Fixing public services: Recommendations

The new government should implement a bold programme of public service reform, with the objective of improving the long-term productivity of services. At the heart of this should be a greater focus on outcomes, rather than inputs; on prevention, rather than acute provision; on capital, rather than day-to-day, spending; on front-line innovation, rather than top-down command and control; and on the contribution of staff to performance, rather than their cost to the exchequer.

Much of this can be delivered without spending more. The government could do this by better prioritisation, by embedding prevention and improvements to investment in the spending framework, by changing policy to address acute demand, and by taking a more collaborative approach to industrial relations. If begun immediately, these changes will start to bear fruit by the end of this parliament. Over the long term, they would deliver substantially improved public service performance at existing levels of spending.

However, if the government wishes to see higher quality services more quickly it will, at least in the short term, need to spend more. We recommend focusing any additional spending on prevention and capital projects, as well as on key staff groups such as GPs, criminal barristers, social workers, and those in management and support roles.

How can the new government spend money more effectively?

Focus on a small number of priorities

This report has identified the biggest problems facing the new government, but the true list of issues that ministers must address is virtually unending. For every meeting that they take or briefing they read, there will be 10 others vying for their attention. It can be easy to be overwhelmed but unless ministers set clear objectives, they will achieve little. As noted by former cabinet minister Kenneth Clarke: “You have got to move on from being slightly shocked and overwhelmed by events to actually being in charge and having some idea of where, at least, you are trying to go and what you are trying to do.” ¹⁰⁹ Interview transcript, Kenneth Clarke, 8 February 2016, Ministers Reflect archive, Institute for Government, www.instituteforgovernment.org.uk/ministers-reflect/kenneth-clarke

Prioritisation is particularly important when funding is tight. Sticking with the status quo will mean rapidly declining performance in some services, and limited improvement in others. If the new government wishes to enter the next election with tangible public service achievements, it must focus ministerial attention on priority areas. In turn, that could lead to prioritising funding for some things at the expense of others (and it could mean cutting them altogether to ensure sufficient funding for remaining responsibilities). But these are exactly the trade-offs that ministers are appointed to resolve. 

Prioritisation should start immediately and at the top. Our Commission on the Centre of Government recommended the government agrees and publishes a ‘priorities for government’ at the beginning of the parliament as part of the King’s Speech. These priorities should be incorporated into the government’s budgeting and performance framework, with oversight by the prime minister and senior ministers. ¹¹⁰ Urban J, Thomas A and Clyne R, Power with purpose: Final report of the Commission on the Centre of Government, Institute for Government, March 2024, www.instituteforgovernment.org.uk/publication/power-with-purpose-centre-commission

Prioritisation within departments is just as important. Critically, ministers must retain focus. David Laws said: “You need not only to identify priorities, but then follow through on them and structure your day and your week and your month around that.” ¹¹¹ Interview transcript, David Laws, 4 February 2016, Ministers Reflect archive, Institute for Government, www.instituteforgovernment.org.uk/ministers-reflect/david-laws

Ministers should also reflect priorities in the performance measures that front-line services have to report against. Targets, though not without their downsides, can be an effective way for raising minimum service standards. For example, there is good evidence that targets to reduce A&E and elective waiting times contributed to substantial improvements in performance under the Blair government. ¹¹² Davies N, Atkins G and Sodhi S, Using targets to improve public services, Institute for Government, June 2021, www.instituteforgovernment.org.uk/publication/report/using-targets-improve-public-services  But the proliferation of NHS targets in recent years means there is little clarity about what those on the front line should prioritise. ¹¹³ Freedman S and Wolf R, The NHS productivity puzzle, Institute for Government, June 2023, www.instituteforgovernment.org.uk/publication/nhs-productivity  Former health secretary Patricia Hewitt, in her review of integrated care systems, argued that the government should “significantly reduce the number of national targets, with certainly no more than 10 national priorities”. ¹¹⁴ Hewitt P, The Hewitt Review: an independent review of integrated care systems, Department of Health and Social Care, April 2023, p. 55, https://assets.publishing.service.gov.uk/media/642b07d87de82b00123134fa/the-hewitt-review.pdf

That is good advice for all new ministers and we recommend that ministers remove targets that do not reflect the priorities of the government. This will not be politically easy. Existing targets were implemented for a reason and new ministers will be tempted to layer new targets on top of existing ones to avoid upsetting relevant interest groups. But the reality is, the more targets there are, the less weight each one carries. Unless the new suite of targets is small and coherent, public services will not respond in the way ministers intend. For example, the government may want to consider whether the high-profile hospital performance targets on A&E, elective and cancer waiting times reflect its stated objective to make the NHS more local and preventative. This will be complex and the government should consider the options carefully, but it must start the process immediately.

