Black holes and green fields

Comment reproduced from post below:

The leaderships approach to finances over the last decade or more has been driven by a single-minded dogma to avoid any rise in council tax, even to match inflation. They have achieved this by relying not only on the government’s normal grant, but also on the government’s New Homes Bribe (ooops, Bonus – which gives payments for 6 years for each house built) which in turn has driven the mind-boggling growth numbers in the East Devon Local Plan which could easily see overall growth of more than 35% – YES THAT IS NOT A TYPO, I DO MEAN GROWTH OF HOMES OF MORE THAN A THIRD – over the period of the current Local Plan.

(Imagine all the buildings in East Devon – in Exmouth, Budleigh, Sidmouth, Seaton, Axminster, Honiton, etc. etc. – all lumped together – that’s a lot of land built on. Now take a third of that huge area, and imagine all the green fields in East Devon that will need to be built upon to make that happen, a lot of which will be in our AONBs. That is the EDDC Conservative vision for East Devon.)

Anyway, back to the finances. So EDDC’s future financial plans were predicated on large income from the New Homes Bonus. But George Osborne introduced an austerity regime which decided to abolish not only the normal grant but also the New Homes Bonus, so now the EDDC’s finances have a huge hole in them (made worse of course by the vanity projects they are undertaking like the no-longer-cost-neutral move from the Knowle).

And that is why we have seen a 4% increase in Council tax this year, and likely to see further increases in council tax way above inflation in the next few years.

Fortunately (????!!!!!), the government has thrown EDDC a lifeline by deciding to allow councils to keep all the local business rates as revenue – so we are now seeing EDDC allowing dubious business developments approved (like the recent Greendale application – submitted by a generous donor to the local Conservatives) and we should expect this to ramp up as the cash flow from the New Homes Bonus runs down.

Now back to the mental picture of 1/3 growth in homes – take the amount of land you have pictured for new homes, and add to it a significant growth in industrial buildings (like Sidford and Greendale). Terrifying isn’t it.

Of course, if you take have been watching EDDC’s actions, you will know that they have already rationalised this by joining (without any consultation with the public or indeed councillors) with Exeter City Council and Teignbridge District Council to form so called Greater Exeter. Think of Greater London and Greater Manchester and you will get the picture – huge sprawling joined up conurbations, with extensive suburbs to feed the businesses in the city centre. We are already seeing assaults on the green wedges that separate our towns and villages – so this is not as far from reality as you might think.

So there you have it. A double whammy – huge increases in Council Tax whilst rampant developments start to cover our beautiful countryside and Exeter grows exponentially in order to meet the huge Local Plan targets for new homes.

Auditors say EDDC “will continue to find it difficult to afford its spending plans against further government spending cuts” say auditors

“Going forward, the Council will continue to find it difficult to afford its spending plans against further government spending cuts, the added pressure of inflationary increases in costs and pay awards, continued low investment income, an increasing call on services, members’ ambitions to enhance and improve services and the wish to keep to moderate increases in Council Tax and other fees and charges.”

Click to access 220916-agenda-item-8-combined-reports.pdf

And no word yet if they have signed off last year’s accounts “after a formal objection was received from a local elector. We are in the process of considering this objection, which relates to the Council’s approach to recording and obtaining receipt of monies due to it from developers through agreements under s106 of the Town & Country Planning Act 1990.

Messy situation for the next meeting of the Audit and Governance Committee.

Unitary councils “save money” … yet a few years ago – they didn’t!

Owl is confused.

A few years ago, EDDC spent more than £250,000 to persuade us – and the Government – that they should NOT be forced to amalgamate into, basically, a “Greater Exeter” OR a unitary authority.

