This is no way to cull the quangosBMJ 2010; 341 doi: https://doi.org/10.1136/bmj.c5615 (Published 12 October 2010) Cite this as: BMJ 2010;341:c5615
- Nigel Hawkes, freelance journalist, London
Do you know what the Tories’ notion of “big society” means? Me neither, but I have the vague idea that it aims to recruit people to serve—voluntarily or for modest rewards—as good citizens, giving their time to improve government and the delivery of services.
People such as the members of the Advisory Committee on Dangerous Pathogens or the Spongiform Encephalopathy Advisory Committee, perhaps? Or the Expert Advisory Committee on AIDS? No, it can’t mean any of those, as they are all being abolished.
“I volunteer, you serve, they set up a quango” seems to be the way the coalition government conjugates the issue. When new ministers take office, quangos are first in line for the axe because they fall outside direct political control, are often in the hands of the last government’s trusties, and nobody can quite remember why they were set up in the first place.
The process is not an unhealthy one. If left unpruned, quangos would spread like rhododendrons, individually displaying exotic blooms but collectively blighting the scenery. The whole of government ought to be subject to the same brutal husbandry but seldom is. Times of economic panic are one of the few opportunities we get to cut them all down to size.
That said, there is something a bit gratuitous about the list of soon to be axed quangos that leaked out last month (BMJ 2010;341:c5297, doi:10.1136/bmj.c5297). Many, like the committees listed above, are not really quangos at all but useful ways of tapping into the expertise of those who really know their subject, at very little cost beyond the odd gong for a retiring chairman. Some look as if they have been added just to make the list look longer and the government more purposeful.
One quango on the list, the Hearing Aid Council, had already been abolished and now exists only as a ghostly presence on its website, like the slowly fading grin on the Cheshire Cat. Go there and you will find a useful guide to how to abolish quangos, beginning with the frank admission that the abolition of the council leaves consumers better protected and the industry £1m a year better off. That’s a really classy way to say goodbye. But will all quangos go so gentle into that good night?
David Cameron’s rules for assessing quangos were outlined in a speech in July 2009. “Does this organisation need to exist?” he asked. If its functions are necessary, which of them should be carried out in a directly accountable way within the department and which independently at arm’s length? And if there really is a need for a quango, how can we make sure it is as small as possible and operated with maximum efficiency, frugality, and respect for taxpayers’ money?
These are reasonable questions at any time, the more so in hard times. But if we are aiming to save money by abolishing quangos, we face a good example of the Pareto principle: 80% of the money is spent by 20% of the quangos. The rest cost peanuts and might be seen as working examples of the big society, not blood sucking parasites on the body politic.
And the bigger quangos generally do have a need to exist. The National Institute for Health and Clinical Excellence (NICE) has proved its usefulness and will now grow by swallowing up others. The licensing of drugs needs to be independent of government, so the Medicines and Healthcare Products Regulatory Agency, or something like it, is indispensible. The Care Quality Commission, though costly, acts as a lightning conductor for legitimate disquiets about NHS standards: better not get rid of that. No chance of losing Monitor: in an NHS with greater freedom of manoeuvre for foundation trusts, an economic regulator is vital.
The Health Protection Agency, though listed among the fallen, is not being abolished except in name. Its functions and most of its staff will be employed in the new Public Health Service.
So we are left with a number of middle sized quangos mostly set up by ministers to score political points (the Council for Healthcare Regulatory Excellence), to escape from accusations of patronage (the Appointments Commission), or to deal with short term moral panics (the Human Genetics Commission, Human Fertilisation and Embryology Authority, Human Tissue Authority, and Genetics and Insurance Committee).
None of these, in my view, satisfies all Mr Cameron’s conditions for continued existence. They did good work, but it is not work that others are incapable of continuing. I am sceptical about merging the Joint Committee on Vaccination and Immunisation into NICE, but only because NICE rejoices in its bloodymindedness, while vaccines need a more human touch. I do not regret the passing of the Appointments Commission, whose choices invariably excluded those whose political views would not be considered simpatico in the NW postal districts of London.
That said, I wish I was convinced that “the cuts,” as we now shorthand them, were being driven by a coherent philosophy. They represent a huge opportunity, as the former finance minister of New Zealand, Ruth Richardson, said in a recent lecture at the centre right think tank Reform, to reshape government and make it better able to sustain the burdens it should truly carry, discarding those it has accidentally acquired. Mess it up and the next economic crisis, when it comes, will be even nastier.
New Zealand’s economy has been less affected than most by the economic downturn, its fall in output about half the United Kingdom’s. That is in good part the result of a strong fiscal position, buttressed by the Fiscal Responsibility Act passed by the government that Ms Richardson served. Bad times are an opportunity for change: the quango cull is a small but necessary element in that change. But it needs to be part of a fully articulated policy if it is to carry political conviction. And that we currently lack.
Cite this as: BMJ 2010;341:c5615
Which quango would you put first in the firing line? Please tell us in a rapid response.