Sunday, 2 October 2016

You can't mothball lives along with hospital beds.

This week NHS commissioners announced plans to make further cuts to hospital services across the city.

Stoke-on-Trent and North Staffordshire clinical commissioning groups (CCG) said that Bradwell Hospital would lose 64 beds. The hospital cares for frail and elderly people, many of whom may now have to go into private care homes instead.

The announcement comes hard on the heels of a decision to 'mothball' all 48 beds at Cheadle Hospital and one ward at Burslem's Heywood Hospital, the future of in-patient beds at Leek Moorlands Hospital is also uncertain.

The decision to close beds at Bradwell has been criticised by local MPs, trades unions representing hospital staff and local health campaign groups.

In a joint statement reported by the Sentinel a spokesperson for the two CCGs said that NHS England would be reviewing its plans for the beds under threat over the next few weeks and that any final decision would be 'subject to formal consultation.'

'Mothballed', 'decommissioned' (another bureaucratic favourite) carefully masks the fact that behind a decision made by a committee lie innumerable real lives. In this instance the lives of highly vulnerable people and those of their carers.

The fear expressed by health campaigners that further bed closures will lead inevitably to higher use of A&E services, piling yet more pressure onto a system that is already struggling to cope is entirely credible. What haunts me though is another, equally frightening possibility.

There is a very real risk that with services at Bradwell Hospital downgraded and, in a worst case scenario, closed at some future date vulnerable people and their carers could simply fall off the radar. Trapping them in a nightmare struggle against odds that can't be beaten without adequate support and with a very real risk of a tragic outcome.

The end result will certainly be people accessing services later when their problems are far more complex and the support they need more costly, cancelling out any earlier savings at a stroke.

The CCGs talk a good game about caring for people at home rather than in hospital for as long as possible. This is a noble aspiration and helps people to retain their independence for far longer, at least it does if home care is properly resourced; but at present it isn't.

What frail elderly people and their carers get is an all too familiar fudge, promises of jam tomorrow and a diet of bread and water today. They and their carers are forced into a miserable obstacle race after support that is never enough to make a difference even though it costs them their savings and maybe their home.

The NHS is a truly great British achievement, even more so when you consider that it was founded at a time when the country was near to bankrupt. Sadly the visionaries of 1948 have long since been replaced by political pygmies who don't understand the value of having a free at the point of use health service.

As a result we are witnessing its slow dismantling through a mixture of endless tiny cuts and managerial meddling from central government. It is telling that Jeremy Hunt prefers picking fights with the junior doctors to sorting out the shambles that passes for elderly care, if he thinks about it at all he probably dismisses the whole thing as a problem to be solved by 'market forces' or some such meaningless twaddle.

There is a very real risk that we could slip backwards to the not so good old days when good health and a long life was a luxury denied to the vast majority. A bleak future that wilfully wastes potential and puts prosperity and social stability at risk.

This is something we should fight against by opposing every bed closure, every attack on the working conditions of hospital staff and every attempt to sneak privatisation in by the back door. The NHS belongs to the people and we should do all we can to defend it.

Tuesday, 20 September 2016

Watson: stop 'supporters' voting in future leadership elections.

Labour deputy leader Tom Watson has called for party rules to be changed to exclude registered supporters from taking part in electing the party leader.

He told a meeting of the party's National Executive Committee (NEC), the BBC reported today, that their participation had been 'unpopular' and called for the reinstatement of the previous franchise based on members, trades unionists and MPs electing the leader.

Last year 105,598 people paid £3 to sign up as supporters, 84% of whom voted for Jeremy Corbyn in the leadership election. Ahead of this years race the fee was raised to £25 and it is believed that 129,000 people signed up; there are no prizes for guessing who most of them are going to vote for.

Supporters were given a say in choosing the party leader by Ed Milliband in 2013, although they have been around since the days of New Labour.

Watson, the BBC reports, told the NEC that the change to rules had been 'rushed' and had proved 'unpopular', principally with MPs who felt it had allowed the far left to infiltrate the party.

He said the proposed change to the rules was not intended as a threat to Jeremy Corbyn; allies of the soon, probably, to be reconfirmed leader see them as an attempt to prevent the circumstances that brought him into office ever occurring again.

