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  • Owen Paterson – 2012 Speech to the Food and Drink Federation

    owenpaterson

    Below is the text of the speech made by the Environment Secretary, Owen Paterson, to the Food and Drink Federation on 12th December 2012.

    This time last year the FDF launched its 2020 vision for growth. This is a shared vision for the UK food and drink industry to deliver sustainable growth of 20% by 2020. I would like to take this opportunity to thank my predecessor Caroline Spelman who played a key role in its launch.

    I fully support the FDF’s work on this. It chimes well with the instructions the Prime Minister gave me on my appointment. He asked me and my Ministerial team to focus on growth while improving the environment. These two are not mutually exclusive; in fact I believe that we cannot have one without the other.

    One of the first events I attended in office was a meeting at No. 10 with farmers, producers, distributors and exporters.  I understand that Government needs to work in partnership with industry if we are to get the best from the food and drink manufacturing sector.

    This sector is a great success story. The food and drink manufacturing sector employs 3.6 million people and agricultural work employs a further half million. The manufacturing side is worth £9 billion to the UK economy. Last year exports hit £12 billion

    The Government is investing in the future of the industry. We spend over £410million on agriculture and food research annually. I know that as an industry you invest £1 billion each year in R&D. That enables a staggering 1,500 new products to be launched each quarter. Innovation has a key role to play in ensuring that the sector continues to grow and that we can expand into new markets.

    Recently I was in Shanghai to open the Food and Hotel China trade fair. Incredibly there were UK Companies who were selling tea to China. They were creating a market by offering innovative high-quality products.

    The Green Food Project is looking at how to produce more food while simultaneously improving the environment. We’re working with partners from across the food supply chain, from farmers to retailers, to design and implement policy that works for businesses, consumers and the environment.

    I am currently working with David Willetts, the Science Minister, on the Life Sciences Agri-Tech Strategy to help encourage innovation and new technologies. We want to use the UK’s world class science base to increase the competitiveness of the agricultural sector and address the global food security challenge. We need to be able to translate research into new products, processes and technologies, and this should include serious consideration of GM. It is reported that in 2011, 16 million farmers in 29 countries grew GM products on 160 million hectares. That’s 11% of the world’s arable land. To put it in context that’s 6 times larger than the whole surface area of the UK.

    We need to discuss this at national level and unblock it at EU level. Above all we need to make the case to the public. That will require government, industry and the science community to work together. I agree with Jim [Mosely] that the UK risks becoming a “food museum” if we fail to embrace new technologies such as GM, so it’s crucial we get this right.

    The Agri-Tech Strategy will build on our world leading scientific expertise in the UK. We need the best research, technology and knowledge transfer that we can get, so that the industry can continue to develop. This is a great opportunity for UK economic growth and a way to continue to increase exports. We also need to educate the public sentiment so consumers understand the possibilities that new technologies offer.

    The FDF have had a great success in achieving their pledge to double the number of apprenticeships by the end of 2012, there are now over 4,700 in the sector. The industry is really leading the way both for growth and delivering for wider society. The Graduate Excellence Scheme is exactly the sort of thing we need. It will encourage young people into this exciting, innovative industry. They will be rewarded with a fulfilling career. My sincere congratulations to all the companies who have pledged their support.

    The Food Supply Chain Skills Action Plan will help us to continue to deliver on improving the perception and image of the food and drink sector. I would like to pay tribute to Sir Jim Paice the previous Agriculture Minister for the excellent work he did on creating this plan. I discussed the issues of improving skills and improving the image of the sector when I met with the FDF Executive Committee in October this year.

    This plan is important because, as the FDF is clearly already aware, improving skills is fundamental to sustainable growth of the sector and of the economy.

    As well as investing in the future of the industry through research and skills, the Government is evening out the balance of power in the supply chain to ensure that everyone gets a fair deal for their hard work.

    We are introducing a Groceries Code Adjudicator to make sure that direct suppliers to major retailers are treated fairly. This will also mean that consumers get a good deal; they shouldn’t lose out because of unfair contractual practices. I would like to thank the FDF for their support on this initiative.

    We are continuing to support the UK dairy industry through the Code of Practice. The Code means that in future, contracts between farmers and dairy processors will be freely negotiated, fairer and more transparent.  Yesterday we made another great step forward for dairy farmers with the Dairy Package that David Heath launched on the Isle of Wight.

    We can all do our bit to help the industry. We have a £1.2 billion trade deficit in dairy products. Each year we bring in 115,000 tonnes of ice cream – more than double the 50,000 we send abroad. 150,000 tonnes of yoghurt – six times the 25,000 we export. We have a dessert deficit. If we all reached for dairy products with made in the UK on the label, we could make a massive difference.

    Increasing exports is widely seen as one of the largest opportunities for growth in the UK food and drink sector. Look at the recent deal with Russia. There’s a market just opened up worth potentially £80 million over the next three years exporting beef and lamb.

    There have been seven consecutive years of record growth in exports in the food and drink sector. This demonstrates the opportunity for exports in this sector to have an even greater impact on the UK economy.

    That’s why I am focusing so much of my energy on getting exports moving. I’ve already mentioned the trade fair in Shanghai where there was the largest ever delegation of food and drink companies to China. I also went to a highly successful reception promoting our new agreement to sell beef on the bone to Hong Kong.

    British food is becoming increasingly popular abroad thanks to its excellent reputation. We have high quality ingredients and raw materials. We have rigorous food production standards. We have totally reliable traceability. This is what the research for the FDF’s Vision for Growth showed. The research also showed that branding and new product development were particularly good.

    We’re continuing to work on this through our action plan “Driving Exports Growth in the Farming, Food and Drink Sectors”. We aim to open markets and remove trade barriers, encourage SMEs to explore overseas opportunities and build a business mindset about exporting as a key route to growth.

    If you have any problems with technical or regulatory issues please come to us. In China we found that the UKTI can offer practical advice on the ground. I want to get the message out; we are here to help.

    As well as looking at what we’re doing in the UK, we also need to look at the wider conditions we are working in.

    In the European Union with the other Member States I‘m pushing the Commission hard on CAP reform. I have a clear end point that I’d like European agriculture to arrive at although we might not get there this time. Decisions on which food to produce should be left to the market, so farmers alone decide which crops to grow and animals to raise. Tax payers’ money should be used to support the environment through our excellent agri-environment schemes, so that farmers and landowners are compensated for the public goods they provide and for which there is no market mechanism.

    I am seriously worried that some countries are looking to reverse the long-term destination set out in the MacSharry and Fischler reforms. These countries want us to continue to subsidise food production with public money. For instance the EU has agreed that sugar quotas should end in 2015. At the Agriculture Council in November I made it clear that sugar quotas need to go. The price of sugar is 35% higher than it needs to be; it adds an unnecessary 1% on to the weekly shopping basket. This is ridiculous when China imported £1.2billion worth of raw and refined sugar in 2011, more than double what it was the year before. We should be able to export our sugar to them.

    Growth is not enough on its own. As well as finding ways for the sector to continue to expand we also need to improve the environment.

    We are already making progress, since 2006 food waste has been reduced by 13% but the UK still threw away 15 million tonnes of food and drink waste in 2011. That’s £500 worth of edible food the average family chucks out each year.  As well as household waste we should think about industry by-products that have other uses, for example agricultural waste in Anaerobic Digestion plants.

    I welcome the FDF’s leadership in developing the Five-Fold Environmental Ambition. It has targets for five areas of environmental sustainability: achieving an absolute reduction in emissions by 2020, sending zero food and packaging waste to landfill by 2015, reducing the carbon impact of packaging, reducing water use, and embedding environmental standards in transport.

    I also congratulate the FDF on taking part in voluntary agreements, such as the Federation House Commitment for water saving. I thank the FDF for continuing to drive the sustainability agenda forward. Through the efforts of the members of the FDF sustainable behaviours are now the norm for the sector. This is an excellent achievement.

    My colleague Jeremy Hunt in the Department of Health has asked me to thank the FDF for its commitment to the Public Health Responsibility Deal Food Network. The FDF has done much this year to enable people to eat more healthily and we need to keep building on this success.

    I am delighted to be the Secretary of State working with the industry at such an exciting time. I am looking forward to continuing to work closely with you all.

    I want to thank all of you for the contribution you are making to increasing growth while improving the environment. Next year the FDF celebrate their centenary, they should rightly celebrate 100 years of championing the industry and supporting innovation.

    I wish you a very Merry Christmas and a most successful New Year.

  • David Laws – 2014 Speech on Free Infant School Meals

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    Below is the text of the speech made by David Laws, the then Schools Minister, in Birmingham on 11 July 2014.

    Thank you for inviting me to speak at your conference today.

    I am delighted to be here and to be able to thank you in person for all your hard work which you do and also – crucially this year – for the massive and successful effort which many of you are putting in to deliver the government’s policy of universal free infant school meals from this September.

    I was reading recently about a research study into school food in the north of England.

    In the study, around 40 children from 2 schools were provided with state-funded breakfast and lunch. The study reported how the meals improved the pupils’ behaviour.

    What was the date of this study? It was not 2007, or even 1997. It was from 1907.

    History of free school meals

    In the mid-19th century, charities such as the Destitute Children’s Dinner Society raised money to provide meals for poor children.

    Manchester provided meals for its poor and badly nourished children in 1879.

    A similar scheme ran in Bradford, where the local school board argued that if the state were to take charge of educating pupils during the day it should take charge of feeding them as well.

    These pioneers were taking a huge risk.

    Incredibly, they were breaking the law in those days by providing these meals and could have been forced to stop.

    Yet they understood clearly that, without a healthy meal, children would be less able to concentrate and succeed in school.

    Pupils weren’t slow to realise their potential and take them up.

    One of the first dinner ladies, Miss Cuff, reported that while on day one 13 children declined her oatmeal porridge, the next day this dropped to just 2 and from the third onwards her cuisine was eaten and enjoyed by all.

    At first, the arguments that there should be national provision of free school meals fell on deaf ears.

    To the Westminster establishment the idea seemed too radical, too expensive, too difficult and questionable in ideological terms.

    Then, as now, there will always be people who find excuses to resist change.

    But, gradually, people began to listen.

    Recruitment of young men for the Boer War of 1899 to 1902 highlighted the under-nourishment of many of our children, and there was a new focus on the importance of healthy eating.

    In 1906, we saw the passing of the 1906 Education (Provision of Meals) Act.

    This gave local authorities the green light to spend public money on school food – and crucially – money from the treasury in order to do so.

    The trail-blazers of 1906 lit a torch that would be taken up by people like Jamie Oliver, the School Food Plan team and many in this room a hundred years later.

    Take up of free and paid for meals increased dramatically during the Second World War – from just 3% at its outset, to over 30% at its conclusion.

    Come 1946, the day of our now much loved ‘dinner lady’ dawned: popularity of school meals had grown so much that paid assistants were introduced to supervise children as they ate their lunch.

    And in June 1949, the number of school dinners reached nearly 3 million, over half of the total school population.

    Take up reached a high water mark in 1974, when 70% of pupils ate school meals.

    But one thing is clear: since that peak in the 1970s, the number of children receiving school meals has been in steady decline.

    In the 1980s, the then government cut back on free school meal entitlement, and removed some of the standards designed to ensure healthy meals.

    Take up of meals, and the quality of much food, went into steep decline – with a fall in the proportion of children taking school meals from roughly 7 in 10 to just 4 in 10.

    That has been bad for attainment in schools. It has been bad for children’s health and concentration. It has undermined the socialisation which comes from children sitting down together each day and eating together.

    And the removal of free meals has been an extra pressure on family budgets which has particularly hit low income families who take the initiative to get into work, but who then find that they lose their entitlement to free meals which can be worth almost £1,500 per year for a family with 3 children.

    Free school meals are sometimes regarded as an aspiration and idea from the political left.

    But I regard this as a common sense policy for the mainstream majority.

    I happen to have the old-fashioned view that given that these children are the responsibility of the school and the state for around 7 hours a day, the least we can do is ensure that they eat healthily.

