As the country prepares for the next prime minister, the latest edition of Performance Tracker finds that for the first time in years, the government may have pledged enough money to maintain standards in most public services. But more money will be needed to raise standards over the next five years.
In adult social care, the service facing the most pressure, any government would have to spend nearly £1 billion more just to keep pace with demand.
Published by the IfG and CIPFA, Performance Tracker 2019 projects the demand and spending on nine public services for the next five years: GPs, hospitals, adult social care, children’s social care, neighbourhood services, police, prisons, courts, and schools.
The report’s authors express serious concerns about rising prison violence and about the scope of local government services despite cash injections from the Johnson and May governments.
The report estimates that the government and local authorities will spend £191.1 billion on these nine services by 2023/24. While this may be enough to meet demand (except in adult social care), this will not be enough for the government to make improvements, such as better care for cancer patients and reduced violence and self-harm in prisons.
The report finds that all public services analysed have seen some decline in performance – either in their quality (the standard of public service provided and how satisfied users are) or scope (the range of services provided and the number of people able to access them).
Demand is rising particularly quickly for health and care services because of the ageing population, an increase in number of people with multiple health conditions and rising life expectancy for people with physical and learning disabilities.
Over the past nine years of curbs on public spending, most public services have done more with less by limiting staff pay increases and prompting workers to be more productive. But public services will find it difficult to sustain any efficiencies made now the public sector pay cap has been lifted and with many services struggling to recruit and retain staff.