“Sticking plaster won’t save our services now”

“Britain’s fabric is fraying. It’s not just the occasional crisis: schools that can’t afford a five-day week, prisons getting emergency funding because officer cuts have left jails unsafe, a privatised probation service that isn’t supervising ex-criminals. The services we take for granted have been pared so deeply that many are unravelling. The danger signals are flashing everywhere.

Local authorities have lost three quarters of their central government funding since 2010. They are cutting and selling off wherever possible: parks, libraries, youth services. The mainly Tory-run councils in the County Councils Network warned last year that their members were facing a “black hole” and were heading for “truly unpalatable” cuts to key services, including children’s centres, road repairs, elderly care, and rubbish collection.

The chief executive of the Local Government Information Unit, a think tank, says councils are already on life support. Yet they face their biggest fall in funding next year. Volunteers are already running some libraries and parks. Councils will have to cut further; Theresa May’s new stronger towns fund is far too small to make a difference.

The criminal justice system has been stretched beyond reliability. The number of recorded crimes being prosecuted is falling and runs at just 8.2 per cent, as funding cuts bite, evidence isn’t scrutinised, courts close and neither defence nor prosecution teams have adequate resources or time. The chairman of the Law Society’s criminal law committee says “we are facing a crisis within our justice system, we are starting to see it crumble around us”.

In health, waiting times at A&E have hit their worst level in 15 years; in some surgeries the wait for a GP appointment can be weeks; and this week public satisfaction with the NHS fell to its lowest for more than a decade, at 53 per cent, down from 70 per cent in 2010. Britain’s spending watchdog, Sir Amyas Morse, departed from his usual role as a tenacious critic of government waste to warn us, bluntly, that May’s recent boost for the NHS is nothing like enough. An ageing population will need higher spending. The falling budgets for social care are “unsustainable”.

The news in education this week was that 15 Birmingham primary schools will close at lunchtime on Fridays because they can’t afford to stay open. It’s the most vivid recent example of the slashing of budgets per pupil by almost 10 per cent, in real terms, since 2010. Sixth forms have lost a quarter of their funding. Schools have reduced teaching hours, cut A-level courses in maths, science, languages, sacked librarians, school nurses, mental health and support staff, and cut back on music, art, drama and sport.

When this process began in 2010 I backed it. Like many people, I had come across enough unhelpful, incompetent jobsworths to know the state was wasting money. As a Labour supporter I’d written at the end of the Brown years warning that Labour was destroying its case for high public spending by squandering much of it.

Privately, many in the system agreed. One chief executive of a Labour council told me he’d been relieved to get rid of half his staff in the first couple of years; it had cleared out the pointless and lazy, and forced everyone to focus on what mattered and what worked. Other chief executives agreed cheerfully that they too had been “p***ing money up against the wall”.

But we are years past that point. We have moved beyond cutting fat, or transformation through efficiencies. Instead we are shrivelling the web of hopes, expectations and responsibilities that connect us all, making lives meaner and more limited, leaving streets dirtier, public spaces outside the prosperous southeast visibly neglected.

So many cuts are to the fabric that knitted people together or gave them purpose. The disappearance of day centres for the disabled, lunch clubs for the elderly or sport and social clubs for the young is easy to shrug off for the unaffected. But the consequences are often brutal for those who lose them, isolating people and leaving them with the cold message that unless you can pay, nobody cares. The hope that volunteers and charities could fill all the state’s gaps has evaporated. They haven’t and they don’t. Is this how we want Britain to be, and if not, where does this end?

Austerity was never meant to be lengthy, just a few tough years to drive reform. It was intended to be over by 2017, when a thriving economy would float us off the rocks, but events did not go to George Osborne’s plan. The economy is not about to rescue us now, either. All forms of Brexit are going to slow our growth.

Which leaves us with three choices. We could accept the decay of services, and decide to live in a crueller, more divided, more fearful country. If we didn’t want that, we could back a party that planned higher taxes to fund them — Britain’s tax burden is currently 34 per cent, three quarters of the French, Belgian and Danish rates.

Alternatively, Philip Hammond could seize the chance to start reversing this policy in his spring statement next week. In America many Republicans and Democrats, for different reasons, have begun to treat deficits with insouciance, after years of obsessing over them. What matters is whether governments can afford the interest on the debt. Rates are low. Britain desperately needs investment in its people and their futures. The cautious Hammond should open the financial taps.”

