Chris Skidmore MP: The Liz Truss plan that Clegg blocked could cut childcare costs by a quarter for working parents

Chris Skidmore is Member of Parliament for Kingswood and a member of the Education Select Committee. Follow Chris on Twitter.

The cost and quality of childcare is an issue which touches millions of parents and families across the country. All parents want the best care for their children, and they also want it to come at a reasonable price. Yet somehow, as important an issue as it is, we have managed to stick with a system that isn’t working for anyone.

The costs to families are huge. They face the second highest childcare costs in the OECD - at 26.6 per cent of family income it is more than double the OECD average of 11.8 per cent. When it takes an average of four months full time work for a mother to cover the cost of her child’s care, it is hardly surprising that many are being kept at home because they can’t afford to go out and work. Department for Education (DfE) data shows that half of all stay at home mothers want to get back to work, but the sky high costs of childcare provision are holding them back. Worryingly, the problem is getting even worse. Figures from the Daycare Trust show childcare costs are increasing by six per cent a year, well above the rise in wages.

High costs aren’t for lack of Government funding. In spite of the large costs to parents, the Government is still spending twice the OECD average on child care. These also aren’t a reflection of a much higher quality of care in the UK. While costs are high, wages for carers are low, which is dragging down quality. On average a childcare worker in England is paid just £13,300, and a supervisor £16,850, compared to £20,000 and £30,000 respectively in both Germany and Denmark.

It is of course no coincidence that the crippling cost comes alongside the other thing which makes our childcare system an exception in the world: the hugely restrictive ratios of staff to children we impose. While in England nurseries must have one member of staff for every four two year olds in the Netherlands and Ireland the ratio is one to six; in France is one to eight; and in Denmark, Germany and Sweden there is no national limit at all.

Chris Skidmore MP: The Local Authorities that fail our children should be replaced by Learning Trusts

Chris Skidmore is Member of Parliament for Kingswood and a member of the Education Select Committee. Follow Chris on Twitter.

Over the past three years, Michael Gove’s tenure at the Department for Education has produced nothing short of a revolution in education, with no sign of slowing down: the introduction of free schools, controversial changes to the national curriculum, the extension of the academies programme - and now further changes to make GCSEs more robust qualifications have meant that the Department’s programme for reform has been one of the benchmarks of the coalition’s success. With so much already being achieved, this should not mean that we should let our foot slip off the accelerator of reform, but to constantly ask ourselves the question: where next?

One of the most pressing problems we should be turning our attention towards is the large inequalities in performance between Local Authorities. Ofsted’s report last year picked up on the huge variations across the country in the chances a child has of attending a primary school ranked good or outstanding. While nine out of ten children in Camden and Barnet will get to attend such a school for those in Derby and Coventry that figure drops to just four out of ten, leaving the majority in schools in need of improvement.

These variations exist at least in part because, unfortunately, there are a significant number of local authorities that are simply failing to make use of the tools they have been given to improve schools. The Ofsted report revealed that of the three authorities with the greatest proportion of schools found to be inadequate between 2007 and 2011 - Leicester, Bournemouth, and North East Lincolnshire - two hadn’t issued a single warning notice. Looking at the 17 authorities where ten per cent or more of schools were found to be inadequate, it was found that only ten had issued any such notices. A similarly poor usage of Interim Executive Boards was discovered, with almost half of authorities having not used even one, despite having the kind of weak schools which IEBs were introduced to help quickly turn around.

Chris Skidmore MP: We’re rewarding failure in the NHS. We need to reward good, efficient care

Chris Skidmore is Member of Parliament for Kingswood and a member of the Education Select Committee. Follow Chris on Twitter.

Figures released this week revealed the huge scale of six figure salaries amongst NHS managers and consultants. More than 7,800 were paid more than £100,000, with a third of them on salaries larger than the Prime Minister’s.

