Better Public Services Start With Putting People First, Not Piling On More Rules

Politicians and experts in the United Kingdom are debating the best way to fix public services like the National Health Service, or NHS. Some people think more rules and oversight are the answer. But a growing number of economists and management experts argue that putting customers first — not following long checklists — is what really makes services better. The debate is heating up as the government weighs what reforms to push forward before the next election in 2029.

Politician Andy Burnham once said he wanted to 'rewire' the economy, meaning he hoped to make big changes to how public services are run. But he has since slowed down, pushing most major reforms into the 2030s. Plans to reorganize local government, overhaul the water industry, and reform social care have all been put on hold. Critics say these delays are not needed, because enough information already exists to start making real improvements now.

Economist Sir John Kay, a professor at Oxford University, has written about a key idea: organizations work best when they focus on the people they serve. In his book 'Obliquity,' Kay shows that companies chasing profits as their main goal often failed in the long run. But companies that focused on making the best product or giving the best service ended up succeeding — and the profits followed. Kay argues the same idea applies to public services, where focusing on citizens can lead to better results and less wasted money.

The NHS offers clear examples of both success and failure in public services. On the positive side, more people are now able to see a doctor more quickly, especially for regular checkups and outpatient visits. But serious failures have also occurred, such as when managers at some maternity units tried to hide rising death rates among mothers and babies. Experts point out that neither the successes nor the failures came down to how much the NHS was regulated — they came down to whether workers were truly focused on helping patients.

Adding more rules and oversight does not always fix the problem, experts warn. When agencies focus too much on following rules, workers can end up just 'ticking boxes' — doing whatever looks good on paper rather than what actually helps people. One striking example involves a road-building agency called National Highways, which planted 850,000 young trees along a road north of Cambridge in 2020. Three years later, an internal review found that three-quarters of those trees had died — a costly failure that highlights what happens when the focus is on completing a task rather than doing it well.

Management consultant John Seddon has spent years studying how public organizations can do better. His firm has used methods similar to those developed by the Japanese carmaker Toyota to help public agencies improve. One success story is Portsmouth city council's housing repair service, which won international awards after using Seddon's approach. He says this kind of system puts the focus back on the real goal: giving people the help they need, as quickly and effectively as possible.

Seddon does not think all regulation should be scrapped. Instead, he believes rules should be based on how well an organization is actually serving its purpose. He says that when regulators focus on purpose, they can step in quickly if something goes wrong — rather than reacting too late, after the damage is done. He warns that today's tick-box style of regulation treats public workers as suspects rather than as skilled professionals who want to do a good job.

The message for government leaders is clear: stop letting arguments about who owns public services — the government or private companies — take center stage. Instead, focus on how those services actually perform for the people who use them. The evidence about what works is already out there. Experts say the government does not need to look very far to find it.