Day of the Ed

Having satisfied myself that I can’t separate my work from my politics, I have a somewhat indulgent post about the current events of the day. I’ve been following the Labour Leadership contest with intermittent interest.

Since the election the interregnum between Gordon Brown’s resignation and the assumption to the role of leader by  Ed Miliband has given the coalition time to ride out their ‘honeymoon’ period. At the time, I thought it might have been better (although I don’t think the Labour Party constitution would allow it) for another leader to be crowned as soon as possible. In retrospect, I can see the benefit of having had the hustings and debate about the leadership and more importantly, the time for the Coalition to ride out the initial positive freshness and have a strong leader in place for the upcoming spending review and into the future.

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I am no wise political pundit – I was always expecting a Miliband victory – just not necessary that particular Miliband..There was the curious factor in having two brothers fight the election against each other and in a competition between two Eds and two Milibands, I suppose it satisfies a certain neatness to have the candidate who is both an Ed and a Miliband win. Away from the flippancy,  I expect an intellectual rigour and broad understanding of policy. The noises made seem to be fairly positive and, as the election proved, the electorate needed change and if I had had a vote, I would have voted for him.

I don’t really need to explain my views about Balls – I have elsewhere and I won’t ever be able to shake off my distaste for him. I find him below contempt.

I respect Diane Abbott as a politician and have for a long time. She is a welcome face of diversity among the candidates – not just as a black woman but because of her background politically. She is a strong conviction politician. I hope she has a place in the future of Labour and that her voice remains strong although I don’t really have much doubt that it will – it’s just a matter of  how closely she is held to the centre of the power axis.

Burnham was a bit bland in my view and I didn’t really know where to place him but I’m not a long-standing Labour activist. My only ‘contact’ with him was a Secretary of State for Health and to be honest, he didn’t have time to make a deep mark. I have no doubt he’ll pop up again.

So back to  the Milibands. David, possibly lost out by being more closely associated with the previous government and the backing of Blair possibly didn’t help him in the wake of the publication of  Blair’s memoirs but ultimately, the race was just so close that any number of things could have affected the result one way or the other.

Ed placed himself to the left of David. He spoke more about grassroots and not losing sight of the Labour movement from which the party grew. David, as the more senior politician was more closely linked to the previous government and her policies – some of which, especially the military action in Iraq and Afghanistan and deeply unpopular. Ed is a little less tainted by association.

The whispers have already started about the place the union and affiliate membership had in the electoral college system that Labour uses to elect a leader. I expect they will continue for a long time. As a union member, I don’t see why the positions of the unions shouldn’t have value. Although there’s a massive difference between union member and union activist (which I’m not really – although I’m beginning to feel maybe I should be.. ). Lots of the target centre voters are union members as well – they aren’t the sole domain of the blue collar classes. I have a feeling unions may become ever more important over the next few years as well as the cuts bite and it’s worth remembering that union members are people with votes too and shouldn’t necessarily be discounted so readily by the press.

From here, I wish all the candidates well, especially the new leader of the Labour Party. Personally, I hope he’s able to restore some of my faith in the Labour Party.

On a more fraternal note, I wonder if it’s the first time that the winning leadership candidate told his closest rival that he loved him on stage.

Liberating the NHS – some thoughts

There has a lot been written since Lansley announced the new government White Paper on reforms to the NHS called ‘Equity and Excellence : Liberating the NHS’ My hesitation in summarising the points immediately came partly because the thought of another ‘transformational change’ was just about grinding my brain into smithereens. I don’t have enough digits to count the transformations and reconfigurations that have been planned and actioned over the last 10 years of my practice. I haven’t actually read the White Paper – work has been tiring! I have read a few summaries though so that will have to suffice as far as analysis goes until I find some more hours to plug into a day!

In very brief summary, there is talk of GPs taking over the commissioning of care and services in consortia and the abolition of PCTs. Hospitals will be forced to become Foundation Trusts and these Foundation Trusts would be able to lift the limits they currently have on provisions for private patients.

There will be an independent NHS Commissioning Board which will oversee the processes and public health functions will be handed back to the already overstretched (remember the council tax freeze!) local authorities.

