This April, the largest re-organisation of the NHS since its creation came into effect. GPs are now responsible for planning and purchasing health care for their local communities, via the Clinical Commissioning Groups which replace the old Primary Care Trusts. Meanwhile, the proposed closure of Accident and Emergency units at Charing Cross, Hammersmith and Central Middlesex hospitals is under way, and the NHS Direct phone service has been abolished in favour of the new problematic 111 line. And whilst the NHS has been protected from the worst cuts in public spending, which have been applied to local government, policing and elsewhere, cash pressures are building up nonetheless. Is it a coincidence that, this spring, the NHS has been convulsed by the worse emergency services crisis since the late 1980s?
Government Ministers would have us believe that the problem lies almost exclusively with GPs, whose new contracts, which came into effect in 2004, led to a collapse in out-of-hours services. This in turn has led to increased pressure on Accident and Emergency units. It is certainly true that A+ E attendances have been rising over the long term, but in fact the data shows that the largest rise in percentage terms happened before, rather than after, the new contract came into effect! Subsequently, while some GPs did change their working arrangements, with some buying out-of-hours services from private companies (with very mixed results), in other areas, including ours, many entered into new co-operative arrangements to spread out-of-hours cover between them.
Meanwhile, many other things have been changing too: the population has risen- especially in London, and our population is ageing fast (the two facts are, of course, connected). Older people, understandably, are much bigger consumers of health care. And the squeeze on local government has led to big cut backs in social care, which in turn makes hospitals less able to discharge patients into the community, and leads to a backing up of pressure throughout the hospital. Westminster Council is not alone in having cut social care for the majority of elderly and disabled users. The result is a classic case of savings in one place leading to extra spending in another.
What can be done? Firstly, we must not blunder into making the position worse. In the longer term there is a strong case for improving community services and concentrating emergency care in fewer, more specialist hospitals, but closures before alternatives are in place cannot be accepted. Second, given how fast patterns of demand and need are changing, and the long lead-in time for planning and delivering changes in care, we need to know that our information is completely accurate and up to date. Third, we need a new approach to social care, which includes piloting approaches that integrate social and health care more fully. Social care has been the poor relation for too long and this can't continue. Lastly, we have now learnt that this NHS re-organisation has been expensive, ineptly managed and a distraction from the real issues facing health care in this country. We can't turn back the clock, but we do need to learn some lessons fast- and one of them is: don't heap blame on the people who work in the NHS for what has gone wrong this spring. The quality of the workforce is our most important asset and in what should be an endless drive to raise standards, doctors, nurses and other health and care workers must be partners.
This April, the largest re-organisation of the NHS since its creation came into effect. GPs are now responsible for planning and purchasing health care for their local communities, via the...
Over the years of being a MP I have worked hard to engage and communicate with my constituents using all available forms of communication. I have made great use of new technologies especially emails and twitter. However, it is not always easy to communicate complex and difficult issues in short mail-outs or quick web-posts.
For those of you that know me, I have always tried to tackle the issues within Westminster and recently have been no different. So far this year I have commissioned two surveys gathering local opinion on the Harrow Road and Basement Developments, along with challenging the changes to policing within the borough and London as a whole.
This is why I have decided to start to link these reports and letters through my new Scribd page to my website.
Please find my first two entry's on Basement Developments and my response to the consultation on police premises and policing in London through the links below-
Read them on my Local News section of my website.
Karen Buck MP
P.S. Coming soon my report on the Harrow Road.
Over the years of being a MP I have worked hard to engage and communicate with my constituents using all available forms of communication. I have made great use of...
It wasn't long ago that people retired from work expecting, at best, a few years in which to enjoy the fruits of their labour. The transformation of our society into one where retirement spans decades for the majority is remarkable, welcome- and challenging. There are now more pensioner than young people in our society for the first time. So the question of how to provide and pay for good care- whether medical care in hospital, or social care at home- is one of the most profound of our age. There has been plenty of bad news to ponder. The collapse of standards at Mid-Staffs hospital may be the biggest and most deadly scandal to rock the health and social care world, but enough stories have emerged about neglect and apparent indifference towards elderly patient in the public and private sectors to justify a rigorous re-examination of our whole approach. The costs of residential care can easily run into the tens, if not hundreds of thousands of pounds, forcing many people to sell their homes to cover the bills. Meanwhile more than £1.3 billion has been cut from local council budgets for older people's social care since the Coalition came to power. As a result, many vulnerable people can't get the support they need and are having to pay more for vital services. 8 out of 10 of those who used to receive social care from Westminster Council lost that service as this government's cuts began to bite in 2011.
