Public Services: Radiators or Drains?
Across the board, our public services are under stress. Budgets for the police, the NHS, Social Services, and education have all been hit, hard, since 2010. Even the NHS, to which the Conservative government keeps trying to tell us it is giving ‘extra money of £8billion’ is, in real terms, dealing with a cut in its budget. The word ‘extra’ is a fib too: it refers to what was really the initial tranche of the promised funding for the first stage of a new NHS development plan.
And so we see, daily, reports of what this means, on the ground, to us, as we go about our daily activities.
Mrs May says that we must balance the budget and so the money for these services has to be cut too. Mrs May says that these services are drains on the public purse and that the endless flow of money into them has to be reduced. But is this true? Do we all see these vital services, like the NHS, like GPs, like the police, like carers in care homes, like nurses: do we see these people as drains on the public purse? Or do we see them, in effect, as ‘radiators‘: those things which actually help us, as a society? Which enable us to care for each other when we are sick or vulnerable? Those services which help us feel safe and secure in the knowledge that if we, or our loved ones, become ill or lose a job, that we will be helped temporarily to get back on our feet? Those services which warm us and help us feel we are supporting – and being supported by when needed – a wider community.
Right now, where I live, it feels like we have more drains than radiators.
I do not like living in a city where increasing numbers of homeless people go to sleep on the streets, every night. I volunteer in a Food Bank, but I don’t like living in a city where so many people need to use one. I don’t like the amount of stress my younger neighbours are living with – and the ways in which the crushing pressures of worries about their jobs, working long hours and trying to do the right thing by providing for their children affects them and their behaviour towards others. I don’t like the effects of cuts in social care which mean that another neighbour can’t get help caring 24/7 for her disabled husband because she is a WAH. We have known her for 30 years as a lively strong woman, actively working in the community she was brought up in, but now that Wife At Home label means she is exhausted and worn out – yet can’t qualify for social services support – and she is only 70, with many more years ahead of carrying that burden.
All this in the name of Austerity, because ‘we have to reduce the deficit’. But the Austerity strategy isn’t working. It’s not balancing the books, and it’s not increasing productivity, and it’s certainly not increasing our sense of well-being, individually or collectively.
It doesn’t have to be this way. Vote on Thursday and change things for the better, please!
NHS: Why Are We Waiting?
Waiting times in the NHS are going up. The situation in England got so bad this year that some targets were removed. The rationale given for this is that ‘targets are detrimental to improving performance as they focus attention on the wrong issues’. Well let’s see how that is working out in practice.
First a little history: in 2009 waiting lists were low enough for leading economists to propose that variable waiting times be introduced, set by local area health authorities, to better match clinical need and demand.
In 2009 a Labour Government was still in power and funding for the NHS was at, for the UK, historically high levels (But not out of line with spending levels in comparable countries).
Today in 2016 NHS spending is lower than it was on 2009, both in real terms and as a proportion of GDP. In terms of international comparisons. For example:
- In 2000, the UK was spending 6.3% of its GDP on healthcare.
- Tony Blair, as PM, committed to increasing this spending to 8.5 % of GDP to bring the UK into line with the other 14 EU countries’ then level of spending on health care.
- By 2009, the UK was spending 8.8% of its GDP on healthcare (by which time the EU average had increased to 10.1%)
- By 2014, the UK spend on healthcare as a proportion of GDP had gone down to 7.3%.
- Between 2014/15 and 2020/21, the UK’s GDP is expected to grow by 15.2% BUT the proportion of spending on healthcare by then is not expected to increase by more than 5.2%, meaning that we will be spending only 6.6% of our GDP on healthcare.
- By this time (2020/21) we would need to increase our spending on the NHS by 30% -£43bn – to match our EU neighbours’ healthcare spending levels.
Is this really what we want for ourselves or for our nearest and dearest? The UK government is committed to increasing healthcare expenditure but the projected increases are nowhere near to helping us match our EU neighbours’ spends on healthcare.
