Brexit starves public policy of its oxygen 14 December 2018 It’s a funny way to take back control: vital areas of public policy that directly affect our lives are being sacrificed to the obsession with Brexit, and there seems little chance of respite. While Brexit sucks up all the political oxygen, major areas of public policy, including local government, health and social care, are drifting. Councils in England have finally had details of how much money they will have for the next financial year, after the financial settlement was postponed for the Brexit vote on 11 December that didn’t happen. But the local government minister, Rishi Sunak, has said the outcome of the fair funding review – the long-discussed overhaul of how local government funding is distributed between authorities – will not be revealed until “late spring” next year (late spring being one of those elastic political seasons that can stretch out long enough to encompass early Christmas shopping). It is not that the delay is critical; it is the attitude of contempt towards local government that angers councillors and officers. The NHS long-term plan has been oscillating between imminent publication and postponement until the new year. It’s caught between Brexit and, as Denis Campbell revealed, a bust-up between the NHS England chief executive, Simon Stevens, and the government over his refusal to promise a leap in performance in exchange for the £20.5bn of additional funding announced over the summer. Read the full article at Guardian Society __________________________________________________ Councils are used as austerity punchbag 30 November 2018 The truth is finally out. Parliament has been told that ministers have no vision for local government beyond carrying out basic functions dictated by Whitehall. Even while cutting real terms local government funding by 49%, the government usually at least pretends it sees some wider role for councils in shaping the future of their places. But evidence from Melanie Dawes, permanent secretary at the Ministry for Housing, Communities and Local Government, to the public accounts committee inquiry on local government spending has laid bare the true position. She told MPs: “We believe that the sector as a whole is sustainable if the amount of resources available to it can deliver the statutory services that it is required to deliver.” When pressed she added: “We also have an eye on whether there is some flexibility in the system for responding to events, emergencies and so on, or indeed to be able to provide that broader leadership of their area.” The event – or possibly emergency – she highlighted was Brexit. Dawes’ revelation is critical for local government as it heads towards next year’s spending review by the chancellor. It prepares the ground for little or no real terms increase in central funding. Read the full article at Guardian Society __________________________________________________ Poverty and illness are ugly bedfellows 16 November 2018 Deprivation is robbing people of years of good health from their 30s onwards, driving people out of work and reinforcing poverty as they head towards retirement age. A huge new study by the Health Foundation shows the impact, as poverty piles pressure on NHS services. More than 14 million people in England now have more than one health condition: this detailed study of 300,000 people with multiple health conditions reveals that people living in the least deprived fifth of England have an average of two conditions when they are aged 71, while those living in the most deprived fifth reach the same point at 61. Around 16% of people aged 65-74 in the least deprived group have four or more conditions. For the most deprived group, that figure leaps to 28%. But living with multiple conditions is by no means restricted to older people – significant gaps in health are already apparent by the time people reach their late 30s. As other studies have shown, deprivation and having multiple conditions is strongly associated with frailty, with symptoms such as weakness and weight loss. This is blighting the lives of many younger people as well as older people. Read the full article at Guardian Society __________________________________________________ There is a toxic culture among NHS staff 2 November 2018 The most recent NHS staff survey revealed that more than 15% of those working in the health service have experienced violence from patients, relatives or the public in the previous 12 months. It’s the highest figure for five years. According to research by Unison and the Health Service Journal, violence is particularly high in trusts struggling to meet their performance targets or with large debts. Attacks include being stabbed with needles, biting, spitting and sexual assault. Research in the US illustrates the many ways in which staff can be attacked. While intoxication or confusion are obvious problems, health professionals are also particularly at risk while trying to put in tubes or intravenous lines, or while trying to give injections or take blood. Violent incidents may also occur when patients are being moved, such as from a chair to an examination table, while another common problem is patients attacking staff because they want to leave while being treated. Attacks like these don’t just impact on staff themselves: there are indications that health workers who feel fearful or defensive provide lower quality care. Read the full article at Guardian Society __________________________________________________ UK babies are dying because of the cuts 19 October 2018 The increase in UK infant mortality over the past two years, after more than a century of decline, is the starkest indicator of how we are failing to support the physical and mental wellbeing of children and young people. The frightening implications for individual families and the long- term pressures on the public sector have been spelt out by the Royal College of Paediatrics and Child Health, which on Monday published its projections of likely outcomes for child health up to 2030. The study compares the UK with the EU15+, comprising 15 long-standing EU members plus Australia, Canada and Norway. It shows that by 2030 the UK infant mortality rate will be 80% higher than the EU15+, even if the country resumes its previous downward path. If we carry on as we are, the rate will be 140% higher. As always, the impact is greatest among the poorest. To put this into context, United Nations’ estimates of infant mortality indicate that only about six other countries have had increases over the past two or three years. We are keeping company with Dominica, Grenada and Venezuela. Read the full article at Guardian Society __________________________________________________ Whistleblowers still hit by closed culture 5 October 2018 As whistleblower Dr Chris Day finally gets his case fully heard, it is clear the health service and the rest of the public sector is still far from establishing the open culture that has repeatedly been promised. Day is the latest in a long line of NHS staff forced to fight in an employment tribunal after making what he asserts was a “protected disclosure”. It is true there has been progress. Following the 2015 review of health service whistleblowing by Robert Francis QC, there is now a network of “freedom to speak up guardians” across NHS trusts, supported by a national guardian for the health service, a post energetically filled by Dr Henrietta Hughes. Her first report, published in September, reveals that more than 7,000 cases were raised with freedom to speak up guardians over the previous year. A third involved patient safety and service quality, and 361 people alleged they had suffered at the hands of their employer as a result of raising concerns. That thousands of people feel able to approach the guardians – albeit a fifth of them anonymously – is promising, and Hughes pushing for action at the trusts that failed to record any cases is a good sign. Read the full article at Guardian Society __________________________________________________ Public sector staff are being pummelled 1 October 2018 Despite some cautious indications that the worst of the public sector job cuts may be over, local government is still being hammered, pay is still being suppressed and the future for many workers is still precarious. After eight years of being beaten down by austerity, the once- unacceptable has now been normalised. The relentless attrition upon adults’ and children’s services, including the loss of 70,000 local authority adult care jobs since 2009, has become framed as merely the annual round of difficult decisions, rather than the withdrawal of essential services for the most vulnerable. Even the shocking realisation that austerity is shortening lives has caused barely a ripple. Sharp rises in gun and knife crime have accompanied a huge decline in police numbers. Having bottomed out in December 2016, police staffing staged a brief recovery before slipping back. While the NHS has certainly avoided the worst of austerity, a failure over many years to plan for its workforce requirements has left roughly one in 10 medical and nursing posts unfilled. These vacancies mean that patient safety is being compromised every day in virtually every hospital. Operations are being cancelled. Read the full article at Guardian Society __________________________________________________