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Below is the text of the speech made by David Cameron, the Prime Minister, on HMS Ark Royal on 24th June 2010.

Thank you very much indeed, and can I say what a huge honour it is for me to be aboard HMS Ark Royal, and to see you all today. I know that I am only the warm-up act, because I was speaking last night to Her Majesty – how much I love being able to say that – and she told me how delighted and excited she was about coming to see again her beloved Ark Royal as she will be next week.

I wanted to come here today for one reason, and one reason alone. I know that all of you probably think that back in the United Kingdom, all we are thinking about is eleven people who are going to take to that football pitch on Sunday. Of course, everyone is willing them on, but I can tell you that everyone in our country is thinking of something else as well, and that is the enormous debt that we owe to our armed services for everything that you do for us. Saturday is Armed Services Day, and I wanted to be here with you before that, to say to you as directly as I can how much we owe our armed services – our Air Force, our Royal Navy, our Army – for everything that you do to keep us safe.

The first thing I wanted to say is a very, very big thank you. You work incredibly long hours. You are taken away from your loved ones. You spend a long time away from home and at sea. You do a job that many of us simply couldn’t do, and it’s right that we should say a very big thank you for what you do. Samuel Johnson once said that every man looks at himself more meanly if he has never been a soldier or never been to sea, and that is right, so thank you for your courage, your dedication, your professionalism, and for what you do.

The second thing I wanted to say is that I think we should take huge pride in our Royal Navy.  Standing here on the fifth Ark Royal, and thinking of all our incredible naval history, from Nelson back to Drake, from Trafalgar to Jutland – history that I hope we can now teach properly in our schools – we should be proud of all we have achieved in the past, but we should also be very proud of all that we are going to do in the future.  We have a great naval future as well as a great naval past. I know that sometimes, with everything that has been happening in Afghanistan, that the Royal Navy can sometimes feel a little forgotten.  I will never forget what you do, and no one should ever forget that in Afghanistan, an important part of the Royal Navy, the Marine Commandos, are fighting incredibly hard in Afghanistan on our behalf.  We have heard more bad news overnight about casualties in Afghanistan, and our hearts should go out to every one of those men and their families and the loved ones that they leave behind.

As well as talking about the debt of gratitude that we owe, as well as speaking about our proud naval tradition, I also wanted to say something about the Strategic Defence Review that we are undertaking, that I know of course causes huge concern and worry right across our armed services.  It is right that we have one.  We have not asked the fundamental questions about the defence of our country, about our role in the world, since 1998.  If you think of all the things that have happened since then – the actions that you have taken part in, in Sierra Leone, and Kosovo; the wars that we fought in Iraq and Afghanistan – huge changes have taken place in our world: the attacks of 9/11; the attacks in our own country in July 2005.  It is time for us to think again about how to make our country safe, how to project power in the world, how to look after our national interest, and how to make sure we are secure for the future.  That is what we should do.

I know absolutely that the Royal Navy will have a huge role to play in that future.  We are a trading nation.  We have got to keep our sea-lanes open.  We want to stop drugs coming from our shores, and that is the work that you do.  We have to deal with the appalling threat of piracy off the Horn of Africa; that is what you do.  We have to make sure we keep vital sea-lanes open, and the work in the Gulf; that is what the Royal Navy is doing today.  I know that whatever the outcome of this review, whatever the changes we will have to make, we should make them together and recognise that the Royal Navy is going to have a huge role to play in our future, in our defence, and in our security.

The last thing I wanted to say to you today is simply this: I am very aware that as the British Prime Minister, I can expect incredible things from you.  Dedication, bravery, courage, service.  I want to say what you can expect from me.  There is this thing called the Military Covenant, written down, which is what the country offers you in return for what you offer us.  You do so much: you put your lives on the line, your safety on the line, and it is time for us to rewrite that Military Covenant, to make sure that we are doing everything we can for you and your families at home, whether it is the schools you send you children to, whether it is the healthcare that you can expect, whether it is the fact that there should be a dedicated military ward for anyone who gets injured or wounded in Afghanistan or elsewhere.  I want all of these things refreshed and renewed and written down in a new Military Covenant that we write into the law of our land so we show how we stand up for our armed services.

As far as I am concerned, public service is a vital part of our country, and you are at the noblest end of public service.  A great military commander once said that those things we do for ourselves, die with us; those things we do in the service of others, they live forever.  That is what you do in the Royal Navy; that is what you do in our armed services.  I am here as the new British Prime Minister to say a very big thank you for your service, your dedication, your courage and all that you do on this historic ship, in this great place, at this time, with Her Majesty the Queen coming to see you next week.

Thank you for all you do, thank you for all you are, thank you for all you represent, and recognise that back home in Britain, it is not just the government that reveres our armed services; it is the whole of our country, from the homecoming parades, to the businesses that allow Territorial Army reservists and other reservists to go off to sea or to fight overseas, to the great public support you see for our armed services.  We are proud of you, so thank you, and remember you are never forgotten.  Thank you very much.

Below is the text of the speech made by David Cameron about the Structural Reform Plans, made at the Civil Service Live event on 8th July 2010.

This is my first time here – so let me make something very clear from the start.

I have huge respect and admiration for the civil service.

In my twenties I worked in the Home Office and the Treasury.

I saw then just how talented and committed our civil servants are.

And I’ve seen it again right from the first day of this government.

Yes, I like to think we’ve given some political leadership – but it’s you and your colleagues in the civil service who have delivered.

Just think of what we’ve done – together – in two months:

The full programme for government.

The National Security Council.

The Office of Budget Responsibility.

The in-year spending review.

The emergency Budget.

The immigration cap.

The abolition of ID cards.

And we’ve taken the first steps on the long-overdue reform of our schools, our prisons, our welfare system – and of course, our political system too.

These things can’t be done by a handful of politicians.

They get done because officials get stuck in.

Whatever your political views, however hard you might have worked on a previous project…

…you always uphold the values of the civil service – integrity, honesty, objectivity, impartiality – and that’s what makes our civil service the envy of the world.

So thank you.

Deficit

Of course, this is just the beginning.

We’ve got some massive challenges ahead – and nothing looms larger than the budget deficit.

Fail to deal with this – and we risk a major crisis in our economy.

That’s why we’ve got to make these cuts.

But let’s also be clear how we will make them.

We’ve got to do this in a way that is responsible and fair – that demonstrates we’re all in this together.

That’s why we’re asking for your help.

We’ve thrown open the challenge of identifying savings to you – to the whole of the public sector…

…and the response has been fantastic – more than 50,000 ideas in just two weeks.

And tomorrow, the Chancellor and I will be setting out some of the best we’ve received.

Reform But people are making a big mistake if they think this Government is just about sorting out the deficit.

That’s not why I came into politics.

It’s not what the coalition came together for.

We came together to change our country for the better in every way.

The best schools open to the poorest children.

A first-class NHS there for everyone.

Streets that are safe, families that are stable, communities that are strong.

These ambitions haven’t died because the money is tight.

The real question is: how can we achieve these aims when there is so little money?

How can this circle be squared?

The answer is reform – radical reform.

We need to completely change the way this country is run – and that’s what I want to talk about today.

Bureaucratic accountability

Now I know you’ve heard talk of reform many times before.

I’m not going to criticise everything the previous government did.

Many of their intentions were right.

Where they went wrong with reform was the techniques they used.

Top-down. Centralising. Above all, bureaucratic.

To improve public services, to get value for money, to deliver their stated aims, they set up a system of bureaucratic accountability.

In this system of bureaucratic accountability almost everything is measured or judged against a set of targets and performance indicators, monitored and inspected centrally.

The evidence shows this hasn’t worked.

All the new learning strategies in schools – but the gap in educational achievement between the richest and poorest widened.

All those NHS targets – but cancer survival rates in Britain are among the lowest in Europe.

And worse than these failures is that the very act of imposing this top-down system has undermined the morale and judgment of so many public sector workers…

…the very thing that good public services depend on.

Democratic accountability

That was the past.

Now we have a new government.

A new coalition government, with a new approach.

We intend to do things differently, very differently.

If I could describe in one line the change we plan for the way we approach public services, and reform generally, it’s this:

We want to replace the old system of bureaucratic accountability with a new system of democratic accountability – accountability to the people, not the government machine.

We want to turn government on its head, taking power away from Whitehall and putting it into the hands of people and communities.

We want to give people the power to improve our country and public services, through transparency, local democratic control, competition and choice.

To give you just one example: instead of teachers thinking they have to impress the Department of Education, they have to impress local parents as they have a real choice over where to send their child.

It really is a total change in the way our country is run.

From closed systems to open markets.

From bureaucracy to democracy.

From big government to Big Society.

From politician power to people power.

And let me tell you why, now, this vision is possible.

It’s not just that the two parties that make up this coalition believe, instinctively, in giving more power to people.

It’s that’s where power has shifted to.

Let me explain.

A couple of centuries ago this country was in a pre-bureaucratic age – transport and communication were so slow that information and power had to be held locally.

Then with the invention of the steam engine and the telegraph we moved into the bureaucratic age…

…when it was possible and practical to file the nation’s paperwork in one corner of the country – in Whitehall – and that’s where all the power has been too.

But today, with the revolution we’ve had in communications and technology, we can move into the post-bureaucratic age…

…where information and power are held not locally or centrally but personally, by people in their homes.

And the consequences for government – and the way our whole country is run – are incredibly exciting.

It means we can abandon the old bureaucratic levers that we know have failed…

…and instead improve public services and get value for money with new approaches that put power in people’s hands.

That what I want to focus on now.

I want to explain these approaches so you understand clearly what this government expects of you…

…and so there can be no doubt about our attitude to reform – and to solving problems.

Choice

One way we can bring in real accountability is through choice.

Wherever possible, we want to give people the freedom to choose where they get treated and where they send their child to school – and back that choice up with state money.

Because when people can vote with their feet…

…it’s going to force other providers to raise their game – and that’s good for everyone.

Competition

Another tool we must use is competition.

By bringing in a whole new generation of providers – whether they’re from the private sector, or community organisations, or social enterprises – we can bring in the dynamic of competition to make our public services better.

That’s what we plan in education.

We will let any suitably qualified organization to set up a school…

…creating real diversity and real competition so there’s real pressure to raise standards.

Payment by results

Of course there are some areas where competition and choice aren’t possible.

We understand that.

So we’ll do the next best thing – and introduce the principle of paying providers by the results they achieve.

Rewarding people for work well done is a simple way of driving up standards.

There are some people who say we can’t do this – that it’s against the spirit of public services.

I say: we can’t afford not to do this.

You wouldn’t have a plumber round to your house and pay them for ruining your drains.

Why should public services be any different?

So we’ll pay welfare-to-work providers not just by how many they get into work but how many stay in work.

And we’re going to pay independent providers – and eventually prisons – by the levels of re-offending.

Elections

Sometimes it won’t be possible to have choice, or competition, or to pay by results.

But that doesn’t mean we have to give up on bringing in people power.

Here, we should have direct democracy.

That’s what we’re doing with policing.

Instead of having chief constables answer to Whitehall, we will make them answer to police commissioners with a mandate to set local policing priorities.

That mandate will have been earned through election – and those priorities will have been developed with the consent of local people.

So police will stop looking to Whitehall for direction and start looking to people.

Transparency

And whatever the circumstance, there is one tool that we will always try to use – and that is transparency.

We’re shining a light on everything government does…

…not just the pay, the perks and where public money is spent…

…but on how well that money is spent, too – on health outcomes, school results, crime figures.

That way people can see the value they’re getting for their money and hold us to account for it.

I know there are some people who think this is unfair.

I’m sorry, I just don’t agree.

We are the servants of the people of this country.

They are the boss.

Where is it said that the boss is told they can’t look at the books or know the pay of their staff?

It doesn’t happen in the private sector and from now on it won’t happen in the public sector.

More for less

All these different approaches are designed to put people in charge and give us services that are more local, more responsive and more effective.

And there’s another big, important by-product of these reforms.

They’re going to help us save money.

Not just because we can scrap the whole expensive apparatus of top-down bureaucracy and inspection.

But because when people have the power to hold public services to account, they’ll help make sure they’re less wasteful and more effective.

When social enterprises and charities have the power to compete in the public sector, that will increase competition, drive costs down and put pressure on existing providers to raise their game.

And when these providers are paid by the results they achieve, we can get value for money.

Arguments against reform

But I know there are people who questions our plans for reform.

They say it will be the poorest who lose out when you increase choice.

They say it will create wider gaps between communities, with some getting left behind.

They say when you increase competition some organisations will fail – and that will disadvantage the people who use them.

I’m going to be taking on all these arguments in the weeks ahead.

But on the fairness point – because it’s so important – let me say this briefly today.

The old top-down system failed the poorest.

It widened inequality.

In a system where people have no choice, it’s the richest who can opt out while the poorest have to take what they’re given.

And just consider the evidence of the most recent years, in those areas where principles of competition, choice and greater independence for institutions have been introduced.

Academies are transforming education results in our poorest communities.

Some foundation hospitals are bringing the very best care to the people who need it most.

More independence, more freedom, more openness – and standards are raised across the board – improving life for the most vulnerable and disadvantaged as well as for the better off

That’s why we are so determined to press on, go further and go faster in bringing about a real people power revolution.

Structural Reform plans

So what part will all you have to play in making this change happen?

Going from bureaucratic accountability to democratic accountability will require radical reform.

I need your help to make these reforms happen.

But let me be very clear: I do not want you and your colleagues to think your role is to guarantee the outcomes we want to see in our public services – or to directly intervene in organisations to try and improve their performance.

It’s our job – we as politicians, you as civil servants – to create the conditions in which performance will improve, by making sure professionals answer to the public.

And today, we’re announcing how we want to keep those reforms on track.

Starting with schools and local government, we will be publishing Structural Reform Plans for every Whitehall Department.

They will be part of the full departmental business plans published after the Spending Review.

And I want to be very clear about how they are different from the old top-down system you are used to.

They’re different because in these plans you will not find targets – but specific deadlines for specific action.

Not what we hope to achieve – but the actions we will take.

They will show how each department plans to bring democratic accountability – how they will create the structures that put people in charge, not politicians.

I want you to read these reform plans and work with them.

They mean a real culture shift for you, a sea change in what you do.

Where there has been caution about devolving power there’s got to be trust.

Where there has been an aversion to risk, there needs to be boldness.

I’m telling you today that your job under this government is not to frustrate local people and local ideas, it is to enable them.

Conclusion

Everything I have spoken about today – the ideas that lead the reform, the plans that shape it, the deadlines that will drive it – these things do not guarantee success.

A lot of the ideas, the impetus needs to come from you.

I hope I’ve left you with a very clear idea of what we want to achieve.

You need to know, instinctively, what will get a green light or a red light from me.

If you want to make our public services more transparent, open them up to make them more diverse, to give people more power and control – you can be confident it will get the green light.

But if you want to set targets, set new controls, impose new rules, don’t bother because you’re likely to get the red light.

