It has just come to my attention that Hywel Williams, Plaid Cymru MP for Afon,
has published an early day motion to try and get the government to scrap plans to abolish
disability living allowance and replace it with a new benefit.
Early day motions (EDMs) work rather like a petition for MPs. So, if enough MPs
sign it the government may take notice, but they are not legally bound to.
Still it's good to see the issue being raised in this way.
This is far from the first since the government set out its plans for the
benefit.
Williams himself published an earlier motion criticising
the government's presentation of the case for DLA reform in its consultation on
the subject.
One which expressed similar concerns, centred around the introduction of
periodic "medical" (their words not mine) assessments from claimants
was published by Labour MP
Kate Hoey last summer and seconded by Tory MP Peter Bottomley. It achieved
97 signatures.
Another protesting the
removal of the mobility component of DLA from those living in care homes
could be considered to have been successful as the government has pushed this
back and intends to internally review the decision. It did this with only 72
signatures.
Not content with publishing just one EDM in day he's published a second on to stop the time limiting of
employment and support allowance. The government plans to stop those
claiming contributory employment and support allowance after a year. Those
claiming it on the basis of a low income will still have no time limit to their
access to the benefit, under the plans.
April 2011 Archives
Earlier this morning, I detailed why we had chosen not to run the Department for Work and Pension's stats stating 75% of sickness benefit claimants are 'fit for work'.
Well, I'm not the only one who thinks those numbers are a bit odd.
The National AIDS Trust (NAT) have just put out a statement on the figures.
Deborah Jack, chief executive of NAT, comments: "The refusal of 39% of ESA claims is not conclusive evidence that Work Capability Assessment (WCA) is effective. These claimants may be found 'fit for work' under the rules of WCA, but many face very real health-related barriers to work which have been overlooked during the assessment process.
"NAT is extremely concerned by the high drop out rate of 36% closing a claim before a decision on their benefits is reached. Withdrawing a claim is not proof of ineligibility for ESA. An independent review of the WCA revealed serious problems with decision-making and administration in the ESA system, and real failures in the way the DWP communicated with claimants. Stopping a claim halfway through the process points towards these fundamental flaws in the system - which are yet to be resolved - as much as the merits of the claim itself."
Well, I'm not the only one who thinks those numbers are a bit odd.
The National AIDS Trust (NAT) have just put out a statement on the figures.
Deborah Jack, chief executive of NAT, comments: "The refusal of 39% of ESA claims is not conclusive evidence that Work Capability Assessment (WCA) is effective. These claimants may be found 'fit for work' under the rules of WCA, but many face very real health-related barriers to work which have been overlooked during the assessment process.
"NAT is extremely concerned by the high drop out rate of 36% closing a claim before a decision on their benefits is reached. Withdrawing a claim is not proof of ineligibility for ESA. An independent review of the WCA revealed serious problems with decision-making and administration in the ESA system, and real failures in the way the DWP communicated with claimants. Stopping a claim halfway through the process points towards these fundamental flaws in the system - which are yet to be resolved - as much as the merits of the claim itself."
Today figures from the Department for Work and Pensions,
which show 75% of sickness benefit claimants are fit for work are doing the
rounds, but not on Community Care.
The BBC has reported them with the headline: "Benefit applicants
- '75% fit to work or drop claims'"
The Metro has: "90%
of people on disability benefits 'were fit to work'"
The Press Association has gone with the sympathetic: "Sickies:
Three-quarters fit to work"
All these reports wheel out the quote from Chris Grayling, minister for employment:
"We now know very clearly that the vast majority of new claimants for
sickness benefits are in fact able to return to work."
Community Care hasn't run the story despite being sent these figures yesterday,
just like all these other press outlets. The reason for this decision is two
fold.
One the figures are based on the old version of the work capability assessment
test for sickness benefits which was introduced in October 2008 (today's
figures relate to the period between October 2008 and August 2010). This test
has been widely condemned by disabilities charities for not being terribly
accurate at assessing people.
The government appeared to accept much of that criticism last year when it
agreed to implement all the recommendations from Professor
Harrington's review of the work capability assessment. But, to then quote
figures from before the reforms as definitive seems a little disingenuous.
Absent from most press reports, mercifully, is the statement by the DWP that
the WCA has been "substantially improved" by the reforms following Professor
Harrington's review. While this is doubtless true, and certainly a good thing,
it has zero bearing on today's figures.
Secondly, this is all remarkably similar to the last time the DWP put out
figures on disabled work benefit claimants. The conflating of those who were
found fit for work and those who drop out of the process before they are
assessed, is dubious at best. This is exactly what the DWP did a couple of
months ago and exactly what they have done today.
The last
time the DWP did this it resulted in one newspaper being reported to the
Press Complaints Commission and Grayling himself being reported for a possible breach
of the ministerial code of conduct.
I'm not, at the time of writing, this sure of the outcomes of either of those case were but needless to say it makes me view subsequent figures with suspicion and half an eye on Community Care's budget for lawyers.
Image by The US Army on Flickr
You've got to admire care services minister Paul Burstow for his ability to stick to his guns.In Parliament yesterday, he said the following: "The government provided adequate resources in the financial settlement last year, alongside efficiency savings, to ensure that every local authority could choose to maintain the current levels of eligibility and services in its area if it so wished."
Close observers of Burstow will know that he has said this many times since last October's comprehensive spending review unveiled cuts of 28% in real terms to local authorities from 2011-15, mitigated in small part by an extra £1bn a year for social care from the NHS.
Burstow's steadfastness comes on the back of surveys by the Local Government Association, the Association of Directors of Adult Social Services and the Labour Party showing the proportion (about 15%) of councils that are raising eligibility thresholds.
His opposite number - Emily Thornberry - was kind enough to remind Burstow of the results of Labour's survey yesterday:
"My survey has found that not only have eligibility criteria been tightened, but 88% of councils are increasing their charges, 63% are closing care homes and day centres and 54% are cutting funding to the voluntary sector. Now that I have told the Minister the facts, will he take back his comment that "no councils need to reduce access to social care"? Would he like to start being straight with the public?"
Ouch!
Well, you wouldn't have expected Burstow to back down and he didn't:
"I will take Labour facts with a pinch of salt. Under Labour, social care was always very much the poor relation."
You wouldn't have thought it was election season would you?
(Image on Flickr from The Health Hotel)
A fascinating report by the charity Alcohol Concern has suggested profit margins on white cider are significantly bigger than those on other alcoholic drinks, thanks in part to tax breaks designed to help traditional British cider makers.White Cider and street drinkers, which is backed by homeless charities Thames Reach and St Mungo's, reveals that the Treasury takes 32p in VAT and duty on the sale of an 85p can of White Ace, leaving a remainder of 53p.
As anyone who works with the rough sleeping community, white ciders are a problem for those trying to combat excessive drinking of strong drinks among clients as it leads to all sorts of health-related problems, which we have documented in the past.
The report lists a series of recommendations:
- To considerably increase tax on ciders above 5% in a bid to get manufacturers to decrease the alcohol levels in white ciders.
- To link cider duty rates to beer duty rates, especially super-strength lagers, and to look at minimum pricing.
- For the Licensing Act 2003 to be amended to allow local authorities to ban the sale of super-strength drinks across their locality.
- An end to the practice of selling cider above 5% in two and three litre bottles and one litre cap to be introduced.
Photo from Flickr.com courtesy of dichohecho
Followign the end of yesterday's inquiry into a care home blaze which killed 14 people, there have been calls for much more rigorous fire safety training for all care home staff.
Richard Evans, commercial training director for St John's Ambulance, put out a statement: "Whilst it is of course appropriate for businesses to designate fire marshals, it is still important for more, if not all employees, to be aware of the basic procedures in fire safety management, regardless of the organisation's size.
"Fire drills are often treated with complacency, but they are done for a reason - to minimise the level and severity of injury caused, if and when a fire does occur."
Can't see anything to disagree with there.
Richard Evans, commercial training director for St John's Ambulance, put out a statement: "Whilst it is of course appropriate for businesses to designate fire marshals, it is still important for more, if not all employees, to be aware of the basic procedures in fire safety management, regardless of the organisation's size.
