After 70 years of centralized public services in the UK, stark differences between regions ("postcode lotteries") remain. These are typically seen as undesirable, but could instead foster experimentation and improvement. Historically, cities competed through local taxation and services, dramatically improving living standards. Postcode variation in policies like smoking bans could have allowed helpful trials of different approaches. Rather than futile attempts to impose identical standards nationwide, devolution could support regional differences that drive progress through competition.

1. ChasingChimeras
Callum Whittaker
Or
How
ILearned
To
Stop
Worrying
And
Love
Postcode
Lotteries

2. At the same time though, British people have
historically always voted for relatively low tax
burdens. As such, we want Anglo-Saxon style
income and tax regimes but with high-cost and
redistributive European style social policy. This
paradox is the root cause of why British governments
spend so much time reforming and reorganising
public services. The pressure to deliver
comprehensive equal services to everyone but with
insufficient power either to redistribute or raise taxes
sufficiently has tended to lead politicians to set
national targets or reorganise the NHS and services
within local government in a continuous attempt to
realise this impossible task. Indeed, the debate on
this issue has even spread beyond public services to
areas where the private sector tends to dominate –
in terms of broadband infrastructure for instance or
even supermarket coverage as some maintain that
everyone should have access to reasonably priced
food. Confusingly, the term ‘postcode lottery’ is used
to describe both variation in policy inputs such as
funding levels and also for variation in policy
outputs or outcomes such as differences in life
expectancy.
We in the UK are prepared to tolerate very wide
income inequalities; with much higher Gini
coefficients than other European countries like
Germany, France and (rather unsurprisingly) the
Scandinavian states. This has been the case for a
long time and so we must conclude that we as a
country must consider inequality of income a
desirable, or at least tolerable, feature of our polity.
However, whilst we have maintained this income
inequality we have at the same time come to crave
public services that treat people equally. In effect, the
UK has sought to develop public services that
straighten-out any inequalities that emerge as a
result of this inequality of income. Britons have come
to expect schools to educate pupils in such a way
that they all have exactly the same life chances and
the NHS to ensure that everyone can expect the
same rates infant mortality and life expectancy. As a
consequence of this, schools and hospitals are thus
repeatedly set targets determined by officials in
Whitehall to try and meet nationally set outcomes.
Introduction
The phenomenon of “postcode lotteries” is deeply
rooted in the British national psyche. In the UK the
term is used as short hand for the failure of public
services to treat people fairly and equally. It
dominates and frames the way that we talk and think
about our public services and is one of the key
metrics by which we hold our politicians to account.
Yet curiously this is a concept that does not really
exist in countries other than the UK – indeed, the
term is virtually unknown even in other English
speaking nations. This alone should cause us to
pause and consider – is the concept of a postcode
lottery a meaningful phenomenon?
Current situation – policy inputs,
outputs and outcomes
Under averycentralised political and economic system stark differences between UK
cities and regions have emerged. These ‘postcode lotteries’ are characteristically
perceived as undesirable and detrimental to good government rather than an
opportunityfor areas to experiment and improve on the deliveryof public services.
Confusingly, the term
postcode lottery is used to
describe both policy
inputs and policy outputs
or outcomes. For example:
Policy Input Policy Output Policy Outcome
Higher health
spending
Longer life
expectancy
Increased access
to medical services
Despite a fear of postcode lotteries being deeply
entrenched in public debate, there is surprisingly
little written down about the evils of postcode
lotteries – just an assumption that observers should
accept that they are undesirable. This acceptance that
postcode lotteries are undesirable phenomena is
reinforced by frequent newspaper headlines which
decry “Cancer patients dying early due to inexcusable
postcode lottery” (Guardian: 15th August 2014) or the
“Postcode lottery of NHS dementia care” (Daily Mail:
28th January 2015). Probably the strongest argument
for eliminating post code lotteries that one could put
forward is thus: once a polity assents to the idea of
free and universal public provision of services it is
morally unacceptable that any individual, family

3. allocation is decided from the centre of Whitehall.
Given this powerful redistributive role, it is therefore
reasonable to request that provision be equal as it is
all coming from the same place.
Overwhelmingly people in the UK believe that
accidents of birth should not impact upon access to
public services; a belief which is now deeply
embedded in Whitehall’s operating and
administrative procedures. One can trace the origins
of this way of thinking back to the early socialist
movement and the Fabians in particular. The
prominent British socialist and co-founder of the
London School of Economics Sidney Webb argued
strongly for equalisation between rich and poor
areas and for stronger central government oversight
of local government’s service delivery. Subsequently
his thinking has greatly influenced the construction
and allocation of grant funding to UK local
government and also the design and administration
of our National Health Service.
morally unacceptable that any individual, family or
group is treated differently to any other. Given that
all are subject to the same rules around paying taxes,
everyone should receive services in exactly the same
manner.
A potted history of postcode lotteries
As well as this strong technocratic tendency towards
fiscal centralisation and redistribution in Whitehall,
the success and growth of the post-war welfare state
has further helped to reinforce the idea that the state
is able to reduce inequalities through public service
provision. For example, the mass construction of
social housing had a significant impact on improving
the standard of living and life expectancy of millions
of Britons. Similarly, universal access to quality
healthcare and education services further improved
quality of life and access to employment
opportunities that would otherwise be beyond the
reach of millions of Britons. The success and
prevalence of these government interventions has
combined to create an increasing sense of voter
‘entitlement’ to quality public services in the UK.
Compounding these two phenomena is a uniquely
powerful centralising institution in the form of HM
Treasury. This body is the sole arbiter of all taxes in
the UK and is responsible for the collection of
around 95 per cent of these – consequently, all
resource
"After 70 years of a national health
service, a vast amount of expensive
academic research, needs mapping,
complex formulae for spending
allocation and countless government
interventions to equalise provision the
UK’s healthcare system is still riddled
with postcode lotteries."
Chasing chimeras
Yet despite all of the Whitehall intervention and the
absolute centralisation of tax and spend in the UK it
has proved impossible to eliminate postcode
lotteries. For example, health outcomes vary
massively across different CCG areas and
consequently health inputs vary significantly. In any
rational world, one would expect more money to be
spent in those areas where the need for services is
high in order to deliver equal outcomes. Yet (as
noted earlier) public opinion appears to want both
equal inputs and equal outcomes – this would be
impossible. For this to occur, there would need to be
identical localities with identical population and
demographics where the profile of age, illness etc. is
exactly the same.
So in effect we seem to want the eradication of
postcode lotteries in one area (policy inputs) even
though it will almost certainly worsen them in
another area of social policy (outcomes and policy
outputs). After 70 years of a national health service, a
vast amount of expensive academic research, needs
mapping, complex formulae for spending allocation
and countless government interventions to equalise
provision the UK’s healthcare system is still riddled
with postcode lotteries. Given the failure of all these
interventions, we must surely conclude it is simply
not possible to eliminate postcode lotteries. We are
collectively chasing chimeras.
Postcode lotteries as a force for good
So should postcode lotteries instead be considered
in a more positive light? I would suggest that yes:
differences in service levels and provision are a
good thing. In the 19th century UK cities competed
with one another to improve the quality of life for its
citizens through improvements to and the expansion
The success of the post-war
welfare state has helped to
reinforce the idea that the
state is able to reduce
inequalities through public
service provision.

