3 February 2005
Howard: Power to parents and patients
Speech to the Guardian Public Services Summit
"I know you wouldn't expect me to count the Guardian as my favourite morning reading.
But then you wouldn't have expected Nixon to go to China, De Gaulle to decolonise Algeria or Margaret Thatcher to be the first Western leader to sound the warning on global warning.
The curious thing about politics is that it is often Conservatives who are the real radicals. Time and again it is politicians from the centre right who can see where an old consensus no longer works and liberate people to establish a new one.
When it comes to innovation, the Guardian has an estimable record. Not least in its coverage of the public sector. I particularly welcome the space you devote to reporting and analysing change in our public services.
Because I think of myself, more than anything, as a public servant. I have faith in the power of Government, exercising its responsibilities properly, to make a difference for the better.
Governments don't have all the answers - far from it. But if they govern with the right values, they can make a real difference.
And one overwhelmingly important value for Government is honouring public service.
Teaching, nursing, becoming a doctor or police constable - these are noble careers. More than that. They are professions. Worthy of respect.
It is natural that teachers should want, more than anything, the satisfaction - the sheer joy - of inspiring the next generation, and passing on that most precious commodity, knowledge.
Nurses and doctors, above everything, are inspired by their mission to cure the sick and heal the injured.
Policemen and women are driven, above all, by the wish to build safer, more cohesive communities.
We should trust these professionals to exercise their common sense and their judgement - to follow their instincts.
But this Government doesn't respect autonomy or appreciate what is distinctive about the professional's vocation. It just doesn't trust people.
Professionals are second guessed at every opportunity by Whitehall diktats, initiatives and targets. Our public servants have become human instruments of ministerial will.
Twelve pages of paperwork land on a head teacher's desk every school day.
The police now face 37 different Home Office targets.
The number of managers in the NHS is increasing three times as fast as the number of new doctors and nurses.
The balance in our society has been tilted too far in favour of central government at the expense of local communities and individual responsibility.
Britain must change track.
The question is how?
Power to Professionals
First, we must drive power downwards - ending the all embracing centralisation to which our public services have been subjected for too long.
Command and control doesn't work. We learnt that lesson with the economy in the 1960s and 1970s. The role of politicians is to set the right framework - not micro-manage from the centre.
That is why a Conservative government will get rid of Whitehall targets for schools, hospitals and the police - targets which distort priorities and get in the way of the delivery of good, local services.
Over 5,000 people a year now die from infections they picked up in hospital - more than are killed on Britain's roads. Yet central government targets prevent doctors and nurses closing wards that they know have been infected with MRSA.
Florence Nightingale, gazing at the field hospital in Scutari one hundred and fifty years ago was moved to remark that: "The very first requirement of a hospital is that it should do the sick no harm".
It is a duty, sadly, which her successors are not given the freedom to fulfil today.
Targets to reduce the number of expulsions from school prevented head teachers
expelling troublesome pupils. The disruptive minority are allowed to ruin the education of the majority.
If doctors and nurses need to close wards to clean up the super bug they should be free to do so.
If head teachers need to expel pupils for the sake of the majority, they should be able to do so.
Power to Parents and Patients
Second, we need to give more power to parents and patients. I believe that if people are given a choice they will generally make the right decision for themselves and their families. I utterly reject the patronising notion that the State knows best, that people should shut up and take what they are given.
Choice shouldn't just be the preserve of the rich - I want everyone to have the kind of choice in health and education that currently only money can buy.
Today's empowered consumer expects to be able to exercise choice. Yet our healthcare and education systems reflect the assumptions of the immediate post-war era when resources were limited and rationed. But we're not living in 1945 any more. A system that denies people choice over the most important aspects of their and their children's lives is out of tune with the times.
We need a new approach. We need the Right to Choose. We must let parents and patients choose what they believe is best for them and their children. Instead of bureaucrats deciding where the money goes, parents and patients will.
Some people want to cling on to the old ways. Gordon Brown is one of them. He has said that in health, "the consumer is not sovereign".
Let me repeat that. Gordon Brown said that in health "the consumer is not sovereign".
