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By shalondon, Jan 15 2016 11:12PM

Dear Everyone


Wishing you a happy and productive 2016!


After the sheer joy of my friends in the Lewisham & Greenwich NHS Choir reaching Number 1 ( thanks to the publicity efforts of our member Neil Nerva's daughter Harriet and the lovely Joe Blunden from Lewisham Hospital's comms team ) London has suffered the sudden joint loss of super-talents David Bowie and Alan Rickman in a sad and surreal synchronicity - even down to them havng the courage to hide their medical conditions from the wider world, despite the challenges that must have brought. Those friends who have shared touching anecdotes of working and social encounters with them have demonstrated just how important thoughtful personal connections are in life. Here is a most touching tale about our late Labour friend from Peter Hyde MP.


In the political and health field we have certainly found ourselves in the midst of an instant flurry of activity.


On the down side you will of course have seen that within just 8 days of the new year that UK has already breached its full annual quota of NO2 - the worst offending places ( recorded ) being in London @CleanAirLondon


The monitoring equipment in Oxford St, which was in all probability the first to fail the target mysteriously broke down the day before the recording was due. On past track record where particulates have been attacked by water/glue to stick them to the pavement away from the monitoring device, this is unlikely to be a coincidence. Putney High St then came in as a close second.


it is for every good health reason that Sadiq Khan highlights the need to address London's air quality as a matter of urgency.


Sadiq Khan Campaign

Many of us were out bright and early on return-to-work Monday morning distributing leaflets about the Boris fares hike - and more of this is in store!

On the first Thursday of the New Year I joined more than 100 other Londoners at the new Sadiq Khan operations base in Westminster, fast followed by the first Sadiq SuperSaturday which was hosted by Hammersmith CLP. The positive response from voters we spoke to was an exciting start to what I know will be a 2016 ccampaign fizzing with energy and dynamism.


The Sadiq Khan Campaign phone bank - with added biscuits and banter - takes place each week on Mondays and Thursday 6.00 - 8.00pm.

If you would like to volunteer to help in phone banks or at the many doorstep sessions which are

planned - here's the place to do it


the London Region Consultation Event just prior to Christmas, which was well attended and very productive. SHA London submitted a paper outlining the key current and future challenges to the London health economy and a range of suggestions to counter them,


Meetings

Now that the hectic autumn and shuffles are behind us, I am once again able to plan a calendar of events around Shadow Health diaries. The first two are :


Tuesday, 26th January 6.45 - 8.45. House of Commons

Maintaining public health in the face of a falling budget

Shadow Minister for Public Health, Andrew Gwynne

Hammersmith & Fulham Air Quality Project

Labour Campaign to End Homelessness

Murad Qureshi AM

All welcome - as usual we will also be inviting our friends from relevant affiliate group


February meeting - 9th February 7.00 - 9.00 House of Commons

Shadow Minister for Care, Barbara Keeley

Fiona Twycross AM

Hammersmith & Fulham Council care service rep.

Care specialists tbc


At Central Council in Bristol it was decided that the national SHA will campaign on the care crisis - so this meeting will now fit into that project.


Labour Campaign for Mental Health @Labour_MH

We are planning to continue our working partnership with the LCMH which will link up with the work of Luciana Berger - you will I'm sure have noted the debate she held which highlighted the crisis in the service - and particularly CAMHS. Norman Lamb had attempted to do something the previous week, but the fact that he is one of the architects of the previous governments' assualt on these services is not exactly a positive calling card.


Junior Doctors #juniorcontract

Of course the most high profile issue at present is the Junior Doctors Contract - and the revelations by the Independent's Charlie Cooper that Hunt had pressurised Sir Bruce Keogh into introducing doubts about commitments to a rapid response to terror in the event of strike action - which for me holds shades of their similar manipulation over the Lewisham Hospital issue where '100 lives saved' figures where misappropriated.

You may also have seen the clip on our News page which shows a Dept Health spinner telling a Sky reporter that he may not ask where Jeremy Hunt has been hiding. A quite extraordinary occurrence.

Since the large demo on October 17th which I know many of us attended, the issue has hit the national consciousness like no other - and for very good reason.

Now we sadly find ourselves in the midst of the first industrial action by junior docs in 40 years, purely in the face of Hunt's outrageous tactics and brinksmanship.

Despite what Hunt and the media are saying, senior staff will ensure safety through providing additional cover.

It was good to see several of our members at the BMA for discussion about the issues with the BMA's Johann Malawana and many of us were out on the frontline at various hospitals across the capital. Johann Malawana @JohannMalawana and Roshana Medhian @RoshanaMN ( a really gt organiser!) are the ones to follow for the most up to date information.


Student Nurse funding #BursaryorBust

A good number of our members were on the Saturday march where we converged on St Thomas' before the march on Downing St with Shadow Secretary of State Heidi Alexander ( @heidi_mp ) supporting a large number of nursing students, unions and campaign groups.

London MPs Neil Coyle, Ruth Cadbury and Wes Streeting ( who was invited to speak ) and Assembly Member Fiona Twycross also SHA member ) accompanied in support.

@coyleneil @RuthCadbury @wesstreeting @fionatwycross


In London we have an increasing crisis with an horrendous 10,000 nursing vacancies


Aside from the government's mismanagement of the NHS, this is also due completely unaffordable housing costs which have seen such a huge hike under the 8 years of Boris' Mayoral tenure and which are impacting on the recruitment and retention of all key workers. If the proposed measures on nursing student funding, the junior contract and the compulsory return of migrant medical workers earning under £35k all go ahead, the NHS will clearly become a shell of its former self. I know that our members are highlighting all of these risks.


Housing

Sadiq has quite rightly highlighted this as a primary area of concern for London. As he said in the

Housing Bill debate last week, which the government manipulated into 2/3am vote - entrenching

£450k as an 'affordable' starter home is just unacceptable and indeed scandalous.


This was closely followed this week by the tragic vote which rendered the basic right to a decent home illegal - so as it now stands there is now no minimum standard of accommodation to which landlords must comply. This Dickensian model has serious health implications.


You may also like to check out the work Karen Buck ( MP, Westminster North @KarenPBuckMP ) is doing to highlight the structural and health hazards which go with the trend to develop large scale subterranean basements in old terraces.


Labour Campaign to End Homelessness

On New Years Eve, I joined the LCEH team to distribute essential food and warm clothing to rough sleepers in Camden & on the The Strand. Many had been looked after by Crisis at Christmas up until 29th, but we were told by The Met in very positive terms that we were the only team out working on the streets on NYE. Over 200 rough sleepers were engaged with - a difficult testimony to the fact that rough sleeping more than doubled during the last government. @LCEH2030


London Young Labour Conference

Our Vice Chair Dr Aysha Raza addressed Conference this year on a range of womens' issues - including the challenges for BAME representation within politics.


Fabian Womens Network - namely how to enable more women to become part of the political world.

On 19th January the 5 year assessment of the highly regarded Fabian Womens Mentoring Programme, founded by Seema Malhotra, will be launched. The Birkbeck report 'Footsteps in the Sand' gives us many examples of success.


The Fabians New Year Conference will take place this coming Saturday, 16th January.

