Blair must commit long term or lose the future

The prime minister must match his triumphs overseas with long-term strategies at home, says Diana Green.

Dear Mr Blair,

This letter is about our public services. I understand you have taken personal responsibility for delivery of the government's commitment to matching the quality and standards of the National Health Service to the best of healthcare in Europe.

Electors are justly concerned about the quality of public services. Voters expect a Labour government to reverse two decades of underinvestment. They applaud the commitment to increasing public expenditure over your second term, but fear that this plan may get blown off-course by recent international events. Many are surprised by what they see as the betrayal of your government's fundamental values. Some question the logic of your plans to "modernise" and speed up service delivery by using commercial skills and cash. They look at the railways fiasco and, not surprisingly, fear for the future of other public services such as education and healthcare. Underinvestment is a common theme. In education and healthcare it has affected the quality and standards of all aspects of the services and their delivery, including the recruitment and retention of high-quality staff.

I will illustrate this with a personal anecdote. My mother is an intellectually sharp 81-year-old, although physically frail due to Parkinson's disease. One August evening she fell and broke her hip. After three hours in the accident and emergency department of a regional trauma centre, she was admitted as an emergency. She then spent six days in the hospital, on the emergency list, sedated by morphine, before the essential surgery took place. She was "bumped" off the list daily for "more urgent" trauma cases and because a non-urgent case had waited for a hip replacement for more than the target 18 months. The problem was not a general lack of investment. The hospital has a modern wing and is well-equipped. However, only one theatre was operational because of the shortage of trained staff.

After this, I was pleased to hear you respond pragmatically to the growing waiting lists for elective surgery by utilising the spare capacity in European hospitals. That hospitals in Germany, France - and even in Menorca - can offer this facility must surely suggest that they have found a better way of organising and funding service provision in the face of an exponential growth of demand.

This brings me to higher education. I understand your problem here. Universities are not part of the public sector, although we are paid (diminishing amounts) for providing public services. Your government needs universities to deliver an ambitious policy agenda but cannot afford either to make good the years of underinvestment or to pay the high price of the additional services required. You want world-class research universities and you expect us to help deliver your ambitious expansion plans for social inclusion reasons.

How many world-class research universities can we afford? Five? Certainly not 137. My own university has excellent nationally and internationally recognised academic research in a limited number of areas but cannot afford to aspire to world-class research excellence across the board. We are focusing on what we are good at but we struggle even to achieve our own aspirations here - let alone deliver your widening-participation agenda - because of our huge and growing investment needs.

Clearly, it is time for creative thinking. I know you are conducting a strategic review. Inviting universities to participate in it might have helped repair the poor state of government-higher education relations and produced outcomes with a sporting chance of success.

You have shown great personal leadership in international affairs over recent months. At home, you have set challenging targets for improving the quality of our public services. You need universities to help you deliver what is a moral as well as an economic imperative: opening higher education to those economically and socially disadvantaged who would not otherwise benefit. This cannot be done at marginal cost. We should be offering potential students an educational experience equal in quality to the best in Europe.

There may be a political imperative, too. Traditionally, higher education has lost out in spending reviews because it has not won votes. But the unpopularity of your policy on student finance has shown how this is changing in line with the success of policies on widening access. Democratic politics inevitably focuses on the short-term. Restoring and re-invigorating our public services is not amenable to a quick fix. Now is the time for a long-term commitment. It is essential if you want to avoid losing the universities and thus losing the future.

Diana Green is vice-chancellor of Sheffield Hallam University.