This government believes you get value for money by opening services to choice and competition…

…by trusting professionals and restoring their discretion…

…by publishing in full all the information.

This government believes in accountability: but it has to be democratic accountability, not bureaucratic accountability.

Be in no doubt about our determination to do this.

Yes, we’ll deal with the deficit – but we’ll also completely change the way our country is run.

So let’s push power out, let’s reform our public services, and let’s change our country for the better.

Let’s bring on the people power revolution.

Below is the text of the speech made by David Cameron, the Prime Minister, on the economy. The speech was held in Milton Keynes on 7th June 2010.

Today my speech is about the deficit and the debt and the financial problems that we face. But at the same time as that we must never take our eyes off the need for building strong and sustained economic growth in Britain, growth in which our universities – and perhaps the Open University in particular – should play a huge part.

The knowledge-based economy is the economy of the future, and in building that economy and in recognising that it is not just about young people’s skills but about people’s skills all through their lives, the Open University has a huge, huge role to play. It is a great British innovation and invention and it is a privilege to be here this morning.

I have been in office for a month and I have spent much of that time discussing with the Chancellor and with government officials the most urgent issue facing Britain today, and that is our massive deficit and our growing debt. How we deal with these things will affect our economy and our society, indeed our whole way of life.

The decisions we make will affect every single person in the country and the effects of those decisions will stay with us for years, perhaps even decades, to come. And it is precisely because these decisions are so momentous, because they all have such enormous implications and because we cannot afford either to duck them or to get them wrong, that I want to make sure we go about the urgent task of cutting our deficit in a way that is open, responsible, and fair.

I want this government to carry out Britain’s unavoidable deficit-reduction plan in a way that tries to strengthen and unite our country at the same time. I have said before that as we deal with the debt crisis we must take the whole country with us, and I mean it. George Osborne has said that our plans to cut the deficit must be based on the belief that we are all in this together, and he means it.

Tomorrow, George Osborne and Danny Alexander will publish the framework for this year’s Spending Review. They will explain the principles that will underpin our approach and the process we intend to follow including, vitally, a process to engage and involve the whole country in the difficult decisions that will have to be taken.

But today, I want to set out for the country the big arguments that form the background to the inevitably painful times that lie ahead of us. Why we need to do this, why the overall scale of the problem is even worse than we thought and why its potential consequences, and the consequences of inaction, are therefore more critical than we originally feared.

There are three simple reasons why we have to deal with the country’s debts. One: the more the government borrows, the more it has to repay; the more it has to repay, the more lenders worry about getting their money back; and the more lenders start to worry, the less confidence there is in our economy.

Two: investors – people lending us this money – they do not have to put their money in Britain. They will only do so if they are confident the economy is being run properly, and if confidence in our economy is hit, we run the risk of higher interest rates.

Three: the real, human, everyday reason this is the most urgent problem facing Britain, is that higher interest rates hurt every family and every business in our land. They mean higher mortgage rates and lower employment. They mean that instead of your taxes going to pay for the things we all want, like schools and hospitals and police, your money, the money you work so hard for, is going on paying the interest on our national debt. That is why we have to do something about this.

This argument that we have consistently made, for urgent action to start tackling the deficit this year and an accelerated plan for eliminating it over the years ahead, has already been backed by the Bank of England and the Treasury’s own analysis. It has been made more urgent still by the sovereign debt crisis in the Eurozone over recent months. The global financial markets are no longer focusing simply on the financial position of the banks. They want to know that the governments that have supported the banks over the last 18 months are taking the actions to bring their own finances under control.

This weekend in South Korea, George Osborne received explicit backing from the G20 for the actions this government has already taken. Around the world people and their governments are waking up to the dangers of not dealing with their debts, and Britain has got to be part of that international mainstream as well.

So we are clear about what we must do. We have also been clear about how we must do it – as the Deputy Prime Minister has said – in a way that protects the poorest and the most vulnerable in our society, in a way that unites our country rather than divides it, and in a way that demonstrates that we are all in this together.

And we should be clear too that these problems have not just appeared overnight. [Party political content]. Now that we have had a chance to look at what has really been going on, I want to tell you the scale of the problem that we face.

We have known for a long time that our debts are huge. Last year, our budget deficit was the largest in our peacetime history. This year – at least according to the previous government’s forecasts – it is set to be over 11% of GDP, of our whole national income.

Today, our national debt stands at £770 billion. Within just five years it is set to nearly double to £1.4 trillion. To put it in perspective, that is some £22,000 for every man, woman and child in our country.

Now, we knew this before. Soon, the independent Office for Budget Responsibility will set out independent forecasts that will show the scale of the problem we are in today. For the first time people will be able to see a really truly independent assessment of the nation’s finances and the size of the structural deficit.

This important innovation has been noticed around the world, and I believe will help restore confidence in our fiscal framework. But what I can tell you today – and what we did not know for sure before, in fact what we could not know, because the previous Chancellor of the Exchequer did not make the figures available – is how much the interest on our debt is likely to increase in the years to come.

We have looked at the figures and, based on the calculations of the last government, in five years’ time the interest we are paying on our debt – the interest alone, not the debt itself – is predicted to be around £70 billion. That is a simply staggering amount. [Party political content.]

Let me explain what it means. Today we spend more on debt interest than we do on running our schools. But £70 billion means spending more on debt interest than we currently do on running our schools in England, plus on combating climate change, plus everything we spend on transport. Interest payments of £70 billion mean that for every single pound you pay in tax, 10 pence would be spent on the interest on our debt. Not paying off the debt itself, just paying the interest on the debt.

Is that what people work so hard for, that their hard-earned taxes are blown on interest payments on the national debt? Think about it another way: corporation tax raises £36 billion a year, so all the money from all the tax on all the profits on every single company in Britain just pays a little bit more than half of the interest on our national debt. That is how serious this problem is. What a terrible, terrible waste of money.

So, this is how bad things are. This is how far we have been living beyond our means. That is the legacy that our generation threatens to leave the next unless we act. So no one can deny the scale of the problem, and that the scale is huge. But what makes this such a monumental challenge is the nature of the problem.

There are some who say that our massive deficit is just because we have been in a recession, and that when growth comes back everything will somehow be okay. But there is a flaw in this argument and it is rather a major flaw: we had a significant deficit problem way before the recession. In fact, much of the deficit is what they call ‘structural’. A problem built up before the recession, caused by the government spending and planning to spend more than we could afford. It had nothing to do with the recession and so a return to growth will not sort it out.

This really is the crux of the problem we face today and the reason we can’t just sit here and hope for the best. The previous government really did think that they had abolished boom and bust. They thought the good times would go on forever; the economy would keep on growing and they could keep on spending.

But the truth about that economic growth – and the tragedy – is that it was based on things that could never go on forever. The economy was based on a boom in financial services, which at its peak accounted for a quarter of all corporation-tax receipts. But this was unsustainable because the success of financial services – a great and important industry – was partly an illusion, conjured from years of low interest rates, cheap money and a bubble in the price of assets like houses.

The economy was based on a boom in immigration, which at one point accounted for a fifth of our annual economic growth. But this was unsustainable because it is just not possible to keep bringing more and more people into our country to work while at the same time leaving millions of people to live a life on welfare.

The economy was based on a boom in government spending, with some budgets doubled or even trebled in a decade. Again, this was not sustainable because, in the end, someone has to pay for all that spending. So when the inevitable happened and when the boom turned to bust, this country was left high and dry with a massive deficit that threatens to loom over our economy and our society for a generation. So the problem we face today is not just the size of our debts, but the nature of them.

We are now publishing the information about how all your money is spent. We are shining a spotlight on where the waste went and it is a scandalous sight to see: a Department for Work and Pensions that increased benefit spending by over £20 billion and gave some families – some individual families – as much as £93,000 in housing benefit every year; a Ministry of Defence that allowed 14 major projects to overrun, which at the last count are between them £4.5 billion over budget; a Department of Health which almost doubled the number of managers in the NHS; and a Treasury that sanctioned all of this because it published growth forecasts that were far more optimistic than independent forecasters’.

And look at how [this was done] while at the same time doing so much damage to the fundamentals of our economy: letting it get completely out of balance by hitching our fortunes to a select few industries; accepting as a fact of life that eight million people are economically inactive in our country; and allowing our economy to become far too dependent on a public sector whose productivity was falling; and far too hostile, I would argue, to a private sector that has now actually shrunk in size to a level not seen since 2004.

Nothing illustrates better the total irresponsibility of this approach than the fact that [party political content] unaffordable government spending [increased] even when the economy was shrinking. By the end of last year our economy was 4% smaller than in 2007. But if you look behind the headline figures, you see why we face such a massive deficit crisis today: because while the private sector of the economy was shrinking, the public sector was continuing its inexorable expansion. While everyday life was tough for people who didn’t work in the public sector with job losses, pay cuts, reduced working hours, falling profits, for those in the public sector, life went on much as before.

Since 2007 public spending has actually gone up by over 15% – some extra £120 billion in just three years. And while private-sector employment fell in this period by 3.7%, public-sector employment actually rose. So it has been, if you like, a tale of two economies: a public-sector boom and a private-sector bust.

But there was a problem with this public-sector splurge. The previous government argued that more spending would support the economy, conveniently forgetting that if you start with a large structural deficit, you ramp up spending even further, which is actually going to undermine confidence and investment, rather than encourage it. So, while the people employed by the taxpayer were insulated from the harsh realities of the recession, everyone else in the economy was starting to pay the price.

And now, today, we’re all paying the price because the size of the public sector has got way out of step with the size of the private sector. We’re going to have to try and get it back in line and that will be much more painful than if we had kept things properly in balance all along.

And the final part of the legacy is the fact the money the government put in to the public sector did not make it dramatically better or more efficient.

So, while the cutbacks that are coming are unavoidable now, they could have been avoided if previously we had spent wisely instead of showering the public sector with cash at a time when everyone else in the country was tightening their belt.

So that is the overall scale and nature of the problem. And I want to be equally clear about what the potential consequences are if we fail to act decisively and quickly to cut spending, to bring our borrowing down and to reduce our deficit.

If we do nothing, there are three possible scenarios. As we have seen, the best-case scenario is that we pay increasingly punishing amounts of interest on our debt, dozens of billions every year without ever actually paying our debts off. That huge drain on the public finances would threaten the money that could have been spent on the things we really want to spend it on: improving the NHS; giving our children a better education; investing in our country’s infrastructure. This, the best-case scenario, I would describe as dire, unprogressive, a bad outcome for our country.

But, as I say, that’s the best case. If we fail to confront our problems we could suffer worse, a steady, painful erosion of confidence in our economy, because today almost every major country in the world is focusing on the need to cut their deficits. And the G20 has called on those countries with the biggest deficits to accelerate their plans for reducing them.

If, in Britain, investors saw no will at the top of government to get a grip on our public finances, they would doubt Britain’s ability to pay its way. That means they would demand a higher price for taking our debt, interest rates would have to rise, investment would fall. If that were to happen, there would be no proper growth, there would be no real recovery, there would be no substantial new jobs because Britain’s economy would be beginning a slide to decline.

These outcomes would be nothing less than disastrous, in my view, not just for our economy but for our society too, and our vision of a Britain, which we want to see, that is more free, more fair and more responsible.

But even more worrying is the example of Greece – a sudden loss of confidence and a sharp increase in interest rates. Now, let me be clear: our debts are not as bad as Greece’s; our underlying economic position is much stronger than Greece’s; and crucially we now have a government that I would argue has already demonstrated its willingness and its ability to deal with the problem. But Greece stands as a warning of what happens to countries that lose their credibility, or whose governments pretend that difficult decisions can somehow be avoided.

Thankfully this is a warning that has now focused the attention of the international community. This is why we believe there is only one option in front of us: to take immediate and decisive action. That’s why we have already launched and completed an in-year Spending Review to save £6 billion of public spending.

It’s why, shortly, our new, independent Office for Budget Responsibility will set out independent forecasts for both our growth and borrowing so that never again can this country sleepwalk into such a massive debt crisis. Our actions have already been noticed around the world, and I’m glad the G20 summit this weekend explicitly endorsed the decisions we have taken.

So this is the sober reality that I have to set out for the country today. The legacy left [party political content] is terrible. The private sector has shrunk back to what it was over six years ago. Unless we act now, interest payments in five years’ time could end up being higher than the sums we spend on our schools, on climate change and on transport combined.

Because the legacy we have been left is so bad, the measures that we need to deal with it will be unavoidably tough. But people’s lives – and this is vital – people’s lives will be worse unless we do something now. The cause of building a fairer society will be set back for years unless we do something now. We are not alone in this; many countries around the world have been living beyond their means and they too are having to face the music. And I make this promise to everyone in Britain: you will not be left on your own in this. We are all in this together and we are going to get through this together. We will carry out Britain’s unavoidable deficit-reduction plan in a way that strengthens and unites the country.

We are not doing this because we want to. We are not driven by some theory or some ideology. We are doing this as a government because we have to, driven by the urgent truth that unless we do so, people will suffer and our national interest will suffer too. But this government will not cut this deficit in a way that hurts those we most need to help, in a way that divides our country or in a way that undermines the spirit and ethos of our vital public services.

Freedom, fairness, responsibility: those are the values that drive this government; they are the values that will drive our efforts to deal with our debts and to turn this country around.

So yes, it will be tough. I make no bones about that, but we will get through this together and Britain and all of us will come out stronger on the other side. Thank you for listening.

QUESTIONS AND ANSWERS:

Question

Prime Minister, you say we’re all in this together. Does that include the right-wing of your party, who have been lobbying so hard against any tax rises?

Prime Minister

That includes everybody. I mean I would argue the government immediately signalled the sign that we’re all in it together by actually saying that we’ve got to start with ourselves, that ministers should take a pay cut, that ministerial limousines should be cut back, that we’ve got to make sure Parliament costs less money and, yes, it does mean that we have to carry through tax policies, some of which we inherited from the previous government in terms of top rates of tax, as part of the picture.

So I think picking out those two areas is right, and it will help us to make the moral argument about what sort of country this is as we deal with the incredibly difficult decisions that we have in front of us. That’s what the coalition has to do. It is going to be a very, very difficult task, but I believe it’s a task that actually helps to bring us together in this common endeavour of making sure that at the end of this five-year period, at the end of a Budget and a spending round that will be difficult, that actually people say we sorted out our problems, we paid down our debts, we found our way in the world again, we started to grow again, we started to get an economy that was about jobs and living standards and things that we want. That’s what this is about: yes, difficulties, but, as I said in the speech, we’ll come through it together and in the end we will come through it stronger and it’ll be something that Britain will be able to turn round to others in the world and say we did this important thing. It needed to be done, we did it, we did it well, and we’re a better off country as a result of it. That’s what this challenge is about.

Thank you very much for coming. Thank you to the Open University again and thank you very much for listening. In terms of capital-gains tax, I think people understand we need to raise some modest additional revenue from capital-gains tax to pay for the increase in tax allowances that we all want to see to help the low paid, to help protect, as I said, the people that we want to help most at this time.

