When Public Sector Outsourcing Doesn't Work…

Over the Easter weekend I had what ended up being a rather disturbing conversation with an old friend, which I thought sufficiently relevant to this space to share with you. This friend has very recently started a new job, working in an outsourced contact center providing advice to, and processing applications by, users of local (public sector) health and social services (I need to be relatively vague here, for obvious reasons...).

One of the main tasks she has to perform is vetting people who call looking to get access to one particular healthcare-related service. Due to the nature of this service, applicants are invariably over pensionable age (65, more or less, here in the UK) and suffering from illnesses or disabilities that restrict mobility - this is an important point: we're dealing with some pretty vulnerable people in (often serious) need. My friend has to take them through a survey and, at the end of the call, inform them whether or not they've qualified to receive this service.

The problem - one of the problems - is that certain responses to some of the survey questions can disqualify applicants outright. My friend explained some of these to me and, frankly, it's an outrageous situation. For example, applicants who say they're using certain medical apparatuses which haven't been prescribed by their General Practitioners (GP) won't qualify, even though these specific items are the kind of thing one might buy oneself, be given by relatives/friends/charities or procure in some other way simply because they're useful, rather than even considering going to the GP to be prescribed them.

The REAL problem, however, is that at no point during the call can my friend or her colleagues explain to the applicants where they've gone "wrong" if they give disqualifying answers. The hopeful callers merely get to the end of the survey and are told "Sorry, but on this occasion you haven't met the criteria to qualify for this benefit." There is no clarification on which answer(s) may have scuppered their applications, let alone what they need to do to meet the criteria for a future attempt. They are left without access to this service and with no information as to why.

In my opinion (and, incidentally, that of my friend, who is already frantically seeking another job) this is disgusting. While I understand the need to combat the fraudulent use of public services - the putative driver behind this process - we are obviously throwing the baby out with the bath water here. My friend couldn't give me any firm figures but she confirmed that a significant majority of applications are rejected - and I simply don't believe that the majority of calls are attempts to defraud the state. (For what it's worth, my friend told me that rather than responding angrily and aggressively, rejected applicants inevitably sound dejected, upset and confused at being denied what they expected to be a service to which they were entitled by right as long-term payers of National Insurance, council taxes etc. here in the UK).

My guess - and it's one informed by many pertinent conversations on similar topics in recent years - is that the service provider in question has been tasked (either directly and explicitly by the local authority, or because of a driver to maintain a profit) to reduce the number of users of this service, and such mechanisms are the loopholes through which it has found itself able to do so: it's a financial consideration rather than a social one. (Note: I concede that I have absolutely no evidence whatsoever that this is indeed the case, but Occam's razor suggests it to be: I would be more than happy to discuss this with anyone who disagrees, via jliddell@sig.org...) 

This, for me, is a fundamental problem with the belief that public sector outsourcing can be run in the same way as is the model in the private sector. Focusing primarily on the bottom line in the former environment logically suggests reducing service levels - yet the demand for those services can't be reduced other than through artificial contrivances such as the one described above, which of course doesn't really reduce demand at all. The demand is still there, bewildered, struggling, often alone, old and betrayed in countless homes around my friend's region (and I have no reason to believe this isn't a situation being replicated elsewhere across the country). 

Perhaps I am being too idealistic, but the priority in such cases should be delivering services effectively and efficiently, not denying them simply to make the numbers work. If a service provider can't provide a service to those who need it and who should be entitled to it (rather than being disqualified via some shamefully Machiavellian process) and still make a profit, then it shouldn't take or be awarded the contract. If no service provider can make it work, then obviously the outsourcing model isn't appropriate in such scenarios. To force the model into place in the way the UK's national government has done in recent years (local authorities effectively being forced to do the same by Westminster-imposed budget cuts) at the cost of untold hardship and misery on the part of our most vulnerable people is nothing short of a disgrace.

Outsourcing works - often astoundingly well - in the right circumstances (in the public sector as well as the private arena) but where it doesn't work its implementation can be catastrophic. Here, from the outside, there's no catastrophe visible: the provider can show good profits, the local authority can show good (if completely fiddled) usage numbers and (hopefully) balance its own books. Meanwhile, out of sight, the number of old, frail and utterly puzzled people in need, denied life-improving services without being told why, continues to rise - and that's not the fault of outsourcing but of those who decided to implement it in the wrong way, and for the wrong reasons.

Jamie Liddell, Editor, Outsource

Jamie Liddell is the Editor-in-Chief of Outsource. He is a journalist with extensive B2B and consumer experience, particularly in the sourcing and international property sectors. A graduate of Cambridge University, Jamie worked as Chief Foreign Correspondent for property media company Blendon Communications before moving into full-time B2B journalism as launch editor of the Shared Services & Outsourcing Network. He took over the helm of the Outsource brand in April 2010 and has since overseen its transformation and evolution into the world's leading publication focusing on the sourcing, outsourcing and business transformation space.