"Fire drills are often treated with complacency, but they are done for a reason - to minimise the level and severity of injury caused, if and when a fire does occur."
Can't see anything to disagree with there.
Today's
news that Birmingham council's consultation on raising its eligibility
criteria to super-critical has been ruled
unlawful could just be the tip of the iceberg.
If draft
guidance on consultation is implemented by the Department for Communities
and Local Government (DCLG), it will remove the duty to involve local people
and replace it with light touch guidance. In the wake of that we could see more
legal challenges.
Rhion Jones, director of the Consultation Institute, an organisation which
offers training on consultation techniques and legal compliance, said:
"This guidance could well make consultations even worse."
Consultations by councils in the area of social care have been patchy
at best.
Jones said he thought there may well be more appeals for judicial review if the
quality of consultations is adversely affected by the guidance. "It's a
political own goal. It's giving the signal that consultation doesn't
matter," said Jones.
However, Ed Mitchell, Community Care legal columnist, disagreed saying that
cases such as Birmingham's
were rarely reliant on the duty to involve and most often sought to get
decisions overturned under equality legislation.
As
I remarked earlier, it's difficult to imagine how removing the guidance
from an already patchy area will make things work better.
But it seems the jury may still be out on whether that'll mean more embarrassing
days in court for council officers.
Image by quinn.anya
on Flickr
There's a warning today from the Mental Health Foundation that spending cuts for adult learning courses could prove a false economy in terms of tackling the burden mental health problems place on the economy and society.
These stem from new research results, published in MHF's Learning for Life report, which show that people with mild to moderate depression and anxiety experience significant and lasting improvements in their symptoms as a result of the courses.
It is well-known that depression and anxiety are the most common mental disorders in the UK, placing a considerable burden on both the wellbeing of the population and the economy.
Using the industry standard Hospital Anxiety and Depression Scale (HADS) to assess Northampton primary care trust and Northampton County Council's 'Learn 2b' adult learning programme, Learning for Life found that between the start and completion of the adult learning course, symptoms of depression and anxiety reduced by an average of 26% and 22% respectively.
Follow up after six and 12 months saw even greater improvements, with average reductions in depressive and anxiety symptoms reaching 35% and 31% respectively compared to pre-course levels.
These stem from new research results, published in MHF's Learning for Life report, which show that people with mild to moderate depression and anxiety experience significant and lasting improvements in their symptoms as a result of the courses.
It is well-known that depression and anxiety are the most common mental disorders in the UK, placing a considerable burden on both the wellbeing of the population and the economy.
Using the industry standard Hospital Anxiety and Depression Scale (HADS) to assess Northampton primary care trust and Northampton County Council's 'Learn 2b' adult learning programme, Learning for Life found that between the start and completion of the adult learning course, symptoms of depression and anxiety reduced by an average of 26% and 22% respectively.
Follow up after six and 12 months saw even greater improvements, with average reductions in depressive and anxiety symptoms reaching 35% and 31% respectively compared to pre-course levels.
Have next to no information on this but we've heard that the legal challenge to Birmingham's decision to raise eligibility thresholds for care from substantial to critical has been successful.
Not sure on what grounds yet - full story to come tomorrow.
Not sure on what grounds yet - full story to come tomorrow.
The Labour Party has launched a review into older people's policy, including on social care and the NHS.
It will be headed by shadow health secretary John Healey.
It will be headed by shadow health secretary John Healey.
I'm not sure how much credence should be attached to this story in the Daily Mirror, but it's reporting that the odds of former Lib Dem health spokesman Norman Lamb replacing Nick Clegg as Lib Dem leader at 12 to 1 down from 33 to 1.
The odds are a fact, though the likelihood of it happening are remote. However you never know and Lamb is one to watch. The Lib Dems only have to suffer a mauling at the local elections and the pressure upon Clegg will be immense.
The odds are a fact, though the likelihood of it happening are remote. However you never know and Lamb is one to watch. The Lib Dems only have to suffer a mauling at the local elections and the pressure upon Clegg will be immense.
Excellent post today from Fighting Monsters on how ethical social work practice can survive in an era of cuts.
With great difficulty is her conclusion, but she does raise the importance of practitioners being open to criticism of their own practice and encouraging service users to use formal complaints procedures if necessary.
With great difficulty is her conclusion, but she does raise the importance of practitioners being open to criticism of their own practice and encouraging service users to use formal complaints procedures if necessary.
Over sixty percent of the public say that cuts will lead to disabled people being the subject of public anger, a poll by Ipsos MORI for Mencap finds.
What's more, 49% say disabled people will be more vulnerable to hate crime attacks.
As this is a poll of the public, not disabled people, it's difficult to know if this is merely a fear or a statement of intent.
Of course, it takes more than just cuts to draw people's crosshairs of hate towards disabled people. Mark Goldring. chief executive of Mencap, makes the point: "Generally, there has been a disproportionate focus on the very few people who have defrauded the system rather than those who need state support like Disability Living Allowance (DLA) in order to participate in society. The Department of Work and Pensions' own figures show a fraud rate of 0.5 per cent for Disability Living Allowance."
However, I worry the subtleties of this statistical argument may be lost of the baying mob that his pollsters have tracked down.
What's more, 49% say disabled people will be more vulnerable to hate crime attacks.
As this is a poll of the public, not disabled people, it's difficult to know if this is merely a fear or a statement of intent.
Of course, it takes more than just cuts to draw people's crosshairs of hate towards disabled people. Mark Goldring. chief executive of Mencap, makes the point: "Generally, there has been a disproportionate focus on the very few people who have defrauded the system rather than those who need state support like Disability Living Allowance (DLA) in order to participate in society. The Department of Work and Pensions' own figures show a fraud rate of 0.5 per cent for Disability Living Allowance."
However, I worry the subtleties of this statistical argument may be lost of the baying mob that his pollsters have tracked down.
Some of the biggest names in adult social care have come together today to set out a vision for the future leadership of the sector, with a big emphasis on service users assuming a much greater role.
The paper - Design for Life - follows on from the launch of the Think Local, Act Personal Partnership, a sector-led initiative to take forward the personalisation agenda in these straitened times.
Design for Life is basically a discourse on how social care can come out of the current age of austerity in a better place, with more personalised care and a genuine transfer of power to service users.
The signatories are big players from the worlds of local government, service provision, and the user and carers' sectors, so their words should carry weight - though at this stage their thinking is at a relatively abstract stage.
I've copied an extract so have a read and see what you think.
The paper - Design for Life - follows on from the launch of the Think Local, Act Personal Partnership, a sector-led initiative to take forward the personalisation agenda in these straitened times.
Design for Life is basically a discourse on how social care can come out of the current age of austerity in a better place, with more personalised care and a genuine transfer of power to service users.
The signatories are big players from the worlds of local government, service provision, and the user and carers' sectors, so their words should carry weight - though at this stage their thinking is at a relatively abstract stage.
I've copied an extract so have a read and see what you think.
Continue reading Users must have greater say in running social care, say sector leaders.
The Mental Health Helplines Partnership - the umbrella body for helplines - is looking to drive up its membership. This is a summary of its services and here is information about membership.
Interesting blog post from Georgina Owen from consultancy iMPOWER about the geographical barriers to the NHS and social care working together.
With GPs set to take responsibility for commissioning healthcare from PCTs as part of consortia, she points out that GP practices currently cross over local authority boundaries, meaning that consortia inevitably will as well.
The definition of responsibility for people is also different between GP practices and local authorities; practices take responsibility for people on their register, while councils are responsible for people ordinarily resident in their area (this means that someone placed out of area in a residential placement will be the responsibility of health and social care commissioners in different areas).
And the government's plan for people to have the right to choose their GP practice means that there is no guarantee that their surgery will coincide with their local authority area.
But, as Owen argues, effective joint working between health and social care requires some degree of geographical harmony; she says this needs to be addressed through the government's health reforms.
With GPs set to take responsibility for commissioning healthcare from PCTs as part of consortia, she points out that GP practices currently cross over local authority boundaries, meaning that consortia inevitably will as well.
The definition of responsibility for people is also different between GP practices and local authorities; practices take responsibility for people on their register, while councils are responsible for people ordinarily resident in their area (this means that someone placed out of area in a residential placement will be the responsibility of health and social care commissioners in different areas).