Does this really matter? Well, think about the waiting times for diagnosis and treatment that you, your neighbours and friends, and relatives are currently facing.
We know that waiting a long time for diagnosis and treatment is not only a source of great anxiety for individuals and their families. It also can result in people getting sicker and thus needing more treatment for longer. It can make the difference between outpatient treatment and inpatient care too.
In the past 6 months I’ve had two reasons for referrals for two different -both cancer-related, though- problems. In each case the referral was classed as ‘urgent’. The first was a source of a lot of anxiety because of family history. After 6 months’ wait I gave up and went privately (a year later an NHS slot became available). The other was quicker, but still too long-and in the end needed a bigger incision, and more stitches, than it would have if it had been dealt with as quickly as my GP had expected it to have been.
I bet that you and your family can recount similar stories. It is not good enough for any of us. Maybe its time we spent less time and energy talking about the terms of Brexit and more time debating what really will make a difference to us: the NHS and how to ensure it is fit for our purposes!
Welsh language
The Welsh Assembly Government is working hard to promote Welsh language learning among all age groups of the population. Welsh language classes are running locally, under a special initiative and in tandem with Cardiff University. This promotion means that classes are free of the usual restrictions on LEA-run adult education and community learning programs. So even if class numbers are small, the subsidy means that tutors and groups can keep running. What’s more, terms are longer than other LEA-run language courses and there are more levels and conversation classes/learning opportunities too. All this is meant to promote appreciation of Welsh history and culture and so, of course, is A Good Thing.
But is it appreciated? Do Welsh people want it? The 3 generations of a family sitting behind me on the train to London yesterday didn’t. They were unanimously against it. The Gran told her son and daughter-in-law about a school she knew of in Cardiff, where they were ‘trying out’ teaching Spanish instead of Welsh and that, if it worked, the scheme would be spread out across Wales and would reach their schools, too, in the south Wales Valleys. The son-in-law commented that “if people want to learn Welsh they can go to the Welsh schools”.
This unbidden and unprompted exchange surprised me. What about you? What do you think? Should the WAG keep spending upwards of £30,000,000 a year
No Lunch Today
If your children are in infant school in England, they will no longer be given free school lunches. Mrs May has decreed that, if elected, she will take away school lunches and replace them with breakfasts. I don’t think what passes for breakfast under this pledge – a bit of cereal and juice – adds up to much more than increased tooth decay for our children, worth pennies and very little, in nutritional terms. Lunch gives us all – workers and children – a much needed energy boost in the middle of the day. Plenty of studies point to the link between good nutrition and better health, as well as improved performance, at school.
And this Big Idea comes on top of so many cuts to the Education budgets that the pips really are screaming in our schools. A recent analysis by the Guardian reveals that Head Teachers across England
“resorting to desperate measures and making greater demands on parents to save money as budgets are squeezed”.
These Head Teachers are being very imaginative and inventive. According to the Guardian’s analysis, they are shortening lunch breaks, dropping less mainstream subjects, and now, asking parents to foot the bill for “services” as varied as ingredients for cooking, the costs of materials for “creative studies” and even to fund subjects like PE and Latin for some year groups. In Wandsworth, primary school children are being asked to help clean the classrooms because budget cuts mean the schools can’t afford more cleaning staff. Parents of schoolchildren in Taplow (within Mrs May’s Maidenhead constituency) have been asked to contribute £30 per month to plug the gap in next year’s budget, projected to be a £40,000. shortfall – or face making teachers redundant.
The Head of the National Association of Head Teachers is used to speaking out on behalf of his members, but its time we heard him. He reports that slashing school staff budgets was bad enough but is still not sufficient to pay the bills:
“Almost every Head I speak to is thinking about not replacing teachers who leave”
Some are having to lay off staff as well. And this is happening now, today, not something projected for 2020. Larger class sizes makes it harder for teachers to teach and pupils to learn. The National Audit Office’s calculations project a £3 billion real terms reduction in school budgets by 2019, due to existing Conservative policies on education spending.
