PM announces public sector reforms

Gordon Brown has announced plans for a "new wave" of public service reforms intended to put more services in the hands of social enterprises and independent providers.

The prime minister said that the government had only just begun to harness the potential of these not-for-profit organisations.

The first step will come with the forthcoming publication of health minister Lord Darzi's review of the National Health Service which is due out shortly.

Downing Street said that it would include new measures to enable frontline staff working in community health services to opt-out of primary care trusts and set up their own, nurse-led organisations.

Writing in the foreword to a Cabinet Office report on public services, Brown insisted that his approach did not mark a return to the days when the poor had to rely on charity for public services.

Nevertheless, the move is likely to alarm the public service unions at a time when they are already at odds with the government over its determination to hold down public sector pay.

"Building on the success of the foundation trust model in the NHS, which sees a million people actively engaging in the governance of their local hospitals, I believe that over the next decade we will see a growing proportion of our services provided by independent public service providers and social enterprises," Brown wrote.

"We have only just begun to harness the potential for these kinds of non-profit organisations and in the coming weeks we will set out how we can promote a new wave of innovation led by social enterprise whilst protecting the values of publicly funded services free at the point of use.

"Not a return to the most vulnerable in our society depending on charity but a genuine openness to new ways of delivering services to the benefit of all."

Lord Darzi's review will recommend that community care staff should be given the right to request the establishment of a nurse-led organisation, which their primary care trust (PCT) would be obliged to consider.

At the same time, under the review's recommendations, those staff who opt-out of PCT control to set up their own organisation would be able to remain in the NHS pension scheme.

The proposals are intended to build on the foundation hospital approach which has been used to give acute services greater independence from Whitehall.

Stakeholder response: British Humanist Association

Naomi Phillips, BHA Public Affairs Officer, said, "Over the last couple of years there has been a drive by the Government to increase greatly the number of religious organisations in the supply of public services, from welfare and employment services to local health and social care services. Unlike other ‘third sector’ organisations, religious organisations have exemptions from equality legislation allowing them to discriminate on grounds of sexual orientation and against those of the ‘wrong’ or no religion, even when working under contract to provide a public service. Moreover, unlike public bodies, contracted organisations are not bound by the Human Rights Act."

Ms Phillips continued, "All public services, funded by the tax payer, should be open and accessible to all, and be provided on a non-discriminatory basis. Increasing the number and influence of religious service providers in particular will jeopardise these principles, and the Government must take these issues seriously, before it hands over large parts of our welfare system to unrepresentative religious groups. 

"Our recent report, ‘Quality and Equality’, on the contracting out of public services to religious organisations, calls for secular and inclusive services and recommends a more transparent tendering process for religious organisations contracted into public service supply and delivery. Government failure to close discrimination law loopholes which permit religious groups to discriminate seriously jeopardises the future of inclusive public services."