On the campaign trail – Beck Row

0% County Council Tax rises for Beck Row

Out on the campaign trail in Beck Row

So, we have voted in the 2017/18 Suffolk County Council Budget having defeated Labour’s financially dangerous spend, spend, spend plans and delivered on our key 2013 Manifesto pledge of 0% base Council Tax increases, making 7 year at 0% since 2010.

Our manifesto has been a year in the making and is completed, a mixture of innovation and careful financial planning ever mindful of the need to protect the most vulnerable in our communities and ever mindful it’s your hard-earned money.  We will launch it on 17th March both in paper form and on our web site http://www.suffolkconservatives.org.uk/

So, our regular survey and canvass work steps up on the streets talking to resident about our track record and plans for the future.  They say all politics is local and of course that is true so as I start my campaign off as I always do in Beck Row there are a mixture of concerns from a highways parking problem at the local convenience store which I am getting sorted out, to the bigger picture of what is going to happen with Mildenhall Air Base, (its really RAF Beck Row as you can see in the picture on the left) which we are working on but will take a bit longer!

As I am out and about I am asking residents to fill in my survey or do it on line as we now have our surveys up to make it easier for residents.  The one for Beck Row is http://www.surveymonkey.com/r/beckrow

It’s going to be an interesting few months as we set out our vision for Suffolk County Council’s Future and Labour and the Liberals promise as they do, everything your heart’s desire, just one small problem they never ever tell you that they can’t deliver it.  Same old Labour always spending your hard-earned money and same old Lib Dems always…well that depends what you want them to say. As for UKIP… we are leaving the EU so move on.

The battle lines are drawn and now to the campaign.

 

Hospital A&E Winter Pressures & Social Care

A&E sign imageYesterday saw the latest figures for A&E waiting times published and Addenbrookes Hospital at Cambridge, our local major trauma centre declared a ‘major incident’ which are early warning light systems that we have a problem, of course all businesses have peaks and troughs but these figures are particularly worrying is that it’s not a harsh winter rather mild actually and we are out of the ‘perfect storm’ period of closed GP Surgeries over the Christmas period. All of us must use the right services at the right time but interestingly records show that predominately those who present at A&E are right to do so, so what’s the problem? Essentially it is our ageing population, that long talked about issue is now starting to ‘bit’, with unplanned admissions of elderly people at the front end and bed blocking at the far end. With bed blocking perhaps being the first signs that the cuts in local government funding to provide social care and an increasing number of people needing services are making discharge of elderly patients ready to go home increasingly problematical. The figures bring into focus the need for the whole system to work better from GP services, to pharmacists, out of hour’s services, intermediate care beds (that’s what used to be called convalescence) to social care.

The debate rages about Health and Social Care which is the single biggest interface and spend area for Local Government (about 40% of most upper tier authorities budgets) and the NHS spends about £1 in every £6 of national total spend. As Portfolio Holder for Health and Social Care integration at the LGA’s Community Wellbeing Board and LGA CWB Health and Wellbeing Board Ambassador for the East Midlands I firmly believe we have the structures in place to tackle an Ageing population but need Westminster’s continued backing for the Health and Wellbeing Boards to be the place this integration is championed by and driven forward from.

The danger is that as the issue starts to impact hospital’s ability to cope with admissions, Government looks towards the NHS to quick fix the problem and I tend to think reading between the various lines out there, not least Simon Steven’s, the new CE of the NHS, 5 year vision speech, the NHS is quietly lobbying to take control of social care.

This would have two fundamental impacts firstly the cost of social care would rise dramatically, as frankly however well the NHS does things it never does them cheaply. Local Government is the most cost effective part of government for a reason, firstly it’s local, and secondly, and far more importantly, Local Government is articulating a different approach to services built around community capacity and how communities and individuals develop care services in part for themselves. This cannot be done centrally or nor by organisations trying to begin to learn what this thing called ‘community’ and ‘capacity’ is all about. Much of Local Government has for some time been cutting costs and at the same time working differently with communities and developing services in communities and to dismiss it as not clinically valid (in the NHS sense of the word) and start again is a serious mistake. Local Government and the health services in their many forms, through the Health and Wellbeing Boards must be the start and finish point for Health and Social Care integration to solve these problems as our population ages.

Policy to Reality

On Monday I blogged about my Mum’s passing and how ‘far too close to home’, I saw the system of health and social care, policy, commissioning and providers work, in our case, rather well. But as the various systems kicked in I thought to myself you know what, this is precisely why we must get the policies, funding and the way we set up the system, right. This stuff does actually matter for those vital moments in our lives when we need the system to take good care of us.

Last Wednesday I attended the Local Government Association’s Community Wellbeing Board meeting in London and in amongst a packed agenda was a discussion on Better Health and Social Care integration. One of those think tank pieces put together before the next parliament to give the Westminster politicians food for thought as the return after the general election, about the policies they need to enact to hopefully improve the system rather than hinder it.

Geoff Alltimes and Richard Humphries from the King’s fund were in attendance to discuss with us the Barker Report, as it will be known after Kate Barker who is heading it up, as they go about the evidence gathering stage. Here is a link to a short video explaining the commission and its remit http://www.kingsfund.org.uk/audio-video/kate-barker-commission-future-health-and-social-care-England

The report certainly pitches a wide variety of ideas about the future funding of the NHS and what is the role of social care in amongst its mix. Amongst them is such headline grabbers as charging to see your GP or attend A&E alongside the less sensational but more fundamental about the notion of a free NHS and how it sits so uncomfortably with the financial assessment and charging for Social Care. It was quite bizarre as the NHS element of Mums’ care was delivered and you could ‘watch before your very eyes’ the money being spent and yet when it came time for a small element of social care to be planned, out came the forms for this assessment and who is going to pay and the charging mechanism. This is not a criticism of those who very involved as they handled it very well but for such a small element of Mum’s care suddenly the system changed and it was jarring.

At the Board meeting we also discussed the governance and accountability of the NHS and I made the point hat there are so many, many structures in the NHS with vast armies of friends, governors and structures to delivery such things that in reality does it really work or it just a maze where no one, including those who designed it, quite knows who is responsible for what and when it goes wrong across an array of services, well!!. Because in my experience whenever you ask a question of any aspect of the NHS someone seems to point at someone else, just look at the Francis report on ‘Mid Staffs’ Hospital.

In an earlier blog I explored this with new Directors of Adult Social Services, how in local government, Councillors are the first point of call for residents because they elect them. The line to Directors to respond, is one email not a vast system of accountability. In making my point I was stressing to both Geoff Alltimes and Richard Humphries how I saw the future of an NHS delivering services but local government being far more involved with elected representatives being the key local way in which the NHS is provided with accountability and governance. It will be interesting to see their final report and I’ll blog it when it’s published in the autumn.

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