General comments:   It was wonderful to be amongst such an enthusiastic group of diverse people, of wide age range, varied skin tones, many dressed relating to the country of their family origins, with and without disabilities (wheel chairs were very much in evidence); they seemed to reflect the diversity of our population as I experience it on the street. There was a joyful atmosphere despite almost all the topics reflecting the distress amounting to cruelty imposed by this current government on those least able to fight back; the hunger for change, just the prospect of being able to work in a co-ordinated and supportive way to do something about it is palpable. It’s always so stimulating to be amongst people who are energised to tackle the job for which we know there is such urgent need, although the practicalities of undoing the effects of this long austerity will not be easy. It was also useful to encounter organisations of which I was only vaguely aware previously. All the events out of the main hall in both the main conference and the World Transformed were jammed with people, seats quickly taken, standing room also gone and people bulging into the corridor, leaning one ear towards the door to catch as much as they could.

Women’s Conference:   The SHA Motion supporting Abortion Rights across the UK was not taken forward to the main conference. Coral Jones seconded this motion with a strong statement, and spoke of the dilemmas facing Northern Ireland GPs forced by the 1861 law to make decisions they wouldn’t choose in non-professional circumstances, and that Ulster women choosing an illegal abortion might face imprisonment for the rest of their lives. There is also the situation of BAME women who cannot speak openly for cultural and patriarchal reasons. The other motions were Childcare, Women’s Health and Safety and Women and the Economy. The motions, presentations and supporting contributions from the floor were so persuasive, I would have found it difficult to choose which one to support for the main conference had I been a voting delegate.   All of these motions indicate a deteriorating situation for women and therefore the health and well being of future generations too since such adversities cascade down the generations; problems introduced in one generation may never, or take many generations, or take many generations to be resolved. I suggest SHA takes up the 3 motions which were rejected for the main conference at an early date. Domestic violence, the silenced experience of 1 in 3 women is commonplace, whilst specialist supportive services for women and children have been lost since 2010. Two women killed each week in the UK is not a trivial matter; these murders are about male power and coercive control of ‘his’ woman and a new campaign ‘Level Up’ aims to get more informed, responsible, less sexist, reporting of these situations in which the woman is usually ‘blamed’ for promoting his violence. Support is being given to address male violence (which seems good), but takes funding from the woman and children and often gives the man access to his family again without having reformed his abuse of them

World Transformed – SHA, Health Campaigns Together and NEON (New Economics Organisation Network) combined presenting the debate on ‘Saving the NHS’. Speakers including Jean Hardiman Smith and Deborah Harrington (www.publicmatters.org.uk) made excellent cases with many references back to Nye Bevan’s ‘In place of fear’, how the arguments and threats raised in chapter 5 of this pamphlet in the 1940s are very relevant today, services being unaffordable, people living too long, demand too high etc… and to Julian Tudor Hart’s Inverse Care Law applying throughout the World. There was a pertinent reminder that services free at the point of need only matter if they’re of good quality. Bonnie Castillo, a nurse from the US – National Nurses United (www.nationlnursesunited.org) – pointed out that most and rising ill-health in the US is from preventable diseases, US neo-natal mortality is the highest in the developed world, and that though grass roots demand ‘Medicare for All’ is huge, it’s frustrated by corporate donor pressure blocking supportive Democrats from voting for it. It’s a timely reminder for us in England as corporate lobbying of politicians erupts volcanically here; conflicts of interest seem never to be challenged now and politicians switch easily between well paid corporate and governmental posts.

Fringe meetings on the Future of Care and Universal Credit (in association with the Trussell Trust) were predictably bleak. Barbara Keeley MP said all aspects of care is in crisis, (services, informal family and paid care); care itself had become more intensive and complex as people live for longer, sometimes with profound disabilities and requiring much more intimate intensive personal support often than before. The hollowing out of social care had led to 25% of caring situations now rated as poor resulting in ever more responsibilities being left to involuntary ‘volunteer’ family / friends. The Government’s promise of a Carers Action Plan (vague at best) and extra support for young carers had been forgotten, whilst Local Authorities, deprived of funding could not meet statutory responsibilities, so many people in England now never even approached their Councils for help, thereby contrasting with Scotland where Social Care is still funded. A commission to investigate the range of problems consequent to unpaid care in England would raise the profile of family carers and point out its impact on neglected matters like their entitlement to a pension; a pension is only available to those on the meagre Carers Allowance. The lack of training for unpaid and newer recruits to paid care also needs addressing; insofar as it works currently, the care system relies on an older workforce teaching the younger recruits voluntarily. Re-ablement, helping people to recover care for themselves is of very low priority. It would be useful to publicise the Dilnot Commission Report on Social Care (2011) and its recommendations and to take government to task for its failures. Why call it a caring system when it clearly isn’t?