So what are we voting for today? The Conservatives are promising £1 billion per year additions to school budgets. According to the Institute for Fiscal Studies, this amounts to a 3% further fall in school funding by 2020. Labour is promising to increase education funding by £4.8 billion per year, funded by reversing cuts to corporation tax. This is not funny money, or the ‘magic money tree’ of Tory jibes. The magic money tree is a label better suited to the quantitative easing of the past 7 years! This is a costed proposal, based on common sense, and a very different set of values.
Well that’s how it looks to me. But however it looks to you, do get out and vote today! Its pouring rain and pretty miserable outside, but go for it anyway and make a difference: you’ll feel better for it, if nothing else!
Our NHS: Who Can Help Now?
The NHS is a real priority for me in this election. As an aging woman I want to know it will be there as I and my friends get older and weaker! And so far, it has been. But more than that, I love the NHS. I worked for it for 30 years, first as a volunteer and then, as a manager and an academic. So, although I’ve never been on the front line, I’ve worked hard to help those who do to understand and apply changing health policies to improve their own services on the ground.
I’m committed to the NHS as a citizen too, not least because I’ve seen the impact of the US healthcare system at closer quarters than I wished: watching my aging and weakening parents, able to choose any form of diagnostic test, any time any place – but this choice meant that they were left having to find out who to turn to get the results interpreted. They had choice aplenty – but not the information they needed to find the best person to diagnose and treat them. All that was down to word-of-mouth, which doctor their friends liked without any way of knowing whether that same doctor had the expertise and experience they needed. And all this at their own cost, because despite good health insurance cover and Medicare top-ups, doctors charged additional top up fees. Added to this, prescription drug costs were very high. And then the home care services, privately provided so outside insurance coverage, were a lottery. Despite paying for them, the carers were of variable standards and seemed to arrive at random times, frequently a different one than the day before, all of which was unsettling and unnerving.
Is this the path we want to continue on for ourselves? Because this is the path we are on now. Is it good enough for you or your friends and family?
Today, NHS waiting times are at their highest for a decade. The Conservatives scrapped targets allright – because their funding levels meant that the targets could no longer be met. This has meant longer and longer waiting times for us patients.
For example, the waiting target for cancer treatment, from diagnosis to treatment, is for 95% of patients to be diagnosed and treatment started within 62 days. This target was met every year since its introduction in 2009, through to 2013/14. But it has been missed every year since. Last year, 2016/17, only 82% of patients were diagnosed and treated within the target time.
The NHS runs on its people – and too many of them are overworked. Tired doctors mean mistakes -and then the doctor is blamed. Stressed out nurses get sick – or leave the service. There are not enough GPs in the system now to cope with the demands of an aging population. None of this is down to immigration. N HS pay levels have been capped in the name of Austerity. Budgets are cut – in real terms – in the name of Austerity.
We spend less on our health care system than do our European counterparts. From what we can see so far, none of the parties’ promises will bring us up to their levels of spending on health.
The Liberal Democrats’ promise of 1p on income tax is a good idea because it provides a level of stability for NHS planning here-to-fore unknown. This would be a big help.
Labour is offering £30 billion – the most of all the parties, as far as can be judged from manifestos. That £6billion a year will also cover re-instating bursaries for nurse training, which should really help recruitment. The rest will go a long way to shoring up struggling services. Labour has also pledged to end the current pay restraint which will help retention too.
The Tories, well, we know what we’re getting now and its not good enough. The end to nurse training bursaries on top of pay caps on nurses’ salaries is already having an adverse effect – and nurses are leaving, meaning that Hospitals have to plug the gaps with more expensive Agency staff, all to do the same jobs, but adding massively to their deficits.
What do you think? Whose policies do you think will help the NHS most? Whatever you think, do go out and vote on Thursday!
Security and public safety
Congratulations to the South Wales Police Heddlu De Cymru for doing such a brilliant job throughout the UEFA Cup Final weekend! Two thousand police officers worked on what Sky News claims was the biggest security operation in Wales since the NATO meeting in 2014.
