Showing posts with label Tessa Jowell MP. Show all posts
Showing posts with label Tessa Jowell MP. Show all posts

Wednesday, 24 December 2014

Democracy, decency and devolution - speech by Tessa Jowell mayoral candidate for London

I don't agree with this speech but here is the full text. I've added some graffiti below it
and a related rant on another site that says you can feel sorry for MPs but assembly members are shit

Democracy, decency, and devolution
Inaugural lecture delivered by Dame Tessa Jowell MP on her appointment as Professor of Practice at the London School of Economics - Monday 8th December 2014

1.
It is my great pleasure to have become a Professor of Practice at LSE.
I hope that in this inaugural lecture I can apply my experience of 38 years as an elected representative to respect both my hosts – LSE Cities and the Department of Government.
I have fought 12 elections and may just have 1 or 2 left in me!

2. In this lecture, under the themes of democracy, decency and devolution, I want to talk about the rupture between the public and politics, and the chronic dissatisfaction with the actions of government, with the resultant sense of alienation; but also how there is one more important preposition to add to Abraham Lincoln’s exhortation of ‘government of the people, for the people, by the people’; and that is,
government with the people.





3. Trust in politics, politicians and the governing is at rock bottom;

and there is cynicism, suspicion about motive and a feeling that most politicians live in a world different from everybody else. It’s open season on politics and politicians. But in praise of representation, the sacred bond between the elected and those that they serve, I say this – that in 23 years as a Member of Parliament I have never walked through the Central Lobby or into the Chamber of the House of Commons without a sense of awe at the responsibility I hold for the 80, 000 people I represent.

4. It is not always easy,
I am there as their representative and not their delegate and it is a role and function at its best when a thread of engagement with individuals often with unimaginable problems, runs through and links their experience to the big decisions about legislation and policy. What are often derided as the ‘social work functions' of MPs are vital to ensuring the legislation is animated by the ambition, frustration, fortitude and ingenuity of lived lives.

5. There is also vagueness about exactly what a MPs job should be. The balance between
  • local activist,
  • caseworker,
  • legislator
  • campaigner
is undefined. Are MPs too young or too old? Are they less competent if they have not done what are generally regarded as “proper jobs” pre Parliament?

6. While trust in MPs generally remains low, it is trust in ‘Your MP’ that has fallen significantly and fuelled the campaign for recall. That is something we should worry about.

7. So much is focused on the pace of change and the lack of control that people feel over what is happening to them. The fear and insecurity that this creates. The sense that people are on their own. The fracture of the two-party predominance. The end of tribal party loyalty.

8. But in some ways national politics has become more representative over my 38 years. I am especially proud of the way that Labour has promoted women candidates and MPs, including by the once controversial means of all-women shortlists. When I became a Member of Parliament there were more MPs called John or Jonathan than all the women from parties put together. That has changed but changed is too slow and the ease with which Westminster seems disconnected and becomes disconnected from the burning day by day concerns of those we represent is one of the biggest contemporary challenges of our parliamentary democracy.

9. At the same time it is important not to overdramatise the position: in the 1970s election the turnout was 72%; in 2010 it was 65% - a decline, but not a collapse. The turnout in the recent Scottish referendum was 85%. More worrying is the decline in participation among younger voters - only 44% of 18-24s voted in 2010 - and declining support for the two larger parties, which in 1970 took 90% of the vote but only 65% in 2010. For my party, and the Conservatives, there is a massive challenge to continuing being parties of government while engaging and properly representing the mainstream majority.

10. Of course that sense of connection and relevance to people is important. Often it exists more in unspoken ways than it does in highly publicized intention. ‘Get on and do it’ and then tell people you’ve done it is so much better than heralding intention before anything has changed. Remember the Suffragettes: deeds, not words.

11. I am concerned that more people are entering Parliament without having worked in the world beyond politics. I had a professional career spanning 20 years and I have drawn so heavily on that experience in most of what I have done. The importance of relationships between users of public services and their providers, the small changes that can bring huge benefit to vulnerable people – and I’ll tell you that training and working as a psychiatric social worker there were daily reminders of that - the importance of routines in overseeing the delivery of policy. The speech is itself is not what bring about the change it promises. It is systematic and well planned execution of a plan is. And when I was leading the reorganisation of social care in Birmingham twenty five years ago I learnt most by staying overnight in each and every one of their many residential homes. Nothing experiences policy making better than experiencing in that slightly artificial way how policy making is delivered, and seeing first-hand how the instinctive humanity of residential care staff is sometimes outlawed by the rule book issued by the central department.

