When a Prime Minister is willing to outline their political philosophy, it is behovely for people who are interested in politics to listen, even if it mean wading through the fourth relaunch of The Big Society.
You can access the unabridged text here, but I'm pulling out key and health-relevant sections below. First, a few observations.
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At least some of Mr Cameron's speech seems to be a homage to the virtuoso satirist Chris Morris's brilliant 'Paedogeddon' episode of Brasseye. Mr Cameron twice describes his political assertions in the phrase "it's (a) fact".
The line is unfortunately reminiscent of the words used by Dr Fox (Capital FM version; not chubby leaky Liam version) that "paedophiles have more genes in common with crabs than they do with you and me. Now that is scientific fact — there's no real evidence for it — but it is scientific fact".
Other sections read like a job application to write Patience Strong-influenced poetry or copy for greeting cards: "strong families, strong communities, strong relationships - these are the things that make life worth living".
There is a lovely irony in his suggestion that the current co-creation of health policy was in some way intended: "For the first time, we can involve people on a mass scale in helping to design policy, scrutinise legislation, get rid of pointless regulation". Ahem.
There are also heroic assumptions that people will agree on what 'the right thing to do' is - or indeed on the right way to do the right thing. Cultural and socio-economic differences on this are huge.
In one of the most strikingly simplistic lines, Mr Cameron states that "social problems need social solutions". So, how do social problems arise? Is it ever as a result of political or economic factors? Or simple bad luck? Or bad public policy?
Social problems are generally complex, multi-factorial and pretty rarely solely the result of social factors. A mystical faith in 'society and the right thing' is unlikely to serve as a Get Out Of Jail Free card. Much is asserted in the speech; little is proven.
Extracts from the Prime Minister's latest Big Society relaunch speech
"We must build a bigger, stronger society. We must build that bigger, stronger society because we can’t keep tolerating the wasted lives and wasted potential that comes when talent is held back by circumstance.
"But above all we must build a bigger, stronger society because in the end the things that make up that kind of society - strong families, strong communities, strong relationships - these are the things that make life worth living and it’s about time we had a government and a Prime Minister that understands that.
'Creating a bigger society. Creating a country which feels like a community, where our relationships are better and the glue that binds people together is stronger. Where we actually think about people’s well-being when we make decisions".
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"what I want to endure as the lasting legacy of this administration - helping to build a society where families and communities are stronger, where our nation’s well-being is higher, and where all these things are accepted as central, not peripheral aspects of what modern governments should hope to achieve".
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"The question of course is: how do we help to make it happen? For me, there are two aspects to this.
"The first is the way in which we modernise our public services. The public services that we all rely on – schools, hospitals, policing, parks and public spaces, these are vital building blocks of the bigger, stronger society I want to see.
"And that’s why it’s so important to me that we don’t just cut public spending, but we modernise public services. And it is also important how we do it. ...
"In our health service, we’re not giving patients more control and doctors more professional freedom because we want to save money. We’re doing it because it’s the best way to improve the NHS.
"During the past month as we have paused our reforms and listened again to those who care most about our NHS, I have been struck by the incredible passion there is amongst patients, professionals and charities to take more control and improve our heath service. People with long term conditions who want to help determine the care they get. Cancer charities desperate to use their expertise and resources to save lives. Physios, OTs and so many other Associated Heath Professionals who believe they hold some of the keys to building a healthier nation, but who have been locked out in the past. Again, enabling them to drive change is the Big Society way to improve the NHS.
"It’s because our public services – and the results they deliver – matter so much to my mission of building a bigger, stronger society that I’m so determined to modernise them. I set out the case for modernisation in a speech at the start of the year. And I showed then, whether in welfare reform or school reform, early years support or drug rehabilitation, the NHS or prisons that we plan important changes based on clear principles.
"Get rid of centralised bureaucracy that wastes time and money.
"Break open state monopolies and open up them up to new providers, saying – ‘if you’ve got the ideas and the people and the commitment to tackle our most deep-rooted social problems, come and play a role in our public services.’
"Wherever possible put power – and money – in people’s hands to choose what’s best for them.
"Pay providers by the results they achieve.
"Be as tough on private sector monopolies as on state monopolies.
"Make sure there is transparency so people can see what they’re getting in exchange for the taxes they pay. (my emphasis of bolded section)
"This is real people power, and there has never been a better time to do it. Technology is helping to turn the traditional power relationships on their head. For the first time, we can give everyone the information they need to hold government and the public sector to account. For the first time, we can give everyone the information they need to make choices about the services they use.
"For the first time, we can involve people on a mass scale in helping to design policy, scrutinise legislation, get rid of pointless regulation. And it’s because this technological revolution is matched by our philosophical belief in the principles that underpin it – openness, competition and true people power that we are applying it so enthusiastically to our mission of making government and public services more open, more transparent and more accountable.
"This is a whole new way of looking at public service delivery – the modern way, the 21st century way, the Big Society way. By opening up public services, putting the people who use them and pay for them in the driving seat, restoring professional discretion and calling on our charities, social enterprises and private companies to get involved, we can build world-class public services that are engines of opportunity and that help build our Big Society".
