I work in the NHS, where the principle that healthcare should be commissioned in accordance with local need, in order to make most effective use of scant resources, is well-established. I have been wondering if there are any parallels in the NHS with current free schools policy. The post which follows is the result of my musings:
Imagine a rural area of roughly 600 square miles, where the population of around 270,000 is divided between four market towns and a large number of villages (some of which are fairly large and provide facilities for smaller surrounding villages). This area is currently served by a district general hospital known as St Michael’s, based in the largest of the market towns.
The population is ageing (by 2021 over 65s will account for a quarter of the population), and the numbers of school-aged children are decreasing. It is a fairly affluent area, with house prices above national average, and although unemployment itself is low, the average wage is less than nationally. Larger towns are within 30-45 minutes drive. However, in common with many rural areas, public transport provision within the area and to the surrounding region is poor.
Health and wellbeing are generally good in the area, though as would be expected with an ageing population, there is a relatively high incidence of heart disease and falls (often causing broken hips in the elderly). Public satisfaction with services is generally good, though with concerns about access to services (patient transport in particular), and response times from emergency services. St Michael’s itself is looked on favourably by most people in the area. As part of NHS developments, more outpatient care is now provided in community clinics.
The area is not known for innovation in public services. However in recent years patients in one area (around the village of Abbotsford) have leapt at the opportunity to become more involved in planning healthcare. They recently seized a Department of Health funding opportunity only available for building new hospitals (it could not be used to expand existing facilities), and proposed a new small hospital for Abbotsford. It was to focus principally on delivering elective care in orthopaedics and ophthalmology (hip and cataract operations, for example), as these are areas of high demand by the elderly.
The proposal appeared on first glance to have a number of positives: Patients living nearby Abbotsford would travel shorter distances, local GPs would have closer ties with the new hospital, and staff would be more familiar to local patients. As a new build, it would have excellent though limited facilities and was considered likely to attract staff.
However, on closer inspection there were a number of disadvantages: As a small hospital providing a specific set of services, it could not provide extensive consultant cover or intensive care beds, so would not be able to provide for patients with complex needs such as those with additional heart disease or poorly-managed diabetes. So, many patients who might have wished to use the new hospital would still need to travel to St Michael’s for treatment. At the same time, St Michael’s would not need to provide as many routine procedures as now, so would reduce its capacity in these disciplines. But as there would also be an increase in the proportion of complex patients requiring a longer stay in hospital to recover from operations, overall waiting times for surgery at St Michael’s were considered likely to increase, for factors completely outside St Michael’s control. In addition, there would be risks to patients whose condition deteriorates whilst at Abbotsford, as they would need to be transferred urgently to Intensive care beds in St Michael’s or hospitals elsewhere in the region (providing beds were available). Lastly, core costs at the Abbotsford [new] hospital would be relatively high as the hospital would be a stand-alone provider, with its own board of directors. So overall, costs of providing orthopaedic and opthamology services across this rural area would increase, because two hospitals would need to provide the basic service instead of one, yet standards or patient experience would not necessarily improve, as the new service would only be suitable for some patients.
The proposal enjoyed significant support from Abbotsford patients. However, given the concerns over the impact on St Michael’s, the potential risks to patients, and the expense, the proposal was judged too risky and poor value for money, and the plan was dropped. Yet in education, the opposite happens when Free Schools are proposed in areas like this. Why?
Comments
We are certainly paying for education from my point of view when you see the program of work set out for children in a typical free school. We will always be paying for dogma the question is only what dogma. If parents and children want to go to a school that is their opportunity to reject or consent to any particular dogma. If they can't find anything they want new schools should be an option.
Ben - how can you say that WLFS seems to be excellent value for money when we can not find out how much it is costing? This is also true of the academies. We have no data.
Yes we need the data I agree on that. The WLFS capital costs reported by Toby Young are very good when compared to the average for a new state school. Revenue costs I don't know but it should be also comparable. We do need DfE to collect and publish this data, I suspect that the coalition want to mask some high initial costs of establishment of some free schools or just want to lower the admin burden. In the long run the objective costs will have to come out.
Ben my concern is that free schools are using public money and we should be looking for minimal risk and effective use of money across the whole system in a locality, not just in individual elements of that system.
In both health and education the normal systems of consultation which challenge policy with reality until it becomes fit for purpose were shut down by this government, making it possible for ludicrous policy to be pushed through. You're lucky in health because the LibDems have a fair grasp on health policy and substantial changes have been made in the direction of policy being fit for purpose. I'm not saying it's great but it's better than in education they were taken by surprise and they key policies were pushed through in the first few weeks of this government when they had to go along with everything to settle the markets and the worries about the viability of the coalition.
