Cummings plan will fail deprived areas 10 January 2020 The obsessive focus of Boris Johnson’s advisers on shaking up Whitehall reinforces the failed belief that all the answers lie in better central government. If they really want the UK to be the most dynamic state in the world and to “level up” the most deprived areas, they need to devolve power away from London. There is good evidence that decentralised countries have stronger growth and better public services – and even the Treasury recognises that the UK is one of the most centralised states in the world. Instead of poking at the problem with a few grudging concessions negotiated through city deals, ministers need to give local government the decision-making and tax-raising powers it needs to make a difference. That would be the fastest route to “levelling up” and beginning to tackle endemic problems such as skills shortages, low productivity and poor public transport. The signals about how Whitehall will be reformed have been mixed. The growing expectation that the cabinet secretary, Sir Mark Sedwill, will be staying for the foreseeable future rather than becoming ambassador to Washington provides experience and continuity at the top. Read the full article at Guardian Society __________________________________________________________________ Queen’s Speech fails to deal with crises 20 December 2019 For all the talk of being bold and radical – a “blueprint for the future of Britain” – the government’s timid plans will perpetuate problems rather than solve them. Its tactic of focusing relentlessly on the NHS is distracting attention from other urgent social policy priorities. While the health service received star billing alongside Brexit in the Queen’s speech, there was little on the growing crises in social care and homelessness. The health and social care secretary, Matt Hancock, had previously let slip that his department had done nothing to prepare a policy on social care, blurting out that “we’ve already been having discussions about starting that work”. This is years after a green paper was promised by Theresa May’s government. The government’s 80-seat majority gives it enough parliamentary firepower to create a long-term solution for social care funding and up to five years in which to achieve it, but ministers are already setting it up to be lost in the quagmire of cross-party talks by saying they will be looking to build a consensus. Conveniently for the government, there is little chance of Labour agreeing a policy among themselves, let alone with anyone else, in the near future. Read the full article at Guardian Society __________________________________________________________________ Myths and ideology blight NHS policies 6 December 2019 The general election comes as every part of the NHS in England is in flux and social care waits for a reform plan. The two main parties are promising a monsoon of extra funding for the health service. But while Conservative commitments lack credibility, Labour’s ideological tinkering risks getting in the way of service delivery. The Tories trumpet their mythical 40 new hospitals, of which only six are funded while the remainder include 12 community hospitals in Dorset. Throwing cash at desperately needed projects such as rebuilding Whipps Cross hospital in London is better than nothing, but the Conservatives’ “famine then feast” approach to capital spending ramps up maintenance costs and harms patients by depriving the NHS of investment in vital technology such as scanners. The Tories’ promise to enshrine NHS England’s long term plan  in legislation matters because it includes legal changes to help NHS organisations collaborate on priorities such as improving population health, scrapping many rules around competition and procurement. Unlike Labour’s approach, this clears the worst of the wreckage of the current system out of the way without risking even more reorganisation. Read the full article at Guardian Society __________________________________________________________________ Scandals put spotlight on toxic culture 22 November 2019 The NHS’s worst maternity scandal raises fundamental questions about the culture and safety of our health service. The Independent has revealed that an inquiry into maternity care at Shrewsbury and Telford hospital NHS trust has uncovered dozens of avoidable deaths and more than 50 babies suffering permanent brain damage over the past 40 years. The trust joins the roll call of NHS hospitals where endemic poor care has caused harm and death. Failings uncovered at Shrewsbury include a lack of transparency and honesty, defensiveness, a disrespectful and unkind attitude to families, a failure to learn from or even recognise serious incidents, and a “toxic” culture. The 2015 inquiry (pdf) into deaths of babies and mothers at University hospitals of Morecambe Bay NHS foundation trust, the Francis inquiry two years earlier into failures at Mid Staffordshire, and the 2001 landmark public inquiry (pdf) into children’s heart surgery at Bristol Royal infirmary all revealed layer upon layer of systemic failings. These included the breakdown of teamwork, poor leadership, lack of respect between professional groups, a tolerance of poor standards, defensiveness, dishonesty, failure to assess risks, and repeated failures to recognise and investigate serious incidents. Read the full article at Guardian Society __________________________________________________________________ Austerity cuts lifelines for crisis families 8 November 2019 Domestic violence, poverty, poor housing and substance abuse are driving a surge in children at risk, as austerity pushes families over the edge. A survey of lead councillors for children’s services in England just published by the Local Government Association delivers a devastating assessment of the factors behind massive and rising demand, while the same relentless cuts fuelling it prevent local authorities from providing the care and support that is so badly needed. While much of the debate about council funding has focused on adult social care, the survey reveals that for each of the three years between 2015 and 2018, well over half the councils had to make significant cuts to children’s services. Half of the 152 councils in England responded to the survey, with 47% saying that budget shortfalls last year created a severe or significant risk to children’s social care. Cuts to services such as policing and youth work are aggravating factors, and there are major concerns about what will happen following the end of the budget for the Troubled Families programme next year. Read the full article at Guardian Society __________________________________________________________________ Dirty air is key to the climate emergency 25 October 2019 Nine more people in Bristol and 13 in Derby are going to have a stroke because of air pollution. Dirty air will give 12 more people in Birmingham and 87 in London a heart attack. In Liverpool, seven extra children with asthma will be hospitalised, as will five more in Nottingham. These stark figures from King’s College London on the impact of high pollution days on individual towns are a reminder that dirty air is a killer and that the climate emergency is a health emergency. But it is also a clear warning that while the NHS and local government are gradually getting to grips with the air pollution crisis, piecemeal solutions will fail without massive government action. Cutting air pollution by a fifth would result in 77 fewer children in Oxford and 150 in Southampton suffering low lung function each year. Twenty fewer people in Manchester and 17 in Liverpool would develop lung cancer. Like the microscopic particles themselves, air pollution is sometimes difficult to detect in the climate emergency debate. It is certainly part of the narrative, but the immediacy and severity of its threat is yet to be highlighted fully by campaigners. It is hard to think of a more compelling message than we are being poisoned in our own homes, right now, every day. Read the full article at Guardian Society __________________________________________________________________ Potential and risks of citizen assemblies 11 October 2019 As Extinction Rebellion protesters bring Whitehall to a halt, one of their three demands is for the UK government to cede control of climate policy to a citizens’ assembly. They are not alone: Camden council in London is already experimenting with a similar approach. And Camden’s move comes as councils across the country grapple with how to work with residents to make bold decisions and tackle the climate crisis. At least 11 councils are now using citizens’ assemblies to drive climate action, including Devon, Dudley, Cambridge and Test Valley. But will it work? Analysis by Friends of the Earth says Camden is already the best-performing London borough on the climate crisis, and one of the best local authorities in England and Wales. This week the Labour-run council unanimously accepted the 17-point action plan drawn up by a citizens’ assembly. As well as easy goals such as encouraging local people to eat low- carbon food and “make CO2 reduction fun”, it includes bold proposals such as making all new homes zero-carbon, piloting a community energy scheme and making all council properties fossil-free. But citizens’ assemblies are fraught with danger for councils if they blunder in without thinking through what they are unleashing. Read the full article at Guardian Society __________________________________________________________________