Category Archives: Health & Wellbeing
Steve Barclay MP on the NHS
On Monday an MIU Seminar was presented to Councillors at Fenland District Council.
I asked for permission to share the slide presentation with the public and was told “yes.”
So here it is:
Tonight I attended the meeting held by the Clinical Commissioning Group (C.C.G.) at the Queen Mary Centre. It was interesting.
From the outset the local LabKipInd (the new name for the generic mish-mash of “not Conservatives” who make up a ragtag “opposition” in the town) did their best to turn the whole thing political. They tried putting propaganda leaflets on every seat. They had bussed in a Labour Councillor from King’s Lynn who also just happened to be a Unison Rep. They had virtually every notable Leftie summoned to take part. Their questions, which repeatedly started with “I’m a local Labour Party member…” and then went on to try and make the whole thing about “Government Cuts” really didn’t work. The public weren’t interested in it at all.
The C.C.G. lady was very good. She presented their situation well, she explained the reasons why services were being considered. And she went to some lengths to suggest that among the options on the table was also an “improved service offering wider treatments.” You’d never know that from the generic “Austerity Is Doom” shouting from the LabKipInd.
The public questions were intelligent, heartfelt and useful. Once you stripped out all the Momentum-style “wholesale privatisation of the NHS” stuff that the Labour, Independent and ‘Kippers seemed to be spouting, it was all really quite useful.
Her presentation done, the C.C.G. lady presided over a well-chaired and wide-spanning discussion. It was a good example of consultation at work, even if it is all a bit late. Better late than never. Now it’s important that we push for an outcome that involves improved health services for local people.
A few points I liked. I enjoyed the fact that the lady pointed out that the C.C.G. decisions are overseen by the County Health Committee, and recognised Cllr. Paul Clapp from his membership of said Committee. He has been making comments about “Government Cuts” when he is the only local Councillor who sits on the relevant Committee able to challenge this stuff first hand, he does not appear to have been doing so AT ALL, and it was high time somebody called him on his slippery avoidance of that.
No matter how many times Momentum people, Marxists and other collective Left-Wingers tried to push the C.C.G. lady to say this was “all about Government cuts” she absolutely refused to agree with them. She made reference to the challenging budgets that they face – an aging population, better life expectancy, more health challenges – but also admitted they have a billion pounds and were not “short of cash” just “overspending”. This is good, since the whole “cuts to the local NHS” mantra has been false from the outset. No budget can be allowed to be a bottomless pit and all organisations have to be sure to get best use of their taxpayer pounds. Value for money isn’t “right wing” it is pure common sense.
Most of all I enjoyed the little debate at the end of the meeting. I don’t know what the collective noun for a bunch of Momentum and Union people is, do you dear reader? How about “a Coercion of Momentum and Union types?” Okay, so a Coercion of Lefties approached, spitting feathers over the fact that I hadn’t given their propaganda leaflet the attention and respect they felt it deserved. (I balled it up. Though this was tame compared to some of the things I saw other people doing with it. To be honest, given how many were left laying around I think I was being conscientious in not leaving the litter for the cleaners.) Since I’ve argued with them about that stupid leaflet since they first started trying to spin with it, I don’t know why they were surprised. But in fierce debate with them, I challenged each of them to admit they were not telling the truth. Each of them in turn attempted to divert the discussion rather than do so. What has happened to local Labour – who appear to be completely in the grip of the Corbynite Momentum movement – is tragic. They used to be completely different to this. In the end, they resorted to name-calling. And then made a plea to avoid name-calling. It was all very muddled. But I think they may have just been a bit grumpy because so many chairs in the now-empty hall were still adorned with their leaflet. Not much “take home” going on there.
Silly local politics aside – the meeting was useful and the public performed well, giving the C.C.G. people much to think about. It rather seemed to me like they were beginning to backtrack and move towards much better outcomes than has previously been suggested. I certainly hope so. Time will tell.
Despite my attempts to make Virginia Bucknor see reason and drop the party political nonsense in regards to the Minor Injuries Unit, she’s rejected that entirely.
