Streamlining operations is a universal imperative in the health and human services industry, but myriad possibilities exist for how to tackle it. Deciding on the best approach demands a keen understanding of the convergence dynamics that shape the operating environment. At the national level, and in the midst of economic crisis, convergence becomes even more complex. Such was the state of affairs in Ireland beginning in 2008.
To streamline services amid recession, Ireland developed a strategy of consolidation, bringing several service agencies together under a single roof. But like any worthwhile transformation, consolidation presented a unique set of challenges.
In this session Niamh O'Donoghue, Secretary General of Ireland's Department of Social Protection (DSP), described how the recession effected a transformation imperative for social services even as it simultaneously produced mounting challenges to such broad change. She revealed how the DSP consolidation plan helped meet these challenges, allowing them to provide a single point of contact for all employment and income supports.
Prior to 2008, O'Donoghue said, Ireland was "the poster child" for economic health and prosperity in Europe, enjoying venerable employment rates and two decades of steady—sometimes exceptional—economic growth. Financial experts had even started referring to Ireland as the "Celtic Tiger."
But in late 2007 Ireland began to feel the effects of a global financial crisis, and by the following year had become one of the most severely affected countries in Europe. In 2010 Ireland sought financial intervention from the international "Troika" committee comprised of the European Commission, the European Central Bank and the International Monetary Fund. And from 2007-2011, the number of Ireland's unemployed tripled to 328,000 citizens, coinciding with a surge in the number of citizens needing income support and a host of other services.
Unlike the U.S., Ireland has no state governments, and local governments are limited in function. Public-sector health and human services are exclusively the purview of the centralized Government of Ireland. Historically, the core function of Ireland's DSP has been income support, including support for children and families, for people out of work or earning a low income, for citizens with illness or disabilities, and state pensions that citizens receive at the end of their working life. The department was also responsible for registering major life events (e.g. marriage) and providing citizens with public service numbers to verify identity for the purposes of establishing eligibility and access to services.
Before 2010, the department operated 10 centralized offices about 60 local offices, and employed nearly 4,000 staff, dedicated primarily to processing claims (2 million per year) and making payments (80 million per year). When the recession hit, the department accounted for roughly 40% of government expenditure, or about 20 billion Euro annually. "A very significant amount of money in a very, very difficult period," O'Donoghue said. When the financial crisis hit, droves of new customers began to show up at DSP offices, most of whom, O'Donoghue pointed out, "never ever expected to actually be looking for state support or unemployment payments."
The financial crisis created intense, external pressure for public service reform, shaped by a disillusioned public, the demands and expectations of Ireland's elected officials, and international organizations with a financial stake. The transformation imperative was clear, but the path was not. A multitude of convergence dynamics, inside and outside of Ireland's human service agencies, made developing a plan for transformation a daunting and delicate enterprise.
First and foremost were the citizens themselves. Angered and bruised by economic collapse, increasing numbers were finding their way into DSP offices, many of whom had never accessed services before. Moreover, the sentiment toward public service grew increasingly negative, due in part to the amount of public money spent in keeping the nation's banks afloat. To engage them effectively, the new DSP would have to quickly gain citizens' trust.
The DSP transformation would also coincide with a momentous political shift. Amid the financial crisis, support for Ireland's ruling party crumbled, and a general election in 2011 replaced them with a new coalition. While the previous government had already made several decisions around realigning public services, and in particular aligning job training with a consolidated approach to income support, the new government restated this reform agenda, folding in additional services that seemed to mesh well with the core DSP functions.
The financial assistance from Troika organizations brought with it external pressure to reform (as well as firm ideas for how Ireland should go about it), which could potentially prove more troublesome than helpful. "That’s a hugely difficult thing for a sovereign country to face," O'Donoghue said. "All of these external people come in and start telling you how to do your business and what you need to be prioritizing and focusing on."
Transforming service-delivery also meant transforming the workforce, and here, too, several dynamics would have to be considered. Civil servants were already under tremendous strain, having received significant pay cuts while being required to work longer hours. Public-service organizations could also not replace change-resistant employees with the same freedom that private companies could, and any significant changes to workforce conditions would have to meet with some degree of union input and approval. Finally, DSP would be transforming the workforce in the midst of a strict moratorium on recruitment—no new hires into the public service. To win hearts and minds, DSP leaders would need to construct an elaborate plan for workforce engagement, one that hinged upon a shared and promising vision for change.
And of course, the transformation plan would have to be implemented quickly, without any interruption in service. "All of this was a bit like changing the wiring in the house while the lights were still on," O'Donoghue said. "But that’s all we can do."
The government of Ireland recognized that, historically, DSP had particular strengths that made it a promising foundation for public service realignment. The department had a rich history of organizational change, for instance, and also possessed a variety of channels for customer service delivery, channels that could be leveraged to deliver not just income support, but also support for employment, housing, and other services geared towards activating citizens.
DSP became the anchor of a consolidation plan designed to streamline public services and build capacity at a time of limited resources. The ultimate goal for this plan was to proactively and efficiently move clients toward independence, in support of a new policy document that mandated getting citizens back to work over sustaining them in unemployment. The DSP plan focused heavily on developing the workforce, engaging potential employers, and creating a single point of service-access.
