The spending review announced by Chancellor George Osborne on Wednesday, demonstrated the harsh reality behind the relative optimism of the Coalition Government's Big Society agenda. Decentralising decision making and shifting the responsibility for providing services from the Public to Private and Third sectors has long been mooted as part of this agenda to reduce Government costs. The review revealed just how large this contribution would have to be.
Recent publications by the Government, , such as Equity and excellence: Liberating the NHS, have set out how organisations should set out to take up this responsibility and these have thus far received generally positive responses, such as that from the Association of Chief Executives of Voluntary Organisiations (ACEVO) discussed in our previous article. But now that the scale of the task is becoming apparent, along with just how far belts will need to be tightened, will the outlook for and attitude towards the Big Society remain so rosey?
The NHS Chief Executive, Sir David Nicholson KCB CBE still seems to be looking on the bright side in his letter sent to major NHS stakeholder following the review. As he mentions, the NHS is actually one of the few Public services that isn't having it's budget cut. It's actually set to rise by £10 billion over the next four years, but Sir David fails to mention that this only represents a 0.1% annual rise once inflation is taken into account, a fact widely reported by the press. So, for all intents and purposes, that's a cut, and savings will need to be made.
But as mentioned before and reiterated in Sir David's letter, the rest of Society is there to take up the slack. All well and good if it's in a position to take up that responsibility, but as the Government and various stakeholders have said, huge changes and restructuring need to take place before that can be the case. It may be a house of cards, where everyone involved needs to precisely place their card or risk it all falling apart.
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