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Patricia Hewitt – 2006 Speech to Unison Health Care Conference

patriciahewitt

Below is the text of the speech made by Patricia Hewitt, the then Secretary of State for Health, on 24 April 2006.

It’s a real pleasure to be here today with so many Unison health service workers. And it’s a particular pleasure to be back in Gateshead – a wonderful example of a city renewed.

I know that our programme of NHS investment and reform is the cause of great debate amongst UNISON members. I know that you’ve had your rally today. I know from the regular contact I have with Dave Prentis, Karen Jennings and others of the concerns, the anxiety, even the anger that some of you feel.

I want to hear about that directly from you – which is why I’ve asked for plenty of time for comments and questions this afternoon.

This is a challenging time for the National Health Service and everyone working in it. Change brings both opportunities and uncertainties. So we all need to be honest and realistic about the challenges ahead, the tough decisions that need to be made – and why we are making further changes in the NHS. .

But let’s also be honest and realistic about what you, the staff of the NHS, backed by our programme of investment, improvements and reform have already achieved.

It is vital that, when we are debating the future of the NHS, we recognise the realities of how far we’ve come – as well as how much more we still have to do.

The best year ever for patients

That is why I make no apology for saying that from the patients’ point of view, the NHS – thanks to the efforts of all of its staff – has just had its best year ever for patients. The facts speak for themselves.

We can all remember what it used to be like.

March 1997 – 283,000 people waiting more than six months, in pain, for a hip replacement or other operation. Every winter an NHS beds crisis. Patients waiting on trolleys in A&E departments for hours and hours on end.

No wonder the public told us what their priorities were. More staff. Better paid staff. And cut the waiting lists.

And we’ve delivered. 307,000 more staff than we had in 1997. More staff – yes, and better-paid than ever before, and I make no apology for that either. Almost no-one waiting more than six months, and for most people far shorter than that – a target that people said was crazy when we promised it, and which the NHS delivered three months ago, in one of the coldest winters for decades.

Last year, the NHS treated more people, faster and better than ever before – and we saved more lives than ever before. 43,000 more people saved from cancer, over 60,000 more saved from heart disease.

No wonder, in every survey, patients tell us the health service is good – and it’s getting better.

These are huge achievements, I think you are entitled to be proud of them – and to get more credit for them in our media.

Financial problems

But if things are so good, why are the headlines so bad? If the NHS is getting more money than ever before – which it is – why are there deficits, jobs being cut and some staff facing redundancy?

Most of the NHS is not in deficit, of course. The majority of NHS organisations are in balance or surplus. The overall deficit in the NHS is just one per cent of the total NHS budget. That’s like someone on £20,000 a year having a £200 overdraft – it’s a problem, but it’s a manageable problem.

The real challenge comes in the minority – 7 per cent of NHS organisations which are responsible for 50 per cent of the deficit: It can’t go on.

We’ve written a very big cheque for the NHS, and we’re proud of that, But it’s not a blank cheque. It never has been and it never will be.

So over-spending hospitals and other organisations do have to put their house in order. Because in the old NHS, the over-spenders were always bailed out by the under-spenders. The under-spenders were usually from the poorest communities and the greatest health needs. It wasn’t fair. And part of our reforms means that every hospital and every area has to take responsibility for getting the best possible healthcare and the best possible value for the extra money that we have asked the public to contribute. That means every hospital becoming more efficient in how it uses precious NHS resources, precious staff time.

For some, that means cutting the money spent on agency staff – which as anyone will tell you is massively expensive. [West Hertfordshire] hospital, for instance, has a deficit of £17 million – and an agency staff bill of £16 million. So of course they should do what [many] other hospitals have done, re-organise their rotas to use their permanent staff better – and cut their agency bill.

Those aren’t redundancies – even though they’re included in the headlines. It’s common sense.

Most places will tackle their deficits and make themselves more efficient with few or no redundancies.

But we will have to face up to some difficult decisions. And in some hospitals, there are staff facing redundancy.

I met some of those staff a few weeks ago in North Staffordshire hospital, in Stoke. Utterly dedicated staff, working flat out – and working in two out of date, old-fashioned buildings. They’re now facing the shock and anxiety of a consultation on up to 1000 redundancies – although, as you’d expect, the hospital is doing everything possible to get that number down. But the problem they’re confronting is not just financial. The real problem is that the hospital isn’t organised in the most effective way possible.

I met A&E staff, for instance, who told me that there are four different places, on two different sites, where patients can arrive in an emergency. And then some patients – many of them seriously ill – have to be moved from one site to another, so that they can be assessed, and sometimes they have to be moved back again, so that they can be admitted. Thousands of patient journeys a year – distressing and risky for patients, and a waste of precious hospital resources. So they’re going to put all the emergency work onto one site. But that means they will need fewer transport staff. They’re going to do more day case operations, because that’s better for patients – but it will mean they need fewer beds and fewer staff on some wards.

This is a hospital that only last year was taking on new staff whom they couldn’t afford – staff who they wouldn’t in fact have needed if they’d organised their services better in the first place. I think that is grossly unfair on the staff, who were undoubtedly let down by the previous board of the hospital, a board that has now resigned. Thank goodness, it happens very rarely – but when it does, and when staff are left facing redundancies in a situation like that, I think they deserve an apology.

I know how devastating redundancies are. That’s why we are working with staff representatives and local management to ensure that the threat of redundancy is contained to as few people as possible.

That’s why we will support any staff member who loses their job to help them get new jobs and, if necessary, new skills.

That’s particularly important when new medical practice and technology is making it possible to shift far more care out of hospitals and into health centres and community hospitals and even patients’ own homes. So our chief nursing officer, Chris Beasley, is already working with UNISON and other organisations on Modernising Nursing Careers – making sure we have the right framework to train and retrain people for NHS careers that will be even more varied, even more flexible than in the past.

Engaging front-line staff

I know that, in every organisation, the people who really know how to do things better and how to get rid of waste and inefficiency are you, the front-line staff.

The best NHS managers are the ones who work most closely with clinicians and front-line staff – reducing the stress for staff, improving the care for patients.

Let me give you just one example. The hospital where patients complained that the porters dragged them around backwards like a sack of potatoes. It was demeaning and disorientating, particularly for elderly people. It turned out that the porters were using wheelchairs that were so old and decrepit they couldn’t be pushed forwards. The porters had been saying it for years – but no-one had listened. At last, managers did listen. They bought new wheelchairs, let the porters do a proper, professional job … and that one small change transformed the support and reassurance the porters were able to give to a worried patient.

I want every hospital, every manager listening to front-line staff, getting rid of waste – and making the improvements, small as well as big, that matter so much to patients.

The need for change

Let me turn now to the wider programme of improvements and reforms that we’re making in the NHS.

I know that Unison isn’t against change. You helped lead the way in negotiating Agenda for Change – the biggest job evaluation scheme in the world – which not only means higher pay for most NHS staff, but even more important, new opportunities for staff to get more skills, take on more responsibility and work in different ways.

I know there’s more we need to do to complete the implementation of Agenda for Change, including fair payments for workers doing unsocial hours.

We need to get the new Knowledge and Skills Framework into place for staff by October. It’s agreed with 90% of staff – but we need improved personal development and skills for every one of our staff.

We need to do more to persuade all trusts and contractors to sign up to the two tier workforce agreement – the new Code of Practice that I agreed a few months ago with Unison and the other NHS unions.

All part of the changes taking place in the NHS.

But there are other changes that are more controversial.

We are giving patients more choice and more control over their treatment. It’s what people expect in every part of their lives. And the people who want it most from the NHS and other public services are people on low incomes – like my constituents in Leicester – who’ve never had the choice that the best-off and the best-educated can take for granted.

We are bringing in the private and independent sector – not to take over from the NHS, but to contribute more capacity and even more innovation to the NHS.

That includes the independent sector treatment centres that introduced mobile surgery units to the NHS and helped us cut waiting times for cataract patients to just three months – four years earlier than we said we would.

We’re using private finance to build [70] new hospitals already – and the new hospitals we’ve just announced at Barts and the Royal London, St Helens and Birmingham, and many others to follow.

That’s not privatisation, that’s progress.

Every one of us in government, every one of us in the Labour Party, believes that the NHS must stay true to its founding values. Funded by taxation. Care based on clinical need, not your ability to pay. Treatment free at the point of need.

That’s non-negotiable, at least as far as we’re concerned.

But there are others who would abandon those principles.

Doctors for Reform demanding the introduction of social or private insurance, an end to ‘free at the point of need’.

The Daily Telegraph just last week, saying it doesn’t want progress, it wants privatisation.

If we are to succeed in defending the NHS, free at the point of need, then we can only do so by changing to meet the three great challenges that confront every healthcare system in every developed country. Rapidly rising public expectations. An ageing population. Medical technology and science changing faster than ever before.

That’s why the NHS has to go on changing.

So there will be more arguments and controversy over the next year, and more difficult decisions to be made.

But by the end of 2008, we will effectively have abolished waiting lists – the way the old NHS rationed care and kept within its budget. We will be giving patients a more personal service than ever before, with more choice about where you’re treated and appointments booked in advance to suit the patient, not just the provider. We will be treating more patients in the community and in their own home. And all of it free at the point of use.

That is how we will protect Nye Bevan’s legacy, the legacy of the great reforming 1945 government.

That is how we will persuade people that collective provision is not only fairer, but that collective provision can also meet people’s aspirations – 21st century aspirations – to be treated as an individual, to get personal services.

That’s how we will protect the founding values of the NHS for another generation against those who want insurance, charges and privatisation.

And that, friends, is a prize worth fighting for.

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Patricia Hewitt – 2006 Speech at Royal College of Nursing

patriciahewitt

Below is the text of the speech made by Patricia Hewitt, the then Secretary of State for Health, in Bournemouth on 26 April 2006.

It’s a real pleasure to be here today with so many members of the Royal College of Nursing.

I want to hear what you have to say, which is why I’ve asked for plenty of time for comments and questions.

But there are a few points I’d like to make first.

I know you are angry about the prospect of redundancies amongst some NHS staff. Anyone facing the possibility of redundancy is entitled to be distressed and angry – and you are entitled to be angry on their behalf.

This is a challenging time for the National Health Service and everyone working in it. So we all need to be honest and realistic about the challenges ahead, the tough decisions that need to be made – and why we are making further changes in the NHS. .

We all know that the NHS is getting more money than ever before. But in that case, why are there deficits, jobs being cut and some staff facing redundancy?

To start with, most of the NHS is not in deficit. The majority of NHS organisations are in balance or surplus.

The overall deficit in the NHS is just one per cent of the total NHS budget. That’s like someone on £20,000 a year having a £200 overdraft – it’s a problem, but it’s a manageable problem.

The real challenge comes in the minority – 7 per cent of NHS organisations which are responsible for 50 per cent of the deficit: It can’t go on.

We’ve written a very big cheque for the NHS, and we’re proud of that, But it’s not a blank cheque. It never has been and it never will be.

So over-spending hospitals and other organisations do have to put their house in order. Because in the old NHS, the over-spenders were always bailed out by the under-spenders. The under-spenders were usually from the poorest communities and the greatest health needs. It wasn’t fair. And part of our reforms means that every hospital and every area has to take responsibility for getting the best possible healthcare and the best possible value for the extra money that we have asked the public to contribute. That means every hospital becoming more efficient in how it uses precious NHS resources, precious staff time.

