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    Today (Monday 6 July), hearings in the Grenfell Tower Inquiry begin again after a pause due to the coronavirus pandemic.

    The Fire Brigades Union (FBU) has called for no more “painstaking postponements”, saying that “in the cold hard light of day” the crimes of those responsible are apparent.

    Matt Wrack, FBU general secretary, said:

    “The bereaved, survivors and residents of Grenfell should have seen justice delivered by now, but instead have been forced to wait, first because of the obscene moves from corporate witnesses to secure immunity from prosecution, and then because of the coronavirus pandemic which made continuing the inquiry all but impossible.

    “We are now more than three years on from the disastrous fire at Grenfell Tower and there can be no more painstaking postponements.

    “Before hearings were paused, we saw those involved in the refurbishment of Grenfell Tower try again and again to evade responsibility. But in the cold hard light of day, the crimes of those who wrapped the building in flammable cladding, and who ignored the concerns are residents, are apparent – and they must be held accountable.

    “Firefighters continue to stand with the Grenfell community in their pursuit of justice.”

    Joe Karp-Sawey, FBU communications officer

    2 Comments

    https://youtu.be/1jFWY7WmPBA

    Campaigners and Lewisham residents offer thoughts and thanks to the NHS.

    The Save Lewisham Hospital Campaign has launched a new video on the 72nd Birthday for the NHS on Sunday, 5th July 2020. The Campaign say: “In the middle of a global pandemic, with 65,000 deaths in the UK, some thanks and thoughts on the NHS 72nd birthday.”

    Happy birthday to the NHS – you were clapped but tories will not deliver the cash needed #NHSBirthday #SecondWave https://t.co/WOrG41PeDl

    — Alan Hall (@alan_ha11) July 5, 2020

    On this day, The Observer reports that the Chancellor of the Exchequer, Rushi Sunak refuses a £10 billion cash injection as Ministers have been warned that a second surge of Covid 19 infections let alone the now usual ‘winter pressures’ will leave the NHS “crippled” and “perilously unprepared”.

    The Government promised that the NHS would receive “whatever it needs” and NHS bosses claim that this pledge is to be broken now.

    Further claims that the Government’s chronic underfunding of the NHS will inevitably lead on to the fragmentation and privatisation of the NHS have been made.

    Interestingly, in the video a resident reflects by saying:

    “Stop using Covid as a cover to push through a restructuring of the NHS without public consultation.”

    Periodically, when cash has been tight in the NHS proposals surface to downgrade Lewisham Hospital’s A&E Department.

    Brian Fisher, a retired Lewisham GP, in the video says: “We continue to defend you [NHS] and fight for publicly funded social care.”

    In that spirit, Cllr Alan Hall has written to the Chancellor of the Exchequer, Rishi Sunak supporting Citizen’s UK asking for social care workers to be paid the London Living Wage locally.

    You’ve clapped, now’s the time to act! 🌈

    We know that care workers deserve a real Living Wage so here’s a little reminder that you can send to your MP.

    Help care workers get a real #LivingWage by clicking the link below 👇 https://t.co/iwlaKjaPex#LivingWage4KeyWorkers

    — Citizens UK (@CitizensUK) July 5, 2020

    Time to pay care workers a London Living Wage

    Citizen’s UK say: “Careworkers have been on the frontline of the UK’s fight against COVID-19, but a Real Living Wage would put them at the heart of our economic recovery too. Increasing pay to £9.30 an hour (£10.75 in London) would enable a million low-paid workers to start spending in local businesses and communities up and down the country.”

    The text of the letter is below.

    Dear Chancellor Rt Hon Rishi Sunak MP,

    On the 72nd NHS Birthday, I am writing to you as a constituent to ask for your support for Citizens UK’s Living Wage for Careworkers Charter, which aims to ensure careworkers are paid the real Living Wage of £9.30 an hour (£10.75 in London).

    Those in the social care sector are at the frontline of the fight against Covid-19 and I know in our community so many care recipients and their families value their vital work.

    We have all been ‘clapping for carers’ on Thursday evenings in recognition of the danger they face, and yet they are often paid the minimum wage (also known as the National Living Wage) of £8.72 an hour.

    Citizens UK is calling for the UK government to invest the £1.4 billion that the Resolution Foundation estimates it would cost for every care sector worker, who delivers publicly–funded care, to be paid the real Living Wage of £9.30 per hour. This would allow careworkers to live with greater dignity and to escape from poverty pay.

    We know that the public, commissioners of social care such as local authorities, employers of care workers, and recipients of care would all like care workers to be paid the real Living Wage, but to do that we need additional investment from the UK Government.

    I really hope we can also count on your support for our campaign. Please let me know whether or not we can add your name to Citizens UK’s Living Wage for Careworkers Charter, which you can find below.

    Citizens UK’s Living Wage for Careworkers Charter:

    We all rely on the one million careworkers on the frontline of the UK’s fight against the pandemic. Careworkers have worked tirelessly throughout Covid-19 to look after the most vulnerable in our society – and have found themselves at risk, often without adequate PPE, and without the esteem afforded to NHS workers.

    Over half of frontline careworkers earn below the voluntary Living Wage of £9.30 an hour (£10.75 in London) and are struggling to keep their heads above water.

    As careworkers, care recipients, care commissioners, council leaders, politicians and community leaders, we all agree that no careworker deserves poverty pay. We have applauded careworkers on Thursday evenings – now is the time to match our applause with a guarantee that they will earn enough to live a decent life.

    We call on the UK Government to provide the £1.4 billion in additional funding so that every care sector worker that delivers publicly funded care can be paid at least the voluntary Living Wage of £9.30 an hour (£10.75 in London).

    Yours sincerely,

    Cllr Alan Hall

     

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    The late 1980s and the early 1990s was a time when the HIV and AIDS pandemic was in the news and high on the political agenda.

