Public Services in Rural areas; is it realistic to expect them to be excellent?

I live in Penrith, Cumbria, the home of the UK’s Lake District and the most sparsely populated rural district in England. Cumbria would be the undisputed first choice for a British remake of the Dukes of Hazzard. Apart from being overly cold for the frequent wearing of hot pants, we have most of the ingredients required. Some rough and ready drinking holes, I should know, wide expanses of lawless rurality, a hapless police force, a jolly if decidedly dim police commissioner, no shortage of incompetent public servants, and the obligatory gaggle of entitled landowners and favour pulling businessmen.  

When it comes to the running of our public services, we have a bad habit of celebrating ineptitude and welcoming the detritus discarded from elsewhere that is unable to find refuge in any other place. Behind Cumbria’s picture-postcard scenery is a patchwork quilt of poorly performing public services who owe our continued tolerance of them on a mix of stoic rural self-reliance, community spirit and an army of committed volunteers. I think this typifies how communities in many rural areas survive. 

We make such a wonderful hiding place for dross, that recently an unqualified psychiatrist, which I guess means she wasn’t really a psychiatrist, was discovered in the employment of Cumbria’s NHS providing counselling to some of the county’s most vulnerable people. Even pre-Corona, Cumbria’s NHS was so stretched it would have welcomed Harold Shipman if he could be resurrected with a pulse. Mind you, this could help reduce our ageing population and if his services were publicised adequately, deter further retirees from coming here to see out their days in rural tranquillity. 

If our police force are a laughingstock, our NHS hospitals are an undisputed basket case. The NHS in Cumbria has been in crisis for as long as anyone cares to remember.  The county’s healthcare system is regularly highlighted by NHS England itself as one of the most challenged and dysfunctional in Britain. North Cumbria NHS has had fourteen different chief executives in the last twenty years, a national record.

As inept management, consistent failings and a culture of collusion and wilful blindness have inevitably led to serious harm and even death, the NHS in Cumbria has been forced to pay out tens and tens of millions of pounds in compensation to patients and their families. The cost to UK taxpayers of continually baling Cumbria NHS out of the crap it appears unable to climb out of, is only exceeded by the tragic personal cost and often irreversible damage done to those it has failed and their loved ones. 

As for the county’s council services, I’ve yet to meet anyone who expresses delight in them, then again is anyone ever delighted with their local authority. Cumbria’s six small district authorities and its countywide council are widely regarded by citizens as unfit for purpose, particularly children’s services which are regularly lambasted in the local and national press. We will leave the state of Cumbria’s education for another day. Suffice to say neither competence nor courage are obvious qualities in the upper echelons of Cumbria’s public services. 

Cumbria has never been and is unlikely to become a beacon of brilliance attracting the brightest and best of the public sector. On the rare occasions leading-edge thinkers might seek employment in public services, it’s an unfortunate reality that isolated rural areas like Cumbria lack the critical mass needed to attract them. Unable to tempt the good and providing sanctuary for the inept, places like Cumbria deliver a double whammy to rural populations who need their public services to be innovative if they are to be effective. 

Tom’s book, Lions, Liars, Donkeys and Penguins – The Killing of Alison is available in paperback and Kindle on the Amazon website https://amzn.to/2yAwa0j

Tom is currently developing a website to highlight the need for increased honesty & integrity in Public Sector services at www.hipss.org.uk

He can be contacted at tom@hipss.org.uk

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