More responsibility for the integration of health and social care services will fall back to local authorities and the Financial Times quotes Lansley as claiming that some of the expertise for commissioning mental health services might exist within local authorities saying

There were “sufficient synergies” between mental health and social care for councils to provide “very good support” for mental health commissioning, he said.

The problem is that we can very well assume that there will be little ring-fencing of local authorities already over-stretched budgets. Cuts are coming hard and fast. Supposedly the NHS and health budgets were protected. Local authority budgets are fair game.

Rethink and MIND have both issued statements raising concerns about the expertise that might exist in primary care to commission mental health services.

With Rethink’s press release explaining that

Rethink discovered that only 31% of GPs feel equipped to take on the role for mental health. While three quarters of GPs say they can take responsibility for diabetes and asthma services, less than a third felt the same for mental health services.

Rethink is concerned that unless there’s a national plan to up-skill GPs in mental health many of the 1.5 million people with severe mental illnesses may fail to get the treatment they need.

Meanwhile, Paul Farmer, the Chief Executive of MIND issued a statement saying,

“Transferring powers for commissioning to GPs presents an opportunity for them to develop mental health services that meet local needs and give patients the choice they want.

“However, GPs currently lack the specialist mental health knowledge and training to understand the complexities of mental health commissioning.

“There are already huge variations in the standard and types of mental health care patients receive depending on where they live. For example, access to talking therapies remains patchy, with people waiting months and sometimes years for certain treatments while antidepressant prescribing has soared. Any structural changes must not widen inequalities.

“GPs already have a heavy workload and asking them to add commissioning mental health treatments on to their to do lists will be an extra burden.

“It’s crucial that these new responsibilities don’t cut the amount of time they spend talking to patients.”

I wonder if it will be a case of those who are able to ‘shout loudest’ for their services will be the first to benefit from ‘choice’.

While supposedly this choice will be market-driven, it’s worth looking at the past experience of the  implementation of the ‘care management’ model of social care which was supposed to add purchasing power to social workers and institute a purchaser/provider split between the local authorities and a more extensive range of providers. What the free market managed to do in these circumstances was absolutely gravitate to far fewer choices by larger private companies who were able to drive costs down by employing temporary staff on minimum wages to provide personal care services.

Putting the budgets in the hands of social services teams led to the extension of ‘procurement teams’ who took bids from the private companies and forced the prices (and quality of care, incidently) lower and lower.

Unsurprisingly, these changes make me nervous. Not just because change is so very tiring but it is also costly in terms of consultancy fees.

Dan Parton in the Social Care Blog excellently summarises some of the implications for social care in general and basically finds that there is a span from very little to absolutely nothing mentioned about people with learning disabilities, mental health problems and dementia in the White Paper.

He ventures a guess that possibly these services will be mentioned separately at a later date but it is a very tentative hope. The problem is that the people who use these services are not the ones that the Health Secretary is likely to be thinking will be clamouring to support him.

The Shrink at Lake Cocytus also summarises his response. Again, there is the sense of reconfiguration fatigue that I can absolutely and completely recognise in my own reaction. He extends his fears that the commissioning processes which can be enormously complicated and time consuming will be picked up by large multinational companies who will happily – at a fee – do this job.

The other element packed into the White Paper and mentioned by Community Care is that NICE (National Institute of Clinical Excellence) will be given more powers to ‘drive improvement in social care’. This of course begs the massive question about the position of the current ‘Social Care Institute of Excellence’ and whether will be still actually exist or be consumed by NICE. While SCIE has charitable status and therefore has some independence from the government, if all it’s functions are taken over by NICE – and NICE having further statutory functions – it makes one wonder what might be left of the more distinctive SCIE and whether it is a sign of things to come where social care is marginalised further.