    Professor Virginia Berridge, Director of the Centre for History in Public Health and author of AIDS in the UK, gives us this accurate and succinct historical context:

    An expert advisory group on AIDS (EAGA) had been set up in 1985 in the Department of Health with input from clinicians and scientists involved. The Chief Medical Officer, the main public health government official, Sir Donald Acheson, led the group. Despite the level of expertise, the committee faced many problems. They included the attitude of sections of the press, which called for a punitive response to HIV/AIDS. An initial lack of political interest and the danger that, if political interest were awakened, the Conservative government led by Prime Minister Margaret Thatcher might take a punitive stance. Issues such as segregation and quarantine were freely talked about.

    In 1986, a sense of national emergency materialised, and developed high-level political interest on the subject. A Cabinet committee on AIDS was set up, a major health education campaign was initiated, funds were released for research, and the main health education body, the Health Education Council, was reformed as the Health Education Authority. Despite this progress, there were still powerful calls for a punitive approach, such as when the Chief Constable of Greater Manchester, James Anderton, spoke of people ‘swirling in a human cesspit of their own making’. However, the general tenor of the government response was pragmatic – focussing on safe sex rather than no sex, and safer drug use rather than no drug use. This liberal response was influential at the international level too and was promoted through AIDS specific organisations set up as part of the World Health Organisation (WHO) and the United Nations (UN).

    Source https://commons.wikimedia.org/wiki/Category:Epidemiology_of_HIV/AIDS

    In South East London, the local HIV groups were formed in response to the direct experiences of people who faced barriers accessing health and social care. These specialist organisations included the Positive Place in Deptford – which started in an office in Sydenham where Cllr Alan Hall was a volunteer.

    Sydenham is a very interesting area. Geographically it is on a hill which has a ridge with its apex at Crystal Palace. Crystal Palace is the place where five local authorities meet – the boundaries of London Boroughs of Bromley, Croydon, Lambeth, Lewisham and Southwark.

    Locally, social services are provided by Councils and health services were overseen by regional health authorities at this time. The provision of HIV services were very variable and much of the work and support was provided by specialist sexual health clinics at the major London teaching hospitals. Hospital social work could provide some support but the end of life care and care at home fell to the patients’ home local authority.

    By 1991 the Government had put in place a ringfenced Government Grant called the AIDS Support Grant (ASG) – this was to recognise the additional resources needed to provide services for people with AIDS.

    AIMS OF THE GRANT SCHEME

    To enable Social Services Departments to draw up strategic plans, based on local population
    needs assessments, for commissioning social care for people with HIV/AIDS; and to enable Social Services Departments to finance the provision of social care for people with HIV/AIDS, and where appropriate, their partners, carers and families.
    The grant is to assist local authorities with the costs of providing HIV related personal social services.

    At the Positive Place – then in Sydenham – we became aware that people with HIV were having problem accessing social services in Bromley. There were general comments and complaints in the other neighbouring boroughs however, in Bromley people were routinely refused a social service.

    After extensive enquiries and local research, a meeting with Bromley Social Services Committee Councillors was arranged and a briefing document produced. Richard Cowie, the Clinical Nurse Specialist for South East London Health Authority, David Thomas a Trustee of the Postive Place which had established as a centre for people with HIV in SE London based in Deptford – joined Alan Hall who had become a member of the Bromley Community Health Council and set up Bromley Positive Support Group in Beckenham.

    The first section is instructive it is called: NO AIDS HERE

    “The first response to deny HIV services is that there is ‘no demand’ for them. In effect, this means no AIDS in Bromley. In 1992 this was the reason used by the London Borough of Bromley for not applying for AIDS Support Grant. Every District Health Authority must submit returns regarding the number of HIV infections and AIDS related deaths yearly and much more detailed information under the provision of the AIDS (Control) Act 1987.”

    “The figures are collated in a technical manner and require considerable caution interpretating them. However the latest report for Bromley (1993/4) shows that there are ’48 people living with HIV infection and 2 babies of indeterminate status’.

    “It is accepted that this is an underestimate. This includes people who attend Bromley Hospitals or services. It does not include all the people attending specialist centres of excellence, eg Middlesex Hospital, King’s College Hospital, St Thomas’ Hospital, Chelsea & Westminster….of which we know there are several cases. We estimate that there are at least 60 cases – this does not include their families, partners or carers. The no AIDS in Bromley is a myth. Indeed, the Department of Health classifies Bromley as a “moderate” prevelance area.”

    “Frequently, AIDS in Bromley has been dismissed as a small number of cases, insignificant. This is a favourite argument of Cllr Cooke. Clearly, 60 people with HIV plus their families is not a small number. Contrast this with the number of people receiving intensive personal care – this is in the order of 70 people.”

    The conclusion of the document states: “All of the myths, I am sure you will find have their root in prejudice and bigotry.”

    Whilst the Positive Place was in Sydenham the local MP, Jim Dowd agreed to ask a Parliamentary Question. This question revealed that Bromley Council had failed to apply for its indicative allocation of AIDS Support Grant in 1992-3.

    Hansard records the written parliamentary question on 14th January 1993:

    AIDS
    Mr. Dowd : To ask the Secretary of State for Health (Virginia Bottomley)

    (1) on what date the London borough of Bromley applied for AIDS support grant for the current financial year ; and what efforts have been made by her Department to urge Bromley to apply for it ;

    (2) what amount of AIDS support grant was allocated to each local authority in each year since 1990-91 :

    (3) what extra costs she estimates to have been incurred by neighbouring boroughs obliged to deal with HIV/AIDS cases turned away by Bromley social services department ; and what steps she proposes to take to recompense the neighbouring boroughs ;

    (4) by what date London boroughs should apply for the AIDS support grant for 1993-94 ; and what steps she will take to ensure that the London borough of Bromley applies for the grant on time ;

    (5) how many people in each London borough have died from AIDS :

    (6) how many cases of HIV have been reported in the borough of Bromley in each year for which figures are available.

