We will shortly have a new Prime Minister and, with him, yet another promise of better public service delivery and growth across the country.
Every government I have studied for more than nearly 40 years of measuring public opinion has tended to think: improve public services and the public will notice, the public notices, confidence improves and you are re-elected.
Unfortunately, in many services, the political payoff depends far more on whether delivery is seen and experienced than on whether outcomes improve in technical terms.
Confusing delivery with being seen to deliver is why genuine progress often goes unrewarded, why targets are met while opinion worsens and why ministers are baffled when gratitude never arrives.
The current Government is a case in point: the public are most likely to remember failures and U-turns and least likely to remember what they themselves regard as successes, if asked.
Three lessons emerge from 40 years of public opinion data: performance explains only part of satisfaction. The mundane, universal state weighs heavily on reputation and ‘delivery' has little political weight without narrative, dignity and belonging.
Ipsos and King's College London's work on the ‘democratic disconnect' finds that the share of Britons who think public services are ready to listen to complaints has roughly halved over the past two decades, falling from around 49% in 2002 to about 26%.
New Prime Minister Andy Burnham has to do something different. Britons are far more likely to say councils, schools and hospitals are failing than to say the same of the shops and banks they use daily. Asked to describe public services in three words, they reach first for ‘underfunded', then ‘bureaucratic', ‘unaccountable', ‘unresponsive', ‘infuriating', ‘faceless'. Being ‘efficient' and ‘good value for money' sit at the bottom of the list, which should worry reformers who assume efficiency gains speak for themselves.
These are reputational failures, not just performance failures and reflect how people experience contact with the state.
Asked what most needs improving, the answers have hardly changed since the Blair Government of 2001-2005: speed, simplicity, ease of access.
Asked about the biggest barrier to better services, they say money – not structures, and certainly not ‘reform', which excites Westminster, but registers with almost nobody outside of London SW1.
And the picture has hardened. Ipsos and King's College London's work on the ‘democratic disconnect' finds that the share of Britons who think public services are ready to listen to complaints has roughly halved over the past two decades, falling from around 49% in 2002 to about 26%.
Nearly half feel they have little influence over their area and the most powerless are gravitating to Reform UK.
Every failure now confirms the anti-politics mood in Britain and every success is discounted in a low-trust environment.
Performance and perception are only loosely related.
Satisfaction with a service – however complex it might be – is driven by a handful of things: delivery of the outcome, timeliness, being kept informed and staff attitude. Together, this explains about two-thirds of the variation in satisfaction scores. What dominates is the felt experience, the wait, how often you had to make contact; whether promises were kept, whether anyone apologised.
What users value is often quite different from what professionals and inspectors focus on. The gap is where reputations go to die.
The NHS is a vivid illustration. Across trusts, patients' overall ratings of their inpatient care correlate strongly with whether they felt treated with dignity and respect.
The correlation with the standardised mortality ratio for a hospital is very weak – around 0.11 – and with the amount spent per patient weaker still, about 0.05 – effectively nothing.
A hospital can be clinically excellent and efficient and still be disliked because rudeness at reception and a filthy toilet are the visible signs that patients use to judge it, compared with surgical success rates, which along with mortality ratios are some of the things the public often least want to know.
Local government is the same. Time and again, the strongest influences on a council's reputation are perceived value for money: street cleaning, liveability, media coverage and direct communication from the authority, with many statutory performance indicators for the services where the vast majority of money is being spent, like social care, among the weaker drivers.
In one analysis, perceived street cleanliness alone explained 32% of the variation in the satisfaction score for the local area – more than housing, education and planning combined.
The mundane, visible, universal fabric of a place does more for the standing of public services than the big ticket statutory services on which most of the money is spent.
Should we give up? No. We should recognise that public services themselves are only one driver of perceptions and rarely the most powerful.
For services like the NHS or immigration control, where most have little direct experience – only about 40% visit a hospital each year – media coverage, the reputation of the Government of the day and staff advocacy – what they tell the public – all have more impact than actual performance.
Obviously, performance and efficiency matter, but as you cut waiting times there are real lags and tipping points in perception.
We found with average waiting times that when they fell from six months to three months, there was no shift in perception, which flatlined. The tipping point came only when waiting times went below three months. Then, overall perception began to shift quickly.
Despite former communities secretary Eric Pickles and others' invitations to the public to become ‘armchair auditors' of published performance, most people have other things to do.
There are also phenomena, like the local-national gap – where my GP is wonderful but ‘the NHS' is collapsing; where in my area everyone gets on fine, but nationally, immigration is out of control. And there are signal events where one horrific case swamps a thousand quiet successes.
