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It is a great pleasure to be here this morning.  I know you were expecting Stephen Ladyman, but I am the new Minister responsible for social care.  My portfolio includes physical and learning disability, older peoples services, carers and children's and maternity services.  

Because this is one of my first public speaking engagements as a Minister and I am at the end of my first week, I am not yet an expert in this field of policy.  So today is an opportunity for me to talk to you because I think that you are key to delivering our vision for the future of social care. What I thought I'd do if I may is to talk to you about three key elements:

During the rest of this morning, it would be especially helpful if you could give some thought to what your personal experiences are of simple, practical things that have really helped you or others to improve health or access healthcare.  And it would also be helpful to get your perspective and analysis on the with real irritants and frustrations that you or others have encountered.  During the breaks, take the opportunity to talk to other people about your experiences, talk amongst yourselves and talk to Department of Health officials. 

Debra Moore of the Valuing People Support Team will be talking to you later about the more detailed pieces of work she is leading on to support the health needs of people with learning disabilities.  It would be enormously helpful if you could feed your reflections to her. 

How we got here

As you know I joined the labour party at fifteen because of their values, because of their commitment to equality, because of the belief that we do more together than we do alone. Let me start with the knowledge that has brought us to this point.  As a Government, we are clear it is not acceptable that, in some areas the significant improvements in the National Health Service are not reaching people with more complex needs. Nor that peoples' health is suffering due to lack of accessible information.  So we are committed to reducing the inequalities and exclusion that people experience, that is the values of the labour party, and the values of our manifesto.

We know many people with learning disabilities have greater health needs than the rest of the population.  They are more likely to experience mental illness, and are more prone to chronic health problems, epilepsy, physical and sensory problems.  And yet, you know there is clear evidence that they experience difficulty in accessing health services.  We know for example that women with learning disabilities are much less likely to undergo cervical smear tests than the general population.  One study showed 19% undergo cervical smear tests versus 77% in the general population. 

There is also evidence of avoidable illness and premature deaths amongst people with learning disabilities.  This is something we absolutely have to address, but first we need to know how and why this is happening. 

Many of you here today will know that the National Patient Safety Agency is taking forward work on a new Confidential Inquiry.  A preliminary report into the best way to conduct the confidential inquiry is going to report to me in Spring 2006.  The full inquiry will be time limited to 5 years to enable us to reflect its findings in future policy development. 

The Inquiry is also going to support the work of the Disability Rights Commission with their Formal Investigation into inequalities in primary health care of people with learning disabilities and those with mental illness.

So that's a bit about why we are here together.

The state we're in

I think it is vital that we acknowledge both the hard work and money that has gone into improving services for disabled people.

The work we are doing to deliver services and support to people with learning disabilities comes in the context of a much broader approach that the Government's is taking to public sector reform. 

We should take the lead in establishing the framework within which services operate.  But we need everybody who has an interest to be involved.  That includes you; people who use services, their carers, the professionals and those who provide services.  These services can't be micromanaged from Whitehall.  Its not possible to manage and implement the changes from the centre.  This is an interdependent relationship; we need all our partners to implement developments, a message very much echoed in Hilary's opening remarks.

So how are we doing?  In March this year Rob Greig, the National Director for Valuing People reported on the progress we have made since the White Paper was published in 2001. He consulted people with learning disabilities, family carers and professionals involved in the implementation of the policy so far.  He had a remarkable number of responses to his consultation  - 3000 which is a remarkable number by any standards.

One of the things it shows is that adults with learning disabilities are being listened to more.  And that initiatives such as 'person centred planning' 'Supporting People' and 'direct payments' are helping change people's lives.

The report, however, does not say that everything is perfect. It recognises that for many people not much has changed, particularly for those who face additional barriers like those with complex needs as well as people from black and ethnic minority populations. The report also sets out the challenges for the next 5 years of Valuing People.  I look forward to having the opportunity to discuss these issues with Rob over the next few months.

