Embedding sustainable development across Government, after the Secretary of State's announcement on the future of the Sustainable Development Commission - Environmental Audit Committee Contents

Examination of Witnesses (Question Number 25-51)


20 OCTOBER 2010

Q25   Chair: I thank both of you for coming along. Our session is very curtailed this morning, so I hope you will bear with us. We are hoping to have a full half hour. That gives you some indication of where we are. I think we wanted to invite you along because the Department of Health seems to have been cited as a good practitioner in terms of sustainable development. To start off with, what we would like you to do is perhaps just introduce yourselves and then my first question will be: from your perspective, has the Sustainable Development Commission been good value for money and what arises out of that?

Flora Goldhill: Thank you very much, and thank you for inviting us today. I'm Flora Goldhill. I am acting Director General and Chief Operating Officer at the Department of Health. My colleague, Richard Mundon, is Director of Operations at the Department of Health and he leads for us on sustainable development.

  Our view of the Sustainable Development Commission is that they have been very good partners. They've really helped us understand the agenda. I think I would say by way of introduction, though, that health and well-being is at the heart of what we in the DH, the NHS and public health do and believe in. I think we have been very open to what they could offer us. I think they particularly helped us interpret what we do in the language of sustainability. As the SDC have just said, you often don't realise that you are talking about sustainability when you're talking about particular things, but we have found them an extremely valuable partner and we've learned a huge amount from them. We believe we are on the way to embedding what we've learned. We've particularly valued the fact that they've embedded in the department one of their team, who has really worked with departmental colleagues, to help them understand the sustainability agenda and present it in a way that's helpful to broader understanding.

Q26   Chair: That all sounds very well and good, but, if I was going to convey to one of my constituents about how that's made a difference in the Department of Health, I'm not sure that they'd know where the detail of the policy is. Can you give us an example of something that's real—something that's actually delivered results—and how you've changed your policy, how you've done things in a different way and how that's led to money savings and environmental well-being?

Flora Goldhill: Richard will have many examples, but if I could just start with one example that the SDC helped us with, they helped us develop a sustainable development tool that supports the NHS in understanding sustainability. Some 80% of organisations in the NHS use that tool to help them make decisions about sustainability, which deliver better quality and value for money.

Q27   Chair: Can I just ask you there whether you are talking about the NHS estate or whether you are talking about hospitals and those, if you like, who are technically outside the NHS estate?

Richard Mundon: The tool that Flora is referring to is a good corporate citizen model, which looks at buildings as part of its remit, but also looks at many other aspects of sustainability. One of the things that Andrew was talking about a little earlier is that Government departments are very often focused on operational estate. The Department of Health has a very small operational estate and most of our opportunities for delivering sustainability are around how we influence people and how we deliver policy, so we were very keen to develop a tool that was broader than just operational estate and looked at other aspects as well.

Q28   Chair: Can I just press you on this a little bit? I think you were here for the earlier evidence session. It talked about, I think it was, designing obesity out of the equation. So how is it possible for a new hospital to be designed within the NHS which didn't have a kitchen at the heart of it, where local food could be produced in terms of promoting high, good nutritional standards for people in that hospital? How do you make sure that all the different tickboxes are ticked when it comes to sustainable development? How has working with the Sustainable Development Commission assisted with that agenda, or not got to where it should be on that agenda?

Flora Goldhill: The role of the department, obviously, can't be to get into all local decisions. Local decisions are for local people. What we do is create an environment, create a framework, create the strategy and policy and the levers by which we encourage sustainability, but we can't do it for individual providers on the ground. That is something where they have to be accountable for themselves. But we do want them to take those things into account. For example, the way that contracts are constructed requires providers to produce a Sustainable Development Action Plan themselves so that in the NHS those who commission services can understand how sustainability is going to be delivered through provision; but how individual providers do that is something they have to be held accountable for.

Q29   Zac Goldsmith: Can I ask you, just on that point, am I right in thinking that the department's latest Sustainable Development Action Plan doesn't make any reference at all to sustainable food procurement? That is my understanding of it, in which case I think that would provide something of an answer to your question, but that also to me seems quite shocking given that it is a Sustainable Development Action Plan. Is that correct?

Richard Mundon: It mentions sustainable procurement—

Zac Goldsmith: Food procurement.

