When ‘more for less’ becomes ‘less for less’: the implications of central decision-making for the delivery of frontline services

With his unique perspective on the public sector, the Comptroller and Auditor General, Sir Amyas Morse, explains some of the elements of financial management and planning that determine success in major reform programmes. He uses examples from local government, adult social care, and NHS reforms to conclude that, too often, ‘efficiency’ improvements have shaded over into unplanned grass roots service reductions, as a result of central austerity measures.