Most places will tackle their deficits and make themselves more efficient with few or no redundancies. For example, cutting the money spent on agency staff – which as you always tell me is massively expensive.

Re-organising rotas to use permanent staff better, getting the agency bills down – that’s not redundancies – even though they are included in the headlines. It’s common sense.

But we will have to face up to some difficult decisions. And in some hospitals, there are staff facing redundancy.

I met some of those staff a few weeks ago in North Staffordshire hospital, in Stoke. Utterly dedicated staff, working flat out – and working in two out of date, old-fashioned buildings. They’re now facing the shock and anxiety of a consultation on up to 1000 redundancies – although, as you’d expect, the hospital is doing everything possible to get that number down. But the problem they’re confronting is not just financial. The real problem is that the hospital isn’t organised in the most effective way possible.

They’re not doing enough day-case surgery. Lengths of stay for some operations are well above the national average. Emergency care is split between two different sites and four different entrances. That’s not good for patients. And it’s not good value for money either.

This is a hospital that only last year was taking on new staff whom they couldn’t afford – staff who they wouldn’t in fact have needed if they’d organised their services better in the first place.

I think that is grossly unfair on the staff, who were undoubtedly let down by the previous board of the hospital. I think they deserve an apology.

I know how devastating redundancies are. That’s why we are working with staff representatives and local management to ensure that the threat of redundancy is contained to as few people as possible.

But we all recognise that new medical practice and technology are making it possible to shift far more care out of hospitals and into health centres and community hospitals and even patients’ own homes. Nurses are leading the way in making these changes. It’s what the public want … it was the central theme of our new White Paper, Our health, our care, our say that the RCN worked with us to develop.

So our chief nursing officer, Chris Beasley, is already working with you in the RCN and other organisations on Modernising Nursing Careers – making sure we have the right framework to train and retrain people for NHS careers that will be even more varied, even more flexible than in the past.

And as I said earlier this week, we need to do more to support any nurse or other staff member who loses their job to help them get a new job and, if necessary, new skills as quickly as possible … and we will work with you and others to make that happen.

Record improvements

Just as we should be open and honest with each other about the challenges we face, we should be open and honest about the achievements as well.

And I want to congratulate the RCN.

Next month, 12th May, you’re going to be celebrating Nurses’ Day.

Celebrating your milestone of 400,000 members – particularly impressive when union membership has been falling in so many other sectors.

You’re entitled to be proud of that … just as we’re all entitled to be proud of the fact that the NHS is employing over 85,000 more nurses than we were in 1997.. 34,000 more staff as a whole in the last twelve months alone, 307,000 more as a whole since 1997.

More staff – better-paid staff – treating more patients faster than ever before, more people’s lives saved. Let’s tell the public about that too.

Working together

I have no doubt at all that the NHS works best when we all work together.

We worked together on Agenda for Change – a ground-breaking agreement to ensure equal pay for work of equal value and to open up new opportunities and new careers to staff for the benefit of patients.

We worked together to extend nurse prescribing.

You pushed for a comprehensive smoking ban – and we will deliver that next year, even earlier than we originally planned.

And we listened to you and many others on Commissioning a Patient-Led NHS. You told us we were wrong on PCT provision. We listened. I agreed we had made a mistake – and I said so, I changed it last autumn and confirmed the position again in the White Paper.

So I want us to go on working together and listening to each other.

Of course there will be occasions where we won’t agree.

But there is one issue – the biggest issue of all – on which I believe we are completely agreed.

The founding values of the NHS.

Every one of us in government, and I am sure every one of you, believes that the NHS must go on being funded by taxation. Care based on clinical need, not your ability to pay. Treatment free at the point of need. The fairest healthcare system in the world.

That’s non-negotiable, at least as far as we’re concerned.

But there are others who would abandon those principles.

Doctors for Reform demanding the introduction of social or private insurance, an end to ‘free at the point of need’.

The Daily Telegraph just last week, saying it doesn’t want progress, it wants privatisation.

If we are to succeed in defending the NHS, free at the point of need, then we need to meet the challenges that confront every healthcare system in every developed country. Rapidly rising public expectations. An ageing population. Medical technology and science changing faster than ever before.

That’s why we’re giving patients more choice and a more personal service. That’s why we believe in more diverse providers, including NHS social enterprises and not-for-profit organisations – as well as the private sector – not to take over from the NHS but to give patients better, faster care. And that’s why we’re shifting services out of hospitals and into the community, to improve care for patients and free up more resources for new drugs and treatments.

So there will be more arguments and controversy over the next year, and more difficult decisions to be made.

That is how we will persuade people that it is worth paying more for the NHS. Persuade people that collective provision is not only fairer, but that collective provision can also meet people’s rising aspirations – 21st century aspirations – to be treated as an individual, to get personalised services.

That’s how we will protect the founding values of the NHS for another generation against those who want insurance, charges and privatisation.

And that is a prize worth fighting for.

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Patricia Hewitt – 2006 Speech at HR in the NHS Conference

patriciahewitt

Below is the text of the speech made by Patricia Hewitt, the then Secretary of State for Health, on 27 April 2006.

It’s a real pleasure to be here today with you, at this important conference about the future of Human Resources practice in the NHS.

I want to hear from you this afternoon so I’ve asked for as much time as the conference programme will allow for your comments and questions.

But let me place our discussions today in the context of the programme of investment and reform that we have embarked upon. Starting in 2000 with the NHS plan, what we tried to do was build a patient-led, responsive to the demands of a changing society, and robust enough to prosper into this new century. But crucially, true to the founding values of the NHS: free at the point of need, available to all of us, and funded by all of us through a progressive system of taxation.

This is a challenging time for the National Health Service and everyone working in it. So we all need to be honest and realistic about the challenges ahead, the tough decisions that need to be made – and why we are making further changes in the NHS. .

But I also think we have to be honest and realistic about what the improvements and reform have already achieved.

The facts speak for themselves.

Almost no-one waiting more than six months, and for most people far shorter than that – a target that people said was crazy when we promised it, and which the NHS delivered three months ago, in one of the coldest winters for decades.

Last year, the NHS treated more people, better and faster than ever before – and we saved more lives than ever before. 43,000 lives were saved from cancer, over 60,000 more saved from heart disease.

No wonder, in every survey, patients tell us the health service is good – and it’s getting better.

I think you and all the NHS staff are entitled to be proud of these achievements. I think you deserve more credit for them than the media sometimes gives you.

We have 307,000 more staff than we had in 1997, including 85,000 more nurses and 33,000 more doctors.

More staff – yes, and better-paid than ever before, and I make no apology for that either.

And let me make it absolutely clear: I do not believe that we have too many managers in the NHS. I am fed up with people who talk about managers as if it is a dirty word. I believe we need the very best managers in the NHS, working with clinicians and other frontline staff to deliver the very best care for patients with the best value for money.

You can’t run an organisation of 1.3 million staff and a budget which will be £92 billion by 2008, without first rate management.

Financial problems

But if things are so good, why are the headlines so bad? If the NHS is getting more money than ever before – which it is – why are there deficits, jobs being cut and some staff facing redundancy? Why are you having to make some very difficult decisions?

Most of the NHS is not in deficit. The majority of our NHS organisations are in balance or surplus. The overall deficit in the NHS is around one per cent of the total NHS budget. That’s like someone on £20,000 a year having a £200 overdraft – it’s a problem, but it’s a manageable problem.

The real challenge comes in the minority – 7 per cent of NHS organisations which are responsible for around 50 per cent of the deficit: It can’t go on.

We’ve written a very big cheque for the NHS, and we’re proud of that, But it’s not a blank cheque. It never has been and it never will be.

And that’s why I am so clear that over-spending hospitals and other organisations do have to put their house in order. You know better than I do that in the old NHS, the over-spenders were always bailed out by the under-spenders. The under-spenders were usually from the poorest communities and the greatest health needs. It wasn’t fair. And part of our reforms means that every hospital and every area has to take responsibility for getting the best possible healthcare with the best possible value for the extra money that we have asked the public to contribute.

Hospitals have to become more efficient in how it uses precious NHS resources, precious staff time. And you know how to do that.

You’ve been telling me that you just don’t recognise these headlines about mass redundancies. Cutting down on agency staff, as many of you are doing, isn’t redundancies. It’s good management. And it delivers better care for patients.

And from figures published today, the cost of sickness absence: a cost of on average £5.4 million for every single NHS Trust. We can do better by our staff, and save money at the same time.

Most places will tackle their deficits and make themselves more efficient with few or no redundancies and the more you and we can explain that to our staff, and the media, the better.

But of course there are difficult decisions. And in some hospitals, there are staff facing redundancy.

I know how devastating redundancies are. That’s why I know you are doing everything possible, working with staff representatives to ensure that the threat of redundancy is contained to as few people as possible.

You, as HR professionals, know that every redundancy is a blow to the individuals, their families, and the people they leave behind. You understand the need for sensible, sensitive management processes, and a good dose of human compassion and common sense.

That’s why we will support any staff member who loses their job to help them get new jobs and, if necessary, new skills.

Explaining this is particularly important when new medical practice and technology is making it possible to shift far more care out of hospitals and into health centres and community hospitals and even patients’ own homes.

Every one of us here believes in the NHS – funded by taxation, free at the point of need.

But not everybody believes in these principles.

Doctors for Reform demanding the introduction of social or private insurance, an end to ‘free at the point of need’.

The Daily Telegraph just last week, saying it doesn’t want progress, it wants privatisation.

If we are going to defend the NHS, free at the point of need, then we can only do so by changing to meet the huge challenges that confront every healthcare system in every developed country. An increasingly demanding public. An ageing population. Medical technology and science changing faster than ever before.

That’s why the NHS has to go on changing.

That’s why, together, we have to make difficult decisions.

But look at the prize.

But by the end of 2008, we will effectively have abolished waiting lists – the way the old NHS rationed care. We will be giving patients a more personalised service than ever before, with more choice about where you’re treated and appointments booked in advance to suit the patient, not just the provider. We will be treating far more patients in the community and in their own home. And all of it free at the point of need.

We are making some structural changes. But what really matters is cultural change.

And you are the experts.

Your job is not a back office function. It is on the front line, supporting our staff with skills they need to give the best care to our patients.

Thank you.

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Patricia Hewitt – 2006 Speech to NHS Confederation

patriciahewitt

Below is the text of the speech made by Patricia Hewitt, the then Secretary of State for Health, on 20 June 2006.

I want to thank the Confederation – Peter, Gill and all your team – for your leadership of the Confederation. The leadership you showed in your recent report challenging the idea that bed numbers are the measure of success. The leadership and support you have provided this week to this vital part of the NHS family.

I have learnt a great deal over the last year, and what I’ve learnt has deepened my admiration for NHS staff and my absolute determination to give you the support you need to give every patient and user the best possible care.

I am here, as always, to listen to you – which is why I’ve asked Ian to join me for a discussion with you. But I want to take the next 15 minutes or so to acknowledge the difficulties we are facing, talk about the change in culture we need and underline why the reforms are so important.

The last twelve months have been far more difficult than we anticipated. So I am here, first and foremost, to thank each of you for the leadership, the dedication and the sheer professionalism you contribute to the NHS.