So now we have her, the local Labour “Momentum” people, a disgraced ‘Kipper, the ‘Kipper who sits on the Health & Wellbeing Board (who are supposed to oversee things like this MIU business, but seems to want to blame anybody but himself) and the local “Green” activist all choosing to run the “austerity is to blame” and help the CCG avoid culpability for their poor decisions.
All evidence aside, this seems to be nothing more than a quick way to score party political points.
I tried to be reasonable and not let past grievances get in the way. I asked her several times to rethink her approach and stand together. She scoffed at, reviled, or ignored, every attempt.
If we lose the Minor Injuries Unit because of weakness and disunity, or because the CCG have been given an easy “out” to push closure, I swear I will never let anybody forget the part her group played in it – and she was the key organiser and instigator who created the leaflets which began the political nonsense.
The fight isn’t over. I guess we’ll just have to campaign separately and hope we can still win. But what a terrible shame it has come to this.
United We Stand, Divided We Fall
I know that some of my political opponents watch my blog, or are told when I post something of interest. Nothing wrong with that.
So this message is for them.
The Minor Injuries Unit is too important for political games.
It would be easy to make it political. I have information I could easily use which would do so. But I am choosing not to do so because we all have to STAND TOGETHER on this.
Trying to make it “Political” with a capital “P” is a very very bad move. Trying to make it about “national cuts” (which it is NOT) or to turn it into a point-scoring election issue in advance of next year’s County Council election is also a very very bad move.
We have to be ONE VOICE. United. Standing together. If we are not we will lose, and our Town will lose its Minor Injuries Unit and potentially the whole hospital. Our disunity will be used against us, our differences capitalised upon.
PLEASE. Labour. UKIP. Independents. Anybody else. For this one issue if nothing else, put aside the Politics and just campaign for common sense and for the good of our town. If you do this then you will have my 100% support and I am sure the support of all my colleagues. Nobody but nobody wants the MIU to close.
WE ARE ON THE SAME SIDE. Don’t throw it away!
Direction Of Travel
The following blog post is my personal view only, based on my anecdotes as previous Cabinet Member for Health & Wellbeing at County Council many years ago, as (briefly) the Chairman of the Health and Wellbeing Board, and based on the alleged leaks brought to public attention by Steve Barclay MP. They are strictly my personal view and not the view of any Council or other body – and they are based on the emerging picture and my observations only.
A few years ago when the County Council first went to “no overall control” and the Rainbow Alliance of UKIP, Labour, the Lib Dems and the Independents set about their act of turning it into a Committee System rather than a Cabinet System I warned what the consequences would be. I said that it was a recipe for stagnation and weakness and that we would be feeling the consequences for years to come. We have been and we still are. Trouble is, when some bad policy appears it can be hard to trace the roots back and note the cause. Such is always the way with these things.
Our current problem with the C.C.G.’s apparent desire to close our Minor Injuries Unit is one of those consequences. But how? It certainly is hard to see and you have to understand some of what went on, and why, to follow it. Defenders of the Committee System, who really should be hanging their heads in shame by now, will deny deny deny as they always do. Which is a shame because the ongoing local costs of this farce will continue to reverberate until the whole useless shambles of a system is wiped away.
Back when the Coalition Government decided to controversially shake up the NHS one of the aims was to localise the NHS service. To make it more flexible and driven by local needs. To make it more answerable to local demand. To give it local strategic and democratic insight instead of being run by very remote and distant bureaucratic grey-suited bean counters. It was a laudable aim. Although there was a lot of political saber-rattling about it, many senior NHS people I spoke to would privately admit that they saw the sense in it.
The senior body which would provide the strategic links and the democratic oversight was a new County-Wide body called the Health & Wellbeing Board. That Committee would comprise of senior people from County Council, District Councils, health partners, Public Health and the NHS.
The County Council Leader at the time was Nick Clarke and he understood very quickly the importance of this Committee to make the whole thing work. He determined to keep the Committee small, with only “senior players” at the table, in order to make it a place where meaningful decisions could be quickly taken and carried through. He also chose to be the Chairman himself. At the time some thought this a bit of a “power grab” given that he was already Leader of the County Council, but I believe that was not a fair view of his motivations. Indeed, the Senior NHS people and County Officers told me at the time that they thought this a strong move and they supported it. “It shows we are serious about the remit and breadth of this Committee and its role,” I was told by more than one senior official.
