Health and Social Care

Today I attended a meeting on the newly proposed Health and Well being campus in the grounds of the community hospital.

There were many good proposal, improved outpatient care, good public health and proposal for medicial assessment and the new Grove House Doctors Surgery.

The downside to the proposal was the reduction in bed numbers from 16 to 8 beds with an additional 2 beds for medicial assessment and 2 beds for amulmatory care.

There was no real discussion on the social care, this is a major challenge for the coming years.

The truth that came from the meeting was the very real challenge that will face the NHS in the coming few years.

Somerset health services has to reduce its expenditure by £200 million in today's money terms over the next five years.

The Health and Social Care Act has further complicated the future provision of health services, it would appear that there is no current advice from the department of health in relation to capital investment in new health centres, further to this the site and buildings are owned by the NHS Proprtty services Ltd, any future provision will have to be agreed with them and of course they are now having to maximise their income, the Somerset Clinical Commissioning group will fund the new facility with another provider supplying the staffing.

Grove house Doctor surgery wishes to build its own buildings.

We must ensure that Shepton Mallet receives the best healthcare, that offers the patients and their families good quality health services, that includes maximises the number of beds and good quality outpatient services, but also high quality public health advice that will give individuals the tools to have better health and save the NHS money.

We need to repeal the Health and Social Care Act and replace it with a set of policies that genuinely puts patients first, rather than markets, we need collaboration not competition, services before profit.

That is the choice.

A decent housing choice

Today Rachel Reeves made a speech that exposed the failing of this government policies on housing and welfare.

The remodelling of employment, where a growing number of workers are in insecure jobs, that are part time and low paid with the result of tax payers having to pay for this governments failure.

The recent figures that showed in the Wells constituency 38% of workers earned less than a living wage, with the average wage around £17000 pa.

Rachel Reeves, the shadow work and pensions secretary,  says that the number of working people claiming housing benefit is due to double between 2010/11 and 2018/19. Her figures, which are drawn from the House of Commons library, show an increase in working people claiming housing benefit would cost £12.9 bn – or £488 for every British household between 2010/11 and 2018/19.

The bulk of the increase will come in rent subsidies in the private sector and, in part, reflects the number of people in part-time or low-paid work. Housing benefit makes up about 14% of welfare spending, much of which goes into the hands of private landlords.

It is likely that the number of working people claiming housing benefit is set to double, this because the Tory government has failed to tackle low pay, insecure work and the cost-of-living crisis, with the consequents of thousands more people are being forced to rely on housing benefit to make ends meet.

The tax payer is effectively handing their taxes to private landlords with no assets accrued for the tax payers investment, just redistributing wealth from those who do not have to those with wealthy assets.

To continue on this course of low pay insecure work will lead to higher welfare payments, it is obvious that a change of approach is required, we need a government that will tackle low pay, raising the skills of workers, this must lead to an increase in the minimum wage and move towards the living wage, a basic requirement in making work pay.

The housing market needs to be rebalanced, it is unsustainable for the current (over) ten times annual salary for the average house price, with the gap between wages and house prices increasing.

It is clear many, many more affordable houses need to be built, without action the current housing crisis, will get worse, with the welfare budget increasing with little benefit to the tax payer or for the local communities.

 

Nothing to offer

The last four years has seen government devoid of ideas, we have seen cuts to essential public services and further marketisation of society.

The architect of public sector reform Oliver Letwin has made it quite clear the direction of the governments policy, that discipline and fear was the prescribed medicine, this means schools and hospitals closing driven by markets, this would not happen by accident, Letwin says that some of those running schools and hospitals would not survive the process and that it was an "inevitable and intended" consequence of government policy. This is why the Health and Social care Act was passed to introduce competition law into the NHS, allowing private profit and making cooperation and collaboration harder.

As Letwin says "If you have diversity of provision and personal choice and power, some providers will be better and some worse. Inevitably, some will not, whether it's because they can't attract the patient or the pupil, for example, or because they can't get results and hence can't get paid. Some will not survive. It is an inevitable and intended consequence of what we are talking about."

To translate for you, if your local Academy school has a falling intake of students and closes (this maybe just down to low birth rate in your local area), then tough this is an inevitable and intended outcome to government policy and your child can travel to another school outside your town..

Likewise the government sees that it is important to add more flexibility into private sector jobs, with the growth of zero hours contracts, part time working. This government has made it harder to fight unfair dismissal, this obviously is the much needed fear and discipline to make us more productive.

Yet despite years of this fear and discipline the UK productivity is low, in fact still below the 2007/08 rates and about a fifth less per hour of our competitor nations.

