Firms quit work experience scheme

Firms and charities are to be invited to bid for a payment-by-results scheme to try to get “Neet” teenagers into work or training, in a project launched by Deputy Prime Minister Nick Clegg.

The £126m scheme is aimed at 55,000 teenagers in England with poor qualifications who are currently not in education, employment or training.

Mr Clegg says it will help youngsters “into the world of work”.

But Labour says the project is “too small and much too late”.

Chris Keates, leader of the Nasuwt teachers’ union, accused Mr Clegg of being responsible for an increase in Neets by scrapping the Education Maintenance Allowance.

‘Ticking time bomb’Mr Clegg described the problem of rising youth unemployment as a “ticking time bomb”.

“Sitting at home with nothing to do when you’re so young can knock the stuffing out of you for years,” he said.

“We urgently need to step up efforts to ensure some of our most troubled teenagers have the skills, confidence and opportunities to succeed.

“Many of them will have complex problems: truancy, teenage pregnancy, a lack of GCSEs and health problems.”

Mr Clegg said to see teenagers who have left school with no qualifications “slumped on the sofa in front of the telly is not only tragic for them… but it stores up huge problems for the future if we don’t help them now”.

He said it was also about getting “crucial early years in a child’s life at school right” to “save on so much heartache later”.

“If you start early it then allows children to start their school career with a sense of enthusiasm for learning,” he said.

The scheme, part of the Youth Contract announced in the autumn, will invite bids for contracts worth up to £2,200 for each teenager who can be sustained in work, education or training for 12 months.

The target group will be 16- to 17-year-olds without any GCSEs at C grade or above.

The aim is for long-term savings from an early intervention.

Almost one in five young people aged between 16 and 24 are classified as Neet – with the most recent figure standing at 1,163,000.

This response from the government is aimed at teenagers at the lower end of this age range who are already at risk of “disengagement” from the world of work.

The organisations that win these contracts will have a free hand to decide their approach – with the emphasis on rewarding a successful outcome.

Payments will be staggered, so that the full amount will be paid only to contractors when young people have remained in work or training for a year.

The funding will reflect the highest level of Neet youngsters in this age group – with £14m available in the West Midlands, where 11.5% of 16- to 17-year-olds are in this category.

The project has been challenged by the ATL teachers’ union, which accused the government of damaging the chances of teenagers “by dismantling the careers and advice service and abolishing the education maintenance allowance”.

 ”We have deep misgivings that getting charities and businesses to provide support for unemployed youngsters outside the education system will undermine the likelihood of success,” said ATL officer Adrian Prandle.

The government’s health reforms run a high risk of reducing levels of safety and patient care while leading to overspending, internal NHS reports have warned.

The potential for conflict between NHS organisations in the new system and upheaval during the transition is high, according to risk assessments drawn up by the four English NHS regions. There is also a high chance the reforms will fail to achieve hoped-for management improvements and budget cuts, they say.

Some of the anticipated problems are rated at the highest risk category, “significant”, and many others are considered “high risk”, even after mitigation measures designed to tackle the issues raised, and despite all actions taken after previous risk reports last autumn.

The warnings – dated January and not due to be updated for three months – will be in place when the controversial health and social care bill becomes law, provided the government succeeds in getting it passed before Easter.

The reports are by the four NHS super-regions in England, created last year by merging 10 regional bodies together into London, the south of England, the Midlands and east, and the north of England. They emerge at a tricky time for ministers as they are likely to reflect the concerns raised by a national risk register, drawn up by civil servants at the Department of Health last year, which the health secretary, Andrew Lansley, is fighting a legal battle to avoid publishing. Pressure on Lansley will be further raised next week when Labour has called an opposition day debate on the issue.

Andy Burnham, the shadow health secretary, highlighted the “devastating” finding in London that officials are still warning of “preventable harm to children” because of the risk of losing key staff, and poor information sharing between the newly created organisations.

“You know something is seriously amiss when NHS London has identified a risk of ‘preventable harm to children’ but has been unable to reduce it,” said Burnham. “That should surely be a sign that it’s time to listen to the view of health professionals that it’s safer to abandon the reorganisation than press on.

“What these devastating documents reveal is that, even though risks to patient safety have been identified, the NHS has not been able to mitigate them. The reason for this is simple: the government gave the NHS mission impossible when it asked it to save a massive £20bn whilst simultaneously dismantling it.”