    The Minister for Health, Tom Sackville, MP replied:

    Mr. Sackville : In December 1991 the Department issued a circular (LAC(91)22) inviting all social services departments in England to bid for extra resources for HIV and AIDS services in 1992-93 under the AIDS support grant scheme. Criteria for bids under this scheme are set out in the circular. Copies are available in the Library. The closing date for bids was 7 February 1992. The London borough of Bromley submitted an application in November 1992 although not in the form and detail set out in departmental guidance. By that time AIDS support grant moneys had been fully committed. The Department was, therefore, unable to allow Bromley’s bid to proceed. Although not in receipt of AIDS support grant money in 1992 -93, we understand that the London borough of Bromley plans to spend £15,000 on HIV and AIDS services in the current year. We have no information to suggest that the borough has been compelled to turn away people affected by HIV.

    For 1992-93 local authority social services departments will again be invited to apply for an AIDS support grant allocation. The closing date for applications will be 8 February 1993. It will, of course, be open to the London borough of Bromley to bid for funds under this scheme.

    Information on the number of HIV and AIDS cases reported in individual boroughs and of deaths is not held centrally.

    The table shows the AIDS support grant allocations which have been awarded since 1990-91 for a full list in England see Hansard.

    Allocations for Individual Authorities in London are shown.

     

    London Borough Grant 1990-1 Grant 1991-2 Grant 1992-3
    Camden 471,000 489,840 730,000
    Hammersmith 1,003,359 1,042,000 1,300,000
    Kensington 627,500 652,600 970,000
    Lambeth 551,000 573,040 930,000
    Westminster 625,000 650,000 940,000
    Brent 290,000 290,000 400,000
    Ealing 250,000 260,000 290,000
    Greenwich 136,280 136,280 190,000
    Hackney 322,500 335,400 460,000
    Haringey 357,500 371,800 500,000
    Hounslow 231,250 240,500 320,000
    Islington 235,000 244,400 360,000
    Lewisham 163,750 170,300 240,000
    Richmond 135,000 140,400 200,000
    Southwark 215,000 215,000 300,000
    Tower Hamlets 309,000 321,300 481,000
    Wandsworth 165,122 120,152 188,000
    Barking 14,000 17,173 32,236
    Barnet NIL 26,000 40,000
    Bexley 25,000 26,000 46,000
    Bromley 8,500 9,520 NIL
    City of London 25,000 26,000 47,000
    Croydon 24,500 30,000 49,000
    Enfield 14,938 16,702 50,000
    Harrow 25,000 26,000 42,000
    Havering Nil Nil Nil
    Hillingdon 23,207 35,000 120,000
    Kingston 25,000 26,000 64,000
    Merton 14,000 17,178 66,000
    Newham 72,500 110,000 250,000
    Sutton 22,260 30,000 57,000
    Waltham Forest 70,000 90,000 135,000

    The Boroughs are listed in prevalence order and grant awarded

    Alan Hall followed up the lack of funding and more importantly, the lack of a strategy in 1993. On 11th October he received the following reply from Baroness Cumberlege, Parliamentary Under Secretary of State for Health in the Lords, this said: “The Department is aware that there has been an absence of a clear HIV/AIDS strategy in Bromley and has been monitoring the situation.”

    If the Government were aware, why didn’t they act?

    Perhaps, we will never know the answer to that. But the refusal of Bromley Council’s social services Committee members to allocate funding and support proposals for a change in direction led to protest.

    The community activists in Outrage knew that Bromley Council were resisting change and they decided to mount a protest. Activists enetered the Council Chamber, chanting and holding placards. Labour and Liberal Democrat Councillors stayed in the Chamber whilst shocked tories walked out. The photograph below was taken by the acclaimed photographer, Gordon Rainsford.

     

     

    Outrage in the Bromley Council Chamber

    The Pink Paper carried a report of the protest with the headline: “Tory Mayor flees AIDS protesters in Bromley”.

    Outrage alleged that the Mayor of Bromley, Cllr Edgington attacked one of its members. This is particularly interesting as this is believed to be a counterclaim, when the Mayor of Bromley made a complaint to the Police that one of the protesters drank from his glass thereby assaulting him.

    The fifteen activists held a “die in” where they laid down in the Council Chamber and held tombstone shaped placards with slogans such as killed by Bromley neglect.

    In the press report, the case of a 28 year old man who was refused a home help and told to ‘try a private nursing home’ a day before he died is raised.

    Daniel Winchester a local resident said that Bromley Council had shown ‘contempt’ to the ill and dying over the last ten years of the pandemic.

    The independent voice of social workers – Community Care – carried an article on HIV and AIDS social service provision in March 1993 saying: “Bromley Social Services is behind with its HIV work. It’s bid for 1992-3 was late, so it did not benefit from the 50% increase and that there was great pressure to meet the standards for grant status.” In response a senior Bromley Council social services manager is quoted as saying: “Our services are pretty thin on the ground in this area.”

    Leaders in the social work profession at the time, believed that there were additional benefits with specialised HIV services as they were ground breaking and that they benefit other areas of social work like confidentiality and increasing good practice more generally.

     

    Outrage blow fog horns and whistles to get attention from Bromley Council

    website link:  https://alanhall.org.uk/2020/06/30/bromley-council-and-hiv-the-fight-for-social-services/

     

     

     

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    The United Kingdom has overtaken Italy with the highest official death toll from the coronavirus, Covid-19 in Europe. New figures released on Tuesday, 5th May 2020 show that this is the trend, we ask, what does this mean for London and Inner London Local Councils?

    London is a vast geographical area and has a complex demography. The inner London boroughs are more diverse, in general and the outer London boroughs are more suburban.

    The incidents of coronavirus in the capital have been measured by the Office for National Statistics.

