Author Archives: Chris Perry

STOP: think again, does the Health and Social Care Bill address the issues?

The Government is putting in excess of £40 billion (and counting) into the NHS and social care. More money into the first aid camp at the bottom of the cliff instead of building a fence at the top. At the same time the Government has reduced the income of older people by stopping the free television licence and reneging on the triple lock which will inevitably increase demand upon health and social care absorbing much of the additional money. There appears to be a lack of understanding by Government of the correlation between income and demand upon the NHS or …

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A “mending” not a “minding” service

With so much media and political attention on social care there is a danger that social work, which is a very undervalued resource, may be further marginalised. This article attempts to demonstrate that social work and social workers are vital to a “mending” rather than a “minding” service.

In the late 1960s and early 1970s social work was regarded as a valuable resource and social workers seen as “agents of change”. Since then, social workers have been increasingly regarded as “gate keepers” assessing the eligibility for practical help and rationing of services.

The Seebohm Report which led to the establishment of Social Service Departments in 1971 recognised the value of social work. It did not, however, create the “one door to knock on”, it promised, as a multi-disciplinary / inter-agency response is often required. This was subsequently recognised with the establishment of Area Child Protection Committees (post Maria Caldwell), Mental Health procedures, “Community Mental Handicap Teams”, and Youth Justice Teams etc.

The undoing of much of the public sector was down to the Thatcher years and more particularly, in respect of Health and Social Services, to Sir Roy Griffiths and his mistaken belief that people were motivated by and could be controlled by money. This led to the introduction of the contract culture with the purchaser / provider split which Sir Roy thought would create a level playing field to facilitate a mixed economy of care thereby forcing quality up and prices down. It has subsequently been proven to have had the opposite effect and led to over-prescription taking away the ability of carers to react in situ to changing need. It led to greater fragmentation with different components of a “package of care” bought from different providers.

Social Workers were deployed on the “purchasing side”, assessing the need for specific services (often responding to “presenting problems” rather than the “underlying problem”) which led to several social services departments providing “minding” rather than “mending” services with an ever-increasing workload of dependent people.

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HGV and social care crises – some alternative solutions

As people queue for petrol the Government intends to reverse another of the consequences of Brexit by making it easier to recruit drivers from Europe. The promised trades deals have not materialised, and far from getting Brexit done, a solution has yet to be found for the Irish Border.

A radical reform of our governance, in which elections are won or lost on a few marginal seats and MPs speak to themselves in parliament, at great public cost, with Government seemingly taking little notice, is long overdue.

The system promotes quick fix component level solutions to whole system problems thereby creating problems for future administrations to deal with.

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No need to break any election pledges to fix social care

So, the Government is to pour more and more money into the first aid camp at the bottom of the cliff rather than building a fence at the top.

Yesterday’s announcement on the funding for social care does nothing to enhance the quality of life of older people or reduce the demand for hospital treatment or long-term care. 4/5th of the expenditure of the NHS is on older people, there are 1.8m older people living in poverty, with a correlation between income and demand upon the NHS in all age groups.

When campaigning for the abolition of the “retirement age”, which was responsible for a great deal of depression amongst older people many of whom were forced into retirement and condemned to spending the rest of their lives in poverty, I advocated that people should go on paying National Insurance whilst ever they were working, not to squander on more of the same as the Government now intends, but to increase the basic State Pension to enhance the lives of older people and reduce the demand for long term care.

The Netherlands with the highest pension in Europe spends 60% of its health budget on older people: Britain, with one of the lowest state pensions spends 80%. Increasing the basic state pension in line with many other European Countries, could be self-financing (needing only upfront pump priming) with no need to raise National Insurance or any other tax, by reducing demand for both hospital treatment and long-term care and enabling those who do need long term care to contribute more from their income, whilst still retaining their personal allowance, with no need to take savings or capital into account.

