Archive for the ‘Society’ Category

Whose party is it, anyway?

Like several other local Labour Party members, I have spent a little time in the last couple of weeks putting leaflets through letter boxes in Hadleigh, as there is a County Council by-election on Thursday. Doesn’t sound all that exciting, I appreciate. But it matters. Not just because it matters anyway, but particularly because at the moment our county council (Suffolk) is one of those which is squirreling away reserves whilst cutting public services such as community transport, library funds and putting vulnerable elderly people into privatised but failing care homes. And there is always the possibility of a by-election getting the council to a tipping point where, with enough opposition, some of this damage can at least be paused, if not reversed.

Protecting public services is the kind of result local people – of all political hues – generally want.  Which is why many, more active, party members across the country get through a lot of shoe leather every week, pounding pavements and knocking on doors in attempts to persuade people of the case for voting Labour – or indeed for voting at all. (And despite the bad press given to most politicians, I think you’d be hard-pressed to find a committed member of any party who hasn’t done the same, in their attempt to persuade people that their answers to the big and little questions of public policy are the best solutions.)

But yesterday I hesitated before putting the leaflet through one of those letterboxes with a ‘No Junk Mail’ sticker.  There are, sadly, many people who think that political communications are junk mail. Maybe they have bought into the discourse that all politically-active people are ‘in it for themselves’; maybe they just aren’t interested in much at all. Either way it’s a pretty sorry state of affairs. But if it is because they are disillusioned with the state of the debate at national level, I’m with them. I was actually rather relieved that no-one was about to talk to, as it’s rather embarrassing being in the Labour party at the moment.

I’m a member of the party. That doesn’t make me a crazy Corbynista, a machiavellian plotter, an infiltrator or (what seems the worst insult of the moment) a ‘centrist’. It doesn’t make me a supporter of Momentum, nor does it make me proud of the MPs who decided that just when the country most needed strong opposition, they would create political havoc (all to no avail, it would appear) – even though, like them, I don’t think Jeremy Corbyn is the best person to lead the party. Like, I think, many thousands of party members, it makes me someone who wants Labour values to influence public and community life, and good left-wing policies in place at local and national level: things that make a positive difference to our lives and our children’ futures.  But the present narrative in the mainstream media and the social media whirlwind is that Labour members are all new or old, democratic or anti-democratic, naive or selfish. There appears to be no middle ground. Well, I don’t want to be pigeon-holed, and nor do most of the people I know. Nor do I want to abandon the party just to get stuff done.

A couple of weeks ago, I voted for Owen Smith. Not because he has all the answers, but because he at least represents an opportunity to start a new conversation. This time six years ago I was in the room at Labour party conference when Ed Miliband won his surprise victory. It’s no exaggeration to say the atmosphere was tense. I’d voted for him, for a number of reasons. And I know, it didn’t work out. Doesn’t look as if my candidate is likely to win this time round, but what is most frustrating is that whichever of them wins, neither of them is making things happen locally.

The everyday things that get discussed in councils – like whether 17-year-olds should have to pay to get to school, or which town can do without a fire engine – really do make a difference to people’s lives. The deeper that austerity bites, the harder it is for councillors (with the right values but the wrong budgets) to fight for the right answers. But the more we and the media focus only on the people at the top of the party, and on the splits in the party, the less room there is to actually discuss those issues and support the  councillors and their supporters trying to stand up and make the right choices every day. Last week, the Labour opposition on the County Council proposed a motion aimed at improving the way elderly care home residents are treated in Suffolk – including the requirement that the county stop placing people in poorly-rated care homes. The Conservatives voted it down.

That by-election? It’s to replace a Conservative councillor who swanned off to live in the USA and refused, for eighteen months, to resign from his seat. The kind of self-serving caper that makes it into Private Eye, embarrasses even the Tories, and gives politicians of all hues a bad name.  Whatever is going on in the national Labour Party on Thursday, and however it is played out through mainstream and social media, let’s hope the people of Hadleigh can see the wood for the trees and vote for the right candidate (which would be Sue Monks).