One sector that has not received the fear and discipline is the banking sector, the sector that created the economic crash and the same institutions that received hundreds of billions of pounds to keep them afloat, yet has failed to release finance to allow business to invest in their businesses.

Those who has most have the most have received tax cuts on their income, this is based on a government who believe in trickle down economics, yet we see that the average families are £1600 a year worse off in this parliament, now the architect of discipline and fear, is leading conservative thinking on taxation, Oliver Letwin is now arguing for flat taxes. This simply put is one level % of tax everyone should pay, we know the Chancellor Osbourne likes flat taxes, again this would benefit those with the most in our society and those who already enjoyed a tax cut.

The Institute for Fiscal Studies calculates that in order to raise current tax revenue, a flat tax on income would have to be set at 31%. People earning between £10,000 and £41,865 a year currently pay 20% in income tax. At the other end of the scale, it would mean a significant tax cut for top earners, who currently pay 45% tax on earnings over £150,000 a year.

This is why the cutting of public is spending by this government is important to them, under cover of austerity and deficit reduction is the restructuring of public services and spending, this will in turn will lead to lower taxation with the leading lights of the conservative party now arguing for flat taxes, this is regressive benefitting the most wealthy at the cost to ordinary families.

The Conservatives believe in crude blunt instruments to support the most wealthy in society.

This Conservative government has not restructured the banking system, not rebalanced the energy market, not rebalanced the housing market, not tackled the lack of productivity within our economy, or made childcare costs more affordable, we have a government that shrugs its shoulders and argues about ill defined problems, research and independent facts are not friends to this government.

We have ten months until the election, surely government has to be more about tackling the fundamental issues that affect our society, shrugging shoulders and talking about myths are not enough, it is time for change.

 

Why we need good public services

To quote Led Zepplin ' it's been a long time' since I blogged, I went on holiday and then broke my collarbone, in a bicycle accident.
I learned something from this accident;-
That I'm not so young as I was, bones don't mend quite as quick as they did.
Secondly, how important it is to wear a bicycle helmet, even on short rides, something I did not do, so  I conclude I'm a lucky man I landed on my shoulder!
Thirdly, how good public sector workers are, the ambulance was there to patch me up within minutes, then the care at our local community hospital, just one note here, the nurse couldn't order a chest        X-Ray, but could if I had gone to Frome, seriously odd. I then was transported by ambulance to Yeovil hospital where I was taken to the crash unit, seemed a little over the top, I think they thought I'd punctured my lung, the staff were amazing.
I'm now starting physiotherapy, so with a fair wind back to work in two weeks.
Surely this is the strength of good public funded services, no one could predict I was going to fly over my handle bars and need medical help, the care I received in financial terms must of cost a tidy sum, but a publicly funded health service was there, I was treated as a patient not what my insurance covered me for.
This is what makes the NHS so important, I work and happily pay my taxes and for this when I need health care it was there for me, surely this is a fair deal, having said that I hope I don't need it again, breaking bones is just too painful.
Oh yes and public servants need to be paid well, my gratitude is measured in gold!

Response to the Journal report on the Living wage

The recent report by the Trades Union Congress that showed the extent of the low pay that blights the local economy.

In last week’s Journal our local MP Tessa Munt, exposed her complacency and dismissive attitude on low pay, in the Wells constituency nearly 4 people out of 10 earn less than £7.45 an hour.

She seems to thinks it acceptable for low pay for part time workers and those in the service sector, every worker should earn an acceptable wage, these workers should not be deemed to be second class. 

The Joseph Rowntree Foundation’s recent research shows that the cost of a minimum living standard has increased by a quarter since 2008, this to rising costs; in food, energy costs, housing and cuts or freezes to tax credits and other in-work benefit. This means the pressure to raise wages has become even greater.

The growth of insecure, part time jobs has further undermined wages.

Low pay is a symptom of economic failure, yet it those who are paid low pay are those who pay the price with poor living standards.

This week the Financial Times stated that productivity in this country is 20% lower in this country than other leading economic countries in recent years. This shows how the coalition government has failed to invest in regional infrastructure, failed to help business to attract finance from the financial sector, failed to increase training opportunities in the workplace.

It is obvious that government has to do more in providing affordable housing and reducing childcare costs.

The economy cannot afford not to invest in supply side measures such as training, as only a high skill productive economy can pay better wages.

It is clear that this government and our local MP has failed to focus on the issues that affect low paid workers, they have failed to tackle the utility companies and their huge price hikes, not invested in child care, they have cut in work tax credits and done very little to tackle the housing crises.

 

Low pay a blight on our economy

Britain has a larger proportion of low-paid, low-skilled jobs than most developed countries, and the number is likely to increase. People who work in these low paid jobs are more likely to face insecure contracts, and less likely to receive training.

