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More power to people
The Courier Mail, September 05, 2009
Article by Dennis Atkins
JUST after 8 o'clock, with breakfast plates being cleared, the Brisbane Sebel Citigate is an unlikely time and place to hear talk of revolution.
And the urbane Alan Milburn, in regulation dark suit, crisp white shirt and strong blue tie, makes an unlikely revolutionary.
His breakfast address for the Brisbane-based Eidos Institute, a research think tank sponsored by nine universities, is deeply informed by his four years as Britain's health minister, running the National Health Service with its 1.5 million employees.
Milburn's vision is to turn public service on its head and give it back to the people. He pioneered this while running the NHS where patients suffering chronic illnesses – such as diabetes – are given individual health budgets to spend on treatment.
In his address and an interview afterwards, Milburn made it clear he would like to see this kind of voucher system used not just in health but in education, housing, special needs and training. He calls it "empowerment", which is "an idea whose time has come".
"The old top down approach to government simply no longer works," says Milburn, although he still believes in the state playing a major role.
In fact, he argues the recent experiences of governments in the wake of the global financial crisis, when co-ordinated intervention in markets and massive fiscal stimulus plans battled a potential meltdown, demonstrated the need for strong central government.
Milburn says there has been a natural progression of policy development towards his model since 20th century state-run services broke down.
Milburn lists five significant forces pressuring democratic governments everywhere, which, he believes, will mandate the policy shifts he's advocating.
These are:
- A demand for equity, to cover the widening gap between haves and have-nots, will be most easily resolved by giving people control over using public services;
- Shifts in demography will redefine what we call old age and leisure, with the next generation of senior citizens refusing to accept what's been provided in the past;
- Technology will provide more citizen control, which will be seen particularly in major service areas like health;
- Funding demands are ballooning – the amount of national income absorbed by health is set to double in the next 40 years – and will bring the "good times" to an end; and,
- Public expectations are rising with a more informed and more inquiring society wanting services tailored to individual needs.
Milburn argues that the kind of empowerment he envisages will be accompanied by greater public participation in the process of change, something he says already is happening despite traditional engagement – such as joining political parties – being in decline.
"Politicians will have to get into the business of engaging (with the public) more than just at election time," says Milburn.
Milburn says technological change – which has produced the 24/7 news cycle and fostered social networking sites like Twitter – will lead to not just greater participation but also more accountability.
Milburn, a close friend of Kevin Rudd, has a word of caution for the Prime Minister who is often accused of being too focused on media management.
"We (the Blair Government) were obsessed by media management – and we became very good at it – but you are not judged (by the electorate) on media management," says Milburn. "We fell into a trap of elevating media management to an art form."
Milburn says he's not about to give advice to the Rudd Government but points out a big lesson from the Blair years is that if ministers stay focused on long-term reform they will earn greater credit than through just being clever by dominating the headlines for each 24 hours cycle.
It was a small irony that Milburn's eloquent and easy-to-grasp address came on the same day as Rudd's speech to the Australia New Zealand School of Government, in which the Prime Minister outlined a process-laden reform agenda for Australia's public service – with little more than a passing reference to service delivery. Rudd's speech up against Milburn's was like people speaking different languages.
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