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Dear George Osborne…

Dear George Osborne

I’ve just flicked through my FaceBook feed in the hope of finding something diverting to read. Instead I found a report of a proposal by by Tendring District Council to charge people who fall over in their own homes nearly £26 for being picked up again. This annual fee would be in addition to the £23 already paid each month by people using the Careline service. According to the council, the purpose of this proposal is to avoid unnecessary ambulance call-outs which would otherwise happen automatically when someone sets off the trigger on their care alarm. Which is all to the good. But why should the person falling over have to pay for it?

There’s been an understandable outcry in response to this story. And some of the reports don’t note that the purpose of the scheme is to reduce unnecessary ambulance call-outs, which is a shame.  But the fact remains that Tendring council appear to be exploiting vulnerable people by making them pay for support most of us would regard as pretty basic – being picked off the floor.

As I write, I can hear an assortment of answers that you will have already prepared to such a story. First up is one of those neutral ‘deflect it’ ones along the lines of “Local Authorities are accountable to their electors for the decisions they make about local services”. Well yes, in theory. But as you know, that’s not how it works in practice. Local authorities are completely hamstrung by the cuts you have made to their budgets. Added to which most people don’t really care which particular authority has made which particular decision – and what’s more they probably don’t actually know. So whilst you exploit that situation by trying to play the elder statesman to the inept local politician, elderly people who have fallen out of bed have to pay to be picked up again.

The second response I can hear goes something like this: “We have given additional resources to Local Authorities to make sure the needs of the most vulnerable are met”. Well no you haven’t. You’ve just taken it out of another budget and hoped we wouldn’t notice (integrated health and social care budgets ringing any bells?). And by the way what exactly do you mean by ‘the most vulnerable’? Probably not the same thing I mean, as there isn’t enough money in the system any more to cover the people I (and most other people) might define as vulnerable.

Along the same lines is the response that ‘local authorities should be cutting back-room functions not frontline services’. Who do you mean, exactly? Those backroom people who make sure the money is being spent properly, the ones who have to fire people because the authority needs to make savings, or the ones who sit on reception dealing with the ever-growing frustrations and queries of the visiting public? Please stop dissembling. Frontline services are only efficient if they have backroom services to call on who deal with the other stuff. Can you imagine having to do without all those ‘backroom’ special advisors?

Finally there’s  the kind of response where you adopt a different tone and blame the Local Authority for a shameful decision: something like “We will hold those local authorities who do not carry out their responsibilities to the most vulnerable in society (them again) to account”. Really? How, exactly? Are you going to take away the party membership of people who actively try to punish people just for being old and frail? Or are you just hoping that we think all they need is a public telling off?

You may want to live in a world where only financially well-off people get to keep any dignity in their old age. But I don’t. And I don’t think I know anyone else who does. So please stop pretending that proposals like the one in Tendring are all someone else’s fault. Those local authorities might be wielding the paintbrush, but you’re the one distributing the paint.

 

Pay for healthcare, Lord Prior? We already do…

Below is an open letter to my MP, James Cartlidge, the Conservative MP for South Suffolk.

Dear James Cartlidge

I understand that a few days ago the government health minister, Lord Prior, suggested during a Lords debate on the NHS that he would set up an inquiry into the future funding of the NHS. Apparently, now “demand outstrips supply” (as he put it) in the NHS, the inquiry needs to consider whether we need to move away from a tax-payer funded system to one based on insurance or other means of co-payment. I am writing to you as it seems to me that as citizens – and therefore as as taxpayers and NHS users – we should know whether Lord Prior was announcing government policy, or was going beyond his ministerial remit in proposing this debate. Yes the government needs to consider how to ensure the sustainability of the NHS in the short, medium and long-term. And yes as citizens we should engage to a degree in debates about priorities and the level of funding needed to meet them. But to have a minister announcing that an inquiry should be considering other forms of funding for the NHS – and explicitly, forms of funding which require those in need to pay – rather seems to give the game away.

I’m currently working in a community dementia service. Such services (despite the consumerist language used by Lord Prior and countless others) are not driven by demand, they are driven by need; very high levels of need for complex, scary conditions we all hope we never have to face, which pose huge demands on families, services and social care. Yet last Friday, as I drove home from work in that dementia service, I listened to a news article that outlined why proposed government changes to uplift the cap on people’s contributions to the cost of their care can not now take place until 2020 because of the need to stabilise the social care crisis facing local authorities. This social care crisis isn’t a surprise: over the last few years the government has made local authorities the delivery agent for austerity, even though they are charged with looking after the most vulnerable people in society. Add to that the challenges of an increasing elderly population and the need for private care homes to make a profit, and a crisis is inevitable.