There is a wide range of speakers, including Jeremy Corbyn @FabianWomen



Climate Change & Flooding

Our hearts go out to those areas of the country which have been hit by hideous levels of flooding. With the changing weather patterns no community can be deemed entirely secure, with very clear health implications. On Wednesday I attended the Select Cttee hearing where the Environment Agency chiefs were interviewed. As Angela Smith MP exclaimed after a v poor standard of responses

'who on earth appointed you to this post?!'. I'm sure our friend and long term member Rachael Maskell, (York Central @RachaelMaskell ) would concur.

We must now be thankful that Sir Philip Dilley has since resigned and can only hope a more suitable replacement will be appointed.


Climate Change and flooding is of course a health issue and we need to do our best to ensure that the government takes on board the urgent need to protect households and also re-consider further building on flood planes. Here is the London flood risk analysis supplied by our friend Murad Qureshi AM, Environment chair


Most worryingly, when seen in tandem with fracking, the public health danger is considerable because of the risk of contamination of the water supply. An article in the Independent today also reveals that insurers are planning to refuse to cover contamination costs to housholders living within 5 miles of any fracking site.


Given the government has signed up to COP21 - we can see that they are hardly committed to the principle.

Barry Gardiner (Brent N @BarryGardiner ) Shadow Minister for Energy & Climate Change heavily criticised their sudden change of stance - indeed a turn on a sixpence between Monday - Thursday of the same week.


For those of you who have been following the very sad case of 7 year old Zane Ghangbola who died in the Chertsey floods, it seems that evidence suggesting an attempted cover up of hydrogen cyanide has now been revealed by Leslie Thomas QC (who also acted for the families of Bobbi & Christi Shepherd who died as a result of CO poisoning in Corfu).

As a result, the coroner has now postponed the full inquest until June.


On the same day, there were 3 very interesting debates in Westminster Hall, all of which involved matters of health and human rights:

The appalling mistreatment of Palestinian children arrested in the night and imprisoned without parents present or legal help was highlighted by Sarah Champion @SarahChampionMP , supported by Andy Slaughter @hammersmithandy and a raft of other MPs from London and nationally on a cross party basis. As a result. she has now secured a full debate in the House of Commons.

Visits to The Jungle in Calais have been made this week by both Andy in his role as Shadow Minister for Human Rights and subsequently also Keir Starmer ( Holborn St Pancras @Keir_Starmer ). Andy secured a debate and also flagged up the even worse conditions in the Dunkirk camp.

The 3,000+ unaccompanied children are at great risk and based on my prior work as a children and young peoples' specialist I do believe that the whole situation is in breach of the UN Rights of the Child.

For those who cannot make the trip but wish to help in practical terms over and above donations, friends of my son who works in the theatre are holding simple shelter building workshops to replace tents in liaison with Medecins Sans Frontieres. Clearly we hope that these jungles are soon unnecessary, but in the interim a sturdy wooden construction will to an extent help to prevent the rise in disease and poor health in these sites. ..

Finally, Kate Osamor ( Edmonton @KateOsamor ) held a debate about the disgraceful treatment of women and children in Yarl's Wood http://www.bbc.co.uk/news/uk-33871283 - male guards are allocated to womens' quarters and maternity services are in a shocking state - as highlighted by the RCM.


Each of these debates highlights the dedicated work which Labour MPs are doing aside of the press focus on internal matters.


TfL Bill

you may have spotted that in his Autumn Statement, the Chancellor entirely withdrew TfL support funding which means he wishes the organisation to behave like a private company. This is of course deeply concerning for a variety of reasons.

The premise of the objections to the aspects of the Revived TfL Bill to engage in aggressive developer offshore agreements which will leave no community or householder safe from securing their property or environment still stand.

Their approach to dismantling the Earls Ct community and their lack of attention to health, safety and risk assessment in the Lewisham Gateway development give us fair warning.

You will also note that both Clive Efford ( Eltham @cliveefford) and Matthew Pennycook ( Greenwich @mtpennycook ) are opposing the current proposals for the Silvertown Tunnel on mainly environmental reasons


I will continue to work in this regard with Andy Slaughter, John McDonnell, the RMT and the other private objectors.

You can follow each phase - including its prior incarnation - here :


London Ambulance Service

I attend the LAS consultation forum.

You will be aware that the service is now under Special Measures following a damning CQC report in November, citing poor response times and a culture of bullying amongst other worrying issues.


The 20% paramedic vacancy rate due to a combination of inaffordable housing and workplace stress & fatigue has resulted in supplementary recruitment drives in Australia and New Zealand, which are attracting applicants, though many need re-training, which is slowing down deployment.

It is to be hoped that the new CEO Fionna Moore will be able to fully address these issues in the face of aggressive govt cuts.

@Ldn_Ambulance


London Fire Brigade Consultation

Whilst we would prefer that the cuts were not on the agenda - do contribute thoughts which may minimise their damage

Just prior to Christmas I was asked to speak at the Stratford Picture House on the Future of the NHS in a debate with a speaker from the Social Market who favoured privatisation and competition. The audience was largely in tune with the view I presented.

These events are organised by Cllr Susan Masters ( @NewhamSue ) who also runs Newham Save our NHS with which we have established links.


The NHS Bill

Previously known as the Reinstatement Bill, the NHS Bill 2015 is to be scheduled for a second reading debate on March 11.

This Bill is sponsored by Caroline Lucas


NHS Commission proposals.

You may have noted that on Wednesday Norman Lamb presented a Bill to bring health and social care together under an independent commission, staing that it would take the NHS away from 'political interference'. As I watched him I could not but help recall the times when he used to stare daggers at me whenever he encountered me from the Front Bench or in Bill Committees - or even in corridors.


To be frank, the thought that Alan Milburn, Stephen Dorrell and some of the sadly now more hard nosed charities should be running our NHS is for me deeply concerning. I'm not entirely sure this would be much of an improvement or have more of a chance of introducing those key measures which urgently need to be addressed - indeed, I fear it could increase the hold of privatisation rather than secure our services for the future.


This Bill is sponsored by Lamb and supported by all the Liberal Democrat MPs, by Caroline Lucas, Jim Shannon, Philip Lee and Ivan Lewis.


Finally we must of course not forget to keep an eye on TTIP developments - there are conflicting views as to whether the NHS will be safeguarded at EU level or whether we will be reliant upon our government to do so - clearly the current incumbents being big fans of opening up to futher competition and privatisation. The debate in the Commons just before recess shone a lens onto the insidious ISDS.


You will also find the details of the statement on the Southern Health deaths requested by Heidi Alexander of Jeremy Hunt just prior on the same morning.


We also now know that just 10 Conservative MPs have voted in an obscure committee to get rid of student maintenance grants - which will result in the least well off having to take out expensive loans and therefore pay more to access post 18 education than their wealthier counterparts. Yet again this government turns the good sense and logic on its head to create a climate of stress & intimidation.


With the dawn of 2016 barely over, one thing is clear we must above all be vigilant and focus our energies on safeguarding what we can from the most aggressive government in memory - and beyond.


