Wednesday 28 March 2018

Government intransigence over immigration rules causing problems for CAHMS services.

Figures produced by the NHS and highlighted by the Royal College of Psychiatrists (RCP) show that in some parts of the country there are just 4 consultant psychiatrists for every 100,000 children.

This despite government promises to recruit an extra 100 psychiatrists specialising in child and adolescent mental health (CAMHS) by 2021 as part of its mental health workforce plan.

Sussex, Surrey and Kent are the worst served areas with 4 consultant psychiatrists for every 100,000 children, North Central and East London fare best with 17 psychiatrists for the same number of young people.

This shortfall comes at a time when, according to the Children’s Society 10% of children between the ages of 5-16 have clinically diagnosed mental health conditions, yet 70% have not received an appropriate intervention.

Figures produced by the Mental Health Foundation show that 20% of adolescents have a mental health condition, early intervention is vital as 50% of enduring mental health problems are established by the age of 14.

Under the mental health workforce plan unveiled last year the government plans to increase the number of people working in the sector, plans to do so have been criticised as ‘naive’ by Labour MP Luciana Berger.

Writing in Progress in August of last year she said ‘long hours and low morale’ were driving staff leaving the mental health sector, adding that ‘a dangerously underfunded and overstretched environment’ is hardly likely to attract new recruits.

She also called for the budget for mental health services to be protected saying that despite government promises it had not been ‘ring fenced’ and had been ‘siphoned off to prop up other areas of the NHS’.

Responding to the shortage of psychiatrists trained to work with young people Dr Bernadka Dubika, Chair of the Child and Adolescent faculty at the Royal College of Psychiatrists told Mental Health Today ‘short-staffing in CAMHS is no secret, we are already struggling, and the government’s own green paper impact assessment predicts a rise in referrals’.

Among the solutions proposed by the RCP is recruitment of more mental health professionals from overseas to plug the gap in the short term.

There are though significant problems in attaining clearance for such professionals to work in the UK, speaking to Mental Health Today Dr Dubika cited the case of an Indian psychiatrist who had his application turned down because the quota for tier two visas had been reached, psychiatrists are not included on the Home Office ‘shortage speciality list’.

Dr Dubika called for the Home Office to reconsider the occupations included on the list, saying ‘recruiting from overseas is key to quickly employing doctors specialising in children’s mental health and will ensure the profession is seen as a priority by the Home Office’.




Monday 26 March 2018

The House of Public Schoolboys needs to address its problem with bullying along with so much else.

The caricature is that the House of Commons is the last bastion of old style boorish, class obsessed masculinity. All rough jokes, pink gin and institutionalised insensitivity.


Like every cliché it contains an uncomfortably large grain of truth, as the bullying of parliamentary staff by MPs demonstrates. The public -school mentality is alive and well, staff are the 'fags' and elected members the prefects with a divine right to bully them.


The wind of modernity might be about to blow through the dusty halls of privilege as the House of Commons Commission gave its support to an inquiry into bullying last week.


David Natzer, clerk to the House of Commons told the BBC he had 'no doubt' there are 'unresolved issues over bullying and harassment '


And how; issues that go all the way up to the foot of the Speaker's Chair. Current incumbent John Bercow was named in a BBC report as having, allegedly, belittled a female aide, he has strongly denies having done so.


As a result, he will not be involved with the inquiry, a significant loss because for all his love of the limelight Mr Bercow has been a consistent proponent of modernisation.


The inquiry has been welcomed by Leader of the Commons Andrea Leadsome and the cross -party membership of the House of Commons Commission. In a statement reported by the BBC they said it had been 'agreed the inquiry should be initiated immediately.


It will be carried out by non-executive lay members with an 'expert' lead and will be fully independent. There have been calls for it to deal with 'historic' allegations of bullying, however no decision has been taken on this point yet.


One such case might be that of then Liberal Democrat MP Julian Huppert, in 2013 the BBC reported that he had complained about the 'absolutely hideous' treatment he had received at the hands of fellow MPs. He accused them of behaviour that was 'sexist' and 'deeply rude'.