The good news is that Whitehall and the wider public sector are responsive to ministerial direction. Ministers can hope to make meaningful improvements to public services. But to do so, they must focus on a small number of priorities within each service.

• Use the King’s Speech to set strategic priorities for the new government
• Focus ministerial time on a small number of priorities
• Scrap targets that no longer reflect the government’s priorities. 

Make changes to the spending framework to provide front-line services with more autonomy and to embed prevention and improvements to capital spending

The new government may not wish to spend more, but it can improve outcomes by spending more effectively, through changes to the spending review process, spending management, and how departments spend their allocations.

It is expected that the new government will hold a one-year spending review this year to determine budget allocations for 2025/26, with a multi-year spending review being presented next year, which will cover 2026/27–2028/29. If the government wishes to make improvements to public services, then it should base these spending decisions on clear priorities. The government has already started to lay these out, but greater clarity is needed soon.

Whichever outcomes the government chooses to prioritise, it must address rising acute demand and the poor state of buildings and equipment. To that end, we recommend embedding prevention and improvements in capital spending into these spending review processes.* For the former, and as set out in previous Institute work, this should involve agreeing a definition of preventative spending, ring-fencing this, publishing a cross-government prevention strategy and funding thorough evaluations of preventative spending as part of the government’s first multi-year spending review. ¹¹⁵ Hoddinott S, Davies N and Kim D, A preventative approach to public services, Institute for Government, 22 May 2024, www.instituteforgovernment.org.uk/publication/preventative-approach-public-services

For capital spending, the multi-year spending review should provide five years of spending settlements at least. The Treasury should also establish more, large capital spending programmes – for example, to build hospitals and prisons – setting even longer term base levels of investment for these. The government should also aim to make the spending mix more capital-intensive over time. ¹¹⁶ Pope T, Tetlow G and Pattison J, Capital spending in public services, Institute for Government, June 2024, www.instituteforgovernment.org.uk/publication/capital-spending-public-services

Better spending management can also improve how money is spent. For example, previous Institute work on capital spending ¹¹⁷ Pope T, Tetlow G and Pattison J, Capital spending in public services, Institute for Government, June 2024, www.instituteforgovernment.org.uk/publication/capital-spending-public-services  has recommended amending the Managing Public Money guidance to provide a stronger incentives to maintain existing assets, giving major capital programmes a separate line in spending documents to provide greater clarity and certainty about these budgets, and rebalancing accounting officer responsibilities so that they are also scrutinised for underspends, not just overspends.

Finally, there is much that the government could do to improve how departments allocate spending to their ALBs and delivery bodies. The objective should be to provide front-line public service providers with greater certainty and flexibility so that they can make more strategic investments to deliver the government’s top priorities, as well as local ones, based on their understanding of needs in their area. There are already good examples of front-line services delivering performance improvements at little or no cost – see the Institute for Government and the Productivity Institute’s Productivity Pitches event series ¹¹⁸ Institute for Government, ‘Productivity Pitches #2: criminal justice and law enforcement’, 22 February 2024, www.instituteforgovernment.org.uk/event/productivity-pitches-2-criminal-justice-system ^{,  119} Institute for Government, ‘Productivity Pitches #3: Health and social care’, 23 May 2024, www.instituteforgovernment.org.uk/event/productivity-pitches-3  – but many more would be able to do so with greater freedom to innovate (as well as support to increase front-line management capacity, which is discussed below). 

The best way of empowering the front line would be to provide longer term funding settlements, particularly for capital, and reducing the huge number of ring-fences around small pots of money, but putting a single broad ring-fence around areas of spending that local areas can use for preventative services. The government should also redesign financial incentives in public services so they align with its priorities. For example, it will be hard to shift NHS funding towards prevention while such a high proportion of it is allocated on a ‘payment by results’ formula that encourages more acute activity in hospitals.

