What would public services look like if they were designed the way users and front line staff would want?
That was the big 'what if' posed at this week's GC Live conference when delegates were asked to imagine a world where public services are designed the way users and front line staff want them.
Of course this type of thinking has been bandied around the public sector for some time, but it may have to become reality.
The levels of public sector investment seen in the past 12 years will never happen again – or at least not in Sir Michael Bichard's lifetime, the former permanent secretary and director of the Institute for Government thinktank, told delegates.
Bichard likened this investment as to pouring money into a leaky bucket, albeit one that is now becoming smaller. For all the millions spent, investment has been fragmented by a government structure consisting of niche providers who have found it difficult to work together, he explained.
Bichard said that poorly designed services have failed to engage the user and it was time for a radical and innovative rethink.
Services should first and foremost be built around the client to enable transformation. Better services at less cost to the taxpayer cannot happen without better innovation and design.
Bichard, who is also chairman of the Design Council, said design in this country is seen as something esoteric and aesthetic rather than a root to innovation.
The recession is cutting across bureaucratic boundaries; to introduce better services at less cost the public sector must adopt an appetite for change in its design and engagement for front line procurement, he urged. The result would be a benefit not only to the user and staff – but also the taxpayer.
Alexis Cleveland, director general of transformational government at the Cabinet Office, has the brief of trying to influence a new way of doing things in government.
She acknowledged that customer expectations are high, but said better services can be obtained with less resource if the citizen is engaged more at point of contact through better use of technology – something Cleveland herself implemented when chief executive of the Pension Service.
A service designed around the client, she said, is also beneficial to staff, who feel they are doing a worthwhile job in being able to help.
Joan Sadler, national director for patient and public affairs at the Department of Health, told delegates that the public sector should pick up on Barack Obama's recent speech to the Muslim world in Cairo. There should be a mutual respect between the two and a government or country should not simply impose their views on people.
Good communicators make good leaders. NHS staff also feel they could offer a better service if they were listened to more, said Sadler.
The service design challenge instigated by Lord Darzi's Care for All review of the NHS, has clearly started the process, said Sadler, but how many people know about the NHS choices site?
Sadler explained that it was set up to deal with NHS patient experience, but the message is simply not getting across, she said.
She said it was simple: people want and expect a flexible, efficient service designed around them. It is their right to be able to choose a service or choose a clinician who will arrange a service for them. The way forward for the NHS is through personalisation and personal care.
Chairing the debate, David Brindle, public services editor of the Guardian, spoke of a fiscal Armageddon facing public services. Bichard, in response, said behavioural rather than exclusively fiscal economics will be the key to streamlining the system.
Diseases such as obesity and diabetes will be a greater drain on the system without early preventive measures; the only trouble is, he said, the government does not yet understand behavioural economics.