At the time two opposing views were expressed to the BBC, Labour's Lisa Nandy said such behaviour showed 'the worst of politics'; Tory James Wharton said, 'the theatre of politics is not a bad thing'.


The 'theatre ' in question being things like the weekly playground spat that is PMQs, where the leaders of the two main parties trade scripted insults before an audience of baying back benchers is held up as evidence of our healthy democracy. If you follow such thinking to its illogical conclusion there should be a daily game of British Bulldog organised in the division lobby.


It is democracy as imagined by an old school games master, the weaker boys just need to toughen up and play the game. A viewpoint that is as outdated as it is witless, in any other workplace it would have been pensioned off a generation or more ago.


Just how damaging bullying in the workplace can be was proved in 2015 by a TUC survey that found a third of the people researchers spoke to said they had been bullied at work, often by someone in a senior position.


General Secretary Frances O'Grady said 'bullying causes stress and anxiety and can have a devastating long -term effect on victim’s health, no one should have to leave their job due to being bullied'


What has, allegedly, been happening to parliamentary staff needs to be investigated and those responsible, regardless of position or prestige, named and sanctioned. That though can only be the start, there needs to be a thorough examination of how parliament works.


Behaviour is often the product of the environment in which it occurs, the House of Commons with its arcane rituals and public -school ethos is a toxic place to work. It encourages the worst excesses of the white, upper class and emotionally constipated types who make up most of its membership.


Anyone who doesn't fit their limited template of how an MP should look and behave is a threat to be neutralised with ridicule, as for the staff; they're there to fetch and carry for their betters and not to have the temerity to complain about how they're treated.


That is no way to run a parliament that is truly representative of the people its members represent. It must look and sound like modern Britain, less gin- soaked braying in the chamber and a lot more talk about what it’s like to live in our troubled country in the voices of women, minorities and the working classes.


I am not so naive as to think that a more diverse parliament would be a utopia, put any group of people together and there will be friction; some people will always pick on others as a way of hiding their own weaknesses. Proximity can though can breed tolerance and mature compromises, both of which are all too often absent in politics.


At the very least it would make for an environment in which staff were valued and MPs could get on with the important job of representing their constituents instead of having to navigate around the sort of behaviour that belongs in the playground.

Tuesday 20 March 2018

Living Wage is key to tackling inequality says Equality Trust manifesto.

Campaign group the Equality Trust has launched three manifestos aimed at empowering supporters to fight inequality on a national, local and individual level.

Among the measures called for is action to tackle the 'astronomical' levels of pay inequality in the UK, currently the pay of bosses in both the private and public sector massively outstrips that of workers.

This has created a situation where the richest one thousand people in the UK, the Equality Trust claim, own more wealth than the poorest 40% of the population put together.

The manifesto also calls for action on a national level to tackle the housing crisis through building more social housing, stronger protection for worker’s rights and an end to child poverty.

Key to this is the adoption of a Living Wage, something the Equality Trust have been actively campaigning for local councils to adopt. They renew this call in the manifesto, as well as asking supporters to only trade with businesses that pay the Living Wage.

Figures produced by the DWP for the House of Commons Library give the number of people living on low incomes in 2015/16 as 10.4million, 2.3million of whom are children. In the same report the Institute for Fiscal Studies is quoted as suggesting the number of people living in poverty will rise by 2% by 2022, with child poverty rates going up by 4% over the same period.

The launch of the Equality Trust manifestos comes a week after a Spring budget statement in which Chancellor Philip Hammond claimed to be feeling 'Tiggerish' about the country's economic fortunes.
Responding to the statement Dr Wanda Wyporska of the Equality Trust said, 'we have too many people who are struggling to survive in this country', citing 'rising homelessness, rising food bank use and threadbare public services' as symptoms of rising inequality.

She added that in a country where the wealthiest thousand people hold more wealth than the poorest 40% 'the vast gap between the rich and the poor is damaging our social fabric'.

The National Minimum Wage, based on recommendations made by businesses and trades unions and calculated on a percentage of minimum earnings, is £7.05 an hour and is paid to workers over twenty- five. A Living Wage would be paid at £8.75 an hour, rising to £10.20 where London weighting applies.