The atmosphere in central Cardiff was fun. One hundred and 70,000 football fans poured through the city centre and there was no hint of trouble. And down at the 4 day Festival in the Bay, the crowds milled round the festival stands and queued up to join in the activities at different stalls along Marina Quay.
The weather helped of course -though at times the big silver replica UEFA Cup swayed in the freshening southwesterly breeze! But the real heroes of the weekend, to my mind, were the security services and the police.
The security operation was enormous. I had some qualms, watching it all being set up in the days before the event: huge black barriers across the routes in the Bay (some of our favourite cycling tracks!), the city centre roads closed completely for 4 days – and even the run down the River Taff was barred at the Railway Bridge! All our bags were searched as we walked our bikes through the Festival – and those without bags were frisked – but the whole thing was done quickly and effectively- and with plenty of smiles and laughs. Grace and professionalism characterised the whole security operation. Far from being intimidating, their behaviour and presence only enhanced the atmosphere.
We are so lucky to be able to say this, on the rainy Monday morning after the event. In the wake of the terrible events in London that same weekend, coming so quickly after the Manchester Arena and Westminster Bridge attacks, the story could have been so different. My heart goes out to all the different individuals affected by those tragedies, and to their families and friends, whose lives will never be the same again.
Thanks to the efforts of the Army, the South Wales Police and the countless numbers of volunteer Ambassadors and helpers throughout the weekend their were no adverse incidents, beside a few ticket touts being arrested.
Our police need our support. It is not enough to say ‘Enough is Enough’ Mrs May. We need to pay our police adequately for the huge risks they take on our behalf, risks which are increasing every day. Yet under this government, since 2010, and especially under Theresa May as Home Secretary during that period, our police forces have faced more opprobrium than praise.
Over a year ago, in July 2016, the press were reporting that our police forces were being cut. The BBC reported that we had 20,000 fewer police officers in 2016 than in 2009: a fall of 14%. The Police Federation noted that its budget had fallen 18% in the same period. And at the same time the numbers of police officers on long term sick leave have increased during this same period. I recently met a police officer who told me that his colleagues were leaving the force in droves, through early retirement or for other jobs, because they were so stressed by their growing workloads and the expectations on them. This is a vicious circle which demoralises remaining staff and makes it increasingly difficult for them to keep working effectively.
Of course, changing times need changes in work methods. According to the Police Federation the 6% drop in crime during this period shows that the police have indeed been able to do more with less. But we also know that as the nature of crime changes towards more insidious forms, such as the kinds of smaller scale but deadly incidents we are now seeing in the UK, and towards cybercrime, then it is likely that we are going to need more individualised responses from our police and security services. To my mind, that implies needing more officers on the ground, not less.
I don’t think our police or security services are safe in Mrs May’s hands. If you don’t either, Vote on Thursday! And vote for some one else! Jeremy Corbyn’s Labour Party is pledging to add 10,000 new police officers, I’m good with that.
Is Brexit Really What Its All About Prime Minister??
Mrs May has called this snap election to, she tells us, strengthen her hand at the negotiating table with our EU soon-to-be-ex colleagues. But she already had a Parliamentary majority and, seemingly, faced very little effective opposition to anything she put forward in terms of Brexit. We got it: we were leaving, face it and man up.
But that’s not really what this election is about. Really Mrs May just wants a bigger majority to strengthen her hand in her larger aim: she wants a smaller state. Is that what we citizens want though?
Us citizens, trying to get GP appointments, trying to ride the trains, with a seat (if we’re really lucky!), trying to get help for a loved one who needs it, trying to get a hospital appointment, or supposedly ‘non-urgent’ surgery. The Conservatives have spun us a tale that the pressure on our public services is all down to the influx of immigrants. But if you look around you, is that what you see?