After a time, Nick Clarke handed the Chairmanship to me as the appropriate Cabinet Member – once he was confident that I understood his vision for it. I did. It had to be dynamic, flexible and provide an opportunity for all the parties involved to become greater than the sum of their parts. If something controversial, like the closing of a Minor Injuries Unit, were to emerge it was the Health & Wellbeing Board who would be on it in a flash, calling the C.C.G. to account, able to get to the bottom and look at alternatives very quickly because everybody who needed to make a decision was already connected to the Board. The results of the County Election meant that I never got to continue as Chair the Health & Wellbeing Board, but I certainly hoped it would be well-placed to continue its important role.
Unfortunately, that was when the Council fell to “no overall control” and the Rainbow Alliance immediately set to work dismantling a system that had worked well, replacing it with the toothless shadow that has emerged. They will tell you they did this to “reflect the changes in the political make up” and to be “more democratic.” I don’t believe a word of that. In my opinion, they did it partly out of spite – they didn’t want Conservatives in “control” anymore. And partly to give themselves the trappings of “power” without the responsibility that should come with it.
They created, in one short year, a system where the buck stops nowhere. Where decisions can be taken and apparently everybody can say: “Nothing to do with me Guv.” Where everything is quietly run by Officers and democratic oversight only happens when the dirt really badly hits the fan and creates enough waves to force the warring parties to briefly align in their position. Though not even then, sometimes. Watchers of County Council have noticed that the whole place has become disfunctional with some County Councillors openly calling for their own Council’s dissolution. Recently, they voted for “devolution” which most people I’ve spoken to are confident will ultimately mean the end of County Council (if they are prepared to give you a candid answer.) Yep. It could well be that indirectly, they voted for their own demise.
The effect on the Health & Wellbeing Board was apparent. The first thing they did was stuff it full of loads more members. The argument that this was “more democratic” didn’t mention that it was also taking a streamlined and effective Committee and changing its very nature. A bunch more Councillors from all different parties joined, creating an adversarial and political backdrop that had previously been absent. Its not that any of those individuals had anything but the best intentions. It’s not a failing of the Chairman or any other specific individual. Only that they were now one voice in a throng, lost in the hubbub of competing views. The power of the Committee was now diluted, in my view. I suspect this was deliberate. Some people take a very ideological view of the NHS and don’t want to see any democratic oversight on it.
At a Health & Wellbeing Board meeting in May one of the Agenda Items was called “Sustainability And Transformation Programme Update.” This from the minutes of the meeting:-
The Board received a report updating it on the progress of the Fit for the Future, Sustainability and Transformation programme for the Cambridgeshire and Peterborough area, since the last report on 17 March 2016. The report was presented by Catherine Pollard, Programme Director, NHS Improvement (NHSI) and Matthew Smith, CCG Assistant Director, Improving Outcomes. It was explained that the Programme Director was attending to mark the importance NHSI and NHS England (NHSE) attached to supporting the work being done in partnership with local colleagues to establish a long-term plan to bring the health economy back to financial balance, and more importantly, to address and deliver improvements in healthcare.
Introducing discussion of the report, the Chairman drew attention to its statements that a further update would be provided at the Board development day, and that early engagement with the public was planned from July 2016. Points made in the course of discussion included
(1) one of the themes of the Sustainability and Transformation Plan spoke of the importance of avoiding the need for acute care, yet under the Action Log item earlier in the meeting, the question of withdrawal and closure of services from communities had been raised; such actions (or rumoured actions) ran counter to the direction of travel, which was to extend services rather than withdraw them
(2) the Plan was about making resources work best for patients; it was necessary for the CCG and partner providers to take a broad and objective look at what patients wanted and needed, and avoid piecemeal discussion about closure in isolation from the Plan, particularly if older people were to get the services they needed within their communities
as part of efforts to make the Sustainability and Transformation work more publicly useful, and to support more positive wider public engagement, Healthwatch had been working with the CCG on the question of patient and public involvement within each organisation
(3) it was not entirely clear where leadership of the system resided
the financial situation of the NHS and last year’s significant overspend had created anxiety which was raising questions about future structures
(4) working together in the course of developing the Older People and Adult Community Services contract with UnitingCare had brought local health partners closer together
local councillor members of the HWB and NHS members needed to work together to improve the way the NHS functioned locally.