Some of these changes will take a year or more to fully implement, but work on all of them should begin in the next six months to deliver improvement by the end of this parliament.

• Agree a definition of preventative spending, ring-fence this, publish a cross-government prevention strategy and fund thorough evaluations of preventative spending
• Provide five-year capital budgets and make the spending mix more capital-intensive over time
• Provide front-line services with longer term funding settlements and reduce the number of ring-fences around small funding pots. 

* It will not be possible to fully do this in a one-year spending round taking place this year, but the government should try to make as much progress as possible in the short time available. 

Make changes to regulations, tax or other policies to reduce demand as part of a prevention strategy

High levels of demand for acute services place a major strain on public finances, which could be reduced by preventing acute problems materialising in the first place. Debate on prevention often focuses on specific government programmes – such as Sure Start – and the up-front costs of setting up and running these. These types of preventative programmes have a critical role to play and, as discussed below, there is a good case for providing them with additional funding. But these are not the only policies that affect acute demand for services. The new government should consider the tax, regulatory and other changes that it can make.

For example, research suggests that smokers need social care earlier and are more likely to be admitted to hospital. ¹²⁰ Khan J, The Khan review: making smoking obsolete, Office for Health Improvement and Disparities, June 2022, https://assets.publishing.service.gov.uk/media/62a0c3f38fa8f503921c159f/khan-review-making-smoking-obsolete.pdf  As a result, it has been estimated that smoking has a net cost to the UK’s public finances of £13.5bn a year, including more than £3.5bn in costs for the NHS and local authorities. ¹²¹ Reed H, Cost Benefit and Public Finance Model of Smoking, Version 2.2, Landman Economics, commissioned by Action on Smoking and Health, May 2024, p. 32, https://ash.org.uk/uploads/CBPF-model-May-2024.pdf  The Khan Review ¹²² Khan J, The Khan review: making smoking obsolete, Office for Health Improvement and Disparities, June 2022, https://assets.publishing.service.gov.uk/media/62a0c3f38fa8f503921c159f/khan-review-making-smoking-obsolete.pdf  made a number of recommendations to reduce smoking that would cost little or even raise money.

These included raising the minimum age for purchasing tobacco, promoting vaping, introducing a tobacco licence for retailers, increasing taxation on tobacco, and ensuring health care professionals talk to people about smoking cessation every time they come into contact with health services.

Likewise, the UK has the third highest level of obesity in Europe, with rapid increases in recent years. It is estimated that the NHS spends around £6.5bn a year on obesity- related care, with the total annual cost of obesity to society thought to be 1–2% of GDP. ¹²³ Metcalfe S and Sasse T, Tackling obesity: Improving policy making on food and health, Institute for Government, April 2023, p. 16, www.instituteforgovernment.org.uk/publication/tackling-obesity  The ‘sugar tax’ was introduced in 2016 and has been effective in reducing the volume of sugar sold ¹²⁴ Metcalfe S and Sasse T, Tackling obesity: Improving policy making on food and health, Institute for Government, April 2023, p. 21–22, www.instituteforgovernment.org.uk/publication/tackling-obesity  but government proposals to implement regulations restricting advertising and promotion of food that is high in fat, salt and sugar have been delayed or dropped. ¹²⁵ Metcalfe S and Sasse T, Tackling obesity: Improving policy making on food and health, Institute for Government, April 2023, www.instituteforgovernment.org.uk/publication/tackling-obesity  Implementing some of these measures, alongside other activities like education and awareness raising, would likely reduce future obesity-related demand for public services.

Chris Whitty, the chief medical officer for England, has also used his annual reports to address the impact of alcohol ¹²⁶ Whitty C, Chief Medical Officer’s Annual Report 2023: Health in an ageing society, Department of Health and Social Care, November 2023, https://assets.publishing.service.gov.uk/media/65562ff2d03a8d000d07faa6/chief-medical-officers-annual-report-2023-web-accessible.pdf  and pollution ¹²⁷ Whitty C, Chief Medical Officer’s Annual Report 2022: Air pollution, Department of Health and Social Care, December 2022, https://assets.publishing.service.gov.uk/media/639aeb81e90e0721889bbf2f/chief-medical-officers-annual-report-air-pollution-dec-2022.pdf  on public service demand and the regulatory, tax and other policy changes that could be used to reduce these.