NOW:

We have East Devon District Council

We have Devon County Council

We have Greater Exeter – EDDC, Mid-Devon, Teignbridge and Exeter Councils – the very thing EDDC fought only a few years ago

We have STRATA – an IT partnership between EDDC, Teignbridge and Exeter but NOT Mid-Devon

We have the Local Enterprise Partnership – all of Devon and all of Somerset

AND

Research apparently reveals that unitary councils could save several billion pounds:

Creating 27 unitary councils across the whole of England could save as much as £2.9bn, according to an independent analysis of local government reorganisation options undertaken for the County Councils Network.

The report by consultants EY examined six different single and two-tier governance scenarios for county and district authorities, using existing county boundaries. Based on the analysis of national data, EY found that creation of unitaries along county boundaries could save between £2.37bn and £2.86bn over five years, and average up to £106m per county. The single unitary option has the shortest payback period, generating savings within two years and two months, according to the review. …”

Owl’s head hurts…

Hernandez “unavailable” to comment on Devon and Cornwall policing crisis.

Spotlight reported tonight on a crisis in Devon and Cornwall Policing. A survey of police officers revealed an overstretched and underfunded force, demoralised and angry.

The Chief Constable was interviewed and he agreed that the force is in crisis and they need more police on the beat.

And where was our selfie-loving Police and Crime Commissioner?

“Unavailable for comment”.

Her Chief Executive, Andrew White was wheeled out instead and basically refused to say if more police officers would be or could be funded.

Funny how she turns up for publicity shots and disappears when anything turns up that isn’t just publicity …

RD and E on collision course with “Success Regime”

R D and E has recently taken over responsibility for the local community hospitals where the “Success Regime” plans to cut half the beds.

It seems that RD and E is totally out of synch with the “Success Regime” and is refusing to close beds BEFORE adequate social care provision is in place – well done R D and E!

Increasing patient demand on RD&E shown by 23 consecutive red alert days”

http://www.exeterexpressandecho.co.uk/increasing-patient-demand-on-rd-e-shown-by-23-consecutive-red-alert-days/story-29863017-detail/story.html

RD&E pledge not to remove community hospital beds until it is safe”

http://www.exeterexpressandecho.co.uk/rd-e-pledge-not-to-remove-community-hospital-beds-until-it-is-safe/story-29862481-detail/story.html

People in glass houses would be well advised not to throw stones

An EDDC district councillor recently talking about NHS bed cuts:

The CCG uses inaccurate logic and biased consultation questions, therefore it’s not a real consultation – it’s an act of manipulation.”

An independent councillor? No – true blue Honiton Tory councillor Mike Allen,

Come on, Mike – you’ve been a Tory councillor at EDDC for years – surely you shouldn’t start complaining about these tactics now!

Biased questions – go to any regeneration area or anywhere Section 106 funds are being discussed: “You can have this or that”, “But we want the other!”, “Well, you can’t have it – it’s not on the form and we don’t want it.”

Real consultation? Name one EDDC consultation that didn’t have people up in arms.

Manipulation includes bending with the wind … remember the good old days when you were Chair of the Local Plan panel and refused to let the Ottery (independent) councillor speak about his ward on a crucial part of the plan? Biased? Maybe, maybe not – though Owl recalls you were rapped on the knuckles for that one.

Remember the good old East Devon Business Forum meetings that you attended?

Oh, and you can’t have inaccurate logic – it’s either logical or it isn’t.

Time to wake up and smell the … well, it certainly isn’t coffee.

Whatever happened to … Knowle relocation costs?

Given that Exmouth’s regeneration plan costs have more than doubled from £1.5m to £3.2m (see below) and part of that cost is said to be the development costs rising, whatever happened to Knowle relocation costs?

First it was going to be cost neutral …
Then it was going to cost an extra £4 million …
The latest estimate (some time ago) had the extra cost at £9.7 million

Since then:

… labour costs have increased (minimum wage rise)
… skilled labour is less available (migrants choosing not to come or being sucked into Hinkley C, our older skilled workers retiring and not being replaced by youngsters with the required training due to skills gap)
… imported raw materials costs have risen enormously due to the falling pound
… Community Infrastructure Levy to be paid

Of course, EDDC could build prefab offices to keep down costs, just as the government intends to do with housing …

Suddenly Knowle looks much more attractive in that bright autumn sun, with its lovely park and the view of the sea …

Oh, wait … it’s been flogged off for luxury retirement housing.