    Many of our minds are now on this September, when infants will have a new entitlement to a healthy meal at school.

    This policy is the latest milestone in the long history of school meals.

    And it is one of the most important.

    It is the biggest expansion of free school meals in over 65 years.

    1.5 million additional pupils will become entitled to a free meal.

    Now every step forward in the last 100 years has had its critics.

    But remember that the work you do has a proud and long-standing heritage. You are part of a progressive movement that has always had one overriding priority: to improve school food.

    The School Food Plan

    It should come as no surprise that there is strong public feeling about school meals.

    Whether we enjoyed them or not, they are a nostalgic part of British life.

    Every parent wants their child to be able to eat healthily.

    The nutritional quality of school meals has rightly been at the centre of recent debate. Demand for healthier, more nutritious, school meals has come from parents, schools, school cooks, caterers, academics and celebrity chefs.

    Successive governments have responded by working with schools and their caterers to improve the standards of school meals, ensuring that they contain more healthy foods, such as fruit and vegetables, and less unhealthy foods, such as fat, salt, and sugar.

    But it is the work that all of you do that turns these standards into a reality.

    The quality of school meals has continued to improve, thanks to the hard work of school cooks, caterers, teachers, parents and nutritionists, and we can now look back on turkey twizzlers as an unfortunate blip in the proud history of school meals.

    But it was clear to me, and I am sure to many of you, that more needed to done.

    That is why the coalition government commissioned John Vincent and Henry Dimbleby to undertake an independent review of school food, to look at how school food was being provided across the country.

    I am hugely grateful to John, Henry, Myles and all those who contributed to the review.

    The review confirmed that many schools now do a brilliant job of producing healthy, tasty, school meals and promoting the value of healthy eating.

    But the review also found that there is still work to be done. There is still too much food with little or no nutritional value, low take-up of school meals and too many children eating packed lunches.

    Many parents mistakenly imagine that a packed lunch is the healthiest option.

    In fact, the evidence is that fewer than 1% of packed lunches meet the school food standards.

    So, almost exactly 1 year ago to this day, the results of the School Food Plan were published and John Vincent came to this very stage to tell you what he and Henry had learnt, and what the government had committed to do next.

    The plan contained both actions for government and for the school food sector. Like John and Henry, once we knew what needed to be done, we wanted to get straight on with improving the quality and increasing the take-up of school food.

    Those of you here yesterday heard from Myles Bremner about the fantastic achievements in just 1 year. For example:

    • the new cooking and nutrition curriculum for all pupils up to the age of 14, which becomes statutory at the start of next term
    • new training materials, which focus on school food, in the headteacher training curriculum
    • work with Magic Breakfast to set up self-sufficient breakfast clubs in schools
    • significant work beginning to increase the take-up of good school food

    And importantly, we have developed clearer, easier to implement, school food standards, which we published on 17 June, alongside practical and down-to-earth guidance for schools and their caterers. These regulations will become statutory in January 2015.

    Universal free school meals

    The plan also recommended that the government should offer free school meals for all children in primary schools.

    This was a big and radical idea; but it wasn’t a new one.

    Durham and Newham and other parts of the country had already piloted universal free school meals.

    The results were clear.

    Good, healthy school food, combined with universal provision, had a positive effect on all pupils, but particularly on those from the most disadvantaged backgrounds.

    Universal provision increased take-up among the disadvantaged who are eligible for meals, but don’t always take them up.

    They removed the stigma of ‘being a free meals kid’.

    They meant that the 1 in 4 children from working families, but who nevertheless live in poverty, got a meal for the first time.

    When I visited a school recently in south London, I was moved when the headteacher told me about 1 parent who currently just misses out on free school meals, because she is in a low income job, being in tears after being told of the new entitlement, because of the positive impact it would have on her family’s budget.

    Some people in the media seem to think our country is made up of very poor people on benefits who are the only ones needing financial help, and then the so called ‘middle classes’, who they view as all earning £100,000 or more each year.

    But most people aren’t very poor or very rich. They are getting by. On £15,000, or £20,000, or £25,000. As a teacher in that London school said to me last week, ‘If you are a parent in London on £18,000 with 3 children, you don’t feel rich.’

    This policy will make a huge difference to family budgets in these hard times. And do not worry about whether we are wasting money on families who can afford the meals – we are not paying for free meals in Eton, Westminster or Rugby private schools.

    The pilots also showed that when universal free school meals were implemented, children were less likely to eat crisps and unhealthy packed lunches during the school day, and more likely to eat healthy food instead.

    And, most importantly, there was a positive impact on children’s levels of literacy and numeracy.

    Crucially, the pilots showed that to achieve the benefits of the policy it has to be a universal offer – to all children.

    The pilots in which entitlement was only extended modestly to low income working families did not see the attainment and other benefits which we want to secure.

    So this is a universal entitlement which we’re introducing not just because it’s popular with parents, though it most certainly is, but because the evidence shows that this is the right thing to do – the only way to secure the improved outcomes we want to see.

    There are some who are against this policy as a point of principle. They don’t think it is the job of government to make sure all children get a healthy lunch.

    Like those who blocked the first moves to provide healthy meals to school children 100 years ago, they argue it is too expensive; too radical; too difficult.

    Government does not share that position.

    We cannot allow some siren voices to undermine a policy that will save ordinary parents money and improve children’s education and health.

    Left to their own devices, those who want to undermine this policy would take us back in time, unwinding over 100 years of progress on school food.

    Government will not allow that to happen.

    And that is why it is so important that we work together to make this policy a stunning success in September.

    If we get this right, no one will be able to take it away – because it will be so popular with parents that no politician would dare.

    That is the prize we are all working for.

    Delivery

    I do not underestimate the challenges this poses to some schools – which will have been passed on to you and I’m especially grateful to LACA and the School Food Trust for the support they have given.

    But I am determined and confident that we can work together to overcome them in some schools.

    In the pilot areas, schools, catering providers and local authorities demonstrated that it is possible to deliver this policy of good quality hot meals in schools in the timescale we have allowed.

    For some schools, the transition will present few challenges.

    But I do understand that for others the challenge is much greater.

    Every infant and primary school should by now have a plan in place to deliver universal free school meals to all of their infant pupils from September.

    And the government is providing the necessary financial support. We have allocated over £1 billion of revenue funding to this policy over the next 2 years.

    We have allocated £150 million of capital this year, specifically to help schools improve their kitchen and dining facilities. And for small schools, which I know can face particular challenges, we are making an additional £22.5 million available this year.

    We will keep the availability of that small schools funding for future years under review to establish if we need continuation in the future.

    In addition, we are funding a support service run by school food experts – including, of course, LACA and their main partner organisation, the Children’s Food Trust. That support service is doing a brilliant job in supporting school and caterers to find local solutions to their own individual problems, and I am enormously grateful to everyone involved for their hard work. Thank you to the whole, fantastic, team.

    It is clear to me that schools are doing a truly brilliant job in preparing for this milestone.

    I simply do not share the pessimistic view of some that headteachers do not have the ability to deliver on bold, ambitious challenges, with the support of many of you in this room.

    Through local authorities and the support service I just mentioned, I have been tracking the progress schools towards meeting this important commitment.

    And I can announce today that based on evidence from local authorities, schools and the support service, over 99% of schools now have a plan in place to deliver universal free school meals in September.

    We are aware of fewer than 100 schools which still need further work to devise a delivery strategy, and the department and the support service are now working through, school by school, to offer support and ensure all schools are on track to deliver at the start of term.

    This is a tribute to the phenomenal efforts of everyone in this room and headteachers, school catering teams, local authorities and governors up and down the country.

    Of course, this does not mean everything will be perfect on day 1.

    As has been reported, some schools will provide a cold meal initially, until capital works are complete.

    In the medium term we expect all schools to be giving a hot food option – which is what is really necessary to meet the school food standards consistently.

    And of course many schools will be bringing in meals from outside caterers, rather than cooking them on site – as we all know they do now.

    Many of these meals are excellent, and some schools will want to continue this approach.

    But let me be clear that I know many schools are raising their sights and want to bring back the on-site kitchens which were lost in the 1980s and 1990s in many parts of the country.

    Some have already done this with our £150 million capital injection.

    Others will want to do so in the future, after they have seen the increase in take up.

    I commit today to looking very closely, after September, at what the government can do to support schools further in creating the right facilities and school environment to maximise the quality of food and the experience of eating it.

    It would be unrealistic to think that in just 1 year we could rebuild the entire school estate, and reverse decades of neglect in some areas.

    But we will commit to support this policy over time.

    And I was not willing to allow the search for perfection to get in the way of delivering a step change in healthy eating which is needed right now.

    And to the remaining very small number of schools who do not yet have a plan in place for September: my message is to work with your caterers and with the support service to ensure successful delivery.

    They can give you practical help, and show you how other schools have risen to the challenge.

    We will do everything in our power to help you deliver for your children.

    Take Cheam Fields School in Sutton for instance. Following the announcement of September’s roll-out, the school stated publicly that they would not be able to implement the policy.

    But after working closely with the support service, they now have a plan in place and are on track to deliver free meals to all their infant pupils from September.

    In fact, I visited them last week and not only do they have a new pod kitchen, but the children have also composed a free school meal song!

    I am excited that where many thought it impossible, there is a way of making this happen – and it is you in this room making it possible.

    Cheam Fields School proves that, by working together, we are not only capable of changing systems, but also cultures and mindsets.

    I realise that many of you are still on the journey Cheam Fields has made, and you are grappling with the challenge of delivering this policy.

    I have seen first hand that organising school catering is not unlike a small military operation.

    But I have also seen how much difference you – the unsung heroes of our children’s nutrition and education – can make.

    You are doing an outstanding job. And the numbers prove it.

    Of course there will be challenges along the way and the support service is continuing to provide support and guidance in the lead up to and over the summer holiday. In fact, the support service will continue to be available until the end of 2015, to help schools as they move forwards on that journey towards delivering a really excellent, sustainable school meals service.

    But thanks to you, we are on track to defeat the sceptics who said we’d never do this; who argued that this shouldn’t be a priority.

    I am enormously grateful to all of you in this room for all your hard work to make a reality of this exciting policy.

    And I am grateful too to headteachers and their teams up and down the country, who are working tirelessly to make a success of universal infant free school meals at the same time as introducing other important reforms, such as a new national curriculum and assessment arrangements.

    So it is a real privilege to be able today to speak to LACA members who are the cornerstone of this and to thank you for the work you have done and are continuing to do as we head to September.

    This policy is going to be a success, thanks to your work.

    It is going to be one of the landmark social achievements of this coalition government – good for attainment, good for health, great for British food, and good for hard working families.

    Ignore the critics who want to snipe from the sidelines.

    Together we are going to deliver something of which all of us will be very proud and which will make our country a better place for children to grow up in.

  • David Laws – 2014 Speech on Grammar Schools

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    Below is the text of the speech made by David Laws, the then Schools Minister, at Broadway House, Toothill Street, London on 19 June 2014.

    It is a great pleasure to be here today and have the chance to say a few words on social mobility.

    I would like to set out how government and grammar schools can work together to help every child succeed, whatever their background.

    We may not see eye to eye on every point.

    But I do think, between the Department for Education and grammar schools, we share a common goal in wanting to raise expectations, standards and access, so that regardless of a child’s background we offer them the best possible chance to fulfil their potential, in yours and other good and outstanding schools.

    It is shameful that, in this country, the best way to predict a child’s exam results is to look at their family income and social background.

    Breaking this stubborn attainment gap between richer and poorer pupils is my party’s key objective in the Department for Education. It is what drives me as a minister – it is behind the pupil premium – and it is at the heart of this coalition government’s education policy.

    I know that it drives many of you too – and may well be what brought you into teaching in the first place.

    The grammar school sector has a long and distinguished history and has been part of the English education system since the Middle Ages. Many of you can trace your school’s history back to the 16th and 17th century, if not earlier.