Doing nothing isn't an option and the money has to come from somewhere. A commission led by the respected economist Andrew Dilnot suggested care costs be capped at £35,000, to provide some certainty for older people and their families. This week's government announcement does not go nearly that far- setting the maximum at £75,000. This is still a step forward, and will help some people who need residential care in 5 or more years time but Dilnot warned that anything above £50,000 won't provide adequate protection for people. And these proposals won't do anything for the hundreds of thousands of elderly and disabled people who are facing a desperate daily struggle to get the care and support they need right now.
We are going to need a far bigger and bolder response to meet the needs of our ageing population, including a genuinely integrated NHS and social care system which helps older people stay healthy and living independently in their own homes for as long as possible. That will inevitably mean a fair contribution from those who can afford it, but one capped at a realistic level, so it can be planned for and so that the number of people forced into losing their homes in their lifetime is as low as it can be. Long life should be a cause for celebration. Our generation's task is to ensure that the celebration doesn't curdle under the pressure of costs and the lottery of care.
It wasn't long ago that people retired from work expecting, at best, a few years in which to enjoy the fruits of their labour. The transformation of our society into...
Boris Johnson and Met Police consulting on massive programme of police station closures
The Metropolitan Police service is under huge financial pressure, and must save £500 million out of its £3.6 billion base budget by 2014.
The suggestion is to get rid of around one-third of the buildings/space the Met occupies. Many boroughs are being advised that there will only be 1 24-hour station in each area, althoughWestminster is expected to keep more than one.
The Deputy Commissioner has said:
We are considering reducing up to 65 front counters and replacing them with over 200 contact points in popular locations such as community centres, supermarkets and shared local authority buildings. Every borough will maintain one police station open 24/7.
As of earlier this year, Westminster was served by the following:
- Belgravia: 24 hours.
- Marylebone: 24 hours.
- Charing Cross: 24 hours.
- Paddington: 24 hours.
- Harrow Road: 24 hours.
- West End Central: 24 hours.
- St John's Wood: 9am - 5pm Monday - Friday
Since then, Marylebone and St John's Wood stations have closed to the public (and, in the case of St John's Wood, without any effective prior consultation).
As at least one station will obviously have to be maintained in the West End, the concern is that either, or possibly both of, Paddington Green and Harrow Road stations will close.
It is obviously reasonable, over time to review the police estate, especially as fewer people are visiting stations in person as more are making contact on-line. It is also sensible, where possible, for public services to look to share premises .But, because the police, council and NHS are all under pressure and out-of-step with each other co-operation is not as easy to do as it should be.
I would certainly not oppose all change, if proper alternative provision were made and any money saved was used to keep up police strength and did not reduce response times.
• We need to know exactly what we are being consulted on. Is the intention to close either or both of Harrow Road and Paddington Green stations? If so would this mean the entire station or just the public access counter? This has not been spelt out.
• What impact would the loss of access to Harrow Road station have on a deprived community with a high level of social stress? We have been fighting for ten years to clear up the drug dealing and anti-social behaviour around the Prince of Wales junction, and there is a real risk that the loss of police presence in the area would set this back.
• Similarly, would the closure of Paddington Green impact upon Church Street, Little Venice and the Edgware Road, which are also areas of high mobility and stress?
• At present, there is no custody suite in the north of the borough, requiring police to travel to the south after each arrest, with all the travelling time this implies. What guarantees can the Met give about the impact on response times and the extra time it takes police to travel across Westminster each time they have to take someone to the custody suite?
• If there is a plan to introduce new police contact points to offset counter closures at either of these stations, how many and where? Have negotiations been entered into to secure these premises?
On top of this massive programme of station closures, emergency services are being cut back in many other areas too:
• London Ambulance Service will lose £53million (19% of its budget) by 2015/16, resulting in 890 job cuts. 560 of which will be frontline staff
• We have already lost over 1,900 police officers in London, including half our SNT sergeants
• London is losing seven A&E departments
• And 31 fire stations are at risk of closure.
I am writing to protest about the inadequacy of this consultation, and to make these points about station/counter closures, but I would very much welcome your comments or questions. You may also want to make your own representations
Jubilee Sports Centre Closure
As you know, Westminster Council took the decision to go ahead with the closure of the Jubilee Sports Centre in order to upgrade the Moberley Centre- although this must still go through the planning process.
Thanks to the massive campaign against the loss of facilities at the Jubilee, the Council have agreed to build a new community sports facility on the Jubilee site and to upgrade the Games Area at Queens Park Gardens to allow for increased and more varied use.
