Queen's Speech Debate
Full Debate: Read Full DebateLord Mawson
Main Page: Lord Mawson (Crossbench - Life peer)Department Debates - View all Lord Mawson's debates with the Department of Health and Social Care
(14 years, 5 months ago)
Lords ChamberMy Lords, I should like to add to the deluge of praise. I congratulate the new Government on their success and wish them well in the coming years as they try to develop a working partnership and deliver their programme. I also want to take this opportunity to wish the Minister, the noble Lord, Lord Hill, well in his new job and to thank new colleagues for four excellent maiden speeches. I also congratulate the noble Earl, Lord Howe, on his new appointment.
As a result of many years of bringing disparate groups of people together to deliver practical results, I know that the key to partnership is to focus on relationships and not just on new structures, processes and strategies. Focus on the relationships and everything will follow. Ignore them and you will face serious difficulties. My colleagues and I have spent more than a quarter of a century bringing together partnerships to modernise public services so that they are more responsive and fit for purpose in our modern enterprise culture.
I thought that it might be helpful if I shared with the new partnership Government a few lessons that my colleagues and I have learnt at the coalface. It might also help them to put some flesh on the bones of what the big society might look like in practice. Many people are wondering what this piece of marketing means. We all know that it is crucial for a new Government to lay solid foundation stones on which real change and development can grow. Real change is elusive and may not come to fruition until a Government have left office. Effective innovation can take a generation and requires committed individuals to champion it. It is rarely captured in a policy document, written by what my colleagues affectionately refer to as “the bright, young things”. Real change has to be grown and deeply rooted in communities, otherwise, as I suspect that new Labour is discovering, it will be blown away like the sand when the first gust of wind comes along.
What are the lessons? How do you create a big society and lift the game in education, health and welfare? First, I would suggest that this Government support organisations that already have a successful record of reforming public services. Do not reinvent the wheel, but build on what works. They should back success and learn from their many years of detailed practical work. Do not, as new Labour so often did, take their best ideas, pass them to the Civil Service machine and exclude these experienced innovators. Let them take the wheel. Support them and enable their efficiency. Do not think that it is now the Government’s job to take control. It is not. They should take the long-term view.
Secondly, we need to question what the overused term “fairness” means. The question to ask is: fairness for whom? If you are seeking to achieve fairness for Karen and her children on housing estates across the country and to improve their educational opportunities or access to health, you must back the best providers with a proven record. It is irrelevant whether they come from public, business, social enterprise or voluntary sectors. However, if you are seeking to be fair in dishing out grants and resources to the voluntary sector, you will do something quite different. Who are you trying to be fair to and why? Life is not fair, and where we began to challenge and question this thinking in east London and embrace not equality but diversity, a thousand flowers began to bloom. “Fair for whom?” is the exam question I leave with the Minister. It is not possible to be fair to everyone.
Thirdly, if fairness is about creating opportunities for employment and improved services, the future must be about enabling environments where business and social entrepreneurs can do business together. These are the new relationships that will reform public services and they are already showing significant success, but this means that some of our cherished ideology will need to be examined and probably dropped. For the last decade, bureaucrats have fed a bureaucracy monster and it is now very large indeed. Often, contracting out has transferred a large government bureaucracy to private sector companies with large contracts—prisons, for example. Then the civil servants have migrated from one large organisation to another. The contracting process seems designed to stifle innovation and risk taking. The role of the new Government needs to be to create a level playing field where new relationships and networks can grow, particularly between business and the social enterprise sector.
Fourthly, I would ask the Minister how he will practically encourage new environments where people “learn by doing”. Will he get his hands dirty by planting the seeds of enterprise in the fertile soil outside the comfortable but dry world of theory? If this new generation of politicians is to gain any understanding of how the real world works in practice, and not hide in the bubble of Westminster, I would humbly suggest that each Member of Parliament should become involved in one project in their constituency to play their part in building the “big society”. Do not pontificate about it: do it. Legislators might then begin to understand the relationship between legislation and practice because attempting to deliver a new school, health centre or service is a practical nightmare nowadays, given the number of contradictory hoops laden with half-baked ideology that practitioners like me have to jump through. The confusion that exists between delivery and democracy is a minefield. The micro is the clue to the macro. Learn from it and gain the public’s respect in the process.
If this Government are serious about empowering communities, Ministers will have to get involved in messy detail. For example, one of the difficulties we face in giving people more professional independence in health is the awkward fact that often doctors do not want to innovate. They have not been trained to think like entrepreneurs and so resist change because they have an entrenched view and an expensive biomedical model of health to protect. This is not just my view, but that of the doctors I have worked with. Can we leave commissioning with doctors? Will they be responsible? It depends on the mindset of the individual doctor.
Finally, the idea that devolving power to local authorities will deliver a plurality of outcomes is not always correct either. Local authorities are not neutral when commissioning services. They often have an aversion to selecting innovative approaches because they do not understand them. Many of their staff have only ever worked in the public sector. They do what they have always done, but change the wording on the forms to please the Government of the day. Look carefully and you will still see the same bodies under new clothes. Local authorities are often the least likely to choose an innovative approach to service delivery, so why are the Government looking to them alone? Could the Minister tell the House what criteria will be used to choose these authorities? How will he select the sheep from the goats? Or, like doctors, are they all as good as each other? Not in my experience.
I wish the Minister well in this time of opportunity. Partnership is a great thing and the present financial crisis is the time to embrace innovation. Never miss the opportunity presented by a good crisis. If you are to deliver, I would humbly suggest that you do not rely on structures or theories, but on people. Back the best people, be they in the business, public or social enterprise sectors, and, funnily enough, you will be fair to everyone.