    The political argument of the 1970s, as to whether selective schools should continue in the state sector, resulted in a significant decline in grammar schools. Today just 5% of schools are grammars, compared to a peak of 38% just after the Second World War.

    Since the 1980s the number of grammar schools has remained fairly constant at around 164.

    No political party now proposes to change this. The debate about grammar schools seems to have been put in the political deep freeze – with no plans either to increase or reduce the number of what are extremely popular schools in their localities.

    I am not here to revive arguments about the relative merits of grammar schools and comprehensive schools.

    I am here because I accept that grammar schools are a significant feature of the landscape in many local areas, and as Schools Minister I want us to be able to work together openly and constructively on social mobility and other areas

    Grammar schools are often excellent schools. I accept them as an established fact of our education system and want to consider what greater role they can play in breaking the cycles of disadvantage and closing the opportunity gap.

    I want to work with you, not preach at you, and help you to do what many of you are seeking to do already.

    In doing so, I want to challenge you to improve the social mix of your schools, while accepting that the government and the non-selective primary sector also has a big responsibility in this area too. You cannot do this alone.

    Original purpose of grammar schools

    Many grammar schools were originally established to be engines of social change. Grammar schools were often established by charitable trusts or individual benefactors whose ambitions were to provide for the education of all local children, not just the privileged who could pay for it.

    You will be aware of many schools established in the 16th and 17th centuries to help poorer children. Harvey’s Grammar School in Folkestone, for example, was established in 1674 for “20 poor boys of Folkestone”. The Blue Coat School in Liverpool was founded in 1708, and the founders described the school as “a school for teaching poor children to read, write and cast accounts”.

    Before we look forward today, I therefore ask you to pause and look back.

    How far do you meet those proud aspirations?

    Are you, as some would have it, “stuffed full of middle-class kids”?

    Or are you opening up opportunities to all bright children regardless of their background, or can you do more?

    Why is entry to grammar schools so often maligned?

    In my first month as Schools Minister, back in 2012, I was sitting at my desk in the DfE one day when a pile of answers to parliamentary questions was put before me to approve.

    One of them that caught my eye asked how many disadvantaged children attend each English grammar school.

    I knew the figures were bad. But as I read down the list of schools I was shocked, genuinely shocked, to see how few children from poor backgrounds are going to your schools.

    In some schools the number of pupil premium or free school meal eligible pupils is actually single digit numbers.

    You cannot be proud of that and you and us at the Department for Education should want to do something about this.

    Critics often point to a culture of intensive coaching that can put off those with the potential but not the means to pay, and this could be one reason for the low levels of pupils from disadvantaged backgrounds in grammar schools.

    Proportionately, grammar schools have the lowest levels of FSM admissions in England.

    Last year, 21 grammar schools had fewer than 1% of pupils eligible for free school meals.

    Ninety-eight grammar schools had fewer than 3% of pupils eligible for free school meals, and nearly all grammar schools (161) had fewer than 10% of pupils eligible for free school meals.

    That is compared to a national average of 16.3% across all secondary schools in England.

    Too often the proportion of disadvantaged children entering grammar schools is out of step with their catchment areas. For example, in Buckinghamshire in 2011, 14% of the year 7 cohort across the county were eligible for the pupil premium. But only 4% of those admitted by grammar schools were eligible for the pupil premium.

    In Lincolnshire, it was 21% across the county, compared to just 7% in grammar schools.

    I accept of course that this discrepancy is not just confined to the selective sector.

    Many top-performing, non-selective schools also fail to attract a fair proportion of pupils eligible for free school meals.

    Two-thirds have a percentage of FSM pupils that is 5 percentage points or more below the local area average.

    So in the same way I’m challenging you and working with you, I will also be looking at those schools to do what we can do to help pupils from disadvantaged backgrounds.

    What can government do?

    I recognise that these headline figures hide a more complex underlying picture.

    I asked analysts in my department to undertake a more substantial piece of work to dig deeper into the data, so we could really understand why so few bright but poor children end up in grammar schools.

    This work presented an interesting picture.

    It showed that a key barrier is the low level of free school meal pupils achieving level 5, typically a proxy for pupils you admit. So this is not just a challenge for grammar schools, but for the whole education system.

    In other words this is not just something that can be blamed on grammar schools. I totally accept that.

    But I simply cannot and will not accept a system that fails poorer children in this way.

    My promise to you, alongside my challenge to you, is that this government will do everything in its power to make sure that more children from poorer backgrounds achieve their full potential.

    We have introduced the pupil premium – £2.5 billion this year alone – targeted at those pupils who need extra help.

    This money is supporting primary schools, feeder schools in all your areas, to boost the attainment of disadvantaged pupils.

    We have made it easier to identify high-achieving pupils from low income families by asking primary schools to monitor the academic progress of disadvantaged pupils in key stage 2 increasingly closely, with better data available through the RAISEonline system.

    We are introducing free school meals for all infants, which in pilots raised attainment in English and maths, particularly for disadvantaged children.

    And we have made the early years a top priority – extending free early education for all and giving 2-year-olds from lower income homes a free early years education for the first time ever.

    Next year we are extending the pupil premium to disadvantaged early years children, while raising the primary pupil premium, skewing the budget to the age range that makes the most difference.

    Finally, but crucially, we will not accept persistent weak performance and leadership in any school.

    Schools in poor catchment areas often underperformed in the past, often for many years.

    Now both the DfE and Ofsted will act swiftly to intervene in failing schools, so that they have the leadership and governance which they need.

    Taken together, and over time, I believe that these crucial policies will start to shift the dial for poorer children – so that more and more reach level 5. There are already signs that the attainment gap is narrowing, particularly at key stage 2.

    What can grammar schools do?

    But what about those disadvantaged children who are academically able and do already achieve level 5?

    In wholly selective areas fewer than half of pupils eligible for FSM achieving level 5 go into selective schools, compared with two-thirds of non-FSMpupils.

    This cannot be right.

    We calculated it would require a shift of just 200 level 5 FSM pupils to go into grammar schools in wholly selective areas to remove this particular bias – the failure to recruit pupils who should already be able to access your schools based on their attainment.

    I was surprised that the number was so small, and actually so achievable.

    Sadly, this speaks volumes of the work we need to do to secure better results in primary schools.

    Your first, incredibly modest, job is to get these children into your schools. Over a decade, that would still be 2,000 more able pupils accessing some of the best schools in the country.

    But, I think we would all acknowledge that aiming so modestly is not a satisfactory or inspiring ambition, and something neither you nor I are keen to do.

    I want us to aim much higher than that.

    My ambition is that all selective schools should aim for the same proportion of children on free school meals in their schools as in their local area.

    This would mean an additional 3,500 free school meal pupils in selective schools every year, or an additional 35,000 pupils over 10 years.

    There are likely to be many barriers in the way of this ambition and it is not something we can achieve overnight.

    The problems range from parents not applying; pupils not revealing their full potential in the tests; local primary schools not considering your school as an option.

    This presents a challenge to you and to us. I want us to be ambitious, I want to challenge the preconceptions about grammar schools and I want the sector to be able to show that it is responding to this challenge.

    So we’ve talked about setting a longer-term ambition, but what can we do in the short term? This is something I have thought about a lot and forms part of the programme of work we have been doing jointly with the GSHA.

    I am encouraged to see grammar schools leading the way in using the pupil premium as part of their admissions arrangements. This was a freedom set out in the 2012 Admissions Code and I am pleased to be able to say that 32 grammar schools have implemented an admissions priority for pupils eligible for free school meals this year.

    This is a remarkable step and reflects a laudable commitment to putting the rhetoric around social inclusion into practical action.

    In this area of pupil premium priority, your sector has been the leader.

    I would like to thank the GSHA for working with us to support this move and encourage you all to think about whether this is something you could consider at your school.

    We would like to see every grammar school adopt this approach.

    There has been controversy recently about whether introducing a pupil premium admissions priority means you will automatically face an objection from the Office of the Schools Adjudicator.

    Let me be clear. Anyone can object to the OSA, and you may face complaints.

    There are people who will always resist change.

    But as long as you have properly consulted on the changes and worked with the Education Funding Agency to make sure that the technical details in your funding agreement reflect this – then there is no case for schools to answer. The Admissions Code permits academies and free schools to give priority to pupils eligible for the pupil premium. And the recent determinations on this are clear on that point – these schools are lawfully permitted to prioritise pupil premium pupils.

    We in the Department for Education will fully support any school that chooses to change its admissions criteria in this way – in fact, I want to see all grammar schools give preference to pupil premium pupils over the next few years.

    But has the battle been lost before pupils even get to the point of admission? In some areas, a cottage industry has grown up offering coaching for entry to selective schools. Many children who have been “hot-housed” through coaching for grammar school entrance tests then struggle when they arrive because they have not acquired those independent learning skills that are crucial to further and higher education and the job market.

    We all recognise that parents are passionate about getting their child in to a school that they think will best suit their child.

    I don’t blame any individual parent or family for doing everything they can to help their individual child to get ahead. Doing your best for your child is a natural human instinct and one which we should commend and not criticise.

    But these kind of coaching schemes put another barrier in the way of those children whose parents are unable or unwilling to pay for the additional coaching.

    The GSHA is against coaching, not just because of access issues but because it can be a negative educational experience and the pressures this creates on children can outweigh any gains. So I really welcome the association’s work to encourage a move to entry tests that are less susceptible to coaching, and I am heartened to hear that at least 40% of grammar schools are now moving to the introduction of coaching resistant tests.

    Again, I hope that all grammar schools will soon do so, and it will be interesting to see the impact of this.

    The GSHA will be working with us, the Sutton Trust and the University of Durham to explore ways in which access to grammar schools by highly able deprived children might be improved by looking more closely at the testing process and what may be limiting the engagement of pupils with it.

    I welcome that commitment.

    Lastly, and probably most importantly, is the outreach work you do with your local primary schools and parents.

    We can do what we can to raise attainment, make entrance tests more accessible and to give some priority in admissions – but unless parents and pupils see your school as suitable for them, then our efforts are wasted.

    How many of you are partnered with your local primary schools, how many are engaging to identify those high-performing pupils who are not currently accessing your provision?

    Best practice/call to action

    Well, I know some schools are doing great work.

    Pates Grammar School in Gloucestershire has held awareness events in local schools for pupils, staff and parents, and many of the rest of you will be doing this.

    High-performing local pupils have been invited into the school, to knock down the local perception that this is a school for ‘rich kids’. The school is increasingly seen as an aspiration for local families.

    There is also great work taking place in the 5 Edward VI grammar schools in Birmingham.

    These schools are working towards obtaining an intake of 20% from disadvantaged families.

    They have introduced coaching resistant tests and are building close links with primaries to engage in a test familiarisation project. We at the Department for Education want to see more clusters of grammar schools engaging in projects like these and reaching out to the local community.

    I want all schools to build on the progress that is being made and seek to close the gap by increasing parental engagement, and stronger working with local primaries – with a focus on identifying potential.

    In conclusion

    In conclusion I want to place on record my gratitude to those grammar school headteachers that have already initiated real changes.

    I know that you are deeply committed to educational excellence and seeing disadvantaged children attend your schools, and flourish in them.

    And I want to thank the GSHA for their engagement and work.

    But we are starting from a very low base.

    And it is no surprise that grammar schools are today often struggling to make their case for a big role in English education when one of the biggest claims once made, about social mobility, looks so hollow on the basis of the figures we are all aware of and which I cited early on.

    We all recognise grammar schools need to return to their original mission and great aspiration of being engines of social mobility.

    If you can do this then instead of being treated as a small corner of the educational debate, you will be entitled to make your case with confidence and persuasiveness.

    For our part, government will leave no stone unturned in our mission to raise attainment, for all children, in primary schools.

    We do not expect you to change the world by yourselves.

    None of us in this room can be complacent in our goal.

    We have begun the journey, but there is a long way to go.

    Let us be ambitious about what we can achieve together, and continue with that joint commitment and determination to make the difference for all children.