The deputy leader also wants to see members of the shadow cabinet elected by MPs for the first time since 2011, ending the practice of the front bench team being picked by the leader. This, he said, would help Labour to 'put the band back together' ahead of a possible early election.

Although it is not believed the intend putting forward an alternative proposal supporters of Mr Corbyn want members and party activists to also have a role in electing the shadow cabinet.

On one level almost everything the Labour Party does at the moment seems like rearranging the deck-chairs on a sinking ship. This latest displacement activity though does at least offer the opportunity to watch the Blairites being hoist on a petard of their own making.

Back in the day signing up supporters was the clever wheeze of the moment, they were seen as being more pliable than pesky old fashioned members with their antiquated ideas about having a say in party policy.

The flaw in the cunning plan was that because it was as easy to do as ordering a pizza almost anyone could do it. The left saw an opportunity in this, grabbed it with both hands and inadvertently changed the Labour Party forever.

Tom Watson is a man with sensible instincts and he is right that Labour needs to change its system for electing the party leader, the year long soap opera that will end with Jeremy Corbyn being reconfirmed as leader has been a costly and divisive distraction.

The trouble is he is stuck in the old ways of thinking, he either can't see or won't accept that like it or not, and most MPs very much do not, the election of Jeremy Corbyn as party leader changed Labour forever. However tight they close their eyes and wish the Blairites can never will back into being the old dispensation where party members were seen but not heard.

Although there was a patronising popularism about it Watson was on the right track when he said Labour have to 'put the band back together'; meaning they have to stop being a mob of competing egos and start playing like a team.

That means the keepers of the New Labour flame holding their noses and accepting the brave new world they now inhabit and the Corbynistas growing up enough to realise that idealistic passion doesn't excuse prejudice and always needs to be tempered by common sense.

The alternative is more division, more bitterness and even less influence for a party that is still, even if it hasn't always behaved like it, the official opposition.

Sunday, 31 July 2016

Is a lottery really the answer to funding local good causes?

How does a council go about finding money for good causes when budgets are tight and, thanks to Brexit, could get tighter still?

A three pipe problem and no mistake, or maybe in this non-smoking age a three vape one, either way its enough to give Sherlock a bit of a headache.

Thanks to the Gambling Act (2005) one solution could be the setting up of local lotteries to create a pot from which local charities and community groups could bid for funds. Stoke-on-Trent City Council is set to join Portsmouth City Council and Melton Borough Council in taking advantage of this opportunity.

This could be to the benefit of community groups that have been starved of funding since austerity began to bite and, to their credit, the council do not intend using this as a stealthy way of topping up their coffers.

Punters will pay their £1 for a ticket and have the chance to win the jackpot of £25,000, a car or a range of smaller prizes. Aside from running costs any money raised will go either into the prize pot or to local charities.

The Potto Lotto, an awful name, offers a better return to players with, if it follows the model used by Aylesbury District Council, 60% of the money raised going to good causes as opposed to just 28% of that raised by the national lottery reaching the same destination. There is also no chance of it foisting upon us Mystic Meg or those awful adverts featuring Billy Connolly.

Speaking to the Sentinel council leader Dave Follows said people would be 'more likely to pay a pound for a ticket if they can see where it is going to be spent'

Danny Flynn, chief executive of the YMCA and one of the sharper minds in the local charity sector expressed qualified enthusiasm for the scheme, telling the Sentinel his organisation would 'welcome any attempt to create more resources for local good causes', adding though that the thought 'it would only be part of the solution.'

I hate to be a killjoy but this scheme has all the signs of being something made up to look good from a distance that is rather less attractive when examined at close quarters.

For a start giving punters a list of seventy local charities to which they can donate part of their stake sounds like a good idea, until you think about how people go about making such choices. It is based on the premise that we always make rational decisions; and we just so don't.

When they are picking a charity most people, myself included, are more likely to be motivated by sentiment that common sense. Those good causes that feature kids or cute animals will do well, so will anything that being seen to support confers perceived virtue on the person signing the cheque.

Those charities that support difficult people or unfashionable causes, the homeless or people with mental illness for example will struggle, even though the level of need is equal if not sometimes greater.

In short punters will be offered an invidious choice that invites good people to be unintentionally cruel when they are trying to be kind.