And in thanking you, I am also here to celebrate with you the extraordinary achievements of the NHS.

Just one example. There is scarcely a family that hasn’t been affected by cancer. That’s why we made it a priority and asked you to get rid of the delays between the GP’s referral and the start of treatment.

And you’ve done it.

I also know that it is first-rate managers who make first-rate care possible. I spent a morning recently with the cancer team at the Whittington Hospital, sitting in on the multi-disciplinary team meeting, … I saw for myself, what you see every day, brilliant clinicians and front-line staff absolutely focussed on what each individual patient needed. And it was the clinical director (Mrs Celia Ingham-Clark, a consultant surgeon) who told me that the person who made the team’s work possible was Stephen Dunne, who helped patients navigate around the system, ensuring that everyone had the information they required.

It is people like Stephen, it is you and all your colleagues who have made it possible to bring down the waiting lists, get rid of the trolley waits in A&E, save the lives of thousands of cancer patients.

We put in more money. But you did the work.

I will go on championing your successes and telling people about the extraordinary achievements of the NHS in every part of our country. That’s part of my job as health secretary.

But I will also tell the truth about the difficulties we face.

As I look around at a world that is changing faster than most of us imagined even ten years ago, as I see the extraordinary potential of scientific breakthroughs to transform people’s health and well-being, as I find health services across the developed world learning from what we are doing here in the NHS, I am excited this about journey of change that we are on.

But I know that excitement is probably not the emotion most of you feel right now. Anxiety. Uncertainty. Weariness that change never seems to end – and that change seems to be done to you, not by you. That’s what I hear people telling me.

I know that the latest changes to the strategic health authorities and PCTs compound those feelings, even amongst those of you who believe we’re making the right changes. We are making the changes because we believe they will help make life better for patients and the public. But they are also making life very hard for many of you. Some of you here don’t know if you will have a place in the new structure or what that role might be. Together, we need to do more to support everyone who is facing that insecurity.

There is another reason why I want the opportunity for dialogue with you today. Some of the things you’ve taught me have shocked me. The senior member of a PCT, for instance, who told me that she knew last year’s financial plan was unachievable … but she’d been told submit the plan anyway, and if there were problems, that was her problem.

Of course it isn’t like this everywhere – but too many people have talked to me about a macho culture, bullying, not being able to give bad news.

Ian said yesterday that the centre wasn’t listening.

That has got to change.

So our discussions here are part of creating a new culture: leaders who listen – to bad news as well as good – a culture of openness, honesty and respect. I want that in every strategic health authority, in every PCT, every part of the NHS and throughout the department of health – and I will go on reinforcing that expectation with all my colleagues including the Boards of the new health authorities and Trusts.

From “top down” to “bottom up”

But if we’re going to keep on changing, it has to be the right kind of change. When we started making the investment, when we launched the NHS Plan, we needed national standards and targets to make sure the changes happened everywhere.

But you’ve taught me that there is now too much top-down micro management, too much emphasis on targets set by Ministers – and not enough support for managers and clinicians and other front-line staff to respond directly to patients and users and local communities.

The vision of the NHS plan, “care shaped around the needs and concerns of patients.” That’s the vision for today and tomorrow. And it can’t be achieved by diktat from Richmond house.

So we need to create a system with in-built incentives to improve and innovate. A system that supports you to look outwards to patient and users, rather than upwards to Whitehall and Ministers.

Of course there will still be national standards: without them, empowering front-line staff and local communities just creates inequality and a post-code lottery.

But within a framework of national standards, fair funding and proper accountability, we need to shift the whole emphasis from top-down targets and performance management from Whitehall to change from the bottom up.

And that’s exactly what this next stage of the reforms will do.

The four parts of the reform programme work together.

First, more choice for patients with stronger commissioning by PCTs and practices. We know the public want more convenient, more personal, more local services when they’re ill. But they also want the NHS to support them in becoming and staying as healthy and independent as possible.

As we build on the success that so many PCTs have already achieved, and deepen our understanding of what excellent commissioning means, you will have the tools to focus on the needs of every community, to do more – not less – on public health and prevention, and to work with local practices to design services around the needs of individuals not institutions.

By giving GPs and practices more freedom and more responsibility, with practice based commissioning, we are creating the right incentives to do that everywhere.

Of course, choice has to be within available resources. But for elective care, as we give more choice to patients, we also give every hospital a powerful incentive to focus on how to give patients faster access and better, more personal, more convenient care.

But for choice to be real – and for commissioners to get the best services – we need providers who are constantly looking for better ways of achieving the outcomes that patients, local people and commissioners want.

So the second element in the reforms is a greater diversity of providers, with more freedom to innovate and improve – but also more responsibility for their own success.

Its been there for a long time in mental health and care for older people. We’ve now extended it to acute services.

In primary and community services too, we will increasingly see new providers adding to the great diversity that already exists. Services provided by local authorities, PCTs, GP practices … but also nurse practitioner led services, private firms, social enterprises and the third sector.

When East Derbyshire PCT wanted new and better primary care services for one of their communities, they didn’t specify who was going to provide it, they specified the services people wanted – and they chose the provider who they believed would offer the best. We’re all patients and users ourselves, isn’t that what we’d all want our local NHS to do?

I have no doubt that this diversity brings great strengths to the NHS. But it also brings greater complexity. Sometimes different organisations will be competing to offer the best possible care. Sometimes you’ll be collaborating with other organisations to provide the care that an individual patient or a whole community needs. All within the NHS family. All of it free at the point of need.

And then we need the third element of our reforms, payment by results. We have to get it right, we have to give you proper time to plan – and we’ll work with you over the next few months to do both.

But the reality is that the tariff supports patient choice, it will empower practice based commissioners and it is crucial in both driving improved efficiency and liberating clinical staff , inside and outside hospitals, to develop the services that patients want.

And the fourth element, of course, is the Regulatory Regime that we need – particularly to guarantee safety and quality – so that we can promise the public that the services will be there for you, wherever possible you will have a choice and on the NHS you can’t make a bad choice. It’s not easy to design a light-touch regulatory regime that fulfils our promises to patients without stifling your ability to innovate. But we’re determined to do it and we will be saying more on this next month.

Meeting future challenges

We all know there are huge challenges facing every health service. People want more. Medicine can do more. And we have to cope with these new demands and new costs within a budget that will be higher than ever before because we’ve asked people to pay more than before. But even in 2008, when we will have trebled the NHS budget and reached European levels of healthcare spending, the NHS will still have to live within its means.

So what do we do? Do we cut back on the services that we should be providing? No. We’re not going to do that.

Do we make patients pay top-up fees – as some on the Right are demanding. Never, because that would destroy the values of the NHS.

Or we can do what you’ve been asking for this week: make services far more productive – improving care for patients and improving value for patients and the public too. That is how we safeguard the values of the NHS for another generation.

We will never turn healthcare into a business. But we can and we must be more business-like. Not because we care more about money than about patients but because, as the Prime Minister said this week: every pound wasted is a pound not spent on the values of the NHS.

Conclusion

The final point I want to make before our discussion is about my responsibility to you.

I believe my job is to create the space for you to do your job.

I will play my part with Ian in creating the different kind of leadership that is needed for the next stage of our journey.

Less day-to-day interference: more collaboration and empowerment.

Less instructing, more listening: to the bad news as well as the good.

Not ‘its your fault’, but ‘its the responsibility of us all.’

And I will make sure that if you have the best plan for patients but need to take difficult decisions to deliver them on the ground, we will give you the political support you need to make those changes happen.

Those are the targets you are setting me: the targets I am setting for myself.

And when we meet here again in twelve months’ time, we will know that we are on the right track – not just because we will be back in financial balance. But because, together, we will be creating the culture and the partnership that is right for you, right for patients and true to the values in which we all believe.

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David Cameron – 2006 Speech to the Centre for Social Justice

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Below is the text of the speech made by David Cameron, the then Leader of the Opposition, to the Centre for Social Justice on 18 January 2006.

Today I want to talk about how we eradicate poverty in Britain.

And I want to explain how my approach differs from that of Gordon Brown.

Gordon Brown and I share the same objectives.

We both want to tackle poverty.

But we have different solutions to the entrenched problems of multiple deprivation, and the root causes of poverty in Britain today.

On the one hand, there is a top-down, centralised approach from Labour that means well but fails badly.

On the other, I want to develop a forward-looking vision which recognises that social justice will only be delivered by empowering people to fulfill their potential.

The difference is highlighted by Gordon Brown’s claim that “only the state can guarantee fairness.”

He sees limits on what the voluntary sector, social enterprises and community groups can do.

I don’t see limits.

I see endless and powerful opportunities.

Gordon Brown looks at areas where the state has failed…

…and thinks the answer is more state intervention…more of the same.

I look at state failure and say: let’s try something different.

I look around the country at the people and organisations I’ve met…

…and the thousands that I haven’t…

…who have the solutions to the long-term problems of our most deprived communities.

I look around this room and I see the faces of the poverty-fighters and the social entrepreneurs…

…people like Camila Batmanghelidj…

…Adele Blakebrough…

…Ray Lewis…

…and I know that if we trust you, if we give you more power and responsibility…

…you will succeed where the state has failed.

Our approach: trusting people and sharing responsibility.

Or Gordon Brown’s approach: creating dependency and removing responsibility.

That is the central argument about tackling poverty in Britain today.

This is the right place to be setting out the new Conservative poverty-fighting agenda.

Iain, you have been a magnificent champion for this cause.

The Centre for Social Justice has already made a huge contribution to the Conservative Party’s understanding of the nature and causes of poverty in our country.

And your contribution will be vital in the months ahead as you lead our Social Justice Policy Group.

In September 2003, you said this:

“…there are those who say that poverty in Britain simply does not exist. But it does. Many people do not enjoy the opportunities and freedoms that most of us take for granted. I think of children growing up in homes where it’s still hard to make ends meet. I think of pensioners in communities ruled by criminal gangs. Poverty is real today for those children and pensioners.”

And you concluded that:
“…unless Conservatives can show that we will govern for the whole nation, we will neither win nor deserve to.”

Iain, that is my conclusion too.

Since 1997, Gordon Brown has directed Labour’s efforts to deliver social justice.

He is absolutely sincere in his commitment to tackling poverty at home and abroad.

But Mr Brown’s good intentions should not shield his government from serious scrutiny.

And although some progress has been made, Brown has failed Britain’s most vulnerable people and communities.

This can be seen most starkly in his native Scotland.  Scotland still has the same tax and benefits system as the rest of the UK.

In recent decades, health, education and other public services have also been more generously funded north of the border than in the rest of Britain.

Therefore, if Labour’s anti-poverty strategy is working anywhere, it should be working in Scotland.

Earlier this month, however, The Scotsman published research which lays bare Labour’s failure.

The hundred most deprived postcode areas were dubbed ‘Third Scotland’ because of their Third World level of life outcomes.

If this sounds exaggerated, look at life expectancy.

In Third Scotland, average male life expectancy is only 64 years – lower than in Bosnia, the Gaza Strip, Iran or even North Korea.

Shockingly, this trend is actually getting worse.

Worklessness is also endemic in Third Scotland.

