As pundits call it all, the real sickness in public services is the 'three Ms' : managerialism, marketism and measurementism.
We had all these before thatcher in fact, only without the isms but with the professions forming their own competent structures.
The structures were however vague in the 'roll up, wall street like figures' . They did things often expertly but could say how much better they did it in the term of a parliament over the last one.
All the above 3Ms do one thing overall: they take money away from front line delivery of public services. They place power often in the hands of failed and ailing private sector managers with no relevant profession. The 3 big isms hve been here since the thatcher years and new labour fed the beasts with deproffessionnalisation of front line delivery, opening careers for wannabees who could make the grade as nurses, teachers and police. Fine if they were only helping extra hands and bum wipers, but often they are given more responnsibility than they command or just water down the budget for professional head count and long term cover for sick leave.
Extra hands can be good, and with the exception of the police, assistants existed before with clear cut roles. (you could say traffic wardens at a push).
Measurement and management is good, but for gods sake put it in the hands of professions and let them do MBAs as sabbaticals for example, biut dont place failed middle managers from the private sector as bosses. By all means introduce good practice, apply or develop ISO standards, let management consultant sample-measure but stop piling on costs for management.
Marketism has its place, but i take the principle that the user , customer in the public is not at liberty to choose when they are in need of care, attention or education. A full market economy police is absurd. Placing artificial market structures whereby hospitals compete is not as good a remedy as developing regional centres of excellence and national ISO standards for best practice.
The beast has to be killed before the front line proffessionals become any more disenchanted and the new fascist right have enough ammunition to privatise health, social welfare and education and further deproffessionalise provision outside the more affluent areas.
Firstly i would encourage the Scottish and Scandinavian parliaments to steer managerialism over to the sabbatical and career development route for established proffessionals. Separate out secondary managerial functions like accountancy and building services and by all means, place them out to tender. Trust the proffessionals to manage, and give them the route to the skills they need.
Secondly i would say that there must be best practices taught as such, and maintained by management measuring at point-of-provision. Iso standards, yes ENs , international standards or national standards tailored to provision and building upon established excellence.