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"it’s the second aspect of building a bigger, stronger society that I want to focus my remarks on today, and that is the challenge of creating a culture of responsibility in our country.
Now, I know I use that word a lot. Some say it sounds too much like a theoretical concept that’s hard to define and others complain that it just sounds like a burden on people: an obligatory thing we have to do.
To me, the idea is simple. Responsibility is people doing the right thing – by themselves and each other. It is the essential quality of the good society – of a strong society. That’s not theory – it’s fact".
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"Strong families are where children learn to become responsible people. When you grow up in a strong family, you learn how to behave, you learn about give and take. You learn about responsibility and how to live in harmony with others.
"Strong families are the foundation of a bigger, stronger society. This isn’t some romanticised fiction. It’s a fact.
There’s a whole body of evidence that shows how a bad relationship between parents means a child is more likely to live in poverty, fail at school, end up in prison or be unemployed in later life ... We’ve already announced action on parental leave, flexible working, relationship support and a hugely ambitious campaign to turn around the lives of Britain’s most troubled families.
"Unlike the last government that focused almost exclusively on children, we have had the courage to say loud and clear that if you want what is best for children you have to address not just children but families and relationships too.
"We will shortly be publishing our strategy for the vital early years of a child’s life, including radical new ideas for supporting parents.
"We’ll soon receive Reg Bailey’s report on the sexualisation and commercialisation of childhood – and I’m hoping for some tough recommendations that we can get right behind.
And we are thinking creatively about how we can do more to support family life and to ensure that every child grows up in a stable, loving home".
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"responsibility extends beyond the family to the wider community too. We are not just responsible for those we know and love. We have obligations to those beyond our front door, beyond our street.
"In part that’s about how people behave and the respect they show towards their fellow citizens. In other words, it’s about the things you don’t do – like not littering and not engaging in any forms of antisocial behaviour.
"But it’s also about the things you do do. It’s about getting involved. It’s about how we as a government help people come together in their communities and how we remove the barriers that get in their way.
"The basic premise is that if everyone gives a little of themselves, the benefits for the whole of society can be enormous."
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"we – the Cabinet - we’re all giving at least a day a year volunteering. And we’re encouraging all our civil servants to do the same".
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"When it comes to decisions about how and where to spend money, how policies are designed and implemented, how reforms are carried out, government has sometimes seemed to carry on oblivious to the fact that we are human beings, behaving in ways that ministers and officials can’t possibly plan or predict.
"Government has ignored the fact that at heart, as the American writer David Brooks eloquently points out in his new book – we are social animals.
"In this past decade we have surely tested to destruction the idea that a bit more state action here, a welfare payment, law or initiative there will get to grips with the crime, the drug addiction, the family breakdown that plagues too many of our communities.
"Social problems need social solutions.
"And in a way that I don’t think has been sufficiently appreciated, we are bringing that insight right into the heart of the business of government.
"Right across Whitehall we are today applying to the design of policy the best that science teaches us about how people behave – and what drives their well-being. We are revising the ‘Green Book’ – the basis on which the Government assesses the costs and benefits of different policies – to fully take account of their social impact.
"We are developing a new test for all policies – that they should demonstrate not just how they help reduce public spending and cut regulation and bureaucracy – but how they create social value too.
"And, the Office for National Statistics is developing new independent measures of well-being so that by the end of the year, we will be the first developed country in the world that is able rigorously to measure progress on more than just GDP.
"Taken together, these may be the most quietly radical things this government is doing These are big changes, and they all show how serious I am about building a bigger, stronger society.
"They also show how different our approach really is. In the past, the left focused on the state and the right focused on the market. We’re harnessing that space in between – society – the ‘hidden wealth’ of our nation.
"The idea that the centre right is simply about the philosophy of individualism – of personal and commercial freedom – is a travesty of our tradition. From Edmund Burke and Adam Smith in the 18th century, from Hegel and de Tocqueville in the 19th, to Hayek and Oakeshott in the 20th – all have been clear that individual freedom is only half the story. Tradition, community, family, faith, the space between the market and the state – this is the ground where our philosophy is planted.
"The things I’ve spoken about today – modernising public services, rebuilding responsibility, strengthening family and community all this represents a massive cultural change. But if we get it right, it will not just benefit our society, it will benefit our economy too. If we link effort to reward, if we encourage people to step forward and play their part, we won’t just make our society fairer and more cohesive, we will create the conditions for a more aspirational, entrepreneurial culture. A country of do-ers and go-getters, where people feel they are in control of their destiny, where they trust those around them, and where they have the power to transform their lives, where nothing will stop them from pursuing their dreams.
"That’s the culture we need in our economy as much as our society.
"So is this government about more than cuts? Yes.
"Is the Big Society some optional extra? No. It holds the key to transforming our economy, our society, our country’s future and that’s why I will keep on championing it and keep on building it, every day that I have the privilege to lead this country."