In Calton, in the east-end of Glasgow, 57% of adults do not work at all, even though only 8% are classed as unemployed.

Here, two out of every five adults claim incapacity benefit.

In Hamiltonhill, 61 per cent of children live in workless households.

And this is true for 58 per cent in Drumchapel.

Throughout Britain, 2.7 million are claiming incapacity benefit which offers guaranteed payouts for life.

Together with the associated benefits, this can pay more than an uncertain life of work on the minimum wage.

For others, the skull-splitting complexity of the tax credit system and the proliferation of means testing has debased the very principle of work.

Gordon Brown has created a benefits system that gives millions of people little incentive to work.

Any effort to progress beyond dependency is punished by steep rates of benefit withdrawal.

And there’s the claw-back of excess payments that leads to ever higher debt.

Only this week in my constituency surgery, a working single mum told me that she would have a higher income and a better house if she gave up her job.

She’d done the maths.

She’d be better off on benefits.

But she chose to stay working.

It was a small victory of the human spirit against the vast scale of Gordon Brown’s state machine.

Frank Field has observed that:

“There is now no way by which those most dependent on tax credit will be able by their own efforts to free themselves from this welfare dependency… To rip out the mainspring of a free society – the drive to improve one’s own lot and that of one’s family… cannot but harbinger ill for our country.”

The current welfare system, designed to eradicate the poverty of the last century, is now fuelling the new poverty of the 21st century.

Labour is creating a new class of decommissioned people.

Individuals who should have been guided on to paths out of poverty have instead been shunted into life’s sidings.

As Fraser Nelson put it in the Scotsman:

“Without a radical change, the Prime Minister’s social legacy may have a damning epitaph: that Labour fought poverty, and poverty won.”

I am determined to fight poverty and to win.

We desperately need new thinking if we’re to tackle the problems of multiple deprivation.

We can’t keep pulling the same levers and hope for different results.

We can’t keep growing and growing the welfare state.

We must realise that Gordon Brown’s ever-growing state cannot win the war on poverty on its own.

Gordon Brown says that only the state can guarantee fairness.

One look at his record exposes the hollowness of his claim.

If life in Calton and Drumchapel is his definition of fairness, I suggest he rethinks his guarantee.

Throughout Britain’s hard-pressed communities there has been a terrible loss of faith in politicians who practice his kind of Whitehall-knows-best politics.

The state has become a guarantor of means tested dependency, of the status quo, not of a new start.

Labour’s targets culture has produced a focus on lifting those just below the poverty line to just above it.

The worst forms of poverty haven’t improved under Gordon Brown.

…the gap between life expectancy for the richest and poorest in our country is now greater than at any time since Queen Victoria.

…and almost a third of disabled adults of working age live in poverty.

That’s higher than a decade ago.

Conservatives understand the role of government in delivering social justice.

Modern, compassionate Conservatism understands that spending money…

…to deliver world class public services…

…to ensure law and order…

…and to provide an economic safety net.

…is a positive good, not a necessary evil.

But we also understand the true meaning of fairness.

Fairness is about more than money.

Fairness means the chance to fulfill your potential.

That’s why it can never be the sole preserve of the state.

Any government that sees fairness as a state monopoly lacks the humanity to deliver true social justice.

True social justice demands equal opportunity for economic empowerment.

Economic empowerment means giving every single citizen in our country the means to climb the ladder from poverty to wealth.

And to do that, we have to understand that we’re all in this together – the state can’t do it on its own.

Good jobs and training opportunities are best provided by dynamic businesses.

Parents and strong, extended families, including networks of friends, are best placed to provide children with round-the-clock love and discipline.

And then there are those things that only individuals can do for themselves.

That much was demonstrated by William Galston, the liberal academic who inspired the Clinton-era welfare reforms.

His genius was to relate facts and figures to real lives lived by real people in the real world.

For instance, he found that three questions hold the key to whether an American citizen avoids poverty:

Did you finish high school?

Did you marry before having children?

Did you have children after 20?

He found that of the people who did all three, only 8% were poor; but of those who failed to do all three, 79% were poor.

Of course, there will be endless arguments over cause and effect.

And I’m not suggesting that American tests would be right for Britain.

But what Galston showed is that two people born into identical circumstances can nevertheless find themselves on different paths.

Furthermore the paths aren’t fixed. There are turning points in every life that can lead into or out of poverty.

I have asked Iain Duncan Smith and the Social Justice Policy Group to examine these paths into poverty:

Family breakdown.

Poor education.

Unemployment and dependency.

Addiction and debt.

More importantly I’ve asked the Policy Group to look at the exit points from these very paths.

Four things offer great promise in providing a path away from poverty:

A loving, stable home life.

A good education.

Economic opportunity.

A life free of substance abuse and serious debt.

The Policy Group will break out into four working groups, to study these paths.

THE FOUR WORKING GROUPS

Home and family

The first working group will look at the home and family.
More and more evidence shows that family breakdown causes poverty and poverty causes family breakdown.

Our prisons are full of people whose homes broke up and they ended up in care.

The problems of substance abuse and poor educational achievement are rooted in the fact they never knew the constant love of a parent.

I have said that the tax and benefits system should encourage families to come together and stay together, and to support marriage.

I invite this group to examine how that might best be done.

I also hope the working group will examine the potential of relationship education in preventing family breakdown.

No couple starts a relationship wanting it to fail.

But many need help.

The average taxpayer now contributes at least £570 every year to the direct costs of family breakdown, but only 21p is spent on trying to save troubled relationships.

Paltry sums are invested in helping couples build healthy relationships in the first place.

Harry Benson of Bristol Community Family Trust, who you saw in the film, runs superb relationship courses in ante-natal clinics, civil registrars and prisons.

Everyone should be given the best opportunities to form stable, healthy relationships and, especially where children are planned, to develop happy, healthy marriages.

Education

The second working group will look at education.

Fulfilling your potential without a decent education is increasingly difficult.

Nearly a million children are receiving a sub-standard education in over 1,500 failing schools.

In some of our most deprived neighbourhoods, the scale of educational under-achievement is staggering.

Just before Christmas, I was in the Shankill Road area of Belfast, where I met local people involved in training young people who told me only 16 per cent of young people left school with any qualifications.

Without good education there can be no social justice.

In my first day as Conservative leader, I visited Eastside Young Leaders’ Academy in Newham.

It’s an inspirational project for black boys run by Ray Lewis, an ex-prison governor.

Headteachers refer boys headed for a life of crime to the Academy.

After school, at weekends and during the holidays, Eastside works intensively with the boys to raise their attainment and build their character.

Ray’s not just steering them away from crime, he’s allowing them to reach for the stars.

I want government to give heroes like Ray proper resources to transform young lives.

Instead, we’re seeing the opposite happen today.

In another part of the East End that I visited this week, community leaders told me that one of the biggest problems they faced was the lack of opportunities for young people to do something positive and constructive out of school.

And despite huge investment in their neighbourhood, youth clubs had closed down.

That’s crazy.

Working together, schools and community groups can give every child the start that they deserve in life.

Economic security

The third working group will look at employment.

Gordon Brown likes to boast about his record in creating jobs but his record is poor.

When Labour came to power, 23% of 18-24 years olds were not working.

This has now risen to 26%.

A Conservative Government will ensure that it always makes sense to work.

I am delighted that the vice-chairman of the Social Justice Policy Group is Debbie Scott.

Debbie runs Tomorrow’s People, a national charity with a remarkable track-record in helping people back to work.

Their counsellors provide levels of encouragement and help that our Jobcentres around the country are simply not structured and equipped to provide.

As a result, Tomorrow’s People gets large numbers of people into jobs much more quickly, and at lower cost, than government schemes.

It’s yet another example of the voluntary sector succeeding where the state has faltered.

Drugs, alcohol and debt

The fourth working group will study addiction to drugs, alcohol and debt.

Britain’s most vulnerable communities have been devastated by drug and alcohol abuse.

But families in every social class in every part of Britain are suffering.

More rehabilitation places are clearly needed.
We have to help addicts get clean and stay clean.
Kaleidoscope is a fantastic drug rehab centre in Kingston.

I’ve seen its state-of-the-art detox unit.

It’s a fantastic resource.

But it often sits unused because of the failure of statutory bodies to commission from the voluntary sector.

I want the working group to assess how just how many more rehab places are required, along with the effectiveness of different treatment models.

For most people in the UK, being in debt has become a way of life.

Increasingly, many struggle to make the payments on their credit cards and loans.

Low-income families face cripplingly high interest on their borrowing.

The debt time-bomb could be triggered by any number of shocks to the economy at any time.

The working group will also investigate what more can be done to protect people from debt, and to make cheaper borrowing available to the least well-off.

A NATION OF THE SECOND CHANCE

But we all know that however much we do to help people forge paths out of poverty, some will be left behind.

We must never say to those people – ‘You’ve had your chance and you must live with the wrong choices you made’.

I want to build a nation that never writes any one off. A nation that says that it’s never ever too late to start again.

Never too late to realise those dreams you once had.

And so the fifth of our Social Justice working groups will examine ways to make Britain a nation of the second chance.

For the mum who got pregnant as a teenager the nation of the second chance will enable her to study when she’s 35.

The nation of the second chance will offer rehab to the man who has frittered away his twenties addicted to drugs.

The nation of the second chance will find a warm home and a job for the man who has slept rough since he ran away from the father that abused him.

The nation of the second chance is a different world to Gordon Brown’s decommissioned Britain.

We will never fulfil our potential as a nation by giving up on our fellow citizens, abandoning them to long-term unemployment, educational failure or addiction.

So how are we going to build the nation of the second chance?

Here, I don’t think that the voluntary sector has an important role to play.

I believe that the voluntary sector has the crucial role to play.

Iain Duncan Smith and I share that conviction.

We’ve both seen how the voluntary and social enterprise sectors provide intensive, long-term, holistic care to our vulnerable people.

Above all, the care is personal.

The public sector does a great job, but its targets and caseloads make it difficult to provide the necessary level of help for the most needy.

That is why the fifth Social Justice working group will look at building up the voluntary and community organisations that provide people with a second chance in life.

I invite the group to develop plans for ‘Social Enterprise Zones’ that will incentivise social action where it’s most needed.

The nation of the second chance can only be realised if the voluntary sector gets reliable funding that doesn’t come with too much paperwork.

Small community and voluntary groups who care for broken lives deserve financial support – the use of which isn’t micromanaged by Gordon Brown’s huge army of bureaucrats.

The nation of the second chance will require each of us to pull our weight.

And we Conservatives don’t have to wait until we’re in government to make a difference.

We can start now.

I’ve proposed a National School Leaver programme and will be meeting leading voluntary groups to develop this idea next week.

Our national culture of volunteering must be revived.

I am determined that the Conservative Party should be at the heart of that revival.

At New Year, I invoked those famous words of Gandhi: “We must be the change we want to see in the world.”

An increasing number of Conservative candidates are committing themselves not just to canvassing and leafleting but to helping transform communities.

In Brent recently I saw how Rishi Saha’s work for a community radio station has helped unleash the talents of young people in a deprived community.

Last summer in Warrington Fiona Bruce co-ordinated inmates from an open prison and high school pupils in giving a grubby ward a much-needed makeover.

CONCLUSION

Some say to me that Conservatives should only be interested in small government.

