Extra time to write to the Independent Healthcare Commission about health cuts

The Independent Healthcare Commission set up by four boroughs and chaired by Michael Mansfield QC to look into the effects so far of the implementation of the Shaping a Healthier Future proposals has extend the deadline for submitting evidence to February 24th. This is the evidence Brent fightback has submitted:

In addition to the points made in the BTUC submission which Brent Fightback endorses, we would like to add that effective out of hospital care, care in the community, cannot be provided if social care provided by the Council is slashed.

Brent Council's funding has been drastically cut and among their proposals to achieve a balanced budget are many cuts which will severely damage the quality of care available - in particular the reduction in time from 30 to 15 minutes for carers' visits which has been widely criticised by elderly peoples' charities as ineffective and dehumanising. Also the closure of the (ironically titled New Millenium Day Centre which caters for 80 plus people with complex mental and physical needs - the group SAHF proposals are supposed to focus on.

Also the withdrawal of any provision for rough sleepers who have a high level of unmet health needs and already a disproportionately high level of A&E attendances because they lack alternative means of care.

At the other end of their residents' lives, Brent Council proposes to close ten of its seventeen children's centres. As well as providing facilities for play and education, children's centres often host health services for under-fives including baby and child clinics and advice on health and diet for parents and their small children. Brent has a very poor record on child immunisation, dental health, child mental health and obesity. If these facilities are lost, the NHS primary care services will be put under even more strain.

This is the Submission made by Brent Trade Union Council
 

Over many years the Brent Trade Union Council has campaigned with other concerned organisations and the local trade union movement about the cuts to the local health service.Our colleagues in the health service unions warned us that the removal of services from Central Middlesex Hospital (CMH) would lead to the eventual closure of A & E.

Central Middlesex Hospital was rebuilt and extensively modernised at a cost of more than £62 million, reopening fully in 2008. This modernisation was funded in large part by PFI and was specifically designed for emergency medicine.

In spite of this, over the intervening years, many services have been moved from CMH to Northwick Park Hospital in a far more prosperous area. Services were transferred without consultation, because there was no obligation to consult since the two hospitals were part of the same trust. Staff were often given only a few days' notice that they were required to transfer and eventually Central Middlesex was left without the back up services needed for its A & E to remain viable. So we have a situation where management moved the services, then used it as a justification for saying that A & E was no longer safe or effective as maintaining an A & E service is dependent on the full range of hospital services being available to patients. Yet, right up to the day of its closure the A & E department at CMH was still being sent patients from the overstretched departments at both Northwick Park and St Mary's.

Having moved so many services to Northwick Park and closed the A & E at Central Middlesex, the CCG is now responsible for a splendid modern building which they will have to pay for until the end of the PFI contract and the dilemma of how to make use of it.

Throughout these years, Primary care services have been severely overstretched and continue to be so despite the Shaping a Healthier Future organisation and the local CCG having a “vision” of improving those services by investing to prevent illness, lessen the need for hospital admissions and shorten the length of time patients need to spend in

hospital. Of course the BTUC supports improvements in primary care, but promises were made that these improvements would be in place before radical changes were made to hospital services. However, they remain, to quote the CCG's own documents, “visions” and “aspirations”.

There is a crisis in recruitment of GPs, community nurses, health visitors and other staff needed to transform these visions and aspirations into reality, just as there is a crisis of recruitment for hospital staff and an expensive and destabilising reliance on agency staff. BTUC believes that the government's refusal to pay NHS staff even the 1% advised by their own pay review body and the housing crisis which is extreme in Brent, contribute to the recruitment crisis in the NHS, while cuts to the Council's budget threaten the provision of adequate social care, essential if patients' needs are to be met in the community.

The two Brent wards closest to the hospital, Stonebridge and Harlesden, are some of the most deprived in the Borough. The Locality Profile for Harlesden makes for grim reading. Harlesden is ranked in 30s for deprivation for England.

Despite having a young population 32% below the age of 20 years, in Harlesden ward, life expectancy is 13.4 years for men and 9.6 years for women less than the highest expectancy rate in Dudden Hill ward. It can be described by a tube train journey. If you take the train from Harlesden station and travel a few station north you will gain a decade in life expectancy.

Chronic Illness is significantly higher when compared to London and England figures, the biggest killers are Cancer, Circulatory and Respiratory diseases.