In some cases, there is an even more direct link between policy and demand for acute services. Perhaps most notably, the record size of the prison population is in large part driven by reforms to lengthen sentences and increase the proportion of sentences spent in custody. While longer sentences provide greater punishment, there is little evidence that they reduce crime. ¹²⁸ Berger E and Scheidegger K, Sentence Length and Recidivism: A review of the research, Criminal Justice Legal Foundation, May 2021, www.cjlf.org/publications/papers/SentenceRecidivism.pdf  Whatever the politics involved, reversing some of these changes would certainly be much cheaper than building, maintaining and staffing the many thousands of new prison places needed to meet demand. And in any case, in the short term, the new government has little choice but to reduce the prison population – by, for instance, lowering the automatic release point for most offenders, introducing a ‘queuing system’ for immediate custodial sentences, or allowing sentences of up to three years to be suspended. ¹²⁹ Rowland C, The crisis in prisons, Institute for Government, July 2024, www.instituteforgovernment.org.uk/publication/crisis-prisons

Not all of the examples provided in this section will be in line with the political positioning of the government. But whatever the political views of ministers, there will be some options that are aligned with the wider priorities of the government.

While these tax, regulatory and policy changes are cheap, they may not be politically cost-free. Past efforts have been stymied by fears of being seen as ‘nanny statist’ or ‘soft on crime’. Those fears are not unfounded, but are often overstated. And while political capital is always in short supply, immediately following the election it is more abundant than money. We therefore recommend that the new government incorporates regulatory, tax and other policy changes into a wider prevention strategy, developed as part of its first spending review.

• Publish a prevention strategy that includes regulatory, tax and other policy changes to reduce acute demand. 

Improve the relationship with public sector staff

Workforce problems have been a major contributor to poor public service performance in recent years. It is much harder to deliver high-quality services when staff are unhappy or inexperienced, when turnover and vacancies are so high, and when large numbers of people go on strike. Pay is, of course, a big driver of all these issues, but there is also much that could be done to address them at little or no cost.

First, the new government should seek to improve the relationship between government, unions and staff. Workforce disputes are inevitable, but the Sunak government’s combative approach to strikes likely extended their duration. Its refusal to negotiate for months, misrepresentation of the role of pay review bodies, and introduction of the Strikes (Minimum Service Levels) Act all made reaching agreements harder. ¹³⁰ Davies N, Hoddinott S, Fright M and others, Performance Tracker 2023, ‘Cross-service analysis’, Institute for Government, October 2023, www.instituteforgovernment.org.uk/publication/performance-tracker-2023/cross-service-analysis  More broadly, such a confrontational approach can make staff feel less valued and appreciated, with many, particularly in health and care services, finding it galling given the conditions they worked in during the pandemic. Taking a more collaborative approach and making better use of pay review bodies ¹³¹ Fright M, Davies N and Richards G, Retention in public services, Institute for Government, October 2023, pp. 39–41, www.instituteforgovernment.org.uk/publication/staff-retention-public-services  should be a priority for the new government.

Second, the government should take steps to better manage the workloads of public service staff. High workloads are cited by many staff as a reason for leaving their roles. While workloads are primarily driven by the number of staff relative to demand, bureaucratic requirements can also be unnecessarily time-consuming. The government should therefore carefully consider the impact of reporting, training and other requirements on staff capacity. Departments should also provide front-line services with practical resources on how to reduce workloads. ¹³² Fright M, Davies N and Richards G, Retention in public services, Institute for Government, October 2023, p.41, www.instituteforgovernment.org.uk/publication/staff-retention-public-services

Third, the government should seek to improve the quality of public service leadership and recruitment, another important factor in staff satisfaction and retention. Deeply ingrained cultural problems are hard to address, but the government can remove barriers to effective leadership such as perverse incentives to prioritise personal objectives over organisational performance, short-termism, hierarchical structures and unwillingness to embrace different approaches, viewpoints and backgrounds. ¹³³ CIPD, Tackling the Barriers to Leadership, 27 May 2014, www.cipd.co.uk/knowledge/strategy/leadership/barriers-report

Finally, the government should, where possible, support flexible working initiatives. Flexi-working arrangements are now a key consideration for many staff. While some public service roles, particularly those on the front line, are necessarily less flexible than desk-based jobs, there is often more that can be done. For example, there is evidence that allowing nurses to self-roster reduces turnover. ¹³⁴ NHS England, ‘Improving joy at work – electronic self-rostering (The Royal Free London NHS Foundation Trust)’ (no date), retrieved 5 June 2024, www.england.nhs.uk/looking-after-our-people/the-programme-and-resources/we-work-flexibly/improving-joy-at-work-electronic-self-rostering-the-royal-fr…

• Take a more collaborative approach to industrial disputes and make better use of pay review bodies
• Carefully consider the impact of reporting, training and other requirements on staff capacity
• Improve the quality of public service leadership and recruitment
• Support flexible working initiatives. 