12. When I was first elected as a local councillor in 1971 the purpose of politics was to spend money and if you were on the left to spend more money than those on the right, the input invariably more important than what the spending achieved.

13. The amount of money spent was of itself evidence of success. But money was spent and indeed still is on the general presumption that once allocated it will always be needed. This is a pessimistic view about the potential for investment to secure change in people’s circumstances and opportunities, and produces consequent long term waste in securing resources for services which many no longer be as relevant as when they were first identified.

14. The other great failure on those years was what became ‘the producer domination of services’ which left a legacy, which we live with even now, of services organised more for the convenience of those who deliver them than the convenience of those who use them. This is particularly important now that the pattern of people’s working lives has changed so dramatically. Why else, for instance, would libraries not be open routinely on a Sunday? Why would most post offices be closed on Saturday afternoon and Sundays? Why is there so little co-location of post offices, libraries, GPs’ surgeries and schools?

15. Given this background, the first thing to remember is that the purpose of politics, I believe, is to bring about change by getting things done. That requires leadership; the qualities of successful leaders are well documented, but there are others, as well, which have mattered to me during my time in Government:
- Never forgetting the acrid smell of poverty nor what frustrated ambition looks like in the eyes of a young, unemployed person
- Clear values imbedded in every decision
- Understanding that progressive change is dynamic and that, as one goal is realised, another challenging horizon emerges
- The capacity to be empathetic and emotionally intelligent and
- Being able to tolerate discomfort.
- And, as I always felt about Sure Start which I established in Government, not to become transfixed by the bureaucracy and organisation, but always being able to smell the babies.

16. When I look back over the reasons that the Olympic and Paralympic Games became such a hallmark of excellence, I recall the observation attributed to Harry Truman that ‘It is amazing what a small group or people can achieve together if they do not care who gets the credit’. Or, as Margaret Mead put it slightly differently, ‘Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has.’

17. Building a team which is fit to achieve the task in hand requires strong leadership but also shared success (I would always say to teams I led in Government that everything that goes wrong is my fault but all success is to the team’s credit); you need rigour in selecting the best people but giving them the freedom and confidence to get on with the job in hand.







18. So, how can we add government with the people to the other essentials?

Well, we have to recognise the limits of top-down government and celebrate and encourage the untidiness but often startling effectiveness of local initiative. That principle is subsidiarity – a term often used in connection with the EU, but overlooked in our domestic politics. It involves devolution to the most local available level; that has to be the guiding principle of public policy.

This approach isn’t just a set of policies or tactics, but involves a radical change in the relationship between politicians and people – no longer passive recipients of services, but active agents with control over decisions that directly affect their lives. Our cities, particularly London since the creation of the Mayor and the GLA, have been leading the way, but far more needs to be done. The clichés about the need for a new kind of politics are so tedious because they seldom translate into action – it’s normally no more than a speech followed by short-lived media comment. But the willingness of the public to engage, when the cause is important enough, has been shown to an extraordinary in the Scottish referendum. People knew it was about them and their children, and that is what animated the debate.

19. I will never forget the Games Maker who said to me during the Olympics “You have to understand how much people are prepared to give as long as they’re not doing it because the Government is telling them that they have to.” That neatly explains the failure of the Big Society – a good progressive ambition disastrously presented and executed.

20. This is why the big contemporary question for politicians of the Left is the nature of social democracy in a time of constrained budgets. It is no longer the case that spending in itself is enough to persuade the public of our good intentions. Increasingly, what is done is as important as how it is done. That opens up great scope for creativity and innovation.

21. But back to devolution – there was always a tussle within the New Labour government, which is best summarised as a heart-head tussle - the devolution heart arguing the case with passion – more power to communities and so forth – but the centralising head agonising over the trade-off between localism, the post-code lottery and inequity. It was alright to devolve limited powers to Scotland and more limited powers to Wales and indeed to Local Government. Giving up control is not what most people come into politics for, and that needs to change. ‘Why (as one colleague said) win a General Election only to give away the power you have just won”?

22. If we are to lower the political centre of gravity in this way, we have to confront the post-code issue. It requires the matching of national ambitions to local circumstances, something that can only be done on a case by case basis. Simon Stevens, the new head of NHS England, has intriguingly suggested that the ‘N’ on NHS stands both for national and neighbourhood. There is enormous possibility in that reinvention.