Richard Mundon: —and the NHS supply chain that is responsible for most of the procurement in the NHS has a specific role around food, so through their actions between 64% and 65% of food in the NHS is locally reared or sourced, so there is a specific output as a result of that. The Sustainable Development Action Plan is not specifically about food but it does refer to procurement.

Q30   Caroline Lucas: I want to explore a little bit more about what the loss of the SDC will mean to you in more concrete terms. For example, in some of the reporting that's been shown, although you have been doing very well on sustainability, just recently on some indicators your performance has gone down—for example, on water use. In your note you say that the department hopes to work with the SDC to address performance slippages. In the absence of the SDC, where will you go to get that kind of advice?

Flora Goldhill: Just to go back to one of the points that the SDC made about leadership, we are already engaged with our Ministers, and our Ministers are engaged with DEFRA Ministers and have clearly demonstrated commitment to this agenda, so we have got that leadership right at the top. We have a new Permanent Secretary who takes up post in November, and I am absolutely confident she will be committed to this agenda. We have a very good network of champions—I think that's in the papers we submitted to you—and there is a lot of enthusiasm in the Department of Health for this agenda because they believe in it. It is part of the core of what they do.

  What we will be doing is really exploring all opportunities to learn good practice. That's the way we want to do this. We are confident that we've learnt the benefits of working with the SDC and we want to go on working with the best people who can advise us on this. That will be our way forward in this, so we'll be making as many connections as we can in the hope that we don't miss anything in the way of good practice.

Q31   Caroline Lucas: Apologies, but that does sound a little bit vague. It is one thing to have leadership in champions—that is absolutely essential—but it is also essential to have expertise and the best quality advice. In the absence of the SDC, are you confident that you will easily be able to access the quality of expertise and advice that you have traditionally been able to access via SDC?

Flora Goldhill: There are a number of routes into this, and I will ask Richard to pick up in a moment, but we have a very big research and development budget in the Department of Health. We can use it in many ways. We will be looking at sustainable development as part of the way that we think about our research programme. That will clearly be built in. We will be looking for expertise wherever it exists. I am sorry I sound vague, and am not able to say exactly what exists where.—Richard can help us with that.

Richard Mundon: The real benefit that the SDC has brought to the department around things like water, which was one thing you mentioned, is transparency. It's given us a great deal of transparency, and transparency brings a need to act. By bringing these things to our attention in a much more transparent way, we've acted on them in a way that perhaps we wouldn't otherwise have done. They have offered some expertise around those areas where there are particular issues, but they aren't at the moment the only source of expertise on that.

There are lots of different places. We would look at other organisations. We've got the NHS, for a start, who have many properties, who have developed a degree of expertise in how we might improve sustainability in their organisations. We go to the centre of excellence on sustainable procurement in the Cabinet Office, who also have expertise. And we have colleagues in other Government departments who are both wrestling with the same issues and have developed some expertise around this—for instance, in DEFRA and in DECC. So there are sources of expertise around this that we already use or will use more as the SDC isn't on the scene.

Q32   Caroline Lucas: I have just a quick follow-up on that. In your experience, how useful have you found the Sustainable Operations on Government Estates—the SOGE targets? How useful have they been in terms of incentivising sustainability?

Richard Mundon: Very useful. It is transparent. It shows you absolutely where you are in terms of comparators with other Government departments. That acts as an incentive to try to improve performance. We in the Department of Health have generally been very good on those indicators. You mentioned the occasional blip, which everyone has. The SDC have brought that to our attention and helped us where there are issues. They haven't, frankly, spent an awful lot of time with us because we haven't had massive issues around that. Things like carbon from transport has been one of the things that's been a perennial issue with the Department of Health, and we have worked with the SDC on that. But we've reached a stage now where we've learnt a lot from that relationship and started to act and put plans in place which address those concerns. So they have been helpful, but we still feel confident that we can build on that and move on.

Q33   Dr Whitehead: What about the arm's length bodies? How do you manage the sort of processes you've described in terms of arm's length bodies within the Department of Health, and what sort of targets and arrangements exist for employees in those bodies—assuming they're still there?