    The ONS reports that overall, London had 85.7 Covid-19 deaths per 100,000 population, almost double the rate of the next worst-affected region which is the West Midlands at 43.2 deaths per 100,000.

    Nick Stripe, head of health analysis and life events at the ONS, said: “By mid-April, the region with the highest proportion of deaths involving Covid-19 was London, with the virus being involved in more than 4 in 10 deaths since the start of March.”

    The figures for the top ten London Boroughs are:

    Borough SMR
    Newham 144.3
    Brent 141.5
    Hackney 127.4
    Tower Hamlets 123
    Haringey 119
    Harrow 115
    Southwark 108
    Lewisham 106
    Lambeth 104
    Ealing 103

    If we look even closer within each London borough, we can see the how each Super Output Area is affected. Super Output Areas are a small area statistical geography covering England and Wales. Each area has a similarly sized population and remains stable over time. You can take a look at the ONS interactive map here: 

    The Index of Multiple Deprivation (IMD) is an overall measure of deprivation based on factors such as income, employment, health, education, crime, the living environment and access to housing within an area. [NB There are differences between England & Wales]

    Age-standardised mortality rates, all deaths and deaths involving COVID-19, Index of Multiple Deprivation, England, deaths occurring between 1 March and 17 April 2020

    Looking at deaths involving the coronavirus (COVID-19), the rate for the least deprived area was 25.3 deaths per 100,000 population and the rate in the most deprived area was 55.1 deaths per 100,000 population; this is 118% higher than the least deprived area.

    In the least deprived area (decile 10), the age-standardised mortality rate for all deaths was 122.1 deaths per 100,000 population. In the most deprived area (decile one), the age-standardised mortality rate for all deaths was 88% higher than that of the least deprived, at 229.2 deaths per 100,000 population.

    The bar chart shows how much higher each decile is compared with the least deprived decile for all deaths and deaths involving COVID-19.

    For deciles 4 to 9, the percentage increase in age-standardised mortality rate of deaths involving COVID-19 is similar to that of overall deaths.

    The rate of deaths involving COVID-19 is more than twice as high in the most deprived areas compared with the least deprived

    Local responses will involve contact tracing. This graphic from Public Health England gives a brief description of the process.

    contact tracing is part of a public health approach

    Professor Allyson Pollock of Public Health at Newcastle University has been campaigning to raise the profile of a more localised approach, in a letter she has said that a massive increase in testing and tracing should be the next phase, but decades of cuts and reorganisations have whittled away the necessary regional expertise.

    In the letter the dynamic nature of the pandemic across the country is aptly described as “not homogenous. It is made up of hundreds, if not thousands, of outbreaks around the country, each at a different stage.”

    Her approach champions “classic public health measures for controlling communicable diseases such as contact tracing and testing, case finding, isolation and quarantine. They require local teams on the ground, meticulously tracking cases and contacts to eliminate the reservoirs of infection. This approach is recommended by the WHO at all stages of the epidemic.”

    The history of public health is important including the recent changes in the Health & Social Care Act 2012. This abolished local area health bodies, created Public Health England to fulfil the Government’s duty to protect the public from disease and charged local authorities with improving public health.

    As public health returned to local government, with a sleight of hand, the Government introduced the current programme of public health funding cuts. In 2019/20, the London’s share of the Public Health Grant had fallen to £630 million, representing a per head funding reduction from £80.75 in 2015 to £68.61 in 2019, a fall of 15% and the biggest regional reduction in England.

    “Investing in public health is also hard for governments because the benefits accrue to their successors and there is little to show for spending at the end of the five-year election cycle.”

    “Cutting public health funding would be an act of self-mutilation. If controlling spiralling demand is the priority, for goodness sake don’t cut public health.”

    Luke Allen
    Researcher, Global Health Policy, University of Oxford in the conversation

    A localised response requires political will, expertise and attention to detail.

    Public Health funding and status needs to be revitalised and restored. It is a matter of life and death.

    1 Comment

    31/03/2020 cllralanhall BlogPress Leave a comment

    Personal Protective Equipment, known as PPE is in demand. There are reports that there is a shortage in hospitals and care facilities.

    The Daily Mirror reports that hospitals listed as having shortages include Rotherham General Hospital, Bristol Children’s Hospital, Hillingdon Hospital in Uxbridge, Royal Devon and Exeter Hospital and at St Thomas, Lewisham and two other unnamed hospitals in London.

    “The correct PPE must be made available at every site that might require it. This is vital in order to protect our patients but also to protect the lives of the life-savers.”
    DAUK’s Dr Natalie Ashburner in 

    @DailyMirror @nashburner#COVID19 #testNHSstaffhttps://t.co/Mhd2UISZeF

    — The Doctors’ Association UK (@TheDA_UK) March 19, 2020

    The view from the NHS frontline is explained here:

    https://youtu.be/WphmagWsCUI

    Dr Samantha Batt-Rawden, an intensive care doctor and president of the Doctors’ Association UK, told Nick Ferrari that more doctors will die unless they get proper equipment.

    In a further twist, healthcare workers who raise their concerns are facing being “gagged”. Helen O’Connor, GMB says in The Guardian “It is scandalous that hospital staff speaking out publicly face being sacked by ruthless NHS bosses

    who do not want failings in their leadership to be exposed. Suppression of information is not just a matter of democracy, it is now a major public health issue.”

    The Local Government Association has sent a letter to the Secretary of State for Health, Matt Hancock MP. It says that there is an urgent need for Government to move faster in making PPE available for the adult social care sector. Sufficient supplies that are of acceptable quality are needed immediately. Councils and their provider partners also need concrete assurances about ongoing supplies for the days and weeks ahead.

    Councillor Alan Hall has written to the Director of Public Health for Lewisham seeking reassurances for both hospital and social care staff locally. The full letter is below:

    Catherine Mbema
    Director of Public Health – Lewisham

    Dear Catherine,

    I have been informed that the lack of Personal Protective Equipment for cleaning staff at Lewisham Hospital is a real concern. Trade Unions say that there is a shortage of supply and that staff are very worried. It has been described as “a total nightmare”.