What I see is the effect of cuts, to each and every one of our public services, and all in the name of Austerity. Because ‘we must reduce the deficit’! But must we, really? When so many public sector workers are telling us of the stress they are working under, that they can’t do their jobs to the standard they believe they should because colleagues are either off sick or been made redundant. Public services are labour intensive. To deliver a service means some person has to be there, in place, to provide it. And yes, that does imply a wage bill to match. Cutting the money to pay for those services means there are fewer people to provide them. And this is then reflected in longer waits for care. And sometimes it also means a poorer level of care, too.
In the case of the NHS, capping pay has already adversely affected nurse recruitment. Retention of existing nurses is hit, too. I recently met a nurse who told me that she had worked for the NHS for 25 years but had had to give it up. “I found myself in charge of a whole ward, overnight, by myself and got so worried and upset that I drove off the road on the way home one night. I had to recognise that I couldn’t go on like that; for the sake of my family, I had to leave”. She had two teenage daughters to support.
But for each nurse who leaves, and isn’t replaced by another full time equivalent, the NHS is forced to buy in agency nurses – who cost more. This is having a hugely disruptive effect on hospital planning and financing. This downward spiralling situation is not a given. It doesn’t have to be like this. It is a direct result of the decisions taken since 2010 in the name of Austerity and the erroneous belief that we have to ‘reduce the deficit’. The decision to shrink the State is not a financial imperative, it is one driven by dogma. If we want to improve our public services, to ensure that they are functioning adequately when we, our neighbours, or our loved ones need them, don’t vote for Mrs May!
New Regulatory Bodies for health professionals?
Jeremy Hunt has just produced a White Paper on simplifying the regulatory machinery for health professionals – again. This, on the same day that figures emerged showing that the NHS has faile…
New Regulatory Bodies for health professionals?
Jeremy Hunt has just produced a White Paper on simplifying the regulatory machinery for health professionals – again. This, on the same day that figures emerged showing that the NHS has failed to meet waiting targets for A&E:
- 82% of patient were transferred or discharged within 4 hours of arriving in A&E compared to the target of 95%;
- 60,000 spent between 4 and 12 hours waiting more than 12 hours trolleys in A&E corridors
- 780 people waited more than 12 hours for a bed.
This is the worst performance since the targets were introduced in 2004.
And its worth remembering that each of these 780 is actually a sick person needing hospital level care.
The BMA, the head of the Royal College of GPs, the head of the Royal College of Surgeons: all have expressed – this week -their concern that the NHS is facing crippling pressures. And what does the government do: it orders a review of the royal college regulatory machinery!
Proposing a review of regulatory machinery is not cost free. It costs money to ‘review existing arrangements’. Senior staff have to make time to read the proposals, consult with colleagues, write responses, when they could be contributing that same time to patient care. They are already using their administrative time to try to improve the way their services function by better integrating services locally. And so these proposals also increase ‘opportunity costs’ – the costs of not doing one thing to do another – adding even more to the time pressures experienced by already over-burdened health professionals.
This Mad Hatter of a Health Secretary is doing everything he can to ignore what seasoned – and long suffering – health professionals are pointing out is a crisis in health care provision. We are simply not providing sufficient resources to tackle the problems we are facing. This week a new category of health personnel was invented: ‘corridor nurse’. Surely it is clear that we do not have enough people to do the jobs we are demanding of them in the NHS today. One Junior Doctor is quoted today as saying he is ‘falling down with exhaustion’ – and he isn’t alone.
Is this really what we as patients, as taxpayers, as citizens want? An Ipsos/Mori poll out this week reported that more than 2 in 5 people would pay more taxes to fund the NHS. Fifty-three percent – more than voted to Leave the EU – favour increasing National Insurance payments to increase NHS resources.
So, why are we waiting? And what are we waiting for? These problems can’t wait for Brexit to be sorted out. They need tackling now. Call your MP; do everything you can to help Mrs May see the problems she is missing, veiled by Brexit and an overly optimistic Health Secretary.