In 2011, David Cameron denied any suggestion that the NHS should move to an insurance-based system. If that is still his position why waste government time and resources on such an Inquiry? Good healthcare costs money, and we should not be shying away from that: a truly civilised society recognises need and seeks to meet it without punishing the people in need.

The people in the unit I’m working in aren’t choosing to be there. They may wish that their care could be more comprehensive, more holistic. But their basic reason for accessing care is need. They, as older people, belong to the group much vaunted by the government as having worked hard all their lives. Don’t they deserve better than a fight about who should be paying for their basic care?  Such a fight puts the person needing care in an even more vulnerable position than they are in already.

The NHS Constitution clearly states that the NHS belongs to us all. It doesn’t belong to an insurance company, or any other kind of co-payment organisations. If this Inquiry gets underway, and as debates about the sustainability of the NHS proceed, please will you undertake to do the following:
1) inform me if the Inquiry is part of government policy

2) if it is not, ask questions and seek to ensure that such an Inquiry does not draw on government time and resources

3) in the course of public debates give your assurance that you will support the fundamental principle of the NHS as a service funded through taxation, and that  you seek to use all influence available to you as a Conservative MP to promote a tax-payer funded NHS.

I look forward to hearing from you.

yours sincerely

Emma Bishton

Who cares?

Last week my brother turned 50. Not very remarkable, you might think. Except that he is severely disabled with Down’s Syndrome and has some tricky health issues. Not that long ago it would have been considered remarkable for someone in his situation to live well into their forties – and a century ago life expectancy for someone with Down Syndrome was just 12.

Also last week I signed a petition about a severely learning disabled man from Suffolk who has had a stroke, and who was occupying a hospital bed he no longer needed because the local health and social care authorities have not agreed which of them should fund his package of care. His case, sadly, is not unusual. As happens so often, the issue here was whether the man needed ‘nursing’ or ‘social’ care. To most of us this is an abstract and rather meaningless distinction, not least since social care can include carrying out essential health-related tasks which most of us don’t have to do for ourselves, let alone for someone else (injecting insulin, for example). But providing care costs money, both health and social care organisations need to make financial savings, so each wants the other to pay. As the distinction between nursing and social care is often finely drawn even for the professionals, such debates are now protracted and commonplace.  The person who needs the care – and their family – are left waiting whilst care is broken down into a series of tasks and an associated set of costs.

I don’t believe the decision-makers in these or any other health and social care organisations lack empathy or understanding (even though it might seem that way at times). They are required to make objective decisions in the interests of fairness, and to use public resources effectively, and that is what they are seeking to do. But they are hamstrung by inadequate resources, as we don’t place enough value on care work to pay for the levels of care we would ourselves wish to receive.

Care costs, there is simply no way round this. If we need someone to help us get out of bed in the morning, and (for whatever reason) we don’t have family members who can help us do that, then that carer needs paying. (And even so, many carers who help people to live are not themselves earning a living wage, nor do they often have time to provide companionship and social support to the people they care for.)  As we constantly hear in any debates about the future of healthcare, we live in an ageing society. For people with learning disabilities that means they will often outlive their family carers – or that their physical care needs will become impossible for family carers to deliver. And, due to the complex nature of their disabilities, that care may be complicated to plan and deliver.  But that doesn’t mean they should be subjected to abstract debates about the nature of care. Perpetuating the ongoing division between nursing and social care just makes work for the organisations involved, wastes hospital beds, and leaves the cared-for person – and their family – adrift in the system. People who need care are entitled to it, whatever it is called. It’s time we gave them the dignity of paying for it.

Councils, councillors and constituents

On Monday I went to a seminar organised by the Centre for Mental Health on the Mental Health Challenge for local authorities. The point of the Mental Health Challenge is to assist local councils in opening up the discussion about mental ill-health and in taking actions that will help improve mental wellbeing for the community as a whole, as well as helping address the inequalities endured by those with mental health problems (the challenge is not about mental health services per se).