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The Triple Lock: An 8% rise is justifiable

The Government appears to have forgotten why, the predominantly Conservative, Coalition Government introduced the “triple lock” whereby the State Pension increases in line with earnings, prices or 2.5%, whichever is the greatest.

It was an attempt to reverse the 30 years of erosion since Margaret Thatcher replaced the “earnings link” with a “prices link”. And after only ten years there is a long way to go to restore the pre 1980 relative value.

Prices are about the cost of static living. Earnings are about the standard of living and quality of life. As the economy grows so too do the expectations and necessities of life. For example, very few people had fridges in 1950; it would be difficult to manage without one today.

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A longer read: Women born between 1954 and 1960 lose up to £40,000 each

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From October 6th anyone born after 5th October 1954 will have a state pension age of 66 – for some women this is six years later than they were originally promised.

The 1995 Pensions Act intended raising the age of eligibility to the State Pension for women to 65 over a ten-year period between 2010 and 2020. The 2011 Pension Act accelerated this and raised the age to 66 for both men (previously 65) and women.

Women born in the 1950s might have spent half their working lives paying National Insurance in the knowledge they would get their State Pension at 60 years of age and may now get up to £40,000 less than they knew to be their entitlement.  There is evidence of women retiring only to discover they will not get their State Pension. Even some people closely involved with older people and pensions were unaware of the precise timetable as so little publicity was given to it.

The “Back to 60” campaign lost its appeal in the High Court, in October, but “Women Against State Pension Inequality” continue their campaign. These women have a very real grievance and yet appear to be being brushed aside. Both LibDems and Labour had it in their manifestos to do something about it. And former Pensions Minister, Baroness Ros Altmann would appear to support some compensation on grounds of maladministration as these women were not written to personally in either 1995 or 2011.

More than 1million female workers have no savings or private pension provision, of which 43% have less than £100 saved. Two million people over 75 live alone, of which 1.5 million are women.

There are 1.9m older people living in poverty in Britain today many of whom were forced into retirement and condemned to spending the rest of their lives in poverty. Britain has one of the lowest State Pensions in the developed world at just 29% of average earnings with the official definition of poverty being anything less than 60% of median household income. Britain’s 29% compares with 100.6% in Holland, 94.9% in Portugal, 93.9% in Italy, 91.8% in Austria, and 81.8% in Spain.

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How we improve Covid-19 care for care home residents

Having just spent several hours wading through the final report of the “COVID-19 Social Care Support Taskforce” one wonders how those working in the service will ever find time to read it – let alone implement all 42 recommendations which are designed to make bad practice safer!

Care homes are not, and were never intended to be, hospitals. The residents are just as entitled to hospital care, if that is what is needed, as are the rest of us. That so many have been left to die in Care Homes, rather than being admitted to hospital, and thereby denied the benefit of oxygen, ventilators and intensive care which might have saved their lives is the real concern. The minute a resident exhibited symptoms they should have been tested and if positive admitted to hospital. The discharge of older people from hospital to care homes, without testing, in order to free up beds for coronavirus patients may also have spread the virus. That not all older people have an “assessment of need” and “verification of wishes” by a social worker prior to admission to a care home whether or not they are self-funders, as envisaged by the 1990 National Health Service and Community Care Act, is a real concern. Admissions to care homes should have been stopped from the time relatives were stopped from visiting.

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Brexit: Heading for Disaster or Brinkmanship? Part Two

The Irish Border was always going to be the stumbling block to BREXIT. Part of the problem is that the House of Commons is not representative as the 7 Sinn Fein MPs have not taken up their seats as it would mean them taking the oath of allegiance to the Queen. The people of Northern Ireland voted to “remain” whereas the 10 Democratic Unionist Party MPs favour BREXIT. A border down the Irish Sea would not be acceptable to the DUP any more than a border in Ireland would be acceptable to Sinn Fein.

