The postcode lottery test: which answer do you pick?

Lottery ballsHello again to a post I first wrote in 2009 about a topic that’s still very relevant: how should you react when policy outcomes vary around the country?

James Graham’s typically pugnacious post about postcode lotteries has prompted me to write down a question that’s been knocking around at the back of my mind:

When you read about a public service varying from area to area (aka postcode lotteries), do you think:

a. “This is a problem. We must introduce more measures to ensure that the service is driven by national standards”, or

b. “This is inevitable. We must introduce more measures to ensure that the service is driven by local decision making”?

The classic political response is (a): the service is worse in one place than in another, so we must make it better in the first place. In isolation, that’s an obvious – and commendable – response. But “must make it better” usually translates to “impose standards or funding rules from above so that they have to make the service the same” – and that then runs into the reality that circumstances, preferences and abilities vary around the country.

There is no inherent reason why the population of a small Scottish island should have the same health priorities as that of a densely populated London borough. There is no inherent reason why a swathe of rural Wales should have the same transport priorities as a chunk of urban Midlands.

The problem is not variation. The problem is when variation happens for the wrong reasons. And so the answer is not trying to impose uniformity, it’s about greater local decision making – so the variation is for the right reasons, not the wrong ones.

It’s the lottery part of postcode lotteries which is the problem, not the postcode part.