23. The rich inventiveness of local Government is in fact so often under- recognised by media commentators who dance to the Westminster fandango. It’s a curious paradox, isn’t it, that public trust levels are so much higher in local newspapers, local radio and television, but that so much of the focus settles on the inter-relationship between Westminster media and Westminster politicians. Is it any wonder that the public feel so much of the time that they are uninvited eavesdroppers on a private conversation?

24. But if a progressive and successful devolution strategy is to be achieved, new ways of organising the design and delivery of services will need to be created.

25. It so happens that many diligent constituency MPs are outstanding localists, and it is essential to preserve in Government these skills of community connection and of community organisation against the rip-tide of the Westminster and Whitehall currents so that, as leaders, politicians become enablers of more local power and agency.

26. This new way will be articulated by a three-way interaction between responsible businesses, civil society and local government which will maximise the effectiveness of government expenditure at a time of severe financial restraint, which is likely to last for the foreseeable future. A General Election win for Labour will not change this fiscal landscape.

27. First, we have the potential for a concordat between responsible businesses that recognises that social purpose also drives commercial success, creating resilience, and customer and employee loyalty. We see this, for example, in the growing trend for employers, of their own volition but with strong public encouragement, to pay not just the minimum wage but the far more equitable living wage - and the London living wage in London. Decent treatment at work, starting with decent pay, will be at the heart of the new social contract.

28. Secondly and alongside this, we will see stronger civil society bodies and associations sharing in the delivery of services to their local communities. We adopted this approach with the Sure Start Children’s Centres which Labour set up - complementing existing parental and childcare support for vulnerable children, with strong parental involvement in the design of services.

29. The third element is the state, whether national or local government, which is steadily more efficient and more devolved, achieving more for less, transferring more power down to more local tiers of government and promoting stronger collaboration between central and local government. In this collaboration will lie the solution to the large numbers of elderly people who against their own wishes have to stay in hospital because of a failure of imagination and collaboration to arrange for their care at home.

30. Public services will face tough funding reductions whoever wins the next election. The best and most realistic local authorities are already planning on that basis and reconfiguring services – spending less sometimes means doing better and building more value for example through the examples of co-production in Sunderland and Oldham, the tri-borough shared services arrangement in West London or the way in which Lambeth, as one of the co-operative councils, is tendering services to community trusts.

31. There is much about the disciplines and incentives of successful private sector delivery that public services can learn from, but so too is their reciprocal benefit in acquiring the disciplines of transparency, accountability and openness and proportionate reward that are requirements of public service delivery.

32. While the march of New Labour to 13 years in Government after 18 years in Opposition is well documented and well framed by the mantra of ‘the many not the few’, ‘the future not the past’, ‘strong leadership not drift’, the transformation in local Government which has, much more quietly, achieved remarkable successes is much less well documented.

33. A bit of autobiography here and a cautionary tale. I was elected by accident to Camden Council in 1971 (being promised that as a paper candidate there was no chance I would be elected). I then served for 15 years during which, on two occasions, the homes and livelihoods of Camden councillors including me were under threat from the District Auditor.

34. First in defiance of the then Tory Government’s Housing Finance Act that removed local determination of rents from local Government control and second, because in 1979 we set a local minimum income guarantee to reach an end, locally, to the Winter of Discontent dispute. The 80s saw the battle between the social democratic mainstream and ideological hard left of Labour and militant in cities like London, Manchester, Sheffield where every decision was ideologically driven. It was a terrible time and I well remember leaving Council meetings with police protection in the face of the attempt to intimidate me by the hard left minority.

35. The behaviour of those councillors in putting ideology before the delivery of local services meant that Labour was punished for decades. For example, Ted Knight ceased to be Leader of Lambeth Council in 1986 but it wasn’t until 20 years later in the 2006 Local Elections that his name was no longer mentioned as a byword for profligacy, ideology and disregard for local people. That is a salutary reminder of the frailty of
public confidence. The provision of basic services in an efficient way is for any councillor their licence to practise.

36. There is an important and bigger point here, which is about tribalism. Decent local politics tends not to be sharply ideological, but rather grounded in community values and commitment to that community. This requires the Labour Party to reach out beyond its core and embrace people who may not be Labour Party joiners but share Labour’s values.

37. In my own constituency the Labour Party has always been a pre-eminent community organisation and indeed in each General Election, since 2001, more of the volunteer helpers in the campaign were non-party members than paid up card carriers.. A few years ago I was inspired by the work of London Citizens and Arnie Graf of the Industrial Areas Foundation in America to train as a community organiser. We should remember that Labour is best when it represents the mainstream majority, and when its membership also reflects that.

