Author Archives: Chris Perry

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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