Jos Bell

Chair, SHALondon



By shalondon, May 5 2015 08:38PM

‘Can the last 36 hours make a difference?’ asks Jon Snow.............


Surreally, we now have just 2 days to go to #GE20 15 – it barely seems possible to dream that after 5 long years of slog, battling the most insidious and damaging set of policies in living memory, that we are in touching distance of potentially taking the Tories out of power.


When long term right wing commentators such as Peter Oborne Tweet that the ‘Tory Party's uncosted and fiscally reckless manifesto shows that George Osborne still firmly in charge’ and that the ‘Tory manifesto also highlights Cameron's error in allowing post of chief political strategist and Chancellor of Exchequer to be merged.’ even Crosby must know he’s in trouble - which explains the vitriol of the final front pages of press bias towards Ed.


After 18 constituencies and 35 canvas sessions, I can see the ballot boxes are now in sight. But with heart in mouth – the key question remains :

What will the end result hold?


For Labour to win we have to tap into the fundamental reasoning of each voter -

I know the reasons I have taken an interest in current affairs since I was in primary school. I know the reasons I have been a Labour supporter since I left school (despite my family’s politics!). I know the reasons I support the NHS – numerous family members have been medical practitioners of one kind or another and I have worked for and with the NHS in various ways since I was a teenager on work placement. The NHS has also saved my life – more than once and has kept me going. Last week the NHS provided a family member with crucial life/death treatment. A nature /nurture fusion of reasons - personal circumstances and personal reasoning - which any political party has to tap into - or not.


Only because of the NHS have I been able to canvas and campaign – for Labour and for the NHS.


We all know that if Labour does not win the General Election 2015, we will be in grave danger.


A further 5 years of Tory ( or dare to speak the dread words ) a Tory/UKIP/DUP Coalition, will reduce our public sector and our NHS to rubble and the UK to a fragmented disunion, as Scotland at the very least, flees in disgust. Forget what Lucy Powell has gaffed this afternoon – the question is :


With the polls predicting what could even amount to a democratic crisis, what more can we do to minimise yet another Tory administration from taking hold?


For some, there is absolutely no compromise. Last week, the unmatchable ex chair of the Royal College of GPs , Dr Clare Gerada, told me that she could at last go public on her decision to resign from NHS England in order to campaign for the Labour party


‘We are at the tipping point for the NHS – I resigned from my post with NHSLondon in order to be free to explain the situation publicly. My visit to South Thanet and to marginal seats in London has proved to me that many at people still need to know the acute danger that we face if we do not have a Labour government next week.


The NHS is a national investment which helps to hold our economy together and we need a government who will rescue it from being consumed by the private sector. We must focus patients and only Labour will enable this to happen.’


Clare made an Election speech to the Royal College of GPs on Friday and her first fully public political appearance with Andy Burnham and Jo Brand in Ealing on Saturday.


Meanwhile Andy is conducting a whistlestop tour of the country – a boggling 15 rallies in 6 days – with travel time in between. On Saturday he went from Bristol, to Ealing to Norwich. Standing ovations are following his rallying words ......


’We’ve got the faith – let’s get the fight together! We are going to give hope! Pass the word on – get that message out!’


‘I’ve called time on this market experiment........ we are going to ask the NHS to lift up social care!’


‘our new Bill – which we are already writing, will fully exempt the NHs from EU procurement & competition law, it will put the right values back at the core – it will put collaboration before competition, people before profit – that is a firm commitment’


Ed Miliband also adds to the weight of the Burnham argument


On Sunday Clare and I went from Ilford North out to South Thanet to bother Nigel Farage. On Monday we did the London key marginals of Bermondsey and Battersea.


Aside from some much needed bracing sea air, our visit to the South coast was a salutary lesson in how far our nation’s politics have been tainted by Farage .....


‘I really don’t care!’ said one woman when I mentioned the plight of those who would not be able to afford private healthcare – or simply to be greeted by a sheer look of utter disgust from another doorstep dweller as soon as she opened the door. She was evidently a fan of the man who rhymes with her garage, but other than a performing a drunken song on a pub tabletop is rarely to be seen thereabouts. Another was just grateful that someone had come to speak to her about #GE2015 - the first time she had ever been approached by any party.


Local Labour activists are 100% behind their brilliant young candidate Will Scobie . Sympathetic voters say that it is only since the arrival of the UKIP leader have they noted that a few people feel they have permission to speak in an aggressive and prejudiced way instead of the usual polite & friendly approach in the community. With vigorous street teams #TeamScobie continue to press both UKIP and the Tories hard and it seems increasingly likely that Farage will not succeed, although UKIP founder turned Tory ,Craig McKinley remains the one to beat.


Nationally, Labour has already achieved well in excess of the planned 4 million conversations – and thanks to an army of thousands of volunteers, a week earlier than expected. Will Martindale in Battersea, fighting Hunt minister Jane Ellison and Neil Coyle fighting justice system destroyer Simon Hughes are running the best of campaigns. A combination of carefully targeted door knocking teams, Super Saturdays, bus tours and intensive phone banking is steadily moving the message into target communities. In other key marginals, a set of formidable new BAME women candidates, including Uma Kumaran, Tulip Siddiq and Rupa Huq are rattling those Tories to likely victory


As Labour has visibly gained ground, the hostile press ( sadly including the BBC ) is increasingly against us – to the point of Richard Littlejohn’s nauseating correlation between a Labour govt and Savile, to which I will not supply a link, but instead offer the fantastic Kitty Jones blog to provide us with the theoretical analysis of the politics of blame which lies behind all of this....


The Scottish situation is set to become the clincher. Clearly Sturgeon believes she is to be the broker, with Clegg potentially out to grass, courtesy of Labour’s Oliver Coppard – although tactical voting by local Tories now seems likely to bring him back ( sadly). So dubious Clegg could yet be the 'kingmaker'.


It will certainly be anathema for Labour to do business on the basis of full devolution, but clearly the Scots will expect far more autonomy in return for support in the Chamber, should the need arise. Labour has consistently stated that the SNP cannot be a full Coalition partner – meanwhile Sturgeon is doing her best to play the two main parties off against each other, which is making her seem increasingly untrustworthy to all but her Scottish supporters – some of whom have no compunction about using aggressive tactics of the far right.


Certainly across the English constituencies I’ve canvassed so far, there does seem to be an increasing focus on the two main parties in England – and with not only Steve Coogan but also Russell Brand speaking out for Labour. Flirtations with the Greens and even the previously ubiquitous UKIP seem to be more limited than was indicated a few weeks ago, as the polls lurch backwards and forwards across a knife-edge result, the best it seems likely we can hope for is a minority Labour govt or a Borgen-esque left leaning coalition, but only the results will tell.


To win the day, clearly we must


a Highlght Tory/UKIP shortcomings – especially where health & the economy are concerned, backed up by hard evidence.


b. Explain to doubters what Labour has firmly outlined – with 100 new policies there is plenty to go at!


To push as far away from a coalition scenario as possible, we need to maximise on the key differences between Labour and the Tories to pull ahead in those key marginals – while the parties all state similar objectives, the means of delivery are very different :


Tories :

Attack our NHS. Pro unaccountable market – pro TTIP, pro competition. Keep the H&SCA and Section 75. Not a single penny of the £8billion promised has been identified. Hunt now says it will simply come from a ‘stronger economy’ however we know that all the evidence points to them increasing cuts to acutely dangerous levels. Market is also v wasteful of precious funds.


