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Speaking today at the Social Market Foundation former local government secretary Stephen Byers said: ...
Speaking today at the Social Market Foundation former local government secretary Stephen Byers said:

'The challenge for Labour in government is how we can renew ourselves and not just become incumbent managers of the government machine. How we can be true to our values and principles while driving through a programme of modernisation and reform of our public services.

Last month the prime minister said 'now is not the time for a quiet life. It is the time to hold firm to the path of radical reform'. These are good words but it is actions that will count. Some tough choices will need to be taken. The stark choice is between being a government of incremental change or being prepared to accelerate the programme of reform to fundamentally change our country and significantly alter its direction.

Far reaching change in the way our public services operate is vital. Such an approach is not without risk. There will always be those who resist change.

Of course in the Labour Party itself there are those who have never accepted New Labour. Seeing it simply as a cynical corruption of the true socialist faith. Only to be tolerated in order to get back into power and then discarded at the first opportunity. Their criticisms of Tony Blair reflect their disappointment that this hasn't happened and that in office his government has sought to reconcile what at one time were seen as conflicting views: patriotism and internationalism; rights and responsibilities; wealth creation and social justice.'

On public service reform he will make the following main points:

- Two conditions should be applied to the reform of essential services like the NHS and schools. They are that they should remain free with no charges or co-payments and that while there will be a role for the private sector its involvement must be in the public interest and that there should be no privatisation.

- Targets. Mr Byers strongly defends the use of national targets. He said:

'Targets have an important role to play. Targets which are well defined provide direction. They reflect the priorities of the government. Targets give the public a practical statement of what will be delivered.

Targets can be uncomfortable for politicians - that is no bad thing. They are a means by which they can be held to account. For a minister they can provide a very public demonstration of failure.'

- Financial entitlements. He will say that choice has to be at the heart of the reform programme. But he will raise the prospect of choice operating through the purchasing power that would come from having a financial entitlement in respect of a specific service.

He considers such an approach in relation to care and support for the elderly. Instead of services like home helps; home adaptations or meals on wheels being provided directly why not give the pensioners the cash equivalent and allow them to choose their own provider. Through co-payments they could put in some of their own money to enhance the service they receive.

- Penalties. With the right to exercise a choice comes responsibilities. Mr Byers points out that last year in the NHS over 26 million appointments were missed by patients causing delays and costing millions. He asks whether some sanctions should be imposed in such circumstances.

- Guidance on choice. In order to make sure that everyone is able to exercise choice there should be a system of mentors or advocates introduced to take people through the options available to them.

- Primary care trusts. He supports the establishment of foundation trusts in NHS but believes the changes need to go further. In particular there should be elections to primary care trusts and they should have limited tax rising powers.

Mr Byers concluded:

'The government has adopted a high risk strategy towards public services. With people paying more a heavy political price will be paid if we don't see signi ficant improvements in our public services.'

* The full text of the speech is available here.

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