In other words people cannot be trusted to make decisions for themselves and their families when it comes to health care. But that is simply not true.
Choice works. It transfers accountability from politicians to patients and parents - those with the single greatest stake in the outcome. Doctors, nurses, teachers and everyone else employed in the healthcare and schools systems will no longer work for politicians, but in partnership with patients and parents.
They may be demanding - but that's because they want the best for themselves and their families. And it is far more rewarding to work for them than for interfering politicians.
I know that enfranchising individuals by giving them the ability to shop around and use their entitlements wherever they like will be distorted by the Government's spin machine. But it's a battle I'm delighted to fight. Our health policy will enable individuals to choose the treatment, supplied by the NHS or others, which is right for them.
In this debate, as so many others, we are on the side of expanding liberty, Labour are defenders of an outdated conservative order. We believe in respecting the intrinsic dignity of every individual by honouring their choices and decisions, Labour are culturally resistant to respecting that individual dignity.
The Right to Choose is not about removing government involvement - but simply about changing what government does. Government is transformed from being a monopoly producer and manager of healthcare and education, to one where it guarantees and funds everyone's Right to Choose.
I'm only too aware that when you make the case for choice there's a common response. We don't want choice people say, we just want a good local school or hospital.
Well I agree that people deserve good local services. The question is, how can we deliver them. No-one can honestly claim that we currently have uniformly good local services. choice is a means to an end - and that end is better services. Choice drives up standards in every field of human endeavour. It is monopoly is always the enemy of high standards.
Half the hospitals in Germany are in the private sector, but open to patients whose treatment is funded by the taxpayer.
Seven out of ten children in the Netherlands go to schools funded by the State, but not run by the State.
In Sweden, parents' right to choose has led to a huge increase in non-state run schools. All these systems produce much better results than we get here in Britain.
Our goal is ambitious but simple: for Britain to have world class public services, so we can hold our heads up high and have a renewed sense of pride.
Education: The Ladder of Opportunity
At the heart of the Conservative Government's mission is one objective - to give people greater opportunity in life.
I come from an ordinary family. I didn't have any special privileges. But my State school showed that there is no barrier to success - it is possible to give everyone, whatever their background, real opportunity.
Sadly too many children in Britain don't get that start in life. When I travel round the country, perhaps the most heartbreaking sight I see is the children who have dropped out of school.
Youngsters going off the rails - each of them a story of lost opportunity, but also a warning about the kind of country Britain will become if we do not change direction.
Some of them drop out because school does not enthuse and inspire them. If youngsters who are not drawn to a University degree cannot learn a practical skill, should we be surprised when they get angry and frustrated with an inflexible academic curriculum which seems only to highlight their failings?
One the tragedies of our education system is that we have overvalued the importance of an academic qualification at the expense of a technical or practical skill. It is not a mistake that countries like Germany have made.
It's time to end that snobbery. Our education system must recognise that every person is different, with different aptitudes, skills and ambitions. No path is intrinsically superior to any other, or deserves to be automatically better resourced.
We have to build our education system around human needs, valuing the individual choices people make, abandoning the elitist perception that academic study is somehow nobler than other callings.
Our society needs skilled craftsman, accomplished electricians, capable plumbers - and a whole host of technically-trained new professionals.
The way to build esteem for these professions is to raise the quality and standard of education that the system provides. Then everyone knows that a young person who has chosen a vocational route, and come out of it with flying colours, is not someone who has opted for a standard class education, but someone who has first class skills.
So we will take action:
We will establish a network of skills Super Colleges.
We will provide them with extra funding by abolishing the Learning Skills Council and a whole raft of centrally-directed initiatives and regulation.
We will enable 14 and 15 year olds to start on a vocational path from school and let FE Colleges provide specialist courses for them.
Detailed plans. Detailed action. A timetable for action. A government that will do what it says.
Too often, politicians promise the earth, and claim that they have all answers.
I do not want to mislead people with grand visions of a gleaming new future.
Tackling the problems we face will not be easy.
So I simply want to set out what I want to achieve, and how I aim to do it.
Thank you for giving me the chance to do so today."
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Rt
Hon
Michael Howard QC MP |
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