Exmouth/ EDDC: more of our money down the drain

“A report has highlighted that costs for Exmouth’s Queen’s Drive project have now more than doubled – from £1.5 million to £3.1 million.

The figures come as East Devon District Council (EDDC) continue looking for “fresh ideas” for the biggest chunk of the nine-acre development site – after sacking the previous developer, Moirai, over the summer.

They say they will be consulting with residents, businesses and tourists for this ‘third phase’ of the Queen’s Drive site in Exmouth.

http://www.exeterexpressandecho.co.uk/costs-double-for-exmouth-s-in-limbo-queens-drive-development/story-29858563-detail/story.html

“Tory councils warn of £600m black hole after demise of education bill”

“Conservative council leaders are warning they face a £600m black hole in budgets to improve struggling schools after the government last week pulled the plug on its education bill.

With council budgets already under severe pressure after years of austerity, some say they may need maintained schools to contribute from their own shrinking budgets, while others may be forced to cut support services they provide to local schools, leaving them vulnerable to decline.

The threat to school improvement services comes as Ofsted’s chief inspector, Sir Michael Wilshaw, described England’s schools as “mediocre but getting better”, giving the education system a rating of “6.5 out of 10”.

Local authorities – including Conservative-run county councils in Kent, Hampshire and Buckinghamshire – say they have been left in limbo by the government’s axing of educational services grants worth £600m ahead of passing the bill that would have curtailed the role of local authorities in maintaining community schools in England.

But the demise, announced to parliament by education secretary Justine Greening last Thursday, of the education for all bill, means councils will still be legally required to run school improvement services next year and meet other costs, such as maternity cover for teachers, but without funding from central government.

Martin Tett, the Conservative leader of Buckinghamshire county council, condemned the government’s failure to coordinate its funding and support for the many state schools that have not become academies.

“What we now have is a situation where the grant is being removed but the responsibilities will remain, particularly the statutory responsibility with regard to school improvement. And councils at the moment – particularly upper-tier councils, like county councils – are very financially stretched,” Tett said.

“This is a massive issue for us, because we have an important role in school improvement – not only supporting schools that require improvement or are in special measures, but actually stopping schools from reaching that stage in first place, by intervening early in a preventative approach.That costs money and, at the moment, that money is disappearing.”

The cuts will affect the bulk of the more than 20,000 state schools in England which are still maintained by their local authorities, rather than the fewer than 5,000 academies which are funded directly by central government.

Research by the County Councils Network – representing 37 unitary authorities and county councils – has found that more than two-thirds of academies choose to purchase school improvement services from their local authority, meaning that academies also rely on council support in many places. …”

http://www.theguardian.com/education/2016/oct/30/tory-councils-600m-black-hole-demise-education-bill-grant-england

“Theresa May’s claim on health funding not true, say MPs”

“Two Tories among signatories of letter pointing out that PM’s statement about £10bn extra cash for NHS are untrue.

Theresa May’s claims that the government is putting £10bn extra into the NHS are untrue and the underfunding of the health service is so severe that it may soon trigger rationing of treatment and hospital unit closures, a group of influential MPs have warned Philip Hammond.

Five MPs led by the Conservative Dr Sarah Wollaston, the chair of the Commons health select committee, have written to the chancellor demanding the government abandon its “incorrect” claims of putting £10bn into the NHS annual budget by the end of this parliament and admit the severity of its financial shortage.

“The continued use of the figure of £10bn for the additional health spending up to 2020-21 is not only incorrect but risks giving a false impression that the NHS is awash with cash,” Wollaston and four fellow committee members tell the chancellor in a letter.