A poll of 1016 parents conducted for the Living Wage Foundation by Survation earlier this year showed the stresses living on low pay can cause. Out of the parents who took part 23.9% said it had damaged their relationship with their children, 32% said it was a cause of stress between themselves and their partner.

Research conducted by KPMG found that 84% of the people polled said being paid a Living Wage would make them happier, 78% said it would improve their mental health; 71% said it would improve their physical health.

Speaking about the Survation poll results Katherine Chapman, of the Living Wage Foundation said it was ‘shocking’ to see the ‘corrosive effect low pay has on family life’ adding that without an adequate living wage in place families will ‘continue to struggle to make ends meet, while their family lives and health suffer’.

She ended her comments on a hopeful note saying that ‘thankfully there are now nearly four thousand Living Wage employers who are doing the right thing and paying a fair day’s wage for a fair day’s work’.

Such optimism is welcome, however at a time when austerity is still biting deep into council budgets and employers are seeking to maximise profits in a rapidly changing economy the race to the bottom is very much under way.

In such an environment how many employers will follow Katherine Chapman’s call to ‘step up, do the right thing, and pay their workers a decent wage’ is debatable. Good intentions can all too easily be drowned out by the squeals of shareholders fearful for their dividends.


Monday 19 March 2018

Smoking and its consequences have a higher impact on deprived areas says ONS

That being poor is bad for your health has become almost a truism, this week the Office for National Statistics reminded us there is an uncomfortable reality behind the cliché.

Figures released by the ONS to coincide with National No Smoking Day (14th March) show that people in deprived areas are more likely to smoke than in more affluent areas of England.

In fact, the more deprived the area, the more likely people living there are to smoke. Out of England's 6.3million smokers one in six live in deprived areas, for example in Hastings 25.7% of people are smokers, the national average for England is 15.5%%. Other deprived areas including Blackpool Bradford and Manchester also have high rates of smoking.

At the opposite end of the spectrum just 4.9% of people living in Epsom and Ewell are smokers, Wokingham in Berkshire and Chiltern in Buckinghamshire also have low levels of smoking; all of which are leafy, affluent areas.

Smoking is a major contributing factor in 85% of cases of lung cancer and chronic obstructive pulmonary disease treated by the NHS, conditions that people living in deprived areas are twice as likely to suffer from.

This can be linked to factors including living in insecure or temporary housing, having few formal qualifications and being in a low skilled occupational group. All of which can make individuals three times more likely to be smokers than people in skilled or managerial roles.

High levels of smoking, along with other risky behaviours, can be seen as contributing to the disparity in life expectancy between affluent and deprived areas, with gender further skewing the figures.
A boy born in Kensington and Chelsea can expect to live for 83.3 years, girl for 86.7 years; in Blackpool and Middlesbrough life expectancy falls to 74.4 years for boys and 79.8 years for girls.

The inequality in life expectancy between affluent and deprived areas has widened over the past two decades.

Overall the trend for the number of people in deprived regions of England who smoke is falling, dropping from 32.7% in 2012 to 27.2% in 2016. In more affluent areas it has fallen over the same period from 10.0% to 7.9%.

The figures cited in this article were produced by the ONS using data from the Annual Population Survey and apply to England only, the other UK nations conduct their own health surveys and publish separate data on inequality.

The government and the NHS aim to reduce the number of adults in England who smoke from 15.5% to 12.0% by 2022.

Statistics say only so much about why levels of smoking are so persistently high in deprived areas. To get close to the truth you must look past the quantitative analysis to the qualitative story behind.

In the 1930's George Orwell wrote about working class people numbing themselves against the hardships of their lives with cheap pleasures, picture shows, football, beer and cigarettes mostly being their poisons of choice. Pleasures the comfortable but concerned upper middle classes neither understood nor approved of.

The world has moved on, but if you are poor much has stayed the same, work is still dull drudgery, expectations and horizons are limited; sometimes a cigarette or a bag of chips is the closest thing to comfort you are going to get. A salad and a brisk walk will, for sure be better for you in the long run, but forward planning is often another luxury out of reach of the poor.