I agree that a state that grows too large becomes a burden on its hardworking citizens and stifles enterprise.

But that ambition alone cannot be enough.

We must raise our horizons.

You cannot have a smaller state unless you have bigger, more responsible people.

Growing levels of social breakdown are creating growing demands for welfare and other forms of government intervention.

Limited government is impossible without renewing the forms of behaviour and social structure that prevent poverty and create community.

And communities are not created from the top down, but built from the bottom up.

For me there is much more to this than the economist’s calculator.

I want the next Conservative Government to care about every Briton’s quality of life.

One nation Conservatives cannot just define Britain as a nation but also must care for Britain as a people.

Patriotism is about the crown, the flag and our nation’s institutions but it is also about believing in justice for everyone from Moss Side through to Easterhouse and to Hackney and beyond.

People here are crying out for a change, for fairness and opportunity.

These parts of Britain must be every bit as important to us as the greener, leafier Britain surrounding them.

Conservatives will always promote a nation of enterprise, individual freedom and personal responsibility.

But we must remember too that personal responsibility must be part of a shared responsibility…

…that it is neither the state alone which guarantees fairness, nor individuals acting alone…

…but all of us together.

All of us together, fighting for the empowerment of all of our citizens.

That is the way to bring social justice to this land.

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Jim Murphy – 2006 Speech on Child Poverty

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Below is the text of the speech made by Jim Murphy, the then Minister of State for Employment and Welfare Reform, to the Capita Child Conference on 11th July 2006.

Introduction

Last week’s End Child Poverty Report: Unequal Choices drew together some of the feedback from recent stakeholder events organised with the Joseph Rowntree Foundation.

One of the participants said:

“Childhood cannot be re-lived. Isolation, desperation and hurt are not just words for young people – they have a scarring impact. It is unforgivable that these years can be allowed to be stolen from young people through poverty.”

No speech from a Minister can sum up the impact of poverty better than that.

There is a chain of disadvantage that runs through generations of the same families. Each successive generation is a link in that chain. We have to go further to break these generational links.

This cycle of deprivation has been building momentum: poor girls become mothers younger and Joseph Rowntree Foundation research last week suggested that one million children growing up poor could produce, on average, an additional 120,000 poor children in the next generation.

We have made striking progress in tackling child poverty since 1997. In the mid to late 1980s, the UK suffered higher child poverty than nearly all other industrialised nations. Over a period of 20 years, the proportion of children living in relative poverty had more than doubled and one in three babies born in Britain was poor.

Since 1997, we have tackled worklessness by investing in Jobcentre Plus and the New Deal; we’ve introduced the National Minimum Wage to make work pay and established Tax Credits to target financial support at families with children.

The child poverty rate is now at a 15 year low and we are close to the European average for child poverty – instead of bottom as we were in 1997. We’ve made the biggest improvement of any EU nation and the number of children in relative low-income households has fallen by 800,000 since 1997.

In politics, it’s very easy to talk a lot about statistics. But that’s 800,000 more children more likely to thrive in childhood and better able to fulfil their potential as adults. 800,000 individual lives transformed – given the kind of beginnings we want for all children, and which they should have by right.

So, much progress has been made. But it has not extended far enough. Too many remain trapped in a chain of disadvantage, and those that do remain are often the poorest and most socially excluded in our society.

Working together, we must do more to break this chain. We simply cannot accept poverty as an intrinsic feature of the social landscape of the UK, where – for the most excluded – there is little more that can be done to lift them out of poverty.

We know that this problem of poverty is of human making – for too long politicians tacitly, and sometimes explicitly, accepted that a lifetime on benefit was the solution for some of our fellow citizens. That’s just the way life was. People left to struggle in poverty without any suggestion that there might be a different way of doing things. A more just way, that acknowledges human potential and the dignity families feel when they are able to provide for themselves rather than rely solely on the state.

But just as the problem of poverty is of human making, the answer to breaking the chain of generational disadvantage lies in our hands. Which is why we set ourselves the target of eradicating child poverty by 2020.

Why child poverty and why now?

The moral case is evident: children in the UK are not even born equal. The child of a poor household is more likely to be premature and the infant mortality rate is twice as high for the poorest.

By the age of 15, the 5% most disadvantaged are 100 times more likely to experience multiple social problems.

And an ever-growing body of research attests to the particular importance of a child’s early years in forming their life chances as a whole. Which is why our focus on child poverty is so essential. Through improving children’s life chances, we’re also working to prevent adult disadvantage – that life of obstacle rather than opportunity that is still the reality for too many families and communities in Britain today.

But there is also an economic case for breaking the chain of disadvantage. Child poverty is a significant factor contributing to social costs of:

£500 million a year spent on homeless families with children;

£300 million a year on free school dinners;

Up to £500 million a year on primary health care for deprived children; and

£1billion on children’s residential provision.

And where individual lives go into a downward spiral – perhaps culminating in crime or drug dependency – the cost of interventions can lead to tens of thousands of pounds of expenditure. Prevention is better than cure for the individual and for society. Eradicating child poverty is the ultimate prevention.

Evidence suggests that education, as well as parental income, is key in providing poor children with the foundation for a route out of poverty. It is through education that we can first sense and ultimately fulfil our potential.

Looking forward to 2020 – I see not the world of today, but one of unimaginable change. Today our economy has 9 million highly skilled jobs – but by 2020 will need 14 million highly skilled workers. And whereas we now have 3.4 million unskilled jobs, it is estimated that by 2020 we will only need 600,000 unskilled workers.

So, weak educational outcomes for poor children represent not just the squandering of untapped promise, but a lost opportunity for them to contribute to the economy as adults.

Today’s teenagers will be the parents of 2020 – and today’s young people are the first generation who can truly be said to be competing in a single global economy. Their competitors in the job market are the citizens of China and India, not just their peers from their community, country or continent.

Emerging and developing economies have increased their share of world trade by around a third since 1990;

China is now the sixth largest economy in the world, and is projected to be the third largest within a decade; and

China and India are producing 4 million graduates a year.

These are challenges not just for our economy but also for individuals – for the children who are at school today. Government must face up to these challenges and equip individuals to compete. I see globalisation as an opportunity. But it is an opportunity from which all must benefit.

Vision – what government is doing

Tackling poverty and breaking the cycle of disadvantage isn’t just about improving educational opportunities for poor children or putting more money into parents’ pockets. It is a multi-dimensional challenge – so we must use all the tools at our disposal in a concerted effort to end child poverty:

Improving the targeting and tailoring of our employment support – to help all those who can work do so. Achieving an enduring reduction in child poverty means that, whereever possible, people must have the opportunity and support to work and provide for themselves. Since 1997, the number of children living in workless households has fallen by over 370,000 – but the UK still has the highest proportion of all children living in workless families anywhere in Europe.

Our Welfare Reform Bill, introduced to Parliament last week, will provide the legislative framework for a new and innovative, personalised approach to supporting Incapacity Benefit claimants back to work. And because children of lone parents not in work are over five times more likely to be in poverty than children of lone parents in full-time employment, we must continue to consider how we can best target support to this group.

I also want to see the tools of the Welfare State better targeted at helping families with children in the years ahead, including considering whether and how we can refocus our employment programmes and the delivery of our future reforms, so that helping parents back into work is fully integrated into their objectives and ways of working.

Providing the right financial support – creating the right incentives to work, balanced with support for those who can’t. This is particularly important in supporting the transition into work. Good quality childcare is an essential part of this picture – building further on our investment in Sure Start and early years education, to deliver our commitment to universal, affordable childcare for 3 to 14 year olds by 2010.

Tackling in-work poverty – enhancing skills to lay the foundation for progression in the workplace and supporting the partners of those in work. Around half of the children living in poverty in Britain today live in a household where an adult is already in work – largely couple families who do not work enough hours or earn enough to escape poverty. To help the in-work poor we must look at new ways of encouraging second earners into work; continue to make sure that work pays, and do more to improve progression in the labour market by supporting and extending investment in skills.

And we must also improve awareness and understanding of the benefits system, so that, for example, more people realise that Housing Benefit and Council Tax Benefit can be claimed in work. Recent evidence has shown that this would increase work incentives.

Reforming the Child Support system – so that it is fully aligned with our target to halve and then eradicate child poverty. Research from the Joseph Rowntree Foundation showed that, in 2000, child support made only a 3% contribution to tackling child poverty in the UK – compared to as much as 25% in Switzerland and Austria.

Child Trust Funds – ensuring that all children are brought up with a chance to save, with poor children benefiting from a boosted Government contribution. So that all young people can embark on their adult life with a financial nest-egg to help them get their foot on the opportunity ladder and build the habit of saving. For Labour, the politics of aspiration and the politics of poverty are not in conflict, in fact they go hand in hand.

Redistribution of power in public services – we must see a real improvement in public services, but we haven’t yet gone as far as we need to. Inequality still remains in some aspects of our public services, and in some of our poorest communities they have not improved quickly enough. So what is the solution? Wait for a gradually improving uniformity to reach the poorest performers? I, for one, am not willing to wait.

I want to enable further choice in public services – meaningful choice of high quality services. I want to ensure that those without:

The sharpest elbows;

Family networks or social capital; and

Those whose voices have not yet been heard in this debate

… have greater power placed in their hands.

Political progressives have long discussed the redistribution of wealth. We have been inexplicably muted on the redistribution of power.

So we must be confident that we are using all our tools to combat child poverty to maximum effect. Tackling child poverty is DWP’s number one priority; we are reviewing the work of the entire Department to assess what more we can do – and have appointed Lisa Harker to advise us as we develop our renewed strategy.

Engaging Young People

Our efforts must address the key areas of disadvantage that research shows limit young people’s life chances. By renewing our strategy in these areas we can make real and sustained progress towards our ambition of ending child poverty in a generation – breaking the chain of disadvantage for good.

The disability rights movement has a saying – ‘nothing about us, without us.’ I believe that to bring about lasting change – and to truly break the chain of disadvantage which links the generations – the same must be true for the children of poverty. Not least because the parents of the children of 2020 are themselves at school today.

Many of us have our own experiences of child poverty. I want to hear from young people about the impact poverty has on them and what they think Government and others could do to make their lives better. Later this Summer we will be bringing together a number of children from deprived areas of the country for a Summer Seminars here in London – where we will be exploring their perspectives on what poverty means and what can be done to tackle it.

The results will be included in DWP’s renewed strategy – to be published this Autumn – and we will be seeking nominations for participants from, for example, charities, schools and families of children who are living in poverty today.

Closing

Government is well placed to make the economic case for ending child poverty. But young people’s voices are essential to making the social justice case.

The chain of generational disadvantage – reinforced in the 1980s – has been weakened in recent years. But it has not yet been broken. I believe that to break this chain, two generations will have to be freed from it.

Achieving our target of eradicating child poverty by 2020 is the challenge and responsibility of Government. But our approach must be strengthened, not just by popular engagement but by popular refusal to tolerate child poverty in today’s Britain. For this to happen, I believe we must extend awareness of what poverty means to children in Britain today. By helping young people’s voices to be heard – we truly can “make poverty history at home”.

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Jim Murphy – 2006 Speech on the Welfare Reform Bill

jimmurphy

Below is the text of the speech made by Jim Murphy, the then Minister of State for Employment and Welfare Reform, to the Edinburgh Conference on Welfare Reform on 30th October 2006.