In a time of public sector pay restraint these figures highlight the need for reform of pay on the NHS, particularly as they have increased at nearly half of the trusts which were surveyed. This contrasts sharply with the broader outlook on pay, which has changed more positively over the last year. From 2010/11 to 2011/12 total staff costs have fallen by £1.5 billion, with the cost per head reduced by an average of £215. 

Staff costs account for a huge proportion of NHS budgets. According to the King’s Fund, NHS spending on staff, at £42.8 billion, accounted for 64 per cent of the operating costs of Primary Care Trusts, NHS and foundation trusts. As we face up to an ageing population and fiscal reality this is clearly an area that should be targeted for savings, and it can’t be right that managers at the top are protected.

Chris Skidmore MP: Margaret Thatcher set the terms of the education debate we have today

Chris Skidmore is Member of Parliament for Kingswood and a member of the Education Select Committee. Follow Chris on Twitter.

One of the many things that is being said of Baroness Thatcher in the light of her sad death last week, from across the political spectrum, is that she set the political landscape in which we still live today. This is certainly true in education; during her time in power there was a fundamental shift in approach which lasts to this day.

One of the key legacies is the idea, which we now take for granted, that parents should be able to make informed choices about what is best for their child. Prior to the 1980 Education Act there has been no obligation for local authorities to take account of parents’ choice of school.

Parents weren’t only being deprived of choice; they were also not being properly informed about the quality of their child’s education. Under Thatcher, schools became obliged to publish prospectuses giving details about examination results and Inspectors’ reports ceased to be secret.

Chris Skidmore MP: Burnham will do anything to avoid facing up to the Labour's NHS failure

Chris Skidmore is the Member of Parliament for Kingswood and a Member of the Health and Education Select Committees.  Follow Chris on Twitter.

Following an extended period of silence Andy Burnham has finally stuck his head above the parapet on twitter, repeating predictions he first made in 2011 that the NHS is at death’s door. Only this time, apparently ‘this time we mean it’.

In less than 140 characters, it seems that Burnham, still damaged from the Francis report’s horrific conclusions into Labour’s tenure at the department, has torn whatever remaining credibility he had to shreds. Last year I took a retrospective look at the ridiculous claim he’d made when the Health and Social Care Bill was going through parliament that there were only ‘72 hours’ to save the NHS. Months later, with the Bill passed, it was clear his predictions of death had been premature.

As I noted ‘the political debate ended up becoming more about paranoid speculation than the practical content of the bill itself, with Andy Burnham championing the interests of the middle-managers rather than professionals and patients, claiming that there was "72 hours to save the NHS". For someone who in the final months of the Labour government was championing GP-led commissioning, it was an unfortunate corner to be backed into. Months on, the NHS remains alive and well’ (Conservative Home, 29 August 2012).

Chris Skidmore MP: Let's seize this golden opportunity to put history back at the heart of the national curriculum

Chris Skidmore is the Member of Parliament for Kingswood and a Member of the Health and Education Select Committees.  Follow Chris on Twitter.

The way in which history is taught in this country has long been in need of a radical change. That is the message delivered today by leading historians in an open letter to The Times (£) (reprinted in full below).

The signatories to the letter, including Niall Ferguson, Antony Beevor, David Starkey, Michael Burleigh, Andrew Roberts, Simon Sebag Montefiore, along with history professors based in Oxford, Cambridge, London and Exeter argue that the current system is denying pupils ‘the chance to obtain a full knowledge of the rich tapestry of the history of their own country’. Sadly many students are leaving education with gaping holes in basic historical knowledge. The extent of this was revealed in a poll commissioned by Lord Ashcroft which shockingly found that 11 to 18 year olds were significantly more likely to be able to correctly identify a picture of Churchill the insurance dog than one of Churchill, our great wartime leader (Lord Ashcroft Polls, 25 June 2012).

Worryingly, too few students are choosing to carry History on to GCSE or A-Level. What’s more, as I found out when I produced a report on the GCSE uptake of History, it is disproportionately dropped by those coming from low-income backgrounds (History in Schools, 19 December 2011). This should be of grave concern for anyone who believes that History, like Maths, English and the Sciences, is one of the key elements of a good education and an important tool with which to build an understanding of the world.

