’Jazz hands’ presentational maestro Tony Blair spent a decade at the top of British politics. He gave a presentation to the Institute For Government a month ago, and I finally got round to reading the transcript.

A selection of quotes follow below. For the time-poor, Blair appears to be pro-restructuring government systems; believes the public sector is useless at project management; and has a touching faith the private sector management techniques, US HMOs as the way to run things, and Special Advisors.

The historical perspective is interesting.

“Systemic change is absolutely essential in today's world, you take any successful private sector company, they are reinventing themselves virtually every year, some of them month by month. If you want effective delivery and that requires systemic change, you will not get such change unless you are prepared to do what I call challenge the givens. What a lot of the time you do in Government work is you assume the system is the system and then you say 'how can we make it work more effectively?'. Actually what you very often have to do is say 'let's challenge that assumption, maybe the system doesn't have to be like that'.”

“Until you changed the system you weren't going to get something that really worked. When we got NHS waiting lists down, and the dog that didn't bark at the last election was the NHS, it's one of the extraordinary things, every election probably up to maybe 2005 that I can remember was absolutely dominated, even 2001 as I certainly remember, was dominated by the NHS. We got health service waiting lists down and you can actually see this, when we changed the system within which health care was delivered, by introducing competition, the private sector, and so on.”

“We need a far greater interaction I think between the public and private sector. Much of the skill set as necessary today as a skill set that people will learn in the private sector. If you are trying to get something done and you are trying to deliver a project, project management is a private sector skill. I think a lot of our best public services as servants would benefit enormously by spending some years outside and then coming back in. I think there is absolutely no reason why you shouldn't have an exchange between public and private sector. I think we are actually in danger of looking at rules of priority in relation this and them almost becoming an obstacle to that free exchange between public and private sector. I will put in a personal though maybe not terribly popular plea or SpAds. The fact is, in modern politics it is completely absurd to think that there is something wrong with brining in people who are political, but the fact that they are political doesn't mean to say that they can't also be useful believe it or not (laughter). I know this may sound a heretical thing to say but actually I found the majority of Special Advisors were people who weren't brought in to do what I would call the sort of more dirty street fighting stuff at all. Most Special Advisors were brought in because they had both a political idea of where the Government was trying to get to, but also had some ability in terms of policy to get things done. And I just think for our system to think that when you've got 80 SpAds in Government this is a constitutional outrage, I just think this is absurd. Personally I think you need to have that, and Governments for example need to have communications people as well. The idea of Government today surviving without an effective communications machine is just ... you might as well try to face body line bowling in a jock strap with a pencil (laughter), it's just not going to work.”

“The basic problem was some of these issues that you are grappling with, like how to reform the National Health Service, I mean they are hard. So one of the things that happened was that we were learning, so at first we really did it through; we are going to set a series of targets, and then we are going basically say to the front line of the NHS 'right you get on and deliver that'. The trouble is, I came to the conclusion about two years in we needed systemic change because actually just flogging that system wasn't going to work. Now that took quite a lot of iteration and reiteration. One of the things I think however I benefited from enormously, and certainly in the second term, was outside policy advice from people who were practitioners, non-academics actually but who were practitioners. So I thought nothing of getting four people who were running health management organisations in the USA to come in and tell me how they found their issues to do with things like procurement, and managing the balance between primary and secondary [transcript marks word(s) as unclear] care, and I think we don't do nearly enough of that either. You take something like procurement in Government today, procurement is a private sector ... everyone has to do it. But how many organisations in the public sector do their procurement in the way that a private sector organisation would do it? Now we are beginning, to be fair, it's happening, but it needs to happen a lot faster.”

In discussion with Peter Riddell (PR)
TB: I used to say the whole time when I was in Downing Street that my ambition was to get the point when I am sitting round the table with the Minister and my policy people, the departmental people and I'm having to say 'oh my goodness, that is too radical, we can't do that' ...
PR ... did you ever get to that stage?
TB Towards the end, once or twice.
PR What areas?
TB Actually some of the welfare ideas and one or two of the health things, but having said that once I'd thought about it I was quite up for it anyway.

TB (on targets): “the targets ... look, I think we should just de-mystify the targets business, we at a certain point definitely had too many, right, and some of them conflicted, which is just silly to have that. However, I can't think of any organisation that is going to spend billions of pounds on something and not say we want some output. So I think we've just got to de-mystify that. We are talking about things we would learn, you know, I think that's one thing. If I were them I'd be really careful of that. Not in the sense that you shouldn't make the targets and everything sensible, but some of the change we got was by having a target, and as I say I can't think of a private sector organisation that wouldn't have a target if they are spending a very large sum of money supposedly to achieve an outcome. That they wouldn't at least say 'we expect this outcome to be achieved'. So I just think we should be sensible about that, and we did on occasions take it too far I think, but basically it would be a mistake to get rid of them all together I think.”