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.