Indeed, SCIE’s response to the White Paper seems a little defensive and nervous

With regard to our future role, as care services minister Paul Burstow has made clear “SCIE … continue to have a role but it won’t be the same role they played directly alongside NICE in the past”. SCIE provides a wide range of services – including supporting the development of quality standards alongside NICE.  As an independent charity we explore innovative approaches to deep-rooted challenges (eg our new approach to serious case reviews in children’s safeguarding). We provide practical, accessible, evidence-based support to frontline care workers through our guides and learning materials, including digital solutions such as Social Care TV. Crucially, we capture and analyse information about latest developments in social care – and share that quickly with the sector (eg our updated guide to personalisation captures the latest developments in how to transform adult care services).

We will work closely with Department of Health and social care organisations to ensure that the personal care and support – as well as the health care – needs of individuals are supported by the reforms within the White Paper. We have the contacts and knowledge needed to ensure this happens.

There is a sense of ‘look, look, we ARE useful – we ARE doing good things’. I think it would be a shame as personally, I’ve found SCIE information very useful.

Indeed, David Brindle, in the Guardian expresses some of these concerns in a piece earlier in the week. , in a piece frighteningly titled ‘Is social care about to be swallowed up by health?’. It’s a look ahead at some of the possibilities that may lie ahead for the social care sector and it doesn’t look rosy.

I can’t say that the investigating some of the details of the White Paper has left me with anything except trepidation and a wish to fight and challenge some of the implications that haven’t been expanded upon yet.  I see it as absolutely crucial that the needs of those with social care needs are not forgotten or left behind through this process.

Interesting times.

The Road to May 6

The long weekend is over but it doesn’t quite feel like a ‘back to work’ sensation yet. A pleasant weekend was had but the weather wasn’t terribly clement – no matter – a few days off work can never be a bad thing..

And we have the news that an election is going to be called this morning. Gordon Brown will meet with the Queen this morning and ask her to dissolve Parliament. To say it was expected is an understatement but I’ve always rather enjoyed the build ups to the General Elections. I missed one when I was living overseas but generally, I like to take an interest. I’m rather glad we have a set four week period for electioneering though – sometimes it seems to drag a lot in the United States where there are fixed terms.

The alternatives all seem a little drab at the present. I’m pretty sure I know which way I will vote. I’m also pretty sure it won’t make a blind bit of difference in the constituency in which I live – which is a very safe seat. I am, as always, determined to vote even though the vote might seem to be ‘wasted’ as at least it will figure in national statistics and the like – and with London local elections on the same day (although I suspect they are fairly safe in my ward as well) there is more possibility of a move on that basis.

For me, it seems that the certainty of a Labour defeat is far shakier than it was. I can’t help but feel bitter towards the government (Ed Balls, I’m talking to you!) and their abandonment of what I would have termed Labour principles. Working from inside the public sector, in an agency which has been a political football – I wonder if some of the damage that has been done will ever be able to be undone. Hard decisions haven’t been made when they should and could have and there has been too much pandering to the mob mentality. Targets, targets and more targets have been crippling at work. And there are very real effects on the day to day life of people who should be served and protected by public services.

For all of Labour’s disappointments, I find it much harder to stomach the Conservatives at the moment. Not least because they have presented themselves as a train wreck party without a clue about how to actually appeal sensible policies (obviously this is my opinion – many people would view their policies as sensible) but also because they did far more damage in their last incumbency although that was so long ago now… I will watch them with interest though – see if there is any room for surprises although I’m more than a little sceptical.

That leaves the Liberal Democrats (I  have voted Green in the past but never in a General Election, I have no time for UKIP whatsoever). They certainly feel the most akin to some of my own thoughts and ideas naturally but it’s easier to  make these statements if one is the smaller ‘third’ party without a chance of governing. I have to say I haven’t followed them too closely but that’s something I can remedy.

As I have done at each election (save one) since my eighteenth birthday (I was very much more interested in politics with a large ‘P’ in my youth!) I’ll secure myself a manifesto of the three largest parties and try and provide some of my thoughts as the week goes on – particularly in relation to social care and social policy –  but also covering other areas of interest.

Although looking at an election through the glasses as someone who works in a sector that is completely dependent on ever-changing boundaries and government initiatives and reliant on generally held paradigms of social policy, it will make for interesting comment nonetheless.

