17 January 2011
Prime Minister David Cameron has sought to reassure public sector staff over the pace and scale of reform by attacking the approach taken by previous Conservative governments.
In a speech in London today he said that job losses were inevitable because of spending cuts but that ‘as we take the tough but necessary steps to deal with the deficit, our first priority is to protect frontline services and jobs in the public services’.
Cameron sought to persuade public sector employees that his policies were not a threat to them.
‘No one believes that the budget deficit is the fault of public sector workers,’ he said. ‘Responsibility lies squarely with ministers in the last government who allowed spending to run out of control.’
Economies would be sought elsewhere before jobs were lost, he said.
Cameron said that past Tory governments had had ‘some really good ideas about introducing choice and competition to health and education, so people were in the driving seat, but there was insufficient respect for the ethos of public services – and public service’.
Those governments had given the impression that only the private sector created wealth while the public sector spent it.
‘This analysis was – and still is – much too simplistic,’ the prime minister said.
‘Public sector employees don’t just provide a great public service – they contribute directly to wealth creation… Our teaching hospitals and universities, can be one of the great wealth-creating engines of the 21st century, knowledge-based economy.’
Labour governments had by contrast respected public services but had developed ‘a whole architecture of bureaucracy and targets [while] significantly understating the valuable role of charities and the voluntary sector’.
Cameron defended the pace of his government’s public service reforms, in particular in health, saying: ‘We won’t eliminate the scars of deep poverty and huge inequalities in our country if we go on with services as they operate today.’
He said that without reform ‘demand rises, the chains of commands can grow, costs may go up, inefficiencies become more entrenched.
‘We need modernisation, on both sides of the equation. Modernisation to do something about the demand for health care – which is about public health – and modernisation to make the supply of health care more efficient – which is about opening up the system, being competitive and cutting out waste and bureaucracy.’
The government’s starting point for reform was one of ‘huge respect for the ethos of our public services – and a commitment to advance it free to all who need it.
‘Universal coverage, impartiality – these are principles must never come under threat.
But Cameron added: ‘If we have learnt anything about public service reform in the past few decades, it’s that simply setting standards and issuing diktats from Whitehall doesn’t mean they actually happen. We do need structural changes – not just edicts about standards.’
Leaders of health care unions have described the government’s proposed NHS shake-up, based on GP commissioning, as ‘potentially disastrous’.
Writing an openletter ahead of the expected publication on January 19 of the Health Bill, the leaders of six unions, including the British Medical Association and the Royal College of Nursing, said: ‘There is clear evidence that price competition in health care is damaging.
‘With scarce resources, there is a serious danger that the focus will be on cost, not quality.’
The letter added: ‘The sheer scale of the ambitious and costly reform programme, and the pace of change, whilst at the same time being tasked with making £20bn of savings, is extremely risky and potentially disastrous.’
The other organisations supporting the letter were: Unison, Unite, the Royal College of Midwives and the Chartered Society of Physiotherapy.