Mental illness affects one in six residents, TB is the second highest in the Borough and HIV is “considered to be very high” (Locality Profile).

Too many Children are found to be obese in their reception year when starting school and teenage pregnancies are also high.

We have only outlined a few items from the Brent Locality Profile for Harlesden Ward but we want to emphasise how completely unacceptable it is to close the A&E and other services in the middle of a population that so desperately needs a proper A&E and the important the general health services that go with it.

To compound this misery the facilities at Northwick Park which is the A&E that is suppose to replace the CMH facility, cannot cope with the extra load from the CMH and was rated as the worst A&E in the country.

The near impossibility of using public transport to go to Northwick Park. The difficulty of taking a sick child in the middle of the night to the A&E does not bear thinking about. Again the Harlesden and Stonebridge wards have the lowest levels of car ownership and minicab costs are prohibitive for those on low incomes.

Brent Trades Council also want to support and be associated with the submission from The Hammersmith and Charing Cross Save Our Hospital Campaigns.

On behalf of the Brent Trades Union Council please place our submission before Mr Mansfield.

 Brent Fighback adds:

In addition to the points made in the BTUC submission which Brent Fightback endorses, we would like to add that effective out of hospital care, care in the community, cannot be provided if social care provided by the Council is slashed.

Brent Council's funding has been drastically cut and among their proposals to achieve a balanced budget are many cuts which will severely damage the quality of care available - in particular the reduction in time from 30 to 15 minutes for carers' visits which has been widely criticised by elderly peoples' charities as ineffective and dehumanising. Also the closure of the (ironically titled New Millenium Day Centre which caters for 80 plus people with complex mental and physical needs - the group SAHF proposals are supposed to focus on.

Also the withdrawal of any provision for rough sleepers who have a high level of unmet health needs and already a disproportionately high level of A&E attendances because they lack alternative means of care.

At the other end of their residents' lives, Brent Council proposes to close ten of its seventeen children's centres. As well as providing facilities for play and education, children's centres often host health services for under-fives including baby and child clinics and advice on health and diet for parents and their small children. Brent has a very poor record on child immunisation, dental health, child mental health and obesity. If these facilities are lost, the NHS primary care services will be put under even more strain.

 

Submissions should be made to: Peter Smith, Clerk to the Commission, at Hammersmith & Fulham Council. Submissions should be addressed to him at Room 39, Hammersmith Town Hall, London W6 9JU or sent by email to peter.smith@lbhf.gov.uk. Later submissions will be forwarded to the Commission but may not be given the same attention as those received by the deadline.

NO TO AUSTERITY - Brent TUC October 11th

Butt on the cuts and next year's budget

This report on the meeting with Cllr Muhammed Butt, leader of Brent Council is from Wembley Matters

Speaking at an open meeting of Brent Trades Union Council Wednesday September 26th, Brent Council leader Muhammed Butt admitted that some of the decisions the  council had made could have been made more wisely and that things could have been done differently. He said that he wants to take residents' views into account more in the future and that desire had caused some 'push back', which had culminated in the argument with Gareth Daniel.

He said that he wanted to take a detailed look at the council's budget, "How we provide services and why, reviewing every service."  He said that all directly employed council workers would receive the London Living Wage from October 1st  and that the council would be writing to schools to urge them to pay the LLW. He would be meeting with the London Living Wage Foundation to find ways of ensuring all the council's suppliers were London Living Wage compliant. He said that given the current difficult times the council had to do something positive to put money in people's pockets.

Other initiatives were to look at tenancies and how the council could improve standards without increasing rents, extend collective  energy procurement to include residents as well as council buildings and schools, and find ways of strengthening voluntary organisations such as the Credit Union, Private Tenants Group and the Law Centre.

He said, "We want to go back to what Labour stands for and why we are here."

In the discussion Butt was urged to recognise that the Labour Party was much more than just a council, it was part of the labour movement, and thus should be a campaigning  organisation against the capitalist system. He was asked how he was planning to organise a fightback alongside trades unions and the community.

Butt responded, "Me being here is just a start. I am willing to go anywhere, whether to a warm reception or a hostile one, to have a dialogue."

 He said that the Labour Group had appointed a new local organiser who would help get their message across and have a dialogue to move things forward, "We are starting campaigning and need to raise awareness. We want to make that change and if we don't our residents will suffer."