Introduction

For too long, too many people have been written off.

That’s why I’m delighted to be here to talk to you about Welfare Reform.

Over the past decade, there has been the greatest extension of disability civil rights this country has ever seen. From establishing the Disability Rights Task Force in 1997 to the Disability Discrimination Act 2005, we have put in place a secure legal foundation of rights for disabled people. Employers and service providers of all sizes are now – almost without exception – subject to the DDA.

In December this year, the public sector disability equality duty will come into force, establishing a variety of obligations for public authorities to actively promote and support equality of opportunity for disabled people.

But we now need to go further. The crucial next step in empowering disabled people is extending their opportunity to work and play a full role in society. The framework of legal protection against employment discrimination is in place – but the support for the people who have until now been written off has been missing.

That is a frank admission that not enough has been done before. But in the past decade we have come a very long way in employment and welfare in the UK.

Legacy in 1997

It is important to remember that:

Not so long ago the UK suffered higher child poverty than nearly all other industrialised nations;

Over a period of 20 years, the proportion of children living in relative poverty had more than doubled and one in three children in Britain was poor;

By 1997, almost 5.5 million people were on benefits, 3 million more than in 1979; and

Over that same period, the number of people claiming unemployment benefits had risen by 50% –and the numbers claiming lone parent and incapacity benefits had more than tripled.

These appalling statistics paint the picture for the country, but they cannot capture the impact on communities, on families, and on individual lives – the neighbourhoods where unemployment and benefit dependency wasn’t a matter of months, or perhaps even years, but of a whole lifetime; a way of life.

And even today a child born into the most disadvantaged 5% of families is 100 times more likely to have multiple problems at age 15 than a child from a family in the most wealthy half of the population.

Progress since 1997

Of course, there has been real progress.

Since 1997, we have tackled worklessness with a strong economy and by investing in Jobcentre Plus and the New Deal:

More people are now in work in the UK than ever before, with more than 2.5 million more people in work than in 1997;

We have the best combination of high employment and low unemployment and inactivity of the world’s major industrialised countries;

Thanks to our reforms to the tax and benefit system, families with children are on average £1,500 per year better off in real terms, and those in the poorest fifth are £3,400 per year better off than in 1997.

Future Challenges

But just because there are no longer enormous marches for jobs, it doesn’t mean that our job is done.

There remain great causes in British public life including eradicating discrimination, ending child poverty and making all our public services world class.

I want to talk about three specific areas today:

– Welfare Reform, in particular our changes to Incapacity Benefit;

– Globalisation and skills; and

– Shaping our services around the citizen.

Incapacity Benefit Reform

It is inactivity – rather than unemployment – that is the principle employment challenge we now face. In the years up to 1997 the number of people claiming unemployment benefits had risen by 50% – but the numbers claiming lone parent and incapacity benefits had more than tripled.

The reasons for people coming onto Incapacity Benefits have changed dramatically since the benefit was first introduced. It was previously considered a legacy of an industrial heritage. But now:

People with mental health problems now account for 40% of the IB caseload – up from 27% in 1997; and

One third of new claimants now report mental and behavioural disorders as their main reason for coming onto the benefit, compared to a fifth back in 1997.

And we know that:

About three-quarters of Incapacity Benefit customers have been on the benefit for more than two years; and

After two years on Incapacity Benefit, a person is more likely to retire or die than ever work again.

But society has changed since incapacity benefits were introduced – and in particular attitudes to mental health and learning disabilities. It used to be thought that work would be the worst thing possible for people – whether they had a bad back or a mental health problem. Now we know that there is:

Strong evidence that work is good for physical and mental health; and that

Work can be therapeutic and can reverse the adverse health effects of unemployment and the damage it does to people’s self esteem.

But our systems haven’t kept pace with these advances in our understanding. We know that barriers still exist and discrimination still goes on. But without the DDA, disabled people wouldn’t have the right in law to challenge unfair treatment.

I know too that disabled people sometimes do face limitations in the sort of activities and work that they are able to undertake. But that’s why the essence of our Welfare Reform proposals is to focus on capability. To look at what people can do, rather than concentrate on what they can’t.

We intend to provide the support that will help those people that can do so, to work:

That’s why our Welfare Reform Bill will replace Incapacity Benefit with a new Employment and Support Allowance;

Turning the current system on its head, we will focus on what steps could help people into work, rather than simply assuming they are incapable of doing so on the basis of a health condition or disability;

We will match this new work focus with greater support for those people for whom it would not be reasonable to require to take steps towards a return to work, giving them a higher rate of benefit, together with the option of taking up the work-focused support on a purely voluntary basis;

But for the majority who – with help – can reasonably build their capacity to work, this support will be coupled with the responsibility to take up the help that is available;

These reforms will be built upon the foundation of our innovative Pathways to Work programme, which provides a holistic approach to tackling the health-related, personal and external barriers people face to returning to work;

And the new Personal Capability Assessment – reviewed by medical experts and stakeholder groups to ensure that it meets today’s needs – will provide Personal Advisers with work-focused health-related assessments for each claimant, so they can tailor packages of help and support for each individual customer.

Globalisation and Skills

Secondly I want to talk about globalisation.

Too often in the past, the conversation about globalisation is about what it means for nations and businesses rather than what it means for citizens.

Today’s young people are the first generation who can truly be said to be competing in a single global economy. Their competitors in the job market are the citizens of China and India, not just their peers from their community, country or continent.

Emerging and developing economies have increased their share of world trade by around a third since 1990;

China is now the sixth largest economy in the world, and is projected to be the third largest within a decade; and

China and India are producing 4 million graduates a year.

There is little future in low-skill employment. Today our economy has 9 million highly skilled jobs – but by 2020 will need 14 million highly skilled workers. And whereas we now have 3.4 million unskilled jobs, it is estimated that by 2020 we will only need 600,000 unskilled workers. This is another reason why we need to build the confidence and skills of the 2.7 million people currently on Incapacity Benefit.

So we need to look ahead and think now about how we can build the highly skilled workforce we will need. The Leitch review of skills will provide us with a valuable starting point. I believe we must build on the remarkable progress made in tackling unemployment by developing new approaches to help customers enhance their skills – considering how Jobcentre Plus can support people in low-skilled, low-paid work to progress in the workplace.

Making an impact through building skills will mean working effectively with a broader range of partners, at national and local level, to develop the kind of innovative approaches that will make a difference and will deliver the capabilities that employers need.

Skills are also crucial if we are to eradicate child poverty. Employment is the most effective route out of absolute poverty. Skills are a major part of eradicating in-work poverty because enhanced skills are the best path to sustained employment and a career.

All the tools of the Welfare State have to be better directed at helping families with children, including refocusing our employment programmes and the delivery of our future reforms, so that helping parents back into work is fully integrated into their objectives and ways of working.

Making further – greater – progress on tackling child poverty doesn’t just mean children’s lives changed for the better now. It’s the most important step we can take to break the chain of disadvantage that traps the poorest and most socially excluded in our society. That chain of family disadvantage which is passed from generation to generation – where each successive generation is a link in that chain. In recent years we have weakened it. But if we are to eradicate child poverty we need to break the chain of disadvantage.

We simply cannot accept poverty as an intrinsic feature of the social landscape of the UK.

That’s why tackling child poverty is DWP’s number one priority;

That’s why we are reviewing the work of the entire Department to assess what more we can do; and

That’s why we appointed independent child poverty expert Lisa Harker to advise us as we develop our renewed strategy – Lisa’s report will be published very shortly.

Shaping services around the citizen

Thirdly I want to talk about shaping our services around the citizen. I believe we must focus relentlessly on the needs and wishes of our customers.

The private sector has revolutionised the way that it does business as a result of the development of ever more powerful IT systems. It’s become the norm for many of us to book our holidays, do our shopping and our banking online. And these innovations have taken off because they meet our need for convenient access to services. I think it is reasonable to talk about Government for a Google Generation. We know that people are more impatient and – I think rightly – more demanding in the standard of services they expect from us.

There has been real innovation in public services. But an enhanced focus on customer services has been slow to reach the poorest people in our communities. Those who, in fact, depend the most on their interactions with public services.

That’s why I’m delighted to announce today a series of changes that will help Jobcentre Plus to provide a better service to our customers at the first point of contact:

We’re establishing 0800 numbers for people making new claims to working age benefits – everything from Jobseekers Allowance and Income Support to Incapacity Benefit;

For the majority of our customers, a single call is now all that will be required to make a new claim;

So there will no longer be a need to await a return call from Jobcentre Plus, meaning that the system will be quicker and customers will spend less time on the phone. Unsurprisingly our customers tell us that they prefer dealing with a single person and not having to repeat themselves;

And because the initial telephone process is quicker, customers get to meet a personal advisor sooner for work-related support and advice – which has to be good news in helping them get back into the labour market!

Such changes can make a big difference – our focus on reforming and renewing the welfare state must be matched with a continuing commitment to getting the details right in our relationship with our customers.

Conclusion

As we look ahead, to the impact of our current welfare reforms when they are rolled out in 2008, and beyond – to the future challenges that will shape our evolving welfare system – it might seem that the only constant is change.

But this change is driven by fundamental – and unchanging – values:

– the commitment to offering every individual and every generation the opportunity and support to achieve their potential; and

– the dedication to tearing down the remaining barriers that still hold people back.

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Jim Murphy – 2006 Speech on Homelessness

jimmurphy

Below is the text of the speech made by Jim Murphy, the then Minister of State for Employment and Welfare Reform, to the 16th November 2006.

Introduction

I’m very pleased to have this opportunity to join you this morning – to offer my support for the invaluable work that so many of you here are doing to tackle homelessness – and, of course, to celebrate the launch of the Transitional Spaces Project.

Why tackling homelessness is so important

Tackling homelessness is about much more than simply putting a roof over someone’s head.

It’s about understanding the causes and addressing the factors that so often lead to homelessness, such as:

– relationship and family breakdown;

– debt and unemployment;

– mental health problems; and

– alcohol or drug dependency.

Tackling these issues helps provide a way back for people on a path to homelessness – helping them to hold on to a place to live even when facing other challenges in their lives.

We know that – if we don’t tackle the root causes – many homeless people can get trapped in a vicious cycle of deprivation; a cycle that eats away at their confidence and self-esteem; a cycle that was so vividly portrayed for the first time 40 years ago today – when the BBC first aired the drama documentary “Cathy Come Home.”

12 million people – a quarter of the British population at the time – watched the story of Cathy and Reg. Initially a happy couple, their lives spiral downwards when Reg loses his job. After periods of squatting, eviction and care homes, finally – on a suburban street in front of astonished passers-by – Cathy has her children forcibly taken away from her by the social services.

It shook the social conscience of a nation. Even as recently as 2000, a British Film Institute poll voted it the 2nd Greatest British Television Programme of the 20th Century.

Progress

We’ve come a long way in 40 years. The Homelessness Persons Act of Callaghan’s 1977 Government finally put a duty on local authorities to find accommodation for homeless applicants. And despite a marked lack of progress in the early 1980s and 1990s – this Government has made huge strides forwards:

Today rough sleeping is down nearly three-quarters since 1998;

We’ve ended the scandal of families spending long periods living in bed and breakfasts;

The number of new cases of homelessness is at a 23 year low – down 29% on the same period last year; and

We’ve set the ambitious target of halving the number of households living in temporary accommodation by 2010 – and have already seen a 7% reduction over the past year.

