The Southern Care crisis: A warning ahead of public sector change?

DAVID CAMERON, perhaps unwisely, pushed on yesterday with a speech on how he planned to reform the public sector.

He wants to do away with the 'here's what you're getting' mentality and replace it with some sense of empowerment to get the public services we want.

In theory, sounds great. We tell the councils, the schools, the NHS, the police the services we want and, presumably if enough of us say the same, we get it.

Only there is a catch. We're expected to help deliver those services too. That might be via a company, or a not-for-profit group. Doesn't sound so appealing now, does it?

I've no doubt the coalition government will, over the coming years, be able to demonstrate examples of community groups taking over libraries, or private companies coming and running services more effectively for councils.

But the problem will be in the areas which aren't appealing to private companies. Running meals on wheels might be quite attractive in a leafy part of Berkshire, but maybe not so in socially-deprived areas where visiting people in their homes could involve a likelihood of vehicle being vandalised, staff being abused and so on.

What Cameron has announced isn't really new. The private sector has been a part of the public sector for a long time. Care homes are a classic example. Whereas once, councils ran OAP care homes, now they pay the private sector to do so.

And that brings me to Southern Cross. Closing down after failing to make a living off looking after old people - partly because councils insist on below-cost deals for the OAPs they pay for - thousands of pensioners face an uncertain future.

Labour MP John Mann has been one of the few MPs to switch his attention from phone hacking to the Southern Cross crisis. He says it is a bigger crisis for the government than News International is. Should we suddenly see pensioners being transferred from Southern Cross homes or left homeless, then he may be right.

Longer term, if Cameron pushes ahead with the plan to allow the private sector and voluntary groups to cherry pick parts of the public sector they can profit from/have an enthusiasm for, it almost certainly will be a bigger crisis for Cameron.

Mann wants to see councils running the Southern Cross care homes. That's a very Labour response - bring in the state. But the problem for Cameron will be that if lots more of the public sector is run by organisations who can just opt out when the going gets tough - as National Express with the East Coast Mainline franchise - then there won't necessarily be the public sector infrastructure left to pick up the pieces.

Then, as Mann says, there will be a crisis which threatens to have people out on the streets. Much as Cameron claims to understand how much people care about the NHS, he's wrong to think that regularly complaining about council services is a sign people like the idea of others being put in charge.

For Big Society, read Southern Cross. And worry.