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Response to CPF consultation on Public Services

I am pleased to share with you the following formal response from Munira Mirza, Director of the Prime Minister’s Policy Unit, to our consultation on Health, Social Care and Education, completed late last year.

John Hayward, CPF Manager


Dear John,

Thank you for your latest report on Public Services, covering Health & Social Care and Education. We remain grateful for CPF members’ enthusiastic contributions to the development of policy and for the ideas that they generate.

On Education, we acknowledge the strength of feeling that the 2021 exam season should run more smoothly than in 2020, as well as the need to ensure online learning is of high quality to support this. The level of interest in a fair deal for students was also striking, going beyond the pandemic to consider the broader terms of how their loans are repaid, particularly on interest rates. We note the overwhelming support for increased investment and attention to technical and vocational education, including apprenticeships, and welcome the wide range of ideas suggesting how this could be done.

Specific proposals of interest included the need to promote lifelong learning, incentives for employers to recruit apprenticeships and creating a clearing system such as UCAS for apprenticeships. We are exploring these more closely. We were also struck by the level of support for focusing more on the family and are considering a number of ways in which this can best be done.

Since the CPF sessions took place, we have published our approach to awarding grades this summer. We will be putting our trust in teachers to award grades fairly through a range of resources, guidance and human moderation. We have also announced a significant increase in our hardship support for university students, which now stands at £70m, and will soon be publishing a consultation on the response to the Augar Review of higher education funding.

In January we published the landmark paper, Skills for Jobs, which set out a comprehensive programme for strengthening and investing in further and technical education, including apprenticeships. Central to this is the Prime Minister’s Lifetime Skills Guarantee: from 1 April this year, millions of adult learning without an A-Level equivalent qualification will become eligible to take a free technical qualification in a subject that leads directly to a job, including digital, construction and health care; and, over the course of this Parliament, we will be introducing a Lifelong Loan Entitlement to make it as easy to study for a technical course as a university degree. The Skills for Jobs paper also sets out plans for a £1.5bn investment in our college buildings and facilities, a £2.5bn National Skills Fund and plans to put employers and business organisations at the heart of designing qualifications.

In addition to the topics discussed at CPF, we are continuing to make progress in delivering members’ priorities from our manifesto. We are launching an independent review of the children’s social care system, and we were of course glad to hear from you that members were enthused by our recently published plans to strengthen free speech and academic freedom in universities.

On Health & Social care, we share CPF members’ desire to cut red-tape and are working to reduce unnecessary bureaucracy that can incumber the NHS. For example, in our new Health and Social Care Bill we will cut bureaucracy around procurement. This will mean the NHS will only need to tender services when it can lead to better outcomes for patients – rather than the current requirements which mean all tenders have to be competitive even if this adds time but no value.

Members are right to be focused on outputs rather than inputs. In the past successive Governments in health policy have often targeted metrics around activity (e.g. waiting times at A&E), rather than real public health outcomes, such as obesity rates or cancer survival. That is why the Prime Minister has been emphasising these issues, such as with his recent focus on obesity. We recently announced a new £100m funding package to improve the support given to those living with obesity to try to help people lead healthier lives – this includes better measures of obesity outputs and outcomes in GP surgeries.

Another part of this package is a new health incentive scheme, run by former Olympic tsar and entrepreneur, Sir Keith Mills. This programme will help to shift our focus from always dealing with the consequences of ill health, to start rewarding and improving good health to prevent ill health. We’re also bringing forward policies which makes it harder to run adverts promoting unhealthy foods on TV, online or in supermarkets. This should make it easier for the public to make informed health choices which will help to improve health outcomes.

You will have seen the Prime Minister has been very engaged on youth mental health issues recently, recognising the big changes and challenges faced by young people during the pandemic. We note the concerns of some members regarding the potentially negative connotations of the term ‘mental’ health. The Prime Minister has been talking about ‘positive mental health’ and ‘building resilience’, mentioning basic changes, like exercise, that can contribute to positive mental wellbeing, rather than characterising mental health as an exclusively negative term.

We note the keen interest that members take in the future of social care. As our Prime Minister has said, we are committed to tackling the social care issue ‘once and for all’. We will be bringing forward plans for social care reform that will fix what many have characterised as a ‘broken market’ which doesn’t currently incentivise investment or innovation into the sector. Our measures will not only address funding reform questions, but also set out a strategy that helps older people to live as independently as possible for as long as possible at home.

Members who raised concerns about lack of join-up across the health care system should be reassured that in our new Health and Social Care Bill, we are bringing forward ‘Integrated Care Systems’ which explicitly aim to join up and coordinate care across primary, secondary and social care. We recognise the incredible collaboration that we have seen during COVID between these different parts of the system and our legislation will ensure such collaboration continues. At the same time this Bill should improve accountability within the NHS, addressing some of the challenges that the Lansley legislation created, when it separated the NHS from ministerial control.

Thank you and the CPF for all the energy, creativity, and insight that you bring to these reports. We look forward to reading the next one.

Kind regards,


1 Comment

Thanks, Munira. Your last sentences was 'Bill should improve accountability within the NHS, addressing some of the challenges that the Lansley legislation created, when it separated the NHS from ministerial control. ' Hear, hear.

I followed Lansley and Earl Howe, and supported their efforts to 'fill the democratic deficit in health' and assumed that they would devolve the budget to Local Authority councillors. Their mistake was not to trust them, and give it instead to GPs, who have no democratic mandate, and useless in the job.

I am a former councillor with Brighton and Hove City Council, and attended every meeting of my Health and Wellbeing Board and CCG, and wrote many papers making suggestions, all published on section …

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