Many esablished state schools which are not academies (including free schools) are obviously not cost effective and low risk given that they fail to educate their children. Capital costs of many free schools should be good they are mainly doing refurbs of property. There might be a revenue problem of maintaining some of these buildings but that is generally true of the state school stock and making low carbon buildings is still often a gold plating exercise.
What is prompting you to say these random things?
You need to compare other systems such as social care in England which is moving more and more to service user defined services and most other health systems in Europe which use centralised mutual funding but have a multiude of providers for their patients to choose from paid for by the funding. Both systems have mechanisms for efficiency which don't occur in commanded services - such as competition. And providers don't have to use cost as a competitor, they can compete on quality which often means being responsive in a way the command systems can't be even if they wanted to. This often also means better working environments for staff as they have more autonomy.
If we contrast the social care sector today with say 30 years ago, would you rather disabled people still lived in asylums or huge residential care homes, rather than normalised domestic settings? I am sure the asylums were potentially more efficient but they were not fit for purpose from a contemporary ethical, legal and even practical view. They used to bath "lunatics" in reused water as recently as the early 1970s on Nightingale wards, something like this unfortunately still exists for the elderly, but I am sure we don't want the equivalent for our school children when it is practicable to deliver an alternative.
Under the previous system a great deal of the money which went to the LA was redistributed from the large, full schools (which were cheap to run per child) to the less full schools and the small rural schools (which were much more expensive to run per child - but it made more sense to keep them open than to close them). The large, full schools are, in general, the schools in more affluent areas where kids get better results (because their parents are well educated) so they get good Ofsted grades. They are the ones which chose to become academies to get back their full quota of money per child at the expense of the schools which need the extra funding.
Hence the heads of the schools which have become academies are better able to provide services than those of the schools which have not.
Is that clear now Ben? I know it's complicated so if it's not clear please do ask again.
None of us want a return to the 1950s. Except Michael Gove.
From a the point of view of parents and children when they choose a free school over an existing school, I would guess that they percieve a lower risk in the free school. This also says something about the obviousness of school quality - "Of course they educate their children." Well this is is subjective to every parent and child as well as being objective, if we can agree that certain measures like OFSTED and exams are supposed to be some measure of objectivity however imperfect.
And the risk of failing free schools is at least part of a system of detecting and solving failure through continuous improvement by new or succeeding schools replacing failing ones. I would suggest such improvement is not as dynamic in the concept of enforced local comprehensivisation to the degree of even being static = non existent.
Ben I don't want to get into a long debate on this subject as it should be properly explored elsewhere, but I think you are wrong to draw parallels between changes in education policy and the closure of institutions for disabled people. The closure of such institutions stems from a change of view about how we view and care for people who are vulnerable, and the realisation that the methods employed to keep large groups of people 'safe' were often dehumanising. Having worked in one for 10 years, I very much doubt they were cheap to run, either.
The problem is Emma that I see your description of our closed asylums as descriptions of too many present day schools.
The main opposition is that the very obvious consequences for the other local schools has not been thought through or planned for.
"So we know that there is a problem with the published cost data being deficient but there enough to guess that things should turn out reasonably. "
No there isn't (but do feel free to supply some evidence to support your assertion). All logical analysis suggests this policy will be a complete disaster and will collapse. Doubtless the free schools which exist will be absorbed into whatever dog's breakfast of policy happens next.
After that I just can't follow what you're saying at all Ben.
That's not his fault, Rebecca.
Do feel free to ask politely for a simpler explanation.
Ben and I have been chatting for a long time Ricky so thank you for your concern but please don't worry!
Ben - as an example, the Stour Valley Community School which opened as an 11-16 free school in Clare last September has needed 4.8million for its refurbishment of an existing middle school, to make it fit for purpose as a secondary school. If it had not been refurbished as a middle school, the expectation was that the site would be sold and the resulting capital used to help fund developments required in all our local schools to accommodate the change in Suffolk from 3-tier to 2-tier schooling. Stour Valley has around 180 pupils across three year groups. It is in an area where there is already a surplus of secondary school places, as has already been highlighted on this site. And the secondary school to which many of its pupils would otherwise have gone - Sudbury Upper School - has 25 pupils in its new year 7 and 8 combined. SUS may not be a popular school at the moment, but this kind of action increases the risk of it staying that way. Please show me how this is either cost-effective or low-risk?
