As just about everyone now knows, our national finances are totally up the spout.
Almost no matter whom you ask, they will tell you that the Exchequer has been living wildly beyond its means and that we can’t go on like this.
The recognition that we face a gargantuan fiscal crisis is, of course, the first step towards achieving the change we need.
But a new mythology has now sprung up.
This new myth consists of the suggestion that the only way we can hope to reduce government spending is by cutting back on services.
If competing firms in the free market were in the grip of this myth, they would rapidly head to bankruptcy. A firm that offers its customers reduced service in the competitive market place will make its problems worse rather than better — since customers will move next door.
The result is, of course, that competing firms struggle mightily to think of imaginative ways in which they can reduce their costs while keeping up the quality of the goods or services they produce.
And this is exactly what the public sector has to do over the next few years. But, I hear you say, is it possible? Can we really get more for less in the public sector just as we do in the private sector?
The answer – that we most certainly can – came home to me with great force last week when I was talking to some marvellous people from Macmillan Cancer Care in Dorchester.
They pointed out an amazing fact – that there are now about 1.6 million cancer survivors in England, and almost two million in the UK as a whole.
This is an astonishing tribute to the progress that medical science has made over the past few decades — since it isn’t long ago that one thought of cancer as something pretty close to a death sentence.
But this huge advance has a consequence. There is a significant risk that cancer survivors will fall ill in other ways after their resistance and strength have been diminished.
As the experts at Macmillan pointed out to me, through effective monitoring and well-targeted care we can vastly reduce the incidence of illness amongst cancer survivors — and thereby improve their quality of life while also saving large amounts for the NHS.
But what was really fascinating about the Macmillan message was that they did not favour the traditional, bureaucratic idea of medics seeing cancer survivors at specific intervals to go through a check-list.
Their message was, on the contrary, that the effective method is to equip the cancer survivors themselves with enough understanding and enough technique to spot early any worrying signs, so that the medics can rapidly intervene when and where this is necessary.
This is a tell-tale case. Right through our public services, we will need to exhibit exactly the same sort of imagination as the Macmillan people were exhibiting.
Out go the clunky, ineffective bureaucratic systems that cost large amounts of money and produce poor results. In come new post-bureaucratic methods that harness the expertise and understanding of the individuals on the front line, who are receiving and providing the service.
This way, effective, cheap, commonsense solutions can be found — to deliver more for less.