Sunday, 31 August 2014

Cognitive dissonance from NHS bosses planning changes to cancer care.

Under plans put forward by the government NHS Cancer and End of Life services in Staffordshire are being opened up to tenders from private companies, a contract worth £1.2 billion.

There is, say campaign group Cancer-Not for Profit, no business case for privatising the service citing figures from the Office of National Statistics showing that 90% of patients in Staffordshire are satisfied with the care they receive from the NHS run service. The NHS Support Federation says that 70% of the contracts put out to tender have been won by private companies, a testament, perhaps, to their greater experience of the tendering process.

The Clinical Commissioning Group (CCG) led by Andrew Donald claim the service needs to be ‘joined up’ to prevent patients from falling through the crack, under legal advice they have been instructed to consult with the public before putting their plans into action.

Cancer-Not for Profit have collected 10,000 signatures on a petition opposing the sell off and on Wednesday they held a public meeting at the Civic Centre; it proved to be a stormy evening for Mr Donald.

The meeting took place in the Jubilee Hall, a grand wood panelled space redolent of a civic self -confidence noticeably absent from the cuts haunted landscape of local government today. Down at the front of the room the four speakers milled around, Stoke South MP Rob Flello wearing a distinctive white suit, whilst half a dozen earnest young people fussed around with cameras and light-meters.

There was a fairly large crowd, not surprisingly really since the NHS is one of the few political issues that still has the power to galvanise the public. The age range was well above forty, a danger sign for any politician considering an assault on the NHS because this is the demographic that votes; mostly because they can remember when doing so meant something.

Andrew Donald, the Staffs and Surrounds CCG Chief Officer and Transforming Cancer Care EOL programme sponsor, a title that if he has it painted on his office door must have doubled the NHS signage budget at a stroke, the opposing captain so to speak put Dr Jonathan Shapiro a consultant with experience of a family member using the NHS cancer services in London in to bat.

A smart move in the sense that he had an emotive story to tell about his elderly father’s struggle to cope with a service that seemed to be focussed more on its own systems than the needs of patients, a fair criticism that can be levelled at some aspects of the NHS. He lost the audience though with a patronising analogy that placed the private provider as the ‘conductor’ bringing the disparate elements of the health care orchestra together tunefully that he hammered mercilessly, suggesting a bedside manner that was a little on the grandiose side.

Andrew Donald also ran with the line that although the service delivered was in general good it needed to be redesigned to make it more integrated and focussed on patient needs by getting the various providers to work together. He summed this up as the creation of a service delivering ‘patient seamless care; a piece of bureaucratic double-speak that could mean anything or nothing depending on who he is speaking to.

He was slippery to say the least when questioned from the floor as to why this new service could only be created by bringing in a private company, saying at one point that opponents were ‘assuming’ that one would be brought in, although the ONS figures suggest any other outcome is unlikely. Mr Donald also didn’t take kindly to being questioned about the CCG’s patient consultation, saying huffily that they had put together a team of ‘patient champions’ although he was unable to say what these people actually did apart from being force fed CCG biased information.

Rob Flello MP, taking the crease for the Labour Party gave a rather off the peg speech about an NHS that was ‘cracking at the seams’ due to government underfunding and called the privatisation of cancer care the ‘biggest auction in NHS history. He was more animated in the panel discussion asking several questions that made Mr Donald squirm inside his expensive suit. It was hard not to feel though that his hands were tied by the fact that the plan could be forced through before the election leaving an incoming Labour government unable to reverse it for fear of being sued and that his party though it is often at the anti-cuts dance has been rather timid when it comes to taking to the floor.

Rachel Maskell, head of Health for UNITE savaged the plans as an attempt to ‘drive profit from the sick’ and contrasted the way the NHS owned by the public operates and the secretive practices of many of the private companies set to bid for the contract. Dr John Lister of Coventry University also attacked the lack of democratic accountability in the tendering process and the limitations of the public consultation conducted by the CCG.