Indeed there is a surplus number of secondary places in the county. And Suffolk parents nearly always get their first choice school. So, the fact that free schools appear to command such an usual level of support should ring alarm bells. But instead of insisting that parents send their children to schools that they dislike or distrust, why not pay heed to what the parents are saying?
Perhaps the existing schools are too big? Maybe the curriculum on offer is poorly planned? Is the standard of teaching high enough? Are the schools performing well or badly?
Some of the arguments against the free schools have not been entirely honest. For instance, despite the surplus places, the council is itself planning to open at least one new school itself. This would be only a few miles away from two of the proposed free school sites. If the free schools go ahead and thrive, the council can sell the land it has acquired and save the building costs. The financial position nets out in the longer run.
How? How is building two schools cheaper than building one?
"But instead of insisting that parents send their children to schools that they dislike or distrust, why not pay heed to what the parents are saying?"
Here we get to the heart of the reality that the free schools policy was always about fulfilling the desires of parents who want to run schools. That's why it caught everyone out. Until now policy had always tried to to put children at the heart of policy rather than parents. Suffolk has more free school applications because it has more of the types of people who would by tempted to set up schools than other places.
I suppose someone somewhere was taken in by the ludicrously simply idea that if you put parents first you will end up with the best solution for children and just didn't actually stop to check that assumption.
Because the capital costs for a new secondary typically run at close to £25m a pop, whereas the capital costs of turning middle schools into secondaries are - if Stour Valley is anything to go by - as little as £4.6m (though that seems too little to me).
Suffolk has more free school applications because it has more of the types of people who would by tempted to set up schools than other places.
Actually three (or is it now 4?) of the Suffolk free school proposals are backed by the same trust. Besides, it is not the number of parents who want to take part in the process of establishing a free school that matters, it's the number wanting to send their kids to them. Toby Young started with a dozen on his team (and not all of them parents) but has >1200 applicants for September 2012.
"£4.6m (though that seems too little to me)" Well spotted. Could you link to a case where a middle school has been converted into a secondary?
Suffolk is closing its middle schools. The sites are where people live. Those that do not want to have their kids bussed to towns miles away welcome the conversion of the middle schools into secondary free schools.
Could you link to a case where a middle school has been converted into a secondary?
http://www.stourvalleyeducation.org/#
How will it work?
It would be good to know whether the middle school conversation to secondary to which you refer is based on retaining its current footprint and therefore cohort size or whether it will open as new academy/free school with funding for both refurbishment and an extension to cater for increased capacity.
In terms of economy of scale smaller secondary schools are not the most economic but that is a pure £ and p determinant whereas, and from a personal perspective, the smaller size has great potential to enhance the quality of teacher/pupil relationships and also lead to postive impact on the quality of the learning outcomes.
http://www.education.gov.uk/establishments/urn/136757/stour-valley-commu...
I agree with you about the improved quality of relationships and personal care for students small secondaries but am all too aware of the challenges associated with teaching in them. For a start you can't afford enough teachers in a subject to have fully streamed maths so if you do manage to have four sets you have to have them in two halves so for example in maths you have end up with a maximum of two ability sets. That's seriously hard to teach.
I will await Ricky's response as to whether he has a specific middle school conversion project in mind and whether this is a straight switch of education phase or a refurb + extension/addition to existing building footprint.
Now why can't we compare this to schooling? We can see that there are differences but we can see many similarities. For example there is a statutory system of regulation that sets certain constraints in law for acceptable behaviour. Why is it such a leap to run a comparable system in schooling?
Councillors are also trying to encourage day centre staff to join with these organisations if they want to keep facilities open. Mr Boles [MP} added: “The council is very, very keen for people working in the day centres and for other charities and community groups in the area to come forward with proposals to take these day centres forward and to set them up independently so that the centres remain open. They would then have to win the support of their client base."'
So, the Council wants to hive off its responsibility. The local MP wants "private providers", among others, to fill the gap. I can't see any of these rushing forward to run something as unprofitable as day-care provision for people suffering for dementia or who have learning difficulties (described by the MP as the "client base").
This kind of unprofitable, but necessary, provision is what people pay taxes for.
http://www.stamfordmercury.co.uk/news/health/health-news/reassurance_fro...
The money will still be potentially available for day centres but they will only get it if people decide to go there. Many learning disabled people don't like to use day centres they can be rather impersonal despite the best efforts of their organisations. It is up to the service users and that can include legal and practical support to manage budgets with assistance even when mental capacity is a problem. The council remains liable to fund and obtain services for assessed need.
If you want to discuss profit then consider that there are many providers run on a not for profit basis.
Finally contrast this with the edcuation system and we can see that there is a precedent for successful state funding of a choice of services. We are paying for education. Whether or not we pay for dogma is a question that we can devolve to parents and children.