As well as being more interesting, a reformed curriculum will, crucially, be a great deal more enlightening. As is made clear in today’s letter the principle of the changes being proposed recognises that fundamental to a full understanding and appreciation of history is a strong foundation of knowledge of the historical context in which events occur. When a pupil understands the context within which events occur they are able to gain a far richer understanding of them and how they relate to each other over the course of a period.

Chris Skidmore MP : Mid-Staffs laid bare the cost in lives of Labour’s time in charge of the NHS

Chris Skidmore is the Member of Parliament for Kingswood and a Member of the Health and Education Select Committees.  Follow Chris on Twitter.

For a party that will even take falling unemployment as an excuse to attack the government Labour have been deathly quiet in response to the shocking revelations about what went wrong in the Mid Staffordshire Foundation Trust. They have good reason to be, for the Francis report laid bare the cost in lives of Labour’s time in charge of the NHS.

As we now know there was failure at regional and national levels in the NHS. At the Mid-Staffordshire trust this resulted in as many as 1,200 avoidable deaths between 2005 and 2009. One cannot fail to be moved when one hears the harrowing accounts from the families of those who died needlessly due to systemic failure and a culture which put up with inexcusably low standards of care.

Labour, and their target-centred, reorganisation-heavy approach to the NHS, which did so much to sap morale and incentivise bad behaviour, should be taking their share of the blame for the crisis. A crisis, it is striking to note, that happened in a trust which, in a move proposed by then junior minister Andy Burnham, had been awarded the supposed gold-standard of Foundation Trust status.

Rather than be held to account Labour and Andy Burnham have desperately tried to brush this all under the carpet. As health secretary Andy Burnham ordered the first inquiry into the incident as reports of avoidable deaths came to the public’s attention. Its highly constrained terms of reference and private hearings gave Andrew Lansley cause to warn parliament at the time that it was an inquiry ‘designed more to focus on local management than to get to the full truth and the full context of the tragedy at Stafford hospital’.

Chris Skidmore MP: Richard III's remains should lie in state at York

Chris Skidmore is the Member of Parliament for Kingswood and a Member of the Health and Education Select Committees.  He is also is author of Bosworth: The Birth of the Tudors (Weidenfeld and Nicholson) published on 23 May 2013. Follow Chris on Twitter.

The tombs of our kings and queens are difficult to miss. Encased in grand monuments of marble or bronze, in death as in life, they represent the glory and greatness of the royal bones gathering dust in the coffins beneath the ground. Westminster Abbey is full of them, including the Renaissance tomb of the first Tudor king, Henry VII, depicted as an old man staring piously to the skies, his hands clasped in prayer. It is tempting to imagine him giving thanks to God for placing him on the throne at the Battle of Bosworth in August 1485 when, having landed at the westernmost tip of Wales with his band of foreign mercenaries and Welshmen just two weeks before, Henry had managed to steal victory against his enemy, Richard III.

In contrast, the tomb of England’s last Plantagenet king has long been lost to history. After the battle, Richard’s naked body, ‘besprinkled in mire and filth’, had been carried into Leicester the afternoon after the battle. Trussed over the back of a horse, with his ‘privy parts’ barely concealed by a loin cloth, members of the public stood by the roadside, gazing in bewilderment at the body of a man who that same morning had rode into battle King of England. For two days his body was placed on public display to banish any rumours that he had survived, before being buried in a pauper’s grave in the nave of Greyfriars Church in Leicester. It was not until ten years later that Henry decided to spend a paltry £10 on a gravestone, which eventually was broken up along with the monastery during the dissolution of the monasteries in the 1530s. The site became a country house, before the ravages of progress witnessed the expansion of the city, and the location of Richard’s final resting place was turned into a council car park. Since then, any notion that Richard’s body might be one day discovered has been the stuff of legend — until now.