38. This is one of the many reasons that I welcome the decision to select Labour’s candidate for the London Mayoral Election by a primary. Labour supporters for the first time being able to take place in the selection.

39. Devolution will only work if the devolved institutions command public confidence - and aren't seen as imposing new and unwanted tiers of political bureaucracy. There is little public appetite for more politicians!

40. The era of big public authority re-organisation is over, I hope. The agenda, rather, is collaboration between councils in delivering services and the creation and strengthening of city regional authorities to take on strategic functions from Whitehall and Westminster.

41. There is a big debate about devolution to city regions within which the argument for more powers for the London Mayor and London Assembly features strongly. It cannot be right that in circumstances where 18.5% of national economic growth is exported by London to the rest of the country that London Government retains only 7% of the revenue it raises while New York retains over 50%. This must be one of the big negotiations for the next Government. London faces big threats to its status as the number 1 global city – threats that arise from failure to provide enough homes for Londoner to upgrade infrastructure, to match the increased demand of a city of 10 million by 2030.

42. We should be worried by the division of London between the very rich and the welfare dependent or the in-work poor, and the virtual impossibility of the majority of young working people being able to buy a home in London. The tensions are well documented in Deborah Mattinson’s London Thinks study, which most disturbingly underlines the disaffection of 18-35 year olds who are drawn to live in London for work and other reasons but feel on the margin, insecure and pessimistic about their futures. London may be the greatest city on earth but it is not the greatest city to live in if you are young, on a low income.

43. In reviewing the Government of London, it’s important to be clear that London is not claiming, nor should it claim, city state status but greater fiscal autonomy consistent with its interdependency with the rest of the UK. This is one of the many reasons why HS2 is important. Fast easy links with the cities of the West Midlands and North of England will prevent London overheating and promote their economic growth.

44. London is the primary economic generator, but other cities are underperforming with only one apart from London, Bristol, performing above the average national GVA per head. This underperformance arises from underinvestment, hence again the importance of HS2 AND HS3 radically improving the transport links between the cities of the North from Liverpool to Hull as well as their links to the Midlands and London.

45. Further and substantial devolution is straightforward in that it would not require further legislation so it becomes wholly and solely a test of political will. So why not devolve each of the following:
- Funding for further education, skills and apprenticeships which could include the funding for London currently allocated by the Skills Funding Agency and the Education Funding Agency.
- Spending by UK trade and investment.
- Funding for regional growth, economic development and business support which is currently made available to the London Local Enterprise Partnership.
- Commissioning of the Work Programme.

46. It is inconceivable that, by stripping out the layers of bureaucracy which frame the relationship between central Government and the local initiatives exercised under each of these, it would not be possible to win on two fronts – more local determination closer to the communities being served while also saving money.

47. What about the further devolution by the GLA to the boroughs? Here again, the GLA and Boroughs have substantial latitude to exchange functions with one another and the GLA can with consent delegate its responsibilities to London boroughs.

48. London boroughs similarly have the freedom now to exercise their functions by another more local authority. It’s also interesting to consider whether a defined community can assume a power to act for a defined period of time in order to take responsibility for responding to a particular local need. There is essentially nothing to stop this as the law stands. A well organised, geographically defined, group can certainly negotiate with the Borough to take on responsibility for maintaining a local library or park – in my own constituency Lambeth Council is certainly devolving much service delivery in this way.

49. So the key point is that possibilities for further devolution without further legislation already exist.

50. So in considering the future health of London, economic success, a city to which people feel they really belong, there are lessons we must learn from past failure:
- The failure to trust Local Authorities enough to deliver local solutions beyond national prescription and in turn the willingness of Local Authorities to trust local initiative and to engage civil society in the delivery of local life.
- A periodic disregard to what matters most to local residents – you get a long way in local esteem through regular and efficient rubbish collection and clean streets. However when asked what makes them most optimistic about London those sampled by You Gov overwhelmingly referred to London’s culture, their pessimism arose from housing costs and shortages.

51. But in order for devolution to mean anything in practice communities must have freedom to create new institutions which may not necessarily need to be permanent but exist for as long as they are needed for example, a pop- up parish council in order to convene local opinion about a particular local issue, to resolve the issue and implement any consequent action – intermediate organisations specifically focused on the boundary between community organisations and the local council and both these models offer a high level of decentralisation. Only one parish council has been set up in London since 2007. A ready-made format for the most local devolution – why are there not more?

