It's the customer, stupid
Policymakers should look beyond the current efficiency-drive and ask how they can design productive user-centred public services, says Joe Manning.
More than twenty years ago, the influential management consultant Peter Drucker argued that the most important thing to remember about any enterprise is that there are no results inside its walls. “The result of a business,” he wrote, “is a satisfied customer.”
By the early nineties, Drucker’s philosophy had become widespread throughout many industries, but there was somewhere it was still missing: the public sector. In their landmark work Reinventing Government, American political scientists David Osborne and Ted Gaebler noted that “few people in government ever use the word customer.” Indeed, it was worse than that. “Most public organisations don’t even know who their customers are.”
Fortunately, things have moved on. Having inspired the National Performance Review of the Clinton-Gore White House, Reinventing Government influenced New Labour’s Modernising Government agenda. The perspective was confirmed with the HM Treasury’s 2003 publication of ‘Public Services: Meeting the Productivity Challenge’. This was not a big state or a minimal state: it was an ‘enabling state’ – an idea that reflected Osborne and Gaebler’s vision for a new kind of government.
Yet, attempts at reform have slowed. For example, in the provision of welfare to work, vulnerable people often interact with multiple services when a cross-departmental approach would avoid expensive duplication and be more effective. There are opportunities to do more.
The current round of spending cuts must be an imperative for change. In a climate of public spending constraint rather than investment, services have to be productive, providing value for money and the outcomes users need.
In order to redesign services, policymakers must do three things: understand service-users’ needs, intervene early, and encourage self service.
Listening vs. understanding
A.G Lafley, the former CEO of Procter and Gamble, knew that his company had to reconnect with its customers. He urged his management team to use social anthropology to uncover customers’ latent needs. Under Lafley, P&G developed a range of leading products – including sanitary pads with wings, washing powder for cold water, and toothpaste that whitens your teeth – that opened new markets. Along the way, he doubled the company’s turnover from $40bn in 2000 to $80bn today.
Lafley recognized that companies prosper when they understand the real-world experience of their customers. It’s all about empathy, as Dev Patnaik argues in his book Wired to Care. Unfortunately, the public sector remains overly reliant on focus groups and satisfaction surveys, market research approaches that validate existing practices, but do not do enough to encourage innovation.
Sophisticated research techniques, such as ethnography, generate understanding, providing a ‘thick description’ of human behaviour. To design user-centred public services, this is where we have to start.
Some innovators have already made fantastic progress. The service design agency Thinkpublic worked with the Alzheimer's Society, building on ethnographic insights to co-produce a seamless service. Nicola Jacobson, dementia adviser, said: “The key change is that now we're putting the person at the centre of the service, not the carer. And this is something that's been long neglected.”
During the US presidential elections, Barack Obama campaigned on a whole community approach to early intervention, arguing that it can break the cycle of deprivation and under-achievement.
“If poverty is a disease that infects an entire community in the form of unemployment and violence; failing schools and broken homes, then we can't just treat those symptoms in isolation,” he said during a speech in Washington, DC. “We have to heal that entire community.”
In the UK research suggests that large savings could be made through such early interventions. For example, it is estimated that every £6,000 invested in Family Nurse Partnerships, a programme for teenage mothers, saves £17,500 in unemployment and educational failure later.
Graham Allen MP, chair of the Cabinet Office review into early intervention, and Jim O’Neill, chief economist at Goldman Sachs, have argued that if such policies were scaled up, they could have “a profound impact on Britain’s structural deficit, much of which is caused by paying for the future costs of social failure.”
This is not just a chance to save money; by designing services around the principals of early intervention the public’s needs would be better met.
Self service: reliably and seamlessly
Large supermarket chains are increasingly using self check outs to reduce overheads, the ATM remains one of the most useful banking innovations in recent decades, while the internet has radically disrupted the marketplace, and continues to change patterns of supply and demand– think Amazon, Google, Facebook and iTunes.
The internet has also allowed crowd-sourced problem solving. The so-called ‘cognitive surplus’ has been harnessed by websites such as Patient Opinion, while countless lives were saved in the recent Haitian earthquake by the website Ushahidi, which aggregated mobile phone field reports in real time.
These developments have exciting implications for public policy. In healthcare, the emerging field of telemonitoring allows patients to record their own vital signs - blood pressure, cardiac rhythm - with a special device that transmits data to their doctor. Online networks can support telemonitoring, for example, by creating communities that encourage patient uptake of prescribed medication. Deutsche Bank Research has found that telemonitoring and e-health could be particularly successful in the treatment of the chronically ill and those with long-term conditions.
The UK public sector has been reluctant to invest and adjust, and the detail and quality of online interactions has often been lacking. The detail is crucial. As Wired editor Chris Anderson has argued, “much as we love freedom and choice, we also love things that just work, reliably and seamlessly."
Internet technology gives the government the means to ‘join-up’ centrally through intelligent networks and devolve power to users, providing a ‘one stop shop’ for self service. The digital era provides an opportunity to both redesign and ‘reinvent’ government.
Changing the question
Policymakers should look beyond the current efficiency-drive and ask how they can design more productive user-centred public services. They should be more confident about ‘changing the question,’ and think holistically about commissioning insights and redesigning services. Successful customer-focused corporations have been able to do this through developing new relationships with their subjects – be they customers, markets or processes. The public sector has the potential to do the same.
Joe Manning is a Policy Advisor at the Design Council.