So first (1) they are challenged about closure of local services and they declare that this runs “counter to the direction of travel.” Notice that they don’t actually say they aren’t going to do it. But they certainly intimate that. “Move along now, nothing to see here.” Except, since our local MP has received leaked information we now know this was, it certainly appears, completely false. It would seem that at that point, while telling the Health & Wellbeing Board that they weren’t aiming to close local services, they have already decided that was exactly what they wanted to do.
The second paragraph (2) is a bit weasely, don’t you think? “Making resources work for patients” doesn’t sound like it means closing them down. But when you start hearing that people want to take a “broad objective look” and “avoid piecemeal discussion about closure” alarm bells should start to ring.
Particularly shocking is the idea that (3) “it was not entirely clear where leadership of the system resided.” Not because I’m actually surprised about that, only that it’s an outright admission of exactly what I predicted from the outset. Leadership should very clearly originate with the collective Senior People on the Health & Wellbeing Board, or at least with one of them answerable to the others, all working together to get the best outcome for the people of Cambridgeshire. But apparently that’s “not clear.” I guess, hypothetically, if you’ve cocked up a massive contract, lost millions and are looking to close vital services to pay for those mistakes, not being “entirely clear” where Leadership lies is quite useful.
Finally, the meeting apparently reminded “local Councillor members” of the Boards duty to “work together to improve the way the NHS functioned locally.” It’s a shame they felt the need to remind them. The only Wisbech Councillor on the Health & Wellbeing Board is Cllr. Paul Clapp, who was present at the meeting. I would have hoped he might double down on the claim that the Minor Injuries Unit was not going to be closed and get it in the minutes for posterity. It doesn’t appear that he did, sadly. But it’s hard to really blame the guy – after all, you heard what the NHS said: “Closing stuff? Nah. Don’t be ridiculous. That’s counter to the direction of travel.” Or words to that effect.
It is not unreasonable to suggest that we are now subject to the arbitrary decisions of remote, unelected bureaucrats again. The exact situation the new system was supposed to cure. That the new “working towards the services communities need” approach appears to mean closing them down.
That the signing of major contracts can lead to disaster and millions lost, and that this absolute disaster can be spun to sound like (4) a good thing “working together in the course of developing the Older People and Adult Community Services contract with UnitingCare had brought local health partners closer together”. Unbelievable. Essentially: “Our massive multi-million pound disaster has made us work well together.” As team-building exercises go, I’d stick with paintball. And isn’t “making health partners work well together” supposed to be the role of the Health & Wellbeing Board. Isn’t that its entire original remit, in short summary?
If the leaked information is correct that would seem to mean that the senior body covering Health & Wellbeing for our County, the better part of a million people, can now be openly deceived by the NHS with no consequences whatsoever. Except the consequences to the thousands of Fenland people who face the potential closure of their Minor Injuries Units. But it is not too late. The Health & Wellbeing Board can prove themselves as strong as ever. They can do so by making it quite clear, at their next meeting, that there will be no closures. That there will be no change in the “direction of travel.” And that the people of Fenland will not pay the price for the bad contractual management of the CCG or its lack of “clear leadership.”
On Mental Illness
For the record – I have not been diagnosed with a mental illness.
But that doesn’t mean I never will be.
Mental Health problems are very common in the UK, affecting around one in four people in Britain. Virtually everybody will know somebody; a friend, a family member, a colleague – who has suffered or will suffer with some type of mental illness during their lives.
Mental health problems can affect the way you think, feel and behave. Sadly, even though these problems are widespread and affect people from every part of society and every community, there is still stigma and discrimination towards sufferers. Sometimes this is due to a misunderstanding of what different diagnoses mean, sometimes it is due to fear or discomfort driven by a lack of understanding, sometimes it is just small-minded bigotry.
A mental health problem is every bit as real as any other illness and should never be demeaned, ignored or ridiculed simply because it is not as immediately visible as Measles, or Chicken Pox. Sufferers of serious conditions struggle with them, often extremely bravely and often in the face of confusing and frightening circumstances. Sometimes for their whole lives. They deserve all of our support and understanding.
