Abolishing NHS England was a good start – now tackle the rest of the quangos
The abolition of NHS England sets a welcome precedent, but unless we get rid of the laws and regulations that spawned these quangos in the first place, nothing will change, says John O’Connell
Nothing ever changes. How many times have you heard that phrase when talking about the state of the nation with friends and family? The sad truth is that they have a very good point – for several decades, however we’ve voted there has been an overriding sense that politicians with big ideas are not really in control. Indeed, the current government stormed to a 170-odd seat majority and just a few months in were dismayed that nothing happened when they pulled levers.
A large part of the reason – as the Prime Minister made clear last week – is the growth in size and scope of the quango state. Quasi autonomous non governmental organisations (quangos) are similar to a subsidiary company in the corporate world. They operate at a distance from their parent company – in this case a government department or parliament – but remain in some way linked to it. The distance at which they operate from the department varies considerably between quangos, with some afforded considerable managerial independence from the parent department and others almost none. Similarly, some quangos receive no financial funding from the taxpayer, while others rely upon it entirely.
So when Sir Keir announced the abolition of NHS England – cited by some as the world’s largest quango – it was big news. He talked a lot about accountability; about how the NHS spends somewhere around £200bn a year and that it should be brought back under the control of elected politicians. That is commendable – if a government fails to deliver on its promises in any policy area, ideally it should have been able to at least try to implement them. If they are stymied by a powerful, independent technocracy, then no wonder nothing ever changes.
Quangos: Bureaucracy begets bureaucracy
After all, quangos are useful fodder for ministers seeking to avoid taking responsibility for failures in public service delivery. Those with a slightly longer memory might recall the Qualifications and Curriculum Authority (QCA) providing a useful buffer for departmental ministers during the SATs fiasco. Indeed, NHS England itself was set up to take the politics out of the running of the NHS.
But public choice theory tells us that bureaucracy begets bureaucracy. Civil servants and the special interest groups that enjoy close relationships with them are self-interested, seeking to grow their influence and budgets. Little surprise then that NHS England was originally intended to be a lean organisation with only a few hundred employees – it now has well over 10,000.
Bringing back functions into departmental control is not a democratic panacea
A challenge for the government now is the (welcome) precedent it has established. It has said that we need more democratic control – great, so why not do the same with net zero policy from the obscenely powerful Committee on Climate Change? How about bringing the Sentencing Council to heel to quash its guidance on two-tier justice? Why set up 27 new quangos on entering office? These are questions that must be constantly asked of government ministers given the Prime Minister’s words last week.
In any case, bringing back functions into departmental control is not a democratic panacea. The proper questions about what the state does and what it should stop doing do not end with a change of branded stationery. To reverse the grip of bureaucratic control, this government – or any in the future – have to address the laws and regulations that spawned these quangos in the first place. There must be a sustained programme of repealing bad law to allow the state to shed the considerable bureaucratic burden, and save taxpayers’ money to boot. Fail to do that, and we will continue to have non-existent growth, crime-ridden streets and porous borders. Nothing ever changes.
John O’Connell is chief executive of the Taxpayers’ Alliance