And I think people also understand, and actually if you read any of the things written by anyone who is concerned about capital-gains tax, they all understand this massive leakage of revenue that takes place when you have a very low rate of capital-gains tax and a very high rate of income tax. And clearly it would be irresponsible to allow that massive leakage to take place; we do need to be in a position where we get our deficit down. I think people understand that, but they know that there’ll be an answer in the Budget and I hope that will be an answer that people will find shows that we’ve addressed the concerns that people understandably have.

Question

Thank you, Prime Minister. You say these cuts will affect our whole way of life, that they will affect every individual in the country, and yet you still have not spelt out any area that you’re looking for which will be painful to people. When will you start to do that? And when ministers make comparisons with, say, Canada, they blew up a hospital in Canada, they made redundant tens of thousands of people, they cut benefits too; is that what Britain has to look forward to?

Prime Minister

Well, what I would say is this: that we’ve got a proper process for doing this, a process where we have a Budget on the 22nd of June where we’ll set out the spending over the next three years and then I want to see a proper debate take place, that involves as many people as possible, that will lead to the actual spending reductions in departments being set out and what the consequences of those spending reductions are, and I want us to go about this in the best way possible, to take people with us.

What I would say about Canada – and I was speaking to the Canadian Prime Minister about this just last week – while they do stand as an example of a government (it was a previous government) that sorted out a debt and a deficit crisis, the great warning they give is that actually they put it off for too many years before they did it, so the problem they had to solve was even worse by the time they got round to it. I’m determined, seeing the figures as I can now see, understanding the warnings which I made before but make again today, that we shouldn’t put this off. We need to get on with what needs to be done. Yes, we need to take people with us, yes, it will mean difficult departmental decisions, and, yes, it will inevitably mean some difficult decisions over big areas of spending like pay and pensions and benefits, and we need to explain those to people.

But I profoundly believe that government is about acting in the national interest. It is our national interest to do this, and it’s in our national interest to try and take the country with us as we do it, but ducking the decisions would be a complete betrayal of what I believe in, which is government, public interest, national interest, doing the right thing. If this is the right thing to do, we must be able to convince people that it’s the right thing to do, and irrespective of how unpopular some of these decisions will be, we will, I think, in the long run, be able to take people through to a brighter economic future beyond.

Question

Just quickly, you’re saying people will get a sense of what this might involve, come the autumn and the spending round? Or within weeks?

Prime Minister

There will be difficult decisions in the Budget, undoubtedly. There will then be discussions over the summer about public spending and public spending changes that are going to have to be made in different departments and, as I say, these will be relatively open discussions, because once you start setting a spending envelope for the next three years – something the last government didn’t do. Once you do that, people will see the sorts of choices that we, with them, will have to make. Perhaps Danny would like to say something about it a week into looking at some of those difficult choices.

Danny Alexander MP

Yes, thank you, Prime Minister. I mean, I’ve spent the last week looking over the books and obviously announcements will be made in the Budget and then in due course in the Spending Review, but I’m in no doubt at all, having done that, that the approach we’re setting out today is exactly the right thing to do. Because, there has been irresponsibility in the way that the previous government handled the public finances and we have to bring responsibility to the way that we do that. That’s the point of this agenda, and, in a sense, what we’re setting out today is, if we don’t take responsibility in the way that the Prime Minister has set out, what are the consequences of that? The £70 billion that we’d end up spending on debt repayments, for example, the consequence that has for money that you can’t spend on public services. That’s why, when you look at all the other options, no matter how painful what we have to do might be, we have to do it.

Prime Minister

Don’t put off what needs to be done is the thing to bear in mind.

Question

I’m interested that you say you want to engage and involve the whole country in this very painful cutting process that has to happen. It sounds good, it also sounds like it might be little more than a talking shop. How are you going to convince people that you’ll not only listen to them, but that you’ll also act on what they want and don’t want to happen?

Prime Minister

Well, that’s, to me, what politics should be about. I mean, we the politicians have got a duty, I think, to explain to the country the nature and scale of the problem. I’ve tried to do that today. I’ve tried to explain what happens if we don’t do anything, if we just sat back, took the easy course, enjoyed being in office and making decisions and having meetings, just sat there, what would happen? And actually, the consequences would be very dire. So we’ve set out the envelope, as it were, of what needs to be done. Then I think there needs to be a discussion following the Budget about, well, what are the priorities, what are the things we need to protect most of all, what are the difficult decisions that we could take, and involve people.

I don’t want to spend a lot of money doing this – there isn’t any money, as one of your predecessors put it so clearly – but I think it is a good idea to take people with you, have this discussion and debate about education spending, about whether we’re spending on transport, infrastructure, how much you try and protect capital spending, all those things, have a discussion with people, and then at the end, obviously, we have the Spending Review where you have to make your announcements.

Inevitably, we are going to make a lot of decisions that people won’t agree with, but we have to convince people first that the big decision, the need to reduce spending and get the deficit under control, is the right one, and I think once you’ve done that, then people, even if they don’t accept some of the individual decisions – because all these choices are hard choices – we can take people with us on the basis that the alternative, the doing nothing, the sitting back, the pretending somehow this is all going to be cured by growth, that would be incomparably weak. That’s what we have to try and do.

Question

Mr Prime Minister, is there a danger, in this globalised world, that by talking about things being far worse than you expected that you perhaps could be seen to be talking down the British economy which could be taken unfavourably by the markets? And also, you talk about uniting the country – isn’t there a danger that you’ll succeed not in doing that but in uniting the country against you and your government?

Prime Minister

Let me take both of those. I think there would be a danger in what you say if we hadn’t, as a government, already taken action. We’re not just arriving in government and saying, ‘Oh, look, this is all, you know, terrible.’ We’ve arrived in government and immediately had a mini-spending round and reduced spending by £6 billion in-year, so we have sent a very strong signal about that this is a government that recognises the problem, but also wants to take action to deal with the problem, and I think what I’ve set out today is a very calm and clear analysis of how bad the problem is and what the consequences are of not taking action, but I think people can judge us by what we have already done and then obviously judge us on the Budget that we announce, the spending figures we announce, the plans for the rest of the Parliament and that, I think, is what people will rightly want to hear.

Is there a danger we could unite people against us? This is fraught with danger. This is a very, very difficult thing we are trying to do. You know, I went to address all the peers in the House of Lords before the election. I remember looking round the room and there were all these great figures from the past, of Geoffrey Howe and Nigel Lawson, and no one in this country has had to deal with an 11% budget deficit before. Why? Because we haven’t had one before. This is worse than anything that people have had to deal with before, and so yes, there are great risks and great difficulties in dealing with it, but to me, the challenge of statesmanship is to take difficult decisions in the national interest because it’s the right thing to do, and you have to try and take people with you as you do that, but what is clear to me is an even easier way of uniting the entire country against you would be sitting back and waiting for the realisation to grow that Britain’s economy was hopelessly in debt, debt interest payments were eating up all of the hard-earned taxes that everyone in this room and beyond pays, and that the government was just too weak and feckless to do something about it.

We have to act, we have to convince people it’s the right thing to do, and then we have to do our best to take them with us on the difficult decisions along that path. That is what this is all about. It’s not meant to be easy, it is incredibly difficult, no one’s done it before, but we have to do our very best to deal with it and I believe that we can. And I think the coalition helps us, because we have two parties together actually facing up to the British people and saying, ‘Both of us have come to this judgment that it’s the right thing to do, and we’re going to carry this through together and we’re going to try and take you with us as we do so.’

Question

Thank you, Prime Minster. If the situation is so much worse than you previously thought, isn’t it time to take the difficult decisions as you suggest and look again at ring-fencing, protecting particular budgets, like sending billions of pounds of taxpayers’ money overseas and the Health Service, because surely everything should be up for grabs? And also, if I may, if the public sector has got too big, how much smaller should it be? Do you have any sense of the kind of share of the economy it could/should take up?

Prime Minister

I don’t believe in announcing some sort of pre-conceived share of what the government should account for in an economy; I believe in trying to get the economy growing, trying to get the private sector moving, trying to fire up the engines of entrepreneurialism so actually we have a more affordable situation, that’s what needs to happen.

In terms of the areas that we’ve ring-fenced, I think there are good reasons for them, and part of them are about what sort of country we want this to be. You know, the NHS is one of the most essential things for every family in our country, and I think it sends a very positive message to say to people: ‘yes, we are going to have to take difficult decisions, yes, there are going to have to be public spending programmes that are going to have to be cut, yes, there may be things that the government did in the past that it can’t do in the future, but when it comes to the service that every family absolutely wants to be there and provide the best they possibly can for their families, we’re going to protect that. So as we take these difficult decisions, a well-funded NHS (because health is the most important thing in your life) will be there for you.’

Again, on the issue of overseas aid, I would say that there is a very good moral argument. Britain has built a place in the world about sticking to our word on our aid commitments, and we can hold our heads up in the G20 or the EU or in any other forum in the world, on the basis that this is a generous country, a compassionate country, that even when we’re dealing with our difficult problems, we send money to other parts of the world where people are living on a dollar a day or less. And the fact that you can look in the eyes of the French politician, the Italian politician and many others and say, ‘Well, sometimes you may not say that Britain is engaged enough in these forums, but when it comes to the promises we make, we stick to them, and we stick to them on behalf of people who are living in incredible poverty, with huge difficulties’ and I think this is the sort of country that wants its government to go on being compassionate in that way, just as the people of this country themselves are compassionate when it comes to Red Nose Day or Comic Relief or all those other events where people give so generously.

So I think picking out those two areas is right, and it will help us to make the moral argument about what sort of country this is as we deal with the incredibly difficult decisions that we have in front of us. That’s what the coalition has to do. It is going to be a very, very difficult task, but I believe it’s a task that actually helps to bring us together in this common endeavour of making sure that at the end of this five-year period, at the end of a Budget and a spending round that will be difficult, that actually people say we sorted out our problems, we paid down our debts, we found our way in the world again, we started to grow again, we started to get an economy that was about jobs and living standards and things that we want. That’s what this is about: yes, difficulties, but, as I said in the speech, we’ll come through it together and in the end we will come through it stronger and it’ll be something that Britain will be able to turn round to others in the world and say we did this important thing. It needed to be done, we did it, we did it well, and we’re a better off country as a result of it. That’s what this challenge is about.

Thank you very much for coming. Thank you to the Open University again and thank you very much for listening.

Below is the text of the speech made by David Cameron, the then Leader of the Opposition, on 31st March 2010.

This election is about big choices. Five more years of Gordon Brown. Or change with the Conservatives.

New energy, to get Britain moving. A new sense of ambition. And renewed optimism that we can build a better future together.

But today, we face a big problem: people are sceptical that change can actually happen.

Voters feel burned by the broken promises of the past and let down by the politicians of today.

People think: ‘you’re all the same, none of you will make a difference’.

I believe we’re starting to show that change is possible when it comes to our economy.

To deal with the deficit that’s holding our economy back; to stop the tax rise that could kill off the recovery.

Labour say: we must not do anything to save money or stop wasteful spending this year.

We say: no, we need to cut spending today to stop taxes rising tomorrow.

Acting now on debt.

Boosting enterprise.

That’s the way to get our economy moving.

So yes, there is a choice – a big change in our economy.

But this election will not just be about the economy.

Britain’s broken society will be on the ballot too.

And it’s especially when it comes to our social problems that people doubt whether change can really happen.

They see drug and alcohol abuse, but feel there’s not much we can do about it.

They see the deep poverty in some of our communities, but feel it’s here to stay.

They experience the crime, the abuse, the incivility on our streets, but feel it’s just the way are going.

They see families falling apart, but expect that it’s an irreversible fact of modern life.

I despair at all these things too.

But I don’t accept them.

We should not accept them.

When it comes to science we have faith in our ability to push boundaries.

When it comes to tackling disease, we have confidence that we can find cures.

When it comes to tackling climate change, we believe we can create the products and services that will do the job.

So why are we so reticent to believe we can do the same for our social problems?

If we put our mind to it, we can overcome them just the same.

But we need big ideas.

And it’s a big idea we’re here to talk about today.

It’s an idea that has informed my whole time as Conservative leader.

In my leadership campaign I said “there is such a thing as society, it’s just not the same thing as the state.”

One of my first speeches as Conservative leader was in the East End of London, at a fantastic social enterprise, launching the Social Justice Policy Group with Iain Duncan Smith.

Throughout the past four and a half years, I have consistently argued for, and developed policies to bring about, a shift from state to society in tackling our most stubborn social problems.

Big society – that’s not just two words.

It is a guiding philosophy – a society where the leading force for progress is social responsibility, not state control.

It includes a whole set of unifying approaches – breaking state monopolies, allowing charities, social enterprises and companies to provide public services, devolving power down to neighbourhoods, making government more accountable.

And it’s the thread that runs consistently through our whole policy programme – our plans to reform public services, mend our broken society, and rebuild trust in politics.

They are all part of our big society agenda.

So too are our plans to deal with our debts.

As you heard from George Osborne and Philip Hammond earlier, building the big society does not become redundant in age where we have the biggest budget deficit in our history.

In the long-run, cutting the bills of social failure is the best way we’ll get the deficit down.

And in the medium-term, reforming the way we provide public services will be crucial if we are going to deliver more for less.

This idea, the big society, is both incredibly ambitious, but also refreshingly modest.

Ambitious because its aims are sweeping – building a fairer, richer, safer Britain, where opportunity is more equal and poverty is abolished.

But modest too – because it’s not about some magic new plan dreamt up in Whitehall and imposed from on high.

It’s about enabling and encouraging people to come together to solve their problems and make life better.

Some people say that there are no big ideas in politics anymore.

But I think this is about as big as it gets.

It’s not the big state that will tackle our social and increase wellbeing.

It’s the Big Society.

And we know we have to use the state to help remake society.

LABOUR FAILURE

This is a long way from where we are today.

For the past thirteen years we’ve had a government that has increased the power, role and size of the state.

There are now more people working in quangos than we have trained soldiers.

Labour have created 3,000 new criminal offences.

More than one in every three jobs created since Labour came to power have been in the public sector.

Why does Labour put such faith in laws, regulation and bureaucracy?

Partly because that is the natural instinct of the Labour Party – and especially of Gordon Brown.

They don’t believe change can happen without pulling a lever from on high.

But there is another reason – and it goes to the core of New Labour.

Always a communications strategy rather than a proper governing one, it’s the Government of “eye catching initiatives”, it’s the Government not of the summit, the action plan, the legislation-as-press-release, it’s government of the short-term, by the short-term, for the short-term.

It doesn’t matter so much what the long term impact is – as long as it is my impact, brought about by my action, following my statement, my initiative, my press release.

If drug abuse is rising, better to appoint a new czar and promise a crackdown rather than consider why so many young people are turning to drugs.

In Labour’s world, for every problem there’s a government solution, for every issue an initiative.

This is not what Beveridge dreamed of when he created the welfare state.

And in the real world this approach is stifling the innovation, the can-do spirit and the imagination that we know is out there in people that we believe is the key to our progress.