I spent several years as Chairman of the Bowthorpe Association, a charity whose specific purpose was to support and help people with mental health issues. Then as Chair of Safer & Stronger Communities at County Council, then Cabinet Member for Health & Wellbeing at County Council, then Chairman of the Health & Wellbeing Board at County Council – I learnt more and more about these issues. Both the isolation and loneliness that some conditions lead to, but also the discrimination and challenges that many face.
The main thing I learnt is that anybody – literally anybody – could suffer from mental illness. It is not a sign of “weakness” any more than any other illness is. It is a disease that can come calling on you, regardless of their personal type, gender, racial origins or other personal characteristics. Sufferers need exactly the same thing as sufferers of any other illness. Love, compassion, understanding, support and friendship. It is entirely possible to recover from many mental health problems and live a normal and fulfilling life. That is made harder by people who are too stupid, bigoted or just plain mean to understand that an illness is just that. An illness. And those who can’t get this through their head should remember the old adage: “There but for the Grace Of God, go I.” It can happen to anybody.
Once again, for the record. I have not been diagnosed with a mental illness. But if I ever am, I will not be ashamed. I will seek help; from my Doctor, from my friends, from my colleagues. And I will do my best, with all the help I am offered, to get well. Just like any other illness.
Over 65? Get The Flu Jab And Get Flu Safe
Older people in Cambridgeshire are being urged to get flu safe with a free flu jab to help protect them this winter.
Dr Liz Robin, Director of Public Health, NHS Cambridgeshire and Cambridgeshire County Council said: “If you are over 65, it is vital to get a flu jab, to protect you at the time of year when you are most vulnerable.
“Flu is not like a bad cold. It can increase the risk of developing more serious illnesses such as bronchitis and pneumonia, or can make existing conditions worse. In the worst cases, the flu can result in a stay in hospital, and it can even be a killer.”
People aged 65 or over can get a free flu jab on the NHS at their GP surgery. This will give them the best possible protection against the virus. Those who care for older people are also advised to get vaccinated to protect not only themselves but the person they care for, who may be particularly vulnerable.
Now is the best time to get the jab to get in early and get flu safe in time for the winter.
Dr Robin added: “Flu is a highly infectious illness caused by a virus. The types of virus in circulation change every year as does the vaccine, so it is important that you have the jab every year, even if you had it last year.
“So help protect yourself and those around you by having a flu jab at your local GP surgery. And remember, the flu jab does not contain live viruses, so it cannot give you the flu.”
Simply contact your GP to arrange a convenient appointment and get your jab. It’s quick, safe and free for those aged 65 or over.
The Shape Of The Week
On Monday I was in Shire Hall for Informal Cabinet and then meetings with officers in regards to my cabinet portfolio. Today I am in London, on business – but I’ve had a number of calls and emails concerning casework and one from a Fenland pharmacist who I get regular useful news and reports from. I must look into the uptake of the Flu jab, which may need some publicity to encourage those who would really benefit from it taking the time to go get it.
On Wednesday I am back at Shire Hall for a Cabinet / Senior Management Team business planning meeting, followed by two meetings with charities as part of a county-wide charity network I’m trying to encourage for feeding into the Health & Wellbeing Board. I’ ve also got to find time to deliver the final batch of leaflets for the Police & Crime Commissioner elections on Thursday – I’ve done most areas in my county division now, but a couple of villages remain to do.
Thursday – most of the day put aside for electoral work of one kind or another. This will be a fascinating election if the turnout is as low as some expect because it will lead to some surprising and unusual results. I welcome this – the PPCs are such a new idea that having different models being tried across the nation will create a type of market approach, competitive, best practice and the like allowing innovation and creativity to thrive. Nevertheless, I hope our Conservative candidate wins here. Or, more accurately, I hope that the Labour or Lib Dem candidates do not win. That would be an unfortunate situation for our county going forwards.
On Friday I’m in Hemel Hempstead for a day’s work and then on Saturday I’m back in london for a convention which will eat up most of the day and evening. Sunday I will be attending my friend Sam Hoy’s baptism.
As weeks go, this one is quieter than most.