“This figure is often combined with a claim that the government ‘has given the NHS what it asked for’. Again, this claim does not stand up to scrutiny as NHS England spending cannot be seen in isolation from other areas of health spending.”

The letter’s other signatures are Dr James Davies, a Conservative MP who is also a family doctor; Labour’s Ben Bradshaw, a former health minister, Labour MP Emma Reynolds; and Dr Philippa Whitford of the Scottish National party, who is an NHS breast cancer specialist.

Their letter’s detailed rejection of the government’s claims raises serious questions about the accuracy of May’s insistence, in a newspaper interview on 17 October and again at prime minister’s questions two days later, that her administration was giving NHS England boss Simon Stevens even more than he had sought in negotiations with ministers.

May told the Manchester Evening News: “Simon Stevens was asked to come forward with a five-year plan for the NHS. He said that it needed £8bn extra; the government has not just given him £8bn extra, we’ve given him £10bn extra. As I say, we have given the NHS more than the extra money they said they wanted for their five-year plan.”

However, the MPs say that May’s £10bn claim cannot be justified. “The £10bn figure can only be reached by adding an extra year to the spending review period, changing the date from which the real terms increase is calculated and disregarding the total health budget,” they concluded.

In the run-up to the general election, George Osborne, the then chancellor, promised to spend £8bn more a year by 2020, a figure that has risen since. But the MPs dispute that arithmetic, saying that the real amount of extra cash being given to the NHS in England between 2014-15 and 2020-21 is only £6bn and even that much smaller sum has only come from cutting spending on public health programmes and medical education and training by £3.5bn.

Worries about health service funding have emerged with increasing intensity in the run-up to the autumn statement on 23 November after it emerged that May told the head of the NHS in private that it would get no additional money this parliament.

Last year, finances were so tight that the NHS overspent its budget but public pressure to fund the health service generously remains strong. During the EU referendum campaign, the successful leave campaign promised to boost funding for the health service by diverting money that it said was being spent in Europe.

Warning of the political risk involved in underfunding the NHS, the five MPs add that “public expectations of the health service, and the continued rise in demand for its care produced by an increasing and ageing population, mean that measures which could be taken in some government departments are not acceptable in the NHS … including rationing of care and cuts in service provision.”

The MPs maintain that what they see as short-sighted cuts to social care threaten the viability of NHS services. They also raised the risks of the Department of Health “repeatedly raiding” the NHS’s capital budget in recent years and the decision to give the NHS only tiny budget increases in 2017-18 and in the two years afterwards.

“Our fear is that, given the ‘U-shaped’ trajectory of increases in funding for the NHS over the spending review period, these short-term pressures will become overwhelming. Despite the real-terms increases set out in the spending review, per capita funding for the NHS is projected to be flat in 2017-18 and actually to fall in 2018-19. That calls into question the ability of the NHS to maintain services in the latter part of the spending review period,” they say.

Andrew Lansley, the health secretary in the coalition government, recently called for the NHS to be given £5bn more than the money already planned.

There have also been widespread calls for the government to make good on the suggestion by Brexit campaigners that leaving the EU could add £350m-a-week to the NHS budget.

NHS England declined to comment on the letter.

Chris Hopson, the chief executive of NHS Providers, which represents hospitals, said that NHS underfunding meant that “it is being asked to deliver an impossible task. Put simply, the gap between what the NHS is being asked to deliver and the funding it has available is too big and is growing rapidly”, he said.

Prof John Appleby, the chief economist at the Nuffield Trust health thinktank, said the MPs were right to warn that cutting the amount of per capita funding for healthcare could mean major restrictions to NHS services being needed in the later years of this parliament, too.

“It is hard to see how this can be reconciled with providing high quality healthcare that meets the needs of a growing and ageing population,” Appleby said. “Something will have to give – whether that’s an explosion in waiting lists, patients not being able to access new drugs coming on-stream or another record set of hospital deficits.”