Burnham added: “David Cameron is putting political pride before patient safety. People won’t forgive him if he digs in and damages the NHS. He needs to listen to the sensible members of his own cabinet and drop the bill.”

There was a further blow to the government after a surge in support for an e-petition on the government’s website that urged ministers to drop the health bill. The petition passed the 100,000 signatures threshold – the point where motions are considered eligible for debate in the Commons.

Health officials stressed the regional risk reports were intended to identify and manage threats in the hope they did not become actual problems. Unlike the national risk register, which was a one-off, the regional risk reports are regularly updated, and the latest versions contain new and upgraded risks, as well as some which have been reduced, occasionally enough to be removed altogether.

A Department of Health spokesman said: “Departmental risk registers are management tools that play a key role in the formation of government policy – they are separate and independent to [strategic health authority] risk registers.

“We have never previously published our risk registers as we consider them to be internal management documents. We believe that their publication would risk seriously damaging the quality of advice given to ministers and any subsequent decision-making.”

The spokesman defended the bill, adding: “Our modernisation plans are essential if we are to put the NHS on a sustainable footing for the future, hand power to doctors and nurses, give patients more choice, and reduce needless bureaucracy.”

The reports are the most up to date assessments of risks to the organisations, staff, budgets and patients in the English regions. Each risk is rated on a scale of one to five for both the likelihood of it happening and the impact of the possible problem, with those scores multiplied to produce a final risk rating of up to 25.

According to the report for the north of England, risks rated 15 or higher are considered “significant” and coded in red; those from 8 to 12 are judged “high” or amber risk. In the north of England officials warn the risk of achieving “productivity gains at the expense of quality”, defined as “safety, clinical effectiveness and patient experience”, rates as 12 – a possible event with major impact – even after the mitigation actions so far chosen are taken.

The same report warns of a similarly high risk of “organisational and system instability” damaging management and governance, and uncertainty caused by the changes that could reduce the capacity and capability of staff and organisations.

Lower rated problems – still considered high risks – cover a wide range, again after existing mitigation, including a “loss of grip on current performance”, that “safety is compromised by lack of clarity on accountability, poor morale, and loss of knowledge”, that the benefits of the reforms are not achieved, and there is a loss of public confidence in the NHS.

In the Midlands and east of England, officials are most concerned that a combination of targets to reduce spending, and the management changes, will cause upheaval during the transition, and similarly warn of worse quality and safety, conflict between organisations, neglect of primary care, overspending, and failure to meet key targets such as limiting the number of patients who wait more than 18 weeks for treatment.

Moderate risks in the region include loss of key personnel, staff working in “silos” and so not co-operating as they need to, a rising risk of fraud, lack of clarity about structures for commissioning treatment for patients, staff distracted or overloaded by the upheaval leading to worse service and higher sickness levels among health service staff themselves, confused and unclear accountability leading to “organisational and system failures”, culture clashes, “mission critical” staff leaving, lack of leadership skills among key staff, and loss of confidence among clinical staff leading to the reforms failing.

Unlike other regions, however, risk assessments in the Midlands and east of England are made only before mitigation actions, as officials say it is too early to judge their likely success.In the south of England, three moderate risks were alerted: that there would be worse safety and patient care, conflict in the system, and that there would be no management improvement or financial savings. In London two new risks were added to the register between September and January, and one removed; five more risks were upgraded as being higher, and three downgraded – though two of those three improved areas still rated relatively high for their overall risk. Among those considered greater problems than three months previously were a lack of clarity caused by the transition to a new system, possibly causing confused accountability; staff losing focus on patients because they were distracted by management changes; loss of “key talent”; and failure to cut costs.

As well as the threat to children’s services, others among the highest-rated risks include future problems for maternity services and “specific failures or deteriorations in the financial position of one or more NHS organisations, with the resulting loss of operating credibility”.

The fate of the health bill – and the health secretary, Andrew Lansley – are on a knife edge. This morning the “home of conservatism” ConservativeHome attacked an “unnecessary and unpopular” bill and talked of a spreading cabinet revolt. On Tuesday, it was reported in the Times that Downing Street insiders’ feet were growing colder by the day.

Coalition loyalists have been wheeled out to support it, but all the evidence suggests it is on the brink of collapse. The question its opponents need to address is, how to deal the final blow? Past experience may provide a useful guide.