Labour :

Defend our NHs via Repeal of H&SCA and protect the NHS from TTIP under the Rule of Sovereignty in the Treaty of Lisbon. Beef up HWBBs to take on joint working role to bring in aspects of housing, leisure etc under a healthy living banner. Bring 999, 111 & out of hours into one service. Re-establish medical training routes and especially GPs. Rescue care provision and create integrated model. Fully costed plan.


UKIP :

We all know that despite latterday protestations that UKIP support a free at the point of need model, that this in reality will mean a business model with insurance/means testing as per the US system.


LIB DEMS

Who knows. Whatever the mood strikes them - and even then they will deny everything.


GREENS

In want of a health policy of their own, followed the NHA and grabbed the uncosted Pollock Reinstatement Bill with both hands - this has much in common with the Burnham approach, but other aspects which deviate towards another untimely top down reorganisation which Burham believes will be too much for the NHS to bear at the current juncture ~ 'it will instead result in the collapse of the very thing they seek to save'.


Pollock also maintains this Bill is 'still in Parllament' and presents it to the great and the good as being the only health legislation on offer.

This is inaccurate for 3 reasons :

a. there has been no Parliament extant since March 30th

b new Parliament requires the presentation of new legislation

c. Team Burnham have legislation in preparation to include in the Queens Speech in the instance Labour form a govt - this includes the Repeal of the Health & Social Care Act & rescue of social care.



USEFUL DIFFERENTIAL REFERENCES :


IFS cut figs -

Tories cut £30 billion

LibDems cut £12 billion

SNP cut £6 billion

LAB cut £1 billion


For an additional barometer as to how far the NHS can make an impact in Tory heartlands - the odds on NHA's Dr Louise Irvine taking Jeremy's Hunt's South West Surrey constituency have just been slashed to 12/1.


One thing is clear - the 2015 General Election is on a cliff edge - and literally every vote will count as to whether we have another 5 years for the 1% or the opportunity to redress the imbalance through a Miliband - led government.


Finally let’s just pop back to London .....


NORTH WEST LONDON HOSPITALS - BURNHAM ANNOUNCEMENT


An interim report from the Mansfield Health Commission into the ‘Towards a Healthier Future’ reconfiguration has stated that the plans are ‘deeply flawed’



When Andy Burnham was in Ealing on May 2nd he stated unequivocally :


‘NW London is now at the frontline of cuts... this local trust has never met the government’s A&E target....A&E is the barometer of what is going on in local services – it tells you that your NHS services are in trouble.


We will call an immediate halt - there has to be a new clinical review.

It cannot make sense to close A&Es in the middle of an A&E crisis – it cannot make sense to close A&Es when they are packed to the rafters


My view is that it will be unsafe to proceed with those changes.


The lack of consultation ...and the way in which you have been treated... is quite shocking...

The NHS Constitution says communities have the right to be consulted – this falls far short.'


With fight like yours I think you will eventually prevail.’


Nowhere so clear is the difference between Tory greed and Labour social justice.


We have 2 more days to make this – and so many other measures we so badly need, happen.

I know you must be tired – but don’t stop just yet!


Please try and lend a hand in those key marginals...


Knock on those doors - make those calls – tell your friends and rellies – Tweet/Facebook/Blog!


WE ARE ON A COUNTDOWN TO SAVE OUR NHS!


WE ARE ON A COUNTDOWN TO RESTORE A CIVILISED GOVERNMENT!


Let's make it happen. VOTE LABOUR!


Jos Bell May 5 2015










By shalondon, Mar 23 2015 09:40PM

Take a case of a rapidly expanding population and the rapid shrinking of essential services...


Saturday 21st March marked the half way point of the Michael Mansfield Health Commission investigation into the so-called ‘Shaping a Healthier Future’ giant reconfiguration of the West and North West London hospitals infrastructure, which includes the seismic closure of 4 out of 9 A&Es – two of which have already bitten the dust before any other plans have been put in place, or indeed before the elusive business plan has been published.


This is all being done in contravention of the original NHS concept of universal healthcare in line with the needs of population.’ (Cllr Steve Cowan – Leader of Hammersmith & Fulham Council).


Just a few days earlier over 600 people had packed Hammersmith Town Hall to listen to a range of speakers share their passion for the need to Defend London's NHS


Witnesses to the People's Commission so far have included the leaders of both Councils and their cabinet members with responsibility for health; MPs Andy Slaughter and Stephen Pound (others were invited but declined ); campaigners from Save our Hospitals and Save our NHS; Tories with differing views from Hammersmith & Fulham and Kensington & Chelsea; hospital consultants; RCN & RCM spokespersons; patients and patient representatives – also local Healthwatch representatives.


The majority of witnesses at both sessions so far have offered a clear line of similar arguments and evidence – which is in part unsurprising, given that as the QC said on day one in Hammersmith Town Hall Council Chamber – ‘we have asked the local NHS to participate or at least respond on several occasions – but so far we have not had a proper reply’. This is a very different situation from the last inquiry, where the Lewisham People’s Commission, which included Baroness Mary Warnock and Blake Morrison along with Mansfield in the chair, heard evidence from Lewisham Hospital CEO, as well as from numerous consultants and nursing staff, also the CCG Chair.


Dr Mark Spencer’s name was repeated often – but in the context of ‘conflict not congruence’ ( Cllr Vivienne Lukey) - ‘Not one single Shaping a Healthier Future person could come out with access figures - evidently just plucking approximations out of the air and hoping for the best’


A series of chaotic approach descriptors emerged in both of the Hammersmith & Ealing Council Chambers......

There are too many known unknowns - but what is known is that other hospitals are operating to capacity’ said Hammersmith & Fulham Council Leader Steve Cowan


There appears to be an ‘awful lot of vested interest in not stirring up the public’ – as evidenced by the poor advertising of ‘changes’ rather than closure ( which we have previously documented on here) as well as a consultation which witness after witness cited as being inadequate, ..........................


Andy Slaughter, MP for Hammersmith, said the whole plan was based upon flawed assumptions about population growth, The plans will result in the removal of 93% of inpatient beds in the borough and all consultant emergency medicine, including the hyper-acute stroke unit, intensive treatment, and type 1 accident and emergency.


Given that targets are regularly missed by wide margins and the pressure on staff and patients is intolerable - there is already insufficient capacity in the system..... It appears therefore that the sole benefits of SaHF are cost savings, or generating capital receipts by land disposal. ‘


Of course this will then result in a further population expansion ‘ we cannot believe they are about to close and downgrade when the population is growing so fast!’ said one witness. In particular, developments in Old Oak Common & Earls Court constitute the largest property expansions in Europe – and there are many are other new builds in the area, which could potentially see these shrinking services completely swamped.


A key question which also remains unanswered : Who will fund out of hospital care?


Consultation :

With the odd Tory exception, the overarching consensus was that the extremely costly McKinsey consultation was to say the least faulty and inadequate.