The real meat of the meeting came when it was opened up to questions from the floor, poor Andrew Donald must have felt like a batsman who had taken to the crease only to find himself facing a bowler using grenades. Time and again questions about the lack of transparency in the tendering process, the possibility of patients having to ‘top up’ the cost of their care and the existence of a preferred list of bidders bounced over his startled head.

In an exchange that drew a sustained burst of applause near to the end of the meeting Jan Zeblocky of the local Green Party accused him of ‘cognitive dissonance’, receiving the message he wants to hear not the one he’s actually been sent, regarding public support for privatisation. It was an apt metaphor for a CCG acting in the name of a government that seems to have been deafened to public concerns by the din of its own ideology.

Fittingly the last word of the meeting came from a woman with a cut glass accent who called out ‘what right have you to take away the NHS people have paid for,’ what right indeed. It was, if you’ll pardon the cliché, the voice of middle England and the government would do well to listen to it before assaulting the NHS people have paid for.

Sunday, 17 August 2014

How we treat libraries says everything about the sort of society we want to be.

The former Stoke Library, a grade two listed building dating from 1878 and described as ‘iconic’ is to be sold off by the council as part of its plans to raise funds by disposing of unused buildings, the sale is thought likely to make £85,000.

Local residents aren’t pleased, the library itself moved to the town’s former indoor market in 2008, but they are concerned as to what use a new owner might put the building. One, Mick Jones (70), told the Sentinel on Wednesday that ‘once it is sold off the community won’t have any connection with its use’, adding that he thought it shouldn’t be sold to just ‘anyone’ because ‘my father, mother and grandparents all paid taxes towards places like this.’

By chance I’ve been thinking about libraries and what our attitudes towards them say about the sort of society we want ours to be quite a lot recently following a discussion that took place at the last meeting of the North Staffs People’s Assembly.

Staffordshire County Council wants to either close a number of its libraries with the option of some being taken over by community volunteers, Newcastle-under-Lyme council has its sights set on closing libraries too. As the annual budget looms what chance is there of Stoke-on-Trent City Council at least contemplating a similar move? I’m not in the business of making predictions, but I wouldn’t rule it out.

Stoke still has a library and it is liable to survive, for now anyway, because it is attached to the council’s Local Centre in the town. That just leaves the question of what should happen to its former home.

Let’s not be naive here, liked it or not the council has to sell of many of its unused or underused buildings to raise much needed cash. When the buildings in question have particular architectural merit or a strong community attachment though a caveat should be attached regarding their future use, the former Stoke Library fits both criteria.

It shouldn’t just be carved up into yet more office space that nobody wants to rent or turned into swish apartments for the sort of ‘young professionals’ estate agents so love to court, it should be turned into affordable housing. This would help make the struggling town centre into somewhere people want to live and raise families and pay a fitting tribute to the social conscience of the people who set up the library in the first place.

You could, of course, make a case for libraries being hopelessly out-dated institutions long ago superseded by the internet. Actually you could make the same case about cathedrals. St Pauls occupies such a first rate location, we’d keep the façade of course and turn the insides into the most divine apartments; it would be worth an absolute mint!

You’d probably think that counts as sacrilege and even though I’m an agnostic I’d be inclined to agree. Not least because cathedrals and libraries are both buildings that have a meaning which far transcends the use they are put to.

One answers to our desire for something larger and more mystical than our own experience of the world; the other seeks to enrich that experience through learning. Lose either in significant numbers and our culture becomes that little bit poorer.

In a city like Stoke-on-Trent where we need to raise people’s skills levels and transform their attitude towards learning, making it into a lifelong activity rather than something that happens in the few years you’re at school for, libraries should be at the centre of their community. A space where everyone is made equal by curiosity, a place of shared aspirations that challenge the self- interested individualism of the market.

This isn’t just lefty idealism, learning, culture, positive interaction between sometimes divided communities, all things libraries are ideally placed to promote, are demonstrably effective ways of improving the social and economic wellbeing of individuals. There is, of course, a place for volunteers in this, but the real drive has to come from local and national government.