Chris Skidmore MP: Overcoming the dementia challenge

Chris Skidmore is the Member of Parliament for Kingswood and a Member of the Health Select Committee. Follow Chris on Twitter.

We have long known that Britain is an ageing country where the amount spent on care is projected to rise continuously over the next decades. The Personal Social Services Research Unit’s modelling of future expenditure for the Dilnot Commission predicted that by 2030, the total annual spending on long-term care for people will have risen from £20.6 billion to £44.8 billion, of which £26.3 billion is state funding. This would constitute a rise in spending in services as a % of GDP from 1.63% to 2.31%. Population projections also suggest that between 2011 and 2016 the number of people aged 65 and over will rise by 1.4 million, and by 2.4 million by 2021.

It is not just the costs of care that we must be concerned with: in particular, an elderly society will present new challenges, particularly around the rise in dementia. With an ageing population, it is expected that the number of people with dementia will increase considerably, to over 1 million by 2021. Estimates put the cost of dementia at £23 billion a year, while the pressure placed on NHS services presents an increasing challenge: in England at any given time, one quarter of hospital beds are occupied by people over 65 with dementia. It is clear that reducing the number of occupied hospital beds is a question of better prevention, not rationing. The American healthcare provider Kaiser Permanente operates on the principle that ‘unplanned hospital admissions are a sign of system failure’, something that is gradually beginning to percolate into the NHS. However, the NHS still uses 3 ½ times the number of bed days for those aged 65 and over, compared with Kaiser Permanente. If we can reduce the demand for hospital beds by just 10%, this could potentially free up £1 billion that could be redirected into community based care services.

As with so many conditions, early diagnosis is key: a recent report by the Social Market Foundation, A Future State of Mind, has highlighted our poor record on early diagnosis and treatment of dementia when compared to our European counterparts, citing one alarming study which claimed that 14% of people diagnosed with dementia did not subsequently make an appointment with a doctor, compared with 0-2% In Germany, Spain, France and Italy. Moreover, it is thought that there are 400,000 people living with Alzheimer’s in Britain, whose condition remains undiagnosed.

Chris Skidmore MP: We need a community right of appeal against planning decisions

Chris Skidmore is the Member of Parliament for Kingswood and a Member of the Health Select Committee. Follow Chris on Twitter.

If there is one issue that unites people in the Kingswood constituency that I was born in and represent, it is protecting the Green Belt. Ever since Labour tried to build 10,000 houses on it, and even before, local campaigns led by committed residents have had to continually fight to prevent development that would pave over much of the open space between Bristol and Bath. 

The problem is that the odds are stacked against local opponents of unpopular planning decisions, in an ongoing battle between David and Goliath. Petitions are signed, protests take place, local councillors are lobbied, and politicians take the message to Westminster. Yet all too often, the deep pockets and corporate resources of developers, combined with a bewilderingly complex planning system, makes David’s slingshot pale into comparison.

At present, it is only the developer that can appeal against the refusal of planning permission, aside from legal challenges there is no similar right of redress for those affected by a decision. Local councils are often keener to avoid a messy appeals process than to stand up for those people that they are democratically accountable to.

After polling my constituents’ views, I introduced a Ten Minute Rule Bill earlier today that would enshrine in law a community right of appeal against planning decisions. 

So, how would this work?

Chris Skidmore MP: Beveridge - a modern conservative?

Chris Skidmore is the Member of Parliament for Kingswood and a Member of the Health Select Committee. Follow Chris on Twitter.

This last week we have been inundated with articles, speeches and pamphlets, commemorating the 70th anniversary of the Beveridge report. Predictably, the majority of these have come from the left, celebrating the report that founded the Welfare State. Yet as the Free Enterprise Group’s recent report A New Beveridge illustrates, Conservatives should take note of the austere old Liberal. Leafing through the faded, yellow pages of The Beveridge Report, Social Insurance and Allied Services, it is startling to see how familiar are the arguments Beveridge makes, and how similar his approach is to that of the modern Conservative Party.