My biggest issue though is that however carefully it is dressed up as a harmless flutter a lottery is still gambling and as such has the potential to cause serious problems. Something that was brought into focus this week by a rise in the number of people reporting an addiction to bingo.

I could at this point make a lot of lame jokes about grannies blowing their pensions down at the local Gala, but I won't, because addiction is no laughing matter. It is usually the outward symptom of a trauma the person experiencing it can't articulate or, maybe, even bring themselves to acknowledge.

Stoke is an impoverished city, there are a lot of people here who are just about keeping their head above water, to them winning £25,000 could look like a lifeline, even if trying to do so proves to be a brass ring they grab for endlessly, but never manage to reach.

I don't of course advocate banning gambling, everyone who buys a lottery ticket doesn't end up stood outside the bookies with three cigarettes on the go and all they own on some nag in the 3:30 at Kempton just as having a drink doesn't automatically lead to chronic alcoholism; but the council shouldn't add to the risk by endorsing it.

They should though be given credit for thinking out of the box when it comes to finding a solution to a problem that is going to get worse before it gets better, even if this time they're on the wrong track.

Thursday, 7 July 2016

Closing ward four would be a false economy with devastating consequences.

Earlier this week North Staffs Combined Healthcare Trust announced plans to close its dementia care unit at Harplands hospital after the area's two clinical commissioning groups cuts its funding.

The staff on ward four have been praised by the national care regulator for their work in helping frail elderly people retain their independence for as long as possible.

Speaking to the Sentinel Combined chief executive Caroline Donovan said the ward's 'outstanding and committed staff' had provided care that has helped patients return home sooner, adding that despite the financial challenges faced by the NHS 'the ward's approach is one I believe should be supported.'

North Staffs Green Party fully supports keeping ward four open and will be actively campaigning to secure its future.

Campaign Coordinator Adam Colclough said : 'I have visited the ward on a number of occasions as a volunteer for a local mental health charity and seen at first hand the good work done there.'

He added that: 'the staff are a credit to the core values of the NHS, cutting the service they provide would be a false economy with devastating consequences for patients and carers.'

The party have written to minster of state for community and social care Alistair Burt asking him to intervene.

The Green Party fought the 2015 general election on a manifesto pledge to provide free social care for older people funded by taxation and to protecting the NHS as a comprehensive free at the point of use health service.

They are also committed to increasing spending on mental health services in line with their pledge to increase health spending overall, and to fighting the stigma and discrimination experienced by people living with mental illness.

Mr Colclough said: 'we have asked the minister to ensure that no decision about the future of ward four is taken until the people who use the service, their carers, staff and local mental health charities have been fully consulted.'

Wednesday, 6 July 2016

Having a conversation about the NHS we'd like to have and the one we can actually afford.

Just before I set off to attend what had been billed as a 'community conversation' about local health services I received and email asking me to send a tweet celebrating the sixty eighth birthday of the NHS.

Happy to oblige, like most Britons I have a deep emotional attachment to the NHS, it helped to bring me in to the world and will probably see me out of it too. Though what sort of state it might be in by then is open to question.

When I arrived at the King's Hall a reasonably large crowd had assembled, milling about between the stalls set up by various charities. Most of the people present seemed to be associated with either the health service itself or one of the charities represented, suggesting that much of the afternoon would be an exercise in preaching to the converted.

To its credit the NHS has, in recent years anyway, made a concerted effort to open up itself up more to public involvement and scrutiny. For their part the public have mostly found something, anything else to do.

For all our protestations of love for the NHS we tend to treat it like a sort of parental figure, expected to be there when we need it; but to be ignored the rest of the time.

This isn't an attitude for which Margy Woodhead, Chair of the local Patients Congress and one of the four speakers has much time. In her view the 'voice of the public' has to be at the centre of how the health service makes decisions about how its large, but still far from adequate, budget is spent.

The public also, she said, have a vital role to play in identifying those areas where the NHS isn't delivering. What is needed is the widest possible range of voices, particularly from hard to reach, or easy to ignore, sections of the community; the people who would miss a free at the point of use health service most were it to wither away from neglect and inertia.

The need for a 'conversation' with the public was echoed by Sally Parkin, clinical director for partnerships and engagement with the Stoke-on-Trent clinical commissioning group. One where the main topic was 'prioritization',meaning how local health services manage to do more with less given the huge challenges they face.