1. Call the rebels’ bluff. Make a stand: Wilson v the unions

In the late 1960s, Harold Wilson decided he needed to tackle growing discontent with trade union power, with legislation to curb unofficial strikes. He promoted Barbara Castle, one of his most popular and successful ministers, to a new department of employment and productivity, and she devised legislation that could ultimately lead to trade unionists being fined or even imprisoned for breaking new rules on strikes.

Trade unions and trade union-backed MPs, led by Jim Callaghan, launched a powerful wrecking movement inside and outside Westminster. Amid angry demonstrations and, more potently, a backbench rebellion that slowly gripped cabinet itself, Wilson and Castle clung more and more tenaciously to the bill, based on a white paper beguilingly but misleadingly called In Place of Strife.

Wilson felt the credibility of his leadership and the viability of his government hung on it. An array of concessions and modifications were offered that only encouraged the rebels. In a final desperate throw, he indicated that he would resign if cabinet would not back him. At the same time, he prepared to sell out.

Castle was sent on a cruise so that negotiations could continue without her, but she got wind of them and flew home. On 17 June 1969, the cabinet met in all-day session. Wilson and Castle stood alone, with Wilson, according to the chancellor of the exchequer, Roy Jenkins, “Lear-like … sounding faintly unhinged”. Cabinet ministers prepared for a leadership contest. Wilson gave in. Castle insisted if she resigned alone it would leave Wilson exposed. The government staggered to defeat a year later.

Lessons: if you make an unpopular issue a question of confidence, you have to carry it through. Better to play safe. Don’t leave the climbdown too late.

Upside: Castle introduced equal pay legislation as a way back to party favour.

2. Undermine the minister: the abolition of pay beds bill, 1975

This also involves Barbara Castle, and is arguably a legacy from the In Place of Strife disaster.

In 1974, Wilson was back in Downing Street with a tiny majority. Castle was health and social security secretary with a manifesto commitment to complete the nationalisation of the health service, by ending consultants’ rights to treat private patients alongside their NHS ones.

Castle, irretrievably damaged by the union legislation fiasco, was a hate figure in the tabloids and brought little political capital to her project, although it was well-supported by the health unions and party activists.

Wilson sent in his chief fixer, the lawyer Arnold Goodman, to undermine his secretary of state with the doctors, then he insisted Castle accept the disembowelling of her bill in order to allow it to proceed. Shortly afterwards he resigned and Callaghan, his successor (see above) immediately sacked Castle.

Lessons: a fine example of allowing a difficult minister to climb a tall tree and then reaching for the chainsaw. Ministers should remember that prime ministers are always ready to sacrifice others in order to save themselves.

Upside: from the backbenches, Castle successfully fought for the introduction of child benefit.

3. Accept defeat, but ignore it: Thatcher and Sunday trading

Margaret Thatcher always appeared the most determined and intransigent politician, but in fact she could duck and dive with the best of them. In April 1986, almost at the peak of her authority, the most-celebrated shopkeeper’s daughter in history decided to end the ban on Sunday trading. She saw it as a simple question of deregulation, the kind of thing a radical Conservative government should be doing as a matter of course.

But there was powerful opposition from both shopworkers’ unions and the churches. Earlier, Thatcher might have backed off, but she had a 100-seat majority in the Commons. On 15 April 1986, despite a personal appeal to the churches, Thatcher suffered her only parliamentary defeat. The bill was thrown out on second reading by a majority of 14, when Northern Ireland Unionist MPs temporarily broke their self-imposed boycott of Westminster to vote against it. Thatcher was unscathed.

Lessons: Avoid casualties and keep it low-key. Accept defeat and move on. On no account refer to it in the memoirs.

4. Rue the day: the poll tax

They told her it wouldn’t work: that keeping track of individuals to tax them would be much, much harder than taxing property. But by 1987, Margaret Thatcher was inclined to regard opposition to her policies as a character flaw.

Replacing the old and anomalous rating system was a manifesto commitment, and the rates were a dangerous source of independence for local councils who increasingly made up the real resistance to her policies.

In 1989, the poll tax was introduced in Scotland, completing the devastation of Tory support north of the border, and putting devolution back at the top of the political agenda. In England and Wales, just before the tax came into force in April 1990, a 200,000-strong demonstration ended in riots. Too late, rafts of concessions and amendments were brought in. Less than six months later, Thatcher was out.

Lessons: People who lose from a policy change will protest. People who gain will never mount rival demonstrations in support, especially not old ladies in large houses who were the biggest beneficiaries of the poll tax. MPs who fear they are going to lose their seats are dangerously unreliable.