The many flaws of Universal Credit and the damning report of July 2018 were aired. The numbers of food banks increased by 13% in the last year, 52% in areas where they were fully established already. The Left Behind Report has highlighted the brutality of the immediate problems of 70% of claimants who go into debt whilst waiting to gain access to support. No-one at these meetings could ever doubt the urgent need for reform of Universal Credit and re-instatement of a proper supportive welfare state providing the safety net it used to do with benefits linked to needs. Work coaches are primarily about implementing cuts. It’s not ‘just about managing’, but a question of survival now with 66% of benefit spent on food and the rest on utilities and never forgetting that this situation applies to 1 in 6 families where at least one member is in work and in work poverty has risen from 13 to 32% in recent years.

There were 2 SHA fringe meetings, both held at the Quakers and chaired by Jean

Emma Dent Code, MP for Kensington and Chelsea claimed it was the most unequal borough in Britain, with care homes run by a well known provider, it has 4 of the worse in the country according to the CQC, it has 4 food banks and has had the greatest fall of life expectation ever recorded – 6 years since 2010. She gave the example of a male in one part of the Borough with a life expectation of 63 years, whilst another living near Harrods would have 92 years. She reported many Grenfell related horror stories.

Judy Downing of the Relatives and Residents Association gave an outstanding presentation of the Labour Party’s failure to highlight the lack of standards and needs of the work force in care homes, many of which were run by small providers for profit. She claimed 1.4 million paid carers in care homes had no qualifications, (whilst this is a situation worse than operated in kennels, the same is true for informal family carers). Staff turn-over in care homes is about 28% (costing an estimated £3 – 5 billion), many leaving in less than a year, and about 50% of care homes are inadequate. Currently, US companies are making 12% profit from care homes in exchange for ‘crap’ care.   She suggested CQC should be nationalised to address these horrors with mandatory regulations and training elements.

Eleanor Smith MP called for re-nationalisation of the NHS, with a proper training budget again. Social care and care for the elderly budgets had plummeted since the 1980s, and the NHS would soon be in the same state if nothing was done. Private providers, international hedge fund managers (‘vampire capitalists’) would soon be able to affect health budgets – a clear conflict of interest – and Local Authority care workers are being warned off speaking about what’s happening. 60% of care homes don’t do health checks, there have been 3 times as many cuts in residential home beds as in the NHS. A Mental Health Capacity Amendment Bill if enacted would allow a care home manager to make the decision to deprive someone of his liberty – a privatisation of liberty! There is a financial incentive NEVER to discharge a patient when it is so profitable to keep him, as has happened for decades in private mental health care homes.

In the Health Inequalities session we were reminded of the Black Report of 1980 which linked health inequalities and poverty and was ignored by Mrs Thatcher so that since then, services have been lost and deaths have risen. How many more tragedies will happen before it is realised that we need a properly funded NATIONAL Health Service? The process has been to carve up the NHS, give powers to the Local Authorities then slash their funding. This has resulted in public health, drug and alcohol services, sexual health clinics, mental health rehab facilities, women and child welfare and support facilities, preventive medicine of all kinds, life expectation and quality of life all plummeting. Staff see a daily erosion of their service, they are subjected to constant pressure, unrealistic targets, so that many at all levels leave ill. Cuts and privatisation are rife. This is a quote from a nurse who can’t wait to leave ‘I did not become a nurse to make profits to line wealthy pockets.’ The NHS is for the people NOT profiteers. NHS Well-being terms are needed to address the injustice and assess the impact of all these changes on the lives people live including those with chronic and disabling health conditions (not forgetting mental ill-health), the unemployed, especially women’s and BAME’s lives

On the last day, Denis Skinner’s contribution was welcomed with a standing ovation. He described being inspired to leave mining and become an MP by the Atlee government of 1945. He has seen an inclusion at the Conference just not seen in everyday life. A fairer society should be judged by the obstacles it overcomes. He was there at the birth of the NHS, mentioned the various surgical procedures without which he wouldn’t now be addressing us. One was a heart by-pass performed by a United Nations team, and he listed all the countries from which the various medical staff had come – it was huge, as was his reception with laughter, clapping and cheering as the list went on and on.

Judith Varley   11.10.18.

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