The scale of these was outlined in a 'quiz' involving some slightly awkward audience participation. Locally the NHS spends almost half its budget on acute care, a hospital outpatient appointment costs £119, a trip to A&E costs £1,569.50 and an operation with a couple of nights on a ward to recover doesn't leave much change out of £3000.

These costs can quickly stack up when you consider the health inequalities people in the Stoke area face, as outlined in his presentation by Dr Andrew Bartlam, accountable officer for Stoke-on-Trent CCG.

For a start if you were born in Knutton you're likely to die fifteen years sooner than it you were born in the Westlands, along the way you're also more likely to suffer from a preventable illness. Childhood obesity levels remain high as does the suicide rate, with the latter 30% higher than the national average.

Add to that problems recruiting GPs and nurses to work in the area and continued pressure from central government to do more with less and the position looks grim indeed.

There is though, Dr Bartlam said, some hope of improvement offers by new models of care that take services out of expensive hospitals and move them closer to patients, more joined up working between CCG's and doing more to address well-being to keep people healthier for longer.

Even so the NHS faces internal and external challenges greater than any it has faced before, a service founded almost seventy years ago cannot continue to operate as if it were still 1948. It has to be more efficient, more focussed on squeezing the most benefit out of every pound it spends; all this whilst staying true to the principles upon which it was founded.

The way we, the public, treat the NHS has to change too, we cannot afford to take it for granted, that plays into the hands of those in government who would sell it off one little bit at a time until there was nothing left.

We need to take more responsibility for our own well-being to ease the strain on services and for being more involved in deciding how the they are funded. The NHS was created by ordinary people who believed, rightly, that health is a public good to be shared equally, it will be defended by people who feel the same way.

Sunday, 3 July 2016

Has the political class learnt nothing from the upheavals of the referendum?

Will it be Michael or Theresa, Liam or Steven; maybe even Andrea? To be the next leader of the Conservative Party and by default the next prime minister.

One thing is for certain it won't be Boris Johnson, a dagger placed neatly between his shoulder blades by old 'friend' Michael Gove caused him to pull out of the race before it had even started. In typical Bojo style though he managed to get more attention for not putting his name on that ballot than any of the people who did.

Anyone who thinks this is the last we're going to see of the dishevelled one had better think again, he has, I'm sure a few more capers to cut on the political stage before his revels are ended.

The gun has at least been fired and Tory leadership races have the benefit of being short, if seldom sweet, theirs is a party that holds its grudges far tighter than a limpet holds onto its rock.

Meanwhile over at the Labour ranch it has been a non-stop round of resignations and recriminations. After a most of his shadow cabinet too their collective ball home and several of their replacements decided they didn't feel much like playing either Jeremy Corbyn has more knives in his back than the lead in a bad amateur production of Julius Caesar.

The parliamentary Labour Party are about as united as they ever can be behind the opinion that he has to go, the one thing they're short of is a candidate to challenge him. Angela Eagle was going to , then she wasn't; now she still might, just not yet. Confused? I'm pretty much baffled.

Showing a surprising amount of determination for someone who wears so much corduroy Jeremy Corbyn refuses, so far, to take the hint and go. If the parliamentary party want to re-enact western classic High Noon, then he's only too happy to take the Gary Cooper role.

Any resemblance between the past week in Westminster and a bad soap opera seems to be entirely intentional. The life of an MP can be dull what with all those committee meetings and the endless case work, so you can, perhaps, forgive them for going a little 'demob happy' when they find themselves playing pat-a-cake with the hand of history.

There is no doubt that since the Brexit vote we have been living through historic times, its disappointing in the extreme that most of the political class just aren't up to the challenges we're about to face.

The public have spoken and just over half of them said they wanted to leave the EU, what everyone who cast a vote a week last Thursday said, maybe not always consciously, was that they want a very different settlement to the one we have now.

Sadly what they've been given over the past week is more of the same. Meaning the political class carrying on as usual engaging in its private squabbles and treating the most important people in the political equation, the voters, as having a walk on part at best in the ensuing melodrama.

The British don't really do revolution, but there is something close to it in the air, this it certainly a time when radical ideas might get a fair hearing in a country that usually prides itself on its conventionality.