St Neots Cabinet Day
Yesterday the Cambridgeshire County Council Cabinet held its Cabinet Meeting outside of Shire Hall for the second time. Early in the year, readers, you may remember that Cabinet came to Wisbech (a trip which led to the Wisbech2020 project). This time cabinet headed to another corner of the county and to its largest market town.
The Cabinet day falls into two parts. In the morning there is the actual cabinet meeting which is a rules-heavy, procedural meeting with the tendency to send even the most engaged members of the public quickly off to sleep unless something controversial is on the agenda. This is necessary stuff, that must be discussed and decided as part of council business, but it’s not what any non-politico is likely to find exciting. Before the meeting the leaders of county and district councils, and the town mayor, gave short speeches and there was a public Q&A for them. After the meeting there were more public questions – handled in an informal and friendly way to promote discussion – with the full cabinet.
The second half of the day the cabinet members each zoom off around the town visiting groups, organisations, projects and sites which relate to their cabinet portfolio. This lets us see what is already happening in the area and talk directly to the people who are enacting, or affected, by what is going on. It also let’s people raise issues with us directly so that we can take them back to Shire Hall with a clear understanding of any problems or requirements.
First I went to the Ernulf Academy to meet the dedicated young people who are part of the KickAsh project (anti-smoking). I sat in on their training session and got to talk to them about the work they are doing and their views and ideas. These are some very bright youngsters doing some powerful work and clearly proud to be a part of it.
Then I walked about 100 yards to the One Leisure building (sports and activity centre) where the council Active Lifestyles team deliver subsidised healthy activities for older people and for people recovering from illness. There is a lot of great work going on here and I was impressed by the knowledge and zeal of the staff I spoke to. I had a very interesting discussion about the way these projects align with the council’s new Health & Wellbeing Strategy, most particularly in the area of Prevention and enabling people to live well and healthy lives. Some interesting ideas were raised which I will be taking back to the Health & Wellbeing Team at County.
I got a chance to look at the Adult and Family Learning opportunities available to people in St Neots and I was completely blown away by the wide range of interesting and useful choices – offered at very reasonable rates. These classes, which include everything from languages, to cooking, to exercise, to employment skills, are delivered out of the two schools run by the local academy – an example of excellent multiple use of buildings and connections between different organisations. I must admit, I was jealous. We need this in Wisbech. But I was there in my cabinet role – so I filed that little nugget away for later. I was teased by the ladies about my interest in something called PowerHoop, which is apparently fitness hula hoops. I expressed a view that men probably wouldn’t be good at hula hooping, but by men I did of course mean me. “You only need rhythm,” I was told. Ah. Right. Well that rules me out then!
I headed back into town to the St Neots Health Center and saw what I believe is a big step forwards in the way health services are provided. The drop-in center, which anybody who feels unwell can visit regardless of whether they are a registered patient, or have an appointment, or even live in the area, was bright and clean and sparkling with newness. There I met a whole team of health professionals dealing with everything from the work of a GP, through to mental health work, dietary advice, anti-smoking, sexual health and everything in between. I had a fascinating conversation with the ladies and gentlemen who serve the people of St. Neots medical needs and cannot express how impressed I was – both with them and the brilliant centre they operate out of. There was no griping or complaining or entranched-views – just a will to make people well and keep them well. There was even some excitement about the way the controversial NHS changes have played out – though you’d never believe such a thing could be true if you listened to some commentators.
Our wash up and debrief at St Neots Football Club made it clear that everybody was as taken with St. Neots as I was. This is such an awesome town! Yes, it has problems. No, those problems are not insoluble. Some political will at all levels, some collegiate working and a little elbow grease and I have every confidence that the wheels will begin turning. In some ways I had the easy bit – because in regards to health and wellbeing St Neots has a jewel in its crown already. But this bustling, exciting, busy town has a very great deal going for it. The Cabinet visit, I very much hope, will be a lever to push its gears into motion. The sky is the limit.
*A thank you is owed to Val Thomas, an officer who had was tasked with being my guide, which meant she spent the afternoon chasing around after me as I dashed from place to place like an overexcited puppy. I don’t envy her the task she had, but she performed it admirably and was a good sport and great company.