4. The results in terms of poverty reduction were
spectacular and national death rates consistently fell
(most especially in the deprived areas of the inner
cities). Thus, when local government was free to raise
taxes and design services for themselves, conscious
decisions were made to compete with one another to
improve services. There was no race to the bottom to
make services worse as many politicians and civil
servants might today suggest would occur, but a race
upwards to improve the quality of life for all.
During the 19th Century UK cities competed with one another to light and pave the
public realm and install sewage and energy infrastructure
of public services. Glasgow and Birmingham vied for
second city status, Leeds and Manchester emulated
them, as these cities implemented programmes to
light and pave their streets, to supply all their homes
with water from nearby lakes and hills and connect
all their housing to new underground sewage
infrastructure. These were all very expensive
investments paid for out of rises in the local rates
that had to be agreed by the electorate – rises in
local rates which previously electors had voted
against; but through regional rivalries and this sense
of competition now voted in favour of.
transport, in pubs, clubs, membership clubs, cafes,
restaurants and shopping centres in England and
Wales.
Case study – the 2007 smoking ban
in England Devolved powers would
have allowed policy
makers to see how a
smoking ban would
work in practice and to
experiment
The smoking ban offers a more contemporary
example of how postcode lotteries offer an
opportunity for helpful experimentation in policy.
For many years, a number of councils had been
considering introducing bans on smoking in public
places, led by Liverpool City Council, which
introduced a bill into the House of Commons seeking
the power to enable it to do this. Opponents raised
concerns that a ban would negatively impact on bars
and pubs, as smoking customers would be driven
away and other critics rejected the idea on civil
liberties grounds, arguing that it was not the state's
role to determine what people do to their bodies.
Parliament elected not to pass legislation that would
allow local authorities to ban smoking by then in
2006 the devolved administrations in Wales and
Scotland introduced smoking bans as Liverpool had
earlier called for. Subsequently, Parliament voted to
ban smoking in all workplaces, on public and work
Now, had Parliament allowed Liverpool City Council
and others to pass smoking bans at their discretion,
this would have led to a postcode lottery for smoke
free public buildings and spaces. This would have
allowed policy makers to see how a ban would work
in practice and to experiment. Almost undoubtedly,
anti-ban councils would study and visit Liverpool
and others to see what the impact was on pubs and
the night time economy and on public health and to
examine the case for introducing bans of their own.
Had this occurred it is likely that by 2007 very few
local authorities would still be without a smoking
ban. Further, central Government would have access
to a significant body of evidence to help support a
decision on whether or not to introduce a national
ban. The postcode lottery in smoking bans would
have led to helpful experimentation, evidence
building and consequently to public health
improvement.
In addition, the evidence developed through this
kind of policy experimentation would mean that
politicians and civil servants would not need to use
their time or public money travelling to other
countries (typically America) to examine the
experimentation in public services that has taken
place there. Policy experimentation through postcode
lotteries would undoubtedly lead to huge
improvements through positive differences and
healthy competition between state agencies and
places, exactly as in nineteenth century British towns
and cities.

5. turn has created a vast panoply of central
government targets and regulations complete with
intrusive auditing. This approach inevitably results in
every public service being seen to fail as each is
unable to meet impossible targets. By contrast, a
devolved approach would allow for experimentation
in policy making so that places could test the success
(or indeed failure) of different approaches to service
delivery. The experience of nineteenth century
municipal forefathers demonstrates that such
competition can have transformative effects on
towns and cities and the wellbeing of all who live
among them.
To conclude, no one wants to see a postcode lottery
emerge that means that accidents of birth lead to
poorer social outcomes for some people due to the
different geographic performance of public services.
On the other hand, the UK’s past experience and
failure to eradicate this variation suggests that
postcode lotteries are in fact unavoidable. Our
poorly thought-through attempts to stamp out
postcode lotteries wherever they materialise has led
to unrealisable expectations from the public and
politicians whereby identical policy inputs are
expected to achieve identical outcomes; which has in
Conclusion
Callum Whittaker
October 2015