for elective care in Wales was eleven weeks, over two weeks longer than in England.
• After 2015, Scotland consistently admitted, discharged or transferred a higher proportion of A&E patients within four hours than England, Wales, and Northern Ireland.

The last 20 years provide a fascinating – and sobering - experiment for policy makers to learn from each other. For the four nations to do so, the IfG report recommends:

• The Treasury regularly publish its analysis of the level of spending on comparable public services in each nation and region of the UK.
• The four governments work to improve the comparability of public service performance data.
• The four governments must work to fill key data gaps in unpaid social care, private funding. of social care, and educational attainment before age 15.
• The Treasury and devolved administrations jointly conduct or commission a new assessment of the relative spending needs of each part of the UK.

IfG senior researcher and report author Graham Atkins said:

“Devolution offered Scotland, Wales, and Northern Ireland the opportunity to run public services differently. After two decades, public services now look very different. Some policy decisions have been had beneficial results while others have not – in particular, Scotland spends more on schools but does not appear to deliver better outcomes.

Unfortunately, it has become increasingly difficult to compare performance. The four governments must now prioritise improving data comparability to allow policy makers to collect and analyse data to improve public services in each nation.”

Notes to editors

1. The Institute for Government is an independent think tank that works to make government more effective.
2. For more information, including data to reproduce any charts, please contact press@instituteforgovernment.org.uk / 0785 031 3791.