Source: The Times (pay wall)

Ambulances not reaching rural areas quickly enough

The article includes a postcode checker to show the situation where you live.

“Critically injured patients in rural areas are at risk due to the time it takes the ambulance service to reach them, a BBC investigation has found.
Some rural communities wait more than 20 minutes on average for 999 crews or trained members of the community to reach life-threatening cases such as cardiac arrests and stab victims.

A response should come in six to eight minutes, depending on where you live.
Experts said delays could make the difference between life and death.
This was particularly the case for cardiac arrests where “every second counts”, the British Heart Foundation (BHF) said. …”

https://www.bbc.co.uk/news/health-47362797

“At last we are turning away from our mania for hiving off public services”

Owl says: Do not be mislead into thinking, when reading this article, that the NHS has stopped privatisation. In fact, it simply makes it cheaper and easier for private companies to compete with the NHS.

“… In the wave after wave of attacks on the NHS launched by the right, the issue of values is brushed aside. The monopoly of the NHS must be broken. Forget the principles of the co-operative: in practice, runs the argument, it becomes an inefficient monopoly of production and delivery that must be challenged by private sector competition. The NHS can still be free at the point of use, but the structures that provide health must be the closest simulacrum to a market as possible. The NHS can be reduced to a brand that houses a hyperefficient network of private sector deliverers competing for contracts.

Hence the Andrew Lansley health “reforms” in 2012 that compelled the NHS to outsource delivery. But the same thinking informed the Tories’ engagement across the public sector. Thus justice secretary Chris Grayling’s probation service “reforms” in 2013 and the normally sane Philip Hammond, as defence secretary, agreeing that army recruitment could be contracted out to Capita in 2012. Tory antipathy to the public sector was given free rein, the lush public outsourcing industry was turbo-boosted – and the public sector fragmented.

Last week saw the death knell of all three “reforms” and with it a pillar of thinking that sustains the current Tory party. Thursday’s call by NHS England to repeal section 75 of Lansley’s Health and Social Care Act, which requires every significant contract worth cumulatively more than £600K to be outsourced in any circumstance, replacing them with a best value test, is a watershed. It will empower commissioners to weigh up whether the loss of an integrated, co-operative service by outsourcing offsets any short-term financial gain. A health system is a structure of interconnected moving parts that requires co-ordination, backed by the overriding principle that the alpha and omega of decision making is care, not maximum profit. …”

https://www.theguardian.com/commentisfree/2019/mar/03/at-last-we-are-turning-away-from-our-mania-for-hiving-off-public-services

NHS Patient Survey on “Improved Access to GP services” in Devon

If you want to have your say on “improved access” to GP services in Devon there is a survey you can fill in here:

https://www.surveymonkey.co.uk/r/66MFMTV

What they really want to know is whether patients would be prepared to see another GP from another practice in another area out of normal office hours, how far they would be prepared to travel and by what means.

“Sidmouth doctor speaks out over struggling GPs and lack of extra funding”

“A struggling Sid Valley GP surgery missed out on extra funding after it all went into secondary care, prompting a Sidmouth doctor to speak out.

Doctor Joe Stych, a practice partners at Sid Valley Practice, has voiced his frustration after a funding bid was denied to redevelop Blackmore Health Centre which was rated as ‘unfit-for-purpose’, by regulators the Care Quality Commission (CQC).

Dr Stych said Sidmouth GPs had been working hard on a plan to future proof GP services in Sidmouth for the last two years.

The latest setback follows the disappointment in 2016-17 when a plan to buy and redevelop the centre was turned down.

Dr Stych said a plan to extend the Beacon Medical Centre and move GP services from Blackmore Health Centre to Sidmouth Victoria Hospital was proposed, helping support the hospital’s medical Ward.

He added: “It was ranked by Devon CCG as the third highest priority project for funding needed locally, but it was overlooked.

“Funding went to the first, second, fifth and eighth ranked projects.

“All funding in Devon has gone to secondary care.

“No funding has been assigned to struggling GPs.

“It is ludicrous that this scheme has been unsuccessful. It makes no sense to me.