Access and information ‘might have been done better – there was an insufficient information stream.’ is one of the more polite descriptors. Merrill Hammer, Chair of Save our Hospitals and her husband Jim, reported their own experience of the consultation.


'There was no space for proper public debate. A large number of the population thought that the outcome had been ‘pretty much pre-decided. Options were closed. Minority ethnic groups under-represented – partly because it was very badly advertised. Staff on the door had no idea re nature of a key meeting. The CQC meeting was much better run.’


Jim reported ‘The planned reduction to 24 beds has been accompanied by no answers to any questions. No one responds! It is impossible to work out who is in charge...!!’


Whilst CCG Chair Spicer has refused over a 2 year period to provide the evidence to back up all the plans whilst also declaring ‘Shaping a Healthier Future is not about reducing hosp beds!’ - that is clearly the case and it is also very clear that the retained services will be concentrated in the richer south.

‘ it cannot be said that due process has been followed in terms of establishing a case, or in terms of consulting with the public, a point which my constituents frequently mention to me. Despite SaHF affecting two million people in west London, most feel they have no ownership of the proposals and that their views are disregarded. ‘ Andy Slaughter MP


Tory-Flagship rump-man Andrew Brown took a different view and even on occasion seemed to disagree with himself. He cited 'working relationships in difficulties' between the Council and / Trust CCG, but when challenged to be specific he said it was 'not documented'. He felt it was unfair to be critical of NHS bodies and dived off the main points to cite the Imperial College Healthcare NHS Trust role in social care and the use of Better Care Fund (the insufficient to need programme which he referred to as a 'leading area') though struggled to explain the correlation with the dangers of uncertainty over A&Es.


Whilst saying he felt 'more could have been done' concerning the closure of Hammersmith A&E, Cllr Brown confessed that there was 'no way of knowing for certain' as to whether whatever eventually replaces Charing Cross A&E will be consult led or GP led - he also remarkably responded ' yes - in an ideal world' to Mansfield’s questioning about as to whether it was ‘remotely sensible’ to implement closures prior to there being anything in their place. Essentially his argument followed the line of a preference for there to be nothing, rather than provision which he maintained had been clinically unsafe!


(Fast-forward to Ealing a week later and we heard that the ‘unsafe’ mantra was possibly written on the back of an envelope in an unseemly bid to justify the closures after Cameron & Hunt began to voice concerns ....)


Cllr Brown also had ‘no idea’ about the huge losses in training and maintained that the Treasury would be organising the financing for the new builds, whilst showing great reluctance to discuss the unknown area of the large funding gap which has hitherto been predicated on a large scale asset strip of the Charing Cross site.


A revealing few minutes opening the lid on the mindset of the previous administration who had been responsible for the ideological drive-through of the chaos.


Interestingly, Cllr Robert Freeman of the Royal Borough of Kensington & Chelsea Conservative Group had a somewhat different take on matters from his Tory counterpart....

‘It was difficult - there was a certain expectation that the proposals would be okayed. My main concerns are how St Mary’s and Chelsea and Westminster will cope and also where the funding will come from to create the essential changes needed to cope with the additional burdens. There is great uncertainty that Imperial are not covering plans - they are not a strong trust financially and have pulled back from FT status’


Said Cllr Freeman - ‘we have to keep services open while works are done’


Cllr Rory Vaughan (LBHF Health Scrutiny Chair ) asked - ‘How is fragmentation going to work and how long will it take to re-educate the public?’


This is not simply a case of early teething troubles plus winter demand – the sharp downturn in performance at Northwick Park has remained, even since the much vaunted opening of a brand new A&E which seemingly has no more capacity than the old one.


Dr Spencer had famously said at an angry public meeting last year that anyone who was making their way to an A&E on the bus should instead stop off at a pharmacist, however in the real world, transport issues were a major concerns for almost all local witnesses.


Efficient transport routes and LAS priorities

So what preparations have been done with respect to the need for patients to undertake far more complex transport routes? Mobility challenges across both boroughs. Northwick Park is notoriously difficult to reach and there are accessibility difficulties to the St Mary’s site.

- The Transport Advisory Group has had little or no information.

- ‘Traffic has got worse, much worse – this holds up blue lighters.’

- For those who have no access to cars – many in the Acton area - there are problems with affording cab fares and complex bus routes.

- One Ealing witness reported that TfL had been approached to co-operate with travel adaptations, but nothing seems to have been forthcoming. ( see Storify)

- One patient gave first hand evidence of Patient Transport shortcomings -

3 patients plus various walking aids crushed into a minicab. On one occasion the patient reported he has passed out in the cab. Since privatisation they are often picked up late - once even arriving after the clinic had closed.


How are local GP services coping?

Not one health professional in a meeting could say how many could be treated in the community – it is clear that NHSEngland have no plans with regard to GP services’ Cllr Vivienne Lukey


There is a much vaunted view by those who promote closures that geographical proximity is not nearly as important as quality of care they allege can be found in super-hospitals. However whilst this is undoubtedly true of some conditions, such as stroke and trauma – several witnesses gave clear evidence that this is not true for over 80% of cases.

- Questions why the highly regarded hyper-acute stroke unit at Charing Cross needs to be re-located when others are not co-located...

- Following the publication of the ‘alarm bells’ CQC report there is ‘concern with more pressure we need more, not less, capacity’

- Worry about the local authorities’ capacity to provide the necessary home care due to severe budget cuts which have been landed on Labour – led local authorities, in contravention off equalities principles and guidelines.

- ‘Acute mental health problems won’t just go away. More patients are being treated in acute settings and waiting times are appalling.’


‘We cannot have a plan without the facts and I don’t think we have them yet’


Healthwatch Chairs came to give evidence and sadly the Ealing operation offered many a cause for concern. A board member related that he had not seen a particular document which he felt he should have had sight of. Both he and the chair then stated that the changes would impact on ‘just a small number of Ealing residents’, spectacularly failing to have kept up with the correct statistical analysis. Pregnancy not being an illness was also a rationale for reducing provision.


John Lister asked if Healthwatch is ‘there for patients or just a voicepiece for health bodies.’ A : ‘The latter – we are not allowed to campaign.’

Michael Mansfield QC asked : ‘ is it your responsibility to take a analytical view of these proposals for the sake of the local population?’

A : ‘I’ll have to think about that - I’m not sure’

Dr Stephen Hirst asked : ‘are you an information or an advisory body?’

A: ‘ what’s the difference?’

Oh dear.


The Twitter Storify from Ealing Save our NHS shows the full day’s session in more detail – including the jaw dropping Healthwatch interrogation.


The Impact of Closures So Far


So with such a complex reconfiguration, with information about only change rather than closure and very challenging new travel demands – the crucial question is: Where to go? What is the public understanding of urgent care centre v the A&E?

‘One of the things that has happened is confusion as to where to go. The sensible anticipation that other hospitals will be put under huge pressure has been borne out.’ reported an Ealing witness.


Waiting times have spiked and stayed that way. Trolley waits have hugely increased – including for the very elderly.


Relocating patients has also added valuable minutes to journey times - which is accompanied by additional pressures on London Ambulance Service who are also suffering a staff retention and recruitment crisis with a 20% paramedic shortfall.