How we treat our libraries expresses what sort of society we have made for ourselves, tabulates what it values that can’t be recorded on a spread-sheet. If we want ours to be a society where we are more than just producers and consumers; then we should be building libraries not looking for ways to close them down.

Sunday, 3 August 2014

For £5.3million the council could pay for Kirsty Alsop to ‘distress’ their old furniture.

Smithfield, the development formerly known as the Central Business District really is the gift that keeps on giving; local tax-payers sleepless nights that is.

It was revealed in the Sentinel yesterday that Stoke-on-Trent City Council is to spend £5.3 million on furniture for its new offices within the CBD, this at a time when budgets are tight and services are being cut.

The money will be used to buy 2116 chairs, 1096 desks and 356 tables for the new offices to be used by the 1700 council staff due to relocate there, part of the money will also be used for furnishings for the town halls in Longton and Tunstall, Stoke Civic Centre and other of its buildings that will remain open after the big move.

Speaking to the Sentinel Alistair Watson, cabinet member for finance said the contract to supply the new furniture would ‘enable the council to take advantage of bulk purchase discounts so we can get the best possible deal.’ Then added with the touch of patronage we’ve come to expect from this council that ‘unfortunately furniture isn’t free.’

Gosh, thanks for reminding me, although I could probably have worked that out for myself. At least I could if I wasn’t so busy wondering why they can’t just use the old furniture in the new offices and thinking that for £5.3 million they could probably pay for Kirsty Alsop to come to Stoke and ‘distress’ the darned stuff with her own fair hands.

Commenting on the contract Dave Conway, leader of the City Independents told the Sentinel ‘this is a huge amount of money, what are they buying; gold plated desks?’

Alan Barret, chair of March on Stoke said, again to the Sentinel, that he realised councils are ‘held to ransom’ when buying furniture, but added that ‘people are already angry at the council spending all this money on the CBD, so they should be showing some common sense and frugality.’

Common sense and frugality, if either were mentioned in the cabinet debates on whether or not to build the CBD in the first place, let alone spending yet more money fitting it out like something off ‘Cribs’ they’d have had to fetch a dictionary to look up what their meaning.

The use of common sense would have entailed a serious discussion as to whether there was any genuine need to build, using borrowed money, a new council HQ at a time when the core services local people depend on are under an existential threat. It would follow logically on that there isn’t and the council’s money should be used to protect vital services, not fund a huge and unnecessary debt. Unfortunately there are precious few photo opportunities in protecting services and so and so the cranes have started swinging and the debts are rising by the day.

As for frugality, that’s something that gets imposed on someone else, whilst the council does its usual Janus faced trick of piously preaching fiscal restraint, claiming that the cuts are nothing to do with them they’re just following orders from the nasty government and then pouring money down the black hole of the leadership’s pet projects like the CBD and the doomed bid to bring HS2 to Stoke.

No wonder Mr Pervez and his cabinet were so keen to force plans for the CBD though the system, had they been exposed to sustained scrutiny they would have dissolved into dust like a mummy left out in the sunlight.

In a city where public faith in the political process is at an all- time low and electoral turnouts are miniscule this is highly dangerous. An electorate that feels its concerns are always going to be ignored by a council dominated by a single party led by people who are out of touch with the public mood will withdraw even further into apathy, perpetuating the cycle of decline that has dragged the city down.

The need grows clearer every day for a greater spread of parties, voices and experiences within the council chamber; a proper opposition that will push the Labour group hard and offer voters a credible alternative to their continued dominance. It may be too late to stop the CBD project, but such an opposition could and should challenge every extra cost imposed in its name.

Whenever I travel into Hanley my eye is caught by the huge cranes swinging girders about as the Smithfield project rises around them. It is a reminder that these controversial buildings are going to be part of the city’s skyline for decades to come; the debt and political damage they have caused may be around for just as long.