And the government's plan for people to have the right to choose their GP practice means that there is no guarantee that their surgery will coincide with their local authority area.
But, as Owen argues, effective joint working between health and social care requires some degree of geographical harmony; she says this needs to be addressed through the government's health reforms.
If you are looking for the beating heart of the campaign against social care cuts then look no further than West Sussex and an organisation called Don't Cut Us Out. It is challenging the £31m in cuts earmarked by West Sussex Council for adult social care from 2011-14, and in particular, the council's decision to raise eligibility thresholds from moderate to substantial.
One of the people who will lose out from this change is Andrew Pickthall, a man with Down's who receives services for his 'moderate' needs. Yesterday he presented West Sussex cabinet member for adult services Peter Catchpole with a petition bearing 10,000 signatures (collected in two weeks) against the cuts (pictured above).
Andrew was also interviewed on Saturday's Today Programme on Radio 4, as part of a report on cuts to adult social care.
This reflects the profile that the campaign has built up in a very short space of time. This is thanks in part to spokesperson Barry Pickthall (Andrew's father), who is used to dealing with the press as he runs a media agency.
It will be interesting to see what the campaign can achieve after building up such momentum, and also what others can learn from its success to date.
Campaigners have backed greater access to supported
employment as part of its package of measures to improve the lives of people
with autism.
In response to the Scottish government's draft autism strategy respondents said
they wanted greater access to mentoring and supported employment in rural
communities.
Among the other responses were:
- Faster and more integrated diagnosis services
- Clearer care pathways
- Autism awareness campaign in schools
- A review and evaluation of existing research to support services
The full analysis of the consultation responses can be seen on the Scottish
government website.
The woman who was a repeated victim of sex trafficking and is now to be paid substantial damages by the Home Office after it returned her to Moldova, despite the fact that she faced grave dangers has told her story to The Guardian.
Be warned it is harrowing but shows up only too well the inadequacies of our immigration system.
Be warned it is harrowing but shows up only too well the inadequacies of our immigration system.
That is the question being asked
by Fighting Monsters this morning after the Care Quality Commission's (CQC)
chief executive,
Cynthia Bower, appeared before a public inquiry to answer questions on the
failings of her previous organisation West Midlands
strategic health authority (SHA).
Bower was chief executive of the SHA while it was overseeing the Mid
Staffordshire NHS Trust debacle which saw hundreds of people die because of
poor standards of care.
CB, the author of Fighting Monsters, is less than convinced about Bower's
qualifications to fulfil the role of chief executive at CQC. Especially given
this morning's report from Which? highlighting
poor standards of care in a random selection of care homes.
There is little I can add to CB's analysis other than to say she is not alone.
While it would be unfair to say the view she expresses about Bower is
pervasive, I have certainly heard it from different corners of the sector on
more than one occasion.
The judgement really depends on how far you hold Bower responsible for the care
at Mid Staffordshire Hospital and whether you think it's therefore fair to
equate this to her ability to run the sector regulator.
The first of these I'm not remotely qualified to comment on because I'm not familiar
enough with the case.
The second I think is fair to do (that is after all how job interviews work)
but hard to evidence concretely.
However, thirdly, you would have to start from the assumption that the CQC does not do a
good job of regulating the sector. Today's Which? report would seem to indicate
that, but being based, as it is, on only four homes undermines its weight.
Perhaps more persuasive is the conclusions of Compassion in Care who's
inspections frequently turn-up problems with care homes which have not yet been
identified by the CQC (at least publically). On that score there is certainly a
case to answer.
However, Bower's qualification to run the CQC I feel will be a question
unanswered until the public inquiry judges how culpable, if at all, she is for
the Mid Staffs failings.
Southern Cross reports that its lenders have agreed to postpone a test of its banking covenants until 31 May buying it more time while talks continue over rent reductions with its landlords.
The care homes group says it is maintaining "regular and constructive dialogue with its lenders who continue to be supportive". But for how long?
The postponement may help the group but key to its survival is its ability to agree terms with its landlords and from what I'm hearing the landlords are in little mood to bargain and even if they are they may not be in any position to agree rent reductions as they've also got banks to deal with.
A statement from Southern Cross from last week said it had held a meeting with its principal landlords to discuss the financial restructuring of the business. At this meeting a series of proposals were outlined, though no decisions were made.
The statement added: "There is a general recognition of the value to all parties of moving forward to a solution in an orderly fashion."
Any guesses as to the final outcome?
The care homes group says it is maintaining "regular and constructive dialogue with its lenders who continue to be supportive". But for how long?
The postponement may help the group but key to its survival is its ability to agree terms with its landlords and from what I'm hearing the landlords are in little mood to bargain and even if they are they may not be in any position to agree rent reductions as they've also got banks to deal with.
A statement from Southern Cross from last week said it had held a meeting with its principal landlords to discuss the financial restructuring of the business. At this meeting a series of proposals were outlined, though no decisions were made.
The statement added: "There is a general recognition of the value to all parties of moving forward to a solution in an orderly fashion."
Any guesses as to the final outcome?
Older people are slow and not fit for work according to youngsters, research by charity Anchor has revealed.
The research kicks off Anchor's 'Grey pride' campaign to end ageist attitudes.
The research found that 41% of 18-24 year olds said that older people were less productive at work and there weren't enough jobs for them to stay in the workplace.
Jane Ashcroft, chief executive of Anchor, said: "Casual ageism has no place in society and the negative perceptions bear no reality to the lives of the over 60s in England today who are active, energetic and contribute hugely to many of the most successful businesses and organisations in the country."
The grey pride campaign calls on greater respect for older people's rights and for the government to introduce a dedicated older people's minister.
The research kicks off Anchor's 'Grey pride' campaign to end ageist attitudes.
The research found that 41% of 18-24 year olds said that older people were less productive at work and there weren't enough jobs for them to stay in the workplace.
Jane Ashcroft, chief executive of Anchor, said: "Casual ageism has no place in society and the negative perceptions bear no reality to the lives of the over 60s in England today who are active, energetic and contribute hugely to many of the most successful businesses and organisations in the country."
The grey pride campaign calls on greater respect for older people's rights and for the government to introduce a dedicated older people's minister.
Now here's an interesting appointment - ailing care provider Southern Cross has hired Deborah Sturdy, the Department of Health's former nurse adviser for older people, as its head of dementia care.
Interesting for a number of reasons:
Reading the press release about Sturdy's appointment, you could have been forgiven for thinking the difficulties that Southern Cross finds itself is of another world. It puts out the message that quality is very high on the company's agenda and that it is very much business as usual.
Interesting for a number of reasons:
- Sturdy was reportedly made redundant by the DH in February, according to the Sunday Mirror, due to government cuts.
- Southern Cross is facing severe financial difficulties because rental obligations to the landlords that own the care homes it runs have become unsustainable.
- The DH is monitoring the situation at Southern Cross closely.
Reading the press release about Sturdy's appointment, you could have been forgiven for thinking the difficulties that Southern Cross finds itself is of another world. It puts out the message that quality is very high on the company's agenda and that it is very much business as usual.
We've been failing a bit in our duties to inform, educate and entertain, well, to inform at least, so here are a couple of things of note that you may have missed:
- Helping prisoners stay in touch with their families is well-known to improve their prospects after release, but charities in this field are struggling to demonstrate their effectiveness, found a report last week by voluntary sector think-tank New Philanthropy Capital. NPC has developed a measurement tool to help charities in this area, but it also has some tough messages for government and commissioners - apparently there is much confusion among charities about what commissioners are looking for, so it calls on government to be clear about the outcomes it is after and to improve access to data.
- Anyone remember extra care housing? I remember when i started reporting on adult social care in 2003 it was all the rage but it has less of a national profile these days. Anyway a recent report commissioned by social housing builder and maintenance firm Keepmoat has attempted to set out the core role of extra care in responding to the housing needs of an ageing society. It predicts an increasing role for extra care in future, both in supporting vulnerable groups, such as people with dementia, and meeting the needs of the wider community.
Care Quality Commission chief executive Cynthia Bower has faced calls to resign during her appearance before the inquiry into the failings in care delivered by Mid-Staffordshire Foundation Trust.