Disturbingly, one Councillor reported that private interests are also impacting on access to paediatric provision.


Ealing A&E has reported much greater attendance and pressure on staff since C Mid and Hammersmith closures.

Northwick Park 4 hr waiting has famously dipped to a 51% - and has become the worst in the country. It also takes 1- 1.5 hrs to get there from parts of Ealing and H/F.


‘It has had a very detrimental effect on Ealing. There is a much reduced chance of getting speedy treatment - to me will be a nightmare if Ealing closes’ Ealing patient


The childrens’ A&E at Hamm having gone has had negative impacts which were entirely predictable


It is clear that medical staff in West London have felt pressurised - and it seems to be only the brave who speak out. One doctor who gave evidence has been sanctioned. Another gave evidence on past work rather than their current medical occupation. Only a small number of GPs have stepped forward.


A call to doctors and NHS from Michael Mansfield QC :

‘a whole sector of the database is excluding themselves from the debate through fear.

Can any of them come out of the woodwork? They can contribute anonymously if necessary.’


We heard from expert witness Colin Stansfield, detailed descriptions of misleading information which having been clarified through FOIs, then mysteriously changed again to show a trail of what can only be a case of figures massaging.


Consultant feedback :

‘Change should be according to need not theoretical. We are experiencing an Influx due to other hospitals not coping. On the matter of centralisation ‘It is much easier to manage home discharges close to community


This can be backed up by the evidence supplied by Andy Slaughter where he cited the College of Emergency Medicine recently expressing the view that most people who go to A&E need A&E care – and the difference in centralising for specialisms and the clinical dangers of centralising all of emergency services. The downside is obvious: fewer centres and further to travel and distance for sickle cell, meningitis, placenta previa etc can literally mean the difference between life and death.


He was joined in this view by the doctors who gave evidence in Ealing the following week. Key parts of the magnificent testimonies by Dr Khan and Dr Sandhu are included in the Storify link.


Anne Drinkell – retired community matron and SoH secretary highlighted a key difficulty :

‘The really big problem is that CCGs are not being able to understand the messages - there are lots of reasons why they don’t want to pay attention to information and bad news.

There is a ‘big disconnect between managers and hugely overworked clinicians’.


She also provided us with a simple but relevant measure

‘ pressure sore stats are a big indicators concerning pressures on care – we are seeing a big increase’.


Michael Mansfield summarised the feedback so far, when he said ‘the fragmentation of the NHS is the overriding concern’.


There is no Plan B – and if the worst case scenario takes place then there will be no option to alter anything back ...


Save our Hospitals sum it up :

‘Shaping a Healthier Future is a cover up for cuts. We cannot see how longer journeys and fewer services are better – and with the extra pressure on staff, this is very, very, bad news.’



In all of this, the question remains Dr Spencer, Dr Spicer and Tracey Batten.

Just where will the patients go?


The next hearing will be on Saturday 28th in Hounslow Civic Centre and the final one will be in Brent on 23rd May, the other side of the General Election 2015 rubicon....


Jos Bell March 2015


By shalondon, Feb 28 2015 01:05AM

Firstly, my apologies for the gap in posts, when, as seems entirely the norm these days, there has been so much action in the health world. This was primarily caused by my own need for NHS services. As ever, my heartfelt thanks to Nye and all who have sailed his fine NHS Ship after him.


Updated 1.3.15.....


This has been a notable week – Saturday 28th was replete with NHS campaiging events across the country and on Sunday, St David’s Day has been celebrated across Wales – not least in Tredegar, home of Aneurin Bevan, where they will also take the opportunity to celebrate the NHS. The celebration was supported ( from a regretful distance ) by veteran campaigner Harry Leslie Smith – his fine words having moved the Labour Conference floor to tears with his sad memories of the suffering of his young sister in the days before the NHS. Actor Michael Sheen ( not Tony Blair! ) spoke with incredible passion – he has been making a programme about the Chartist Movement and the need for people to exercise their vote – so participation in 999NHSTredegar - People’s Vote for the NHS event is entirely logical to him.


'They are us - they ARE us!! No one is alone and there is such a thing as society!

There is never an excuse for not standing up for what you believe is right! '


Wednesday 25th was Harry’s 92nd birthday – and on that day, George Osborne gleefully took to the airwaves to announce that the City of Manchester, incorporating Trafford, the birthplace of the NHS, had been granted a £6bn budget whereby the Council would have complete control of its own health budget – completely independent of any national involvement. Coincidentally, £6bn is also the same amount that is estimated to have gone to the private sector via various bidding rounds . It is also the amount that it is estimated to cost us in outsourcing each year. Only 6% of the NHS is in the hands of the private sector says the Kings Fund and the BBC. 6% my a*se says Jim Royle.


Earlier this week Andy Burnham’s team uncovered measures which Hunt had tried to sneak through unnoticed just before Recess, which would enable EU competition law to snaffle every corner of our NHS.


Let us think about these two chessboard moves for rather more than a moment.


The fact that it was the Chancellor who made the Manchester announcement is significant. The fact that few had advance warning was also significant. The fact that Osborne was so visibly excited when he made his announcement is extremely significant.


We know that Cameron and Hunt have a constant refrain that ‘only a strong economy deserves a decent NHS’ – when actually, as Burnham said in his 10 Year Plan – we were able to invest in our public services in a post War era when the economy was in far worse shape than it is now. Health is an investment – it should not be seen as something akin to damage limitation, where the risk is palmed off to a naively excited Council, who really should know better than to fall for this Swiss Cheese filled rat-trap.


There is nothing wrong with a degree of devolution - and indeed local decision making forms a core part of the Burnham Plan – but to be taken advisedly and as part of a co-ordinated plan for the nation as a whole, not the spiteful pre-Election bite off more than the NHS can chew amputation approach.


Our NHS was once a whole – with some private patient and semi independent GPs in the original mix - then the internal market was added by Thatcher to bring in contract cleaners and MRSA, it then expanded under Labour in order to get 2 and 3 year waiting lists down to 18 weeks. Milburn and Hewitt then tinkered and tangled with the internal market – largely it seems for their own profit motive - until in 2009, Andy Burnham took up post and quickly spotted a flaw in the market model. He then began to change the law to reverse the trend, but this was sadly interrupted by the Coaltion who have since jointly driven an External Market Coach and 4 Profiteering Horses of the Apocalypse through the whole set up – teaming the Health & Social Care Act with added Section 75 to destabilise the entire edifice.


Now we have Georgie on Speed , without any reference to the national aspect of our NHS, out of the blue announcing the amputation of the nation’s left foot. Some in Manchester are very excited and some are very scared. Where are the safeguards – both for the City – and for the rest of us? What if the Council is not competent in this area? What if the money runs out? It seems there has been little or no staff or public consultation and the whole thing seems to be an unaccountable done deal between ‘Mancs Devo’ and Georgie Boy.


Public health expert Gabriel Scally reminded us on Twitter that ‘ Manchester Regional Hospital Board was in existence from 1947 to 1974. George Osborne brings it back as yet another extra tier in the #NHS’

Then the next day in response to @SocialistHealth & @karinsmyth - And to whom is the new Greater Manchester Strategic Health & Social Care Partnership Board to be accountable?