Richard Mundon: Some of them will be, yes. The existing Sustainable Operations on the Government Estate targets don't extend to arm's length bodies, so we have a relationship with each of them based upon a planning framework. That planning framework requires them to take account of sustainability in the same way that the core department does. They are an extension of our family, really. We expect the same levels of performance from them as we would from our own estate. Generally speaking, they are very good at that. Some of them are exceptionally good. Organisations like the Health Protection Agency and NHS Business Services Authority are very good and have sustainable plans of their own that would stand up to close scrutiny. We have regular meetings with the arm's length bodies to ensure that their plans are on track and that they are performing in the way that we would expect them to.

Q34   Dr Whitehead: So are those linked by means of key performance indicators that are in the contracts with the arm's length bodies, or are they just a matter of custom and guidance as far as their relationship with you is concerned?

Richard Mundon: There aren't contracts as such with arm's length bodies. There are agreements around their performance and performance indicators. Some of those take the form of KPIs; some of them are not quite so precise. It varies from organisation to organisation, depending on how big it is. Some arm's length bodies have much less capacity to be dealing with sustainable development issues than others, and therefore you need a tailored approach to how we deal with them. There is a variety of different indicators and measures that we use.

Q35   Dr Whitehead: If you decided within the department that this was all a waste of time for the future—different circumstances, problems in the health service— what sanction would there be on you if you decided to do that?

Flora Goldhill: I can't envisage that we would decide to do that. Going back to what I said at the beginning, health and well-being is absolutely core to what we do. Public health colleagues have argued sustainable development for as long as I can remember. If the decision were taken that this were not a priority, I can't see it not being part of how we do business in health and social care.

Q36   Dr Whitehead: I think the thrust of the question, among other things, is to whom might you be accountable for what you do in this area? If it were, for example, a Cabinet Committee, how might that impact on what you do, or do you see for the future this being very much something that, as you have suggested, is internally generated by your own wishes as a department to run yourself in the best possible way according to what you consider your mission is?

Flora Goldhill: I think in the department we welcome scrutiny of what we do. We have absolutely no difficulty about scrutiny. I think audit is helpful. Audit, and sustainable development could be open to audit. I think the critical thing for us in scrutinising what we do is that the measures are clear and that we can do them readily; that we can collect data readily; that we don't create burdens on those that are providing services; that we can compare data easily. These are the kind of things that we would ask for. We would be very happy to be accountable to a Cabinet Committee. There would absolutely be no difficulty in having scrutiny. In fact, I think scrutiny always does raise your game.

Q37   Chair: I just have a few very quick, short questions, just to get some idea of how things are moving. Looking toward the Liberating the NHS White Paper, I am just interested in how you feel sustainable development will be embedded into the new architecture that will come out from that?

Flora Goldhill: I think the critical piece of architecture is the NHS Commissioning Board, which will be responsible for health outcomes. It says in the White Paper that it will be responsible for designing the model contracts, and the contracts that the NHS use at the moment for commissioning, as I said earlier, require providers to produce a Sustainable Development Action Plan. We envisage that that would continue in the way that the NHS Commissioning Board design contracts.

Q38   Chair: But the specific question is, should it have sustainable development in the health care system, actually as part of its remit, because if it doesn't have it, how can that direct the general direction of policy making on sustainable development lines?

Flora Goldhill: The functions that are envisaged in the new health care system are set out in the White Paper and will be in the Health Bill, which is about to go into Parliament. I think the opportunity will be available to people to argue whether sustainable development should be a core function of any of the bodies that are being created.

Q39   Chair: But as it is set out at the moment, do you believe that sustainable development will be at the core and at the heart of that?

Flora Goldhill: At the moment I don't see it as stated in that way.

Q40   Chair: So it's not there?

Flora Goldhill: I think I go back to my earlier point—that in order to deliver good health outcomes you need to take account of sustainable development, and therefore it's integral to that whole principle of delivering better outcomes for people.

Q41   Chair: But my point is that our line of inquiry with our previous witnesses and with yourselves is, when we're looking at new legislation which is coming in, who is responsible for ensuring that that function of sustainable development is one of the key policy drivers? It would be helpful if you could say whether or not you think that it is there. But if it is not there, presumably some further work would need to be done to make sure that it is stated?

Flora Goldhill: I think I would go back to the proposals made by the Sustainable Development Commission that Dr Whitehead was referring to, which is a Cabinet Committee of some kind looking at the work that we, as a department, do. I think in terms of the NHS, as a core function I think it has to be integrated, it has to be mainstreamed, into what we do.