52. The Mayor’s favourite mantra is that London is ‘the greatest city in the world.’ But is it really? It is obviously great for the arts, sport, and most business. But as a place to live and bring up a family? Or as a place to start out as a school leaver with poor qualifications? The tensions are well documented in Deborah Mattinson's London Thinks study. London is great for the uber rich and pretty good for baby boomers, but it's certainly not the greatest place to live if you are a young person with an insecure tenancy in rented accommodation, or trying to start or bring up a family on a modest income. Whether economically, socially or culturally London is two cities, one for the rich and comfortable and another for the poor and insecure.

53. Everything I have said about devolution, and a more active city and local government working in partnership with local people communities, should be focused on building a stronger, fairer, and more affordable London. Let me take two key challenges to exemplify this - housing and childcare.






54. The shortage of homes estimated at 800,000 by 2030 threatens a crisis.

55. Average house prices at £500,000 plus, an extra 4 millions trips on London transport by 2023, childcare which costs 28% more than the rest of the country and keeps mothers at home when for their families they need to be at work, and nearly half of London companies reporting skill shortages. A city bursting out of its capacity.

56. On housing , it is simply not possible to increase dramatically the rate of house building unless local government takes the lead. In London and virtually every other urban area of the country, local authorities are not only the planning authority, they are also the largest landowner and by far the most knowledgeable public authority when it comes to engaging with other public owners of land and with the local holdings of the private house builders.

57. Local government needs to take a far stronger lead, with central government devolving more resources and the Mayor of London, and city regional agencies in other metropolitan areas, working in partnership to put in place the wider infrastructure, particularly transport links, essential to opening new housing zones; starting with those parts of our cities - think Hackney and swathes of east London for starters - which have grossly inadequate transport links to support new housing and community living.
This means Crossrail2 and the Bakerloo line extension, and the need for the next generation of transport in London to be delivered hand in hand with schemes for housing growth and new communities.





58. On childcare the challenge for working parents is to have their children looked after well and safely while they are at work. Childcare for a child under 2 costs £14,000 a year which is why employment among women is low compared to other parts of the country. Also the terrible and life long inequality that opens up for children from disadvantaging families by the time that they are 3. Again solutions can be delivered by co production with parents, very locally. Parents paid the Living Wage by employers who recognize that decency demands that. Through the rationalization of children’s centres to do more in one building and by using and training childminders to provide the essential flexibility that workers need.

59. In conclusion, I have called this lecture, ‘Democracy, devolution and decency’. I have talked mostly about devolution, and only a little about the other two, but I hope it will be clear why. The missing preposition in Lincoln’s stirring summary of good government – the need for politicians at all levels to be with (that is, alongside, among and amidst) the people – is the key to how good government must now be delivered.

60. The growing gap between those who govern and those who elect them – or in increasing numbers, no longer bother with their election – has created this dangerous democratic deficit in Britain. If the people will not come to the politicians, the politicians must come to them; and when that happens, and around the political purpose are gathered the active elements of civil society, good decent business and the ingenuity of local authorities, politics will be seen for what so many of us have always tried to make it: decency in action.

61. Thank you


A video of the speech is on
http://www.lse.ac.uk/newsAndMedia/videoAndAudio/channels/publicLecturesAndEvents/player.aspx?id=2753

A transcript of what Tessa Jowell said on Question Time about social care is posted on this blog:
http://election-richmond-park.blogspot.co.uk/2014/12/should-social-care-be-given-same.html

I watched 29 minutes of Tessa Jowell's speech on how to govern. I saw
  • no mention of why the N in NHS is important, why the idea of councils running health is bad
  • nor the concept of Insurance, as in National Insurance

    These are important to making public insurance cheap and accountable.
    You pay-in all your life: you get a pension, or child benefit.
    Nobody has to make a speech, or sell you a policy, so it's cheap.
    Entitlement to a defined budget should be similar in the public and private sector, except that in the public sector it's possible to make everyone eligible. People who are new to a welfare state in Brazil so how much better it is to know what they are entitled to, rather than having odd projects and charities define it.

    I do not want my pension it could be lower in one place than another because of "local people" with their concerns about emptying of bins and street cleaning. Consultation of one person over a lifecycle is opposite to consultation of vocal and local people. When I have dementia, I don't think I will be on the neighbourhood committee deciding how much is spent on dementia care and how much on emptying bins or street cleaning.

    At about 29 minutes Tessa Jowell seems to duck the issue of the crisis in social care by offering more local organisational burden instead of more money, and presenting the decision-makers as somehow the owners of the money that has been paid like an insurance premium throughout a taxpayer's life.