We have also set an ambitious vision for people with disabilities in the recent Strategy Unit Report which a lot of people here will have seen.  'Improving the Life Chances of Disabled People', published in January is an important report and recognises the barriers people with disabilities are still experiencing.  It sets out that 'By 2025, disabled people in Britain should have full opportunities and choices to improve their quality of life and will be respected and included as equal members of society.'

So that's a bit about what's been achieved, and I want to conclude with a few thoughts on the journey ahead.

Closing the gap

So how do we achieve these ambitious goals for our society?  How do we accelerate closing the gap?  Some of the responsibility falls to us in determining the framework.

But some of it falls to you.  It is vital that where either mainstream or specialist services are inadequate or where they exclude people with learning disabilities, it is essential that you challenge this locally.  You are best placed to know what it is that is needed where you live and work.

It is also important that you feed into opportunities to influence the framework and the shape of services.  As you know, my Department is in the middle of a very important consultation exercise on adult social services.  The Green Paper seeks to address the challenges in adapting support for a changing society with higher expectations for choice and inter-dependence. 

This paper is going to be absolutely central to the goal of improving social inclusion and quality of life for everyone.  But we absolutely need your input - I hope that many of you have already responded and if you have not then that you will try to do so.  The closing date is 28 July 2005, so there is still time to have your say.

This is a genuine opportunity to look at doing more than make improvements round the edges of the existing services.  We need you to think about what social care really is and what it actually does?  How should the services take account of individuals, carers and families and work with them to enable people to participate as fully as they want to in society? 

Though important, this is not just about focusing on the individual's ability to make choices and to be in control of as much as possible.  It is also about the behaviour and attitudes of those who deliver and commission services and I want to give you an example of what I mean in a minute.

This does not mean that Government has no responsibility, it clearly does.  We recognise that it does not matter how consultative, innovative or - in theory - effective policies are, the key to changing peoples lives is how that policy is actually implemented.  I agree with that and I am confident that the formation of the new Care Services Improvement Partnership will ensure that implementation is no longer the poor relation. 

This newly formed organisation, led by the recently appointed Richard Humphries, will support improvement and development across a range of services.  These include health and local government, for children, adults and older people, including mental  health, physical disability, learning disability and prison health services. 

The Valuing People Support Team will be a key member of this new partnership and so it will have an even stronger voice within the department and beyond, on cross cutting issues, including children's services. 

There are a myriad of different plans and projects happening across the country - far too many for me to mention today.  And most of you will know more about them than I do.   But we are drawing together many of these initiatives under CSIP.  And this will help us to create the right environment to enable the well-being of all the children and adults who depend on services.

Supported Living Outreach Team (Birmingham)

Now as you know I am a MP from Birmingham so I hope that you will forgive me for giving you an example of change that we want to encourage from my home town.  Birmingham's Supported Living Outreach Team is a programme which has really caught my attention.  It supports adults with severe and complex learning disabilities, those for whom it is often difficult to see a positive future.   

Birmingham's Supported Living Outreach Team (SLOT) works with people with profound learning disabilities and complex needs who present significant challenges. Often these behaviours result in the person being placed a long way away from home, or hospitalised. 

The team works with care and housing providers to deliver person centred packages of care, which enable people thought 'too challenging' to live safely in the community, to do so. These packages of care range from outreach support to twenty-four hour support.

They employ local people who, though they do not have specialist training, come to the job with an open mind and perhaps most importantly have the community connections to actually make the support work.  The service has achieved significant reductions in challenging behaviour and improvements in the quality of life for individuals. This has even led to reductions in the cost of some packages of care.

So what in examples like this is a win : win situation - better outcomes for the individual concerned in terms of their quality of life and participation, the risks to staff are reduced and, which many of you will not have expected, as it may cost less, there is money to invest elsewhere. 

So it is clear that many people do need very specialist skilled support.  But this can be delivered with respect for the humanity and dignity of each individual.  It can be delivered in a way that we would all wish to be treated and it will be delivered by us working in partnership in the years to come.