    As the Public Health Lead across Lewisham, I would be very grateful if you could raise the shortage of supply with the NHS and the Hospital and reassure us that PPE will be available.

    Whilst I write, personal carers have reported shortages and inadequacies nationally. Can an assurance that all Lewisham Council and NHS staff have been provided with effective PPE?

    May I take this opportunity to thank you and your team for all the incredible work that has been placed upon you. I have always campaigned against Public Health cuts and the short sightedness of this is surely been borne out now.

    Kind regards,

    Alan

    Cllr Alan Hall

    In an article on the United Nation’s website, there is a chilling message:

    “COVID-19 will not be the last dangerous microbe we see. The heroism, dedication and selflessness of medical staff allow the rest of us a degree of reassurance that we will overcome this virus.

    We must give these health workers all the support they need to do their jobs, be safe and stay alive. We will need them when the next pandemic strikes.”

    Please help: NHS Staff need adequate PPE now https://t.co/XLsLDNaz5g via @socialisthealth

    — Alan Hall (@alan_ha11) April 1, 2020

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    Posted on behalf of Carol Ackroyd and Jan Savage

    A travelling photographic exhibition about NHS-owned private companies and what these mean for staff, patients and the NHS

    Text by Jan Savage
    Photographs by Marion Macalpine

    You are warmly invited to the London launch

    25th November 2019,  6pm to 8pm
    with refreshments

    Unison Centre, 130 Euston Rd, London NW1 2AY
    Speakers to be confirmed

    RSVP to nhssubcos@gmail.com; also for information about access, or any other queries

    The exhibition is accompanied by a research-based booklet giving additional information.
    The exhibition will be available for borrowing without charge, contact nhssubcos@gmail.com

     

    Please circulate to friends and colleagues who night be interested to attend or borrow the exhibition.

    Many thanks

    Marion Macalpine

    Hackney KONP

    and for Jan Savage

    Tower Hamlets KONP

    invitation Subco final RSVP

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    Very quietly the NHS in North West London has asked GPs and other prescribers to reduce prescribing of medicines and products (under the pretext of promoting ‘self-care’) that can be purchased without a prescription. (List)
    The medicines patients are now advised to obtain over the counter include: vitamin D, skin creams, nasal sprays (like Beconase and saline solution for babies), lubricant eye drops, haemorrhoid creams, constipation laxatives (like Cosmocol), the commonly used painkillers, or dispersible aspirin to keep blood thin. One GP tweeted:
    GP tweet
    Such a money saving move hits hard vulnerable, elderly, school age children* or those on benefits, who are exempted  from the prescription charges but now have to buy these medicines, some of which are quite expensive. In order to save money, people try online shopping with a risk of buying cheap quality medicines.
    *(the school age children are exempted if the product needs to be given at school as many schools will not administer medicines that do not have a dispensing label bearing the child’s name and the dose)
    concerns2
    They do so seemingly to avoid bad rating by the Care Quality Commission inspection that would monitor the prescribing of these medicines.
    Those in Harrow who need medical care not only suffer because of the cuts in medicine  but also because of a clinician decision whether a patient meets the evidence-based thresholds for the hospital treatment as defined in the Planned Procedure with a limited Threshold (PPwT) policy and which requires funding approval from the authority running a deficit budget.
    There are thirty three  procedures covered under PPwT policy, including cataract surgery, grommets in children, hip replacement, correcting a deformity of the nasal septum and open MRI, for which individual funding request has to be made to the NHS Harrow Clinical Commissioning Group (CCG) where  the  treatment falls under the ‘not normally funded’ category.
    We understand Harrow CCG has declined many such requests.

    Published with the permission of

    Harrow Monitoring Group

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    Grenfell laid raw the harsh realities for many living in London today. Many stories unfolded in the aftermath. There was the tale of two cities. The question of worth. The story of inexcusable inequality, and lives cut short by political failings. There was also the story of invisibility and fear. The undocumented migrants who died in the fire, forever anonymous, and the survivors who went into hiding, too scared to seek help.

    I went to Grenfell with the charity Doctors of the world UK, a week after the fire. At Westway, the pop-up relief centre, we enquired who to liaise with and were told to speak to Sheena*, she appeared to be coordinating the medical response. We arranged a meeting, she explained what medical support was currently happening and we discussed the logistics of how our charity could help. At the end of the meeting, I asked what was her position. I had assumed she was from the government, or Public Health England, or at least from the council. She told us she was a filmmaker, lived locally, and had come to help the day after the fire. In the void of any eminence of leadership, she ended up as the unofficial coordinator of the medical response. I was dumbfounded.

    There was no doubt that Sheena* and all the other volunteers at Westway, were doing incredible work to provide their best support for the Grenfell victims. But I couldn’t help ask myself the question; Had it been the neighbouring luxury flats in flames, would the medical relief effort be left to be coordinated by a filmmaker? It just seemed ludicrous.

    In the weeks after the fire, the question I heard repeatedly, how did this happen in the richest borough in London? The question we should have been asking, prior to Grenfell, is why in Kensington borough, is there a 14-year difference in average life expectancy between the richest and the poor? Why, since 2010, did that century-long increase in life expectancy plateau?

    Across the UK lives every day are silently cut short, from austerity, poor housing, deprivation and political decisions. According to DoH own data, in all of their 15 markers, health inequality among rich and poor has widened under the coalition and the Tories (after improving over the previous decade). Grenfell laid it raw. But the squeeze on public finances since 2010 is linked to nearly 120,000 excess deaths in England. Housing is core factor. 100,000s live in squalid, unsafe housing. Research by Shelter found that 48% of families in social housing who reported issues about unsafe conditions felt ignored or were refused help. The health implications of this we will be felt for decades.