    Jowell's technique seems to be to state contradictory or inane points slowly, like an TV estate agent who says "The property is aging. The rooms are roomy. This is the kitchen", and then when you are half asleep says "it is out of your budget, but perhaps, in a way, it is within your budget". I would not want to be on a committee with Tessa Jowell as part of her tri-partite partnership. It would be impossible to have a good or a clear idea and be someone willing to listen to the ponderous statements of contradictions. I suppose that nobody with a clearer head would have been able to work for Tony Blair.

    One thing I really want to strangle Tessa Jowell for, like most of the political establishment and journalists, is that she is willing to spend money on the Olympics and talk about a lack of money for social care, as though the two budgets were un-related. This is something people have riots about in Brazil. In the UK, I think we ought to have riots. Nor any apology for the Olympics and their false accounting. Jowell even likes to add an emotive note about the looks in the eyes of people who use services, or whatever phrase, to show that she thinks she's one of the decent ones in politics. Then she mentions the Olympics again. What about the service users who looked inter her eyes: shouldn't they be getting the money, not the Olympics? Her argument is  "stuff them", or in her own words, address a "failure of imagination and collaboration to arrange for their care at home"
    .
I was dissapointed, because there was a frank criticism of politics as a job of 
  • making speeches - "tell us when you've done it" is a good response she thinks.
  • spending like father christmas: "the purpose of politics was to spend money and if you were on the left to spend more money than those on the right" with the amount spent a sign of success. She wants to replace that as budgets fall with local father and mother christmases making speeches to each other about efficiency to tri-partite committee members of favoured social enterprises and local people.
I watched part of the speech before getting a chance to read it. It starts at six minutes 22 seconds into the recording. The video speech has an introduction to the speaker before her own introduction to what she's going to say. The first mention of national social care is at about 29 minutes in, proving the sheer expense in time and effort of making decisions by committee. I think she proves her point about more committees being more efficient to be wrong, just in the length of her own speech.

PS: It is illegal to strangle politicians.

Saturday, 20 December 2014

Should social care be given the same protection as health? MPs asked on Radio 4's question time with Jonothan Dimbleby as chair

Dr Peter Robespierre- audience member
In view of the impending cuts to local authority funding,
should now the funding for social care be given the same protection as health?

Dimbleby - chair
Since 2010 the social care budget for older people has dropped by 1.3b just over 15%, and there is a large shortfall still according to Age UK who gave us these figures.

Should there be the same protection as health for social care, Tessa Jowell?
Tessa Jowell MP
As culture secretary under Tony Blair, Tessa Jowell did much to ensure the success [sic] of the Olympics. Now she is one of the many labour wannabe mayors of London, but not so shy as some of them about saying so in public.
Tessa Jowell MP who spent money on the Olympics
Yes there should. (and)
If the crisis in our A&E departments this winter is going to be avoided , one of the main ways of doing that is for elderly people who become ill over the winter to be looked after at home and the services to be taken to them, and for them to be cared for there. (You know)

What you've got, actually, are two things.
  1. The government willing elderly people to not use A&E, to stay at home, and all the rest of it.
    Yet the funds that are fundamental to support the people who can go in and care for them are being cut in this devastating way.

  2. And the second point is that it's the
    areas of greatest need, like the people I represent, that are suffering dis-proportionate cuts.

The people who will be the victims of this will be the 95 year old ladies who are kept in a kind of limbo on a trolly in a corridor of a hospital ward, defying all the best intentions of the staff, and it is a real crisis, and you are absolutely right, that if there is any chance of elderly people being looked after at home which is where the vast majority of them want to be cared for, then there has to be protection of the social care budget, and proper organisation of integrated services for thier care

Dimbleby - So you are saying that whether it is integrated or not ...
Jowell who spent money on the Olympics  Well it has to be combined
Dimbleby.It has to be ring-fenced?
Jowell who spent money on the Olympics I think it should be [ring-fenced], yes. [but she seems able to keep opposite points of view in her head at the same time - she stated an opposite view in her speech to the London School of Economics here http://election-richmond-park.blogspot.com/2014/12/democracy-decency-and-devolution-speech.html paragraph 29 quoted here and the theme of paragraphs 18-29: "The third element is the state, whether national or local government, which is steadily more efficient and more devolved, achieving more for less, [because it is] transferring more power down to more local tiers of government and promoting stronger collaboration between central and local government. In this collaboration will lie the solution to the large numbers of elderly people who against their own wishes have to stay in hospital because of a failure of imagination and collaboration to arrange for their care at home."]

