经济学人29:公共服务改革,戴夫大冒险让人惊讶

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　　Overhauling¹ the public services is proving slower and harder than the government once hoped

　　整修公共服务：比政府预期还要缓慢艰难

　　HEALTH-CARE reform’s potential as raw material for rappers has hitherto mostly gone unnoticed. Now the government’s plans for the National Health Service have been satirised in a ditty entitled “The NHS is not for sale”; it registered over 150,000 YouTube hits within a week. Nearly a year after the coalition² came to power, offering the most sweeping³ public-service reform agenda since Margaret Thatcher⁴, grind—and ridicule—have beset⁵ it. Ministers look tired; U-turns, refinements⁶ and clarifications are frequent.

　　医疗保健改革本可以让说唱歌手好好做上一番文章，但迄今为止却少有人慧眼识珠。如今，讽刺英国政府改革国民健康保险制度计划的打油曲“健保系统不卖”，在YOUTUBE上一周已获得十五多万次点击。联合政府执政将近一年，提出了自撒切尔夫人以来范围最广的改革议程；然而这项议程却被琐事和嘲弄包围。大臣们面色疲惫；方针、政策等的急速转变，调整提高以及解释说明屡见不鲜。

　　The official line is that reforms to schools, the NHS and other institutions are proceeding⁷ as intended. David Cameron is sticking to his plans to devolve more power to those directly delivering the services, cut out bureaucratic⁸ middle men and enhance competition. But scratch a bit deeper, and worries about the impact and pace of the changes are evident. “We haven’t succeeded in explaining how our approach saves money and delivers better services,” admits a senior minister.

　　官方方针是学校，健保系统和其他机构的改革正如预期进行。卡梅隆坚持自己的计划，即把更多权力移交给这些直接服务的机构，裁减打官腔的中间人员，加强竞争。但是往深里想想，此举的后果和改革步调便显而易见。一位高级大臣承认：“我们没能成功解释这样做为何省钱，为何可以提供更好的服务。”

　　Andrew Lansley’s bid to devolve the commissioning of hospital care, and responsibility for much of England’s health budget, to GPs has proved the most contentious⁹ policy. Under the health secretary’s scheme, GPs will be obliged to form new commissioning consortia; they will also have more freedom to choose private health-care providers over state ones.

　　英国卫生大臣安德鲁??兰斯里的尝试是最具争议的。他计划把医疗保健和大部分医疗预算委任给医生，这样医生必须形成新的医疗联盟；他们还可以更加自由地选择私人健保提供者而不是由国家提供。

　　Mr Lansley points out that his changes are going more smoothly¹⁰ than hostile interest groups suggest: 177 consortia, covering 70% of England’s population, have already been set up (the deadline for transferring to the new arrangements is April 2013). But the timescale is alarmingly variable. One senior government figure thinks this and other public-sector¹¹ reforms will take “between five and 15 years” to bear fruit nationally. That might be asking a bit too much of public patience.

　　兰斯里指出他的改革比反对派所说的进展顺利得多：已经设立了177个联盟，覆盖了英国70%的人口（新安排的最终期限是2013年）。但是时间跨度之多变令人警觉。一位高级官员认为，这项以及其他的公共领域改革将需要“五到十五年”来使全国受益。这可能大大超出了公众的耐心。

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　　Meanwhile the education secretary Michael Gove’s once-prominent focus on new Swedish-style “free schools”—to be funded by the state but run by charities, parents and others—has been wavering. Although he denies a shift, chains of academies—state schools turned over to autonomous¹² providers—are now being heralded¹³ as the driving force of schools reform. Mr Gove is sounding keener on American-style Charter schools than on the Swedish model, in part because the Charter programme has a clearer record of helping¹⁴ to transform education for the poor.

　　同时，教育大臣迈克尔??戈夫曾大力推进的瑞典式“免费学校”政策——由国家出资，慈善机构，父母和其他人运转——一直以来也动摇不定。尽管他否认政策转移，却还有许多学院——现在转由独立个人支持的公立学校——被宣为教育改革的驱动力。乍听之下，比起瑞典模式，戈夫似乎对美国式的特许学校更感兴趣。一个原因就是特许学校能够使教育更好造福穷孩子。

　　And a bitter row is under way over how far the rise in tuition fees to ??9,000 ($14,500) for some universities should be dependent on them admitting more students from poor and ethnic-minority backgrounds. Supported by Vince Cable, the Liberal Democrat¹⁵ business secretary who is responsible for higher education, the Office for Fair Access, a regulator, wants a portion of the higher fees to be diverted to outreach efforts. It threatens to impose a cap for those universities who don’t oblige. Frustration¹⁶ in the universities is matched by outrage¹⁷ among Tories, who are afraid of damaging standards and biasing¹⁸ the system against middle-class applicants¹⁹.