The public also benchmark unforgivingly against the private sector. When a supermarket app tracks your delivery driver or a bank settles a fraud claim by chat in 10 minutes, people ask why government cannot get two departments holding the same address to talk, or why booking a driving test is harder than booking a flight. The comparison is often unfair, but it will not go away.
All this connects to the argument running through Anglo-American politics since Deepak Bhargava, Shahrzad Shams and Harry Hanbury published The Death of Deliverism in 2023, which did the rounds among Labour MPs and deserves to do so in Whitehall, too.
The expanded American child tax credit lifted more than two million children out of poverty – the largest recorded fall in US child poverty in modern history and produced essentially no political dividend.
Among some prime beneficiaries, the share saying their lives were improving actually fell while the money landed. Bhargava's own students, receiving the payments, assumed they were a trap. His conclusion is that people need ‘the cloth' as well as ‘the milk'. Delivery must come with dignity and a story about who is delivering.
The essay spawned a lively debate, with David Klemperer and Aveek Bhattacharya both writing on whether ‘deliverism' or ‘narrativism' better explains outcomes.
I think the point is that the new UK Cabinet will need both: it is not binary.
For the UK, this means pairing real improvements – on waiting times, crime or immigration – with visible experiences of impact and a coherent story about who is acting and on whose behalf.
Outcomes matter, but they are politically weightless until noticed, experienced and narrated. Deliverism is dead only in its naïve form, thinking that outputs will speak for themselves, which Sir Keir Starmer seemed to believe.
They never have. They need a government to tell the story about what it is doing to improve things – a more demanding politics that needs both real outcomes and a narrative that makes those outcomes legible and meaningful in everyday life. That narrative pays off eventually from a grudging public when they notice things really have improved.
So what should the approach be?
The prescription has not changed much in 20 years. The urgency has. All of this assumes the centre can commission and absorb satisfaction modelling and that departments are willing to redesign services around user experience, rather than internal convenience.
First, build a proper model based on both numbers and experiential ethnographic work of each service. Understand which drivers of user and public perception relate to the service itself and to which part or element of the service.
If running a hospital, know that how clean it looks and how quickly people are seen will likely matter more to local perception than your mortality ratio. Understand that much of what people think of it is driven by external factors like social media, or indeed, simple local deprivation.
Second, managers and politicians can learn a huge amount by studying outliers, where the lessons are. Visiting individual sorting offices or A&E wards brought the statistics to life for me: the worst rated hospital I ever saw had a children's ward that looked designed for violent prisoners, a hole in the A&E reception floor fenced with plastic railings and staff who trusted neither each other nor their managers. Go behind the numbers and look at the real lessons of the best and worst.
Third, improve the things users focus on – speed, simplicity, being kept informed, being treated like a human being – and align your language with these criteria: not ‘reform', ‘choice' or ‘growth', but shorter waits, clean streets, fixed roads and clear answers.
Alongside the evidenced, outcome-driven programmes, you will have to improve the NHS and other public services, as well as key issues like immigration hotels, special educational needs and disabilities (SEND) and homelessness, pursued because it is right and measured in real outcomes, accepting that they may not immediately move national perception.
Fourth, treat communications as part of delivery: your own channels, the media and above all, your staff, whose advocacy or cynicism reaches the public more credibly than any campaign.
Staff advocacy depends on how they are led and rewarded. One failure of the Blair years was that meeting a nurse or police officer often left people feeling worse about the NHS or crime. Frontline staff would tell you what they really thought of management and their words carried far more weight than any campaign, even as money spent on pay and pensions increased dramatically.
My favourite illustration remains two staff: the Miele engineer who told me recently, unprompted and proud, that his firm was serious about quality – and the train driver who recently apologised for a delay by noting that, as usual with the people running the railway, customers were the last thing they thought of.
Staff advocacy matters, especially when you employ millions of people, as the British Government does.
So, alongside evidenced, outcome-driven programmes for growth, planning reforms, SEND, etc, invest deliberately in universal, everyday competence: streets, parks, cleanliness, potholes, Driver and Vehicle Standards Agency, passports – the basic transactional state.
Investing in the mundane is comparatively cheap and yields disproportionate reputational dividends, which then create political licence to tackle harder, more deep-rooted problems. It is the only improvement some taxpayers will ever personally experience and it buys the reputational headroom to deliver longer-term outcomes.
After 30 years of watching governments hit targets while public opinion got worse, I hope a more thoughtful – but also decisive – approach could make a difference. The Government does not have much time.
Ben Page is visiting professor at King's College London