Norman Lamb MP
Norman Lamb is the Lib Dem health minister with a brief that among other things includes responsibility for older people and end of life care.

Added later: during the election Norman Lamb floated the idea of local NHS taxes, for liberal-voting "local people" I guess, who never move. I can't understand the logic; I don't see why people take him seriously.

♦ Firstly, a new tax lets government off the responsibility to cut submarines or embassies or whatever, which are over-provided compared to other similar countries. We have not decided what government is for so clearly as other countries and retain them at the cost of welfare state spending.

♦ Secondly, a local tax leads to the problem of someone who paid tax in Westminster with the lowest possible rate, and then uses services in Lambeth that has a higher rate. I prefer the idea of my taxes for all welfare state services being ring-fenced, kept in a fund, and available to me over as wide as possible a number of countries, not just in the UK or Wales or Lambeth.

Dimbleby
As a health minister, Norman Lamb, you have I think - as part of your responsibilities - you deal with local authorities as well? What's your view of this...

Norman Lamb MP [another speech here]

Well I think we have to get away from this idea of two separate systems. I agree with Tessa on this - I think it is rediculous. If you were setting-up a system now would you ever create a system that has a divide down the middle between health and care?  You would create a single system. Particularly given that one of the challenges of this century is people living longer with chronic and long term conditions, and an aging society: we are all living longer.

Giles [a non-MP on the panel who refused to answer the question] incidentally makes a good point about how society treats older people . If we are going to ensure that we remain a civilised society, and that we sustain our health and social care system, we have got to all play a part in ensuring that we don't leave people icolated and stranded and lonely. In a way we have inadvertantly become quite a neglectful society as our extended families have moved far and wide, we've left elderly people often stranded on their own. Government can't do [this task] on their own. It has to be a collaboration between statutory services and the wider community and we all have a part to play in it.

Dimbleby
Very precisely minister, given the
  • cuts that there have been - the actual loss of funding - within the framework of the general austerity cuts which were taken by the government of which you are a member. And the present 
  • impending cuts to local authorities which range from 1.8% overall - I think I'm right - up to to 6% in some cases. 
Can local authorities (which I suppose are complicit in this) avoid cutting yet again, or  having to make the people who depend on social care even more well troubled?

Norman Lamb MP
My view is that we have to absolutely shift resources [away from health - see note at the bottom of the page] towards preventing ill-health, and that means supporting those very services that you are talking about...

Dimbleby
How are you going to do it this year and this coming year?

Norman Lamb MP
I'll explain exactly how we are doing it.
We have got something called the Better Care Fund.
Which for the first time ever pools money between health and social care. 
One of the requirements [interupting himself] this transfers money from the NHS into those very services we're talking about. One of the requirements we have given to local areas [of the NHS to release funding] is that the local authority has to sign-up to say that they are "satisfied that their social care services will not be cut". That is a requirement of transferring the money into this pooled budget.

Dimbleby
Does that mean ring-fencing the budget?

Norman Lamb MP
In effect it amounts to ring-fencing because every local authority has to sign up to confirm that they are happy that social care services will not be cut. That's the start, for me, towards a transition towards creating a single budget for health and care, so that we focus much more on prevening ill-health and ending up with so many people un-necessarilly in hospital, which is the dys-functional nature of the current system.

John Redwood MP
John Redwood once ran Margaret Thatcher's policy unit. He's been a cabinet minister. Now as a leading Euro Sceptic he has the bit between his teeth in demanding not only English votes for English laws but an English Parliament as well.

Dimbleby
Should social care be given the same protection as health, John Redwood?

John Redwood MP who wants to spend money on a 5th UK parliament + Lords & Europe
[recently he has said something about committees in the commons as cheaper than an english parliament]

Well I believe that we need to be very generous on social care, and we need to be more generous than we are at the moment.

I think I welcome the initiative of the Better Care Fund, but for my own two local authorities in Wokingham and West Berkshire we've lost very heavily through it; we think we've got the numbers wrong and I hope the minister will look again at it because we don't want to be making cuts to services inadvertantly because of something that is intended to provide a better system.

I think you need a different kind of budgetary protection for social care than that provided for general health.

General health, people use, generally, as a service. You need to ring-fence it and protect it because  of the costs of the technology and better medecine and the general costs of providing a service.

I think what you need in ring-fenced funding for social care is the amount of money you need to provide a generous service for the people requring it. So the way you do it is that you have a formula based on so-much-per-head. The amount per head has to be generous enough, and we need to have an accurate number of all those who need that care so that the local authority is not left short. I don't think they've got the numbers right yet.