    It also became very clear within our first few hours at Westway, that in Grenfell tower there had been many asylum seekers and undocumented migrants residing. Many had since gone into hiding, too scared to seek help or medical care as they feared deportation. A volunteer told me there was a family that had escaped and were worried about their baby’s breathing but was too scared to seek help as they had a teenage son who was undocumented. We were told of an African woman in her 40s, who had fallen down the stairs on escaping the fire. Her partner and relatives were missing, She was experiencing dizziness and memory loss, but was too scared to go to A&E.

    Unfortunately, their fears are not ill-founded. Migrants too scared to access care is not a new story. At the Doctors of the World clinic, regularly see pregnant women, cancer patients, victims of trafficking and abuse, too scared to access mainstream health services. This is due to laws brought in under Theresa May’s ‘hostile environment’ policy, which uses health care as an anti-immigration tool. The most recent, brought in 2 months before Grenfell, made it a mandatory legal requirement for healthcare staff to refer migrant patients to the home office if they access hospital care.

    Thee were also concerns about visiting the GP surgeries. This is due to a controversial deal the home office has with NHS Digital (that was introduced without the knowledge of NHS staff) allowing the home office to access migrants data held by GP surgeries. The British Medical Association has vehemently opposed this, stating this breach of confidentiality undermines the sacred doctor-patient relationship and will deter the potentially vulnerable from seeking care. In January, after years of us campaigning, the Health Select committee enquired into this data sharing, determining “We are seriously concerned about the way NHS Digital has approached its duty to respect and promote confidentiality”, calling a halt and full review. Yet, the data sharing continues. It appears migrants do not have the right to medical confidentiality as the rest of us.

    It was under these circumstances that Doctors of the World was forced to launch a safe and confidential pop-up clinic near Grenfell Tower, staffed by volunteers, to help survivors who were too afraid to get NHS care. We also had to write Jeremy Hunt, urging him to publicly state that survivors will not have their details shared with the Home Office. It was shameful this needed to be done, in the aftermath of this horrific tragedy. These racial ‘hostile environment’ policies remain in place in the NHS, as highlighted by the Windrush scandal. Encouraging fear around accessing services is a dangerous policy, makes migrants vulnerable, marginalized and invisible.

    Grenfell exposed the human cost of austerity. To give justice to the victims, we need to ask the difficult questions. Do the lives of those on our streets have equal worth? Have our politicians addressed the structural discrimination, classism, and racism that underlaid the tragedy?

    Lessons learnt? I’ll let you answer that.

    *name changed to maintain anonymity

    Dr Sonia Adesara – NHS Doctor and activist

    Tagged | 1 Comment

    Under instruction from the Government, new health proposals across England have been drawn up called Sustainability and Transformation Plans. The plan for our area called “Our Healthier South East London” has now been published with the far greater detail requested by Lewisham Labour. We are worried about the severe funding cuts to the NHS which means the area faces a shortfall of nearly £1billion by 2020/21 if nothing changes.

    This week the British Red Cross said the NHS faced a humanitarian crisis because the Tory government has systemically underfunded the NHS and cut over £4.6 Billion from social care in the last Parliament. To make South East London NHS STP a success it will need far more resources.

    When the British Red Cross is warning of a humanitarian crisis in our health service and even the head of the NHS says there is not enough money, you have to take notice. So I do not have any faith in the government as it is projected that adult social care will be underfunded by some £242 million across the six boroughs – Bexley, Bromley, Greenwich, Lambeth, Southwark and Lewisham – annually by 2020-2021. We must evaluate the plans carefully and rigorously on behalf of the people of Lewisham and the rest of South East London. It is clear a partnership approach across the whole of Greater London is the right approach. No-one will argue with that. Higher quality and more integrated social care, acute care, elective care with specialist and mental health services is a good thing. But we have to make sure that we get it!

    The Save Lewisham Hospital Campaign’s detailed report shows that they believe that the flawed financial modelling could ultimately threaten the future of the A&E again so you can be sure that we will crawl all over these plans wielding a fine toothcomb!

    Alan Hall South East London

    Lewisham Council passed my motion at the November 2016 Full Council.

    COUNCIL MOTION – Proposed by Cllr Alan Hall
    NHS SUSTAINABILITY AND TRANSFORMATION PLANS

    “The Council welcomes the publication of South East London’s Sustainability and Transformation Plan (STP). The Council also notes:

    • That there is a significant shortage of funds in the NHS and social care system
    • That respected think tank The Kings Fund has publicly expressed its numerous concerns over the STP process including:

    “Tight deadlines have made it difficult to secure meaningful involvement in the plans from key stakeholders, including patients and the public, local authorities, clinicians and other frontline staff.”

    “Despite the focus on local ownership, key elements of the process have been ‘top-down’.”

    “National requirements and deadlines for the plans have changed over time, and guidance for STP leaders has sometimes been inconsistent and often arrived late.”

    Therefore, the Council resolves to:

    • Request full publication of all associated documents and appendices
    • Request pre decision scrutiny on changes to NHS and social care provision locally
    • Require full public consultation on significant changes to any services
    • Call on HM Government to provide the resources to fund good quality services across South East London and re-affirms its commitment to an Accident and Emergency Department on the Lewisham Hospital site
    Tagged | 1 Comment

    I owe the NHS everything. I was born in St George’s Hospital in Tooting, as were my two daughters. I know how crucial our health service is to millions of Londoners on a daily basis. That’s why so many Londoners share my alarm at how the Tories have allowed the NHS to drift into crisis.