The government rejected the MPs’ analysis and repeated previous statements made by May and the health secretary, Jeremy Hunt, including the highly contentious £10bn claim. “The government has backed the NHS’s own plan for the future with a £10bn real terms increase in its annual funding by 2020-21, helping to ease the pressure on hospitals, GPs and mental health services. It is wrong to suggest otherwise”, said a government spokesman.

“As the chief executive of NHS England said last year, the case for the NHS has been heard and actively supported. We have allowed local government to increase social care spending in the years to 2020, with access to up to £3.5bn of new support by then.”

http://www.theguardian.com/society/2016/oct/30/theresa-mays-claim-on-health-funding-not-true-say-mps

Honiton NHS bed closure “consultation” meeting 10 November 2016

Beehive

10.00 – 12.30

Please register to guarantee your place.
Call 01392 356 084 or email d-ccg.YourFutureCare@nhs.net.

For more details see:
https://www.eastdevonalliance.org.uk/event/nhs-future-care-consultation-beehive-honiton/

Honiton is to be left with no beds at all in current plans, so it is hard to see what the town is being consulted about.

So far, EDDC top brass have issued watered-down, anodyne statements about the situation, so you might want to quiz your Tory district councillors BEFORE this meeting.

Public toilets next for the chop in East Devon asks EDA councillor?

“Fears have been voiced for Sidmouth’s free public toilets as district bosses review their £800,000 cost in a bid to balance the books.

East Devon District Council (EDDC) is taking stock of its conveniences and is looking into paid access at some ‘key’ sites, leasing some to businesses and ‘innovative’ ways of reducing the cost of providing its StreetScene service.

Also on the cards is ‘rationalising’ its provision, but the authority insists that no decision has yet been made and residents will be consulted. Any changes are at least two years away, says the council.

Councillor Cathy Gardner, ward member for Sidmouth Town, said the result will be taxpayers paying more for less – and warned the authority will soon run out of ways to cut costs.

“A town like Sidmouth needs free public toilets,” she said. “An elderly population and lots of visitors with children need them, otherwise we have an increase in urination in public places.

“As well as cutting services that we’ve had as a mark of civilisation since the Victorian era, we will be paying more in council tax and getting less.

“This is what austerity means at a local level. It really does affect everyone and I doubt whether things will ever be put back.

“Once an asset is sold, it’s gone – never to be returned – and how do you balance the books next time?”

An EDDC spokeswoman said: “The council recognises that public toilet provision is a very important service for our residents and visitors – however, it is not a statutory service and we provide it because we know how much it is valued.

“As part of the council plan, we need to look at ways of operating services differently in order to help meet our budget deficit of £2.6million.

“We spend around £800,000 per annum on our toilets, so we need to assess them responsibly for quality, level of provision in any given area and possible options for different ways of operating.

“However, we would like to stress that no decisions have yet been made – it is far too early and is still a work in progress.”

The spokeswoman said the provision is being reviewed and the options will be discussed by EDDC’s asset management forum and cabinet. She added: “As and when proposals come forward, there will be full engagement, including consultation, with all interested parties.

“We anticipate that any changes would not come into place for at least two years.”

http://www.eastdevonalliance.org.uk/cathy-gardner/20161027/sidmouth-herald-concern-public-toilets-across-east-devon/

Home care instead of hospital? Forget it

Care providers in Cornwall say there’s a crisis in the care of elderly and disabled people at weekends because there are just not enough workers.

One relative called every care agency in Cornwall but could not get weekend help for her grandfather.

South West councils pay the highest average hourly rate in the country, but its still not enough to attract new carers.

BBC Devon Live
http://www.bbc.co.uk/news/live/uk-england-devon-37697692

“Buses make people healthier and wealthier”

Improving local bus services can boost employment and improve income, helping to reduce social deprivation, Greener Journeys has found.

It revealed that a 10% improvement in local bus services is linked to a 3.6% reduction in social deprivation across England, taking into account employment, income, life expectancy and skills.

