My son has a monthly allowance, part of which is for his bus pass to college. At the start of the summer term he comes to me and says he does not have the money to pay for his bus pass. What do I do? If I say that I will not bail him out, the result could be that he does not get to college. If I give him the money, I am giving him every incentive to behave in the same way again.
Or should I listen to any special pleading that he has had unexpected expenses not taken into account when the allowance was agreed and meet the cost of the bus pass, just this once?
In the past, social services and health were regularly bailed out if they overspent. The consequence was to reinforce an attitude that budgets do not really matter. However, an overspent budget can only be funded by taking the money from somewhere else, often causing anger among managers who feel that they have run their finances prudently.
Whatever the budget, it will never be enough to fund all the needs that you would like to meet. Management is about making difficult choices between competing priorities.
In its first annual report, published by the Department of Health and the Audit Commission in 1997, the Joint Review team concluded that “local authorities simply do not know how many people receive social services of what quality or what cost”.1
It is like coming back from the supermarket and not knowing what you have bought, for whom and what you have paid for it. Things have improved greatly in the past six years, but how many managers can truthfully say that they know whether the resources they have are being used in the best possible way to benefit service users? A Joint Review report in 1999, analysing children’s services, found that “there is no obvious link between levels of expenditure on children’s services and their quality”.2 So spending more does not necessarily protect children any better.
Managers need to keep asking “is this the best way to use resources?”. Money should follow policy. For example, after the introduction of the Community Care Act 1990, social care organisations needed to provide more community-based services and yet, for years, budgets would show that spending on residential care was far higher than on, say, home care services. Whereas, if money followed the policy, spending on home care would soar at the expense of residential care.
Some examples will illustrate the question of how to best use resources in practice. About a third of front-line managers’ time is spent in formal and informal supervision of staff, a proportion that is almost unique among the professions. Supervision is, of course, crucial, but time is also a resource and must be managed effectively. We must ask whether the cost of this is justified in terms of better lives for service users.
Lengthy meetings are expensive – try adding up the cost of the management meeting you are sitting in next week. Is this the best way to make decisions that benefit service users?
Joint Reviews also found that the percentage of spending recorded as care management in child care varied between local authorities from 60 per cent to less than 5 per cent. This suggests managers are making vastly different decisions about how to use their resources. The question is, does spending more time in assessing produce better outcomes for children? Placing people in residential care is costly, both in financial and human terms. Could these resources benefit more service users with better results by supporting them in the community?
Social care organisations are beginning to improve their ability to answer these questions. For example, in residential, short break and day care, unit costing and staffing rota schedules are now commonplace. Less so in community-based work where efforts to establish the link between resources and outcomes is still in its infancy.
Managers at all levels of an organisation owe it to the public and their customers, who pay for their work, to make sure that resources are being used wisely. Equally, managing resources well is fundamental to providing a service that enables users to live more fulfilling lives.
Martin Willis is programme director, INLOGOV, Birmingham University.
1 Department of Heath/Audit Commission, Reviewing Social Services, 1997
2 Department of Heath/Audit Commission, Getting the Best from Children’s Services, 1999