Joy
Joy! Who would have thought it? It was a happy gathering: women coming together to protest about Trump’s stance on women and the inherent threat to women’s rights – and, by extension, to human rights. The atmosphere was light and smiling, even though the message was serious. The placards were funny too: ‘Ovaries Without Borders’ was one; ‘This pussy has claws’ was another. Joining in with the small crowd of women gathering around Nye Bevan’s statue in Queen Street Cardiff on Saturday was a very positive experience. The sun was shining and the sky was that bright blue that almost shines too. And it was cold!
I felt both glad to be there, and a bit sceptical. But I had (just!) finished knitting my ‘pussyhat’ and was determined…And then, it turned out that the women there were really, really nice. Not at all like the embittered doyennes of the hard left I had half expected. These were regular women. Real women. And from all over: the woman next to me, a New Zealander, had travelled from Bristol – to make sure her presence was ‘counted’. Arrangements for the Sister march in Bristol had been slow to materialize and so, she said, she had come all the way to Cardiff to make sure she was making a stand that was noticed. That’s commitment. Women of all ages, with their toddlers, their grand daughters, their friends – and their male supporters too (‘Brothas for Sistas’).
People were open and friendly, welcoming and chatty to each other. And as the number of pink hats grew, people complimented each other on them. No competitiveness, no one-upmanship – just pure togetherness. So unexpected and so joyous.
It was wonderful to experience. The feeling of support. As an immigrant ex-pat American, one can start to feel a bit isolated at times like these, when US policy pronouncements or actions become particularly negative – ‘Shock and awe’ statements, etc – and now Trump, the most divisive figure yet to emerge, and the most hateful, it has to be said, because that is his currency. So, in feeling so embarrassed for my country and my people, I expected some disdain and even disgust. But no, none of that. Just positive vibes from all sides of the crowds.
Of course, there were the usual speeches, impossible to hear ‘What did she say?’ and then ‘It doesn’t matter’, but with a smile – and, of course, it didn’t. We were all there together, and knew why. It was the being there that mattered. I was so proud of those women, in Wales, on Saturday – and so glad to be there. Thank you one and all. And thank you Women’s Action Network for organising the event. I think we have a busy 4 years ahead so don’t throw your hats out just yet…
US Election Result 2016
Well I am devastated. Sickened in fact; horrified and disappointed and shocked. And that’s not the half of it. It is indeed Brexit Plus Plus Plus as That Man promised it would be. I can’t face reading the papers. The radio and TV are off unless there is a non-news programme to watch-which means we keep missing the weather forecast. Fortunately the weather is being kind to us and the sunny dry days mean we can keep escaping on our bikes and forget about this awful unbelievable awful event for a while longer.
I didn’t think it could happen in America. I was shocked and shaken by the vote to Leave the European Union but put it down to social conditions peculiar to Britain and our ever widening inequalities.
Now I feel we are in the throes of a major disturbance, politically and socially: a seismic social change seems to be taking place around us. People seem to be digging their heels in, saying ‘I’ve had enough’, ‘I won’t be pushed around any longer’. And, if that’s true, I support that sentiment.
What I can’t accept though is that it comes alongside such hatred and abuse – of women, of blacks, of Muslims. And maybe too of all of us who have enjoyed so much privilege for so long.
Yet, at the same time, I have also been longing for revolution, for so long. I couldn’t understand why no one was rioting in the streets as this narrative of austerity as the only way to handle the Crash was perpetrated and accepted. That workers had to bear the brunt through wage caps while we bailed out and supported the banks. While welfare claimants and the sick and disabled were vilified for needing our financial support. While immigrants were blamed for ‘over-burdening’ our NHS when the real villain was the cap on its resourcing. Britain is better than this. And so is America. I thought.
But in trying to understand and come to terms with this outcome, I hit a huge stumbling block. I am furious. I am revolted to the core. I can’t look at a picture of That Man without retching yet. All the while I am trying to find compassion and understanding and acceptance. Digging deep to try to ‘Be the change I want to see’, to find and to show the grace that Hilary Clinton and Michelle Obama give seemingly so effortlessly. I will keep digging. There really is no other way through. It sure ain’t easy…
acyiqeb 
Recent Comments