Much of this progress has been down to many of you here today. A result of ground-breaking partnerships with local authorities and the voluntary sector in tackling the root causes of homelessness.

Key to our success now is preventing people from ever getting onto the downward spiral that can lead to homelessness and despair.

Through our Supporting People programme we are investing more than £5 billion over three years in locally delivered services to help people maintain independent lives through more settled housing.

In the past decade we have doubled the funding for affordable housing and supported the creation of 230,000 new affordable homes.

We’re investing in social housing and increasing the supply of new social homes by 50 per cent by 2008, providing 75,000 new social homes over the next three years.

And, as our response to the Barker Review of Housing Supply made clear – we’re committed to going further and making social housing a priority in the next spending round as well.

Challenge ahead

But we need to go further. We know:

There are still up to 500 people on the streets on a single night; and

More than 90,000 households are still living in temporary accommodation.

The challenges and causes of homelessness are changing. And our response must reflect these new challenges. We know that the single biggest cause of homelessness – accounting for nearly one-in-four new cases – is where parents are no longer willing to accommodate young people; and while one in five cases results from the breakdown of relationships.

That’s why earlier this week the Secretary of State for Communities and Local Government unveiled a package of measures specifically designed to tackle the root causes of homelessness – with a particular focus on the rising prevalence of youth homelessness – and the need for access to mediation services, to try and prevent the breakdown of relationships in families leading to homelessness.

It means saying no to the use of bed and breakfast accommodation for 16-17 year olds, except in emergencies;

It means training community volunteers and establishing supported lodgings across the country – that don’t just provide accommodation – but also advice and mediation services for young people; and

It means making the initial move into supported accommodation a springboard for helping people turn their lives around, not the beginning of a downward spiral of rejection and dependency.

Off the Streets and Into Work (OSW)

As your report “Multiple Barriers, Multiple Efforts” highlighted, tackling homelessness requires a truly joined-up, holistic approach. Not one that tackles each barrier separately.

That’s why it’s absolutely right that Off the Streets and Into Work should be making the connection between homelessness and worklessness. In “Cathy Come Home” it was, of course, when Reg lost his job that Cathy and Reg’s problems really began.

Most of OSW’s clients are unemployed – nearly a third have been unemployed for more than three years.

But we also know that many homeless people aspire to work. Your own survey in May last year (“No home, No job”) – the most extensive study of its kind in Europe – found that 97% of respondents said they would like to work in the future. And over three-quarters wanted to work straightaway.

We need to go further in ensuring that labour market policy is properly joined up with housing and homelessness policy.

We know, for example, that temporary accommodation can attract high management charges and the resulting high rents can be seen as a barrier to employment.

That’s why we’re working with DCLG and OSW to support the Working Future project being tested by the GLA and East Thames Group. One hundred households in temporary accommodation in East London being offered lower rents in return for increased training opportunities and tailored employment support.

We know that voluntary work or work experience plays an essential role in helping homeless people reconnect with work. As one respondent to your survey said:

“It gives you the opportunity to work in areas that you thought were beyond you.”

That’s why it was so important that we listened to you – and changed the rules on volunteers’ lunch expenses – allowing those on benefits to have their lunch expenses disregarded for benefit purposes. To make it easier for people who are on benefits to volunteer – and to take those crucial early steps on the road to work.

As well as the transition into work – it’s clear we also need to shift the focus away from simply getting a job to supporting people to progress in the workplace.

Through Jobcentre Plus and our wider welfare to work strategy – we have invested heavily in helping people find work. Our welfare reforms – the reform of Incapacity Benefit and our investment in the tailored support of Pathways to Work – are renewing a sense of hope and opportunity for those who have been written off by the welfare system for years.

But our future success will hinge not just on getting people into work – but on supporting them to stay in work and to acquire the skills, confidence and ambition to progress though the workplace. This is the new challenge for welfare. Getting people into work is only the start. Keeping them in work and helping them to progress through the labour market must be our objectives.

Our work to transform hostels – including the current £90 million Hostels Capital Improvement Programme – will make an important contribution by making hostels places where people can acquire skills and training to progress in their lives. Ending the “revolving door” of homelessness and helping people to build their way out of poverty and dependency.

Role of Housing Benefit Reform

Housing Benefit also needs to promote work and support a greater independence. Complexity and lack of transparency in Housing Benefit can act as a barrier to work. When payment is made to the landlord it does nothing to help tenants in developing their financial and budgeting skills or their sense of independence.

By contrast, our new Local Housing Allowance – a flat-rate amount based on household size and location – is paid in most cases to the tenant rather than the landlord. It’s already operating successfully for private sector tenants in 18 local authority areas – and we intend to extend it to new customers across the whole private rented sector.

But with 80% of those receiving Housing Benefit living in social housing and the highest levels of worklessness being in this sector – we’re also clear that there’s a strong case for reforming Housing Benefit for social tenants. While that means recognising the significant differences between the private rental market and social housing – we need to find a way of enabling social tenants to exercise a greater degree of personal responsibility in respect of their managing their finances.

Transitional Spaces Project

Even with Government action to increase the supply of social housing, we need to make better use of existing housing stock – including, with adequate safeguards, embracing the possibilities and choices offered by the private rented sector.

That’s why I’m so keen today to launch the Transitional Spaces Project – a new project that will combine an innovative incentive scheme and a transitional support package to link employment with sustainable moves from hostel accommodation into the private rented sector.

Two pilots: one in Tyneside and one here in London – working with 100 people a year over three years.

Not just providing financial support – but practical and motivational support to help with job-search, CV preparation, interview skills, training and mentoring, financial literacy, budgeting and even mediation with employers if needed. Not just working with people to think about employment – but to think about a career.

Not just doing more of what we already do – but doing things differently. Testing the boundaries of what is possible and forming new alliances and new partnerships which themselves can – and I believe must – drive further progress in tackling homelessness.

Conclusion

Because ultimately there can be no place for homelessness in our society.

Forty years ago “Cathy Come Home” – helped change societal attitudes as well as the Government’s approach. Today we’re still talking about it.

Since then – together – we’ve made enormous strides in tackling and preventing homelessness. But there is much more to do. And it is only by continuing to work together that we can help even more people out of a cycle of homelessness and into independent and settled lives.

We need to finish the job. Homelessness has no place in a sustainable community. Like poverty and disadvantage, our aim should be to eradicate it.

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David Melding – 2006 Speech on Local Government in Wales

Below is the text of a speech made by David Melding on 11th July 2006. Copies of the speech are in both English and Welsh below.

IN ENGLISH:

I also thank Sir Jeremy Beecham and his team. I apologise that I was not able to attend yesterday’s function due to a more pressing one here in the Assembly, but ‘Beyond Boundaries’ will be regarded as a seminal report. It is certainly challenging for us all, not just the Government.

It is an excellent, ambitious vision that wants public services to be at the centre of life and what it is to be a citizen. I completely agree with that vision and that Wales ought to set itself the ambition of leading smaller countries in delivering first-class public services.

Sir Jeremy Beecham says that we need to go further and faster. However, I do not think that this is a cosy report; in a subtle way, it is quite critical of many things that are done at present.

That is not just against this Government; it is also against aspects of the health service and local government, as well as performance from many years ago, no doubt. I think that we need to meet some of the key issues that are raised.

The first issue that I want to mention is that data and key performance measures have to be improved. I have made the point several times in the Chamber that social services data are often weak, and you cannot really manage, scrutinise, and be confident that you are improving services unless you have effective data, which the public can also understand, and which people can be held to account on.

I would like a response—perhaps not now, as it is only 24 hours since it was published—on the recommendation that, presumably, the First Minister, or, indeed, the Finance Minister, makes an annual statement on public service performance. That would be a useful debate to have annually.

Dai Lloyd made the point on improving scrutiny, and I shall not develop his points, but I will say that, in order to scrutinise effectively, you need support and training.

In the Assembly, that means training for Assembly Members on how to look at and track a budget and legislation, and all sorts of things, but also at local government level.

I hope that the start that has been made at the WLGA—as well as at the Assembly Government, in fairness—to improve scrutiny, training and performance in local government goes on, but also that we do it ourselves in the Assembly.

I commend the call for a mixed economy in delivering public services. It is not about privatising services; private companies, voluntary bodies, and, of course, the state sector can all deliver public services.

There is no problem with that—we do not need to construct lots of ideological walls to prevent that mixed economy. The joint reviews often pointed to the fact that councils had not succeeded well in creating a mixed economy for care.

The call for pooled sovereignty as a model for joint working is pushing us, and saying, ‘Look, the voluntary approach is not working well, or at least not fast enough’. We will have to look at this, as well as at more regional services, which should be on our agenda.

There were one or two really quite surprising things, such as whether we should experiment with different models, such as care trusts.

That has been on the agenda in England, though I do not think that it has seriously been a runner in the Assembly; it is only my own party that has ever raised it as an issue, but perhaps we should look at that in more detail.

Finally, I agree that standards should be broad rather than extremely detailed, and we need to allow earned autonomy in the response to local need, which means that you can deliver a broad standard, but if you are told to deliver too many small targets, local flexibility is lost.

However, we must remember that some areas of public services, such as children’s services, are still in need of considerable improvement, and any inspection regime will have to be much more rigorous for much longer, until we are confident that the general service levels are high enough.

 

IN WELSH:

Yr wyf innau hefyd yn diolch i Syr Jeremy Beecham a’i dîm. Ymddiheuraf na allwn fod yn bresennol yn y digwyddiad ddoe gan fod gennyf ddigwyddiad pwysicach yma yn y Cynulliad, ond ystyrir ‘Ar Draws Ffiniau’ yn adroddiad arloesol.

Mae’n sicr yn gosod her i bob un ohonom, nid dim ond y Llywodraeth. Mae’n weledigaeth ardderchog, uchelgeisiol sydd am weld gwasanaethau cyhoeddus wrth galon bywyd a’r hyn y mae’n ei olygu i fod yn ddinesydd. Cytunaf yn llwyr â’r weledigaeth honno ac y dylai arwain gwledydd llai i ddarparu gwasanaethau cyhoeddus o’r radd flaenaf fod yn uchelgais i Gymru.

Dywed Syr Jeremy Beecham fod angen inni fynd ymhellach ac yn gynt. Fodd bynnag, ni chredaf fod hwn yn adroddiad cysurus; mewn ffordd gynnil, mae’n eithaf beirniadol o nifer o bethau a wneir ar hyn o bryd.

Nid dim ond yn erbyn y Llywodraeth hon y mae hynny; mae hefyd yn erbyn agweddau ar y gwasanaeth iechyd a llywodraeth leol, yn ogystal â pherfformiad o nifer o flynyddoedd yn ôl, yn ddiau. Credaf fod angen i ni ddiwallu rhai o’r prif faterion a godir.