It is now fifteen years since the National Minimum Wage (NMW) was introduced, the NMW was introduced to set a legal minimum wage, to stop what Winston Churchill said was to stop the bad employer under cut by the worse.

However, since 2008 the rise in the NMW has constantly failed to keep up with inflation. In real terms it’s been going down for six years. This year the adult rise is 1.9%, against an inflationary backdrop of 3.2% RPI and 2.8% CPI.

It is clear that higher inflation than wages has a higher impact on low paid workers as they are likely to have little or no disposable income, but face the same hikes in their bills such as energy, transport and child care costs.

The Joseph Rowntree Foundation has said “Our research shows that the cost of a minimum living standard has increased by a quarter since 2008 – thanks to rising costs and cuts or freezes to tax credits and other in-work benefits. This means the pressure to raise wages has become even greater.

Today the Trades Union Congress (TUC) has produced a report detailing the problem of low pay, it is clear that the NMW is no longer an income people can live on and it is widely recognised that a Living Wage is required, the TUC says this should be £7.65 across the rest of the UK outside London – but in some parliamentary constituencies nearly half of the people working there earn less than this.

In the Wells Constituency 38.1% of workers are paid below the Living Wage, nearly 4 out of 10 workers are earning less than it is reasonable to live on.

TUC General Secretary Frances O’Grady said: “Extending the living wage is a vital way of tackling the growing problem of in-work poverty across Britain.

“Working families are experiencing the biggest pressure on their living standards since Victorian times. Pay has been squeezed at all levels below the boardroom and it’s costing our economy dear.

“The number of living wage employers is growing rapidly and unions are playing their part in encouraging more employers to sign up and pay it – but government must show equal initiative. We need to see a far greater commitment to pay the living wage from government and employers, and modern wages councils which could set higher minimum rates in industries where employers can afford to pay their staff more.

“During Fair Pay Fortnight we’re asking workers to back our call to MPs to get all political parties to put decent pay at the top of their agendas in the run up to the election.”

It is clear that in a decent society a person should be paid enough to sustain a acceptable living standard.

However pay is just one aspect of the low pay problem.

There are other steps that are needed to create a convincing approach to in-work poverty:

reduce childcare and housing costs;
improve the quality of part-time jobs;
improve training opportunities for low-paid workers to allow the opportunity to higher-paid and more stable jobs.

It is clear that this government and our local MP has failed to focus on the issues that affect low paid workers, they have failed to tackle the utility companies and their huge price hikes, not invested in child care, they have cut in work tax credits and done very little to tackle the housing crises.

Today we saw the difference between low paid workers having to watch every penny and a complacent out of touch government that sold off the Royal Mail for hundreds of millions of pounds less than it is worth to city institutions that has made a fortune.

Sadly we have a government and a MP that's stands up for the wrong interests.

A hospital job

Tonight the Town Council held a meeting concerning Shepton Mallet's Community Hospital.

I unfortunately had a meeting in Wells at the Scrutiny Board for the District Council.

I did manage to get back to engage in the debate.

It is clear that the people of Shepton value their hospital, sometimes I wish the people who run the NHS appreciated it as much.

Let us be clear, our community hospital delivers excellent care, our hospital has high occupancy rates and is a sense of local pride.

I know through personal experience how difficult it can be for those people who suffer a stroke, but of course it is not only those people who suffer from a stroke, but their families who also suffer, the concern and the heartache, just imagine if you, a suffer of a stroke and your loved news cannot visit because they do not have transport?

Then also imagine how this impacts on the stroke patients recovery.

But also how good is the back up community services, the stair lifts, the changes in the home to allow the stroke suffer to live their lives, with dignity. Then how good is the nursing care to be given in the patients home 24/7 or 15 minutes 3 times a day?

Let us be clear, the risk to our beds in Shepton Hospital comes from the Clinical Commissioning Group, this is the body that buys care on our behalf. This risk to our hospital beds is simply about money, it is where they choose to spend our money.

The Conservative party and the Lib Dems introduced the Clinical Commissioning Groups through the Health and Social Care Act, the privatised and marketised NHS, a NHS of providers and purchasers, these changes were said to put the patient first, yet as we are seeing in Shepton, the patients are neither consulted or important, because the Clinical Commissioning group knows best.

I remember Dr Bourke defending our local hospital back in the early eighties, he was magnificent, with the suites sent with a flee in their ears, do we see the same resolve of our GPs today?

It is so important to defend our hospital beds, the Town Council voted unanimously to tell the Clinicial commissioning group, hands off Shepton beds.