  • David Laws – 2013 Speech to Teaching Leaders Graduation Ceremony

    davidlaws

    Below is the text of the speech made by David Laws, the Education Minister, to the Teaching Leaders Graduation Ceremony.

    I am delighted to be here tonight to celebrate the achievement of the fourth graduating cohort of middle leaders from the Teaching Leaders Fellows Programme.

    And thank you all for the hard work you are doing in your schools to improve the standards of education available to the children who are most in need of additional help. Your dedication to getting the most for your pupils is inspiring.

    The importance of high-quality leadership in schools cannot be overstated.

    Analysis of Ofsted inspection reports by McKinsey has shown that the overall performance of a school rarely exceeds the quality of its leadership and management.

    For every 100 schools that have good leadership and management, 93 will have good standards of pupil achievement. For every 100 schools that do not have good leadership and management, only one will have good standards of pupil achievement.

    The support of great leadership and management helps all teachers to improve the quality of their teaching. And recruiting and training high-quality teachers for leadership positions amplifies their impact.

    One great leader can build a team of great leaders. A team of great leaders can build a school of great teachers. And a school of great teachers can support thousands of children to achieve to their full potential.

    It has long been held that having an outstanding headteacher can make a significant difference to the performance of a whole school. But it is not headteachers alone that make this difference. We need strong leaders at all levels within a school, working together as a team.

    Middle leaders are able to take a direct role in improving teaching and learning. First and foremost they can act as models of great teaching. But they can also contribute to improving standards by helping other teachers to develop and by challenging under-performance. And they are at the forefront of developing curricula, and establishing systems to track and improve pupil progress.

    Senior leaders benefit from distributing leadership to a strong group of middle-leaders because it frees up their time to focus on whole school improvement. Schools are stronger with great middle leaders because they are less reliant on a small group of senior leaders, and therefore more resilient to changes in the senior leadership team.

    And by identifying and developing outstanding middle leaders today, we are able to help ensure that we will have a sufficient supply of outstanding headteachers in the future.

    We need great school leaders because the challenges are great. Around 40% of young people still fail to secure 5 GCSEs at grade C and above, including English and maths, rising to above 60% when we look only at children from poorer families. These figures remain completely unacceptable for an advanced society such as England. We cannot accept these levels of educational failure, and there is nothing inevitable about this.

    Excellent practice does of course already exist, and some schools are closing the gap between poorer children and their better off peers. But the attainment of pupils who are eligible for free school meals varies greatly between schools in different regions. There are too few secondary schools outside London where large numbers of pupils from poorer backgrounds are matching the attainment of their peers.

    A recent report from Ofsted found that attainment at GCSE varies across the regions of England by 23 percentage points for pupils eligible for free school meals. But attainment varies by only 6 percentage points for pupils who are not eligible for free school meals.

    In 2012, there were only 97 secondary schools in England with over 14% of pupils eligible for free school meals where these pupils attained above the national average at GCSE. Sixty-four of these 97 schools were in London. Well done London. But we have to be concerned that there were none in the South West or South East of England.

    So schools with a strong record of attainment amongst all of their pupils are heavily concentrated in London. The weakest performing schools are spread across the country, and often in smaller towns rather than large urban areas.

    And the greatest challenge is that within schools the quality of teaching varies too much. The Sutton Trust estimate that having a very effective rather than an average teacher raises each pupil’s attainment by a third of a GCSE grade.

    This is both a striking finding and a great opportunity. It makes clear the consequences for individual children of ending up in the wrong class at school. But it also gives us a clear indication of what we need to do.

    The quality of teaching is absolutely critical. And middle leaders like you can make improvements across a department so that all of the pupils benefit from the same high standards of teaching.

    We look to you to help us meet these challenges. Teaching Leaders identifies and develops middle leaders to improve teaching in the most challenging schools, and for the pupils who will benefit most from it.

    In 5 years, Teaching Leaders has grown from a pilot of 25 middle leaders to over 776 fellows in 365 schools. The vast majority of alumni stay in education. Of those from the 2011 cohort staying in education in the UK:

    – 97% are still working in challenging schools

    – 56% have been promoted within challenging schools

    – 25% have been promoted to the senior leadership team

    You and your cohort are improving teaching for around 15,000 pupils in 81 schools. The pupils for whom you are responsible are making more progress and achieving better GCSE results than the national average. And this is especially impressive given they come from groups that are too often expected to fail.

    These pupils are being helped by outstanding teaching leaders such as Shamim Hussain. Shamim is Head of Maths at Lilian Baylis Technology School in Lambeth, where 76% of pupils are eligible for free school meals.

    He has introduced systems to monitor and support teachers in the maths department. This has led to the majority of the team being rated ‘outstanding’ by Ofsted, and the rest as ‘good’. Shamim also introduced systems to track student progress against challenging targets, giving pupils a clear picture of the learning gaps that they needed to address. Seventy-nine per cent of Shamim’s pupils made 3 or more levels of progress, significantly higher than the national average.

    Jackie Bowen started the Teaching Leaders programme as Head of English and is now Assistant Vice Principal for Achievement at Cedar Mount Academy in Gorton, Manchester. Jackie worked with her team to move each member of staff up at least one Ofsted grade. Having been judged ‘inadequate’ when she arrived, 80% of Jackie’s team now secure ‘good’ or better in lesson observations.

    Jackie’s work has helped achieve big increases in the proportion of pupils making expected progress and the proportion achieving a grade from A* to C. And this has been a success for pupils of all backgrounds. Amongst Jackie’s pupils there was no gap between the attainment of those eligible for the pupil premium and the rest of the cohort. If ever you needed proof that the gap between the achievement of poorer and better off pupils is not inevitable, Jackie has provided it.

    This demonstrates what can be achieved. But we want to do more, especially in those areas that have not benefitted from the programme so far.

    So I am pleased to announce that the Department for Education is investing an additional £9.9 million in Teaching Leaders from 2014 to 2016.

    This funding will more than double the number of Teaching Leaders fellows and alumni from 776 to 1,706. This means over 900 new fellows, working with 3,000 classroom teachers, to improve teaching for 150,000 pupils.

    And as well as creating more fellows we want to expand their reach. We want Teaching Leaders to work with schools outside of the urban areas that already benefit from the programme. This will include schools in the East Midlands, Humberside, West Yorkshire, the North East and Merseyside.

    The new fellows in these areas will benefit from the same intensive programme that you all received. They will receive face-to-face coaching, and there will also be local evening training and more geographically-focused networks, providing opportunities to share with other middle leaders from their area.

    But, of course, we must continue to improve the impact of the programme. Teaching Leaders has already found ways to enable more middle leaders to benefit from the programme within the funding that is available. Getting more from the money we spend is essential given the financial constraints that we face. I would like to thank you for this achievement.

    My challenge to Teaching Leaders, and to you, is that whilst the programme grows in terms of the numbers of pupils it benefits, it also continues to grow in terms of the impact it has.

    I want you to be at the heart of a self-improving school system:

    – by working within and alongside teaching schools to recruit and train the next generation of outstanding teachers

    – by growing the evidence base in education and leading on the development of evidence-based practice in schools

    – and by using effectively the new freedoms that we are making available to schools

    We look to you to provide the proof that by putting the teaching profession in charge of school improvement we can ensure that all children have the opportunity to succeed.

    Thank you for everything you have achieved and will achieve. I wish all of you the very best for your future careers.

  • David Laws – 2012 Speech to the LGA Education Conference

    davidlaws

    Below is the text of the speech made by the Education Minister, David Laws, to the 2012 LGA Education Conference on 4th December 2012.

    First of all, thank you for inviting me to speak to you today.

    Local Government has a massive and crucial role to play in delivering education.

    It does now. It will in the future.

    I want us to stay closely in touch, for two reasons.

    Firstly, because I want to hear from you about any problems or issues at “ground level”, so that we can deal with these together.

    Secondly, because we need to work together if we are to secure the best outcomes for young people in this country. The Department isn’t able to deliver our ambitions without your support and participation.

    The Department’s communication routes with the Local Government sector are changing, as some of you know.

    But I want to ensure that our contact is just as productive, indeed more productive, than in the past.

    That will include a new, small, and focused “reference group” which will meet with me on what I envisage being a quarterly or bi-monthly basis.

    And the Secretary of State and other Ministers will also of course engage regularly and through their own mechanisms.

    I have been asked to speak today on the subject of “Raising Ambition; Achieving Potential.”

    Whether intentionally or not, this choice of subject has a double meaning for me.

    Firstly, because it is obvious that we need to work together to raise our ambitions about what young people, including from the most disadvantaged backgrounds, can achieve in their education.

    We need to ensure that every young person can meet his or her potential.

    We know that this is not presently the case.

    Until recently, only 40 per cent of children secured good grades at GCSE. It is now 60 per cent. Improvements are always good news. But moving from a 40 per cent to 60 per cent system remains completely unacceptable.

    We now need to move to a system in which 80 or 90 per cent of children can reach their potential. That includes stretching the most able.

    But the key element of this must involve closing the appalling gap between the outcomes for disadvantaged children and the rest.

    It is intolerable that in this country life chances are being so determined by social circumstances rather than innate ability and commitment.

    Local authorities in inner London have helped transform the opportunities of disadvantaged young people over the last decade.

    That is great. But it also highlights how badly we are failing these same young people in other parts of the country.

    Young people only get one real chance to get their education right. That is why school improvement must be all about what both Martin Luther King and Michael Gove refer to as “the fierce urgency of now.” That is why Government Ministers are intolerant of failure and impatient for dramatic change.

    Local Government must not only be our partners in delivering these changes.

    You must be Leaders and innovators.

    Local Government is so used to being dictated to by successive central governments that there is a risk that, at best, we just turn you into a delivery arm of central government.

    But this risk is much, much, greater if you simply wait for us to dictate to you.

    My message is this: identify the impediments to success in your area; work to demolish them; tell us what we can do to help. Bang on OUR doors. Do not wait for us to bang on yours.

    In that sense the title of this speech is not just about children.

    I want Local Government to have a greater ambition for its own role in improving educational outcomes. And I want all of Local Government to achieve its potential, not just a few flagship councils.

    Local authorities have a key strategic oversight role in education. It is local authorities which have the legal responsibility to ensure that there is a school place for every child in their area. This is an important role, particularly in areas with rising pupil numbers.

    Local authorities not only have to ensure provision, but they are vital in making the school admissions process work. It is local authorities which help deliver fair access for all.

    There are many other strategic areas where local authorities are and will remain important. Take school transport, for example. It may not be glamorous, but those school buses are of critical importance for many pupils.

    Local authorities can and must do much more than fulfilling their statutory duties.

    Critically, they can and must support schools, challenge schools, and – where necessary – intervene in schools.

    The Chief Inspector of Schools, Sir Michael Wilshaw, made it clear in his most recent report that more children than ever before are in good schools. That is fantastic news.

    He has been clear that there are areas of the country where almost all schools are excellent or good. That, too, is fantastic news.

    But progress and performance are not uniform across the country. Sir Michael has been equally clear that there are areas of the country where only a minority of schools are good enough. That is both tragic and unacceptable.

    According to Ofsted, two million school children are in schools that are not good enough. No-one should be willing to accept that.

    This, surely, is the biggest challenge of all.

    And if local authorities want to retain their important role in schools then they must act when schools in their areas need to improve.

    Too often in the past local authorities have failed to act to deal with failure or mediocrity.

    Too many local authorities have felt that it is their job to champion “their” schools, regardless of whether these schools are delivering for their children.

    But your job is to be champions for parents and pupils, not apologists for performance which isn’t good enough.

    For sure, more schools are now Academies than ever before. And for sure, the relationship between local authorities and schools is different when a school becomes an academy. But the overwhelming majority of schools are still part of the local authority family of schools.

    These schools need your support and, sometimes, your challenge.

    Ofsted, as you know, is now raising the bar on inspections.

    “Satisfactory” is no longer good enough. It now “requires improvement”.