The first step for most councils (and one of the 10 parts to the Mental Health Challenge) is for each council to appoint a Mental Health Member Champion from amongst their councillors.  So far there are fifteen Mental Health Champions, some from metropolitan and unitary councils and at least two from rural county councils.

On this occasion I had my ‘work hat’ on, so was not in activist mode.  Because of the nature and purpose of the event, the councillors weren’t there with their political hats on either. Party politics wasn’t absent, but it wasn’t relevant either; the unifying ambition was better mental health for all, something which can’t be achieved by any one political party.  As it happens, none of the fifteen member champions so far are LibDem, UKIP or Green: three are Conservative and 12 Labour.

The Mental Health Challenge is new and growing fast, so these numbers will change soon.  But looking around me, and thinking of other times I have met councillors, I was struck by two things. The first is that more Labour councillors appear to have worked in the public or voluntary sectors – i.e. in environments or disciplines where talking about mental health is ‘okay’ – and it may perhaps be due to this that more Labour councillors and councils have sought to engage in this challenge so far.  The second is that they looked like a cross-section of the population.  Unlike the members of my county council in Suffolk, where most (54 out of 75) are white males – and most of these are retired.

The Suffolk population is not 72% retired white males.  And nor for that matter is 77% of Norfolk’s population. So where are the women, the men and women of working age, and the men and women from black and minority ethnic groups in my council and other rural councils?  Why can I see female (and male) councillors of working age in metropolitan councils, yet very few in rural ones? Is it simply that the Conservative & UKIP parties in rural areas tend to win more seats and membership of these parties is predominantly white retired males?  Quite possibly.  Is it also that retired business men (well, they mostly seem to be from business) want a retirement project which coincides with wanting to ‘give something back’ to the community?  Possibly.  Or is it that only retired men, for the most part, have the time and resources to travel across large rural areas, attending parish and town council meetings in addition to their county council business?  I think so.

Rural counties, by their very nature, take a long time to drive through – even if just driving in to the middle for council meetings. Council meetings tend to take place during working hours. Add these two things together and it’s easy to see how incompatible being a councillor is with holding down a job, let alone adding in running a household (which, let’s face it, is still mostly done by women).  So it’s hardly surprising there don’t seem (on first glance anyway) to be very many teachers, nurses and housing officers amongst our county councillors, or at least ones of working age.  Yet these councils, like the metropolitan ones, are charged with improving the community’s health and wellbeing, something in my view which needs an empathetic understanding of the issues faced by all groups in the community.

I’ve no doubt that the metropolitan councils face many of the same challenges as rural ones in encouraging residents to engage in local issues and of course actually persuading people to vote in the first place.  But I can’t help wondering what it is that makes them appear – on the face of it, at least – to be more representative of the people they serve, and therefore more relevant to their communities.

Other people have sought answers to this problem for a long time and whilst it’s clear that there are no quick answers, surely the questions have to include a re-evaluation of what rural county councils expect of their councillors? Representational balance is a long time coming, and it will take even longer if we don’t develop a deep enough understanding of the barriers for women, people of working age, and those from minority ethnic groups.

It does not surprise me that, when it comes to the Mental Health Challenge, there’s a lack of white retired males, though there is one notable exception.  The very first member champion was Michael Bevan, a Conservative councillor from Dorset, who got the idea years ago and ran with it.  Which just goes to show that one’s preconceptions – whilst often based on a reasonable premise – aren’t always borne out. Not when it comes to individuals, anyway.

Whose town is it anyway?

Tomorrow morning, Babergh Council Planning Committee will host the latest episode in the  Hadleigh v Tesco saga. Tesco – having bought land in the town – have been trying to build in Hadleigh for many years, despite considerable opposition from local residents and shops.  Hadleigh is a small attractive market town with a population of about 8000 people, and is home to several local shops as well as a Co-op and (from this year) a Morrisons supermarket on the town bypass.  I shop there fairly often as I like the shops – most of those in Hadleigh are not only independent but also good shops in their own right.  (That said I haven’t ever bought quails eggs in them, which our local MP Tim Yeo is proud to claim he has!)