Bower was chief executive of West Midlands Strategic Health Authority, which oversees the trust, from 2006-8, a period which overlapped with higher-than-expected death rates at Stafford Hospital, an issue at the heart of the inquiry.
The Guardian's NHS reforms blog reports that Bower remained defiant during her appearance before the inquiry but faced calls to resign from the CQC from families whose relatives died at ths hospital.
Bower was chief executive of West Midlands Strategic Health Authority, which oversees the trust, from 2006-8, a period which overlapped with higher-than-expected death rates at Stafford Hospital, an issue at the heart of the inquiry.
The Guardian's NHS reforms blog reports that Bower remained defiant during her appearance before the inquiry but faced calls to resign from the CQC from families whose relatives died at ths hospital.
There's an interesting piece over on the BBC website over the
weekend asking, should my hereditary disability stop me having a baby?
It details the tough decision facing Jon Lancaster and his girlfriend as they
decide whether they should adopt or run a 50:50 risk of his child having an
illness which has caused him to be bullied and need multiple operations.
It's a fascinating dilemma which made me think what i would do faced with the
same situation. It makes me feel slightly guilty that would probably take the
easy route and adopt.
What about you? Comments below please.
If you haven't already done so please do respond to our survey about the impact of the outsourcing social care (and conceivably social work). And if that sentence doesn't convince you, here are some reasons to do so:
1) There's a high likelihood that many social care staff currently working for local authorities in England will not be in future. The government's vision for adult social care made it clear that it wanted council in-house provision of adult social care to be reduced radically: "There may be exceptional reasons for the council to retain services, but separating responsibility for commissioning and providing services should become the norm."
2) This applies to social workers as much as those in direct care roles - see the launch of the pilots for social work practices.
3) These changes will have far-reaching effects in the way practitioners work and the way they get rewarded for their work - here are two: reduced terms and conditions are likely as are expectations that social workers will take a bigger role in running the organisations they work for as will be the case with social work practices.
4) This is a matter of firm conviction for this government - ministers' view is that outsourcing services drives competition for the delivery of social care, increasing choice and quality for service users. Here's a quote from that same vision for adult social care: "Evidence from a wide range of public services shows that choice and competition can be a powerful tool to drive up quality and reduce and control costs."
5) Plenty disagree - see this story on a recent report for the union Unite - but their voices are not being heard at the heart of government, where they are seen as representing a dinosaur, leftish tendency.
1) There's a high likelihood that many social care staff currently working for local authorities in England will not be in future. The government's vision for adult social care made it clear that it wanted council in-house provision of adult social care to be reduced radically: "There may be exceptional reasons for the council to retain services, but separating responsibility for commissioning and providing services should become the norm."
2) This applies to social workers as much as those in direct care roles - see the launch of the pilots for social work practices.
3) These changes will have far-reaching effects in the way practitioners work and the way they get rewarded for their work - here are two: reduced terms and conditions are likely as are expectations that social workers will take a bigger role in running the organisations they work for as will be the case with social work practices.
4) This is a matter of firm conviction for this government - ministers' view is that outsourcing services drives competition for the delivery of social care, increasing choice and quality for service users. Here's a quote from that same vision for adult social care: "Evidence from a wide range of public services shows that choice and competition can be a powerful tool to drive up quality and reduce and control costs."
5) Plenty disagree - see this story on a recent report for the union Unite - but their voices are not being heard at the heart of government, where they are seen as representing a dinosaur, leftish tendency.
We finally have some concrete figures on the toll take on adult social care by the government's front-loaded cuts in public spending. It comes from the Association of Directors of Adult Social Services who have found that spending by councils on adult care has been slashed by £1bn from 2010-11 to 2011-12.
If this equates to net spending (i.e. spending by councils that excludes the income they receive from service users) this will equates to a cut of 7% (in cash terms).
Adass, who has surveyed 148 of its members (the vast majority), said that 70% of this cut had been absorbed through efficiency savings and service redesign but the remainder equated to reduced services i.e frontline cuts.
As part of this, it has also round that 13% of councils increased eligibility thresholds last year - most of these raising criteria from 'moderate' to 'substantial'.
According to Adass's figures we have
6 councils on critical (4%)
116 on substantial (78%)
26 on moderate (18%)
If this equates to net spending (i.e. spending by councils that excludes the income they receive from service users) this will equates to a cut of 7% (in cash terms).
Adass, who has surveyed 148 of its members (the vast majority), said that 70% of this cut had been absorbed through efficiency savings and service redesign but the remainder equated to reduced services i.e frontline cuts.
As part of this, it has also round that 13% of councils increased eligibility thresholds last year - most of these raising criteria from 'moderate' to 'substantial'.
According to Adass's figures we have
6 councils on critical (4%)
116 on substantial (78%)
26 on moderate (18%)
Following on from my colleague Vern's article about how changes in immigration rules may trap migrant women in abusive relationships, there's a good article in The Guardian on how changes to legal aid may provide similar difficulties for battered women.
Yesterday, Eric Pickles, communities secretary, unveiled
draft guidance on how councils should deal with voluntary organisations which
provide services and consult residents on any manner of issue.
But the document itself flags up one rather uncomfortable issue.
First, to give credit where it is due the basic principles laid down with
regards to managing contracts with voluntary and community organisations seem
fairly sound. They'd be guaranteed three months' notice of any changes to their
contract, councils would have to consult the local community and inform the
involve organisation as soon as possible.
But it's on how consultation to changes should work that it falls down. Pickles
says he is trying to reduce bureaucracy
by scrapping weighty government guidance on consultation procedure. Again that
sounds good, however, we already know that council consultations are patchy at
best, removing all the guidance doesn't trigger optimism they
will improve.
Sarah Phillips, deputy director of the Centre for Public Service Partnerships, makes the point on the LGiU blog that this will probably require some pretty active citizens to make it work. When you are talking abut users of social care you are often talking about vulnerable people who are often not in a great position to organise and get their voice heard in this way.
As if to demonstrate how freedom may not equal improvement, Pickles' own consultation on the draft guidance gives respondents only nine weeks not the recommended 12 "to balance swift action in light of near-term local budgetary decisions with sufficient time for all interested parties to respond". That, for anyone desperately trying to fight cuts, makes for rather uncomfortable reading.
Image by Look West on Flickr
Interesting blog from former Labour spin doctor Alastair Campbell on why the NHS reforms are bad for mental health: "I have yet to meet one GP who wants to take on MH services in the way set out in the reform plans, or who thinks they can run those services adequately with all the other pressures on them."
It's worth a read.
It's worth a read.
Andrew Lansley has finally found an ally.
Peter Hay, the new president of the Association of Directors of Adult Social Services, has invited him to ADASS's conference later this year and has insisted there will be no need for the health secretary to skulk in through the back door and speak about his health reforms.
This was in reference to Lansley's appearance at the Royal College of Nursing's conference when he spoke only with selected members of the RCN about his ailing bill.
Hay has a wider concern. Along with the Local Government Association, which has also invited Lansley to a face-to-face meeting, he likes aspects of the reforms and does not want to see any risk to these.
These are the reforms that provide local government influence over health commissioning through health and wellbeing boards and through local government having control of public health. Granted it needs a tweak here and a tweak there, but on the whole these aspects are supported.
His worry is this is being drowned out by the opponents to the more health-related reforms, where there are clear problems. So Hay, who is a part of the NHS Future Forum, which is looking at the reforms, has called for councils and social care directors to press the case more strongly for the way ahead for the NHS reforms to be for councils to work with GPs.
"We need to raise our voice and find alliances and point out there's a different way of doing this [the current NHS set up]," he said.
The question is can local government find traction when the problems with the bill are on the health side?
Peter Hay, the new president of the Association of Directors of Adult Social Services, has invited him to ADASS's conference later this year and has insisted there will be no need for the health secretary to skulk in through the back door and speak about his health reforms.
This was in reference to Lansley's appearance at the Royal College of Nursing's conference when he spoke only with selected members of the RCN about his ailing bill.
Hay has a wider concern. Along with the Local Government Association, which has also invited Lansley to a face-to-face meeting, he likes aspects of the reforms and does not want to see any risk to these.