This will be campaigning about cuts and money-saving. Reducing deficits and chopping down the ‘public sector’, but I wonder if there will be any room for hope and expectancy among the policies mooted – any room for creativity and difference.

I approach this election less sure than I have been for a long while as to whom I will vote for. I also have more questions about policies and particulars than I might have had previously – the Labour Party has a lot of explaining to do about the last five years in particular – in my view and I want to be convinced and feel like a vote is a positive choice rather than an elimination of the negatives.

And so the starting whistle is blown. Let’s see where it takes us..

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Broken Britain?

I was disheartened at how quickly the appalling story of Edlington – where two young boys, aged 10 and 11, under the care of the local authority attacked two other boys and subjected them to what surmounts as torture almost to the point of murder – turned into a party political debate about ‘Broken Britain’.



Firstly, there is no doubt that the case indicated is sickening. I’m sure that mistakes were made by professionals – as much as been said openly. But for the leader of the Conservative Party to extrapolate, as he did in a speech last week, that it indicates that society in Britain is ‘broken’ and lays the blame on the current government, reeks of mean-minded opportunism and a poor understanding and analysis of the country today.

We shouldn’t forgot what the previous Conservative government did to break society and to break Britain – from the sell-off of social housing which has led to increased overcrowding and a more desperate rush for the homes that are available to the miners strike and breaking of the industrial base of the north of England, leading to greater divides between the North and South and the promotion of the ‘me’ culture.

Election

Living in London, as I do, we only have the European elections today while parts of the rest of the country contend with local elections as well. I have never missed casting a vote in any election for which I have been eligible to vote and I don’t intend to today. If I’d been a little more organised, I’d have registered a postal vote as the polling station is a little bit awkward to get to  but nothing I can’t live with.

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The European elections are often seen as a good route to protest and yes, I’ve voted for the Green Party before in a desperate attempt to find an A.N.Other option.

Truth is, the disillusionment with politics has cut deep over the past few months. It was probably fairly impressive anyway, but with the details of MPs claiming expenses for memorial wreaths at Remembrance Day events (which personally, I find more despicable than claiming for a duck island) and for ‘servants’ quarters’ there is a lack of faith in the political class.

There is a generalised fear that the far right  BNP will garner some of the votes of those who are disillusioned and really, that is my key motivator to vote – possibly because the system of voting by lists and parties is somewhat different for these elections.

So I’ll go to vote not least because there is more likelihood that the turnout will be low and therefore the votes cast will have more ‘strength’ and to register an opposite view to those based on the hard and dangerous right.

Like the rest of the country, I’m expecting a massive ‘no confidence’ vote in the government and possibly in all of the main stream political parties.

As for my own first choice vote, I’m still undecided. I’m a generally a liberal minded pro-European. I can never vote Conservative and have no inclination whatsoever to vote Labour. It usually deposits me at the door of the Liberal Democrats – who tend to appeal to my warm and fuzzy ‘social justice’ nature and probably will again today although I may be tempted by the Green Party again.

Thatcher and Dementia

I grew up in a household in which Thatcher was something of a dirty word. We were living in Yorkshire in a period of my childhood that coincided with The Miners Strike (83/84). As my father collected us from school, we had to drive through police checks and with his London accent he was often identified as a possible ‘flying picket’ even with  three schoolgirls in the car with him.

I remember that.

I remember the miners’ wives coming door to door asking for money to support their families during the strike

I remember returning south and trying to defend in my rather unsophisticated childish ways why the mines couldn’t close and how important they were to the people whose livelihood depended on them.

I remember the righteous indignation raised against a heartless Conservative government who had showed a callous regard to community and Scotland (I have a Scottish parent!) and anywhere that wasn’t London

I remember the excitement I felt, after the poll tax riots and the ‘stalking horse’ election that anyone other than Thatcher could be a Prime Minister. I grew up with her and was of a generation described as Thatcher’s children.

I don’t know if it is age that has changed my views or just a greater understanding of the nature of politics and politicians.

The revelation (confirmation really in the face of many rumours) that she has dementia made me sad all the same. Best wishes to her and her family.

image SouthbankSteve at Flickr