    Bluntly, there is no way my Department has the capacity to intervene in the number of schools which may now need intervention and support.

    That is why you are so important.

    If you did not exist, you would need to be invented.

    And you do not need re-inventing as Schools Commissioners or some regional arm of my Department.

    You just need to deliver.

    You all need to do what the best councils are now doing.

    I do not want to use this speech to single out those who are at the bottom of Sir Michael’s local authority list.

    You all know who they are. Rather I want to concentrate on those at the top, places like Camden, Sefton and Trafford. I want to challenge those places to work with other local authorities who need assistance.

    And I want you all to learn from the most successful local authorities.

    Local authorities are stronger when they work together and can achieve more when they co-operate. Learning from each other is a necessity, and not a choice, if schools are to improve, and if local authorities are to remain an important part of the school system.

    There are many ways for local authorities to intervene.

    They can offer school support directly. They can encourage schools to form self-improvement clusters. They can find suitable sponsors for underachieving schools.

    There is not one single option for delivering change.

    But nor should there be an option for tolerating failure and mediocrity.

    The Secretary of State, Michael Gove, has recently written to some local authorities highlighting problems in school performance in their area. Those letters have provoked strong reactions. Some people have welcomed them, and described them as fair. I admit that such comments have largely been private, but I assure you that they have been made.

    Others have been upset, or even angry to receive them. Two groups have made representations along those lines. The first do not believe that Ministers should write such letters. I disagree. It is perfectly proper for the Secretary of State for Education to write to local authorities about the standards of education in their area.

    The second group of people protested because they felt that the particular letter that they received was not a fair letter. Where that is the case, you should indeed tell us. Just as it is fair for us to write to you, so it is fair for you to reply. We will take your letters seriously – just as we expect you to take our letters seriously.

    But in the interests of the children of this country, we need to set aside bruised egos and get on with working to ensure that the laggards come up to the standards now being delivered by the best. And quickly. Because each child has just one chance.

    Ofsted will continue to shine a strong light on local authority performance in this area. And I will fully support them as they do this. Sir Michael Wilshaw has rightly said that he will hold Academy chains to account as well. This is not about picking on local authorities. It is about tackling failure – wherever it is occurring.

    That leads to me on my next theme: the relationship between national and local government.

    I want to highlight three legitimate expectations that you can have of us.

    We should offer you the financial support that you need, we should be fair, and we should trust you, while ensuring that you are held properly to account.

    Let me start with financial support. The Coalition Government took the decision at the start of the parliament to ring-fence the schools budget.

    That spending is, therefore, protected come what may.

    Not only that, but we also created the pupil premium that will deliver around £6bn of funding for children from poorer backgrounds over this parliament. That money can and must have life changing effects for those children.

    But let me say this: all Ministers in my Department are aware of the basic need pressures in many parts of the country.

    We know that there is a rise in the number of children, and we know that there are implications for school capital requirements.

    We are also aware that schools need maintaining – that is why we are looking at the quality of the school estate at the moment.

    We have fought hard to make sure that Treasury understands all these needs just as well as we do.

    The Government has a responsibility to treat you fairly.

    The Department has recently concluded its consultation on the future of LACSEG. Clearly reform is needed, and we are striving to be fair to maintained schools, Academies and Free Schools.

    We are listening carefully to what you have to say.

    We are also working hard on a national funding formula for schools.

    The current system is hard to defend, and that is why we are working on a new approach.

    But equally we know that we cannot move quickly from the current system to a new formula, for any new formula will create both losers and winners.

    It is fair that we move to a national formula, but equally it is fair that we move carefully, and protect the losers. As you know, we already have a minimum funding guarantee in place at the moment, and we will want to build on this approach as we move to a national formula.

    Fairness has many attributes, and financial fairness is only one of them. The Department also needs to be fair in the way that it treats different types of school.

    Make no mistake, as I said earlier, we will hold all schools to account, whether they are maintained, Academies or Free Schools.

    There are challenges ahead, for both of us.

    There are delivery challenges in providing the relevant number of places for two-year-olds, and ensuring that they are of good quality. Those challenges are particularly intense in the second year of delivery, when 40 per cent of children will be eligible for a place.

    There are challenges ahead in terms of raising the participation age. We have a duty to fund places for every person who takes them up, whether they want to stay at school, go to college, or take up an apprenticeship. We will fulfil that duty.

    You, in turn, have a legal duty to ensure that people of relevant age are in full time education or training. We expect you to fulfil that duty.

    Already the best local authorities in the country have impressive programmes in place. They identify young people at most risk of becoming NEET, and develop programmes to engage them. They work with schools, colleges and children’s services, with a particular focus on the most vulnerable. This includes referring those who are eligible to the new Youth Contract.

    In such areas the number of young people who are NEET is very low. That is what we should all want to see, and again, local authorities should work with central government and learn from each other.

    In other areas of the country there are still far too many young people who are not engaged in education or training. It is essential that the lower performing areas learn from the best and close this gap.

    Let me conclude.

    The relationship between local authorities and national government has not always been a good one. I regret that. Of course there will be points of tension, and points of disagreement. I understand that.

    But equally, I believe strongly that we can and must create a new working relationship.

    This new deal will be based on honesty, fairness, trust and accountability. And above all it will be based on both sides working together towards a common goal. That goal, of course, is to raise ambitions and achieve the potential for each and every child in our country.

    To do that we need to raise the ambitions in Local Government and ensure that the potential of Local Government is realised in every part of our country.

    Thank you.

  • Andrew Lansley – 2012 Speech on Smoking and Health

    andrewlansley

    Below is the text of a speech made by the then Secretary of State for Health, Andrew Lansley, on the subject of ‘Smoking on Health’.

    I’m very glad to be here today.  I’m grateful to the RCP for your work and this opportunity.

    Smoking remains one the biggest public health challenges. And it has been for a long time.

    Historical context

    When the NHS started in 1948, 82% of men smoked.

    Fourteen years later, in 1962, there was the RCP’s ‘Smoking and Health’ report. It set out an agenda for controlling tobacco that doctors and governments followed for decades to come.

    So in 1965, after calls from the RCP, all TV adverts for cigarettes were banned.

    In 1984, smoking was banned on tube trains, and banned on stations a year later.

    In 1995, Virgin and United Airlines banned smoking on transatlantic flights.

    Then of course, there was the smoke free legislation of 2007 which I was Conservative health spokesperson at the time.

    I said it should be a free vote for MPs. By making sure it was a free vote in our Party, we pushed Labour to give a free vote to their MPs too – knowing that this would mean a full ban, not the partial one the Government had sought.

    It turned out to be one of the most successful pieces of legislation any of us can remember. MPs voted for it, not because we were told to by the whips, but because we believed in it, because the evidence was there and because we knew we had a chance to reduce the cases of respiratory diseases and cancer, and also to reduce the number of heart attacks caused by secondhand smoke..

    And now, I think our health reforms have the potential to be the next step on that path.

    By devolving more power to doctors, nurses and health professionals, more influence will be given to those who know the harms of smoking, and are determined to reduce it.

    Health professionals know their communities, they know their patients. They know the areas, they know the shops, they know the temptations, they know the pressures. And because they know all this, they also know something else – they know how best to get people to stop.

    Our plans, for the first time, will place a legal duty on the NHS to reduce health inequalities. And when you think how smoking disproportionately harms people in the poorest areas, you begin to realise the opportunity these reforms create.  To focus resources and attention on what is a deadly habit and such a significant source of inequalities.

    We’re not going to tell health professionals how to do their jobs. But I do want to see clinical commissioning groups working with local groups and their local authorities specifically to deal with problems like smoking.

    And I do expect to see Health and Wellbeing Boards and leadership of Directors of Public Health backing them up, guiding priorities and providing advice and research, with a particular focus on public health issues like smoking.

    This is a huge opportunity. And it’s one we have to grasp.

    Because despite the medical consensus, the shift in public opinion and even progressive legislation, people still smoke.

    And overall, smokers appear to be less motivated to quit than they were a few years ago. A survey by the Office of National Statistics in 2009 showed that only 63% of smokers wanted to stop altogether, compared to 72% at the turn of the millennium.

    So we need to up our action.  As Healthy Lives, Healthy People set out, successful public health campaigns rely on cumulative interventions over time.  A constant push for positive change.

    And that is what we will do. With central government, NHS and local government all helping people make healthier choices.

    Tobacco cannot now be sold from vending machines inEngland.  That removed, at a stroke, a source of cigarettes that underage smokers could access as often as they liked.

    It was estimated that inEngland, about 35 million cigarettes were being sold to people under age of 18 every year. That is why vending machines had to go.

    It’s not window dressing, or fiddling around the edges. That’s a real development that will stop people, particularly young people, from smoking.  We went to court to fight the tobacco companies that didn’t want the laws, and we won.

    And the tobacco industry was defeated on tobacco displays too. We were gearing up for another court case but they dropped their action just a few days before Christmas.  So in a month’s time, tobacco displays in supermarkets will end. And displays in other shops will end in 2015.

    Of course we have some of the highest priced tobacco inEuropeand we will carry on with a high tax policy.  In the last budget, the Chancellor significantly increased the tax on rolling of tobacco.

    And of course, we’re helping those who want to quit.

    Since January, over a quarter of a million Quit Kits have been distributed.

    Our local stop smoking services are amongst the best in the world.  It’s a fact that smokers trying to quit do better if they use them.

    We will continue to work with clinicians, so every time a smoker sees a doctor, nurse or any other member of the NHS they should be encouraged to kick the habit. Making every contact count.  At the moment, clinicians in some parts of the country are already doing this, I want to see it adopted throughtout the NHS .

    And the Tobacco Control Plan, published just a year ago, set out our strategy for comprehensive tobacco control.

    It set out how tobacco control will be delivered as part of the new public health system. How decisions will be taken locally to target the particular problems that particular communities have. We know very well that smoking rates  do vary dramatically between communities.

    And we will try especially hard to help two particular groups.

    Firstly, we want to dramatically cut the number of pregnant women who smoke. Reducing rates of smoking at time of delivery from 14% to 11% by the end of 2015.

    Secondly, children. Smoking is an addiction largely acquired by young people, so if we can make progress in this group then people’s health will benefit through their entire lives.

    We have already reduced smoking rates among 15 year olds from 15% to 12%, four years ahead of schedule.

    But we’re not going to let up. We can and will do more to stop young people taking up smoking in the first place.

    So for example, we’re putting the finishing touches now to the consultation to come on tobacco packaging, which will be published soon.

    We are the first country inEuropeto be giving that idea serious consideration, and that’s something I think we can be very proud of.

    Obviously it’s only a consultation at the moment, so nothing’s set in stone. But that also means it’s a great opportunity to shape policy from here on in.

    When it comes out, I want to see responses from everyone with an interest. From tobacco control experts, shop owners, to smokers to ex smokers, and even the manufacturers themselves.  But make no mistake – everyone who responds will be asked upfront about any links they have with the tobacco industry.

    We will listen to the arguments and opinions people have, and we will not taking any options off the table just yet. It will be a real opportunity to make sure your opinion is heard.

    So I do encourage everyone, when the consultation opens, to get involved.

    Smokefree homes and family cars

    Another thing we’ll be doing from the centre is running a marketing campaign about the dangers of secondhand smoke, to encourage people to take action voluntarily to protect the health of their families, particularly children.

    This is one of the areas that we can all agree needs further action.

    When the smokefree legislation came in, people used to make spurious arguments about how it would affect the atmosphere in jazz clubs, as if everyone had a better time if there was a pall of smoke clogging up the trombones.

    Funnily enough, those same people didn’t mention the cars full of smoke that children have no option but to breathe. Or in their front rooms. Or the kitchens. Or anywhere children can be forced to inhale someone else’s smoke. That’s the reality of secondhand smoke, and it’s why smokefree environments are so important.

    Even though more people are making their own homes smokefree, as the college’s 2010 report described, far too many children are still exposed to secondhand smoke.  We have to change that. We have to encourage as many smokers as possible not to expose their families to their smoke.

