Why Keir Starmer's decision to scrap massive quango should shame SNP into action

Everyone seems to have known that this particular layer of bureaucracy had become an obstruction to delivery rather than a facilitator. Like most quangos, it served the purpose of out-sourcing responsibility from where it belongs – with political decision-makers, committed to driving reform.

That only changes when there are politicians with the confidence and competence to reverse the process and take power back. In the case of NHS England, former Tory Health Secretaries now say they wish they had done it sooner. A collective sigh of relief seems to have been breathed that decisive action has been taken.

There are plenty lessons to be learned in Scotland which has become a nation of quangos, albeit under tight, centralised control. The combination is stifling. On every front, we have an abject absence of creative, innovative policy driven by ministers who actually believe in what they are there to do.

We also have industrial quantities of duplication and waste. Even according to the public finance minister, Ivan McKee, there are “around 130” quangos in Scotland and their number continues to grow. Mr McKee is aiming to find £5 billion which could be saved through “back-office spending” within the Scottish Government.

Well, good luck with that but I doubt if we will hear much more of it. Our quango statelet has expanded vastly under SNP rule, in the absence of politicians who lack the commitment or ability to drive policies on their own account. They are not suddenly going to become enablers of efficiency.

They have only been interested in one policy and, meanwhile, there would always be someone else to blame. Still, it is an astonishing admission from an SNP minister that while constantly pleading poverty and slashing support to local services, the Scottish Government has managed to accumulate £5bn worth of its own “duplication and waste”.

As far as health is concerned, Scotland starts from a different place because, in the early days of devolution, the Labour-led government did much the same as has now been announced in Whitehall, so that the chief executive of NHS Scotland is also director-general of Health and Social Care in the Scottish Government.

That is a useful reminder of far-off days when sensible progress was made without fanfares of trumpets. But what has happened since should act as a warning to our friends in the south, as well as within Scotland. Without continuing political leadership committed to reform, the dead weight of bureaucracy and associated empire-building will always take on a life of its own.

In the case of Scotland’s NHS, we have had a procession of Health Secretaries who failed the test of leadership. Nicola Sturgeon, Humza Yousaf, Shona Robison, Michael Matheson... they have all been there to no beneficial effect. However, the bureaucracies and quangos grew and flourished.

Scottish Government spending has vastly increased (thanks to the Barnett formula) but reforms which required political leadership were either avoided or, as in the case of the National Care Service, collapsed in incompetent disarray. None of that is going to change without the reforming zeal of an incoming administration… new faces, new energy, new ideas.

We now have about 30 NHS quangos in Scotland, including the 14 geographic boards. Some of them you will never have heard of. Until I checked the list, for example, I admit to ignorance of a Scottish Health Council which reports to Healthcare Improvement Scotland to provide “essential support and strategic direction”. Not many people know that.

Prior to Holyrood, Scotland’s devolved functions had five Scottish Office ministers including one for health. There are now 29 Scottish Government ministers of whom at least four have health responsibilities. By the time you get to the sharp end of Scotland’s health statistics, the conclusion is inescapable that outcomes are in inverse proportion to ministers, quangos and bureaucracies.

At the outset of devolution, 11 per cent of the NHS budget was devoted to primary care. That is now down to six, placing huge extra burdens on doctors. In 2018, the SNP promised 800 more GPs. There are now 200 fewer. Will they ever be held to account for statistics like these, or is patriotic mediocrity now a norm from which Scotland can never escape?

Wherever one looks, refusal to face up to the need for radical reforms has consigned us to a downward spiral of both expectation and achievement. The other most obvious example is education which, according to the departed Ms Sturgeon, was supposed to be the yardstick by which they were to be judged.

Instead, we have seen standards declining to the point at which ministers became frightened to expose them to international comparators. Yet there is absolutely no sign of radical innovations which might challenge the orthodoxies that have led us into this sad state of decline. Do we have nothing to learn from other countries including, whisper it, England?

Can anyone think of a Scottish Education Secretary who has spoken with passion about the reforms needed to restore past glories, far less displayed the will to drive them through to the point of delivery? Again, there are no fewer than five Scottish Government ministers with “education” in their titles, but how many original ideas do they possess among them?

Without a completely different mentality none of this will change, and it is unlikely to come from the current incumbents. On health, on education or anything else… if there were fresh ideas about how to deliver better outcomes, we would surely have heard about them by now. Eighteen years is a long time in politics.