Asked about the budget process and council tax increases and urged to construct a needs budget as a campaigning tool,  he said that with the changes in the consultation system (The Area Consultation Forums have been replaced by Brent Connects) with a member/officer Any Questions type panel there would be more of a dialogue. Council Tax rises of 2.5% and 3.5% had been factored into budget planning but the council were waiting to see what other London councils were doing. The government's announcement of the settlement had been delayed until December but the council wanted an  indication before then. The council were also lobbying the government over the additional 60,000-70,000 extra residents indicated by the latest census which could be worth an additional £4m . This could negate the need for a rise in council tax because the council would only get 65% of the money raised by an increase He indicated that because of the delays the statutory consultation may run out of time.  He invited people to feed specific suggestions and questions into the budget making process.

When others present pursued the issue of making a needs based budget (ie deficit budget)  Cllr Butt said they were looking at campaigning  against the cuts. However, "We can oppose the cuts but budgets have to be set. We wouldn't be doing anyone any favours if the commissioners came in. They would keep only statutory services such as schools and adult social care. We would lose Sports Centres for example. We would land ourselves in more problems by taking that route. Instead we will have a dialogue which may mean working with other London boroughs. If you are asking us to take a lead, we will take a lead."

Outlining the sums the council needed to run services he said that government funding to Brent  was now £152m, was £192m, and by 2016 would be £110m.  Schools and Adult Social Care took £140m of this. The council needed £250m to run services so this total had to be made up from Council Tax and fees and charges.

Another speaker told Butt that a needs budget could not be set in the Town Hall, the council need to go out to voluntary organisations, trades unions and community groups - that was real democracy. He claimed that Labour had "forgotten what democracy looks like". In the absence of a fightback all sorts of rightwing nastiness and racism could arise.

Another speaker returned to the issue asking, "Are you considering a needs budget. It is a good propaganda tool showing what is needed and where the gaps are. Are you considering this or just administering cuts? We can't wait for the next Labour government. We need concrete exmaples of how you are going to fight."

Butt said that he was not ruling out a needs budget which would "show how much we have lost and how much we need". . Muhammed's new political advisor  he would be lobbying the Labour Party over how much cash needs to be put back into local government after the disproportionate cuts it had suffered.

On the issue of Willesden Green Library, raised by three members of the audience, Cllr Butt  said that he had met with Keep Willesden Green campaigners and had passed on their concerns to Galliford Try, planners and the Regeneration Team, and their points will be taken into consideration for the new plans being presented in December.. He said that the old Willesen Library was now being retained and this meant internal redesigns. The council were still looking at 92 private units at the back of the site and this was the only way to fund it.

He was challenged with  the alternative of a small amount of building and refurbishment and the loss of the cinema,  bookshop and car park in the current plans.   The questioner said, "It's like saying I need a new boiler so I will knock my house down! I've heard it called asset stripping."  Butt responded that a lot of the 'stuff' in the 80s building had come to the end of its natural life and the building was unfinished. The cafe and cinema  had closed as a result of not being used. "We need a mini Civic Centre in Willesden so people from this area don't have to travel all the way to Wembley and we need it an no cost to us."

On the plight of the disabled he said that he took the point about how they were being hit and that he was looking at helping them through the Council Tax Support Scheme: "If we have to lobby the government we will do so."

In answer to another questioner about the council's ambivalent attitude to free schools and academies and a possible forced academy in the borough, Butt said that they were a last resort to address the shortage of school places. He said that for free schools the council had set out criteria for partners that would keep the essential principles in terms of admissions, ethos and teachers conditions of service. He was urged to consider federation of schools and extending schools as an alternative.

Asked about the Counihan family, Muhammed Butt said that it was a difficult case. Brent had 18,000 families on the waiting list and only 900 properties available. The council hoped to provide 1,700 affordable properties by 2014. He said the only way  to tackle the problem was through regeneration and Section 106 funds  and the council needed to find developer partners. The situation would be exacerbated by the new Right to Buy scheme which would take out larger properties.

Clr Butt concluded by saying that the council had been rubbished by the press and had to admit it had got its messages wrong: "We need to get better, even if it means starting from scratch."

Pete Firm, chair of Brent TUC said that he felt the council were rolling over in front of developers. Labour seemed to be assuming it was going to win the next election, However, it should not be a matter of voting Labour because the alternatives were worse but Labour putting forward policies that people would be enthusiastic about.