    And in the next year, that will be one of the things our television-led campaigns will focus upon.

    Harm reduction

    We’ll also be looking at the best ways to reduce the damage that tobacco does to smokers’ bodies, even if they can’t or won’t break their addiction to nicotine.

    As you know, although nicotine is an addictive substance in cigarettes, the damage  mostly comes from the inhalation of the smoke itself.

    Anything we can do to reduce that damage is well worth doing, even if some smokers can’t kick the nicotine.

    NICEis drawing up guidance on how that might happen.

    And the MHRA has supported using nicotine patches, gum, inhalators and lozenges as alternatives to smoking, making it safer for the smoker themselves but also reducing secondhand smoke.

    We are also encouraging manufacturers to come up with new types of nicotine replacement products that are cheaper, more socially acceptable and easy to get hold of and use.

    That last point I think is an important one. For nicotine replacement treatments to be really effective, the safest forms of nicotine should also be the most straightforward to buy in the first place.

    In that respect I would especially like to recognise the leadership of Professor John Britton, the Chair of the RCP’s Tobacco Advisory Group and co-chair of the UK Centre for Tobacco Control Studies, for his leadership in this and other fields.

    International reputation

    It’s helping cement our reputation as a world leader on stopping tobacco use.

    In 2010, theUKwas ranked as having the most effective tobacco control policies across the 30 European counties that were surveyed.

    And we are recognised as leading the world in helping people to quit smoking as well.

    According to this month’s issue of Tobacco Control, we are at the top of the international league table when it comes to the WHO’s MPOWER approach to tobacco control – one of only four countries in the world to get score of four out of five.

    I’m also very proud that we’re active members of the Framework Convention on Tobacco Control.

    We have made a big contribution, including supporting the development of guidelines on secondhand smoke, tobacco ingredients, packaging and labelling, and we led the development of guidelines on smoking cessation.

    Those guidelines will help governments across the world improve their own tobacco control strategies.

    And both at home and internationally, we will continue to act against the vested and commercial interests of the tobacco industry.

    As Secretary of State for Health, I haven’t met with those companies. Not now or when I was in Opposition as the Conservative’s health spokesman.  Their interests are not my interests.  My objective is to achieve smoke-free communities; theirs is to make a profit from selling intrinsically harmful products.  We don’t have common ground.  This is not like alcohol, where there is a level of responsible drinking and potential shared campaigns between Government and retailers.  That’s why there is no place in the Responsibility Deal for tobacco companies.  There is no responsible level of tobacco consumption.

    Conclusion

    So let me conclude, the foundations for our current ambition for reducing smoking were laid 50 years ago with the RCP’s report.

    After that, with cause and effect laid out so clearly, the tide of public and political opinion shifted dramatically.

    So while celebrating the 50th anniversary of that report, we should also celebrate what’s happened since then, both inside and outside the RCP and look to the future.

    Government, healthcare professionals, health charities, academics, employers and individuals themselves have all contributed to 50 years of progress.

    Sometimes it’s been frustrating and slow, sometimes we’ve made real progress quickly. But if I compare the number of smokers I see when I’m walking down the street today, compared to when I first started off onWhitehallas a Civil Servant in the 1970s, the shift has been dramatic.   We do not have the lowest levels of smoking in the world, but we have come a long way and I am ambitious that we can go further and faster.

    Promoting good health; preventing ill-health, reducing health inequalities.  All of these will be the result of the implementation of our Tobacco Control Plan and with your leadership here at the RCP and the opportunities given by the new Public Health service, to improve health, to reduce health inequalities, to support Healthy Lives and Healthy People.  That will be our objective.

  • Andrew Lansley – 2012 Speech to the World Health Association

    andrewlansley

    Below is the text of a speech made by the then Secretary of State for Health, Andrew Lansley, to the World Health Association on 21st May 2012.

    I am delighted to be here today to talk on the vital topic of universal health care.

    Universal healthcare has been at the heart of the National Health Service in the United Kingdom for over 60 years. And it will remain so. Universal access to a comprehensive health service – free, based on need, is part of our social solidarity and an essential basis for improving the population’s health.

    When we came into government two years ago we made two very clear commitments. Firstly that we would increase the budget of our National Health Service in real terms, and secondly that we would increase our spending on development to meet our historic 0.7% commitment. I am proud of our performance on both of those commitments.

    Across the Globe, each year, tens of millions of poor people fall ill and die due to diseases and conditions that are preventable and treatable. Out-of-pocket costs stop many of these people getting the help they need. The solution is efficient and effective healthcare that does not exclude or impoverish the poor. Governments have a duty to manage this.

    In July, the UK government and the Bill and Melinda Gates Foundation, with the United Nations Population Fund, and others, will host an international family planning summit in London. The aim is to launch a global movement to give 120 million extra women in the world’s poorest countries access to contraceptive information, services and supplies by 2020. I am sure many of your governments will wish to participate. And I am extremely pleased that our Director General will be playing a key role in the event.

    Back home our investment in the National Health Service is strengthening our universal primary care infrastructure. We are focused on developing preventative services, on early interventions and minimising unnecessary hospitalisation. We are reforming the National Health Service to empower clinical leaders to deliver outcomes for patients which are amongst the best in the world.  We are giving more autonomy to healthcare providers; but we are making them increasingly accountable for the results they achieve.

    We are reforming our public health system, to ensure we are able to tackle the social determinants of health. Nationally and locally, improving the health of the population is a government-wide responsibility. We are recognising and acting on the effects which employment, education, housing and the environment have on health outcomes.

    Our approach to tackling public health issues, is to maximise our impact at key moments in people’s lives, for example through support in maternity and the early years of children. We are also focused on the major risk factors such as obesity, tobacco, drugs, alcohol and sexual health. We will be strong and effective in tobacco control. With food, drink and retail industries we are forming a partnership, based on a shared understanding that public health is everyone’s business and that by co-operation we can achieve more progress, more quickly, towards an environment which enables consumers to lead a healthier lifestyle.

    We have a busy week ahead of us. Our agenda here underlines the importance of the WHO being the best it can be. We need the WHO to facilitate the sharing of ideas and strategies for member states to build strong universal healthcare systems. We need continued action to tackle emerging and continuing public health threats. When these things happen, we must be ready to act collectively.

    The reform of WHO, supporting these objectives, will enable us to make more progress in improving the health of all our peoples.  A strong WHO, ready to face these challenges in the 21st Century is vital.  It is in all our interests to ensure the reforms of WHO are advanced this week.

  • Andrew Lansley – 2011 Speech to King's Fund Leadership Conference

    andrewlansley

    Below is the text of the speech made by the Secretary of State for Health, Andrew Lansley, to the King’s Fund Leadership Conference on 18th May 2011.

    Thank you Kate [Lobley, Director of Leadership, The King’s Fund].

    As the Prime Minister set out so clearly this week, the NHS faces some significant long-term challenges. An ageing and increasing population, increasing burden of chronic disease, rising costs of drugs and treatments, and growing, almost insatiable public expectations.

    If we choose to ignore these pressures, if we stick with the status quo, then in the years ahead the NHS will face a genuine crisis. One that would threaten the core values of a comprehensive health service, available to all, free at the point of use and based on need.

    This government will not allow that to happen.

    But given the financial context, how to ensure the NHS is not only sustainable in the long term, but that it gets better? That it gives the people of this country healthcare that is consistently among the very best in the world?

    I think the answer is straight-forward.

    You put the right people in charge.

    You make it crystal clear what it is they are trying to achieve and how they will be held to account.

    And you then do everything in your power to support them in what they are doing.

    Where they need extra powers or resources, as far as you can, you supply them. Where there are obstacles, you remove them.

    That is what happens every day in successful organisations around the world. And it is what I want to happen in the Health Service too.

    Leadership

    Today is about leadership in the NHS. About what good leadership can do for patients and about how we can support and nurture current and future leaders within the Health Service.

    Note that I say ‘leaders’ – not leader. For leadership in the Health Service cannot be about one person at the very top. The leadership style of Henry V on St Crispin’s day – the man on horseback- as dramatic and inspiring as it is, just isn’t appropriate for something as vast, as complex or as subtle as the NHS.

    The Health Service needs far more than that. It needs leaders at every level, in every institution and in every profession.

    And the people that I believe, first and foremost, should be leading the NHS are clinicians. GPs, hospital doctors, nurses, pharmacists, allied health professionals, scientists.

    We need people in every area to step up to the plate and lead.

    No profession can be left out if we are to deliver truly integrated, high quality healthcare for everyone in the country.

    Managers

    And when I say that, I include managers. But leadership and management are not the same. Some managers are leaders in the service now, like David Nicholson. Others will be leaders in the future – but not just because they rise up the managerial ladder. Management is one of the professional disciplines inside the NHS, but it is a support to clinical leadership, not a substitute for it.

    Just so there is no confusion, I know that high quality managers are essential to the effective and efficient running of the NHS.

    No fundamental change in any NHS organisation ever came about without the support of managers – people who are every bit as committed to the health service and to improving patient care as clinicians.

    The problem is not the people, it’s the system. Managers are placed in an impossible position.

    Too often in the Health Service, change is seen as a process whereby managers tell clinicians what to do. But why is this the case? It’s because people like me in government are constantly ordering them to do it.

    So you end up with a top-down, command-and-control system with the Health Secretary driven more by that day’s headlines than the best interests of patients.

    He then gets his officials to come up with some ploy that he can sell to the press, tells all NHS managers to carry it out and then claim to be saving the day.

    Managers are then left to force it through on the ground – whatever the clinicians might think and whatever the consequences down the line for patients.

    So you get new initiatives with exciting names. Policies that sound great, but amount to little more than hot air.

    The result? Emasculated and frustrated clinicians, overstretched managers caught in the middle and patient care that is at the political whim of whoever happens to have won the previous election.

    And over the years, the accumulated weight of countless…

    – initiatives to implement,

    – targets to meet,

    – reports to produce

    – and boxes to tick…

    …means that the NHS isn’t managed. It’s bureaucratised.

    Managers are no more free to run their organisations than clinicians are. Over these last seven years, it was as often managers who told me to get rid of the top-down culture as it was nurses or doctors.

    And while those who work in the Health Service add “frustration” to their job descriptions from day one, it’s patients who lose out on the potential benefits of a truly clinically-led Health Service.

    It’s been like this for decades. It cannot continue for another. It’s time that politicians and managers handed the controls over to the people who really understand the needs of patients and how to serve them best – to clinicians.

    King’s Fund report

    Today, the King’s Fund’s Commission on Leadership and Management in the NHS has published its report.

    I very much welcome the report. It speaks to the same ambition that I have for the NHS. For a Service led from the front. An integrated NHS that is focussed on improving clinical outcomes and nothing else. A Service that is well managed, not overly administered.

    I understand the caution around the size of reduction to the management and administration budgets. But most of these will come from the abolition of Primary Care Trusts and Strategic Health Authorities.

    Across the public services, similar reductions in administrative costs are required. In the NHS, we can see how we can achieve this by changing the shape and burden of administration, not just the numbers of administrators – not keeping the system the same and asking fewer people to run it, but reducing the scale of administration alongside the cost.

    By handing power to clinicians and by ending the constant micro-management and over-burdensome performance management of the NHS, much of this work will no longer be needed.

    Where I fully agree with the report is in the vital importance of high quality leaders and managers. The gains made in recent years must be maintained and built upon. Every NHS organisation and provider must take their staff development role incredibly seriously, especially new entrants from the charity and independent sectors.

    I’m keen to continue the excellent work of the National Leadership Council. Just last week, I announced that we would fund a further 60 Fellows as part of the Council’s Fellowship programme, developing tomorrow’s leaders from all parts of the Health Service,.

    Every one of whom will make their own individual mark on their local NHS, and collectively make a real and lasting difference to the level of leadership within Health Service as a whole.

