Most people have some grasp of how education works. Ask the woman on the 73 bus about a geography teacher, a local education authority or a primary school. She knows what they do and - depending on the age of her kids - may be an expert. Ask her about a diagnostic radiographer, a strategic health authority or a primary care trust and it’ll be a different story. People she knows are at least as likely to use the health as the education services - so why the difference?

Health’s Agenda for Change goes alongside an overhaul of the structures that plan, deliver and manage the service. The Learning and Skills Council has now announced an Agenda for Change for FE. Do we expect to meet the challenges of the 21st century while retaining the institutions of the 19th? If health can’t, how can we? Reform means rethinking institutions, not just increasing initiatives.

Change elsewhere is unfettered by empty sentiment or tradition. Our woman on the number 73 no longer sits upstairs but round the bend. Whatever we think of bendy buses, there is no lobby for the return of the external stairway. Why is educational change so stuck in structures from the past?

Are we hampered by institutional conservatism? Let’s take the example of workforce planning. The NHS - the largest global employer after the Red Army and the Indian train service - is re-organising its workforce into just eight pay bands. Meanwhile, we have completely different pay bands for teachers in sixth forms and FE - even though they prepare the same young people in the same subjects for the same exams.

But the NHS Agenda for Change is not mainly about pay - it’s about patients. A new framework will match staff to the needs of the service. New roles can be built around service needs and individuals can progress easily to meet these. Meanwhile, rigid educational roles lock teachers into schools, colleges or universities - despite our need to increase coherence and ease transition for learners.

The structures underpinning the service are holding us back. How can 14-19 reform really take off unless we have a clear strategy about the workforce that will provide the new learning? How can we have a clear strategy when we have so many different employers of 14-19 teachers? How can the employing institutions work coherently when they operate under different planning, funding and evaluation regimes?

But instead of making radical moves forward, political thinking seems shackled by those in charge of reform. Charles Clarke was one of a series of secretaries of state whose innovations echo their own long-past experience. Where do the ideas about house systems, uniform and competitive sports come from if not his days at Highgate School? Is this the best we can do in the third millennium?

We need to learn from the past - usually about what not to do. We certainly don’t need to lift models wholesale, although we may need to lift the rose-tinted glasses with which we tend to look back.

So, what kind of radical new structures might support modernisation? Let’s just take post-14 education. A single post-14 institution could operate like a primary care trust in the same area with clear strategic leadership informed by key partnerships across a locality. It would control competition between providers and clarify links with other services. One purse would support one delivery plan. One employer would manage and develop one workforce.

Like a PCT, shared services would resource specialist delivery. We worry about a glut of educational change - but we don’t worry enough about the tools to make the change. Initiatives are heaped on our heads but the bodies mainly stay the same. It’s time to see how other services are shaping up to the future. We know what we want from post-14 learning and Tomlinson offers a framework to achieve it. Let’s build the structures that can get it done.

Ruth Silver is principal of Lewisham college