　　英国大学学费涨价也让大众不满。上调之后，大学学费最高可至9,000英镑（约合14,500美元），但政府规定大学必须采取措施招收更多英国本地贫穷学生和少数族群学生，才能收取最高上限的学费。在主管大学事务的自由民主党人，商务部大臣文斯??凯布尔支持下，扮演监管角色的公平入校办公室也想在增收的学费中分一杯羹，以主动帮助入学。如果哪个大学不从，它便表示要对其收取罚款。伴随着大学的唉声叹气是托利党人的雷霆怒火。他们担心这么做会有损规矩，造成对中产阶级学生的歧视。

　　Serious reform is always painful: Mrs Thatcher was widely loathed²⁰ in her radical²¹ second term; Tony Blair complained about the “scars on my back” from his fights with public-sector workers. As then, today’s plans pitch fears about the cost and alleged²² chaos²³ of upheaval²⁴ against hypothetical arguments for change. But the government’s year-long adventure in reform suggests some other patterns.

　　严肃改革总是伴随着痛苦：撒切尔夫人在第二任任期一片怨声载道；托尼布莱尔抱怨和国有经济工人争斗时“背上受了伤”。今日，改革计划则让人们大惊失色，忧心支出，还有计划可能带来的动乱。但是政府数年来冒险改革也表明了别的模式。

　　First, expectations matter. Before last year’s election the Tories reassured²⁵ voters that there would be no “top-down reorganisation of the NHS”. Mr Lansley’s plans might have caused less of a rumpus with more explicit²⁶ warning. The civil service matters too: Number 10 complains that it is being insufficiently²⁷ zealous²⁸ in implementing²⁹ the government’s agenda. Officials counter that the problem is the volume of new measures, and varying competence³⁰ in departments, rather than intransigence³¹.

　　首先，期望很有关系。去年大选前托利党人向选民保证不会有“自上至下的健保改革”。兰斯利的计划可能引起了一点吵闹和警告。行政部门也有关系：首相府抱怨无法赶不上完善政府计划。官员认为问题在于新政的内容太多，部门间能力不同，而不是死不妥协。

　　Just as importantly, the coalition has learned that the messy happenstance of everyday government can be disruptive and demoralising. A climb-down on the proposed sell-off of forests was followed by a concession³² over the abolition³³ of the Education Maintenance Allowance, a subsidy³⁴ intended to keep 16-19-year-olds in learning, after a threatened legal challenge. Number 10 recently intervened to demand a reversal of plans to cut school-sports funding. None of these was a major reversal; but they have rattled³⁵ MPs, who wonder whether to stick their necks out to defend bigger schemes that might be cancelled or amended³⁶.

　　同样重要的是，政府也学到日常政治生活中的偶然事件也会扰人不休，令人气馁。在售卖森林方面的提案撤回后，在废除教育维持津贴政府又做出让步。这项津贴本来是要让16至19岁的孩子继续求学的。首相最近也干涉其中，要求不要削减学校体育基金。这些转变都不大，但是却让议会恼火。议会质疑是否应该态度更加强硬才能不让计划被取消或者修正。

　　Finally, the exigencies³⁷ of coalition have been a burden. A plan to reform housing benefit, vaunted by the Tories in opposition³⁸, has been dropped from the government’s welfare-reform bill after rows with the Lib Dems about whether it would penalise low-earners. (The broader plan to introduce a single “universal credit” to replace multiple allowances for those out of work has created its own new network of unintended complexities³⁹ and forthcoming climb-downs.) The emphasis on fairness in the Tories’ coalition agreement with the Lib Dems helps to explain the reorientation of Mr Gove’s ideas.

　　最后，联合政府的急切需要成为了负担。托利党人原先吹嘘的改革住房计划，在他们在和自由民主党大吵数架，争论其是否会对低收入者不利后，跌出了政府的福利改革议案（更宏大的引入“通用信贷”来取代失业津贴的计划不亚于画地为牢，执行复杂，前景不佳）。高夫为什么要重新定位也可用托利党和自由民主党的协定中对公平的强调来解释。

　　So far, the architecture of the coalition has held up well. Mr Cameron and Nick Clegg, the Lib Dem deputy prime minister, share a vision of a public sector enlivened by greater competition and less dependent on a dwindling⁴⁰ pot of state funding. They do, however, need to make a bolder case for why they are fighting on quite so many fronts—and to tell the public when it can expect to feel the benefit of the slimmer, fitter Leviathan it has been promised.

　　到目前为止，联合政府的架子站得还挺稳。卡梅隆和英国自由民主党党魁尼克克莱格都认为更多竞争，更少对政府资金的依赖会为公有经济注入活力。然而，他们的确需要告诉公众，为何政府要在诸多方面如此奋斗，还要告诉公众何时他们才能享受到政府允诺的更合适，更便捷的服务。

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