National Life: Shared Values and Public Policy Priorities

Lord Crisp Excerpts

Friday 2nd December 2016 Lords Chamber

[Lord Crisp (CB)]

My Lords, I very much welcome this timely and important opportunity to debate our shared values and discuss how they shape policy priorities. I wanted to speak in this debate but I also wanted to listen, and indeed have already been richly rewarded. These values that we are talking about may or may not be eternal, but they certainly change in how they are expressed and in how circumstances influence them. It really is very important that that they are debated and not just stated—and not just in this House.

When I looked at this proposition of shared values, my first question was, “Shared by whom?”. These values that we have talked about may look very different from different places in our society, and there may be differences as to how they are experienced and expressed by, for example, people who are alienated or disadvantaged in our current society. I think I am following the noble Lord, Lord McInnes, in his excellent maiden speech just now by pointing out the importance here of inclusion in this national debate about what these values should be. I am also reminded of an excellent speech by my noble and right reverend friend Lord Harries of Pentregarth on an earlier occasion when he talked about the engagement of different cultures and religions and a continuing conversation with stakeholders. I think that is extremely relevant here. When the right reverend Primate talks about the need for a new shared narrative, this needs to be built on that wider debate, and of course built on understanding why there are people today who are alienated and disadvantaged, and what we can do about it. My first point here is about inclusion in the development of this new great narrative, based on what may well be, and perhaps are, eternal values.

I follow the last two speakers in your Lordships’ House by turning to implementation and the vastly important role that institutions play in this. They are how values are expressed in our national life; they embody them. What are institutions there for and whom are they there for? Does our health system genuinely treat everyone as equal? Does our education system treat everyone as equal? How do their leaders behave? How are our institutions expressing both these values and the policies on which they are based? This point, about institutions expressing our aspirations and our values about who we are, is well understood globally. Clearly, in the UK, the important point has been about how the welfare states in Europe have developed after the last war as we recreated our societies. After their Carnation Revolution in 1974, the Portuguese immediately set up a national health service as an expression of who they were. Only 22 years ago, Rwanda was just trying to recover from a genocide, and one of its first steps was to set up a national health system that included and engaged everyone, and which is still one of the best in Africa, as an explicit expression of who they were as a people. So institutions are fantastically important in expressing our values.

I wonder whether our policies at the moment always reinforce this vital role that institutions have. I am reminded again that the most reverend Primate talked in his earlier remarks about the dangers of centralisation and the overpowering state, and therefore the important role of intermediate institutions. Certainly I suspect that in public policy in recent years—I had better declare my guilt as a former Permanent Secretary in the Department of Health—we have issued instructions and diktats from the centre that to some extent have taken away power and autonomy locally. As a result, you have sometimes seen people running local areas of our national institutions as branch offices rather than as substantial leaders of their local communities. It is very important that hospital managers, school heads and others are leaders in the local communities and taking on their wider role in society.

There are of course many excellent examples of this. Yesterday, I was with the new NHS Alliance and I saw people in Fleetwood, led by the GPs there, who were doing much more than their job description as a GP, looking at how they could enhance the health of their society and bringing in all local partnerships. I was also with people from Plymouth, and the Beacon programme in Plymouth does the same thing of bringing together different organisations to create the sort of society that they want locally, based on shared values and making use of national policies but locally driven and locally led.

In October, I and a group of others, including four other Cross-Bench Peers and a number of the great clinical leaders in this country, set out in the Lancet a “Manifesto for a healthy and health-creating society”. We think there needs to be a new shared narrative around health, to use the language that we are talking about here, and that it has to be about a healthy and health-creating society. There are four points in the manifesto, and I think I have time to mention the two that are really relevant here. First, while the NHS can be wonderful and politicians can do remarkable things, they cannot do everything that is needed in health. We need to engage employers, educators, designers and everyone who has an impact on health in creating a new health-creating society. This is about expressing our values through public policy and using the institutions that we have locally. Secondly, the final point in the manifesto was simply put. It said that our great institutions of science and health are built on values of integrity—to pick up the point from my noble friend Lord Bilimoria—evidence, openness, sharing and equality of opportunity. These institutions, which benefit from society, should also be playing their role in society in promoting those values in many different ways; they can do so, and there are good examples of their doing it.

While I very much accept, applaud and welcome this debate on shared values and how they need to shape and reinforce good policies, they also need to be accompanied by what one might describe as effective implementation and effective institutions that embody those policies and values.