These are the reforms that provide local government influence over health commissioning through health and wellbeing boards and through local government having control of public health. Granted it needs a tweak here and a tweak there, but on the whole these aspects are supported.
His worry is this is being drowned out by the opponents to the more health-related reforms, where there are clear problems. So Hay, who is a part of the NHS Future Forum, which is looking at the reforms, has called for councils and social care directors to press the case more strongly for the way ahead for the NHS reforms to be for councils to work with GPs.
"We need to raise our voice and find alliances and point out there's a different way of doing this [the current NHS set up]," he said.
The question is can local government find traction when the problems with the bill are on the health side?
The Daily Telegraph has an interesting story about how the mother of a brain-damaged woman has applied to the Court of Protection for permission for artificial nutrition to be removed, leading to her death.
Her mother believes she is in constant pain, but her daughter is being represented by the Official Solicitor, who claims she is capable of communication and opposes allowing her to die.to allow her daughter's life support to be switched off.
This is interesting because it shows the power of the Court of Protection over the most vulnerable members of society.
This contrasts starkly with a documentary being presented by author and euthanasia campaigner Sir Terry Pratchett on the last moments of a terminally ill British man who travelled to an assisted suicide clinic in Switzerland. This undoubtedly will raise debate again on assisted suicide.
Her mother believes she is in constant pain, but her daughter is being represented by the Official Solicitor, who claims she is capable of communication and opposes allowing her to die.to allow her daughter's life support to be switched off.
This is interesting because it shows the power of the Court of Protection over the most vulnerable members of society.
This contrasts starkly with a documentary being presented by author and euthanasia campaigner Sir Terry Pratchett on the last moments of a terminally ill British man who travelled to an assisted suicide clinic in Switzerland. This undoubtedly will raise debate again on assisted suicide.
The social Care Institute for Excellence (SCIE) has a film out today summarising research into the purpose and benefits of reablement.
Among it's conclusions it finds: "Reablement significantly improves outcomes, particularly in terms of restoring people's ability to perform usual activities and improving their perceived quality of life."
Worth a quick watch.
Among it's conclusions it finds: "Reablement significantly improves outcomes, particularly in terms of restoring people's ability to perform usual activities and improving their perceived quality of life."
Worth a quick watch.
David Cameron's government has made no secret of its desire to open up public services to providers from all sectors: private, voluntary, social enterprise or mutual.
Social care - particularly for adults - has a long history of outsourcing provision, particularly to the private sector.
But has this been good for service users and is further outsourcing the right way forward for children and vulnerable adults?
Community Care wants to hear from social care professionals on this issue.
Answer our survey and have your say.
(Image on Flickr from World Economic Forum)
Social care - particularly for adults - has a long history of outsourcing provision, particularly to the private sector.
But has this been good for service users and is further outsourcing the right way forward for children and vulnerable adults?
Community Care wants to hear from social care professionals on this issue.
Answer our survey and have your say.
(Image on Flickr from World Economic Forum)
There's been an enormous amount of sympathy and support for the Hollywood actress Catherine Zeta-Jones, who has admitted to suffering from bipolar disorder.
The episode was was to have been triggered by the stress of her husband Michael Douglas's battle with throat cancer.
Mental health charities have praised her honesty as helping reduce the stigma that surrounds mental ill-health, while others say it has helped open a space for debate.
However Alastair Campbell, the former Labour spin doctor, makes an interesting point that the focus on famous people who suffer from depression can risk blurring the message that depression can affect all.
He is an ambassador for Time to Change, the campaign to change attitudes on mental illness, and says there is a general frustration among mental health charities that the only time they get airtime is when someone famous suffers from depression.
The Daily Telegraph has an interesting take on this that there is a rise in the numbers of women suffering from depression.
Picture from Flickr.com courtesy of jkutterkabat
The episode was was to have been triggered by the stress of her husband Michael Douglas's battle with throat cancer.
Mental health charities have praised her honesty as helping reduce the stigma that surrounds mental ill-health, while others say it has helped open a space for debate.
However Alastair Campbell, the former Labour spin doctor, makes an interesting point that the focus on famous people who suffer from depression can risk blurring the message that depression can affect all.
He is an ambassador for Time to Change, the campaign to change attitudes on mental illness, and says there is a general frustration among mental health charities that the only time they get airtime is when someone famous suffers from depression.
The Daily Telegraph has an interesting take on this that there is a rise in the numbers of women suffering from depression.
Picture from Flickr.com courtesy of jkutterkabat
At last some good news in mental health services.
The Campaign Against Living Miserably - which helps young men talk about their feelings to try to prevent suicide - has been commissioned by three primary care trusts to launch a project in London.
The CALMzone will cover Westminster, Kensington & Chelsea, and Hammersmith & Fulham from the later summer with the possibility of more areas in London being covered later on.
The agreement with Westminster is for three years though only for the first year in the other two.
The way it works is by linking up with events and businesses popular with young men. This could mean a promotional poster in a kebab store or sponsoring a night at a nightclub.
Director Jane Powell says this is great news as men are three times more likely to commit suicide than women in the UK and the incidents of suicide in London can be higher profile as they are often on the tube or rail network.
Powell says the charity hopes to rent its own offices outside of any of the PCTs, which she believes will make it more accessible, have a local coordinator and a team of volunteers.
A story I wrote on Liverpool's CALMzone shows a fall in the suicide rate there, though it is not possible to attribute this to CALM's work.
A department of health report out today on 15 mental health interventions was able to demonstrate that these offered value for money as they were generally low cost and self-financing and had a broad range of pay-offs.
Although CALMzones were not covered in the literature there is no doubting they have an effect in helping to reduce suicide among young men. I look forward to hearing more about the work in London.
The Campaign Against Living Miserably - which helps young men talk about their feelings to try to prevent suicide - has been commissioned by three primary care trusts to launch a project in London.
The CALMzone will cover Westminster, Kensington & Chelsea, and Hammersmith & Fulham from the later summer with the possibility of more areas in London being covered later on.
The agreement with Westminster is for three years though only for the first year in the other two.
The way it works is by linking up with events and businesses popular with young men. This could mean a promotional poster in a kebab store or sponsoring a night at a nightclub.
Director Jane Powell says this is great news as men are three times more likely to commit suicide than women in the UK and the incidents of suicide in London can be higher profile as they are often on the tube or rail network.
Powell says the charity hopes to rent its own offices outside of any of the PCTs, which she believes will make it more accessible, have a local coordinator and a team of volunteers.
A story I wrote on Liverpool's CALMzone shows a fall in the suicide rate there, though it is not possible to attribute this to CALM's work.
A department of health report out today on 15 mental health interventions was able to demonstrate that these offered value for money as they were generally low cost and self-financing and had a broad range of pay-offs.
Although CALMzones were not covered in the literature there is no doubting they have an effect in helping to reduce suicide among young men. I look forward to hearing more about the work in London.
The Scottish Human Rights Commission will be at the United Nations in New York next week to publicise a project it has developed on supporting the human rights of older people called Care about Rights.
The meeting will be the first session of the open-ended working group on strengthening the protection of the human rights of older people.
It is thought that part of the discussion will focus on whether a new international treaty or other measures for the rights of older people are needed, along the same lines as already exists for women, children and disabled people through Conventions which have been ratified by governments including the UK.
The meeting will be the first session of the open-ended working group on strengthening the protection of the human rights of older people.
It is thought that part of the discussion will focus on whether a new international treaty or other measures for the rights of older people are needed, along the same lines as already exists for women, children and disabled people through Conventions which have been ratified by governments including the UK.
Talks continued today between ailing care provider Southern Cross and its landlords over a renegotiated rental settlement.
The company, which is trying to stave off bankruptcy, is outwardly professing confidence that it will conclude a deal by July and continues to argue that the longer this goes on the more pressure there will be on the landlords to agree a deal on renegotiated rents.
As readers may remember its problems are two-fold: Spending cuts are forcing local authorities to cut the fees they can pay care homes while it is also facing higher rents from landlords, which it wants to reduce.
The word is landlords are not best pleased at the prospect of reduced rents, though it has been pointed out by market expert William Laing that it is in the landlords' interests to do a deal.
Recent articles in The Guardian and the Mail on Sunday, both dismissed as nonsense by Southern Cross, suggest confidence may be misplaced.