Greener Journeys, a coalition of the UK’s leading public transport organisations, user groups and supporters, commissioned KPMG and the Institute for Transport Studies at the University of Leeds to carry out the research. It is the first to measure the impact of bus services on deprivation.

It found that if the bus services in the 10% most deprived neighbourhoods across England were improved by 10%, there would be significant, tangible improvements to that area.

In this case, the improvements as estimated in the report would be: 9,909 more jobs, as a consequence of a 2.7% fall in employment deprivation; increased income for more than 22,647 people, as a consequence of a 2.8% drop in income deprivation; and 2,596 fewer years of life lost.

Also, 7,313 more people would have adult skills and there would be an increase in post-16 education of around 0.7%.

The report, The Value of the Bus to Society, considered the impact that bus services have on the ability of households to participate in economic and social activities and, ultimately, on levels on economic, social and environmental deprivation. ….

http://www.publicfinance.co.uk/news/2016/10/buses-make-people-healthier-and-wealthier-research-finds

Big NHS changes demo in Barnstaple

Hundreds of people have attended a march in opposition to proposed cuts in services at a hospital.

The Devon Sees Red march, held in Barnstaple, was to highlight concerns over potential cuts at North Devon District Hospital.

A document leaked to the BBC showed that stroke, maternity and neo-natal provision could feature in cost-cutting plans.
The hospital said “no decisions” have been made about the future of services.”

http://www.bbc.co.uk/news/uk-england-devon-37740026

But, of course, a series of “preferred options” have been chosen. Amounts to the same thing these days.

EDDC spends more than £ 700,000 on external legal advice in 3 years

Summary of request

I would like to know the amount of money the department spent on the services of external law firms and barristers for each of the last three years (years ending March 31). If this is not possible within the restrictions of the Freedom of Information Act, two years of data will suffice.

Summary of response

2013/14 Legal fees including barristers £285,075.61
2014/15 Legal fees including barristers £353,060.78
2015/16 Legal fees including barristers £79,053.34

http://eastdevon.gov.uk/access-to-information/freedom-of-information/freedom-of-information-published-requests/

Small towns and their businesses suffering due to bank branch closures

“In the first report into the effect of bank branch closures on small and medium-sized businesses, seen exclusively by The Mail on Sunday, the Federation of Small Businesses has demanded greater communication from banks over reductions in services and protection for the ATM network.

Its report, Locked Out: The Impact Of Bank Branch Closures On Small Businesses, authored by policy adviser Ben Baruch, is to be revealed tomorrow following focus group meetings across the UK between July and September.

FSB policy director Martin McTague said in the study: ‘Our report shows the disproportionate impact branch closures are having in some parts of the UK and particularly in rural areas. This is concerning as evidence strongly suggests that closure programmes are both expanding and accelerating.’ …

… And the FSB said there were instances of villages and towns ‘literally running out of money’. It complained that business banking services at some Post Office branches and franchises were ‘too limited’ and that the high cost of small electronic transactions was putting some small firms off investing in new payment technology.

Gwyn Evans, chairman of FSB North Wales, said in the report: ‘Unlike in urban areas, if a branch closes in rural Wales, the business owner may face a 20-mile or more round trip to bank cash. Also, when you run a business dealing in cash, you cannot pay in a bag of change over the internet or through a smartphone app – there are limitations to even the most advanced technologies. In addition, online banking is not always easily available in rural areas.’ …

…. Malcolm Harrison, who runs Crazy Horse Coffee Shop in Invergordon in the Highlands, took part in a focus group and accused Royal Bank of Scotland of leaving the town ‘high and dry’ after it closed the last bank branch there.

He said: ‘I have not been too badly affected, but I have been here 12-odd years and am part of the furniture. Two or three businesses have closed since RBS went – a jeweller and another coffee shop, and a gift shop moved to another location.’