All parties agree that a “no-deal BREXIT” would be disastrous for the economy in that 44% of our exports go to Europe (with only 18% of Europe’s exports coming to Britain) and a further 20% of Britain’s exports go via trade agreements with Europe. Most of our food comes from Europe, and Spain in particular, and the World Trade Organisation Tariffs could add up to 10% to prices. No amount of trade deals around the world could compensate for the loss of trade with our nearest neighbours. The recent deal with Japan replicates the deal the UK already had with Japan via the EU.

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Brexit: Heading for Disaster or Brinkmanship? Part One

The Coronavirus possibly poses a greater threat to the human-race than did the second world war and the unleashing of nuclear bombs. The UK should have locked down earlier, worn masks earlier, had test and trace earlier, stopped admissions to care homes earlier, admitted people in care homes with symptoms to a hospital where they could have benefitted from oxygen, ventilators and intensive care. However, we are where we are and quite rightly when announcing further measures to combat Coronavirus (on Tuesday 22nd September) the Prime Minister put saving lives first (and I am delighted that people working in restaurants both in the kitchens and serving are to wear masks). Still, he also said he was keen to strike a balance in protecting the economy and jobs. Given that the Coronavirus is likely to trigger a world recession why then is he persevering with the “UK Internal Market Bill” which risks alienating our closest trading partners, undermining trust in the UK worldwide and scoring an own goal by inflicting untold harm on the economy with a potential no-deal BREXIT in January, whilst undermining the peace process in Ireland?

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A longer read for the lockdown: Reform of health and social care without further top-down re-organisation

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In the daily update on Friday 15th May, Matt Hancock said that the current crisis had demonstrated how closely health and social care need to work together and had acted as a catalyst to reform, referring to “integration”. Care homes are not, and were never intended to be, hospitals. The residents are just as entitled to hospital care, if that is what is needed, as are the rest of us. That so many have been left to die in Care Homes, rather than being admitted to hospital, and thereby denied the benefit of oxygen, ventilators and intensive care which might have saved their lives, is the real concern. The discharge of older people from hospital to care homes, without testing, in order to free up beds for coronavirus patients, may also have spread the virus.

However, that Baroness Ros Altmann also referred to “integration” on “Good Morning Britain”, and Matt Hancock reiterated it on the 21st May, would suggest the matter is under consideration.

Countless enquiries into “child abuse” and “adult abuse and neglect” have criticised agencies for not working together. And successive Governments have tried to get Health and Social Services, in particular, to work more closely together from “joint funding” in the 1970s to the “pooling of budgets”. But no Government has grasped the nettle of the lack of common geographical boundaries, different funding streams and different lines of accountability which have been the real impediments. This does not mean a merger of health and social services, as that would further marginalise Social Work and a different combination of agencies are required depending upon the problem and desired outcome. For example: Child Protection requires children’s services, health, education, the police and foster care to work together. Older People require Adult Services, Health, Housing, Leisure Services and Income Support to work together. – But not all of them all the time. It is quite a complex multi-dimensional organisational issue across countless scenarios.

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Public scrutiny of lockdown exit strategy

The Government must publish its “exit strategy” for easing the “lock down” for public scrutiny to avoid repeating past mistakes and ensure that when the time comes it is ready and it does not overlook anything or anyone.

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Coronavirus: Britain overtakes China

Britain has now overtaken China in respect of the number of deaths from coronavirus and yet unlike China and South Korea we had three months to prepare.

China and South Korea went into immediate “lock down” with widespread public testing, tracing and isolating contacts and the wide use of Personal Protection Equipment and, in particular, masks. In consequence China has all but stopped the spread of the virus with 3,322 deaths or just 2 per million population. The death rate in South Korea has also slowed with just 174 deaths or 3 per million population. In Britain deaths are still rising with 3,605 so far or 53 per million population.

Despite the World Health Organisation’s warnings testing is still way behind as is the provision of PPE.