Q42   Chair: Right, but is it there now? Sorry, is it in what you envisage as coming forward in the new legislation, or does further work need to be done on that to ensure that it is?

Flora Goldhill: I am sorry, perhaps I don't understand the question clearly. If your question is, "Will there be a function to deliver, for example, sustainable development?", at the moment that's not envisaged.

Q43   Chair: It's not?

Flora Goldhill: It's not envisaged in that way.

Q44   Chair: It's not envisaged? That was my question, thank you, that's helpful.

Does the Care Quality Commission have the remit for sustainable development as well, as currently envisaged?

Flora Goldhill: It doesn't have that in its remit at the moment, and there are no plans to change it so that it specifically states that it should have that as a function.

Q45   Chair: If there were plans to change it, where would those plans come from? Would they come from the Cabinet Office or from yourselves? How do you see the whole issue of sustainable development being championed?

Flora Goldhill: Clearly a cross-Government approach is very powerful, and that gives us an impetus to doing things. I think the Cabinet Office is a good place to co-ordinate that. All departments pay good attention to what Cabinet Office requirements are, and we do everything we can to meet those requirements.

Q46   Zac Goldsmith: Can I just add to that? In the absence of the SDC, assuming it ceases to exist as from today, and in the absence of anything being put in its place, where would a reluctant department feel the pressure to pursue the sustainability agenda? Assuming you were a reluctant department, where would you feel that pressure, effectively?

Flora Goldhill: We would feel it here, obviously.

Q47   Zac Goldsmith: Where is "here"?

Flora Goldhill: Here, in front of your Committee, the Environmental Audit Committee. We would feel it here, certainly. We would feel it through any audits that were put in the public domain. If there were targets we would obviously want to do our best to meet them. So anything that was in the public domain where we were being measured and scrutinised would incentivise us to want to perform well.

Q48   Zac Goldsmith: But if we are honest about it—and this is not a reflection on your commitment—if the department is reluctant to take this issue, this agenda, seriously, the answer you've given suggests that there isn't really any pressure at all. If you look at the Department for Education, it will be judged on whether or not it delivers enough school places and whether or not they are good quality. If there isn't someone there with an absolute commitment also to ensuring that the wider agenda is taken into account, it seems to me that without the SDC there isn't that pressure. Is that unfair?

Flora Goldhill: I think the question you are exploring, as I understand it, is what could you put in its place?

Q49   Zac Goldsmith: Yes.

Flora Goldhill: It could be something done through financial penalties imposed by the Treasury. It could be clearly something from Cabinet Office on the cross-cutting agenda and targets that they set. We certainly paid close attention to the Prime Minister's requirement for a 10% reduction in carbon consumption. So all of these things do make us act, but where we would be held to account if we were reluctant—it would be somewhere like this, I think.

Zac Goldsmith: Thank you.

Q50   Chair: We are coming to the end of our session now, I say to colleagues.

On that last question, just a different way of asking it: would it make any difference if delivering on sustainable development were a part of the specification for whoever the chief officer were in the departments—either in your department or in any other department—if that was a requirement of the job description that that chief officer had to deliver on? Is that one way of doing it?

Flora Goldhill: It is a way of doing it. I think the question would be how powerful that would be, because I think if you hold people to account for their objectives it would have to come from the top. It would have to be something that Government expected its civil servants to do. I think it was said before that there have been targets and some departments have not done anything about it and there has been no sanction, even with the SDC. I think the question is, if the SDC were not to exist, what would actually change in terms of sanctions? I'm not clear that anything would change. It is about what's put in the public domain and what is scrutinised. I think that is the critical part.

Q51   Chair: Okay. I have one absolutely final question. With regard to the new Director of Public Health role and the new arrangements that there are to link up the Department of Health with local authorities—do you see that new role as being a trigger for bringing in sustainable development policies and principles into local policies and services from local authorities?

Flora Goldhill: Most certainly it will be an important trigger, and the Directors of Public Health, I think, will have this as a very key component of their job roles. They will want to work with all partners at local level, so I think they are very key to delivering sustainable development on the ground.

Chair: Right, I think that brings us to the end. We do have the comprehensive spending review and Members are very anxious to get down to that. Thank you for your time. Thank you very much for coming along.

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