BIG SOCIETY

Creating the big society means unlocking that potential.

It is our positive alternative to Labour’s big government – and what I hope will be a proud legacy of a future Conservative government.

Indeed just as the past six decades were about building the welfare state, I hope the next decades are about creating the big society – which has the potential to be just as transformational for the country.

The question is how.

Our starting point has got to be a redistribution of power away from the central state to local communities.

As you’ve heard today, whether it’s allowing parents to choose schools, paying families to produce energy, letting residents elect a police commissioner, we will bypass the bureaucrats and give power straight to local people.

But building the big society is not just a question of the state handing over the reins of power and hoping that people will grab them.

We’ve got to actively help and encourage people to play their part.

This requires a new role for the state.

As I said in the Hugo Young lecture last November, the state must be there “galvanising, catalysing, prompting, encouraging and agitating for community engagement and social renewal.”

So let me be very clear: the big society does not mean no government.

It means a new kind of government.

That’s what the policies you’ve been hearing about today are all about.

They explains how a new Conservative Government will use the state to help remake society.

And we’re focusing on three specific areas.

PUBLIC SERVICE REFORM

First, public service reform.

From welfare reform to school reform, early years support to drug rehabilitation, we plan big changes based on clear principles and a common approach.

Getting rid of centralised bureaucracy that wastes money.

Breaking open state monopolies – and even giving people who work in our public services the chance to take ownership of the organisation they work in.

Opening up public services to new providers and saying to charities and private companies – ‘if you’ve got the ideas and the people to tackle our most deep-rooted social problems, come and play a role in our public services.’

And then paying them by the results they achieve.

Again, it’s not enough just to pass on the reins of power and expect charities and voluntary organisations to grab them.

The truth is when you’re paying people by results, it can take time to earn a payment – and this can lock many smaller providers out.

It can deter some of the most innovative people.

So here government has a new role to play.

We’re going to bring in a new Big Society Bank so that social enterprises have access to the ‘start-up’ finance they need to bid for government contracts.

We will use unclaimed assets from dormant bank and building society accounts and get extra private sector investment to provide hundreds of millions of pounds of new finance directly to social organisations.

The Big Society Bank will also provide funding to independent bodies – like the Young Foundation or Esme Fairbairn Foundation – that have a track record in supporting our most innovative social enterprises.

They’ll be there to identify the best social enterprises – however big, however small.

Provide small amounts of working capital to help them grow.

Mentor and advise them so they grasp the best opportunities for delivering public services that serve the public.

And, crucially, to help to franchise the best models around the country.

Just yesterday, I went to a brilliant social enterprise in Liverpool called Home By Mersey Strides.

It gets former prisoners, the homeless and the long-term unemployed to repair and assemble damaged flat-pack furniture and then sells it to students and the local community.

Started in November it already employs forty people.

But at the moment, the amazing work of this enterprise in Liverpool is confined to just one location.

This is the exactly the sort of thing we need to spread across the country – giving more people a chance to make a life for themselves.

That’s the big society in action – all made possible by devolving power and using the state to encourage social organisations and socially-minded individuals to come forward.

NEIGHBOURHOODS

That same approach lies behind our plans to encourage people to come together in neighbourhood groups so they can work together to make life better.

We’re going to give communities the chance to take control.

Setting up new schools. Taking over the running of parks, libraries and post offices. Holding beat meetings so they can ask police officers what they’re doing. Planning the look, size, shape and feel of new housing developments.

Have no doubt: if we win on May 6th, the people will have the opportunity to take power on May 7th.

And today, we’re setting out a big ambition.

We want every adult to be a member of an active neighbourhood group.

I know some people argue that there isn’t the appetite for this sort of widespread community participation.

I don’t agree.

Look at the 400 groups who have contacted the New Schools Network to ask about setting up their own school – and our policy hasn’t even been implemented yet.

Look at the nearly 30,000 faith-based charities who desperately want to do more – but too often find themselves excluded from mainstream funding.

Look at the dramatic rise in volunteering during this recession – with YouthNet alone recording a 115 percent increase in the number of people asking for opportunities.

Those who say there is no appetite for social action are just out of touch with what’s really going on in this country.

But again, we don’t want to leave anything to chance.

Yes, we will hold out the reins of power.

But we want to help people grab it too.

That’s where our plan for community organisers comes in.

In the United States the energy, enthusiasm and passion of community organisers has fired up whole neighbourhoods to take control of their destiny.

We want to see that right across the UK.

So we will use revenue from the Cabinet Office FutureBuilders programme, a programme the National Audit Office has criticised for its poor delivery, and redirect it to training thousands of new community organisers in the years ahead.

And we’ll ask independent groups like London Citizens to undertake this work.

To teach potential community organisers how to identify the doers and the go-getters in each neighbourhood and recruit them to their cause.

To teach them them how to bang heads together to get things done.

Indeed, Barack Obama trained as a community organiser in Chicago.

And I hope that in the years to come, a similar inspirational figure will emerge from community work in our inner cities – and go from the back streets of Bradford or Bolton or Birmingham all the way to Downing Street.

But I know the arguments that some people make – that this sort of community co-operation will only happen in the richest areas.

In building the big society, I want to make sure that Britain’s poorest areas do not get left behind as they too often are today.

So again, we will take money from the Futurebuilders programme, and direct it to community organisers, social enterprises and neighbourhood groups in our most disadvantaged areas.

This is the big society made real – devolving power to the people while using the state to encourage social action and help the poorest.

CULTURE CHANGE

But beyond these important policy changes on public services, on neighbourhood groups – we need something more, something widespread: a lasting culture change across the country.

The big society demands a big social response, mass engagement.

It means millions of people answering that noble question first asked by John F Kennedy: ask not what your country can do for you, but what you can do for your country.

This won’t happen unless the big players in society make it happen.

Business, the civil service – and yes, political parties.

Here we have really started to show what is possible.

Take the social action projects that have really made a difference at our party conferences.

Take the fact that when someone gets selected as a Parliamentary candidate for the Conservative Party, I write to them and say: do something positive, do something worthwhile, start a social action project in your constituency.

As you heard from Sayeeda this morning, there are now 150 of these projects up and running and another fifty jobs clubs too.

And it’s why for the past three years an army of Conservative Party volunteers – Members of Parliament, councillors, candidates, members who are doctors, teachers, coaches or just willing volunteers –  have gone out to Rwanda and played a small role in the rebuilding of that country.

But where politicians can take a lead, I don’t think they should try and pull a lever to bring about a culture change of community activism across our country.

Building the big society is not just about what government does – not by a long way.

And that’s why another event that is happening today – just a few minutes from here – is so exciting.

Today sees the launch of the Big Society Network – and I hope many of you will join me in going along.

Independent from government, the Big Society Network will be a national campaign for social change.

Its aim is to provide encouragement and support for everyone to be an active citizen.

It’s going to be whether or not there’s a Conservative Government.

But of course, a Conservative Government will give it all the support we can.

One of the ways we’ll do that is with an annual Big Society Day, celebrating the work of neighbourhood groups, highlighting the work of community heroes and building public pride in social action.

But the Big Society Network is run by the people, for the people, and I know it will make a massive difference to the whole culture of social action in our country.

CONCLUSION

The vision we’ve been setting out here today is unashamedly optimistic.

And unapologetically ambitious.

But I didn’t come into politics to do small things.

I don’t aspire to run this country to manage Britain’s decline.

I’m here because I want to bring change to this country and I believe we can change this country.

Think of what individuals and communities can do and any despair is defeated.

Are you telling me we can’t mend our broken economy, when we’ve got some of the best entrepreneurs in the world?

Are you telling me we can’t mend our broken society, when everywhere I go I meet the most brilliant and committed social activists?

Are you telling me we can’t mend our politics, when people are crying out to take more control over their lives?

No – we can get our country moving.

We can restore hope in our future.

We can if we come together, work together and build the big society together.

Below is the text of a speech made on May 19th 2008 by David Cameron.

“For the past two and a half years, the changes I have led in this Party have been aimed in one direction: giving people a positive alternative to a failing government. I don’t want us to be elected on the back of a disintegrating Labour Party. I want us to be elected with a clear mandate to make the changes Britain needs.

“So we’ve changed the way we select candidates. After the next election our Party will be more like the country we hope to lead. We’ve changed our policies and our politics: becoming once again the true champions for progressive ideals like tackling poverty, protecting the environment and kick-starting social mobility. We have taken clear positions and stuck to them:

“Putting economic stability before tax cuts.

Improving public services for everyone, not helping a few to opt out.

Recognising that the progress people want to see is a better quality of life, not just higher GDP.

“All this supports the overriding mission we have set for ourselves: to revive our society just as Margaret Thatcher revived our economy; to reverse Britain’s social breakdown, just as she reversed our economic breakdown. And we have set out how we will achieve that mission – by ending the era of top-down state control and big government. We want to respond to what should be a new post-bureaucratic age, by decentralising power, by giving people more opportunity and control over their lives, by making families stronger and society more responsible.

ANGER WITH LABOUR

“That is our positive alternative, the alternative to a Labour government that people are increasingly regarding with contempt. Whether it’s on the streets of Crewe and Nantwich, around the country in the run-up to the local elections, or in the emails and letters I get, I’ve noticed a new feeling of anger.

“It’s not just because the Prime Minister can’t seem to stop treating people like fools – whether it’s on the true reason for last year’s cancelled election, or the true reason for last week’s 10p tax trick. It’s not just because in Britain today there are more people in severe poverty and nearly five million people on out-of-work benefits, because mortgage rates have gone up and the cost of living is going up and because all this shows that Labour have failed to deliver either the social justice or the economic efficiency they promised.

“The anger today is about more than Labour’s economic incompetence. It’s about more than Labour’s failure to advance progressive ideals. The reason people are more and more angry with the government today is that while they see their taxes going up and up, there’s no corresponding improvement in the quality of their lives.

“Of course our quality of life is not just about what government does – far from it. But there’s a real sense of unfairness that people are feeling today. They feel that Labour have broken the basic bargain between government and the people, the bargain that says: “We’ll take money off you in taxes, and you’ll get decent quality services in return.” That’s what I want to focus on today.

WE NEED TO START LIVING WITHIN OUR MEANS

“After a decade of reckless spending under Labour, Britain needs good housekeeping from the Conservatives. We need to start living within our means. Why? Because in the decades ahead there will be pressure to spend more on the essentials – whether that’s care for the older generation, equipment for our armed forces, or more prisons and police to keep us safe. At the same time, we have reached the limits of acceptable taxation and borrowing.

“With the rising cost of living, taxpayers can’t take any more pain indeed they want a government that can give them the prospect of relief. And our economy can’t take any more pain without losing jobs to lower tax competitors.

“So how are we going to square the circle? How are we going to spend more on the essentials without putting taxes up – and over time, creating the space for cutting tax, as we have promised to do? Our overall method and aim are clear: we will share the proceeds of economic growth. Sharing the proceeds of economic growth is what living with our means, actually means. Not spending everything we have. Not borrowing to spend beyond our means. But ensuring that, over time, the economy grows faster than the state, so spending falls as a share of national income and we can reduce taxes and borrowing.

“Those who criticise sharing the proceeds of growth have sometimes not appreciated that if a government actually did this, either taxes, or borrowing, or both would have to fall over an economic cycle. I stress: have to fall.

“Today we are setting out our strategy for delivering this commitment. We’ll do it by attacking the problem at its source: by attacking the three causes of a bigger state and rising public spending.

“First, the cost of social failure. Family breakdown, unemployment, drug and alcohol addiction – these social problems rack up the biggest bills for government, so we’ve got to get them down.

“Second, the cost of unreformed public services. Massive top-down state monopolies cost more and deliver less, so we need to improve the running of public services through more choice, competition and non-state collective provision.

“And third, the cost of bureaucracy itself. All bureaucracies have an inbuilt tendency to grow, so we need to call a halt to the wasteful spending and inefficiency we’ve seen under Labour.

“But that’s not about some one-off efficiency drive, it’s about a whole new method of government that’s careful, not casual, with public money.

“That is our strategy. It learns the lessons from Labour’s failure to control public spending. It’s based on simple Conservative principles of good housekeeping. And it avoids easy answers in favour of commitments that we know we can deliver.

LABOUR AND WASTE

“The first and most obvious mistake Labour have made it when it comes to public spending and taxpayer value is their acceptance of government waste. It’s clear that we now have in power in this country a bunch of Labour politicians who are just shockingly casual about public money and how it’s spent.

“£20 billion wasted on an NHS computer that still isn’t working properly.

£2.3 billion spent refurbishing the offices of MOD civil servants.

And in one year alone nearly £2 billion of tax credits lost due to fraud and error.

“These are outrageous examples of a spendaholic culture in government a culture that is the public sector equivalent of the reckless, debt-fuelled spending spree that Gordon Brown’s policies have encouraged in the private sector. The level of government waste in our country today is evidence of an out-of-touch political elite who have forgotten whose money it is they’re spending. Ministers who get in their offices and think ‘great, now how can I spend lots of money.’ People who have become so accepting of government waste that they assume it’s just part of the job and that anyone who objects must be calling for “cuts.” But Labour’s mistakes on public spending go far deeper than their casual tolerance of government waste.

LABOUR AND REFORM

“I believe that a much more important factor than the waste is the superficiality of Gordon Brown’s political thinking.

“Let me explain how I see it. Contrary to the fashionable view today, I think the Prime Minister has always been rather good at political communication. He was the one who wrote New Labour’s soundbites – “tough on crime, tough on the causes of crime”; “social justice combined with economic efficiency.” He even used to talk about “cutting the bills of social failure.”

“But he has never developed a clear set of political ideas, or a clear political strategy, for achieving the aims expressed by the soundbites. Brown has been good at talking, lousy at delivering. He can tell you what he wants to achieve, but not how he’s going to achieve it. That’s why people are getting so angry now.

“They were promised national renewal, and ended up with very little of substance being achieved at all.

“And so we see today a government with absolutely no coherent plan for tackling our country’s deep-seated social problems – in particular the devastating rise in family breakdown and absolutely no coherent plan for reforming public services in order to make sure they deliver value for taxpayers’ money.

“One minute it’s local accountability for policing, the next it’s a whole new set of top-down targets. One minute it’s a constitution for NHS independence, the next it’s a top-down plan for closing GP surgeries and replacing them with polyclinics. One minute it’s school reform…the next it’s putting LEAs back in the driving seat.

“And with Ed Balls using his job to promote his leadership credentials to the Labour left, it’s just a non-stop series of moves to block and reverse school reform, and to increase state control of education.

“The Prime Minister’s draft Queen’s Speech last week set out his legislative agenda more or less right up to the next election. That’s it. There’s nothing more to come.

“Anyone looking for serious reform, especially in those crucial areas of school reform, welfare reform and strengthening families the areas that can make the biggest difference to our society now knows that as far as this Prime Minister is concerned, the cupboard is bare.

CONSERVATIVE PRINCIPLES

“Our positive alternative is based on three clear principles – principles of good housekeeping applied to the nation’s finances.