    London's health

    Despite the magnificent efforts of our doctors, nurses, and other healthcare workers, patients are suffering. Year on year, waiting lists get longer, it’s harder to see your GP, and waiting times in A&E and for ambulances are increasing. The NHS in London has fallen into a large financial deficit, threatening future cuts to services, while mental health services can’t cope with growing demand. The high cost of living and shortage of affordable homes means many hospitals are struggling to recruit and retain health workers. Underfunded social care services mean that many Londoners don’t receive early support to prevent avoidable hospital admissions. And, since NHS London was abolished by the Tories, London is without the city-wide strategic leadership on health it desperately needs.

    Londoners need a Mayor who will stand up for the city’s health services. I’m determined to be that Mayor, using City Hall to argue for the resources the NHS needs, defending it against Tory attacks, and campaigning alongside patients, health-workers and all NHS supporters against any service closures or reconfigurations without proper consultation. I will fight for new powers to plan and coordinate services across the city, and use them, in collaboration with partners, to ensure that all Londoners have proper access to health services, with solutions tailored to the different needs of patients, communities and places. And I will do what I can to ensure that we move towards parity of esteem between physical and mental health and illness.

    Leadership on health

    As Mayor, I want to take the lead on health in the city. I will:

    • Be a champion for London’s NHS, protecting you, your friends and your family from the worst of the Tory failure on health in the capital, fighting for greater support for GP, A&E, London Ambulance Service and mental health services, and integration of services around the patient.
    • Campaign for extra powers to coordinate your health services across the city to provide proper strategic planning, and ensure greater access for Londoners to crucial services while providing democratic scrutiny of London-wide health services. 
    • Work with the NHS and the London Ambulance Service to help improve staff retention and recruitment.
    • Champion the need for additional funding to plug the social care gap, and the joining up of services to reduce unnecessary hospital admissions. I will promote borough innovation and leadership on the ground to shift from reactive care to prevention, early intervention and care closer to home.
    • Launch a review of the provision of bus services to London’s hospitals.

    Improving public health

    I will be a Mayor who takes action to improve public health and tackle health inequalities in London. The current Mayor has neglected this crucial area, despite the spreading of diseases that we once thought were eradicated here such as TB and measles, worsening air pollution, and the alarming growth in childhood obesity. I won’t duck the difficult decisions necessary to improve the health of all Londoners. I will:

    • Get to grips with health inequality in London, leading from City Hall on reducing the spread of infectious diseases and promoting healthier lifestyles to harder-to-reach groups and communities, while improving the screening of Londoners to halt the spread of TB.
    • Develop a comprehensive public health strategy, focused around the promotion of active lifestyles, including sport, walking and cycling, to all Londoners, supporting those who want to shake off lifestyle risks such as drugs, smoking and alcohol, and tackling childhood obesity, including through challenging the spread of fast food shops in areas close to schools.
    • Tackle London’s dangerously polluted air.
    • Renew our focus on prevention of and screening for HIV, working with boroughs on collective commissioning and provision of prevention services and ensuring that effective information on HIV is reaching the right audiences.

    Greater support for mental health

    So many of us suffer from mental health problems at some point in our lives, yet there is still a stigma attached to mental illness, and within our health services, mental health still does not enjoy parity of esteem with physical health. I will:

    • Lead a campaign to break down the stigma of mental illness, and improve the availability of information and support, particularly amongst young men in London, and particular at-risk groups such as BAME men, and the LGBT+ community.
    • Promote and support Mental Health Awareness Week.
    • Coordinate efforts to reduce the number of people who take their own lives. I will expand best practice in crisis care support, and encourage better joint working between boroughs, health services, police, transport and voluntary sectors when dealing with people with mental health issues.

    This comes from Sadiq’s manifesto.

    Tagged | Comments Off on What has Sadiq Khan got to say about health?

    What the London mayoral candidates have to say about housing policy:

