Over the last few years the term commissioning has moved from being relatively unknown in an Australian context to assume a central role in public service reform processes at state and national levels.
The federal Commission of Audit report recommended the improvement of commissioning within the Australian public service and the development of commissioning expertise within departments and agencies. The 2014-15 federal budget which followed set out the aim of making government as efficient, as effective and as accountable as possible, with commissioning being proposed as one of the levers to achieve this through.
At the state level, the New South Wales government has asserted that strategic commissioning is the “best way” to realise increased competition and innovation in public service provision which can deliver significant benefits. The Victorian and Queensland governments have similarly drunk the commissioning Kool-Aid and have set out steps to underpin reform processes with this approach. Strategic commissioning has become an expectation of public servant competencies, appearing as one of the seven priority areas in the Victorian public sector capability strategy.
Yet, while commissioning has started to appear as a central concept in a range of reform processes, many of us are still unsure precisely what this is and whether it is different from either current practice or previous reform processes. While relatively new in an Australian context, the concept of commissioning has been used in a UK public service context for about 20 years. Despite this, the evidence base is far from clear in terms of what this concept means, the sorts of processes that underpin it and the outcomes that it delivers. A whole industry has emerged to support individuals and organisations in delivering this agenda and navigating the rather murky and complex terrain.
Commissioning is a definitionally fuzzy concept that can mean a range of things to different people. There is no such thing as a definitive definition of commissioning and it tends to be used in a fairly broad way. The English Department of Health describes commissioning as:
“… at its simplest … the process of planning, agreeing and monitoring services … Commissioning is not one action but many, ranging from the health-needs assessment for a population, through the clinically based design of patient pathways to service specification and contract negotiation or procurement, with continuous quality assessment.”
Often the broad array of different activities involved in commissioning are illustrated on some sort of commissioning cycle which forms a virtuous circle of activities based on a Plan-Do-Act-Review type model.
While it might seem like an academic preoccupation to get hung up on definitions of concepts, this does have real implications in practice. In the United Kingdom this was noted by a Government Select Committee, which observed that a lack of clarity over what commissioning is and the different processes it comprises poses difficulty for different areas of government and partner organisations in working together.
Being clear about what is meant by commissioning is important in signalling to government agencies and partners from other sectors what the expectations are in terms of this process and what it might be assumed to achieve. Without a clear sense of what the ultimate aim of commissioning is, organisations have become wound up in the everyday complexities and debates associated with the large array of different activities associated with this concept and can lose sight of the overall aims of this effort.[pullquote] “… many of the uses of the terminology of commissioning to date have been as a synonym for more contracting out or privatisation.” [/pullquote]
In an Australian context this is important — many of the uses of the terminology of commissioning to date have been as a synonym for more contracting out or privatisation. In a number of documents the types of words that appear alongside commissioning are things like “contracting” and “contestability”, with the aim of delivering efficiencies through competition-like mechanisms.
But it is important to note the advent of commissioning in the UK was not just to increase privatisation (although this has arguably been a by-product of the process). Commissioning came about as a result of a number of interlocking aspects of reform agendas in public services at a time when this landscape had become more congested and complex. Budgets were typically informed on an historical basis and many were concerned that this approach lacked allocative efficiency and the ability to think about public services in new and different ways. Many service areas saw the separation of purchaser and provider functions as a way to drive improvements.
While commissioning was seen as a way in which to increase provision by community and private partners, it was also seen as a way to, among other things:
- Drive technical efficiency in services;
- Allow purchasers to focus on needs assessment and service design unhindered from the everyday challenges of delivering services;
- Act as a counterweight to professional dominance in some service areas;
- Make providers more responsive to service users;
- Clarify costs of service deliver; and
- Develop better lines of accountability.
As this extensive list suggests, this was about more than just outsourcing and was often concerned with orienting public services to be more strategic in approach and more explicit about resource allocation decisions.
The obvious question that follows from such an extensive list is whether commissioners have managed to achieve this. Unfortunately, again, the evidence base is less than clear on this. A number of reviews have found that there is a lack of data to suggest that commissioning has had a significant impact on population outcomes. Although there are pockets of improvements and suggestions of best practice, gains have not been widespread.
Local organisations have struggled to work out what it is that commissioning should deliver in their localities and how to operationalise processes. This has all been in a context of rapid change and frequent reorganisations of the bodies involved and more recently, of course, significant cuts to public service budgets which have all added to the difficulty in achieving and evidencing change.
With a broad concept like commissioning it is difficult to be definitive about whether it “works” or not. What the evidence demonstrates is that by investing in staff and organisational processes and thinking carefully about local needs and markets it is possible to deliver reform. Commissioning is less a science and more of an art, requiring significant labour to make a reality.
If we want to increase levels of outsourcing and privatisation then there are easier — although perhaps less politically palatable — means to do this than commissioning. However, if we are interested in the reform of public services, commissioning may be one approach that provides a framework and a vocabulary to support this.