Quite.


Privatisation may well have fragmented our health services, but this is the start of a wholescale chop up. Whenever Georgie is excited, we know that his actions are in nobody’s interests except his special buddies – so we can bet our bottom dollar that there will be further benefits to the likes of Malcolm Rifkind in the arrangement.


On the same privateering theme, when I attended Jeremy Hunt’s oh-so-light-touch interview with Roy Lilley ( ‘this is my friend the Secretary of State for Health – he knows as much about health as I do’ ), the no-Duty SoS declared that TTIP and all types of trade agreement to be an entirely good thing for the NHS. Lilley professed not to understand it and gave no quarter to anyone in the audience who might do. Without anyone having the opportunity to explain that Andy Burnham has received assurance from the EU Commissioner that any government so-minded can protect the NHS and public services from all trade agreements, Jeremy went away happy as can be with a large bottle of whiskey tucked under his under-interviewed arm.


Meanwhile the Tories waste hours and hours of time allocated to the Efford Bill - shamelessly espousing the worst of the filibuster in order to block the Labour members from highlighting the harm the Coalition has done to the NHS. We might know that Jacob Rees-Mogg enjoys Cadbury's Cream Eggs, dislikes Brussels Spouts but has a fondness for runner beans - but how many know the detail of the National Health Service ( Amended Duties & Powers Bill ) 2014- 15. Very few, if the Tories have their way. Compounded in no little part by a large section of the campaigning world having an unfortunate focus on the untimely distraction of the top-down heavy Reinstatement Bill - which aside from not being a Bill but a set of proposals, seems determined to ignore the detail of what the real Bill contains and fails to understand the political worth of waiting until after the General Election to present its thoughts for due consideration. Only that way have any of them a chance of being adopted.


So here we have two high risk moves – neither of which is in any way true to the spirit of Nye Bevan’s NHS – being sped through in the dying days of this most dastardly of Parliaments, accompanied by a curve ball distraction which is focused more on perceived shortcomings of Labour than of the desperate threat presented by an ongoing - and potentially far more damaging incarnation of the Coalition.


This is indeed a recipe for chaos.


The first question is – what else have George and Jeremy got up their sleeves?


The second question is – are we going to be able to put a stop to it on May 7th?


As Owen Jones said at Sadiq Khan’s inspirational fundraiser event last night –

we are in a time when young people receive a text at 6am to let them know if they have any work for the day – we are in an age when the most vulnerable people in society are under constant attack through the bedroom tax and vicious cuts to essential services..... Aneurin Bevan’s NHS is being fragmented and broken. At the same time bankers’ bonuses have doubled and tripled. ......We have just a few weeks to put a stop to it.... We need Labour to win!’


So let’s do it!


with more on this topic to come....


Jos Bell Feb 27th


By shalondon, Jan 30 2015 12:43AM


It is a truism that post WW2 there was none of the defeatism which those who currently do-down the public sector exhibit – now Andy Burnham speaks out to the younger generation in a career defining speech to ‘ come and build an NHS for the future - your future!’


The Burnham Vision is designed to offer both a message of hope to the younger generation and a message of reassurance to those concerned for a secure old age.


‘It is borne out of deep reflection, honest assessment of our mistakes but huge optimism for what the NHS can be in the future.’


So does it fit the bill?


Sir John Oldham provided the fitting prequel to the Shadow Secretary of State’s 10 Year Plan speech on Tuesday 27th, which he put to an assembled audience at the Kings Fund, most of whom -judging by the warm applause he generated, hoped that he will soon be able to ditch the Shadow tag ( please take note Ed ).


Oldham’s work forms a significant part of the new model for the future of the NHS and social care and he was clearly very proud of what was in store for both the gathered audience, as well as the country at large, if the result of the 2015 General Election goes the Labour way - and indeed the only way to secure a national health service for the future.


Andy Burnham’s passion for his work is well known. On this occasion it was palpable.


From the top of his burnished head to the tips of his extraordinarily shiny shoes, every inch of the SSOS seeks to lift the NHS and poor battered social care 'out of the downward spiral to the position of his aspirational vision’ which he sees as an offer of hope 'something for people to believe in' – and we could add - as opposed to the current climate of fear.


Despite the BBC and 95% of the national press’ attempts to obliterate the detail for what these days passes for news (yes - hang your heads in shame Grauniad & Newsnight), the plan stands as one which is not another imposed reorganisation, but one where everyone is invited to participate.


As opposed to the H&SCA - which Burnham calls a 'contested piece of legislation with no democratic accountability – putting a political agenda at heart of the NHS and which goes entirely against its grain...this vision puts the right values back at the heart of the NHS going beyond tariffs and targets’. The idea is to use existing structures, but very differently.


‘One person! One team! One system! - looking at each person's state of physical, social and mental wellbeing - not dropped on from a great height but worked on by everyone’.


The Burnham vision is based, he told us 'on the simple notion that where care starts in home it is more likely to work for the person' (not patient) - with one professional as the key point of contact, doing away with crude 15 minute slots and supporting the needs of those with complex conditions from dementia and autism to cancer.


Citing the A&E barometer with 2015 showing record numbers of frail elderly trapped in hospital - and in one case a whole year for one Lincoln woman, as the warning of severe storms ahead - 'which have indeed been warned of time and time again.... cancelled operations at the last minute including cancer.... cuts to GPs and mental health provision leaving hospitals close to being overwhelmed and creating a vicious circle' – which we now know is of the governments making in a deliberate drive to destabilise & destroy the NHS. Weaponise? The Tories are the party who have launched a full out attack on the service.


It is the job of the Opposition to counter attack – and were Burnham et al simply to say ‘fine - on you go Hunt’ and kick back, where exactly would we be?


We know that further planned cuts by Osborne will mean more cuts to social care to form what Burnham calls ‘a toxic mix of cuts, crisis and privatisation’ which many of us also know could – or even would, see the NHS sunk without trace,


Andy confirmed that he had spent the past 2 years since he first proposed full integration consulting across the country, visiting teams and speaking to as many health workers as possible, taking on board the views of experts – several of whom he listed : the Oldham Commission , Kingsmill, Kate Barker, the Fabians, IPPR and the NHS England 5 Year Forward View – all of which contributed to his plan.


We were also told that the plan is also a substantive response to the Francis report ( with absolutely no vases in sight Julie ) – which Hunt surely mutters about in his sleep, yet has serially failed to implement - and ‘a move away from the hospital based production line approach to a care model where mental and emotional needs are not sufficiently looked at’ - and in particular looking after the needs of children and adults with complex physical disabilities who with the right support are now able to live longer and more productive lives.


On Tuesday evening at the wonderful Prof Geof Rayner & family’s book launch I met therapy professionals whose work has been halted by one of the most pressurised hospitals in London – as they said, this will only result in people remaining in-patients for longer periods of valuable time. A trend which needs to be reversed.


This is a 10 year journey in search of stability for services which were set up to support each of us from cradle to grave and which are now so sadly in increasing disarray.