    The King’s Fund report says that the NHS needs a national focus on leadership and would welcome a national leadership development centre.

    I am now considering the idea of a national centre. I know there are some interesting and novel schemes already running. For example, the innovative programme at UCLH, which has drawn on models of leadership from the armed services. We’ll respond to this and the other recommendations once the listening exercise has closed.

    Outcomes

    I said at the beginning that if you want to achieve success in an organisation you first have to put the right people in charge. But that’s not all. You then need to be clear about what they are trying to achieve and show them how you will hold them to account for that.

    So let me ask you a simple question. What’s the NHS for? We all know when we see it: supporting childbirth; promoting good health; treating illness and injury and promoting recovery; care for those with chronic illness; care when dying.

    But if this is what the NHS is for, why have we never measured in a systematic way how well it’s achieving these aims? Of course, these things are not always easy. But they are worth the effort.

    What is the gain if you treat people in a shorter period of time if the quality of the care and the quality of the outcomes were to be poor? Too often we measure the success of the Health Service by the number of units it processes, not by how well it improves people’s lives.

    So from now on, I want all parts of the NHS to be judged on the clinical outcomes they achieve. We published the Outcomes Framework in December to help all clinicians to pull in the same direction.

    – Reducing avoidable mortality;

    – enhancing recovery after treatment;

    – improving the quality of life for people with chronic conditions;

    – maximising safety and cutting the number of infections;

    – and continually improving patients’ experience of their own healthcare.

    To flesh out the detail, NICE is developing a library of condition specific Quality Standards. These will mean that, over time, every clinician – and every patient – will be able to see just what excellent care really means and judge whether they are receiving it. These aren’t targets by another name. They state what should be achieved, not how clinicians should achieve them.

    As General Patton once said, “Don’t tell people how to do things, tell them what to do and let them surprise you with their results.”

    And because all providers of NHS care will be aiming for the same high quality outcomes, I, the NHS Commissioning Board, General Practice Consortia, local authorities and, most importantly, patients themselves will be able to hold providers to account for delivering that excellent care.

    Integration

    And more often than not, delivering excellent care will mean delivering integrated care.

    But unfortunately, the NHS is not particularly good at integration. What it is good at is episodic care.

    If you’re young and relatively healthy but fall ill with a specific disease, or have a particular injury, the Health Service is excellent at taking you in, making you better and sending you on your way.

    The problem with this is that the vast majority of the people the NHS looks after don’t fit that description. Most of today’s patients are older and with one, or often more than one, long-term condition.

    So you have the typical example of an older person with terminal cancer, having to rely on her daughter to coordinate care between her GP, community nurses, hospitals and social care because they can’t quite seem to join up the dots by themselves.

    And what about the many who don’t have someone to fight their corner? What happens to them?

    The needs of patients are too often not catered for by the strengths of the Service. The result is that, far too often, care today in the NHS is fragmented.

    A patient with COPD might be treated by her GP, by a pulmonary specialist, and by a community nursing team.

    – Three separate groups of people to contact,

    – three separate sets of forms to fill in,

    – and three separate notes to keep track of.

    All this with the patient in the middle, often the one who has to try and coordinate their own care between them.

    Or look at end of life care. At the end of their life, most people want to die in their own home. But the fact is that most people actually die in hospital.

    This isn’t because of the high level of intensive, hospital based care they need.

    It’s not because the people who work in the NHS don’t want to provide the very best care to their patients.

    It’s simply because the system isn’t set up to provide the quality of out-of-hospital care needed to help patients die at home.

    – The system of tariffs doesn’t encourage hospitals to do it.

    – The people with the money, the PCTs, often aren’t aligned properly with clinicians.

    – It’s hard for the voluntary sector – organisations that can add so much at the end of a person’s life – to offer their services.

    – Patient experience and outcomes aren’t measured.

    And all too often, health and social care organisations just don’t join up.

    But there are examples where people have joined together to beat the system. Since 2004, the Marie Curie Cancer Care’s ‘Delivering Choice Programme’ has taken a whole system approach to end-of-life care. Working across all those involved – the NHS, the voluntary sector, social services and carers – to provide 24-hour, patient centred care for those at the end of their lives.

    The evaluation of the first scheme in Lincolnshire, carried out by the King’s Fund, found that deaths at home rose from 19% to 42%, while deaths in hospital fell from over 60% to just 45%. All the while being cost neutral.

    Another important opportunity for joined-up services is in urgent care. Services are too often fragmented, varying in quality across the country and often confuse patients into using inappropriate services – like going to A&E rather than seeing their GP.

    But by adopting new technologies to encourage greater self-care, by introducing the ‘111’ telephone number as a single point of contact for non-emergency care and by giving local commissioners the freedoms they need, we can change this.

    We can deliver a properly integrated urgent care system that turns the NHS into a 24/7 service, and makes phrases like “out of hours” feel redundant.

    Care needs to be organised not around the needs of a particular provider, but around the needs of the individual patient.

    To have good care, care needs to be integrated.

    Choice and competition

    Another thing that is essential for achieving excellence is involving the patient in their own care. This means more than just explaining things to people. It’s bringing them into the decision making process. It’s giving patients a choice.

    Now patients already have a degree of choice. They can choose the hospital that will carry out an elective procedure. Or at least they could if they were able to distinguish to any meaningful degree the quality of care offered by one hospital from another. But whether you’re going in to have an in-growing toe nail removed or for radical cancer treatment, if you don’t know how good a particular provider is, how can you – or your GP – decide which to choose?

    And even if you look at the current overall hospital ratings, they won’t tell you how good their clinical outcomes are at the one thing that you’re most interested in – at the procedure you’re about to have.

    So while patients today theoretically have a choice. In reality, it’s hardly a choice at all.

    So is it any wonder that although almost all GPs maintain that they always offer their patients a choice, according to research by the by Anna Dixon here at the King’s Fund, less than half [49%] of them recall being offered one?

    We need to offer choice where appropriate; but even more so we can make the framework for choice more robust. If you could see not only how good a hospital was, but how good a specific department or even a specific consultant-led team was, wouldn’t that change things dramatically?

    That is when GPs and other clinicians can really draw a patient in to the decision making process. For with the right sort of information, choice becomes meaningful.

    And patients will choose the care that offers the best results for them.

    Last month the National Cancer Intelligence Network published, for the first time, mortality rates 30 days following surgery for bowel cancer. Across the country, the figure was 5.8%. Not bad, perhaps. But that national figure masked huge variation. From just 1.7% to 15.6%.

    Now this doesn’t automatically mean that care at one place is necessarily better or worse than elsewhere. As you know, there will be all sorts of factors at play. But it does give clinical teams pause for thought. To ask the question, is there more that we can do? To look at those with the best performance and see if there are things that they are doing that we are not.

    Making this information available to the public will also have an impact. Patients, with their doctor, will be able to make a more informed choice as to by whom they wish to be treated. And given the choice between one hospital with a very high survival rate and another with a lower one, which would you choose?

    Integration through competition

    Now choice, real choice, means that providers will be sometimes, in effect, competing for patients. They do now. Strengthening information and accountability will encourage all providers, however good they may be, to raise their game and to offer patients the best possible care.

    No provider, whether from the NHS, charity or independent sector will be competing on price. As we extend tariffs prices will either be fixed for all providers nationally or locally by commissioners. The only way to distinguish yourself as a healthcare provider is to provide a higher quality service than everyone else.

    But at this point, some people start to question whether competition isn’t utterly at odds with that other essential ingredient I’ve mentioned – proper integration of healthcare.

    I would like to explain not only why this is not the case, but why competition can actually lead to a far greater degree of integration than would ever be the case without it. And to do that I hope you will forgive me if we leave the realm of healthcare for a moment.

    We live in a complex world where we take for granted the minor miracles of integration that we see and experience every day. Integration that is so seamless that we don’t even notice it.

    Let me take just one example. I bet virtually everyone here today has a phone in their pocket or handbag. Some of you will have more than one. It might be a basic model where you can make calls and send texts and that’s about it. Or it might be one of the latest smart phones that can do just about everything bar the washing up.

    Either way, you are enjoying the fruits of countless individual companies operating in a wide range of individual, highly competitive markets, all working together to deliver that one complex, ubiquitous product.

    Mining companies, designers, chip manufacturers, haulage companies, marketing agencies, precision engineers, logistics companies, data management, network providers, warehouses and, finally, the place that sold you the finished product.

    Each one competing fiercely for business at every step of the way. Each one successful in large part because of the high degree of integration they can offer with the other parts of that supply chain.

    When organisations compete but don’t offer to integrate their services, the result is clear… they don’t get the business.

    It is in the interests of every provider to offer the greatest possible degree of integration. Even with those they are competing directly against. Vodafone and T-Mobile both rely on common standards. Whether you have a Nokia, an iPhone or a Samsung, the same SIM card will work in all three.

    The same can be true of healthcare. Only here we don’t call it a supply chain, we call it a care pathway.

    Of course, the NHS isn’t a mobile phone. It’s infinitely more important than that. If things go wrong on your phone, you can’t make a call. If things go wrong in the Health Service, people’s lives are at stake.

    Modernisation isn’t about competition. It’s about improving results for patients. It’s about building quality services for patients. It’s about extending information and choice. It’s about competition as a means to an end, not an end in itself. And it means ensuring that the service is patient-centred, not provider-centred.

    I know the clinicians in charge of commissioning will demand nothing less.

    Because it will be an essential element of every contract within the NHS.

    Because they will be rewarded by the outcomes they deliver and they will be better if they are deeply integrated within the wider pathway of care.

    So a hospital that doesn’t go out of its way to integrate its general surgery with community nursing teams and with local GPs will quickly run into problems.

    The community dialysis provider that does not link up with specialist community nursing, with hospital renal specialists or with social care organisations will find it very difficult to convince commissioners to pay for their services.

    And if nothing else, if they don’t prioritise integration, their competitors certainly will.

    And in those circumstances where the best care is be provided by commissioning a single provider across the whole pathway, that’s allowed too. The Bill doesn’t prevent that. It will support that. This is about doing whatever it takes to produce the best outcomes for patients.

    Listening

    If we agree that the whole point of the NHS is to provide the very best outcomes for patients, then I believe we must have a fully integrated NHS that is clinically led and that gives patients a real choice.

    I am very clear that this is what we must achieve, but I am also very open to views and ideas as to how we achieve it. To my mind, nothing is more important than getting this right. The law of unforseen consequences can play no part in NHS modernisation.

    That’s why we have paused after the Health and Social Care Bill has left committee to listen and reflect on what people are saying and to see if there are things we can do – substantive things – that will mean that our ambition is matched by the reality on the ground.

    The Bill is necessary not to give more power to the centre, but to give it away to clinicians. You cannot have a clinically led system without the legislation necessary to give them that lead. And if you want the NHS to be truly run from the bottom-up then you do at some point need the people at the top to let go the direct reins of power. That is what the Health and Social Care Bill is about.

    Conclusion

    I don’t want the future of the NHS to be determined by me or any other politician. I want it to be determined by the millions of choices made by millions of individual patients and by the healthcare professionals responsible for their care.

    By local NHS and social care organisations working with local authorities and patient groups to bring cohesion and integration to local patient services.

    And by the many thousands of clinical leaders in GP surgeries, hospitals, cooperatives and independent sector providers all across the country.

    The government will put the right people – clinicians – in charge. We will make it clear what they need to do and how they will be held to account. And we can do everything possible to support them in this difficult role.

    This is our vision for the NHS. A vision of an NHS led from the bottom-up. A vision that puts patient care above news headlines.

    A vision that I believe in and that I fully expect to deliver outcomes that are consistently among the very best in the world.

  • Andrew Lansley – 2011 Speech on Hospices

    andrewlansley

    Below is the text of the speech by Andrew Lansley, the then Health Secretary, given on 26th September 2011 at Help the Hospices.

    Thank you Michael [Howard].

    There are few people better qualified than you are to talk about the relentless cut and thrust of British politics.