Hadleigh has a distinctive town centre,  due to the presence of a variety of shops, public services and places to eat.    Town centres, and the communities within them, only thrive when used. How we use them is indeed changing, and will probably change much more in the next few years.  But opening a supermarket within walking distance of a town centre doesn’t give that centre time to evolve –  it just takes an axe to its economic and community potential, as I saw in a North Somerset town earlier this year.  Does that matter? It depends what kind of world we want to live in, not just now but in our older age: one of the interesting things about town centres, or so it seems to me, is that they are used most by the generations least likely to be  be making decisions about them.

A poll of Hadleigh residents revealed that 73% are opposed to any supermarket on the site owned by Tesco.  Babergh council’s economic development team  (supported by independent academic and judicial reports) states that  “the additional benefits created by a Tesco food store do not outweigh the impact on the high street and the wider economy and [they] consider that approval would have a negative effect on the sustainability and vitality of Hadleigh Town centre.”

So why are Babergh even having to consider an additional supermarket?  Because (or so it seems to me) current arrangements dictate that big business ‘owns’ the debate. Apparently Tesco opposed the plans to build Morrisons.  Perhaps not surprising when you consider that one of Tesco’s justifications for their store is that people have to travel to Ipswich or Colchester for their ‘main shop’ which, it would seem, can only be done in Tesco.  It might be argued that Tesco comes in for particular vitriol, so would people mind as much if the proposal came from Waitrose? I hope so – the plans on the site concerned require compulsory purchase of the town’s allotments, building on a water meadow, safety concerns due to the narrowness of road access and of course the threat to the local shops and the local producers whose products are sold in them.

Here’s the rub: if you spend £100 in a local independent business, between £50 and £70 of that money stays in the local economy. If you spend the same amount in a supermarket (any supermarket), only £10 continues to circulate locally.  That’s partly why towns like Hadleigh, with a mix of independent shops serving a variety of needs, make nice places to live.

People can only eat so much food, so there is only so much they will buy. Independent shops can’t survive as the ‘top-up’ service for goods that aren’t available in the supermarkets. And in Hadleigh, an extra supermarket simply isn’t fulfilling a need, just forcing a competition.  Surely it’s time for Tesco to do the decent thing, as Costa did in Totnes, and recognise that it is not in fact needed everywhere?

 

Banking on a free meal?

Last week I went to the food bank in Ipswich which is part of the local charity FIND (Families in Need).  FIND has been around for some years, and the need to support vulnerable families, especially at times of crisis, is not new. But the rise in need for regular foodbanks run by charities like FIND (and in other areas the Trussell Trust) is a more recent development. Demand for food donations is clearly rising, and it is no surprise to most people – other than the most entrenched or blinkered  – that demand has risen since the changes to welfare benefits took effect.

FIND delivers food parcels direct to people’s homes, rather than asking them to come to a central point.  And people can’t just ask for food, they have to be referred by a statutory agency (e.g. a social worker).  But even without the stigma of having to go to a central point to collect the food, would you want to use a food bank? I wouldn’t, and I don’t think I’ve ever met anyone who would choose this above being able to put food on their own table. So quite why Lord Freud thinks that the rise in food banks is an example of supply-led demand (as reported in today’s Independent), I have no idea. He came into government when bored of banking, it would appear. To say the rest of us are rather bored with hearing bankers expressing opinions they are unqualified to hold would be an understatement larger than I’d care to measure.

FIND is run by Maureen Reynel – a woman who like other inspiring people I have met in the voluntary sector appears both tough and tireless.  She seemed to me to typify the kind of person David Cameron may have had in mind to deliver his vision of the ‘Big Society’ –  people active in their communities, able to motivate and organise others to give up time, money and resources in the pursuit of a more resilient and contented society. But there is a world of difference between a society in which people willingly volunteer to do things like listening to primary school pupils read, taking elderly people who can no longer drive to appointments, or clearing scrubland, to one in which the welfare system is predicated upon some people giving food to others.  Badging work like that of FIND as creating ‘community resilience’ doesn’t even attempt to disguise the desperation with which ‘resilience’ is used a euphemism for “being less dependent on services”. Time for Lord Freud and his team to wake up and smell the coffee.