If the government want the poor to smoke less, then they need to help people in areas that have been left behind for decades feel the future is something worth living to see.



Friday 16 March 2018

Is the council gambling with the city's future by putting more cash into the Smithfield hotel project?

Is Smithfield the unluckiest spot in the whole city? You could be forgiven for thinking so since it seems to attract more problems than is reasonable.

The new civic offices built there with huge controversy were beset with delays and problems with already costly building work having to be gone over more than once. Maybe the former owners of Hancock's pet shop or the Quartermasters Stores put a curse on the ground before they moved out.

If so it has struck again, the council have been obliged to top up their funding for the planned Hilton Garden Inn for the site by £2.3million before a brick has been laid. This comes on top of an initial investment of £4.55 million, taking their total stake to £6.8million.

There is also £9.8 million of private finance invested in the project, in 2016 the estimated total cost was £17.31million, this has now risen to £19.65million with the council having to pick up the shortfall or the cement mixers won't start to turn.

Additional costs have been imposed by extra work being needed to prepare the site, price increases by sub-contractors and 'inflationary pressures'.

The extra money will be taken from funds previously allocated to the council's housing company Fortitor Homes. A council spokesperson told the Sentinel this would not affect Fortitor's 'immediate investment plans and commitments', maybe so, but the thing about extra costs is that there is often no end to them once a project starts to slip off the rails.

Just how serious the consequences of this project going belly up could be are highlighted by the findings of a report published last week by the National Audit Office. They show that local authorities are struggling in the face of what Lord Porter, chair of the Local Government Association described as 'years of unprecedented funding reductions'.

The report, Financial Stability of Local Authorities 2018, not the snappiest of titles but the content is pretty spine chilling, sets out in deadpan official prose that challenges facing councils in the age of endless austerity.

Since 2010 government funding for local authorities has fallen by 49%, at the same time the demand for services like adult social care has grown. Councils have protected those services they have a statutory duty to provide, meaning others like housing and roads have been cut.

The government has announced multiple piecemeal initiatives aimed at helping councils fund services, most have been short term fixes with nothing like a long -term plan emerging. Now as budgets continue to tighten even statutory services are at risk of being cut.

Faced with the choice between a rock and a hard place councils are increasingly looking for other sources of income. For Stoke-on-Trent City Council that has meant trying to be nominated as the UK City of Culture for 2021, wooing Channel Four as they seek a base outside the capital and putting down a hefty chunk of cash on building a luxury hotel on the Smithfield site.

Some of these initiatives have their merits, the bid to be UK City of Culture although unsuccessful did bring an often-ignored city some much needed positive media coverage. There is an outside possibility that Channel Four could be persuaded to relocate to a city with a long tradition of creativity, although again it may be a case of promoting the good image of Stoke on the back of a near miss than winning the prize itself.

What worries me and anyone who has seen the slow unfolding of the mess that is Smithfield are the risks inherent in the Hilton Garden Inn project. The costs are already climbing and soon may outweigh the benefits brought by the fifty jobs it will create.

Five years ago, I joined hundreds of other local people as they marched in protest over building of the new Civic Centre, at the time this was a howl of outrage against a complacent Labour council who were out of touch with public opinion and, it seemed, reality. Their replacement by an Independent/Tory coalition was supposed to herald a new era of more responsive governance; there is little sign of that in this decision.

Local taxpayers have good reason to be sceptical about large capital projects, one of the two buildings on the Smithfield empty for a long period and the former bus station just up the road is still a crumbling ruin waiting to be turned into a shopping centre as a succession of developers turn up, promise to sort out the mess only to slip away in the night.

Speaking to the Sentinel last week a council spokesperson said, 'there is a clear need for a four- star hotel in the town centre to meet demand and allow us to compete on a national scale'. Whether that is really the case when the city has so many other needs is debatable, but it's clear that even if that is true if costs continue to rise the game may soon not be worth the candle.

Friday 9 March 2018

New group aims to make the voices of people living with mental health issues heard.



In December, North Staffs Voice for Mental Health (NSVMH) closed after losing its funding, now some of the charity’s former trustees are looking to launch a new group.