It is important to recognise that Beveridge’s original aims and ambitions were very different from what the welfare state ended up being. If we could return to these founding principles, we may be able to ensure that we can foster greater individual responsibility at the same time as ensuring those in greatest need are supported. His recommendations are tough, but compassionate. The introduction to the Beveridge report explained the way that the new system should operate, in abstract terms:

“social security must be achieved by co-operation between the State and the individual. The State should offer security for service and contribution. The State in organising security should not stifle incentive, opportunity, responsibility; in establishing a national minimum, it should leave room and encouragement for voluntary action by each individual to provide more than that minimum for himself and his family.”

It also made a clear appeal to duty and obligation on the part of the beneficiaries:

‘The higher the benefits provided out of a common fund for unmerited misfortune, the higher must be the citizen’s obligation not to draw upon that fund unnecessarily.’

Chris Skidmore MP: Fewer people will be talking about their NHS treatment than NHS car parking

Chris Skidmore is MP for Kingswood and a Member of the Health Select Committee. His report can be read on his personal website. Follow Chris on Twitter.

At the weekend, the Daily Mail ran a story highlighting the results of a recent Freedom of Information investigation I conducted into the cost of hospital car parking. This involved asking every hospital trust in England how much income they had received through charging for car parking, for each year since 2001. This issue has always been an emotive one, which strikes a chord with many people’s experience of the NHS. It is easy to understand the concerns people have when the data revealed that hospital trusts have received over £1 billion in car parking charges in the last ten years, £160 million in the last year. This has more than doubled in the last decade. Incidentally such charges only exist in England- they were outlawed in Scotland and Wales in 2009. An average trust receives just over a million pounds a year from car parking.

Not all hospitals feel the need to charge to excess - for example Hinchingbrooke Hospital under Circle’s management has introduced a flat daily rate of £2.50 for all visitors, and have scrapped the instant fine system for those without tickets. Moreover, Trafford Hospital in Manchester abolished parking fees entirely in 2010, making the reasonable point that visiting a hospital was already costly enough in terms of stress and time. If some of the best trusts in the country realise that patient experience- including before they enter the hospital building- is central to achieving better quality treatment, then it seems clear that other trusts should be following their lead.

The issue of NHS car parking charges has always been a thorny one. After all, it still costs money to operate a car park and at a time when budgets are tight it is important to scrutinise them line by line for potential savings. That said, in their present form parking charges hit the elderly, the chronically ill and the poorest hardest- as a flat fee they could barely be more regressive. It is also the sort of bread-and-butter issue that genuinely affects patients and their families each and every day. Attending a hospital can be a difficult and stressful experience without having to continually watch the clock before the meter runs out, or worry about being heavily charged for parking or fined.

Chris Skidmore MP, Kwasi Kwarteng MP, Dominic Raab MP, and Priti Patel MP: Britain’s best days are not behind us

By Chris Skidmore MP, Kwasi Kwarteng MP, Dominic Raab MP, and Priti Patel MP.

Our new rivals in the world economy are working harder than us, taking their studies more seriously, keeping their debt low, and taking more risks. If Britain is to remain competitive, we must learn from their example. Britannia Unchained is a rallying cry for the 21^st Century.

Britannia Unchained backs the current government’s deficit reduction strategy as a vital first step to restoring economic growth. Here our model should be that of Canada in the 1990s. Between 1992 and 2000, Canada converted an annual deficit of 9% of GDP to a surplus of 3%, cutting federal spending by around 20% between 1992 and 1997. In contrast, British public spending has continued to grow since 2007, and the deficit has been reduced by a quarter.

On education, we should be looking eastwards for positive role models, to arrest our decline in the PISA world rankings - we have fallen as low as 28^th in maths. Britain has the lowest proportion of students studying maths post-16 of any developed country, at 15%. By contrast, in Japan, 85% of students achieve the equivalent of maths A-level, and Indian students study maths and science for twice as long each week at high school as their British counterparts.

