Author Archives: Joan Walmsley

Baroness Joan Walmsley writes…Wasting a rare resource – and children’s lives

One of the worst scandals in the NHS is the provision, or lack of it, for children with mental health problems.

“Stick with us” is a major report by the Children’s Society about more than 150,000 missed CAMHS appointments in 2016. It is estimated that, at £290 per appointment, they cost £45m last year – much less than it would cost to collect proper data about child mental health. The last proper data was collected in 2004, so it’s not just the present government who are to blame.

These figures, obtained by FOI requests to providers of specialist CAMHS services, are obviously available to government. However, one can only assume that the government did not know, or chose not to find out, how bad the situation is.

As the report points out, there are many reasons why children and young people miss appointments: failure of parents to get them there; lack of transport; lack of appointments at an appropriate time; length of waiting time (average 58 days) between referral and initial assessment so people forget about them; length of time between assessment and first treatment (average 41 days but up to 208 days); stigma; etc etc.

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Baroness Joan Walmsley writes….Tories ensure more taxation without representation

It was Thomas Mayhew, minister of the West Church in Martha’s Vineyard, who coined the slogan “No taxation without representation” in 1750, capturing in that phrase one of the major causes of the American civil war.

Of course, this phrase reflected a clause of the Magna Carta, written in 1215.

British citizens who live outside of the United Kingdom are currently entitled to vote in elections for only 15 years after leaving the UK, but the Conservatives promised to extend this to lifetime enfranchisement in their 2015 election manifesto. The Tories said they were intent on “scrapping the rule that bars British citizens who have lived abroad for more than 15 years from voting” and would introduce “votes for life”, opening up registration to more of the five million Britons who live abroad. (There are currently less than a quarter of a million overseas residents registered to vote.)

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Baroness Joan Walmsley writes…150% rise in patients forced to move GP surgery as practice closures hit record levels

One of the jewels in the NHS, for as long as I can remember, has been the family GP. My GP looked after my mother before I was born and looked after me until I moved away from home. In those days the GP’s long acquaintance with my whole family was important to us. Everyone had a “family doctor”. They even did home visits!

Things are very different now. We still have primary care and acute care, but many more community nurses, health visitors, therapists and care workers, not forgetting the wide range of services offered by community pharmacists and local authorities, where they can still afford it.

Demographic change and rising demand have put enormous pressure on GPs and, in some areas, people turn up at A&E rather than wait for an appointment. However, the role of the GP is still critical to the NHS and it is important that the system enables them to play their part in preventative medicine as well as diagnosis and signposting to other services.

Unfortunately, the demand for a seven-day service, without enough extra money to pay for it, and the enormous pressures on GPs time has made it a less attractive option for newly-qualified doctors. This has led to problems recruiting enough doctors to keep practices going and an increasing retention problem. Many GPs, especially partners who have extra duties and responsibilities compared to salaried GPs, are retiring early. In the last quarter of 2016, there was a net loss of 390 GPs in the NHS. This gives us no confidence in the government commitment to recruit 5000 more GP’s by 2020. According to the BMA, even the 5000 extra training places will only allow us to break even in GP numbers.

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Joan Walmsley writes…Taxing patience and taxing patients

In order to “incentivise employers to think differently about their recruitment and skills decisions and the balance between investing in UK skills and overseas recruitment” (Lord Nash in the Lords on Tuesday) the government has decided to introduce an Immigration Skills Charge, a tax of £1000 per employee, per year, paid in advance by an employer wishing to recruit a skilled worker from outside the European Economic Area.

It does not apply to everyone, of course. Exceptions have been made for a variety of post-graduate scientists (including social and humanities scientists), research and development managers, and higher education teaching professionals.

Two groups that have not been exempted are professionals in health and social care. We know that both of these sectors are heavily dependent upon recruiting professionals from all over the world. We know only too well, from report after report, of the dire financial straits of the NHS: three quarters of NHS trusts are in deficit; nearly every A&E has limped from crisis to crisis this winter; we are short of nurses and retention is awful; hospital doctors’ rosters are unfilled; and GP practices can’t replace retiring doctors. The staff have become the shock-absorber for the NHS.

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Baroness Joan Walmsley writes…Can’t we agree to agree on funding health and social care?

A sight that all of us will have seen since the Autumn is ambulances queuing at A & E and patients waiting on trolleys in hospital corridors. Some of us will have seen the situation at first hand, waiting with a relative or waiting for treatment. Bed occupancy has been dangerously high in many hospitals, with senior managers and doctors having to take decisions that, in some instances, are literally life or death.