He said a lot of business custom moved to the next town when the branch closed, but added: ‘The biggest problem is where to get change from. Even if I put £100 to one side, it affects cash flow and I can get through that in a couple of hours. I then have to drive to the next town, leaving the shop a person down.

‘What was particularly upsetting was that the bank put a lot of effort into marketing online banking, and that affected footfall in the Invergordon branch.

‘We had an idea there was something afoot but the bank denied it was closing it. It has really been underhand in the way it has gone about this.

‘It changed its policy about not closing the last bank branch in town very quietly and left a town already suffering economically high and dry.’

https://t.co/BMW0RZ0TJQ

Swire on health and social care

Summary:

Home care is currently in trouble with local authorities having cut their funding.”

NO! NO! NO! YOUR GOVERNMENT HAS CUT FUNDING TO LOCAL AUTHORITIES!

“… social care is means tested and supplied by the local authority, whose grants, throughout the recent period of austerity have been cut.”

BY YOUR GOVERNMENT!

As to the blame game, it simply won’t get us anywhere.”

YES IT WILL – YOUR GOVERNMENT’S AUSTERITY POLICY GOT US HERE! YOUR GOVERNMENT HAS CHOSEN TO STARVE THE NHS TO FEED HS2 FOR EXAMPLE. IT HAS INSISTED ON TARGETS THAT CANNOT BE MET BY A DEFUNDED NHS AND THEN FINES HOSPITALS FOR NOT REACHING THEM!

(And be honest, if it was Labour in power YOU would be blaming Corbyn!)

Britain spends less as a share of its GDP on health care than most other rich countries. If taxpayers want that to change they will have to pay for it. And yes that might mean patients, diverted from expensive systems of care into cheaper ones.”

NO! IT CAN SPEND MORE ON THE NHS – IT WAS A CHOICE OF YOUR GOVERNMENT TO SPEND LESS AND UNDERFUND HEALTH CARE COMPARED TO OTHER COUNTRIEs AND TO SPEND MORE ON WASTEFUL VANITY PROJECTS. THIS IS A RICH FIRST-WORLD COUNTRY NOT A POOR THIRD WORLD ONE?

“As for surgeries, why can’t doctors deal with some patients by e-mail? it would mean they could devote more time to the seriously ill when they come in. Some people already pay for prescriptions, as they do for dental health, so is the answer for some other services to be charged for?

OWL CAN BARELY REPLY. YOU KNOW IMMEDIATELY THAT THIS MAN HAS PRIVATE HEALTH CARE! CAN YOU IMAGINE PEOPLE DESCRIBING THEIR SYMPTOMS BY EMAIL! AND HOW MUCH EMAIL DOCTORS WOULD HAVE TO PLOUGH THROUGH! AND WHAT IF THE PATIENT THINKS THE PROBLEM HAS TO GO TO EMAIL AND IT TURNS OUT TO BE AN EMERGENCY! OR WHAT IF EMAIL GOES DOWN OR YOU HAVE NO COMPUTER? WHAT ABOUT SECURITY AND CONFIDENTIALITY?

I have an online booking system for my surgery but my doctor tells me only a quarter of people turn up”

SO DOESN’T THAT MEAN EITHER IT IS NOT FIT FOR PURPOSE OR EVEN THAT THERE IS MORE SPACE FOR THOSE WHO DO TURN UP ON THE DAY!

And finally:

These are only ideas, and for many they will feel like a bitter pill to swallow.”

INDEED A BITTER PILL BUT, FORTUNATELY WE DON’T HAVE TO SWALLOW IT … WE CAN FIGHT BACK.

But it’s useful to see Mr Swire’s total toeing of his party’s line. We do know where we stand with him and his party – and for the majority it is NOT shoulder to shoulder but eyeball to eyeball.

Care at home cannot take up the slack from hospitals

A&E units are struggling to cope because social care services that help elderly people have been cut so much that they are reaching a “tipping point”, England’s care regulator is to warn.