On innovation, Britain can emulate the success of Israel, in supporting high tech entrepreneurship, and the USA, in accepting the benefits of risk-taking and losing our fear of failure. The difference between Silicon Valley and Britain is astonishing. In 2005, 3,867 patents were awarded to businesses and individuals in San Jose, a city of fewer than a million people. The total number of patents awarded in Britain the following year was only 2,978.

Chris Skidmore MP: Five steps to tackle foreign citizens' abuse of the NHS

Chris Skidmore is MP for Kingswood and a Member of the Health Select Committee. His report can be read on his personal website. Follow Chris on Twitter.

There will be many issues facing the new Health Secretary Jeremy Hunt as he inspects his in tray this week. Crucially, there remains the challenge of finding 20% savings to be reinvested in frontline care. Already Andrew Lansley's reforms have managed to save £7.5 billion in management and bureaucratic costs, something that should be rightly highlighted. Yet to meet the target by 2015, no stone should be left unturned - after all, the NHS is not free, it is paid for by taxpayers who deserve to know that every penny is being wisely spent, and above all not wasted.

Over the past two years, I have been investigating the issue of foreign nationals using the NHS without paying for its services, something which costs the NHS over £100 million, though it seems that this figure, given data is not collected effectively and primary care remains free for foreign nationals, is just the tip of the iceberg. ConservativeHome has already highlighted this issue, which if tackled effectively would be a popular measure, demonstrating our commitment to protecting the NHS as a service funded by taxpayers who want a service free at the point of use, not abuse. So today, I have sent the new Secretary of State a copy of a new report I've released – The Missing Millions — that gathers together the results of a long-running investigation, and offers advice on how to deal with the problem.  Ronald Reagan famously said that there are no easy answers, but there are simple answers. Here then, are five recommendations which I shall be submitting to the Department of Health.
 
1. All trusts should be legally obliged to collect data on the cost of treating individuals not entitled to free NHS care, and those treated under the EHIC scheme. This is the subject of a Ten Minute Rule Bill that Henry Smith MP is introducing to Parliament on Tuesday. It is a vital measure - it is clear that from Freedom of Information requests from trusts that currently not all trusts are recording or keeping the data needed to charge foreign national patients. Without this information, it is impossible to operate a watertight system.

Chris Skidmore MP: Andrew Lansley's clinical commissioning groups are already improving health services by making them more localist

Chris Skidmore is the Member of Parliament for Kingswood, and a Member of the Health Select Committee. Follow Chris on Twitter.

It's fair to say that one of the most controversial pieces of legislation to pass through this Parliament has been the Health and Social Care Act. Parliament devoted hundreds of hours to the bill, rightly so given the esteem that the NHS is held in. Sadly, the political debate ended up becoming more about paranoid speculation than the practical content of the bill itself, with Andy Burnham championing the interests of the middle-managers rather than professionals and patients, claiming that there was "72 hours to save the NHS". For someone who in the final months of the Labour government was championing GP-led commissioning, it was an unfortunate corner to be backed into. Months on, the NHS remains alive and well: it has not crumbled, as some feverishly predicted. Importantly, we are now seeing the early benefits of creating clinical commissioning groups, the centrepiece of Andrew Lansley’s legislation. 

Clinical commissioning groups (CCGs), are anticipated to take full control of commissioning NHS services from April 2013. The replacement for cumbersome Primary Care Trusts, they currently are in "shadow" form, though many are already being given powers, funds and responsibility for services in their local area.

The results are encouraging. For example, the Kettering locality of Nene CCG in Northamptonshire noticed that too many patients with minor injuries were presenting at Accident and Emergency Departments. Not only does this cost money, but it also increases queues unnecessarily. To ameliorate this, they have trained their nurses to provide minor injuries care, even eliminating the need for many patients to see a GP, let alone make a trip to a local hospital. Simple, straightforward, and an example of where local knowledge and the freedom to innovate can save money and provide better care. At a time when the NHS is tasked with making £20 billion of efficiency savings by 2015, the cumulative effect of these small interventions is potentially transformative.