“These principles matter because when it comes to these big questions of tax and spending, in many ways the nitty-gritty questions that are at the heart of politics people don’t just want some technocratic explanation of projected shares of GDP.

“They want to know where you’re coming from. What your basic attitude is. Why it would make a difference to have a new set of ministers sitting in those offices making those decisions.

“So here’s what we’re about. This is our attitude, and this is why we would be different.

“First of all, we understand that you can’t get decent quality on the cheap. We will give public services the proper funding they need so that everyone in the country can have access to the services they need. As I’ve said before: no ifs, no buts, no opt-outs.

“Second, we understand that when ministers and officials spend money, it is taxpayers’ money, not government money.

“We will be careful with it, not casual. We will expect to be judged on a clear basis: if you’re taking people’s hard-earned money away from them you’d better be able to show that you’re spending it on what people want and that you can get better value for that money than they could.

“And our third principle is the need for long-term tax reduction. As George and I have said repeatedly, we believe in low taxes – because we believe low taxes are both morally right and economically efficient. But as we have also said, we will never trick people into voting for us with promises of tax cuts that cannot responsibly be delivered, or that cannot be sustained.

“We are the party of low taxes for the long term, not tax cut promises for the short term. That is why we are setting out our long-term strategy today. When it comes to tax and spending, it is tempting for politicians to make simplistic promises and to give easy answers to difficult questions. I know there are people who want us to do just that today, and I’d like to explain why I don’t think that would be right.

NO EASY ANSWERS

“We all know that the easiest thing in the world is for an opposition party to stand up at an event like this and blithely talk about all the efficiency savings we will make in government how we will streamline public spending, how we can close tax loopholes, how we can move towards a bright future of less spending and less tax with a few well-chosen cuts that miraculously deliver substantial savings without harming public service delivery at all.

“It is a well-trodden path by opposition parties. I know – I’ve been there.

“At the last election, we produced something called the James Review. A long list of all the government functions, quangos and bureaucrats a Conservative government would cut.

“Well-intentioned – certainly. A Conservative government should always try to cut out waste and deliver value for money for taxpayers. It’s in our political DNA.

“And the James Report was a serious and impressive piece of work. But was the overall approach credible? I’m not so sure. To make a long list of efficiency savings in advance of an election; to add them up to produce a great big total; to turn that total into debt reduction, spending increases elsewhere and a tax cut…?

“People didn’t believe it, for the very good reason that controlling public spending is not about a one-off efficiency drive, it’s about a whole new culture of government.

“There is a simple fact which political historians amongst you will know very well. The government “efficiency drive” is one of the oldest tricks in the book. The trouble is, it’s nearly always just that – a trick.

“In fact it’s such a cliché, there was an episode of Yes Minister about it, called “The Economy Drive.” Ministers are summoned, officials instructed, the media prepared for sweeping savings in the running costs of government. And then, a few months down the line, the sheepish-looking ministers and officials come back and say “well actually, it wasn’t quite as straightforward as we’d hoped, Prime Minister.” Gordon Brown announced another one last week.

“Let me make it clear: I believe that driving efficiency though the government machine should be a constant administrative effort. Every business has to improve its efficiency every year, or it won’t survive. That should be a constant principle of government too

“But I do not believe in simplistic lists of cuts. In naïve over-estimations of potential savings. Or in cobbling together a big number in order to get a good headline. Making government more efficient and cutting out waste is absolutely part of our strategy for controlling public spending. But it is only a part.

“To make it the only thing in our plan would simply not be credible. The scale of the public spending crunch that is coming down the line, the scale of people’s expectations for public services, and the imperative for competitive taxes all mean that we need to think far more deeply about the role of the state if we are to live within our means in the decades ahead.

“It cannot and must not simply be about “efficiency savings.” And it must especially not be about the kind of short-term savings that in the end add to demands on the state because they undermine social value in the name of delivering economic value. Spending cuts that look efficient on a powerpoint chart but end up costing more money are just a false economy. Instead, living within our means is about taking three key steps.

REDUCING DEMANDS ON THE STATE

“The first way in which we will control public spending is to reduce the long-term demands on the state. We need to tackle the causes of the social problems that give rise to public spending in areas like welfare and crime. That means taking forward the work that began with Iain Duncan Smith’s magnificent Policy Group report, Breakthrough Britain.

“The key areas for radical reform, and the early focus of our work in government, will be in school, reform, welfare reform, and strengthening families.

“We have already published: Policy Green Papers on school reform and welfare reform, and some of our thinking on making Britain more family-friendly. And the next stage in our work on strengthening families will be published within the next few weeks. If we get these three things right: school reform, welfare reform and strengthening families, then I believe we will make serious progress in tackling these deep social problems that have caused so much pain, and cost so much money, for so long.

“But we will also be developing policy beyond the immediate focus areas of schools, welfare and families to address the complex and interconnected problems Iain and his team identified in his report, From drugs to debt; from children in care to people with disabilities.

PUBLIC SERVICE REFORM

“The second way in which we will control public spending is by carrying out the work that was the great missed opportunity of the Blair and Brown years – proper public service reform. Unlike the Labour Party, there is no internal feud or ideological war preventing us from carrying out the reforms that everyone knows are needed.

“As Nick Herbert set out in a superb speech last week, there is now a distinctive modern Conservative approach to public service reform, based on clear thinking about how we can give power over services to those who use them.

“Where services are individually consumed we will transfer power over those services to individual people, giving them a choice between competing providers.

“And where services are collectively consumed, we will transfer power over those services to the lowest practical tier of government, opening up provision to social enterprises, private companies and community organisations.

“For us, public service reform is about choice and voice – bringing greater accountability to the provision of public services, so the power relationship is not top-down – from Whitehall to public services but side to side – a new relationship between the professionals who deliver public services and the public, who pay for them and use them.

“So in education we will end the state monopoly and allow new schools to be set up by a wide range of expert organisations, giving parents real school choice for the first time. In the NHS we will get rid of the top-down political micromanagement and put the power in the hands of patients, who can choose the GP who they think will get the most out of the NHS on their behalf. And in prisons and probation we will empower the local managers – and pay them by results.

EFFICIENCY AND TRANSPARENCY

“The third component of our strategy is cut out waste and make government more efficient. That is one of the principal responsibilities of Francis Maude and his implementation team. This is a really significant commitment for us.

“Normally, political parties would only devote resources to the things that directly help them win an election. But we don’t just want to win – we want to know exactly what we’ll do when we’ve won.

“So Francis and his team will be looking at government efficiency right across the board: procurement, staffing, structures – everything you would expect from a modern, professional and businesslike operation.

“We are using the best private sector expertise to find ways to save taxpayers’ money and improve service delivery. But I do not believe that it’s enough to just stand here and make promises about efficiency. I believe we need to create additional pressure on ourselves – and that’s why I believe transparency in public spending is an absolutely vital part of this.

“If we can show people exactly how their money is being spent, that will leave no hiding place for waste and inefficiency. It will shame ministers and officials into spending public money wisely.

“And in this post-bureaucratic age, the information revolution makes such detailed accountability possible for the first time. That’s why last year, we introduced a Bill in Parliament to force the government to list on a public, easily searchable website, every item of public spending over £25,000.

“Unsurprisingly, Labour blocked it – but I can promise you that this will be one of the first innovations of a Conservative Government.

“And I can also announce that we will shortly be launching an online whistleblower service, so that people who work in the public sector can tell our Implementation Team about the waste and inefficiency they would like us to change.

CONCLUSION

“So that is our three-part strategy for controlling public spending: reducing the long-term demands on the state; reforming public services, and making the public sector more efficient and transparent. Britain needs this strategy because under Labour, Britain is on the wrong path.

“They have splashed the cash like there’s no tomorrow – but the trouble is, there is a tomorrow, and it’s got to be paid for.

“Unless we make big changes, we’re heading for a future as a high-tax, uncompetitive backwater with soaring social costs and a falling quality of life. To avoid that future, while fulfilling the essential requirements of modern government, we will need to put into action those good Conservative principles of good housekeeping.

“And then we can look forward to a very different future: a low tax, competitive economy, with a high quality of life and the opportunity for everyone to make something of their life. It used to be said that “good food costs less at Sainsbury’s.” Well I want good services to cost less with the Conservatives. That’s why it’s so vital that we have a serious plan for living within our means.

Below is the text of the speech made by David Cameron, the then Leader of the Opposition, to the King’s Fund on 21st April 2008.

My thanks to the Kings Fund for hosting us today. I am here to talk about general practice and the polyclinic programme. But first I want to set out the context of my party’s overall approach to the NHS.

The health service needs serious reform. That reform should be steady, purposeful and with a clear direction, avoiding unnecessary upheaval. Changes in lifestyles, in technology and medicine itself, in the expectations people have of the services they receive all this means we need a more decentralised, more patient-centred, less bureaucratic system. And at the same time, if we are to maintain public consent for all the extra spending the NHS receives we have to ensure better value for money than we’ve had in the past.

But my point is that reform should be bottom-up, not top-down: wherever possible driven by the discretion of professionals responding to the needs and wishes of their patients.

We need to change the essential power relationship in the NHS: from a vertical relationship where professionals are told what to do by politicians and managers above them with patients left just to take what they’re given to a horizontal relationship where professionals have the necessary autonomy and discretion to respond to the demands of patients and patients are in the driving seat because they have the ultimate power: the power to choose the service they want.

How do we get there? One thing I’m sure of: we won’t get there through yet another massive structural reorganisation. For too long the NHS has been treated by Government like a surgeon treats a patient – laid out unconscious on the operating table, passively receiving major invasive surgery. Instead we should treat the NHS more like a walking, talking, conscious adult, in its right mind: in need of treatment, yes, but able to understand what’s going on and, most importantly, able to take significant responsibility itself. In a word, we politicians need to treat the NHS as if we were its GP, not its surgeon.

Assaults on the NHS

No one says Labour doesn’t care about the NHS. But it’s not enough to support an institution in principle. You’ve got to understand how it works. And to me the way Labour has treated the NHS over the last 10 years shows a severe lack of understanding.

There have been reforms and counter-reforms. The abolition of the internal market under Frank Dobson. The return of the internal market under Alan Milburn, but with the addition of countless bureaucratic targets. Then the catastrophic loss of financial control under John Reid and Patricia Hewitt leading to the closure of community hospitals, maternity units and accident and emergency units.

It is genuinely impossible, looking back, to trace any coherent direction in the path of Labour’s health policy over the last 10 years. The one constant has been a restless series of changes which, to the NHS itself, have felt like a series of frontal assaults. It all reflects Labour’s seduction by management consultants.

It’s said in the private sector that no-one ever got fired for hiring IBM. The same seems to go for the NHS. You see it in all the constant upheavals: the PCGs and the PCTs, the SHAs and the StHAs, the fiasco of the junior doctors system which replaced recruitment by human beings with recruitment by a computer, and an incompetent computer at that; the billions – literally billions – of pounds of public money wasted.

It’s all the product of Labour’s bureaucratic mindset, or what I call policy by PowerPoint: clever flowcharts and organograms which ignore the human relationships that are the most important aspect of healthcare.

GP contract

And this applies especially to primary care. Look at the mess the Government has made of the GP contract. First, they negotiated a deal which took the responsibility for organising extended opening hours and out-of-hours care away from GPs and gave it to Primary Care Trusts.Then, when the PCTs didn’t organise this extended access, the Government cried foul and blamed GPs for it.

It is fundamentally dishonest for the Government to blame GPs for agreeing to a contract that ministers negotiated and urged GPs to accept. Nor is it GPs’ fault that they are being paid far more than they or the Government intended – it’s the Government’s fault for miscalculating doctors’ workload. And that’s what happens when you organise the health service using top-down bureaucratic methods dressed up to look good on a PowerPoint presentation.

Private providers

I often can’t help thinking that Labour have been blinded by the private sector – not just management consultants but private providers too. The ironic result is a smaller role for GPs – the original independent contractors to the NHS. PCTs are taking back control from GPs, and shifting contracts to private providers under preferential terms.

This is a flawed strategy. It didn’t work in secondary care when the Government paid for block contracts with independent sector treatment centres at 11 per cent more than the equivalent cost in the NHS. And it won’t work if executed in the same way in primary care.

Worst of both worlds

So we have a flawed GP contract, and an uneven playing field for providers. Neither side of the purchaser-provider split is working properly. Indeed, the Government has spent 10 years oscillating between the rhetoric of local decision making on one hand and their instinct for central control on the other.

Now, instead of the original system of doctors buying care directly for patients, Primary Care Trusts hold the purse strings. They call it Practice Based Commissioning. But in fact GPs neither hold real budgets nor have the ability to reinvest savings on behalf of their patients.

As Julian Le Grand has put it, the Government was “trying to get the best of fundholding and the best of the health authority and probably ended up with the worst of both.” Put another way, we have ended up with neither a GP-led service nor an efficient central bureaucracy.

The role of the GP

So let me set out how I think general practice should work. I have a simple starting point. GPs should manage the entire relationship that a patient has with the NHS: meaning they should be responsible for providing the care that patients need or commissioning it from other providers or a mixture of the two.

In a nutshell, GPs should control the budgets that NHS patients are entitled to. There is a good economic rationale for this. Budget-holding is a natural guarantee of efficiency, ensuring that money follows the patient and it is spent on frontline care rather than on bureaucracy. GPs – rather than remote managers – should be responsible for reconciling the available resources with clinical priorities and patient choice.

And there is a good health rationale for GP budget-holding too: what’s called the continuity of care. The family doctor service is the way to ensure that – even though the patients may see many specialists – there is always one doctor in charge: the doctor closest to the patient. This is especially important when it comes to preventative action or the management of chronic conditions, which require significant patient involvement.

Five years ago Gordon Brown said that “in healthcare the consumer is not sovereign” – meaning that patients should not be trusted or expected to manage their own care. Well I disagree. Because I believe in general practice. With the GP to advise the patient and to commission care on their behalf from a variety of providers, then in healthcare the consumer can be sovereign.

Polyclinics

All this brings me to the plan for polyclinics. Just at the very moment that patient sovereignty is becoming both possible and popular with technology and consumer expectations both in its favour, the Government is going in the other direction.

The plan for a national network of polyclinics is the biggest upheaval in primary care since the creation of the NHS or even since the beginning of modern general practice in the 19th century. Because of course in 1948 GPs were left alone, as small independent practices operating under contract to the NHS.

60 years later, Gordon Brown is attempting what Nye Bevan never managed to do: make GPs salaried employees of the state, and abolish small practices in favour of large multipurpose centres.

Let me, in fairness, acknowledge the government’s rationale for polyclinics. I accept that the scheme is not simply designed to save money. And as I said in my Party Conference speech last year, it is often a very good thing for GPs to share premises with specialists like physios and pharmacists.

In fact, many GP surgeries already provide these services, and they’re especially popular with young professionals. If you’ve got a back problem, say, and you also need some jabs for a business trip to India a polyclinic open till 8 in the evening may be just what you need. But frankly that’s not the sort of person who most relies on primary care.