The Guardian claimed the company asked Downing Street to tell local authorities not to blacklist its homes while it comes up with a rescue plan while the Mail on Sunday claimed the company had asked for a state bailout.
A DH spokesperson said: "Southern Cross has not made any specific request for help from Government and has not asked us to lobby local authorities on its behalf."
She added the department is receiving regular updates from the company about its restructuring activities.
Earlier this week, Southern Cross's chairman of the past three years, Ray Miles, quit.
The company, which is trying to stave off bankruptcy, is outwardly professing confidence that it will conclude a deal by July and continues to argue that the longer this goes on the more pressure there will be on the landlords to agree a deal on renegotiated rents.
As readers may remember its problems are two-fold: Spending cuts are forcing local authorities to cut the fees they can pay care homes while it is also facing higher rents from landlords, which it wants to reduce.
The word is landlords are not best pleased at the prospect of reduced rents, though it has been pointed out by market expert William Laing that it is in the landlords' interests to do a deal.
Recent articles in The Guardian and the Mail on Sunday, both dismissed as nonsense by Southern Cross, suggest confidence may be misplaced.
The Guardian claimed the company asked Downing Street to tell local authorities not to blacklist its homes while it comes up with a rescue plan while the Mail on Sunday claimed the company had asked for a state bailout.
A DH spokesperson said: "Southern Cross has not made any specific request for help from Government and has not asked us to lobby local authorities on its behalf."
She added the department is receiving regular updates from the company about its restructuring activities.
Earlier this week, Southern Cross's chairman of the past three years, Ray Miles, quit.
I return to an old favourite this morning - Andrew Lansley and his latest difficulties over his troubled health reforms.
The Royal College of Nursing blew a massive raspberry in his direction yesterday with a clear vote of no confidence in his policies.
Lansley continues to say he is sorry and that he will listen during the two-month pause but the question remains will there be substantive changes as many - including from within the coalition - have called for, or will the changes be little more than cosmetic.
This comes with the Local Government Association having now invited him (or should that read demanded his presence?) at a specially convened session of local government leaders to hear their concerns about the lack of powers of the health and wellbeing boards vis-a-vis GP commissioning consortia and that the reforms may fail vulnerable people .
Picture from Flickr.com courtesy of NHS Confederation
The Royal College of Nursing blew a massive raspberry in his direction yesterday with a clear vote of no confidence in his policies.
Lansley continues to say he is sorry and that he will listen during the two-month pause but the question remains will there be substantive changes as many - including from within the coalition - have called for, or will the changes be little more than cosmetic.
This comes with the Local Government Association having now invited him (or should that read demanded his presence?) at a specially convened session of local government leaders to hear their concerns about the lack of powers of the health and wellbeing boards vis-a-vis GP commissioning consortia and that the reforms may fail vulnerable people .
Picture from Flickr.com courtesy of NHS Confederation
By Liz Sayce, chief executive, RadarLast December I agreed to lead an independent review of the specialist disability employment services funded by the Department for Work and Pensions.
My starting point was to find out what disabled people want. The answer is hardly surprising: the same chance as anyone else to work in any and every type of employment in the land, from employee to business entrepreneur, from apprentice to managing director, from social enterprise to mutual. And to pursue a career in any sector - including growth areas like hospitality and indeed care (where disabled staff still seem to be under-represented).
The question is whether employment support programmes are set up to meet that aspiration.
Many people have said to me 'I wouldn't start from here' when they look at the sometimes confusing array of programmes on offer. At the heart of their comments is the insight that support - and resource - should follow the person, so people can easily move between roles as they pursue their working lives; rather than government directly funding particular types of facility. This would prevent disabled people from being funnelled into limited types of work (after all, how many people want to pack boxes just because they are disabled?). Disability leaders and organisations are united in seeing individual support for the full range of mainstream roles as the model for the future.
I've also looked at evidence for what is most effective in enabling people to get in, stay in and get on at work - and found that a 'work first' approach is most evidence based. Rather than fixing, treating or preparing someone - and only after that looking at employment options - it works better to start with aspirations and enabling the individual to move quickly into (or back into) employment, with as much support as they need. Evidence from mental health, learning disability, homelessness, addictions and ex-offenders is consistent on this core message. Peer support and mentoring are particularly useful and support must be as intense, continuous and flexible as needed.
I will be making recommendations to improve disability employment programmes in line with aspirations and evidence. But employment support alone is not enough and I will comment on the big enablers of disabled people's employment: confident and well-advised employers, the occasional well-publicised legal challenge, a benefit system that removes disincentives to work, a media that stops stigmatising benefit claimants, education and skills opportunities for disabled people, accessible transport, digital inclusion and, importantly, effective social and health care services.
Social and health care staff have daily contact with disabled people, can foster hope at the point of a major diagnosis or injury, can let people know their rights and sources of employment support (like the little known Access to Work programme). They should resist the temptation to focus for too long on 'getting someone well' before they think about employment (the person gets less and less likely to get work, the longer they are away). And the social care sector can show how it's done by itself employing large numbers of disabled people, in every type of role.
Some have argued that improving employment support programmes is a waste of time when there are so few jobs around. Yet in the last two recessions, disabled people got totally left behind when the recovery came, in many cases living in poverty for decades. The time to improve support is now, so disabled people have an equal chance of jobs when they come on stream.
Look out for my recommendations in the summer - and the government's response to them - to see how employment support for disabled people will look in the years to come.
Excellent - and worrying - research out today from our children's team about the toll that cuts are taking on the protection of children from abuse.
The poll of 170 frontline workers found that 58% believed pressure had been placed on them to reclassify child protection cases as less serious child-in-need cases.
Here's more on our very concerning findings.
The poll of 170 frontline workers found that 58% believed pressure had been placed on them to reclassify child protection cases as less serious child-in-need cases.
Here's more on our very concerning findings.
Double woe today for health secretary Andrew Lansley; first he has received a vote of no confidence from over 98% of delegates to the Royal College of Nursing's annual conference in relation to his health reforms.And Labour has also chosen today to redouble its attack on the reforms - that are now on hold pending further consultation.
In a document published today, has attacked several aspects of the Health and Social Care Bill, focusing on changes to increase competition for health services, warning that NHS hospitals could go bust and face fines for anti-competitive practices as a result.
Lansley has hit back by accusing Labour leader Ed Miliband of scaremongering but it may not be a message that gets heard above the din of opposition that is blaring out today.
(Image on Flickr from NHS Confederation)
Liverpool council has been
found guilty of maladministration over its failure making a client wait for an
accessible shower for an extra 18 months more because he was a tenant of a
social landlord.
The Local Government Ombudsman said that councils could not shirk their
responsibility to meet an assessed need in a timely manner.
If the man in question had been a private homeowner or private tenant he would
have been eligible for a disabled facilities grant, which would have delivered
the adaptations much sooner.
You can read the full
report on the ombudsman's website.
There's a hard-hitting piece in The Guardian today by ex-Department of Health personalisation lead Martin Routledge about his concerns that cuts could "badly and unnecessarily" damage personalisation.
Routledge - speaking with the freedom of someone outside government (he is now head of operations at In Control, the charity that has pioneered personalisation) has some tough messages for councils that are cutting back on personal budgets or restricting their use (something we have reported on in Community Care).
He says: "In some places we see crude cuts being justified in its name, or restrictions on the use of personal budgets, which make no financial sense yet seriously hinder opportunities for creativity and efficiency. Where rigid local rules only allow individual budgets to be spent on "personal care", this means people can't make their money work harder by, for example, supporting themselves into work."
The result is that people see personalisation as part of the problem rather than the solution for improve care, he warns.
Local authorities in this position should pay heed but so should Routledge's former colleagues in the DH; there may be no more money to play with but this is an issue that will have to be grappled with.
Routledge - speaking with the freedom of someone outside government (he is now head of operations at In Control, the charity that has pioneered personalisation) has some tough messages for councils that are cutting back on personal budgets or restricting their use (something we have reported on in Community Care).
He says: "In some places we see crude cuts being justified in its name, or restrictions on the use of personal budgets, which make no financial sense yet seriously hinder opportunities for creativity and efficiency. Where rigid local rules only allow individual budgets to be spent on "personal care", this means people can't make their money work harder by, for example, supporting themselves into work."