Y mater cyntaf y carwn ei grybwyll yw bod yn rhaid gwella mesurau perfformiad allweddol a data. Yr wyf wedi codi’r pwynt hwn sawl tro yn y Siambr, bod data gwasanaethau cymdeithasol yn aml yn wan, ac na allwch reoli, craffu na theimlo’n hyderus eich bod yn gwella gwasanaethau oni bai fod gennych ddata effeithiol, y gall y cyhoedd ei ddeall hefyd, ac y gellir dal pobl i gyfrif yn ei gylch.

Hoffwn ymateb—nid yn awr efallai, gan mai dim ond 24 awr sydd wedi mynd heibio ers ei gyhoeddi—ar yr argymhelliad i’r Prif Weinidog yn ôl pob tebyg, neu, yn wir, y Gweinidog Cyllid, roi datganiad blynyddol ar berfformiad gwasanaethau cyhoeddus. Byddai honno’n ddadl flynyddol ddefnyddiol.

Gwnaeth Dai Lloyd y pwynt am wella craffu, ac ni ddatblygaf ei bwyntiau, ond dywedaf, er mwyn craffu’n effeithiol, fod angen cefnogaeth a hyfforddiant arnoch.

Yn y Cynulliad, mae hynny’n golygu hyfforddiant ar gyfer Aelodau’r Cynulliad ynghylch sut i edrych ar gyllideb a deddfwriaeth a’u holrhain, a phob math o bethau, ond hefyd ar lefel llywodraeth leol.

Gobeithiaf fod camau cyntaf CLlLC—ynghyd â Llywodraeth y Cynulliad i fod yn deg—i wella craffu, hyfforddiant a pherfformiad mewn llywodraeth leol yn parhau, ond ein bod hefyd yn gwneud hyn ein hunain yn y Cynulliad.

Yr wyf yn canmol yr alwad am economi gymysg o ran darparu gwasanaethau cyhoeddus. Nid yw hyn yn ymwneud â phreifateiddio gwasanaethau; gall cwmnïau preifat, cyrff gwirfoddol, ac, wrth gwrs, sector y wladwriaeth, un ac oll, ddarparu gwasanaethau cyhoeddus.

Nid oes problem gyda hynny—nid oes angen inni godi nifer o waliau ideolegol i rwystro’r economi gymysg honno. Roedd yr adolygiadau ar y cyd yn aml yn tynnu sylw at y ffaith nad oedd cynghorau wedi llwyddo’n dda i greu economi gymysg ar gyfer gofal.

Mae galw am sofraniaeth wedi’i chronni fel model ar gyfer cydweithio yn ein gwthio, ac yn dweud, ‘Edrychwch, nid yw’r dull gwirfoddol yn gweithio’n dda, neu o leiaf yn ddigon cyflym’. Bydd yn rhaid inni edrych ar hyn, yn ogystal ag ar wasanaethau mwy rhanbarthol, a ddylai fod ar ein hagenda.

Ceir ambell beth a’m synnodd, megis a ddylem arbrofi gyda modelau gwahanol, fel ymddiriedolaethau gofal.

Bu hynny ar yr agenda yn Lloegr, er nad wyf yn credu iddo gael ei ystyried yn ddifrifol yn y Cynulliad; dim ond fy mhlaid i sydd wedi codi hyn fel mater perthnasol erioed, ond efallai y dylem edrych yn fanylach ar hynny.

Yn olaf, cytunaf y dylai safonau fod yn eang yn hytrach nag yn arbennig o fanwl, ac mae angen i ni ganiatáu ymreolaeth wedi’i hennill yn yr ymateb i angen lleol, sy’n golygu y gallwch ddarparu safon eang, ond os dywedir wrthych ddarparu gormod o dargedau bach, collir hyblygrwydd lleol.

Fodd bynnag, rhaid inni gofio bod rhai meysydd mewn gwasanaethau cyhoeddus, fel gwasanaethau plant, dal angen cael eu gwella’n sylweddol, a bydd yn rhaid i unrhyw drefn ymchwilio fod yn llawer mwy cadarn am gyfnod hwy o lawer, nes y byddwn yn hyderus bod y lefelau gwasanaethau cyffredinol yn ddigon uchel.

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Anne McGuire – 2006 Speech to the RNIB

Below is the text of the speech made by Anne McGuire to the RNIB ‘Focus on the Future’ Conference held in Aberdeen on 31st August 2006.

It is a great pleasure to be with you all in Aberdeen and I would like to thank John Legg, RNIB Scotland and Grampian Society for the Blind for inviting me to speak at this important event. The conference is an important step in highlighting the employment needs of blind and partially sighted people and I hope that the presentations here today will provide much food for thought and fresh perspectives into addressing the currently low rates of employment for blind and partially sighted people.

As the UK’s Minister for Disabled People I have been asked to set the scene and cover what the UK Government has been doing to improve the employment opportunities of disabled people generally. Although we have been doing a lot I think we would all agree that much remains to be done for disabled people generally and for blind and partially sighted people in particular.

Undoubtedly, we are going through a period of change as we review our services to disabled people and the means by which those services are delivered. I recognise that change can give rise to uncertainty. But change can also provide us with an opportunity.

– an opportunity to build on the progress that we’ve already made;

– an opportunity to shape a new, active inclusive welfare state and to contribute to that goal;

– and an opportunity to support a dramatic extension of individually tailored support that has the potential to transform the life chances of disabled people in our workplaces; in our communities and in our society as a whole.

I want to say a little about that change and the context within which it is taking place.

Since 1997, we have set about implementing the most profound extension of disability rights this country has ever seen. We have strengthened civil rights for disabled people in such areas as access to goods and services, and to public transport, and we established the Disability Rights Commission in April 2000 to help disabled people understand and enforce their rights.

In October 2004, we extended the employment provisions of the Disability Discrimination Act 1995 to provide protection against discrimination for an additional 600,000 disabled workers. A further 7 million jobs and 1 million employers were brought within the scope of the employment provisions of the Act.

Most recently, amendments made to the Disability Discrimination Act in 2005 require public authorities to promote equality of opportunity for disabled people – a real milestone in helping people to eliminate the institutional disadvantage that many disabled people still face. The legislation will ensure greater opportunities for disabled people to work by tackling discrimination in recruitment and employment.

The Act completed the most far-reaching programme of disability rights legislation that any European country has so far put in place and fulfilled our commitment, my commitment and Anne Begg’s commitment to deliver enforceable and comprehensive civil rights for disabled people. It represents a major landmark on the road to a society which promotes equality for all people and in which disabled people can be empowered to live independently, fully recognised and respected as equal members of the community.

But for all the legislative progress that we have made – we know that we have very much further to go if we are to achieve our goal of substantive equality for disabled people. That is why the Prime Minister’s Strategy Unit report published in January 2005 was a milestone in Government’s approach to improving the life chances of disabled people.

Developed in partnership with disabled people themselves, we recognised that unless we changed the way we as public authorities worked, we could not put in place true equality for disabled people.

That is why we are as a result of the Strategy Unit’s report:

– working to promote independent living with the individualised budget pilots currently in England and being watched closely by the government in Scotland and the Welsh Assembly, and we;

– established the new Office for Disability Issues and a new Great Britain-wide National Forum for Organisations of Disabled People which will enable the views of disabled people to be heard by policymakers at the highest level to ensure disabled people really are at the heart of public policy – able to influence the development of policies and service delivery that will affect every aspect of their lives.

But one of the greatest challenges that we face is in trying to ensure that more disabled people get the opportunities that many of us take for granted – access to a good education and being able to move on into a job.

Recent statistics showed, that although we are making tremendous strides forward in tackling poverty:

– disabled people are still more likely to be trapped in poverty than non–disabled people;

– and a quarter of all children living in poverty have long-term sick or disabled parents.

The government is determined to tackle child poverty and to do that, we need to tackle parents’ poverty.

We know that:

– disabled people are more than twice as likely to have no educational qualifications as non-disabled people

– that they are over three times as likely to be economically inactive

– and when they do have a job they earn less on average than their peers. Indeed around a third of young disabled people actually expect by age 30 to be earning less than non-disabled people of their own age.

As a Government and as a society we simply cannot accept this situation.

I think that all of us here today recognise that work is the best route out of poverty; the best route to confidence, self esteem and ultimately independence. The right to work is the bedrock of individual independence.

But we all also know that there are still barriers that prevent disabled people from exercising that right. Disabled people looking for work can still encounter a range of barriers – from policy design and delivery of services, to physical and environmental barriers, to outright discrimination.

This not only compromises our ability to respond to the challenges of economic and demographic change – we simply cannot afford to ignore the skills and contributions of all those who can and want to work – but it also fundamentally undermines that very precious goal of true equality and opportunity for all.

We need to continue to work together to change current culture and raise the expectations of employers, health professionals and disabled people themselves so that these barriers can be overcome.

Our efforts to help disabled people get a job are crucially dependent on employers being prepared to give individuals a chance to demonstrate what they can do in the workplace. I urge more employers to give blind and disabled workers that opportunity.

This cultural and attitudinal shift is precisely what the Welfare Reform Green Paper sets out to do.

We know the vast majority of people who start receiving incapacity benefit want to go back into work – but the system currently provides them with little help to do so.

In early January this year, John Hutton wrote to 100 constituency MPs with the highest levels of people on incapacity benefits setting out research that very starkly demonstrated the clear link between the high concentration of benefit dependency and hardship and poverty.

The country has paid a heavy price for this policy failure over the years. We know that individuals, families and communities suffer when people get stuck on benefits. The previous system has dissuaded aspirations.

Over the last few years thanks to our investment in the New Deal and Jobcentre Plus, the employment rate of disabled people has risen as twice as fast as for the population as a whole. The New Deal for Disabled People has seen over 90,000 job entries since its launch in 2001 with a further quarter of a million disabled people helped into work through the other New Deal programmes. But we all know that blind and partially sighted people still lag behind non-disabled citizens when it comes to job opportunities.

We now want to build on the active labour market policies we have introduced and put in place a network of support that will help people overcome the barriers to moving back to work.

Our Green Paper strategy has three clear aims.

We will take steps to reduce the number of new claimants.

We will provide greater help for those on the benefit to return to work.

And, for the most severely sick and disabled, we will provide greater support.

The new Employment and Support Allowance will;

– be paid to eligible claimants, with an enhanced employment support component for the majority of claimants who will be undertaking mandatory Work Focused Interviews and later activity, and importantly

– include an enhanced support component for those individuals who are unable to engage in any activity because of the severity of their condition

We are also going further to activate the system – to make sure that back to work support is available to people on incapacity benefits.

In 2003 we set up our first Pathways to work pilots – combining employment and health support.

We are now expanding Pathways more widely. By October this year Pathways provision will be available to around one third of all those on incapacity benefits. A key area in its success is engaging with employers.

We need to emphasise the importance of education and the transition into work. We need to challenge the stereotypes of what blind people can and cannot do. We have help and support available through programmes such as Access to Work. We need to re-emphasise to employers the benefits of new technology. We need to work to raise the expectations of disabled people themselves and to provide support when it is needed and with all of that, the sky is the limit.

But we can only do this in partnership with the representatives here today – with workers, with companies, with providers and with trades unions. I look forward to working with you, so that together we can play our part in achieving that ambition of true equality for disabled people in Britain within a generation.

With your support I know we can build on the improvements we have already achieved for disabled people. Improvements which bring greater numbers of disabled people into the mainstream, securing economic and social inclusion for them and their families and contributing to the economic life of our nation.