The Government says that in London, most patients will be within a mile and half of a polyclinic. The people who need GPs the most are the elderly, those with small children and those with long-term conditions. Those are the people least able to get to a polyclinic, and least comfortable in a large impersonal institution. They like to rely on the doctor they know, at the end of their street, often in a building not much bigger than a house. They have a human relationship with their GP that they simply won’t have with a member of staff at a polyclinic.

So I don’t object to polyclinics in principle. I object to the principle of imposing them on local communities without public support and against the wishes of GPs themselves. Where they occur, they should occur naturally, as the voluntary combination of free agents – not as the latest structural re-organisation of the NHS. Lord Darzi, the health minister behind the polyclinics plan, has admitted that doctors will, effectively, be forced into polyclinics using the GP contract. It is quite wrong.

If the Darzi plan is implemented a thousand GP surgeries are likely to close in London alone – that’s three quarters of the total. Another 600 local surgeries will close across the country. Labour has already tried to bring about the end of the district general hospital.

Now they are trying to abolish the family doctor service. Communities which have lost their Post Office, their local shops, their local police station, are going to lose their doctor. So the Conservative Party will fight Labour’s plans to close GP surgeries. We pledge to save the family doctor service from Gordon Brown’s NHS cuts.

Modernisation

The Government presents this as modernisation. Well, as so often, Labour gives modernisation a bad name. I don’t believe that 21st century medicine requires the end of the family doctor service.

A truly modern health service would enhance the small local GP surgery, not abolish it. The creation of an NHS national digital network means that small practices can connect to other services where there is additional need. For example, say more outpatient therapists and diagnostics are required. If GPs are given budget-holding responsibility to contract for those services, they can easily source the necessary providers. Improved provision of care in the community doesn’t require loss of small practices.

GPs petition

I want us to establish now the consensus we need for a primary care led health service in the future. So let me read to you the petition organised by the thinktank “2020health” and drawn up in consultation with Andrew Lansley and Mark Simmonds. It represents the values that GPs and patients have discussed with Andrew and his team over recent years.

I quote:

“We believe that General Practice is the foundation of the NHS.

We are the first point of contact for the majority of patients, and we value the relationships we develop with our individual patients.

We believe that GPs should remain independent contractors to the NHS, and support a level of remuneration commensurate with our responsibilities and the quality and outcomes we achieve.

We want to be free from central Government interference and bureaucracy; able to control our own budgets; rewarded for working in socio-economically deprived areas; free to re-invest for our patients’ benefit and able to innovate in contracts with healthcare providers.

We also believe we should be free to determine the opening hours, size and locations of our practices, in response to our patients’ needs, and object to being forced into polyclinics against our will.

We want a structure of primary care that is truly accountable to patients, and is encouraged and rewarded for innovation, excellence and outcomes.”

These are the values of General Practice which the next Conservative Government will defend. We want to work in partnership with GPs, not in conflict with them as this Government is doing. So I urge GPs to sign up to this petition and ensure that the next Conservative Government has the backing of the profession to modernise general practice in a way that works for the staff and patients of the NHS.

Conclusion

I said at the outset that I believe NHS reform should be gradual and organic – but that it should have a clear direction. This stands in contrast to the sudden, misdirected jerks that have characterized Labour’s health policy over the last 10 years.

So in conclusion, let me set out the four basic steps that a Conservative Government will take. First, our commitment to a fully-funded health service: increased NHS spending year on year. Second, devolution of power to the front-line – and that especially means GPs. More power and responsibility for NHS professionals, and more choice and freedom for patients.

Third, independence for the NHS as a whole. Politicians should be focusing on the health outcomes that the NHS achieves in exchange for taxpayers’ money – not trying to micromanage every decision. So we will formally make the NHS independent of Government control. And then last – the conclusion of these reforms – a transformation of the Department of Health itself. From the national manager of primary and acute care, to the agency responsible for public health. These are the steps that a Conservative Government will take to reform the NHS.

Below is the text of the speech made by the then Leader of the Opposition, David Cameron, to the Community Security Trust on 4th March 2008.

I’d like to thank the Community Security Trust for inviting me to share this evening with you.

It’s great to be among friends and to see some familiar faces.

WHY THE CST MATTERS

But tonight isn’t just about enjoyment.

We are here for a profoundly serious reason.

To raise money to protect the Jewish community.

A community that comes under attack to a greater degree than any other faith or ethnic group in Britain.

All minorities are to some degree at risk from bullies, thugs and racists.

But Catholics can stand outside churches after Sunday mass…

…Hindus and Sikhs and Buddhists can chat outside temples…

…even Muslims, who certainly suffer from abuse and discrimination, can gather outside mosques after Friday prayers.

It is only Jews who are advised not to linger outside synagogues before or after services.

This is not paranoia.

It is a precaution against very real threats.

There is the dreadful hooliganism we saw in Brick Lane on Holocaust Memorial Day…

….when a group of Jewish visitors to the area was attacked with bricks by local youths.

And there is the blood-chilling revelation, during a recent terrorist trial, that the same cell that was plotting to blow up Bluewater shopping centre also had in its possession a list of London synagogues.

This dinner has a very clear purpose: to ensure that the CST can carry on protecting the people and events that we know are potential targets.

Carry on monitoring those who would harm this community.

Carry on raising awareness about the cancer of anti-semitism.

The CST is highly regarded because it is combines vigilance with responsibility and performs its duty with dignity and restraint.

It is seen by the police as integral to their work with the Jewish community.

Britain is still a relatively safe place but, as the CST’s latest report shows, Jews in this country are coming under increasing attack.

The police and security services do a great job but, inevitably, they have many priorities and limited resources.

That’s why the Community Security Trust is so vital – in providing that extra layer of vigilance that could, in certain circumstances, make the difference between life and death.

The young men and women who you see outside synagogues and community events – including those here tonight – do a fantastic job and they need your help so please support the CST as much as you possibly can.

AUSCHWITZ

Let me make one thing absolutely clear.

I support school visits to Auschwitz. Always have. Always will.

The point I was making is that the government press release about funding should make it clear that schools themselves have to make a contribution to the cost.

It didn’t. It should have done.

And let no-one be in any doubt – these visits will continue under a Conservative Government.

BUILDING A SAFER AND STRONGER SOCIETY

But tonight I want to talk more generally about how we can build a safer and stronger Britain…

…and how we should deal with the very real threat posed by those who seek to undermine our society.

I intend to examine three linked elements of that threat.

The first is terrorism which is the most obvious and horrific manifestation.

It demands an effective and unyielding security response.

The second element is the extremist mindset that gives succour to terrorists.

It requires a clear-headed and principled political response.

And the third element is the fostering of community divisions which push people into mutually antagonistic blocs rather than treating them as part of a greater whole.

It requires a generous and inclusive social response.

FIGHTING TERRORISM

Let me deal first with terrorism.

Britain has learned since 9/11, and especially since 7/7, that it’s not just the Jewish community that is under threat from Islamic extremists.

Every man, woman and child is a target for terrorists who are actively plotting indiscriminate slaughter on a massive scale.

We should be frank about the nature of the threat we face.

There are some people who still do not appreciate the new realities.

They believe that the threat is no different from that posed to Britain by terrorism in the past, for example by the IRA.

But in reaching that conclusion they are ignoring the evidence that is piling up from court case after court case.

This terrorist threat is clearly different from those we have faced before.

We are dealing with people who are prepared to do anything, kill any number, and use suicide attacks to further their aims.

These people include a number of our own citizens.

They are driven by an extreme perversion of Islam which holds that mass murder and terror are not only acceptable, but necessary.

As a society our response to terrorism must be robust and unyielding.

It must also be practical.

We must invest in our own police and security services to ensure we are doing all we can to prevent any future atrocities.

We must enforce our existing laws and strengthen them where necessary, so suspected terrorists, and those that incite them, are prosecuted, convicted, and imprisoned – or when appropriate, deported.

I would go further.

We have got to stop thinking of foreign, defence and security policy as separate issues.

That is why I have appointed Pauline Neville-Jones to my Shadow Cabinet.

As a former Chairman of the Joint Intelligence Committee, she brings here formidable experience in this field.

She has proposed the establishment of a National Security Council – and her idea has already been copied by the Government.

In the coming weeks she will be visiting Israel to learn first-hand how it tackles terrorism.

There’s more we should do.

With the huge number of asylum seekers and extensive people trafficking into the UK we need a dedicated border police.

With some of the perverse judgements in our courts that seem to bend over backwards to accommodate terror suspects…

…we need a new Bill of Rights, so that we can replace the Human Rights Act and better defend our security and our freedoms.

I don’t believe in knee-jerk responses to the threat of terrorism.

There’s nothing to be gained from enacting laws that are authoritarian and ineffective.

But a future Conservative government will not hesitate to take whatever measures are necessary to protect British citizens from harm.

DEFEATING THE EXTREMIST MINDSET

The direct threat from terrorism is very real and very deadly but it is at least straightforward.

There is a general consensus about the need to combat it and a raft of practical steps that can be taken.

The second element of the threat we face is much harder to tackle.

That is the extremist mindset that gives succour to terrorists by excusing their actions.

The historian Michael Burleigh has written a brilliant new book I would urge you all to read.

It’s called Blood and Rage: A Cultural History of Terrorism.

In it, Professor Burleigh demonstrates how, time and time again, people who have resorted to terrorism have been assisted and sustained by apologists who seek to make excuses for them.

In some cases, even to glorify them.

We saw it in the 1970s when the Red Brigades were hailed as liberators by some Italian university professors.

We saw it in the 1980s when parts of the Labour Party were prepared to appear on platforms with IRA front men.

And we see it today when some people attempt to justify suicide bombers and call them ‘martyrs’.

To us, it seems self-evident that there is a clear dividing line between those who set out to kill and maim innocent civilians and those who do not.

But the extremist mindset constantly seeks to muddy the water, to blur the distinction and even to invert the reality.

Last year I visited Birmingham Central Mosque.

While there, I was told that the 7/7 bombers were innocent and that, in fact, MI5 may have carried out the atrocities.

I was particularly shocked because the person who said this was not some teenage hothead…

…he was the chairman of the Mosque.

Conspiracy theories are a convenient way for those who sympathise with terrorist aims to dodge moral responsibility for terrorist acts.

The same people claim that the twin towers were brought down by the CIA or Mossad.

Let’s also be clear.

Extremism is not confined to any particular religious or ethnic group.

During protests against the conflict in Lebanon, we witnessed the nauseating sight of well-scrubbed, middle class English people…

…marching through central London holding placards that read ‘We are all Hizbollah’.

That is the extremist mindset in action.

These are the same people who urge a boycott of Israeli goods and academics…

…while saying nothing about China, Iran or Zimbabwe.

Unless we challenge such attitudes and expose them for the morally-bankrupt nonsense they are…

…they will spread through the body politic and become the received wisdom of millions.

The task of fighting ignorance and injustice should not be left to organisations like the Community Security Trust alone.

It is the job of government to provide leadership by taking a clear, unequivocal stand.

Gordon Brown recently banned Yusef al-Qaradawi, the spiritual leader of the Muslim Brotherhood and a notorious preacher of hate, from Britain.

A man who justifies suicide bombing and calls for homosexuals to be murdered has no place here.

That’s why I asked raised the matter in the House of Commons and asked the Prime Minister to keep him out

But at the same time I also called for him to exclude the head of Hezbollah’s notoriously anti-semitic TV station, Ibrahim Moussawi.

Moussawi was recently banned by the Irish government but for some reason he has now been allowed into Britain.

He’s here at the moment, on a speaking tour, spreading his vile message.

The government cannot afford to split the difference with the extremists – excluding Qaradawi, letting in Moussawi.

Terrorist apologists should be kept out. Full stop. Period.

We also have to deal with our home-grown merchants of hate.

Here again, the government has questions to answer.

Hizb-ut-Tahrir is an extremist organisation that poisons the minds of young Muslims against Jews, Christians and other unbelievers.

Some of those who have been through its ranks have ended up in Al Qaeda.

In short, it is a conveyor belt to terrorism.

Tony Blair declared in 2005 that it would be banned.

That didn’t happen.

Instead it is still active, recruiting on campuses and from London street gangs.

There’s only one responsible course of action.

It’s time to close down Hizb-ut-Tahrir.

Another area of concern is the way that public money that is meant to be used to combat extremism has ended up in the hands of extremists.

The government has allocated hundreds of thousands of pounds to local authorities to improve community cohesion.

But there are worrying signs that ministers have taken their eyes off the ball.

Tower Hamlets council has received extensive funding for such projects.

But it has now been revealed that one of the organisations it has given thousands of pounds to is a front for the Muslim Brotherhood called the Cordoba Foundation.

And what was the first thing this organisation did with the money?

It organised a public debate with the title ‘Has Political Participation Failed British Muslims?’

And who did they invite to speak?

The leader of Hizb-ut-Tahrir.

Even the most basic research would reveal that the Cordoba Foundation has close connections to people with extremist views, including Azzam Tamimi, the UK representative of Hamas.

There are indications that this problem is more widespread.

In the weeks ahead I will be making proposals to isolate extremists and make certain they cannot obtain public grants or get invited to sit on public bodies.

That won’t just apply to Islamic extremists.

We will be equally vigilant in ensuring that groups linked to the BNP or animal rights militants are excluded too.

The message should be clear:

To those who reject democracy.

To those who preach hate.

To those who encourage violence.

You are not part of the mainstream.

You will not get public funding.

You are not welcome as part of our society.

We will only defeat the extremist mindset if we understand and confront it.

ENDING COMMUNITY DIVISION

The third element of the threat we must overcome is divided communities.

I believe that we need to place a renewed emphasis on social cohesion and the things that unite people rather than the things that divide them.

Let’s be clear: there is no more contradiction between being a good Muslim and a proud Briton than there is in being a good Jew or a good Christian and loving your country.

But we have to work at finding what we have in common and making this a home for all of us.

It is this context that I’ve been saying for a long time that we’ve been handing a victory to our enemies – to those who want to divide and those who oppose liberal values – through the doctrine we have applied to community relations.

Some call it group rights.

Some call it state multiculturalism.

We know what we’re talking about.

It’s the idea that we should respect different cultures within Britain to the point of allowing them – indeed encouraging them – to live separate lives, apart from each other and apart from the mainstream.

It involves setting ethnic groups against each other in a competition for public money and lavishing vast sums on translation services which could be better spent on teaching people how to speak English.

It means treating groups of people as monolithic blocs rather than individual citizens.

It means turning a blind eye to, or at least failing to intervene in, atrocious crimes like forced marriage.

Of course we should respect different cultures.

But we shouldn’t encourage them to live apart.

As the Chief Rabbi has put it, state multiculturalism is best understood in the idea of Britain as a hotel…

…with separate private spaces so separate cultures can live behind locked doors and be merely ‘serviced’ by the hotel management – in this case, the state.

It is a wrong-headed doctrine that has fostered division and stopped us from strengthening our collective identity.

