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.

Wednesday, 8 June 2016

Swiss vote shows the way on a basic income

It might have been defeated by a comfortable margin of 77% to 23% but the [proposal put to a referendum in Switzerland to pay every citizen a basic income points towards a new approach to tackling inequality.

The proposal would have seen every adult citizen paid £1755 per month with a smaller payment given to children.

This, supporters claimed would recognise the huge amount of unpaid work done by carers, Che Wagner of campaign group Basic Income Switzerland told the BBC "In Switzerland over 50% of total work that is done is unpaid. It's care work, it's at home, it's in different communities, so that work would be more valued with a basic income."

Supporters said a basic income would also address the 'march of the robots'' as ever more jobs are automated.

At the 2015 general election the Green Party campaigned on a manifesto proposing a reform of the tax and benefits system that would see most existing benefits, apart from housing and disability benefits, scrapped along with the personal income tax allowance.

In their place every man, woman and child legally resident in the UK would be paid 'resident in the guaranteed, non-means-tested income, sufficient to cover basic needs – a Basic Income.'

Like the proposed Swiss basic income this would recognise and reward work done outside the formal economy and help to address social inequality, it would also help with the necessary transition to a more sustainable economy.

Switzerland is the first country to vote on a basic income, other European countries are looking at something similar. The Finnish government is considering a trial programme to give a basic income to 8000 people from low income groups, the Dutch city of Utrecht is also considering a similar pilot project set to begin in January 2017.

The Swiss electorate may have rejected a basic income on this occasion, the idea behind the proposal is still relevant.

It prompts us to think about how we reward unpaid work like caring, our response to technological change and how we share wealth and resources fairly.

Sunday, 5 June 2016

Are we flushing away the idea of civic society?

In local government issues of state and the great ideological struggles tend to be conspicuous by their absence, it is all about the small things, the detail. The mundane run of things like where to situate a new taxi-rank or what colour to paint the benches in the local park.

Mundane they may be, but more often than not such concerns can point to important shifts in our society.

That is certainly the case with an issue that, on the face of things sounds mundane in the extreme, the decision by the council to demolish the recently closed public toilets on Crown Bank in Hanley.

They have in the past been the scene of anti-social behaviour and are now deemed not to be in keeping with the proposed £10million revamp of the area as a funky market for fashionable people who wear designer clothes and have hipster beards. In their place there will be a couple of TARDIS style pay toilets on Percy Street.

This instance of a public convenience becoming that little bit less convenient is just the latest in some 1782 closures of public toilets across the UK over the past decade. Local businesses aren't happy, their owners fearing being besieged by people wanting to 'spend a penny', without spending any actual money.

The North Staffs Pensioners Convention aren't pleased either, Chair Andy Day told the Sentinel on Wednesday 'everyone young and old, from disabled people to young mothers needs easy access to such facilities.' They've got some impressive form when it comes to fighting for access to toilets, last year they forced the council to back down over charging to use the facilities in the new bus station.

It's only a loo I hear you say, nobody is going to go to the barricades over something like that. Reasonably adequate alternative provision has been made and if we want clean, safe public toilets then we'll all have to get used to paying to use them.

Fair enough,but look at it another way and you could see this as yet another nail in the coffin of civic society. Remarkably given the public health implications councils have no obligation to provide public toilets, in the past most have done so though because it was the right thing to do.

It still is, the customers of the chic coffee shop or the funky pop-up boutique may be able to spend their penny elsewhere but pensioners and parents with small still need public conveniences that are, ahem, convenient. To deny them access plays into the continued dismantling of the idea that society is a shared endeavour; when we aren't really all in it together the most vulnerable people are the ones who lose most.

The council are, to be fair, doing their best to meet their responsibilities, but are being trapped between a rock and a hard place by the demands of balancing a budget. Last year they bought themselves time and popularity by using money from reserves to avoid making unpopular choices, this could be the first small step down a more difficult and divisive road.

Tuesday, 31 May 2016

Green Party deputy leader to speak at Keele TEDx

Green Party deputy leader Amelia Womack is to take part in a TEDx event taking place at Keele University on 9th June.

Ms Womack (29) is the youngest deputy leader of any UK political party and is committed to making young peoples voices heard within the Green movement and the wider political scene. In eight years of active involvement with the party she has campaigned on issues including TTIP and the shortage of affordable housing.