Regarding market forces and education, there was a long report published in 2010 which looked at much of the research into this. It is called "MARKETS IN EDUCATION: AN ANALYTICAL REVIEW OF EMPIRICAL RESEARCH ON MARKET MECHANISMS IN EDUCATION". It's available from the link below or you could read the summary in FAQs above. Look for "Do market forces in education increase achievement and efficiency?". The researchers found, that the evidence that market forces improve education was “fragmented and inconclusive”.
Evidence, Ben, is the weapon with which to fight "dogma".
http://www.oecd.org/officialdocuments/publicdisplaydocumentpdf/?cote=EDU...
I think it's also helpful to remind people of the pinnacle of 20th Century TV.
http://www.youtube.com/watch?v=0jl2w3xYFHQ
"Latest conspiracy theory (I won't say where it appears because I think the person responsible is unwell) is that I'm http://www.cps.org.uk/experts/tom-burkard/"
That phrase "she is unwell" was written so many times by a core of posters on the TES forum - mixed up with the posts about me being a failed teacher who had never stuck the same job for more than 3 months and so on. Who are these anonymous people who write this awful stuff? Why do they write to organisations to systematically discredit me with lies?
Why do TES delete what they write and then punish the people they write these horrible lies about rather than them? Why would they never investigate what was going on?
Strange old world. If anyone else has got time to compare Burhkard's evidence (and his posts on other forums) with Andrew Old's blog I'd be really interested to hear what they think.
Meanwhile - I'm fine thanks for your kind enquiry Andrew. I hope you're well too.
Rebecca: I am saddened to read that you appear to be attacked on TES Forums but I must add that I fail to see the connection between your latest comment thread and the issue under discussion.
Thanks for pointing out this conversation about evidence has become split over two threads Andy. It started on this thread: http://www.localschoolsnetwork.org.uk/2012/04/are-6-8-million-british-adults-illiterate-are-schools-to-blame/ where Ricky Tarr was using Old Andrew's blog as his evidence to justify his opinion.
It might also be worth noting that she has been a union activist and at the 2010 General Election was the Labour candidate for South Suffolk, where she attracted less than 15% of the popular vote, coming third.
Just sayin'........that's all.
PLAY THE BALL NOT THE MAN
Trying to dismiss the point by attacking the person just makes you look ignorant.
On another thread you asked:
Is OldAndrew a real person? I don’t mean is he actually called Andrew Old or is he a human being I mean does the way he posts have a wider agenda he doesn’t reveal?
So far as I can see, he is just a teacher telling it as he sees it, and has no other agenda.
Emma Bishton, by contrast, definitely does have a political agenda.
You should check what you have said about Michael Gove and Toby Young before you presume to lecture others about playing the ball and netiquette.
Practice what you preach ...
I've messaged Tom in a discussion we're having over in the Free Schools group on linkedin to ask him who Old Andrew is. If it's not him then he's going to know if he's quoted him and also judging by the fact that Old Andrew spotted his reference which took some finding. I've been messaging some of the people who chat to Old Andrew through multiple media to see if they know who he is and it seems they don't.
Ricky I think you have no idea quite how horrific it is to suddenly have a 'crown prince' in charge of education who doesn't even seem to have an MBA level qualification in management. Most of his mistakes are so pigging obvious to so many people in society who are educated and experienced to that kind of level and beyond as many of us are and it's just so blooming unnecessary. I don't think you have any idea quite how many people's lives are being made absolute hell by this indulged pet of Cameron.
As for Young - I've usually been very tolerant of him. I was critical of him in a short interchange starting on the 23rd of February at 10:52pm here. http://www.localschoolsnetwork.org.uk/2012/02/west-london-free-school-se... Which part of it do you think is unjustified?
If there is any other comment about Young or Gove which you feel is unjustified please do provide the link and the reference. If I have spoken out of turn as I sometimes do because I am so upset I will apologise.
In healthcare commissioning on the basis of need is an established principle (albeit one which is tested often). My concern here is that establishing education provision on the basis of demand rather than commissioning in accordance with need leads to less effective use of public resources, and increases the risk to individuals that services will not meet their needs.
Could we please have some analysis of the risk and value for money of letting schools continue which don't meet demand/need?
As far I can see this thread is based on a misconception about Free Schools in that the money being made available is not being taken from existing schools and their rationale cannot be compared with what is happening in the NHS. While I understand the angst and confusion of some commentators there are others on here who know darned well that the comparison doesn't hold water, yet they stoke the fires for either purely political reasons and or personal dislike of Mr Gove and a desire to undermine Free Schools (and thereby launch attacks on Mr Gove).