The modern alternative to the ‘hotel’ of multiculturalism is not a castle of traditional patriotism – pulling up the drawbridge and forcing everyone into a parody of late Victorian Englishness.

Instead, we need to think of our country, and again the Chief Rabbi has described it best, as a house we build together…

…with the common foundation of the values of a liberal society, but perfectly capable of alterations and additions…

…so long as these changes are compatible with the existing architecture.

The problems of community cohesion are real and, in some places, deep-seated.

They cannot be solved simply through top-down, quick-fix government action.

State action is certainly necessary today, but it is not sufficient.

It must also be the right kind of action, expressed in a calm, thoughtful and reasonable way.

And it must respect the distinction between integration and assimilation.

British people have always been more willing than most to accept difference.

The principle we must promote is the right to equal treatment despite difference – that’s a unifying concept.

It creates an atmosphere in which minorities can feel secure and respected…

…which, in turn, creates confidence and willingness to extend respect to others.

That is how we will banish division and build a united society.

LIVINGSTONE

I know this a non-political event.

And, rightly, all parties back the CST.

But I am the first Conservative in 10 years to address this dinner…

…and as it is 2008, I hope you will allow me this one plea.

There is one politician in Britain who not only does not “get” any of what I have said…

…he has repeatedly acted in a completely arrogant, dangerous and divisive way.

In the 1980s he invited IRA apologists to County Hall.

Today he not only plays host to Qaradawi but publicly embraces him.

And through all of this his attitude to British Jews has bordered on the dismissive and insulting.

He’s not a minor politician.

In fact, he is a rather powerful one.

He is the mayor of this great city.

And I hope that on May 1st people of all parties and none.

Of all faiths and none.

People who always vote and those who never vote.

Will rise up as one, go to the polling station and throw Ken Livingstone out of office.

CONCLUSION

I think the Jewish community understands very well the importance of the matters I’ve raised tonight.

You have set a magnificent example of how it is possible to participate fully in national life while honouring and conserving your own traditions.

And, as a part of that, the Community Security Trust plays a key role in underpinning your security and peace of mind.

This is a dangerous and difficult world.

It contains very real threats.

But I am determined that we will face those threats together.

We’ll take them on and defeat them.

And emerge a safer, stronger and more united society because of it.

Below is the text of the speech made by David Cameron, the then Leader of the Opposition, at Chatham House on 1st April 2008.

Tomorrow, NATO Heads of Government will meet in Bucharest for the NATO Summit. When I first entered politics in 1988, this would have been almost unthinkable. Then, Bucharest lay behind the Iron Curtain. President Ceausescu was preparing to host what would turn out to be the Warsaw Pact’s final summit. NATO’s armies faced East to deter invasion. In Afghanistan, the Soviet Army was fighting the Mujahadeen, nearly a decade after their invasion. Months later, everything changed, as freedom rolled East across Europe, the threat of invasion disappeared and a brave new world was born that the experts predicted would be safer and more ordered than the old.

I learned some powerful lessons from those heady days about our national security: how rapidly the global scene can change; never to take the conventional wisdom for granted; and to dare to hope that apparently immoveable structures and forces can change.

As NATO’s leaders begin their summit tomorrow, they will have plenty on their agenda: the vital missions in Afghanistan and Kosovo, NATO’s enlargement, Its relations with Russia and with key institutions like the European Union, and the pressing need to fill gaps in Allies’ military capability.

But underlying those important items lies a much bigger question: what is NATO for in the modern world? Next year, NATO will be sixty years old. This is a key opportunity.

The opportunity, working with the United States, and a more Atlanticist President in France, for our generation – which grew up in freedom under NATO’s shield – to renew our Alliance for the twenty-first century. The opportunity to modernise it to protect us as effectively now as it did in the past. The opportunity to come together as Allies, to renew our commitment to defending, together, our values and way of life, and to championing that task with our peoples.

That is the challenge and the responsibility that falls to Western leaders tomorrow at Bucharest – to set out the big vision for the Atlantic Alliance in today’s world.

The case for NATO

Let me make my position clear right at the outset. What I stand for, and what I believe. I am a liberal Conservative: liberal – because I believe civil rights, democracy, pluralism and the rule of law are the source of progress and a key component of lasting security. But Conservative too: because I recognize the complexities of human nature, am sceptical of grand utopian schemes to remake the world, and understand that you have to be hard-headed and practical in the pursuit of your values. And a crucial part of that liberal Conservative tradition is recognizing the importance of NATO.

I believe that NATO remains as essential to Britain’s security, and to Western security, in the age of global terrorism as it was in the era of Soviet expansionism. The Conservative Party has always been a staunch supporter of NATO. We remain a NATO-first party. We believe in the primacy of NATO.

Not for reasons of nostalgia or sentimentality. But because defending our nation’s security must come before everything else, and NATO remains the best guarantor of our safety, even though the circumstances which led to its formation have altered dramatically. Atlanticism is in my DNA and in the DNA of the Conservative Party.We have always believed in the cardinal importance of the relationship between Britain and the United States, a relationship which, in the security context, is anchored in NATO.

The next Conservative Government will be a Government that makes the case strongly for NATO. A NATO that binds together the US, Canada and Europe. A NATO that is a key institutional bridge between the two sides of the Atlantic and provides a framework of stability in the historically troubled Balkans and in central and eastern Europe. A NATO that helps guard the liberal values of our societies. And a NATO whose continuing relevance can be seen in the queue of countries wishing to join. But we will also be the champion of a NATO that is fit for purpose today.

A changed world

The world has changed almost beyond recognition since NATO came into being. It now includes most members of the former Warsaw Pact, and finds itself engaged in the biggest combat operation in its history in, who could have imagined it, Afghanistan.

We are living in a different age, in which – as the US Ambassador to NATO put it – ‘every school-kid on each side of the Atlantic can tell you what Al Qaeda is but few remember the Soviet Union. And one where we are once again asking ourselves whether the structures we built to take us through the Cold War – our NATO Alliance, the EU, the World Bank, the UN – are up to the 21st century challenges we face today.’

NATO’s evolving role

During the Cold War, NATO’s basic purpose was straightforward: to contain and counter the threat posed by the Soviet Union and its allies and to deter Soviet aggression against Western Europe. As the House of Commons Defence Select Committee put it in their recent report, this common threat ‘served as a glue, binding the Alliance together.’

But when the Soviet Union collapsed, that single overarching purpose disappeared with it. In 1962, the former American Secretary of State, Dean Acheson, famously described Britain as a country that had lost an Empire but had yet to find a role.

Some argue that NATO, with the welcome demise of the Soviet Empire, is in a similar predicament today. I think that’s unfair. I think that NATO does have a role today – a vital one. But I don’t think it’s been sufficiently clear about what that role is.

This lack of clarity has brought two unwelcome consequences. First, a weakening in the solidity of the Alliance. And second, a decline in its popular support. The challenge for NATO leaders today is to articulate clearly the Alliance’s twenty-first century role, thereby both strengthening NATO and building support for its operations.

The post 9/11 world – new threats, old principles

So what is that new role for NATO?

In recent years, the Alliance has transformed itself from a reactive defence alliance into one which, with the EU, has exported stability across central and eastern Europe. It has proved ready to use its military power to enforce peace in Bosnia and halt ethnic cleansing of European muslims in Kosovo.

But it is true that September 11th 2001, although long in gestation, awoke the world to a new kind of threat. Just as the shot fired by Gavrilo Princip ushered in a new and dreadful era at the start of the last century, so this one was marked by its own brutal equivalent of Sarajevo 1914.

Having emerged unscathed from the era of Mutually Assured Destruction, now we were entering a new age in which a fanatic in a cave in Afghanistan – far beyond the North Atlantic area – could orchestrate destruction and mass casualties on the streets of Western cities. NATO responded by invoking its mutual defence clause – Article 5, in which an attack on one is regarded as an attack on all – in a powerful symbolic gesture of solidarity with the United States.

But it was not immediately obvious what practical contribution NATO could make in responding to this new kind of threat, and many predicted that NATO’s days as a valuable defence alliance were over.

And yet with the passage of time, it has become clearer on both sides of the Atlantic that although the threats may be new, the principles we need to apply in responding to them are not.

I would argue that there are four in particular: First, just as transatlantic unity was vital in defeating Nazism and then Soviet Communism, so we must stand together today in protecting our societies and the values we hold dear. Second, just as Europe needed a strong America engaged in the world then, so we need strong American involvement today. Third, just as we needed to make our European voice heard in Washington in those days, so we must help shape American policy today. And fourth, just as the US was entitled to look to its Allies to make a meaningful contribution then, so it is entitled to expect them to carry their fair share of the burden today, especially if they want to be listened to.

Afghanistan

All of these issues are evident in microcosm in NATO’s operation today in Afghanistan. Many criticisms are made of NATO’s efforts in Afghanistan. I have expressed for many months my serious concern about how that mission is progressing. But we should acknowledge up front how far NATO has had to come. In the Cold War, it never had to fight a war or operate out of its area. Now it is doing both.

NATO is having to learn fast.

The campaign in Afghanistan is teaching some hard lessons about what it takes to wage a 21st century counter-insurgency – a combined civil military effort in which soldiers operate alongside development workers, diplomats and police trainers.

As the US Ambassador to NATO put it: ‘Whether flying helicopters across the desert, embedding trainers with the Afghans, conducting tribal shuras with village elders or running joint civil military Provincial Reconstruction Teams, most of our Allies are reinventing the way they do business.’

It is often said that if NATO fails in Afghanistan, that is the end of NATO.

To my mind, the danger is not that NATO would collapse. It is that the US would no longer regard it as having any utility. To echo General Macarthur – the Alliance would not die; it would gradually fade away. The threats and the dangers would remain: but we would have lost our framework for managing them.

The blunt truth is that the NATO mission in Afghanistan has thrown up some fundamental problems which NATO leaders simply must face up to in Bucharest.

These range from:

– uncertainty about the Alliance’s objectives there and how these relate to its raison d’etre;

– a dangerously unequal sharing of the burden in the dangerous south of the country;

– the corrosive effect of national caveats on fighting ability and unity within the Alliance;

– a chronic lack of key pieces of equipment such as helicopters, despite the hundreds that NATO has available on paper;

– competing and un-coordinated chains of command, which Senator McCain and I spoke about when he was here;

– and difficulty in working with other organisations such as the UN and EU, essential to delivering a comprehensive approach, a point I have discussed with Chancellor Merkel.

NATO needs to tackle these problems not just to succeed in Afghanistan, but if it is to be an effective military Alliance in the years to come. Afghanistan is not the only state in danger of failing – not the only state which could provide a haven from which terrorists could plot and strike.

We must hope that in such cases we shall be able to avert by other means the need for military action. But the reality is that future NATO operations are more likely to involve defending ourselves, as in Afghanistan, against extremist violence, than checking an onrush of tanks across the plains of Europe.

When President Truman inaugurated the Alliance in 59 years ago tomorrow, he declared:

‘What we are about to do here is a neighbourly act. We are like a group of householders, living in the same locality, who decide to express their community of interests by entering into a formal association for their mutual self-protection’.

That is as true today as it was then. NATO membership remains an insurance policy in an uncertain world, a world that is constantly changing and where, as we have seen, new dangers can emerge as suddenly as old ones can pass.

So we must stay vigilant; and we must be ready to adapt to tackle these new threats.

Let me set out some practical steps we might take.

Modernising NATO

If NATO is to be effective in the digital age we need to bring its bureaucratic machinery up to date. It needs to be able to take decisions more quickly. This is far from easy in an Alliance of 26 members where political decisions are rightly taken by unanimity, and whose cumbersome political structure is ill-suited to swift political military requirements of today. It is time for change.

For example, we should look at devolving operational command to the NATO Commander on the ground. A number of former Defence Chiefs – including our own former Chief of the Defence Staff Lord Inge, General Shalikashvili, the ex-Chairman of the US Joint Chiefs and NATO Supreme Allied Commander, and General Naumann, the former head of NATO’s Military Committee – have suggested this. This would allow more decisions about military requirements to be made in the field.

It could also be combined with a streamlining of the NATO chain of command. The aim should be to make it easier for the NATO Commander in the theatre of operations, like in Afghanistan, to deal directly with the Supreme Allied Commander without having to go through an intermediate headquarters.

National Caveats

Another issue requiring urgent attention is the abundance of national caveats, under which national governments impose restrictions on how their forces can be used on operations. National caveats are causing immense damage in Afghanistan – complicating the task of theatre commanders and breeding resentment amongst those Allies that are bearing the brunt of the fighting.

As General McNeill, the US Commander of ISAF has said, national caveats ‘are frustrating in how they impinge on my ability to properly plan, resource and prosecute effective military operations’.

The problem is not with a national caveat per se. The decision to deploy troops in combat is the most important decision a sovereign government can take, and it is inevitable that they should wish – and are sometimes constitutionally obliged – to be able to retain an ultimate say in how their troops are deployed.

The problem is with the proliferation of national caveats that started in NATO’s Balkan operations and has got completely out of hand in Afghanistan. Last month the Times reported that examples of national caveats currently range from a ban on deploying out of area, to no night flying, to no flying in poor weather, no involvement in riot control and no venturing from bases without the maximum force protection or too far from the nearest hospital.

This is no way to fight a war. Decisions in NATO are unanimous. No enterprise can be undertaken unless every member agrees. But once a government has agreed to send troops on an agreed enterprise, there has got to be a basic doctrine, that if you’re in, you’re in.

The more flexible a country can be in the tasks its troops may perform, the greater their value to the operational commander – or, as the Polish Foreign Minister, Radek Sikorski, has said: ‘He who gives without caveats, gives twice’.

A common operational fund

But we have to be frank: the problems are not only about structure and process. We have to improve NATO’s military capability. The fact that of the 2.4 millions soldiers Europe has under arms, only 3-4% are deployable in expeditionary operations. The dramatic disparity on defence spending not just between the US and Europe, but within Europe itself. 80 % of defence research spending is by Britain and France.

As President Sarkozy has said: ‘European security cannot rest on the shoulders of 3-4 countries’.Some of our NATO allies certainly need to spend more. The benefits of common defence imply that every ally carries a fair share of the burden. How could this be done better, beyond the familiar appeals and exhortation? I have two proposals.

Under current arrangements, those who do the fighting also do the funding – bearing both the risks of casualties and the financial strain. This is neither fair nor sustainable in the long term. We have seen how it has led to large disparities in the funding of the current mission in Afghanistan.

When Article 5 was invoked in the wake of 9/11, all NATO members agreed that international terrorism did not just threaten some of us, but all of us. And we all agreed to stand together in confronting that threat. Can it be right in an alliance which is underpinned by the principle of collective defence – all for one and one for all – that there can be such wide differences in how the costs for the funding of that protection fall?

Or that those nations that make the biggest investment in modernising their capabilities and as a result deploy most frequently should end up carrying the greatest financial load? We need to look, as Lord Inge and others have argued, to abandon the current arrangement – known as ‘costs lie where they fall’ – and replace it with a common cost sharing formula for operations, to which all Allies contribute.