But I think there are some very wild and exagerated numbers about overall local authority cuts which are very misleading. Net current spending (leaving aside education which has of course gone up under this government because that was also protected) was £74.7bn in the last labour year and is £78.9bn this year, so it is not down 40%, it is up in real...
Dimbleby So in real terms?
Redwood 5th UK parliament  No, that's in cash,
Dimbleby So it isn't really "up" is it?
Redwood 5th UK parliament  So it's been tight.
They've got to budget very carefully but it's not a 40% cut in the way that you read in the newspapers.
Dimbleby But is is important to note, given that you are a financial wizard, that when said that figures you were suggesting £4bn or so increase. It is actually a small cut. It is a lower reduction...
Redwood 5th UK parliament You have to take care of cost increases, but of course it has also been a time of public sector wage restraint and the main cost is wages

Dimbleby
Let me put this question: You asked the question Dr Robespierre. What are your thoughts about it?

Robespierre Well I'm a trustee of south London carer's trust, and we contract with local authorities in order to get, or in order to provide certain services into peoples' homes. We have found it increasingly difficult to get referrals in [to services] because local authorities quite simply can't afford it.

Dimbleby
Should - without getting into details about your local authority - but should, Norman Lamb, the local authority be able to? It doesn't matter what you said about the Better Care Fund, there shouldn't be any reason why the local authority shouldn't be able to provide the care that would save the doctor his problems?

Norman Lamb MP
They should be able to, and in fact when you look around the country the picture has been rather variable.  The point you make about whether it is ring-fenced: the ring-fencing actually was removed under the previous government. I think ultimately you need a single ring fence around the health and social care budget so that we know exactly how much is available in any given area. It is really important that we provide that strong preventative care that stops people ending-up in hospital un-necessarilly.  And the sort of services that you are involved with are absolutely essential.

Dimbleby
So Dr Robesparre should to back to his local authority, in his role, and say: "are you drawing down everything you should do from the better care fund in order to deliver the sort of service that you would seek to deliver?"

Norman Lamb MP
Absolutely

Tessa Jowell MP who spent tax money on the Olympics
But you see the problem with this is that nobody could disagree with most of what Norman Lamb, as the minister responsible for health and social care, has said, but it does not match what is happening on the ground, and Dr Robespierre is the person who is managing what is actually happening in the homes of elderly people being looked after by their carers.
The fact about this settlement is that nobody would pretent that Richmond - this borough we are in - is er more deprived than Lambeth, the borough that in part I represent. Lambeth has had a 5% cut. Richmond has had a 1.7% increase . That's what's not fair, and that's why people get so angry about the difference between what is said by the government and what is experienced on the ground.

Sound byte of the program:
http://downloads.bbc.co.uk/podcasts/radio4/bbcaq/bbcaq_20141220-1100a.mp 

Gov.uk does back-up Norman Lamb a little. Under the title "giving local authorities more control over how they spend public money in their area", it says "the only exceptions are schools and the new public health grant", which probably could have said Better Care Fund as well. The Department of Health in Waterloo Road has asked council chief executives to sign that there will be no funny business.

Note about shifting money away from health. A google finds this from the National Audit Office:

2.24
Central government has begun further programmes to encourage integration and service transformation. From 2015-16, local areas will access the £3.8 billion Better Care Fund. This is a pooled budget for health and social care services, a joint initiative between the Department of Health and the Department for Communities and Local Government. Around £2 billion will come from NHS allocations to clinical commissioning groups. Health and wellbeing boards approve local plans for spending Better Care
Fund allocations. The King’s Fund has reported concerns about the consequences of removing £2 billion from acute care. In 2012, we reported that the NHS had made savings mainly through freezing pay, reducing the use of temporary staff and reducing back-office costs. More savings will need to be made by transforming services. This will be more difficult, will take time and may initially cost money. The Department of Health does not know what scale of savings it can expect nor how quickly the NHS can manage the funding reduction. The tight timescale for change set by the Better Care Fund increases the risk that new services or approaches will not be in place or embedded to meet the demand from reduced services elsewhere.

My impression is that ministers do want national social care funding, but not to say so because the agreed text is that councils are wonderful and everybody loves them as Tessa Jowell said about Lambeth Council for example. Their own job ads said that they were one of the "worst-managed local authorities in the UK" and that they were looking for better managers, but Tessa Jowell thinks that they are wonderful or whatever she says. I did social work jobs in Lambeth and could list details to talk about, just as I could in Richmond where I live.