The result is that people see personalisation as part of the problem rather than the solution for improve care, he warns.
Local authorities in this position should pay heed but so should Routledge's former colleagues in the DH; there may be no more money to play with but this is an issue that will have to be grappled with.
Now I know that Atos, the company which conducts the
Department for Work and Pensions' disability benefit assessments, aren't
exactly the most popular organisation with those who read this blog. But even
the sympathetic few may have difficulty defending them in the light of their
latest antics.
The company has walked
away from a ten year contract to run GP services in east London, just three years into it, albeit with
the PCT's consent.
Now there are an obvious set of jokes about the company's ability to work which
I could make here, but I won't.
Instead let's focus on what this means for greater use of private companies in
general. Social care has a longer and richer history of their involvement than
health of course. But if the government's dreams of more integrated health and
social care services can come true we might well be worried about more
inexperienced large multi-national companies becoming involved in social care,
especially as the boundary between it and health is blurred.
The Guardian quotes local GP Abur Rahim on Atos' tactics in picking-up the
contract in the first place: "They put their bid in with the lowest cost,
but that isn't the same as showing they could best meet the local people's
needs."
That to me sounds awfully familiar to the concerns people have in the cash-strapped
social care sector. The consequences should act as a warning.
The Home Office has alerted me to the fact that there's one month left to contribute to a consultation on getting more disabled people to become MPs and increase the current low number.
Given what many people see as the attack on disabled people that has taken place through various benefits cuts (along with cuts to social care and other services), it seems that it has never been more vital to increase representation.
Here are the full details on the consultation and the link to where you can have your say.
Given what many people see as the attack on disabled people that has taken place through various benefits cuts (along with cuts to social care and other services), it seems that it has never been more vital to increase representation.
Here are the full details on the consultation and the link to where you can have your say.
It's got to be a boost for the profession when the second
biggest party in Wales,
Plaid Cymru, bothers to mention you in such glowing terms.
Clearly valuing the contribution of social workers, the party's election
manifesto, out today, states: "We will work to eliminate delayed
transfers of care, improve services and raise the esteem of social workers and
care assistants."
It also promises to develop a Centre of Excellence for Social Services Research
to strengthen the quality and quantity of that research.
The manifesto also states: "Plaid will examine the case for creating a
comprehensive advocacy service for older people and simplify access to support and
information."
All bold words indeed, although its telling that its promise to provide free
care is tempered by what it sees as a unfair settlement for Wales from Westminster.
That pesky money detail may prove a little problematic for those other pledges
too.
However, it's worth noting that the party stops short of recommending an integration of health and social care which is favoured in Scotland, instead plumping to "greater integration". That, after all, would potentially be even more expensive.
Three patients have died on a psychiatric ward in east London where warnings have been raised about budget cuts and the building's design, according to The Guardian.
The Tower Hamlets Centre for Mental Health, in Stepney, which is run by the East London NHS Foundation Trust, instigated a raft of cuts to save up to £20m over three years.
At the time, staff belonging to the health union Unison warned that the cuts - including reducing nursing cover by the equivalent of two nurses per ward - could put patients at risk.
The statement from the trust spoke of further savings to come.
From a mental health perspective this is concerning as anecdotal evidence suggests that mental health - both in children and young people and in adults - is taking an arguably greater share of the NHS cuts pain than the acute sector.
The Tower Hamlets Centre for Mental Health, in Stepney, which is run by the East London NHS Foundation Trust, instigated a raft of cuts to save up to £20m over three years.
At the time, staff belonging to the health union Unison warned that the cuts - including reducing nursing cover by the equivalent of two nurses per ward - could put patients at risk.
The statement from the trust spoke of further savings to come.
From a mental health perspective this is concerning as anecdotal evidence suggests that mental health - both in children and young people and in adults - is taking an arguably greater share of the NHS cuts pain than the acute sector.
NICE has appointed a social care expert to help it deliver quality improvement and advice within the social care sector.
Colin Angel, head of policy at the United Kingdom Homecare Association (UKHCA), will work one day a month to help NICE fulfil it's expanded role as quality beacon across health and social care.
Angel said his first meeting with Andrew Dillon, chief executive of NICE, had been encouraging.
His application has been backed by the Care Provider Alliance and he will represent all strands of social care provision, not just homecare, as NICE develops it's quality standards for the sector.
Colin Angel, head of policy at the United Kingdom Homecare Association (UKHCA), will work one day a month to help NICE fulfil it's expanded role as quality beacon across health and social care.
Angel said his first meeting with Andrew Dillon, chief executive of NICE, had been encouraging.
His application has been backed by the Care Provider Alliance and he will represent all strands of social care provision, not just homecare, as NICE develops it's quality standards for the sector.
Number crunching time
£10.7bn - the cost of mental health problems to the Scottish economy according to the Scottish Association for Mental Health and up from £8.6bn from 2004/05, which at the time was greater than the NHS budget for Scotland.
£2bn - the annual cost of mental health problems to Scotland's employers.
The new figures are in a new report called What's It Worth Now?, which highlights the potential savings that employers could make by paying more attention to mental health in their workplace.
The report outlines the basic ingredients of a good work programme :-
£10.7bn - the cost of mental health problems to the Scottish economy according to the Scottish Association for Mental Health and up from £8.6bn from 2004/05, which at the time was greater than the NHS budget for Scotland.
£2bn - the annual cost of mental health problems to Scotland's employers.
The new figures are in a new report called What's It Worth Now?, which highlights the potential savings that employers could make by paying more attention to mental health in their workplace.
The report outlines the basic ingredients of a good work programme :-
- Recognition by employers that work is good for mental health and that people do not have to be entirely symptom free to work successfully.
- Prevention of mental health problems, including the provision of mentally healthy working conditions and access for all employers to generalised health promotion and well-being programmes.
- Early identification of emerging problems, with any unexplained change in an employee's productivity at work being treated as a possible warning sign.
- Awareness training for line managers, to increase their knowledge and understanding of mental health issues.
- Better access to professional help, which wherever possible enables people to carry on working at the same time as receiving support.
- Effective rehabilitation for those who need to take time off work, including regular contact with employees during periods of absence.
There are concerns about the future of sex trafficking charity Eaves Housing after ministers withdrew funding in favour of the Salvation Army.
Eaves Housing is known for running the Poppy Project, which it developed to provide accommodation and support to women who have been trafficked into prostitution or domestic servitude. However now the government has decided to award a £6m contract to the Salvation Army.
This could be significant as the Tories have expressed support for faith groups running specialist services.
It is particularly significant considering a woman who was a repeated victim of sex trafficking is to be paid substantial damages by the Home Office after it returned her to Moldova, despite the fact that she faced grave dangers there.
Eaves Housing is known for running the Poppy Project, which it developed to provide accommodation and support to women who have been trafficked into prostitution or domestic servitude. However now the government has decided to award a £6m contract to the Salvation Army.
This could be significant as the Tories have expressed support for faith groups running specialist services.
It is particularly significant considering a woman who was a repeated victim of sex trafficking is to be paid substantial damages by the Home Office after it returned her to Moldova, despite the fact that she faced grave dangers there.
Why a specialist health commissioning body is needed for vulnerable learning disabled patients, by Dr Claire Royston, medical director of specialist provider Care Principles.As the government looks to bring substantial changes to NHS commissioning methods through the implementation of the Health and Social Care Bill, I find myself extremely concerned that vulnerable, learning disabled patients with complex difficulties may not receive the appropriate assessment and treatment that addresses their individual needs.
The bill expects GP consortia to take responsibility for commissioning all services, but due to the relatively low number of vulnerable learning disabled patients, GPs are likely to have limited experience of this.
However, the percentage of adults with a learning disability detained under the Mental Health Act whose care is provided within the independent sector has risen significantly, from 15% in 1998 to 46% in 2008. It is therefore important that GP consortia are able to access the extensive knowledge base and clinical expertise within the independent sector to ensure that the interests of vulnerable patients with learning disabilities are protected, and appropriate and cost-effective clinical and care pathways are provided.
