Issue 5


By Professor Richard Kerley

Over and above the continuing much better/much worse debate that is still the central tone of any discussion of the possible constitutional future for Scotland there are two major policy themes that seem to have emerged recently.

The first is the availability of accurate, robust and in some cases honestly recorded information about our public services. The other is the extent to which we need to pay more attention to the ‘design‘ of various public policies, legislation and public service provision.

As Scotland is a long established legal and administrative jurisdiction we have some very good data on various aspects of our society and our public services, and this is constantly growing in range and volume. This arises both because of deliberate executive action and also as a function of current technologies that embed the collection of data as a matter of routine process. So every time we use a bus pass whether we pay for it or have it provided at £0 cost our usage and movements are tracked.

Of course there are some aspects of our public services where even some of the assumed basic information has recently been found to be either - at best - unreliable because of poor systems design, or - at worst - deliberately manipulated to mislead. The biggest problem appears to have been with waiting list data and the manipulation of figures in more than one health board area. In all the flurry of claim and counter claim it is increasingly unclear what actually happened in some boards; whether the same games were being played in different boards. One of the explanations offered by the Cabinet Secretary for Health, that there were  computer incompatibilities, has the ring of ‘…the dog ate my homework, sir…’ but those who want to believe it will.

At the core of this kind of problem is the extent to which data related to the health service in Scotland is voraciously collected, sorted, sifted and stored, but not readily available to public access. It’s not that such data is hidden or generally subject to  closed access, but easy access to it is not encouraged or publicised in ways that could make for greater public visibility.

In preparing this article, I have just tried tracking Hospital Standardised Mortality Ratios for Scottish Hospitals, something I suspect many would-be patients will have been tempted to do after reading about Mid Staffordshire Hospital. After going round in web site circles on three occasions I gave up. Others may have more patience, or a greater critical wish for this information.

Between the two largest streams of public service provision in Scotland, local government and the health services, the former provides an interesting contrast in how more information can routinely be made publicly available, as our article in this edition on local government benchmarking shows.

There seems to be a case for a similar publicly accessible web site or web sites on the health services in Scotland to be created and made publicly available.

Some good underlying principles for developing such a facility might be found in the findings and principles outlined in the recent report by the Design Commission “Restarting Britain 2: Design and Public Services“.

This report pulls together lots of recent work and thoughts about how we design or sometimes do not design public services. As they acknowledge it’s something of an uncomfortable concept. Design is, after all, something more associated with soft furnishing, clothes, consumer durables, it is not benefit payments, refuse collection or how we run the sports facilities at the Olympic or Commonwealth Games sites once the athletes are gone.

The authors of the report make a good case for design being part of all these and more. As some of our articles argue in this edition, there’s a lot more that could be done now and a lot more that will need to be done post 2014 – regardless of the outcome.

By Professor Richard Kerley

Issue 5


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