    CandidateZac GoldsmithSian BerrySadiq KhanCaroline PidgeonPeter Whittle
    Total annual housebuilding target50,000 a year by 2020200,000 over a 4 year term50,000150,000 private units over 4 year term
    Affordable housing target64,000 social and low cost rent, 400,000 low cost ownership• At least half of all new housing to be affordable
    • Housing Associations to deliver 180,000 new homes over 10 years
    50,000 council homes over 4 year term
    Planning• Expert ‘flying planners’ team to support LA planning departments
    • Standard viability assessments for affordable homes in developments
    • Chief Architect for London
    • London Plan to set aside more homes for Londoners on average salaries
    • Reintroduce 50% affordable housing target for individual developments, require transparency on viability assessments
    • Protect Zero Carbon definition
    • Offer communities a Right to Regenerate – becoming partners in the planning
    of opportunity areas and housing zones
    • Develop planning rules to tackle ‘buy-to-leave’
    • Improve planning and design to offer older Londoners more choice of suitable housing
    • Greater transparency on viability assessments for affordable homes in developments
    • Use powers more effectively to encourage home building, including benchmark that half of housing in new developments should be affordable for majority
    of Londoners
    Large development consents to be decided by local referendums
    Development • Guarantee homes built on Mayoral land are only for Londoners – Homes built on TfL land reserved for those living in London for at least 3 years
    • ‘London share’ retained in public sector land sold for development
    • Company with a £0.5bln fund from council tax
    to support smaller and community builders
    • Free home insulation for homeowners
    • Break up bigger development sites up into smaller plots
    • Setting up ‘Homes for Londoners’ and building alliance of all with a stake in housebuilding
    • Affordable homes to include social rent, new London Living Rent and part-buy- part-rent
    • Attract institutional investors to finance homes for
    long-term, secure rent
    • City-hall owned developer to delivery 50,000 affordable homes
    • Continue to levy Olympic Precept – leading to accessing finance of up to
    £2 billion to build housing*
    • Register of London’s brownfield sites
    • Prioritise Londoners when developing on GLA land
    Buyers • Londoners given first refusal on new-build homes built on TfL land
    • ‘Mayor’s mortgage’ for
    new-build property, 9 month agreement in principle window (instead of 6 months)
    • Phase out shared ownership and replace with models such as mutual home ownership which will remain affordable in the longer term
    • Campaign to reform leasehold law
    • Londoners given ‘first dibs’ on all homes built on Mayoral land
    • Seek to extend ‘first dibs’ to homes built on public land and to a proportion of homes built in all developments across
    the Capital
    Private Rented Sector• Three-year tenancies offered as standard
    • Target high fees charged by estate agents to tenants
    • Campaign for employers to offer ‘deposit loans’ for rental deposits to workers
    • Create a ‘union for renters’
    – which would be an advice and lobbying group
    • Set up a register for landlords, which would allow tenants to rate and compare landlords
    • Rogue landlords named and shamed in public database
    • Set up not-for-profit lettings agency
    • Increase renters’ rights on tenancy lengths and rents
    • Promote landlord licensing and make the case for a London-wide scheme
    • Promote 3-5 year tenancies
    • All landlords to be registered
    • Scrap agents’ lettings fees for tenants
    Higher taxes for buy-to-let investors who leave property empty
    Right to buy (Right to Buy comes under Central Government remit)Encouraging 2 for 1 replacement of properties sold• Lobby for end of Right to Buy
    • Work with Councils and Housing Associations to mitigate impact of Housing and Planning Bill
    Right-to-buy should come with a guarantee that a like- for-like replacement home for social rent will be built in local area• Scrap RtB for Social Tenants
    • Introduce RtB for private tenants when landlords sell property
    * Green beltProtect the GreenbeltProtect the GreenbeltProtect the GreenbeltProtect the GreenbeltProtect the Greenbelt
    Estate regenerationRegeneration to replace run-down estates with
    mansion blocks and terraces
    – where a majority of local residents in favour
    • No complete demolition unless absolutely necessary
    • Regeneration to be led by residents who have right to independent ballot and support from Community Homes Unit
    • Regeneration only with full resident support, demolition only where other options have been exhausted
    • In-fill to boost housing numbers
    HomelessnessExpand ‘No First Night Out’ which helps identify those at risk of homelessnessExpanding ‘No First Night Out’ scheme, with plans to end rough sleepingSet up ‘No Nights Sleeping Rough’ taskforce to oversee funding and implementation of Mayor’s priorities in this areaExpanding ‘No first night out’ schemeSet up a homelessness register at City Hall
    Do you support:
    Crossrail 2 YesYesYesYesNo
    Bakerloo extension YesYesYesYes-
    HS2 YesNoYesYes (but ensure impact on London is minimised)No
    Heathrow extension
    No
    No (and close London City Airport)NoNoNo
    EU membershipLeaveRemainRemainRemainLeave
    Tagged | Comments Off on Housing in London

    First draft of a section of Labour’s Manifesto for London.

    The challenge

    Londoners deserve to live in a safe and healthy city. But for too many Londoners, crime still blights their communities and ill health still affects some sections of the population more than others.

    While crime has been falling for over two decades, there are worrying signs of that certain crimes are on the rise. In particular, data shows that sexual violence and knife crime are increasing. Falling budgets are biting into the number of police on our city’s streets, and there is a very real risk that community policing may disappear altogether. Some communities are still lacking in confidence in the police, and there is still a worrying under-representation of BAME officers in the Met.

    Victims of crime are still too often ignored or treated as an afterthought. Without confidence in our justice system, victims and witnesses won’t come forward and report crimes, and perpetrators will be free to walk the streets.

    London is blighted by some dramatic health inequalities that shame a developed country. Across the city, there are wide variations in life expectancy, incidences of disease and in obesity. Too many Londoners are dying prematurely as a consequence of our polluted air – a scandal which cannot be allowed to continue.

    Sadiq’s plan

    Sadiq wants to build a London in which all its citizens feel safe and live long and healthy lives. He will transform the city’s police force so it looks more like the communities it serves, and in an era when the Met is facing devastating cuts, fight for more resources to prevent and tackle crime

    Public health will be a high priority, with action to improve London’s air quality and challenge childhood obesity, alongside a focus on mental health.

    •  Put victims first: Sadiq wants to build a London in which all its citizens feel safe and live long and healthy lives. He will transform the city’s police force so it looks more like the communities it serves, and in an era when the Met is facing devastating cuts, fight for more resources to prevent and tackle crime
    •  Building community confidence in our police force: Sadiq will reinvigorate plans to create a more diverse Metropolitan Police force so that London’s police look and sound like the communities they are employed to serve. He will ensure the use of stop and search is intelligence led, and not targeted or overused in a way that undermines communitypolice relations.
    •  Tackling childhood obesity and ill health: Sadiq will use planning powers to restrict the growth of fast food outlets near schools and colleges, and promote physical activity and access to nature for all young people to help tackle childhood obesity, while working to tackle childhood hunger and malnutrition.
    • Cleaning our air: Sadiq will promote clean energy schemes, make our public transport network greener, make cycling safer and create more green spaces in order to reduce the damaging effects of filthy air on Londoners.
    • Taking public health seriously: In addition to prioritising cleaner air and tackling childhood obesity, Sadiq will work with health services and professionals across London to ensure a coordinated and proactive approach to prevention. He will work to promote parity of esteem between mental and physical health and ensure that all people, especially young people have access to mental health information, advice and support in the schools and communities.

    Questions for consultation

    1. How can we deal with the major challenges facing community policing in a time of tough public finances?
    2. What new ideas and strategies might be employed to help better detect and fight crime?
    3. How can we build a Metropolitan Police force that is representative of London, and ensure that all of our communities have confidence in the force?
    4. What else should we be doing to improve the way victims and witnesses in London are treated?
    5. What are the key public health challenges for London and how should we address them?
    6. What can the Mayor do to support and improve London’s emergency services?
    7.  What other key challenges and priorities exist in this area?

    The consultation closes at 6pm on 27 November 2015. Respond online

    Tagged | Comments Off on Safer, Healthier Communities