English care home closures are leaving vulnerable people at risk, says watchdog

Hospitals are ending up dangerously full and have seen “bedblocking” hit record levels because of a widespread failure to give elderly people enough support to keep them healthy at home, says the Care Quality Commission.

A worsening lack of at-home care services and beds in care homes are forcing hospitals to admit more patients as emergencies, which deepens their already serious financial problems. “What’s happening, we think, is that where people aren’t getting access to [social] care, and we are not preventing people’s needs developing through adult social care, is that they are presenting at A&E,” said David Behan, the CQC’s chief executive.

Figures contained in the commission’s annual report show that the number of hospital bed days lost through patients being unable to leave because social care was not available to allow them to be discharged safely soared from 108,482 in April 2012 to 184,199 in July this year – a 70% rise.

The fact that growing numbers of mainly frail, elderly people are being left without the help they need with basic chores such as washing, dressing and cooking “creates problems in other parts of the health and care system, such as overstretched A&E departments or delays in people leaving hospital,” he added. GP surgeries are also having to treat patients who became unwell or suffered an injury because they did not receive help they needed.

Behan urged ministers to give social care a higher priority and urgently find extra money for it to prevent its ongoing deterioration causing even worse problems. “We are becoming concerned about the fragility of the adult social care market, with evidence suggesting that it might be approaching a tipping point,” he said.

The CQC’s assessment of health and social care, called State of Care, adds that: “The difficulties in adult social care are already affecting hospitals. Bed occupancy rates exceeded 91% in January to March 2016, the highest quarterly rate for at least six years, and in 2015-16 we saw an increase in the number of people having to wait to be discharged from hospital, in part due to a lack of suitable care options,” the CQC’s annual report says.

The number of people in England receiving local council-funded social care services fell by 26% from 1.1m in 2009 to about 850,000 in 2013-14, at a time of Whitehall-driven cuts to town hall budgets. The number of people with unmet needs has risen from 800,000 in 2010 to more than 1 million last year, according to Age UK.

Growing unavailability of social care was a key driver of the 3% rise in emergency admissions to hospital last year and 11% rise in bed days lost to bedblocking. That was mainly due to patients having to wait for a package of care to be put in place to let them return home or for a place in a nursing home to become available. “The effect of these delays on the NHS is significant, costing hospitals £820m a year,” the National Audit Office says.

NHS bodies, health thinktanks and charities urged government to use next month’s autumn statement to inject extra funding into social care.

Simon Stevens, the chief executive of NHS England, has already called for any extra funding for the health service to instead be used to prop up social care. Jeremy Hunt, the health secretary, is understood to privately agree. On Monday Stephen Dorrell, the ex-Conservative health secretary, said that the government’s policy of giving social care less and less money was “insane economics and bad social policy” and undermined its claim to be backing the NHS.

Cuts to social care and also mental health and public health mean “the NHS is being stretched to the limit,” said Stephen Dalton, chief executive of the NHS Confederation, which represents hospitals. “Relying on political rhetoric that promises to protect the NHS but fails to acknowledge that a cut in social care results in a cost to the NHS, is an economic deception.”

The CQC also disclosed that about 800,000 patients are registered with a GP practice that its inspectors have judged to be inadequate on safety grounds. It is concerned that some surgeries deliver “unacceptable standards of care”. Safety failings include poor management of medicines, inappropriately trained staff and premises that are unsuitable.

The Department of Health welcomed the CQC’s findings that “the majority of the NHS, 72% of adult social care services and 87% of GP practices inspected are good or better – and that improvement is taking place all over the country”.

A spokeswoman said: “The NHS is performing well at a time of increasing demand. The government is investing £10bn to fund its own plan for the future, and crucially is ensuring that the amount of money available to local authorities for social care is rising in future years of the parliament, reaching up to £3.5bn extra by 2020.”

http://www.theguardian.com/society/2016/oct/13/social-care-cuts-take-english-service-to-tipping-point-regulator-warns