On 22nd March the Sunday Times published an article entitled “Ten days that shook Britain – and changed the nation for ever” which revealed that Dominic Cummings, the Prime Minister’s senior aide, had become convinced that Britain would be better able to resist a lethal second wave of the disease next winter if Whitty’s prediction that 60% to 80% of the population became infected was right and the UK developed “herd immunity”. At a private engagement at the end of February, Cummings outlined the Government strategy. Those present say it was “herd immunity, protect the economy and if that means some pensioners die, too bad”.

However at the Sage meeting on March 12, a moment now dubbed the “Domoscene Conversion”, Cummings changed his mind in the “penny drop moment” when he realised he had helped set a course for catastrophe with between 250,000 and 500,000 deaths predicted. From then on Britain was playing catch up.

Listening to Matt Hancock on Thursday’s Question Time one could be forgiven for thinking the Government had still not ditched the concept of “herd immunity” altogether as he referred to “passports” and “certificates” to enable people to get back to work. He himself was back in circulation just short of seven days after testing positive when the World Health Organisation recommends a minimum of 14 days.

Yvette Cooper tried her best to draw Matt Hancock as to the Government’s future strategy and the concept of “herd immunity”, without going over old ground, and also expressed concern that carers were going from house to house without PPE (masks, goggles, gloves, gowns etc) and could be spreading the virus amongst the most vulnerable people in society who were dependent upon their care.

The Government appears to have paid too little attention during this pandemic to the wider population, to home food deliveries or the protection of people working in the Super Markets, food chain, gas, electricity, water and refuse collection on whom we all depend. And has so far failed to even adequately protect those in the NHS!

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Housing: A basic human right?

According to the charity Shelter, three million new social homes must be built in England over the next 20 years of which 1.2 million homes are needed for younger families who cannot afford to buy and “face a lifetime in expensive and insecure private renting”. The Government intends to build 250,000 homes by 2022, including homes for rent.

Travelling around the UK one gets the impression that there is more house building going on than ever before gobbling up agricultural land. This is at the time that we are leaving the EU, the “single market” and the “common agriculture policy”. About 30% of all our food is currently imported from EU Countries and for some products it is 100%. In 2016 more than £30.3bn of Britain’s food imports and £12.3bn of its food exports were with the EU, highlighting the scale of economic disruption if the current trade negotiations result in tariffs.

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Reducing income inequality

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This is the second of three articles on housing

Huge profits are being made out of housing when the Government estimates 4,266 people are sleeping rough. For example Barratts made pre-tax profits in 2019 of £909.8m – even after paying their Chief Executive £3.6m. Nationwide made £833m after paying its Chief Executive £2.37m and the Government collected £9.3m in Stamp Duty.

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Low incomes mean that the basic human right of housing is often beyond people’s reach

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This is the first of three articles on housing

Food and shelter are essential to survival and yet according to the latest Government figures, collected in the autumn of 2019 and published in February 2020, 4,266 people are estimated to be sleeping rough each night in this the 5th largest economy in the world. The Charity Crisis believes it may be nearer to 8,000.

According to the charity Shelter three million new social homes must be built in England over the next 20 years of which 1.2 million homes are needed for younger families who cannot afford to buy and “face a lifetime in expensive and insecure private renting”. The Government responded that providing fair social housing was a priority and it planned to build 250,000 homes by 2022, including homes for social rent.

Housing is big business and it was the collapse of the property marked in America which led to the economic crisis in 2008 which saw the Government bail out the banks and led to ten years of austerity during which the rich, including those responsible for the crisis, got richer and the majority of us got poorer.

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Brexit and the European elections

With the European Elections looming they could be regarded as a test of public opinion, almost a second referendum.

However given that what UKIP and Boris Johnson et al promised in the run up to the 2016 referendum has been shown to be unattainable it is almost inconceivable that

Nigel Farage’s BREXIT Party should be riding so high in the ratings. One can only assume that this a matter of dictatorial principle “you will do as we tell you”, an anti- establishment stance from people who feel totally undervalued, powerless and ignored – determined to win at any cost and regardless of outcome. Nigel Farage now says it is about democracy.