We need to look again at the voting system, not with a view to the sort of timid fiddling represented by the now mostly forgotten referendum on the alternative vote. Only a radical change to proportional representation will address the concerns of the disenfranchised young and encourage a more collaborative style of politics.

That will take time, one change could be effected almost overnight and all it requires is for the Labour Party to stop fighting like cats in a bag and grow up. Over the next few years decisions will be taken that will shape our country for a generation or more, they need to be scrutinised by a strong opposition. Under PR that job would be shared by a number of smaller parties all of whom could work together to hold the government to account, until utopia arrives though the job falls to Labour; it's time they started doing it.

More than anything else we need the political class as a whole to wake up and smell not so much the coffee as the whole damn house burning down. Most of the accusations that have been levelled at the EU, about being remote, overly bureaucratic and unwilling to listen to ordinary people's concerns can, and will, be levelled at Westminster.

The public are angry and in no mood to put up with everything staying the same. If their decision to vote for Brexit, not my personal choice but a democratically expressed one I respect, scared them back into their comfort zone, then the result of the next election could have them running for the bunkers.

Sunday, 19 June 2016

Its taken a tragedy to remind us that politicians are people too.

Last week on the streets of Birstall, a market town in West Yorkshire Jo Cox the Labour MP for Batley and Spen was murdered by a 52 year old 'loner' named Thomas Maier.

Mrs Cox entered parliament in 2015 and in a little over a year had managed to make a lasting impression on her colleagues and constituents. In other circumstances were the Labour Party to some day emerge from its endless internal squabbles she could have been one of the people it turned to in search of a new, more positive direction.

The tributes to her were as prompt as they were heartfelt. A day after her death Prime Minister David Cameron and Labour leader Jeremy Corbyn travelled to Birstall to lay a wreath in her memory.

Speaking to the BBC Mr Cameron called the murder of Jo Cox an 'attack on democracy', it has been suggested that Maier held far right views and was angered by her support of the 'Remain' campaign. He added that if people wanted to 'honour' Jo Cox's memory they should recognise the values of 'service, community and tolerance' she had lived and worked by.

Mr Corbyn said Cox was 'an exceptional, wonderful, very talented woman, taken from us in her early forties when she had so much to give and so much of her life ahead of her.'

Tributes were also paid by Liberal Democrat leader Tim Farron who called her an 'outstanding representative who stood up for her community diligently', Commons Speaker John Bercow said Cox was an 'outstanding' MP and that fellow parliamentarians had come to admire her talent and passion.

Words like tragic and heroic have been overused to the point where they have lost much of their impact, yet there was true tragedy in the way Jo Cox met her death; more importantly there was something decidedly heroic about the way she lived her life.

She was, by all accounts, a woman who lived for others without being either a pedant or a scold, that she did so for its last year in a profession often seen as an exemplar of cynicism and self interest makes her even more remarkable.

The death of Jo Cox has reminded us of something we've always known, but have chosen to forget in recent years. Although they might not all have her qualities most MPs are a long way from being the cheating caricatures the media makes them out to be.

Most work hard, try their best and receive little in the way of thanks for their efforts, if this shocking crime has forced we the public to examine some of our lazier assumptions some good may have come from a bad thing.

What it shouldn't do, and the temptation very much there, is allow us to turn an understandable sense of outrage in to a moral panic accompanied by a knee jerk reaction. There will be an entirely appropriate re-examination of the level of security surrounding MPs as they go about their constituency work.

To this must be applied a sense of proportion, something the British sometimes struggle with applying in stressful circumstances.

The last thing we need is for Britain to become the sort of country where politicians shuttle from one secure location to another surrounded by an entourage of hired muscle in mirror sunglasses, where the only voices they hear are those of sycophants.

To represent their community in anything like a meaningful way politicians have to be part of that community. If they are going to speak for the people they must first have listened to what they have to say, even when it isn't necessarily what they want to hear.

The idea that politicians, or members of any other profession, merit deference should be packed away in the attic along with Grannies wedding dress, but if they make themselves accessible to the public then the public should treat them with respect.

There should always be a robust debate, but it only works if all concerned get a fair hearing and holding an opposing opinion isn't a risk to life and limb.

Few members of parliament are as talented or inspiring as Jo Cox, but like her they are all human beings, imperfect but for the most part trying to do the right thing. Remembering that might be the most lasting memorial to the life she lived so well and lost too soon.