Where should the government prioritise any additional investment? 

Spending more on some services or areas will require trade-offs. Government can either spend less on other areas, increase taxes or borrow more. None would be easy and would entail political and other costs, particularly given Labour was vague about its spending plans and ruled out raising some key taxes during the election campaign – a commitment Keir Starmer repeated in his first press conference as prime minister.

This means any additional funding for public services will be hard earned and must be used as effectively as possible. We therefore make recommendations on where extra money is likely to lead to the most meaningful performance improvements.

Focus investment on prevention and capital

The benefits of spending on capital projects and prevention accrue over many years, potentially decades. Similarly, the impact of cuts to these areas is not always felt immediately. As a result, and particularly since 2010, politicians have found it easier to cut and to raid capital and prevention budgets to make more money available for acute day-to-day spending. The new government should resist this temptation, and will likely deliver greater improvements in public service performance over the course of this parliament by spending any additional funding on preventative programmes and capital projects. ¹³⁵ Pope T, Tetlow G and Pattison J, Capital spending in public services, Institute for Government, June 2024, www.instituteforgovernment.org.uk/publication/capital-spending-public-services

On prevention, there is good evidence that spending on a wide range of preventative services and programmes – including benefits, Sure Start centres, public health and youth work – can improve people’s outcomes and, in time, reduce acute demand for public services. ¹³⁶ Hoddinott S, Davies N and Kim D, A preventative approach to public services, Institute for Government, 22 May 2024, www.instituteforgovernment.org.uk/publication/preventative-approach-public-services  If the government is going to increase spending on preventative programmes, then it should do so in a balanced portfolio of interventions, setting out as part of the spending review process how these will contribute to meeting the government’s priorities. ¹³⁷ Hoddinott S, Davies N and Kim D, A preventative approach to public services, Institute for Government, 22 May 2024, www.instituteforgovernment.org.uk/publication/preventative-approach-public-services  While it is inevitable that some will be less impactful than others, the aggregate impact is more likely to be positive than spending further money on acute interventions. To that end, it is welcome that Wes Streeting, the new health and social care secretary, has committed to increasing the share of NHS funding going to out-of-hospital services such as a primary and community care. ¹³⁸ Illman J and McLellan A, ‘Exclusive: Streeting has ‘total confidence’ in Amanda Pritchard’, HSJ,1 July 2024, www.hsj.co.uk/policy-and-regulation/streeting-well-raise-the-share-of-funding-for-primary-and-community-care-within-five-years/7037402.article

Within capital budgets, spending is currently biased towards politically attractive new projects. ¹³⁹ Pope T, Tetlow G and Pattison J, Capital spending in public services, Institute for Government, June 2024, www.instituteforgovernment.org.uk/publication/capital-spending-public-services  But the poor state of the existing public sector estate is a major drag on service productivity and performance. The government should therefore focus any additional capital spending on maintenance.

Spending now on capital and prevention should make services less expensive to deliver in the future than they might otherwise be, either by improving their productivity or reducing acute demand. As such, there is a case for making an up-front investment funded by temporarily raising taxes or borrowing, on the expectation that this will be paid for by lower spending in coming years. ‘Double-running’* would allow for a quicker and more sizeable initial investment, and thus a more rapid improvement in service performance. Though, given the timeframes involved for some capital investments and the realisation of prevention benefits, it may be necessary to do so for most of this parliament.

• Focus new funding on capital and prevention projects
• Focus capital spending on maintenance
• Consider ‘double-running’ – increasing funding for prevention and capital, while maintaining spending on acute services – to kick-start the recovery across public services. 