This does not meet the objections of most of the campaigners but it is better than losing a facility at the Jubilee entirely.
However, there are many other concerns which still have to be addressed:
• The impact on Queen's Park Gardens
• How the needs of the sporting community (and specifically footballers) can be reconciled with the interests of other park users and more casual play.
• The importance of providing an open access space on the Mozart estate itself to replace the basketball court
• How the Jubilee replacement will be funded to ensure it doesn't stand empty for lack of revenue
• Whether the buildings/gardens currently occupied by the Ark Atwood school can be brought into the wider scheme after the school moves to its permanent base.
The first Project Engagement Committee meeting took place on the 19th November and local campaigners, councillors and I are remaining closely involved with thrashing out the details. Again, your comments are very welcome.
Tell me your views:
• Please don't forget to respond to my survey on the impact of basement excavations!. Although this issue only affects parts of Bayswater/Lancaster Gate and St John's Wood, for those people who find themselves in the middle of such developments the effect on their lives can be horrendous
• Please complete my survey on the Harrow Road and local environment. Cllr Dimoldenberg, your Westbourne, Harrow Road and Queen's Park councillors and I are working together to get a better picture of concerns about the physical environment, community safety and the shopping outlets along the Harrow Road so we can discuss with Westminster Council and other agencies what improvements can be made, and whether planning and other powers could be better used to improve the quality of life in the area.
And finally: May I also take this opportunity to wish you a very Happy Christmas and New Year
Karen Buck MP
Boris Johnson and Met Police consulting on massive programme of police station closures The Metropolitan Police service is under huge financial pressure, and must save £500 million out of its...
Work Programme has failed local job-seekers
The Government flagship Work Programme has so far failed to deliver access to jobs for Britain's long term unemployed- in fact, so bad have the outcomes been that better results would have been achieved by doing nothing.
Here in Westminster, which should benefit from access to the huge labour market in Central London, only 3.6% of those referred have been found work by the private contractors paid to deliver. This leaves Westminster at position 216 out of 379 local authority areas in the country.
The Coalition government scrapped Labour's Future Jobs Fund in favour of the Work Programme, although an evaluation published this week found that the Future Jobs Fund, unlike the Work Programme, was a success and made a net contribution to the economy.
Work Programme has failed local job-seekersThe Government flagship Work Programme has so far failed to deliver access to jobs for Britain's long term unemployed- in fact, so bad have the...
This week, a tiny minority of those entitled to do so will exercise their right to vote for elected police commissioners. These elections will cost around £100m- at a time when the police service nationally is being expected to cut its budget by £1 in every £5 that it spends. London won't be voting- Boris Johnson fulfils that role in the capital- but the challenges are the same. The 20% funding cut is leading to decisions such as the selling off of New Scotland Yard, the loss of 891 Police Community Support Officers be and the closure of up to 65 police stations.
Last month it was revealed that the Mayor might not be able to keep his election promise to have 1,000 more police officers in London than when he took office. Boris has written to the Metropolitan Police asking them to come up with their final proposals for cutting £148m next year. Her Majesty's Inspectorate of Constabulary has stated that the government may be able to cut the policing budget by 12% without damaging front line services- the actual demand is for 20%.
Here is Westminster some 230 PCSO posts have gone. Police officer staffing levels look as though they may be broadly protected but it is essential that this does not mean so much attention on the ‘high volume crime' areas in the West End that the residential communities in the North are squeezed. But we also await further information on police station counter closures. St John's Wood station has already got a notice in the window shutting up shop, which is not exactly the way in which these decisions should be announced.
Services and public expectations change and it may be possible to agree on at least some rationalisation of the estate- especially if this helps protect policing levels,. Neighbourhood police teams can sometimes operate from other locations which are even more accessible, for example. However, the loss of 65 stations in London would fundamentally change the feel of the policing presence. Even more modest options need to take place out in the open, with clear, agreed criteria and above all, transparency in the consultation and decision making processes. As I said to the Met Commissioner a few days ago, the police must raise their game dramatically when it comes to good communication with the public, whether at a counter, or via the phone or e-mail. I believe that the general public view would be that, so long as response times are guaranteed, policing is visible and calls and e-mails are answered thoroughly and promptly, some changes may be possible. What must not be allowed to happen is a slow process of boarding up police stations without proper debate and a concrete guarantee of policing quality and responsiveness in exchange. How possible this will be with a demoralised service under huge financial pressure is another matter.