At the 2015 general election she stood in the Camberwell and Peckham parliamentary seat gaining 10.1% of the votes available, tripling the party's 2010 total.

Born in Newport she holds a degrees in Environmental Biology and Environmental Technology.

TEDX is a programme of self organised local events aimed at sharing innovative ideas from original thinkers and is an offshoot of the wider TED movement that began in California thirty years ago.

Participants in the event at Keele on 9th June include Students Union chief executive Jim Dickinson speaking about how politics can reconnect with the concerns of young people, Keele based research academic Sharon George on society's growing 'addiction' to material goods and its impact on the environment and jazz musician and academic James Tartaglia speaking about how he combines musical and philosophical ideas in his work.

Tickets and further information about the event are available at :

http://kpa.org.uk/tedxkeeleuniversity/

Sunday, 29 May 2016

The political class has turned the EU referendum into their own petty squabble.

Two months in and the campaign over whether or not the UK stays in the European Union is starting to look like a sorry thing. The public are rapidly moving from confusion, to annoyance with the incessant squabbling, to indifference.

There is just over a month more to go before polling day and no sign of things getting better any time soon.

At the end of last week the Treasury Select committee criticized both sides for using 'misleading' figures and 'implausible assumptions' in their campaign material.

The committee was critical of the statement made for the 'Remain' campaign by chancellor George Osborne that families would be on average £4,300 a year worse off were we to leave the EU, calling it 'mistaken' and saying he had 'probably confused voters.' Adding that 'the main Treasury analysis found the impact on family incomes would be considerably less;' can't help thinking Curious George ought have known that.

They also took the 'Leave' campaign to task for their repeated claim that leaving the EU would save Britain £350 million a week, saying it was 'deeply problematic.' Not least because it does not take into account the 'rebate' we receive on our contribution to the EU and the investment Europe ploughs into the country.

Committee chair Andrew Tyrie writing in the report says the claims 'sits very awkwardly' with promises both campaigns had given to the Electoral Commission to 'work in a spirit that reflects the gravity of the choice facing the British people.'

Speaking to the BBC's The World at One programme on Friday he said that what was needed was an 'end to the arms race of ever more lurid claims and counter-claims made by both sides.' Good luck with that as the teenagers like to say.

He added that unsubstantiated claims made by both sides were 'confusing the public' and 'impoverishing political debate', leaving voters 'thoroughly fed up.'

The British public has never shown much enthusiasm for participating in referendums; you could forgive them for ignoring this one entirely, even though doing so is potentially disastrous.

Both sided have managed to turn the whole exercise into a dispiriting circus, one where Ringmaster David Cameron goes through endless photo-ops wearing the pained expression of a schoolmaster taking the dimmer pupils in his house through their Latin prep, statistics get thrown around like custard pies and every five minutes someone invokes Hitler as the bogeyman of choice for unthinking commentators. Whenever it looks like a serious debate might be in danger of breaking out Boris Johnson blunders on stage and starts carrying on like the Cookie Monster on acid.

It would be laughable; if it weren't so serious. If the referendum on Scottish independence in late 2014 hadn't shown us how different things could be.

A referendum doesn't have to be a nasty squabble between the boys and girls in the Westminster bubble, it can be a positive conversation about how we see our shared future that engages voters and reinvigorates a jaded political process.

Whether the mess we're in is the result of accident or design on their part is debatable, what it clearly shows is that the political class of 2016 is worryingly incapable of talking to the electorate. Instead they focus on their own petty squabbles and point scoring all the while alienating the voters to whom they owe their comfortable lifestyle.

Europe matters,particularly to places like Stoke-on-Trent, my Midlands home town, a place that has been battered by three decades of economic change and either ignored or taken for granted by successive governments. Its regeneration, slow and faltering though it may have been so far, has depended on EU funding, that is why I will be voting for us to stay in the EU on 23rd June.

Although I find some of their 'little England' posturing absurd I recognise and respect in the more reasonable wing of the campaign for us to leave a belief that democracy is something we should all value and work to protect.

The 2015 general election taught us that it is never a wise idea to try and second guess the electorate, I am though willing to make one prediction, if we let the campaign continue to degenerate into a childish squabble then whoever wins; democracy will be the loser.