Surely the time has come to set up a Common Operational Fund for expeditionary operations.

Not only would this help offset the costs of those who are making a substantial military contribution to operations. It would also provide a way in which allies who wanted to participate but currently lack the funding to do so would be able to take part in missions. It would give everyone a chance to make a contribution.

But money is only part of the answer. We also need to find ways of making more of NATO’s stock of equipment available for our common defence. For example, as Robert Kaplan has suggested, one area NATO could do more is at sea. Navies make port visits, police sea lanes and provide humanitarian access. The Norwegians, the Germans, the Spanish and others have been investing heavily in new ships, especially frigates. Kaplan argues that, with the US Navy concentrating increasingly on the Pacific, NATO could become the primary naval force to patrol the North Atlantic and the Mediterranean.

That is the sort of imaginative proposal we should be looking at, as is the potential for NATO to become a ‘global enabler’ offering its command and control arrangements for future multilateral operations alongside friendly countries like Australia, Japan or Singapore.

EU/NATO

Which brings me to two related issues: the relationship between the EU, and specifically European Security and Defence Policy (ESDP), and NATO; and the question of how much further NATO should be ready to include new members.

I warmly welcome both President Sarkozy’s intention to send a further 1000 French troops to Afghanistan, as I told him last week. I welcome too as his readiness for France to re-enter NATO’s integrated military structure.

France is one of the Allies that can put real military capability on the table, and the more France is in a position to contribute to our joint endeavours the better. In the case of Afghanistan, I very much hope that Paris will remove outstanding French caveats and place the forces under NATO command.

As far as the development of ESDP is concerned, I think we need to look very hard at what has actually occurred in the last 10 years since St Malo, and apply the lessons as we go forward from here.

A Conservative Government would have three key principles that would govern our approach.

First, what matters is that European nations that are members of NATO should make a greater military contribution to European and global security. That requires greater military capability, not new pillars or elaborate wiring diagrams in Brussels.

Second, we must at all costs avoid the development of separate chains of command. But there is a real danger of that happening.

Third, what we need in Brussels and in theatre is good and close working relations between the EU and NATO, and indeed between NATO and other players like the UN.

ESDP to date has not produced a close and harmonious relationship between the two organisations. It has not delivered greater military capability.

Part of the reason for that is a pre-occupation with process over substance, which has contributed to a feeling that the EU is more interested in bureaucratic empire building and less in making the hard choices – like spending more money – that would actually deliver greater military clout.

At the same time, the friction it has engendered has made it more difficult for the EU and NATO to work together in those areas where the EU can deliver crucial contributions to operations on the ground, through the provision of development aid, police trainers, and so on.

A Conservative Government would focus relentlessly on the practical things that need to change.

NATO should be honing its fighting capabilities for future conflicts which are inevitable though unpredictable, and more likely to be outside Europe than in.

The EU for its part should be concentrating on how to deliver more effectively on the ground the police trainers, the development workers, the customs officers and so on that are such a vital to the success of these modern missions.

And the two institutions must work out how they can work seamlessly together in common cause, both in Brussels and in the field. If that is to happen, we need to resolve the dispute between Turkey and Greece and the Republic of Cyprus which is paralysing relations between NATO and the EU. That is something on which a Conservative Government would take a lead, just as we would argue powerfully for Turkey’s eventual membership of the EU.

My basic position is clear: defence is too important to waste resources on politically inspired duplication of effort – doubling up on institutions while doubling down on capabilities.

Enlargement, and the relationship with Russia

The other subject that will occupy leaders’ attention at Bucharest is the question of NATO enlargement.

As I indicated, the enlargement of NATO has helped to entrench European stability.

It was far from certain that the collapse of the Soviet Union would result in great swathes of Europe making the transition from oppression to democracy with – on the whole – relative ease.

The gradual incorporation of the new democracies into NATO underpinned that process, and paved the way for their later membership of the European Union. And, as with the EU, the process of qualifying to join NATO acted as a motor for reform.

The forthcoming entry into the Alliance of Croatia, Albania and Macedonia is further evidence of that, and will help anchor the Western Balkans to modern Europe.

I hope that other countries, such as Sweden, which could bring a lot to the Alliance and which already works closely with it will in due course feel able to join it as a member. Further afield, Georgia and Ukraine have expressed a wish to join NATO. Their mere aspiration has provoked outrage in Moscow, and threats that nuclear missiles will be re-targeted in their direction. I hope that the arrival of President Medvedev will make it possible to move on from this sort of bellicosity, and towards a more productive relationship between Russia and NATO, and Russia and the West more generally.

Russia wants to be treated with respect. But bullying does not earn respect. If Ukraine and Georgia decide that they wish to join NATO, as democratic, sovereign governments, and if they meet NATO’s standards, then we should support them.

Russia cannot have a veto over their decisions, any more than it can over NATO’s. Equally, Russia should understand – and be re-assured – that NATO and the West pose no threat to Russia. We understand Russia’s historic concern about its security.

We must persuade Russia of our shared interests – in a stable Europe to which Russia can export her energy, in a stable world in which we confront shared threats – such as the threat of a nuclear armed Iran – together.

Russia may be big. But she needs allies too. So we should be clear with Russia that if she wishes, the offer of a co-operative relationship is there, as President Bush has made clear on missile defence.

That choice is Russia’s, not ours, to make.

In the meantime, it is inevitable that the more strongly the chill wind of autocracy blows across the Russian steppe, the more those in its path will seek shelter in the Alliance’s protective embrace.

Conclusion

When President Truman inaugurated the Alliance in 1949, little could anyone have imagined the world that it would inhabit six decades later.

A world of unparalleled opportunity, in which people are being lifted out of poverty faster than at any time in human history.

A world in which the global balance is shifting Eastwards, and we must work together to persuade China that the higher her star rises, the greater her stake in global stability.

A world in which the threats we face today range from terrorism to weapons of mass destruction, from climate change to our dependence on fossil fuels, from cyber-attack to nuclear proliferation.

A world in which our protection no longer depends on static barracks in Hanover, but often on our ability to deploy the right mix of forces – military and political – to tackle extremism on the Hindu Kush.

But Truman would surely recognise that the fundamental tenet on which the Alliance was founded – the belief that we are much stronger together than alone – is as valid today as it has ever been.

So what are the tests for this summit at Bucharest?

It must deliver what is needed in Afghanistan, including a clear expression of our strategy there that the public can understand.

It must start to resolve the relationship between NATO and the EU.

But as the Alliance approaches its 60th birthday, its nations are looking for more than that: they are looking for leadership.

Leadership to fashion a modern mission statement for the Alliance for the 21st century, rooted in the mutual defence pact with which it began.

Leadership to modernise the way the Alliance operates.

Leadership to make the case for the Alliance to the new generation on both sides of the Atlantic.

Below is the text of a speech made by David Cameron on June 24th 2008 at the Royal College of Surgeons.

“A few weeks ago, I said the aim of a Conservative Government is to be as radical in social reform as Margaret Thatcher was in economic reform. That’s why, in office, our reform plans will focus on three particular things.

“The first is radical school reform – so our kids get the best education and learn the skills that will help them compete in the globalised economy. The second is welfare reform, so people move from long-term poverty to long-term employment. And the third is to strengthen families and make Britain the most family-friendly place in the world.

“But I also said, in that same speech, that the NHS must come first. There’s a simple reason for this. It’s because health – be it that of your own or your loved ones – is everyone’s priority and so it should be for politics too. And as we celebrate the sixtieth anniversary of the NHS this summer, let me make it one hundred percent clear:

“The fact we have a health service that takes care of everyone- whatever their needs, backgrounds and circumstances – is one of the greatest gifts we enjoy as British citizens and the Conservative Party will never – ever – take that for granted. We back the NHS. We will build it. And we will improve it for everyone.

GREEN PAPER

“And that’s what this Green Paper we’re launching today is all about. It sets out our ambition for the NHS – to improve our health outcomes, like cancer survival rates, so they are among the best in Europe. And it sets out how we will do that – by scrapping Labour’s bureaucratic, top-down process targets and replacing them with outcome measures , so that the professions can focus on the result itself, not how it is achieved. The ambition – the means. Let me briefly take each in turn.

IMPROVING OUTCOMES

“First, the ambition – to improve health outcomes so they are among the best in Europe. Now this may seem obvious – but it actually signals a major shift in the focus of the NHS. To understand that, we need to go back eight years.

“Back then, Tony Blair sat on Sir David Frost’s sofa and committed the Labour government to matching European levels of health spending. Today, that pledge has been delivered. But despite all this extra money – all that extra spending – we still have some of the worst health outcomes in the whole of Europe. Right now, England’s near the bottom of the table when it comes to five-year cancer survival rates – far below countries like Sweden and Germany, and on a par with Slovenia and Poland. We have one of the worst records of diabetic control – especially among children. And it’s awful that you’re more likely to die from a stroke in England than you are in any other country in Western Europe.

“So we’ve got a situation where we pump the same money into our health system as other countries, but on the thing that actually matters – a patient’s health and the results of their actual treatment – we’re doing worse. Seriously, if the NHS isn’t about improving the health of people – making them live longer, happier and more fulfilling lives – then what is it about?

“This is so typical of Labour. So obsessed with the process that they’ve lost sight of the bigger, and more important, picture – making people better. We’ve made clear our commitment to increase spending on the NHS, year on year, so it gets the investment it needs.

“But what this Green Paper sets out is how we’ll make sure that money delivers – by making our health outcomes among the best in Europe. And be in no doubt about what this will mean. If we improve the NHS so it meets the international average, we could save an extra 38,000 lives a year. If we improve the NHS so our results are comparable to the best countries in the world, we could save over 100,000 lives a year. That’s thousands of more people surviving cancer, surviving strokes and surviving lung disease. There really is no greater ambition for the NHS as it approaches its sixtieth birthday.

HOW WE’LL DO IT

“I know what you’re thinking – great ambition, but how are you going to deliver it? One thing I’m sure of: we won’t get there through yet another massive structural reorganisation. The past decade has witnessed a series of restless changes which, to the NHS itself, have felt like a series of frontal assaults – the latest of which is a national network of polyclinics imposed on local communities – and GPs – that don’t want them. Instead, we’ll offer steady, purposeful change with a clear direction.

“So we will build on and improve the NHS we inherit. Foundation hospitals won’t go, they’ll stay – and we’ll improve them. Commissioning by GPs is right – and we’ll make it really mean something. Not Labour’s phoney – and imaginary – budget-holding, but actually giving GPs real control over their budgets so they can re-invest savings and negotiate contracts with service providers to get best deal for their patients.

“Patient choice is essential – and we’ll make it actually work. Referral management centres were brought in to manage referrals between primary and secondary care. But too often they’ve overturned a patient’s choice of hospital and ordered them to get treatment elsewhere. Patient choice must really mean just that – so we’ll let patients choose any provider that meets NHS standards at delivers at NHS costs. Progressively, patiently, carefully, we will usher in a new era of quality and care.

NEW ACCOUNTABILITY

“But what this Green Paper is all about is how we can improve our health outcomes by ushering in a new era of patient-doctor accountability through an information revolution. If the last ten years has taught us anything, it’s that Labour has tested to destruction the idea that the NHS can be improved by more bureaucracy, more central control and more initiatives from the Department of Health.

“This approach is embodied no better than in the endless top-down process targets they impose on doctors and hospitals. Superficially, some of these targets may look sensible. After all, no one wants to wait a long time to be seen in A&E. But because they push healthcare professionals to make decisions purely to ‘tick boxes’ rather than because they’re beneficial to the health of their patient, too often the result is worse patient care and a worse health outcome. So we get the perverse situation where patients are kept in ambulances or in trolley waiting areas just so hospitals can say they’ve meet the centrally-directed four-hour A&E waiting time limit.

“This is crazy. Labour’s targets are all about chasing good headlines – and nothing to do with the clinical needs and the health of patients. So yes, to make sure our health outcomes are among the best in Europe, a Conservative Government will scrap all centrally-imposed process targets. But don’t for one minute believe the Labour lie that we’re giving up on quality – that we’re going to leave a vacuum of accountability.

“We’ve got a new approach. In fact, it’s an approach so obvious – and so simple – you’ll be astonished it doesn’t already happen. In place of Labour’s self-defeating top-down targets, we will harness the power of information and publish the details of healthcare outcomes. So we’ll measure cancer survival rates, instead of recording the number of radiotherapy courses delivered per month in a particular oncology unit. We’ll measure how well patients are after treatment, instead of timing how long someone’s in an A&E bed. And we’ll measure how many people lead active lives whilst suffering from chronic lung disease, instead of recording how many records GPs have updated into information systems.

“This is about concentrating not the ‘how’, but the ‘what’ about concentrating not on what politicians care about, but on those things that people really care about. How long will my Dad survive if he gets cancer? What are my chances of a good life if I have a stroke? What are my chances of surviving from heart disease? This is the kind of information people want and need. And this is the kind of information that will replace Labour’s bureaucratic, top-down and centralised idea of accountability – between minister and doctor with a post-bureaucratic, bottom-up and de-centralised one – between patient and doctor.

“Just think about the change this will bring. No more five-minute chats in your GP’s surgery picking a hospital based on its waiting times and availability. But the power – the ability – to really compare and contrast different care providers on the things that really matter to you and are easily understandable – survival rates, after care service, patient satisfaction.

“And with that patient choice and patient accountability, the rest will follow. For a start, we’ll start to get real value for money in the NHS. That’s because those who commission care – like primary care trusts and GPs – will be better able to decide how to get the best for their patients from the money available. And instead of sinking money into meeting top-down, politically motivated targets, care providers can actually focus on innovative approaches to getting the right outcomes for their patients and giving real value for money to the taxpayer. But more importantly than anything else, the quality of service will go up and we will achieve the sort of health outcomes enjoyed in the rest of Europe.

“It goes without saying that by making outcome information readily available, we will introduce an element of healthy competition between different care providers. They’ll be able to see what works and what doesn’t – what different practices are doing to achieve result and how they can learn from them. This isn’t about creating a cut-throat business environment. It’s about understanding that everyone who works in the NHS is rightly proud of where they work and will do everything and anything to provide the best possible care.

CONCLUSION

“I’m now going to hand over to Andrew Lansley who will explain in greater detail the changes we are proposing. But let me end by saying this.

“Few things matter more to our country than the NHS. I know the fear that all families feel when they think they won’t get the care they need. And I know the relief they feel when a kind, competent nurse or doctor is there for them. And in this, the NHS’s sixtieth year, I’m proud that people now look at the Conservative Party as the party of the NHS.

“But I don’t just want us to be the party of the NHS – I want us to be the party of a better NHS. And that means being clear about our ambition – to save thousands of more lives a year. And it means being clear about how we’ll get there. No more pointless re-organisations – just building and improving. No more top-down process targets – but an information revolution to measure outcomes. No more talking about patient power – but actually giving it to them, through greater accountability. That’s the way we can create a health service that is truly the envy of the world.”