This week, a tiny minority of those entitled to do so will exercise their right to vote for elected police commissioners. These elections will cost around £100m- at a time...
Energy bills are one of the biggest costs facing families. But only 20 per cent of people are on the cheapest deal. With so many confusing tariffs on the market, people find switching energy supplier difficult, or give up trying because all the companies seem to put their prices up. That's why Labour has organised our www.switchtogether.org.uk scheme.
THE LABOUR PARTY DOES NOT MAKE ANY MONEY FROM THE SCHEME
How does the scheme work?
1. Sign up free and with no obligation to tell us you are interested in switching suppliers to save money
2. You can sign up from 26 September 2012 to 25 November 2012
3. You will hear from us in late November 2012 with an offer of an energy tariff based on your usage
4. We will let you know when you need to tell us whether you want to accept the offer.
And that's it! If you accept the offer, we will provide support and guidance during the process to switch you to your new tariff.
No access to internet or email?
Up to five households can register using the same email address - so if you don't have email, ask a friend or neighbour if you can use their email address (and tell them about our scheme at the same time).
You can also call the free number 0800-048 8112 (from 8:00 a.m. until 5:30 p.m.) to request a paper form.
Energy bills are one of the biggest costs facing families. But only 20 per cent of people are on the cheapest deal. With so many confusing tariffs on the market,...
The national debate about welfare has taken on a distinctly harsher tone of late. Perhaps it is not accidental that the hard line emerging from the government to accompany announcements of a further £10 billion in cuts ( on top of the £18 billion beginning to work their way through the system now) is wrapped in ever tougher language. For if the public perception is that social security really is excessively generous, traps people in dependency, and is mostly claimed by shirkers and fraudsters, then cutting a few more holes in the safety net is just that bit easier. The trouble is, so many of the announcements made by government ministers to justify their positions are either wrong, misleading or flimsily anecdotal. So here are a few myth-busters.
Myth number 1: ‘You are better off on benefits". Wrong. Work already pays in almost all cases, even where wages are low, because of the availability of in-work benefits to help with housing, Council Tax or to top up low pay (tax credits). The trouble is, it often doesn't allow people to keep much of their earnings. The new Universal Credit being introduced by the government next year may roll a number of benefits and tax credits into one, but it works on the same principle as the system it replaces, topping up low incomes and withdrawing as incomes rise. There will be gainers from the slower rate at which benefits are withdrawn under Universal Credit, and because of the increase in the personal tax allowance, but many others will be worse off or see no benefit- and unfortunately the losers look like they will include many London households facing the highest housing and childcare costs.
Myth number 2: Spending on welfare for people of working age has spiralled out of control. Although spending on benefits like Job Seekers Allowance, Income Support and Employment Support Allowance do, of course, cost a considerable amount, they account for less than one-sixth even of all social security/tax credit spending- the largest parts of which are pensions and support for low income working people- and 3.4% of all public spending last year.
Myth number 3: We have a crisis of inter-generational worklessness. In fact, if you don't include students, just 1.5 households out of every 100 have never had anyone in work ( that includes disabled people), and the number of inter-generational unemployed is tiny . The bigger issue is that so many people move in and out of employment, usually because the jobs are themselves temporary, seasonal or casual, and 1.4 million people are working part-time when they really want full-time work.
Myth number 4: There are jobs for all who want them. At last count, there were 5.5 people chasing every registered vacancy, but this figure rises to over 20 to 1 in parts of Scotland, Wales and the north of England. Welfare Minister Ian Duncan Smith has said more than once that there are half a million new jobs referred to Job Centre Plus every week. The true figure is around one tenth of that.
Myth number 5: Under the last Labour government, welfare dependency grew. In fact, up until the recession hit it 2008, the number of working age people on out-of-work benefits numbers had been falling steadily. The majority of the fall was in unemployed claimants, the numbers of which fell by a third over the period.
Myth number 6: Poverty is all about the ‘behaviour' of the poor, including the 120,000 ‘troubled families'. But 3.8 million children live below the poverty line, and half of families in poverty have at least one adult in work.
No-one is arguing that we shouldn't take fraud seriously and that there aren't some people who abuse the system. And it is true that work is usually both valuable in its own right and critical to lifting people out of poverty. Yet we risk spending too much time on the wrong things, when our priorities should be jobs growth and apprenticeship opportunities, skills training fair pay, affordable housing and childcare. So we miss the bigger targets and in the meantime, real people suffer.
The national debate about welfare has taken on a distinctly harsher tone of late. Perhaps it is not accidental that the hard line emerging from the government to accompany announcements...