Consolidating the workforce would include developing a comprehensive Human Resources (HR) strategy, teaching new technology platforms, developing new team models, and training employees to work across two or more service streams. But without shared ownership, any alignment plan was doomed to fail. "If people don’t understand the problem," O'Donoghue said, "they’re not going to understand why you’re imposing a solution on them." Moreover, it was the frontline workers who knew the business best and understood what was needed to deliver services, and so leaders would depend on them to "put the flesh" on the visions and frameworks they developed.
DSP installed a change management approach that was based on building a new organization with a new business that respected the various traditions and experiences that workers brought with them from their respective organizations. O'Donoghue accompanied these change management teams as they held ‘town hall’ meetings with staff in areas around the country. They shared the vision for change with staff, discussed their concerns and ideas, and expressed their intention to maintain constant and open communication regarding the transition. "Even if the news isn’t good," O'Donoghue said, "even if items have fallen off the agenda," keeping staff in the loop was paramount. Reinforcing common culture and values to underpin the new organization was considered as important as the structures and processes of the previous business areas.
The department created a comprehensive learning and development strategy to provide staffers with the appropriate training. DSP envisaged that workers’ new skills and abilities, besides increasing their functional versatility, would build workers’ professional confidence and enhance their sense of ownership over the change process.
DSP also instituted an engagement and innovation program to empower local offices to participate in building the new organization. The program brings together local managers, unions and staff to identify challenges, establish priorities, and innovate solutions within their area. It's noteworthy that this program was based on a model of social partnership that had previously been discredited, but which DSP leaders considered fundamentally sound and still worthwhile. The department was able to revive the model, this time with more staff buy-in and a few other changes.
To create pathways to employment for clients, DSP had to understand employers' needs and how best to meet them. Essentially, their goal would be to offer a competitive matching service, along with a range of new incentives and supports, in order to ensure that employers would consider filling positions through DSP before going to a recruitment agency.
O'Donoghue described one example of a new incentive program involving simplified, in-work payments (as opposed to tax credits). If an employer, for instance, hired someone who had been unemployed for two years or more, the employer received a subsidy—a cash grant payable on a monthly basis for the first two years of that person’s employment.
The DSP formed a labor market council comprised of Ireland's largest employers to serve as a forum to discuss employer needs. They also conducted workshops, road shows and town hall meetings to promote the new vision for public service and associated services for employers, as well as to solicit their input.
As the DSP poised itself to deliver services that were more integrated, they also developed a platform for customers to access these services. This platform, called INTREO, offers a single point of access to those seeking income and employment support, as well as to those employers interested in hiring through DSP and learning about the supports and benefits available to them. The department installed dozens of INTREO centers around the country, providing customers with self-service facilities as well as access to trained staffers.
A customer seeking income support or a related service is first assessed—the platform collects data in areas such as previous employment history, education, mobility and family status, as well as job market and other conditions in the areas where the customer lives and works. Based on this assessment, the system generates a cluster of supports and services tailored to the customer's needs.
The assessment also generates a score to help workers determine the severity and urgency of a case. Customers requiring high levels of support may receive intensive case management and, if necessary, priority status in service delivery. Incidentally, this represented a cultural shift for the department, moving away from the notion of giving every customer equal attention regardless of need, and away from the tendency to process cases chronologically.
The customer is also issued a biometric, public services card to serve as a simple and secure method of identity verification when accessing public services.
Since 2012, when Ireland launched its plan of consolidation and transformation, the physical infrastructure, customer experience and staff experience have changed dramatically. The reorganization involved movement of numerous functions between Government Departments, the most significant of which involved the integration of functions from three agencies – the Department of Social Protection, the Health Service Executive and FAS (the State Training Agency) into the new ‘one-stop’ service, INTREO1, for people of working age.
The number of employees at DSP has doubled, to 7,000 people, and comprises a workforce with rich and varied professional experience combined with extensive new training.
DSP still delivers its core service of income support, but also now offers a range of employment support services, including social and community work opportunities, referral to skills training programs, self-employment training, education grants, internship programs and supported employment for people with disabilities.
By promoting new incentives and supports for employers, DSP has forged strong alliances with businesses all over the country. Recently, the department won a commitment from fifty of Ireland's largest employers: For at least 50% of their open positions, these companies would consider hiring citizens (identified via the DSP “Jobmatch” service) who currently received DSP benefits or support.
Since rollout launched in 2012, DSP has issued over a million public service cards that provide greater efficiency and security when establishing identity for the purpose of accessing public services. In addition, the Department has developed a valuable repository of information and data, which can be shared securely with other public service organizations for the purpose of service provision.
Finally, the new structure, capacity and culture of DSP embraces change in a way that is sustainable and flexible, allowing additional service streams to be folded in when appropriate. The department recently took over a property tax-deduction service, for example, which aligned well with their expertise in transaction processing.
Plans are already being developed for the next area of focus for the Department, which will be about bringing an integrated holistic approach to the activation and income support of clients with disabilities.