At least Emma has the character to admit her political agenda when challenged but others just duck and dive to avoid the truth of what they peddle.
The opening line should read, "Rebecca you openly rebuke Ricky, alleging that he took the man out (Emma) and not the ball, and then launch a tirade of pure vitriol at Mr Gove. A case of the pot calling the kettle black, I think!"
http://www.localschoolsnetwork.org.uk/2011/11/free-school-causes-problem...
Why should we be so keen to protect existing schools if parents don't like them?
To take an anaology in medical care one definition of pain is that it is whatever the patient says it is. This is not the only definition of pain, the point is that the patient is the only one with the subjective experience despite whatever other means of knowing we have available. So when you say "need" is to be assessed we have to realise that it is not just professionally assessed by those with statue powers and so forth, it is also assessed with equal validity by anyone else in a democracy. The decisions of non professionals may look unwise but that is sometimes just how it is.
There is a new Islamic boys' school due to open in Blackburn soon - bear in mind the existing girls' school is the only OFSTED outstanding school in Blackburn. As far as many local Muslims are concerned there is a demand and a need. Their ability to have demands and needs met is lawful in England and the EU. Perhaps if other local schools had responded better to the needs of Muslim boys in Blackburn there would not be demand for a new school. It is important to realise that there is strong demand for academic achievement and character in this locality as well as particular Islamic culture.
There is certainly a need to balance demands and needs with available resources. When existing facilities lose resources that could be said be harm, but you also harm people when you make them use services they don't want. It's our democratic process that means these things are debated and decided, the unions should have no power and authority to be arbitary assessors. They or their members don't have to like it but they do have to adapt to it just like other professionals do. Yes I am ranking the need for continuous employment of teachers as secondary to the needs of parents and children. That is because the parents and children act as employers to teachers through taxation.
I am sure that you are not really saying that if you required legal advice you would consider the views of a non-professional to be equal to those of a properly-trained lawyer, or if you were seriously ill you would take equal notice of a neighbour who swears by crystal healing rather than a doctor.
To carry your argument further: what would be your view of the "demand" of parents to have a school which would provide girls with only the education needed to make them compliant wives and mothers? Or the "demand" of parents who wish their children to be educated only with those of similar race or colour? At what point do parental "demands" need to be countered with the "needs" of their children and those of other people?
You will need to take into account the fact that only the Secretary of State can close academies and free schools. Local Authorities, who have a legal duty to ensure sufficient school places, can only close schools which they maintain which could lead to a situation where an LA with falling school numbers would have to close a popular LA school because it was the only school it had the legal right to close.
The opposite is also true, LAs cannot open new schools - they have to be academies or free schools. No-one has yet explained how LAs in challenging areas can meet the "need" for more places if academy chains or free schools find these areas are uncongenial.
Here's a reference so Ricky can understand it's not just him I say it to:
http://cyberrhetoricbyrebeccahanson.blogspot.co.uk/2011/11/mozilla-festi...
Sorry - I'm just annoyed because I've told him before and he really lets himself down by continuing to do it.
It might also be worth noting that she has been a union activist and at the 2010 General Election was the Labour candidate for South Suffolk, where she attracted less than 15% of the popular vote, coming third.'
This is only an attack on Emma Bishton if you hold a low opinion of music therapists or union activists.
The background information does, however, provide useful context for the reader in considering her thought provoking piece.
Ricky I think you have no idea quite how horrific it is to suddenly have a ‘crown prince’ in charge of education who doesn’t even seem to have an MBA level qualification in management. Most of his mistakes are so pigging obvious to so many people in society who are educated and experienced to that kind of level and beyond as many of us are and it’s just so blooming unnecessary. I don’t think you have any idea quite how many people’s lives are being made absolute hell by this indulged pet of Cameron.
As for Young – I’ve usually been very tolerant of him. I was critical of him in a short interchange starting on the 23rd of February at 10:52pm here. http://www.localschoolsnetwork.org.uk/2012/02/west-london-free-school-se... Which part of it do you think is unjustified?
If there is any other comment about Young or Gove which you feel is unjustified please do provide the link and the reference. If I have spoken out of turn as I sometimes do because I am so upset I will apologise.
You go further in your 07.08 comment by setting yourself up as being perfection personified and wholly patronising "I'm just so annoyed because I've told him before and he really lets himself down by continuing to do it."
Look in the mirror Rebecca and take stock. It would also be good if you stopped hectoring people while ignoring their valid points of view.
Pages
Add new comment