The politics of public spending

Over the last 30 years, Ipsos Mori has worked extensively for government and the public sector examining public expectations on public spending and public services.

Despite changing service expectations in response to technological development, more diverse societies, a less deferential society, more transparency and rises in living standards,  there remains a strong attachment to universal provision of public services, particularly health services, and basic welfare.

There is continued anxiety about ‘post code lotteries’ – the majority of the public for example does not want to see some health services only available in certain parts of the country, for example, preferring to ensure that they are either available everywhere, or not at all.

In Britain and many other countries there is a schizophrenic view where the majority of the public want both ‘more local control’ of public services, but also, in the interest of perceived fairness, service standards to be the same across the country:

Second there is considerable confusion about how much governments spend on what services, and of spending priorities. For example, looking at what people in Britain think has happened in terms of cuts, is very different from what has actually happened, as our 2015 study showed:

Third, austerity has produced some interesting changes – and sometimes unexpected stability – in terms of public perceptions of the quality of services.

Overall, despite large cuts, particularly in local government services, public satisfaction has held up much more than many would have expected in 2010. Road maintenance has taken a hit, with the majority of the public dissatisfied (although even this has declined slightly since 2012) and a large minority of users of care for the elderly have similarly reported a decline, as demand for services rises with an aging population, but local councils find their budgets cut by 35 per cent. But for many services there has been relatively little change. Despite pressures on the NHS, and well-publicised missed targets for treatment, overall patient satisfaction is holding up relatively well – for example, while there are slightly more problems experienced in getting appointments in primary care, the 2015 GPPS survey of all doctors’ patients in England shows overall satisfaction with GPs has remained high.

Despite wanting to protect the vulnerable, welfare cuts are generally seen as necessary, although support for them has fallen since 2012:

The public believes 24 per cent of all welfare spending is fraudulently claimed (compared to DWP’s own estimate of 0.7 per cent).

What does seems to be happening in the UK is that the public have ‘bought’ the argument for the need to restrain public spending to reduce the deficit. So even if services have been cut, withdrawn or entirely reconfigured, there seems to have been some adjustment of expectations. By August 2015 the public assessment was that 28 per cent of necessary savings had so far been achieved. This is far closer to reality than the perception three years earlier in 2012 that 40 per cent of spending cuts had happened.

And when one looks at cuts in spending in general, the public is becoming less, rather than more concerned; only eight per cent are now very concerned about cuts:

Does this reflect an acceptance that reducing the deficit means accepting less public services? It depends. Looking at local government services, councils have managed to maintain public satisfaction by ruthlessly prioritising on key visible services, efficiency savings and trying to protect services for the vulnerable. There is still real reluctance to countenance any significant council tax rises by the public – and no council has risked a public referendum to introduce rises above two per cent per annum.

When we come to the most vital service of all to the public – the NHS – views are mixed about how to meet the funding shortfall. But only a minority say they favour tax rises – the rest want to see more efficiencies or user charges, and one in four are stumped:

The bottom line is that there is no easy consensus on how to fund public services in future.  Instead, government muddles through and so does the public. In my 30 years of looking at public attitudes on the subject, there may be a tipping point in service levels when suddenly opinion changes and where demand for increased spending – funded, if necessary, through hypothecated taxes or charges at point of use – becomes very clear. But we are not there yet. We still want Swedish services for American levels of taxation, but seem more flexible in our expectations than many in the public sector believed in 2010.

The challenge of course is that having done the more straightforward cuts, we are now facing harder and harder choices, in an uncertain fiscal environment. But public attitudes suggest leadership is possible – while belief in services like the NHS (universal and free at the point of use) remain unchanged, the public are more flexible than we might expect.

Photo credit: 1000 words / Shutterstock.com