As Andy had explained to SHALondon last week, he realises that Integration needs to be worked at - so this journey will be built upon relationships which recognise local cultural needs and solutions which are right for each individual area. We also know from what he said to us on 13th January, that the ‘brutal change’ approach currently being taken by the NW London and Imperial Trusts is not his approved mode of service shift.


The Burnham hope is that local authorities and CCGs along with the general population will get behind his new approach so that a consensus can be achieved. ‘We need to get right the things that truly matter.’


Thinking of national initiatives past, it is to be hoped that examples of best practice are at the ready for sharing with those areas who may struggle with innovation.


Then onto the element which has caused Milburn to explode and Kirsty Wark to talk over her guest far more than is acceptable from any interviewer and subsequently leave viewers little more informed than before they tuned in.


Today Labour calls time on the market - it is not the answer - and if we allow it to continue it will eventually take hold of the and finish it off. The market only serves to increase costs and complexity and undermine care, conflicting care with the profit motive!... we need freedom to collaborate without competition law blocking our plans.” Indeed Alan Milburn. Indeed.


The key difference is of course that the Tories have let in the external market rampant with an intent to destabilise and destroy, whereas Labour increased the internal market to reduce 2/3yr waiting lists and operated an av 3% rather than 49% cap on private provision. No matter what the BBC 'Vision On' graph says, the Tories have accelerated the privatisation process far more speedily p/a since Section ’75 in 2013, compared to the 13 years of Labour. Even if your own care may be with PrivateEyeHealth.com, 70% of the last contracts round going to the private sector, including for core services, is just the alarm call we need, thankyou Kirsty.


Next on TTIP – and more. Based upon personal assurances from both the EU Commissioners and the work of David Lock QC, the Shadow Secretary of State was adamant that he would ensure that the NHS would be exempt from not just TTIP, but also other trade agreements which could destabilise the service via Competition Law. In this, he said, the Lisbon Treaty and the sovereignty rule are supreme. ( see past blog July '14 for detail ).


In answer to ACEVO's Sir Stephen Bubb ( my fomer colleague from the National Lottery Charities Board who had far too warmly embraced the H&SCA ! ), he confirmed that his vision will also include voluntary organisations as key partners. As Shadow Health Minister Andrew Gwynne afterwards told me - the Red Cross are already offering us excellent examples of home care packages which are succeeding in keeping the elderly out of hospital. Coincidentally, you may have seen my former housemate Andrew Mullan, now a Red Cross manager in Derbyshire, explaining this in a Channel 4 News A&E piece last week.


For those who fear the involvement of the voluntary sector - this has formed a key part of British culture and skill for longer than living memory and can continue to work in complimentary fashion with statutory bodies - however we also need to be sure that those essential core costs are met in order to support the necessary infrastructure. The plus side is that the Third Sector operates without the profit motive skewing the manner of its use.


It was positive to hear that the primacy role of NICE will be re-established and detrimental approaches of partial treatments ( 1 cataract only ) will be barred - nor will the criminal justice system be disadvantaged as has increasingly been the case, with the vicious help of Failing Grayling.


We were then offered an overview of the other 4 stages of the Burnham Vision


If NATIONAL is the what, Andy Burnham told us - the LOCAL is the how.... and for me, this is where it gets really exciting. Health is to be formally linked across the piece with housing, education, leisure and transport, ‘with the aim of breaking out of the confines of silos where services don’t relate to each other and children in particular lose out’. Music to my ears! The innovative work of Children’s Trusts and Sure Starts which have taken such a battering under Gove and Morgan now have a chance of being revived, but as a mainstream approach to encouraging positive health messages and practice in every aspect of life, including for adults.


The logical rationale is that the more quickly the new model is embraced, the sooner local services will be on the right path – so this is not a policy for the hesitant and best practice examples will need to be reaily shared. Integrated local budgets for children will mean that all the long term savings for that child will return to same pot. This is an authentic early intervention cost saving investment model.


The Year of Care model will be a fundamental shift away from a hospital-centric approach, helping those who would otherwise be stuck in wards for weeks and months on end to be home-based with decent and reliable care packages.


Each health economy ( yet to be defined in legislative terms ) will be required to develop an accountable integrated body which will link into a new role for that most contentious of quangoes Monitor, turning it away from driving through the privatisation agenda to promoting the viability of the NHS and decent standards of social care.


A single point of contact, a personal care plan, therapies and counselling plus care in the place of choice – including for childbirth and end of life, 48hrs GP and 1 week cancer test minimum wait guarantees sit well in a list of quality promises.


The first point of contact mechanisms will change into what seems to be an eminently sensible model, combining out of hours GP provision with ambulance services which will take over and enhance the substandard 111 call centres to offer a new multi-functioning body which will not just carry the sick and injured to hosp but also treat at home. This re-alignment does not need new funding, just better use of existing budgets.


The aim and the intent is to change the care culture and value those in it - valuing staff and valuing people as more than patients through the Year of Care model ( so eloquently explained here by delighted dementia expert Dr Shibley Rahman ), with recognised training paths for both staff and outsourced personnel and a ban zero hours lift the care field out of the desperate morass in which Lamb and Burstow have dumped it.


The dearth of ‘home grown staff’ caused by swingeing cuts to training programmes (despite queues of those with a vocation), will be reversed by investment in new training pathways – including a new apprenticeship portfolio, which will be an integral part of the integrated model.


The big question in the midst of all this is - how can we be sure that no one will be stuck at home with poor care? I have to confess this has happened to me a few years ago after a too-early hospital discharge and I would not wish it on anyone.


Although we already have less hospital beds per population head it seems we must accept that home based care is to be a reality - and the hope is this ‘less patient and more person-centred’ remodelling will be exactly what Andy Burnham sincerely hopes it will be.


The SSOS told us that he would ensure as many safeguards as possible which will be a core part of both a cultural and service delivery shift. New rights will empower people through person centred rights with tougher penalties for those in breach underpinned by amendments to the NHS Constitution.


In recognition that the state will offer a person-centred service, the expectation will be that people will have to do more for themselves in order to stay as physically active as possible by following public health advice and stay as healthy as possible.


Never again should the public’s most valued institution be at mercy of those who seek to do it down. 'Given the current circumstances we urgently need a consensus' says Burnham, challenging other parties to sign up to this ( hello you Greens? ) or if not produce their own – which it seems to Lib Dems are busily doing in a desperate attempt to re-invent themselves


In a clarion call finale – the Shadow Secretary of State speech culminated with a personal plea -

Nothing matters more to me and I know what it means to millions of others – we may not agree with everything but if you agree with the broad direction please get behind it.


It can be what we want it to be – as good as we all want to make it.’’


We now have less than 100 days to rescue our NHS from the brink and breathe new life into social care. Let us view this as more than a last ditch rescue attempt but more an opportunity to build a comprehensive & holistic healthcare system, fit for future generations.


We really had better stick with team Andy.


Jos Bell


NB.

For those who might like to explore the initial predictions about the Health & Social Care Act – which as Andy says, have sadly come home to roost – the 2012 document I wrote for Lewisham SOS NHS ‘Breaking the NHS through Reckless Reforms’ has been re-posted


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