Upsetting as these images are, they show only the tip of a very large iceberg that is threatening to sink an NHS and the social care system unable to cope with demand.

Three reports have been published this week which expose the crisis in other key services.

The Kings Fund’s report “Understanding NHS financial pressures: How are they affecting patient care?” looked at the impact on four services that rarely make the headlines: genito-urinary medicine (GUM) services; district nursing services; elective hip replacement services: and neonatal services. The report states:

The growing gap between demand for services and available resources means that staff are acting as shock absorbers, working longer hours and more intensely to protect patient care. ….
Our findings create a fundamental challenge to the direction of travel set out in the NHS five year forward view ……the NHS appears to be moving further away from its goal of strengthening community-based services and focusing on prevention, rather than making progress towards it.

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Baroness Joan Walmsley writes…Will new PM’s actions speak louder than her words?

On Tuesday, just two days before parliament starts its recess and less than a week after Theresa May first addressed the commons as Prime Minister, Sir Simon Stevens, CEO of NHS England, wrote about his priorities for the NHS. 

For most of us his comments and overall strategy will seem eminently sensible. The question I ask myself is this: Will Theresa May’s government pay lip service to Simon Stevens’ strategy or will they actually commit to the funds and action needed to carry it through?

You might say I am being unduly cynical and that I am not giving this new PM a chance. You may be right, although keeping Mr Hunt as her Secretary of State for Health does not strike me as very smart, given that he is so toxic to the doctors.

Stevens expresses concerns about two policy areas in particular – obesity & mental health, both of which are not getting the focus they deserve.

He points out the vital importance of effective action on obesity. This is not a matter of the nanny state lecturing people on how much they should eat. This is a critical health issue that affects the whole health service, not just in terms of funding but through the need to treat a whole range of different diseases. Financially the cost to the Treasury is now more than the police and fire services combined. One result of the separation of our health care services into NHS, on the one hand, and local authority social care and public health responsibilities on the other, is that it is your under-funded local council’s job to prevent obesity but it is the NHS that has to treat the myriad of diseases that arise from it. However, there are strong rumours that the long-awaited obesity strategy has been weakened because of business lobbying since it was first mooted by the government last year, while the LGA reports that funding cuts are threatening councils’ ability to be effective in this and other areas of public health.

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Joan Walmsley writes…Planning for a healthy future

Hooray for Sir Simon Stevens, Head of NHS England, for putting into practice what I was proposing at last year’s Party Conference! In my keynote speech I maintained that the NHS cannot tackle the country’s current and future health problems by itself and we need a “whole government” approach. The Department of Health must be supported by policies from the Department of Communities and Local Government, the Department of Education, the Department of Transport, The Department of Culture, Media and Sport and, of course, local authorities, since it will not be able to tackle the increasing demand for healthcare by itself. Prevention of avoidable illnesses should be the responsibility of every Government department.

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Joan Walmsley writes … Disadvantaged children should be prioritised in the Early Years, says House of Lords Committee

Childcare Centre

Liberal Democrats have done a great deal in Government to provide more and better early education and childcare. From increasing the free entitlement for three and four year olds and extending it to disadvantaged two year olds to introducing the Early Years Pupil Premium and helping parents with the costs through tax relief, this government has been on the side of young children and their families.

Two things have happened relating to childcare in the last two weeks. Nick Clegg has made some commitments about what Liberal Democrats would fight for …

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Joan Walmsley writes … Campaigning in York

Baroness Walmsley and Cllr Keith Aspden at CastlegateI visited York recently to campaign with our council group there, led by Councillor Keith Aspden, on a couple of important local issues.

One was the Labour decision to close a multi-agency youth advice centre at Castlegate without putting appropriate alternative provision in place. This very successful centre has helped thousands of young people with issues to do with jobs, housing, benefits, drugs, education courses and a whole lot of other matters, many of them linked together. That’s why the multi-agency model is so effective. We were able to highlight how short-sighted the Labour Group were to propose closing it down.

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Baroness Joan Walmsley writes…The NSPCC does not go far enough

Children Walking on TrailThis morning the BBC had an exclusive story from the NSPCC. They have at long last shifted their position on making it a crime to cover up child abuse and have come out with a very half-hearted and confusing policy. I call it “safeguarding light.” Instead of making it the duty of everybody with the care of children in a regulated institution (like a school) to report to the Local Authority any child abuse or serious suspicion of child abuse, as I am advocating, they are saying that …

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