It will therefore need the pro-European Parties, and hopefully Labour, to work together to get the facts across. This is not about democracy: it is about the future of our country for generations to come.

BREXIT could lead to the break-up of the UK, the loss of Gibraltar, and the outbreak of hostilities in Ireland, which could very quickly escalate out of control, and will certainly leave the UK worse off economically. It is doubtful that anyone voted to be worse off and yet this is what the most optimistic predictions, even those of the Government, suggest. Just recall how hard Britain fought to gain access to the“common market” and that 44% of our exports go to Europe (with only 18% ofEurope’s exports coming to Britain) and a further 20% of Britain’s exports go via trade agreements with Europe.

Therefore the NET contribution Britain makes to the EU pales into insignificance compared to the advantages of this free trade agreement. And those that argue that the UK would not have to pay the £39b, so called divorce settlement, were it to leave without a deal, should bear in mind that this is to honour our contractual obligations and what country would enter into an agreement with a country which failed to honour such commitments – not to mention the possibility of sanctions imposed by the EU on top of tariffs

The Irish Border, together with Gibraltar, was always going to present insurmountable problems. It was perhaps “freedom of movement”, more so than the “Good Friday Agreement”, which led to the end of hostilities in Ireland, with people crossing the invisible border daily. However one cannot “control one’s borders” without a border and the only way to retain an open border in Ireland, and avoid hostilities, is to remain in a Customs Union and Single Market (Free Trade Area).

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Setting the young against the old is a smokescreen to protect the mega rich

Setting the young against the old is a smoke screen to protect the mega richThe House of Lords Committee report on “Intergenerational Fairness and Provision” recommends a redistribution of benefits from older people to younger people. Surely it is not an inter-generational issue; but one of confronting the widening income inequality and increasing poverty in our society?

At just 29% of national average earnings Britain has one of the lowest state pensions in the developed world, with much of Europe paying in excess of 90%, and there are 1.9m older people living in poverty many of whom were forced into retirement, pre 2011, and condemned to spending the rest of their lives in poverty.

According to Philip Alston, special rapporteur on extreme poverty to the UN, Government Ministers are in a “state of denial” about poverty. Quoting figures from the Joseph Rowntree Foundation, he said that more than 1.5 million people were destitute at some point in 2017, meaning they lived on less than £70 a week or went without essentials such as housing, food, clothing or heating. A fifth of the population, amounting to 14 million people, are living in poverty, Prof Alston said.

In contrast the pay of Chief Executives at businesses on the FTSE 100 index surged 11% on a median basis during 2017 while average earnings failed to keep pace with inflation, rising just 1.7% with inflation at 2.8%. Many of these Chief Executives have multi-million pound incomes. 

A consequence of this widening inequality is that there are now 3.9 million children living in poverty in the UK – an increase of 200,000 in just one year. The Government has focused on making work pay, but two in three children who are in poverty have a parent who is in work. Children brought up in poverty are less likely to do well at school, more likely to have health problems and have a shorter life expectancy.  

In 1997 Gordon Brown abolished the tax relief pension funds earned on dividends from stock market investment which sent many pension funds from surplus to deficit within a decade and led to the demise of many final salary pensions. In 1971 the index linking of public sector pensions changed from earnings to RPI and then in 2011 from RPI to CPI and more recently from final to average salary. Over the last ten years pensions index linked to CPI have increased by 26.6% when had they still been increased by RPI they would have gone up by 32.4%. Average earnings have gone up by 41.7%. 

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    noncomformistradicalism, ideed, in that you differ radically to me on this! I see the BBC, as the only public broacaster to get the licence, as definitely mo...
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    @Lorenszo Cherin "Few countries do as we do on this. It is not Liberal or social democratic to have a flat tax in order to watch something, all the money going...
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    Roland Not Conservative thinking. Liberal thinking! Compulsion to pay what you choose to pay for , is not as now, compulsion without deciding to! Few c...
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