Hear Our Voices will be a campaign group speaking up for people who use mental health services in the Stoke-on-Trent area. They will also tackle the stigma surrounding mental illness by promoting positive images of people living well in recovery.

Former NSVMH Chair Adam Colclough had been working to help set up the new group, he said: ‘when North Staffs Voice closed down many people were worried that there would be nobody to speak up for them, I and several other trustees decided that we needed to do something’.

He added: ‘Over the past couple of months we have been speaking to local mental health charities and there are a number of opportunities for us to get involved and make a difference’.

Jane Clewes, a former trustee of NSVMH who has been helping to set up the new group said: ‘People with mental health problems can be reticent to speak out as individuals about the services they are receiving, but as a group their views can be represented and shared more easily.’

Speaking about the role the group hopes to play in monitoring services and identifying areas of improvement she said: ‘In this age of target-driven health services, reminders from a user group about what is important to the patient can be helpful.’

Hear Our Voices will be holding an inaugural meeting at The American on Waterloo Road in Cobridge on Wednesday 14th March, access is by the front door of the building only,

At the meeting members will discuss the aims of the group and elect a steering group to lead the project

Anyone who uses local mental health services, carers, or who wants to support a positive image of people living with mental health conditions is welcome to come along. The meeting will take place between 6pm and 8pm.

Thursday 1 March 2018

Lack of affordable houses to rent is making a whole generation put their lives on hold.

Owning a home of your own is the nearest British equivalent to the American dream, an investment of hope in a better future. Over the past couple of decades, it has become an ever more unrealistic aspiration for more and more people; now renting a decent home at a reasonable rent is slipping out of reach too.

Every year there are 30,000 fewer affordable homes for rent built in England alone than are needed to meet demand, if this trend continues, and change looks unlikely, then there will be a shortfall of 335,000 homes by the end of this parliament.

The government made much of investing £2 billion in building social housing in 2017. Sounds impressive? This will deliver 5000 extra homes, a sixth of the number needed.
(Source: Joseph Rowntree Foundation)

A shortage of affordable housing to buy or rent has a serious and lasting impact. On their website homelessness charity Shelter say there are 1.8 million families are on the waiting list for affordable homes, many of whom live in private rented accommodation on short term contracts.

This drives existing problems related to poverty, including poor school attainment and physical and mental illness caused by anxiety. It has also created a shadow market of unscrupulous landlords cramming families into unsuitable housing with all the associated fire and safety risks.

There is a cruel irony in a society that worries endlessly about health and safety allowing such a situation to exist under its collective nose.

The shortage of affordable housing also has more insidious effects. A 2016 YouGov poll for Shelter showed that 59% of the under 45’s contacted had delayed a major life event like getting married or having children because of not having a secure place to live.

Speaking to the Independent about the findings Shelter chief executive Campbell Robb said, ‘our ever -growing housing crisis means millions of young people are bring left behind, unable to reach many of the crucial life milestones that were taken for granted by the generations who came before them'.

If a sizeable number of young people are being forced to delay major life events because they can’t afford a place to live this can only have a damaging impact on our society and economy.

If the problem is well known, and it is, the housing shortage has been creeping up on us for decades; then so are the suggested solutions.

Trades union UNISON has called for 250,000 new home to be built, 80,000 these would be for social rent, they also call for local authorities to start building council houses again. This last solution was echoed in a 2013 report written for Shelter, which calls for it to be made easier for councils to borrow the money to do so.

In response to the recent government Green Paper on social housing the Joseph. Rowntree Foundation have called on the government to reverse the ‘reforms’ to housing benefit so that low cost rents can be used to counteract wages not keeping pace with housing costs.

The government led Theresa May had pledged on numerous occasions to ‘build a Britain that works for everyone’. A shortage of affordable housing that it may not have created, but has done little to address, exposes the emptiness of this slogan.

Sugared words and noble aspirations alone can never solve the housing problem. Yet sooner rather than later it will have to be addressed. As Campbell Robb said to the Independent in 2016 ‘we cannot take this crisis a someone else’s problem, it’s the responsibility of all of us to help fix it'.