^{* Increasing investment in prevention and capital alongside continued funding for acute services.}

Resolve pay disputes and prioritise spending on back-office staff

Workforce problems are an important driver of poor public service performance, and pay is the single biggest factor contributing to these. The fall in the value of public sector pay since 2010 – both relative to the price level and relative to pay in the private sector – exacerbated by high levels of inflation in recent years, led to the most widespread public sector strikes in more than a quarter of a century. ¹⁴⁰ Davies N, Hoddinott S, Fright M and others, Performance Tracker 2023, ‘Cross-service analysis’, Institute for Government, October 2023, www.instituteforgovernment.org.uk/publication/performance-tracker-2023/cross-service-analysis#widespread-strikes-have-had-a-negative-impact-on-public…-  Poor pay makes it harder to recruit new staff and retain existing ones, with staff across public services reporting low and falling levels of satisfaction with their pay. If the government wishes to improve public service performance, it will have little choice but to spend more on pay to address these issues.

The most high-profile ongoing industrial dispute is by junior doctors, who undertook their latest strike in the week before the election. However, while other staffing groups such as teachers, nurses and consultant doctors accepted improved government pay offers over the past year, dissatisfaction with pay remains. For example, teachers backed further strike action in an indicative ballot conducted by the NEU earlier this year. ¹⁴¹ 33 Whittaker F, ‘NEU indicative ballot: Members back strike action over pay’, Schools Week, 29 March 2024, https://schoolsweek.co.uk/neu-indicative-ballot-members-back-strike-action-over-pay  New recommendations by pay review bodies, which are due to be published shortly, and the government’s response to these, could well be the trigger for further waves of industrial action. A change of tone will help to resolve disputes, but will likely need to be backed up with money very quickly.

For other staff groups, the main risk is not that they join the picket line, but that they walk away from the profession altogether. To ensure that the services covered in this report work well, the government should prioritise additional spending on improved pay for GPs, social workers and criminal barristers. In all three cases, poor pay makes it very difficult to retain experienced staff and to recruit new staff from the UK, with staffing gaps often then increasing demand in other, more acute and expensive parts of the system. Shortfalls in general practice and adult social care have been papered over in recent years by recruiting large numbers of people from other countries, but given global competition for these staff and the politics of immigration, there is no guarantee that this approach will continue to be viable. Either way, the new government should ensure that its immigration policies and public service staffing policies are consistent with one another. 

In some cases, the priority for additional spending should be lower profile staffing groups that are nonetheless critical to public service productivity. Management and support staff enable those on the front line to do their jobs well, but are often treated as an unnecessary overhead and a waste of limited funds. Indeed, in the election campaign the Conservatives pledged to cut 5,500 NHS managers to fund spending elsewhere in the NHS. ¹⁴² Conservative and Unionist Party, Manifesto 2024, June 2024, p.41, https://public.conservatives.com/static/documents/GE2024/Conservative-Manifesto-GE2024.pdf  But all the evidence suggests that the NHS is under-managed, and the shortage of managers is a key reason why the substantial increase in hospital doctors and nurses has not led to a commensurate increase in hospital activity. ¹⁴³ Freedman S and Wolf R, The NHS productivity puzzle, Institute for Government, June 2023, www.instituteforgovernment.org.uk/publication/nhs-productivity  Boosting management and analytical capacity in hospital trusts and ICBs (rather than in DHSC or NHS England) would be far more impactful and cheaper than further increasing the number of doctors and nurses.

The government bemoans poor management in local authorities while ignoring the fact that cuts to grant funding mean that local authorities are forced to cut back on staff such as accountants and analysts who would improve the effectiveness of spending. It is a similar story in the police, where the focus in recent years on increasing the number of officers, while maintaining tight budgets, has created perverse incentives for forces to cut the number of PCSOs and staff, filling their roles with more expensive officers. ¹⁴⁴ Richards G and Davies N, Performance Tracker 2023, ‘Police’, October 2023, www.instituteforgovernment.org.uk/publication/performance-tracker-2023/police  It would be more cost effective to allow the number of officers to fall slightly and to recruit more staff and PCSOs instead.

• Back up a less combative approach to industrial relations with pay awards, working with pay review bodies and unions to reach settlements that will retain and recruit staff
• Prioritise additional spending on improved pay for GPs, social workers and criminal barristers
• Don’t just focus on the front line: managers and analysts will help make spending more effective, particularly in the NHS and local authorities.