“It would increase capacity and improve patient care at the same time as saving the NHS money.

“The overall scheme cost was small at £1.3million but would have made a huge difference.”

Dr Stych said the Government had since revealed its ‘10 year plan’ for the NHS with focus on moving more work out of hospitals into GPs and the community.

He added: “Without the infrastructure to support existing health services, let alone an expansion into the community, even more challenging times lay ahead.

“The reality is that we are already working at capacity and have no room to expand.

“We are already limited in what we can achieve by space constraints.”

He said the practice has an enthusiastic team with GPs in extended roles, operating on skin cancer and performing carpal tunnel operations so patients do not have to travel to Exeter.

They are involved in research to offer new and developing treatments to patients and train medical students and junior doctor.

A Department of Health and Social Care spokesman said: “The latest round of funding applications were highly competitive and the funding was prioritised on the strength of bids received from local NHS teams.

“The Devon STP (Sustainability and Transformation Partnership) will benefit from more than £50million to transform services for patients.”

The spokesman added that the funding was not allocated proportionally but on the strength of bids received.

Each was evaluated against six criteria – deliverability, service and demand management, transformation and patient benefit, financial sustainability, value for money and estates.

The Devon funding will go towards University Hospitals Plymouth NHS Trust – with £29.7million going to transforming urgent and emergency care, £9.3million to Devon imaging facilities and £3.5million to digital histopathology.

A further £8million was given to Devon Partnership NHS Trust for adult acute mental health service across Devon.

The spokesman said: “GPs are the bedrock of the NHS, and the ‘long term plan’ makes clear our commitment to the future of GPs, with primary and community care set to receive £4.5billion more in real terms a year by 2023/24.

“Last year a record 3,473 doctors were recruited into GP training and the new five year contract for GPs will see 20,000 more staff working in GP practices – helping free up doctors to spend more time with the patients who need them.”

A spokesman for the NHS in Devon said: “The Sidmouth scheme was a high priority for the Devon Sustainability and Transformation Partnership and we are still working with the practice and our partners to explore other options.”

https://www.sidmouthherald.co.uk/news/sidmouth-doctor-speaks-out-1-5911840

Brexit: education and health spending rerouted to fishing and farming

“Cabinet ministers are being told that some of their most prized projects cannot be developed because so many officials have been diverted to delivering Brexit, it has emerged.

Ministers’ priority programmes have fallen victim to “re-prioritisation”, according to internal government warnings seen by the Observer.

Government insiders said they knew of examples of officials usually dealing with schools and hospitals who were now redeployed to work on farming and fishing as a result of the scramble to prepare for all Brexit outcomes, including no deal. “It’s a real worry now that things are being held up and not happening,” said one senior Whitehall source. “We are really starting to see it as the Brexit process drags on and on.”

A memo to a senior minister, said: “In the context of ongoing cross-government re-prioritisation exercises, departments have not yet been able to resource the necessary cross-government team to deliver the work.”

The government’s plans for resolving the crisis in social care and a review of university finance are among the major policy proposals that are said to have been held up by Brexit, while many other areas have suffered due to the lack of parliamentary time and political instability. …”

https://www.theguardian.com/politics/2019/feb/17/health-and-rail-plans-sidelined-ahead-of-brexit-deadline

Newton Poppleford GP surgery: lost, never to be regained

This means that, should the NHS ever regain the funding and doctors it needs, and should the local surgery then be in a position to open a secondary surgery in Newton Poppleford, it can never happen.

Anyone buying a new Clinton Devon Estates house at Newton Poppleford (particularly if they have children, or a chronic health condition or are elderly) might want to think twice if this is a suitable location for them.

And EVERYONE should beware “promises” from developers.

A Devon development site once earmarked for a “much needed” GP surgery is being turned into housing instead – much to the disappointment of residents.

People living in Newton Poppleford have to travel miles for medical care.

It comes as a report from the government watchdog, the National Audit Office, has criticised how community infrastructure projects for healthcare, education, and transport are often abandoned once planning permission’s been granted.

In a statement, the developers Clinton Devon Estates said the withdrawal of the surgery plans was understandably very disappointing, but the decision was made by a local medical practice due to circumstances beyond their control with unexpected changes to NHS policy.

https://www.bbc.co.uk/news/live/uk-england-devon-47170553