    We all know what we’re getting into, of course, but there are still times when all the press, the interviews, the meetings and policy documents can feel like a bit much.

    But there was a reason why I first asked you if I could be health spokesman for our party eight years ago.  It’s because nothing is more important than the care we give to people when they are at their most vulnerable; and nothing more inspiring than the people who give that care.

    As the Secretary of State in charge, it’s important never to lose sight of that.  That’s why I visit the NHS and other health and care providers every week.  I recently visited three hospices in one day up in the North West.

    Each of them had received funding from the Department of Health’s £40m capital grant scheme.  So I went up to see how it was being put to use.  A proper thing to do from an accountability point of view …but it was also very moving personally as well.

    I saw places where the hospice workers give excellent levels of care and support.  Where patients, their families and their carers get the best experience that their circumstances allow.

    For me, the quality of the interaction and relationships between patients and the professionals who work with them defines good healthcare.

    I know how important hospices are to local communities and what excellent work they do.

    In 2007/8, hospices in England, Wales and Northern Ireland cared for around:

    – 41,000 new adult in-patients,

    – 18,000 new day care patients

    – 102,000 patients at home

    – as well as supporting 110,000 patients in hospital.

    In every single case, they play an essential role:

    – providing specialist care to those who need it,

    – educating health and social care professionals,

    – innovating in service provision,

    – and supporting services for people who want to get their care in the community.

    Hospices play a valuable role in giving people choices.

    They’re well placed to provide, or be a part of, many of the community-based end of life care services set out in the End of Life Care Strategy.

    They’re essential in ensuring that the needs of patients and their families are met, whatever their circumstances.

    That’s why I – and the coalition government as a whole – want to see hospices flourish and develop.  We have already taken action to support that, and we’re going to do more as well.

    End of life care

    It’s said that you can judge the civility of a society based on how well it treats its most vulnerable citizens.  On the basis of some cases that have recently come to light, we need to do a lot better.

    There’s more work to do to develop better end of life and palliative care services, to make sure that all of the people that need that care always get it.

    Care that is compassionate, appropriate and a high quality. And care that always takes account of patients’ choices and their personal preferences.

    Quality

    The health reforms currently being put in to place will put improving the quality of care truly at the heart of the NHS.

    We are developing a new indicator for end of life care, to help assess its quality and to inform the improvement of services.  It will be based on a national survey of the bereaved, who will report on the deceased’s, and their own, experience of care, so that developments will be based on the evidence of those who know.

    And NICE is developing a quality standard for end of life care.  Due in November, it will set out – based on the evidence – the characteristics of what a high quality services.  It will help commissioners and providers see what the best care looks like.

    Already today, end of life care comes from a range of providers, including hospices.  As we move into the future, with an NHS based around patients rather than process, I want to encourage new partnerships and more organisations to get involved.

    Because I believe that, where it’s appropriate, patients should be able to choose from a range of groups, all offering services that are high quality, consistent, and delivered in a way that the patient likes.

    We are asking the NHS to listen to patients, and if they hear a strong call for more choice about who provides care at the end of life, then commissioners should make that happen locally.

    If providers meet strict qualifying criteria, and if they’re ready, it’s right that they should be allowed to offer care to people who want that choice.  It will mean more innovation in the sector, which will benefit patients, because their care will keep getting better, and it will benefit the best providers who will then attract more patients.

    To secure continuing improvements in quality, we must empower people with information, shared decision-making, and choice.  “No decision about me, without me” is, I know, already integral to hospice care.

    I really can’t overstate how important choice is, particularly when it comes to end of life care.

    We want to make sure the wishes of the patient and the family come first.  Moving towards a system where everybody is supported in how they want to die.

    The recent report from Cicely Saunders International on local preferences and place of death told us yet again that most people would prefer to be cared for and to die at home.

    But sadly, it also found that for many people, it just doesn’t work out that way.

    For some, Hospital will continue to be the appropriate place to die.

    But many more people could be cared for and die at home or in a ‘home from home’ such as a hospice…

    – if the system allowed it.

    – if money was available,

    – if services could be provided where and when they were needed,

    – and if some of the red tape could be cut back.

    I want this to happen.

    People need more choice and control about the care they get when they are dying. In particular, services should be set up to help people who want to die where they live, including in a care home if that has become their usual home.

    We want to introduce a right that will make this happen.

    And if it is going to happen, we need to fully implement the End of Life Care Strategy, particularly around delivering improved services in the community.

    Children

    Hospices have a particularly important role to play for children

    When it comes to palliative care, their can differ greatly from those of older patients.  It’s not just a matter of end of life care, but also helping children with life-threatening or terminal conditions to live as full a life as possible.

    We are working with children’s hospices to improve palliative care for children and to develop a more sustainable and patient-centred funding system.

    This year, the Department of Health gave £10m to forty children’s hospices in England through the children’s hospice and hospice-at-home scheme.  The grant, introduced 5 years ago, has now provided £57 million to children’s hospices.

    Last year, we also give up to £30 million to support local projects to develop children’s palliative care services, bringing together local commissioners and providers, including voluntary sector organisations.

    Time

    Altering the system to allow more choice can’t be done overnight.  Everything must be re-aligned and that takes time.  For example, commissioners need to be sure that the right services are available to support people to be looked after at home.  Effective co-ordination of care will also be essential.

    To support this, we have piloted End of Life Care Locality Registers, also known as Electronic Palliative Care Co-ordination Systems, as a way to ensure that all professionals involved in a person’s care at the end of their life have access to key information about a person’s care and their care preferences. And we are now working with partners to help this practice become more widespread.

    There’s a lot of work to be done.  In 2013, we’ll review our progress and see how we’re doing.  See how close we are to giving everyone greater choice.

    Palliative Care Funding Review

    A huge part of all of this is getting the system of funding right.

    The coalition’s Programme for Government says we will introduce a new per-patient funding system for all hospices and providers of palliative care, for both adults and children.

    It’s right there, in black and white, on page 26.

    I’m sure you all have a well-thumbed copy on your bedside tables, so have a look when you get home.

    To help drive forward our commitment to innovative, integrated services, I set up the independent Palliative Care Funding Review.

    In a nutshell, the Review’s job was to develop funding options that would be fair.  Fair to patients, ensuring that they have access to the care they want, where and when they want it. And fair to all providers of dedicated palliative care, including hospices, giving them the means to make it happen.

    Per-patient funding should be sustainable; it should provide stability; and it should actively encourage palliative care to be given in the community, so people can stay at home or in a care home if they want.

    But for it to be a viable option, it also has to be affordable.  Fair to the taxpayer, if you will.  Particularly when you look at the financial situation at the moment.

    I have welcomed the Review’s final report, which has made a really positive start at looking at what is an incredibly complex issue.

    Data

    It came up with a range of significant proposals.  They now need detailed consideration, and, crucially, they need to be backed up with new information and data.  One key conclusion of the review is that “There is a stunning lack of good data surrounding costs for palliative care in England.”

    For example, at present there is no data on individual patients receiving specialist palliative care.  Work is underway to change that, but it may well need to be extended to include the points recommended by the Palliative Care Funding Review.

    The pilots, the next stage in taking this forward, will collect a range of data covering different age groups, different diagnoses, and different settings.

    And they will be designed to consider questions that are central to the development of per-patient funding.

    Questions like:

    – Can clinicians classify patients easily and reliably?

    – What care did patients receive during each phase of their illness?

    – And what will their treatment cost?

    I’m under no illusions about the scale of that task.  But at the same time, I know it’s a hugely positive step.  We’re going to work out how it might best be carried out, and then there will be extensive engagement through piloting.

    A key outcome of the pilots will be to develop the building blocks – the currencies, as the jargon has it – that we’ll need to construct a tariff – a set of NHS prices for services delivered.

    A national tariff will provide a clear and transparent method of reimbursing service providers.  The introduction of a tariff for most acute services has helped to shift discussions between providers and commissioners onto quality and away from price.

    Linking payment to better patient outcomes drives improved quality, encourages efficiency and supports patient choice.

    I’ve been hugely encouraged by the numbers of organisations already offering to help with the pilots.  Already, over 25 had said they want to be involved, and we’re always on the lookout for more.

    Getting per-patient funding off the page and into practice is not going to be easy.

    But without losing sight of the practicalities, we should all recognise the potential benefits.

    We have an opportunity to give people the best care at the end of their lives.  We need to push forward with reform and I want a new system in place by 2015.  Moving forward faster than the review proposed.

    We also want to get people’s opinions about what our priorities should be when we reform the care and support system.

    On 15 September, the Government launched Caring For Our Future: Shared Ambitions For Care And Support, an engagement with those who use care and support services, carers, local councils, care providers, and the voluntary sector about the priorities for improving care and support.

    Both the National Council for Palliative Care and the National End of Life Care Programme will organise events where you can give your views on how to improve end of life care through social care reform.

    As part of this, we would also value views on the Palliative Care Funding Review.  In particular, we’d like to be able to explore in more detail its recommendations on free health and social care at the end of life.

    Conclusion

    As progress is made, we need to move forward together.

    Today we published the Third Annual Report on the End of Life Care Strategy, which provides more information on work and developments over the past year.

    It’s available on the Department’s website and it’s a good and encouraging read.

    Of course, there is much more to be done.  But if patients are to receive the care they deserve at the end of their lives, then hospices are going to be central in delivering improved care, providing an expanding range of vital, high quality, compassionate services in the community.

    I look forward to continuing our partnership with all of you in the hospice movement.

    Thank you.

  • Andrew Lansley – 2011 NHS Modernisation Speech

    andrewlansley

    Below is the text of the speech made by the Secretary of State for Health, Andrew Lansley, on NHS modernisation to NHS staff at Frimley Park Hospital in Surrey on the 5th April 2011. The Prime Minister, David Cameron, and the Deputy Prime Minister, Nick Clegg, were both also in attendance.

    There is no more important institution in this country than the NHS. This is true for everyone, not least for me. I am passionate about improving our NHS; for today and for generations to come.

    As David and Nick have said, there is widespread support for the principles of our proposals:

    – For a patient-centred service with ‘No decision about me, without me’;

    – For clinical leadership,

    – And a relentless focus on what matters most, clinical outcomes and results for patients;

    But while there is agreement on the principles, people also have genuine concerns as to the detail. So in the coming weeks we will pause, listen, reflect and improve with the professions and the public to make the Bill better in four areas.

    First, we need to make sure that we have the right sort of competition in the Health Service. Not competition for its own sake, not cherry picking the lowest hanging fruit, not giving preference to the private sector over and above NHS or charities.

    Fair competition that delivers better outcomes for patients.

    Second, we need patients and the public to play an active role in the NHS. Local decisions should not be made behind closed doors, but open to the genuine influence of the people they serve.

    Care should be integrated and designed around an individual’s needs. The needs of the patient, not the convenience of the system, should come first.

    Third, commissioning should mean GPs coming together with their colleagues across the NHS – nurses, allied health professionals, hospital consultants – to design the best possible services for patients. That is the idea. The Bill must make this a reality.

    And finally, education and training. The new NHS must build upon what works for the benefit of patients.

    Today heralds the first of a series of listening exercises and events with the Prime Minister, the Deputy Prime Minister and me. This as a genuine opportunity to shape the future of the NHS.

    The NHS Future Panel, a team of top health professionals, will help lead the process and be chaired by Professor Steve Field, former head of the RCGP.

    And anyone can go to the Department of Health website to put forward their ideas on the four areas.

    By taking advantage of this natural pause in the legislative process, taking us up to late May or early June, we can be sure that we achieve what is our ultimate goal:

    – a health service that is free;

    – that is based on need and never a person’s ability to pay;

    – and an NHS that, on what matters most – on outcomes for patients – is consistently among the very best in the world.

    I want to thank the more than 6,000 GP practices already taking the lead in improving local services and to thank the 90% of local authorities who are starting to bring a greater degree of local democratic accountability and coordination to the Health Service.

    I encourage everyone to take part in this and to help make the NHS as good as we know it can be.