By Ollie Stone-Lee
BBC News Online political staff
The head of the UK's top watchdog on public services has warned ministers not to race from one extreme to the other in handing power from Whitehall to frontline staff.
We trust doctors but faith in the NHS is lower, says new research
Audit Commission chairman James Strachan said moving from "no faith to blind faith" in local workers would end in tears.
Instead, regulators could help ensure there was "organisational ability" to ensure extra cash was well spent on a local level, he argued.
His words of caution came as he unveiled a new survey suggesting the public trusts individual doctors and police officers, but their faith in the institutions which employ them is lower and falling.
Mr Strachan suggested reforming governments risk losing public trust because they raise expectations faster than improvements could be made.
With its foundation hospital plans and other schemes, the current government has been putting more stress on giving more power to local workers in public services.
As attention returned to the domestic agenda after the Iraq war, there would be frustration at lack of progress, he said.
"The danger is we are going to race foolishly from one extreme to another," he continued.
Mr Strachan criticised "risk paranoia" among those civil servants who concentrated too much on processes instead of outcomes.
The best services were those who put consumers first.
In procurement deals too many people were "seeking comfort in the audit trail" but leaving "totally inadequate" outcomes, he said.
The Audit Commission joined up with pollsters Mori for the new study into trust in public services.
Identifying a difference between attitudes towards public servants and public institutions, it suggests that 91% of people trust doctors, while only 62% of people trust the NHS.
Council trust problems
Politicians and journalists are at the bottom of the public trust list, based on previous research, which is topped by doctors, teachers, and judges.
Among public institutions, the new figures suggest 48% of people do not trust councils, compared to 24% for the police and 18% for hospitals.
Mr Strachan said: "As far as I can see, the double whammy of perceived bureaucracy joined up with politicians may go quite a long way to explaining why councils are far more distrusted than the police."
He said a common response from those questioned in the survey was: "You trust the staff but you do not trust the bureaucrats behind them."
Mr Strachan said there were no magic answers to why trust in decline, but said public bodies had to be more honest and open.
The media needed to do more to trumpet successes when they did occur.
The Audit Commission chief said his watchdog would be publishing a report in the next fortnight showing "some quite significant advances" being made in the NHS.
But he predicted the headlines would focus on the negative aspects of the report.
Mr Strachan suggested the media was "constantly stamping on the little flower of public services that is trying to emerge".
Ben Page, director of Mori's social research institute, said the new study showed the media did have a real impact on public trust.
He cited how perception of the NHS had peaked on the weekend when there was a rush of positive newspaper articles about the 50th anniversary of the health service.
But Mr Page identified other ways the research showed public institutions could use to build trust:
- Deliver quality services
- Say sorry when promises are broken and explain why it will not happen again
At the seminar, Matthew Taylor, director of leading think tank the Institute for Public Policy Research, underlined the need for a coherent rationale for why trust was important.
Efforts to build up trust for tactical reasons, such as Labour's pre-election pledge cards, could prove counter-productive, he warned.
Mr Taylor pressed for a "democratic renaissance" to engage in the difficult trade-offs public institutions had to make.
He suggested that appointing 50 "ordinary citizens" to the House of Lords could help the process, because they would be able to explain the difficulties of law-making.