As I pointed out in a submission to the Health and Social Care Bill committee, one way this can be achieved is through the establishment of a specialist commissioning body, advised by appropriate psychiatrists, which would be significantly involved in the commissioning of services. This body would have commissioning responsibility for three patient groups in particular - offenders with a learning disability, offenders with a learning disability and a personality disorder, and people with complex presentations of autism. It is these three groups that I feel will be most vulnerable as a result of the government's changes.
Historically, there has been an imbalance that has seen people with learning disabilities lose out when compared with those with mental health problems; and I firmly believe that a body whose remit is to focus on service provision for those with learning disabilities will help to redress this disparity. This is especially true in the criminal justice system.
The government may be putting £3m into 40 diversion sites for adults and £2m for young people this year, but that is simply aimed at diverting offenders with mental health problems away from prison; it does not take into account the needs of those offenders with learning disabilities.
The commissioning of highly specialised services for the small but very vulnerable group of patients with a learning disability and challenging and/or offending behaviour that require secure treatment and care is a challenge. Having a specialist body that includes experts from the independent sector would bring together those responsible for commissioning services with those tasked with service delivery. This can surely only benefit the patient and ensure they receive the highest level of care and rehabilitation.
It's important that with the current health reforms, those vulnerable learning disabled patients aren't forgotten and that provisions are made to ensure their needs are met.
How and why do you look for information on social care?
These are the questions being posed by the Social Care Institute for Excellence and the National Institute for Health and Clinical Excellence in a new joint survey.
It is designed to inform the development of information put out by Scie and NHS Evidence (part of Nice).
To take part, you need to register and then you may be contacted to take part in the research. As an incentive, interviewees will be put in a prize draw for some Amazon vouchers.
These are the questions being posed by the Social Care Institute for Excellence and the National Institute for Health and Clinical Excellence in a new joint survey.
It is designed to inform the development of information put out by Scie and NHS Evidence (part of Nice).
To take part, you need to register and then you may be contacted to take part in the research. As an incentive, interviewees will be put in a prize draw for some Amazon vouchers.
Not content with putting all
the council duties which protect and provide service for vulnerable people
up for auction, the government has now extended it's crusade agaisnt red tape to
the Equality Act.
Well I say now, I mean last month. But I was just made aware of it by Rich Watts of the Essex Coalition of
Disabled People.
Buried in the government's Red Tape
Challenge website is the suggestion that maybe those pesky equalities laws
are just holding us all back.
Well, certainly they do mean that councils have to give due regard to disabled
people and other groups, a situation which is frequently relevant to decisions
about social care.
Perhaps the government is opposed to this because they have been caught
out on it before now? Or maybe they really think if we just remove these
protections everything will still be fine.
Any new act to repeal the Equality Act or make significant changes to it would require
an equality impact assessment, which should make for interesting reading.
The Royal College of Nursing has published research today showing that 40,000 frontline jobs has gone or are due to go in the near future as primary care trusts, hospitals and NHS organisations struggle to cope with flat or reduced budgets.The revelation, which will pile yet more pressure on health secretary Andrew Lansley's pledge to protect the frontline, comes as research by the Guardian shows that services for patients with mental health problems and addictions and those who need physiotherapy after accidents are being scaled back.
This comes as Norman Lamb - the deputy prime minister's chief political adviser and former Lib Dem health spokesman - threatened to quit the coalition over the controversial health reforms, potentially putting the coalition under more pressure.
Lamb's main demand is that GPs should be free to opt into commissioning consortia, which Lansley is unlikely to accept. So we could be about to see an almighty political battle. The question is does his view represent the majority stream within Lib Dems or the minority?
My guess is it's the mainstream view within the party and piles yet more pressure on the deputy PM Nick Clegg, the prime minister and the embattled Lansley.
Interestingly in an interview this morning Clegg refused to back Lamb's call but did point to slippage on the 2013 target for all GP consortia to take on commissioning functions and still insists there will be "substantive changes" to the bill.
Clegg also said there was unity in the Lib Dem party and that the government was not "about to re-open the Pandora's box" of the basic design of a new system.
Finally there is an interesting article on "failings" in the mental health system with regard to mental health tribunals and the secrecy in which they are carried out combined with difficulties in the independent inquiry system, which have to be carried out when a patient carries out a fatal attack.
Picture courtesy of Flickr.com from The Health Hotel
Today will see officials at London
Councils sit down to start sifting through consultation responses on whether it
should cut £9m from charities grants this year, after the deadline passed last
Friday.
London Councils were forced to rerun
its consultation on the plans following a judicial review which found flaws
in the original exercise.
The result of this new exercise could prove prophetic for other councils.
Judicial reviews of their decisions to cut spending or services are springing
up across the country to challenge
councils' cuts plans.
However, the problem with judicial reviews is they cannot order a council to
reverse its decision only take it again, this time considering the things they
missed out previously. They can, in theory, legitimately come to the same
conclusion or even one which is worse for these complaining about the original
decision.
The only one of these to have been completed recently saw care
homes in Pembrokshire get an increase in their fees from the council, after
appealing against a cut. But the London
Councils decision will be the first to reflect upon the third sector, which
provides a heft amount of support to older and disabled people.
The recommendations flowing from the responses to the London
Councils consultation will be unveiled on 6 May.
Image by haven't the slightest on Flickr
Ok, so it looks like it's not just Scotland where the idea of fuller health-social care integration is taking hold; it's also on the Welsh election agenda.
Plaid Cymru, which is in government with Labour, is making it part of its election pitch:
"Like many working in, and receiving, health and care services, we in Plaid have had enough of the artificial divide between health and social care," said health and social services spokesperson Helen Mary Jones in the Western Mail. "We will insist on the pooling of local health and care budgets, legislating if need be."
Plaid appears to be running neck and neck with the Tories for second place in the elections for the Welsh Assembly; however Labour is well ahead and looks on course for an overall majority. So let's wait and see what its manifesto says when it is published on Thursday.
This is the Conservatives' platform.
Plaid Cymru, which is in government with Labour, is making it part of its election pitch:
"Like many working in, and receiving, health and care services, we in Plaid have had enough of the artificial divide between health and social care," said health and social services spokesperson Helen Mary Jones in the Western Mail. "We will insist on the pooling of local health and care budgets, legislating if need be."
Plaid appears to be running neck and neck with the Tories for second place in the elections for the Welsh Assembly; however Labour is well ahead and looks on course for an overall majority. So let's wait and see what its manifesto says when it is published on Thursday.
This is the Conservatives' platform.
Care after death may seem an odd concept but guidance issued this week shows that it is a significant issue for care homes in particular to take account of.
Key things to bear in mind is ensuring the privacy and dignity of grieving families are respected at all times and honouring the spiritual wishes of the deceased, says the guide from the National End of Life Care Programme.
In addition, care staff and their managers need to protect the health and safety of all those who come into contact with the body and, if the death is referred to the coroner, ensuring no action is taken that might prevent cause of death being established.
A key message is to talk to people nearing the end of life to establish their wishes for after their deaths.
Key things to bear in mind is ensuring the privacy and dignity of grieving families are respected at all times and honouring the spiritual wishes of the deceased, says the guide from the National End of Life Care Programme.
In addition, care staff and their managers need to protect the health and safety of all those who come into contact with the body and, if the death is referred to the coroner, ensuring no action is taken that might prevent cause of death being established.
A key message is to talk to people nearing the end of life to establish their wishes for after their deaths.
An excellent investigation from The Guardian last week found that job centres were setting targets for staff to refer welfare claimants for sanctions - i.e. benefit cuts - on the basis that they had breached conditions, such as failing to apply for jobs. A whistleblower told the paper that some claimants were being tricked into failing conditions so they could be sanctioned.
The Department for Work and Pensions initially responded by saying that this was all nonsense but has today admitted that some job centres have set such targets as a result of a "misunderstanding" between them and the department.
This practice has now been stopped - a victory for the Guardian's journalism but also a shocking indictment of what the "welfare cheats" agenda that successive governments and media organisations have pursued for years can lead to.
The Department for Work and Pensions initially responded by saying that this was all nonsense but has today admitted that some job centres have set such targets as a result of a "misunderstanding" between them and the department.
This practice has now been stopped - a victory for the Guardian's journalism but also a shocking indictment of what the "welfare cheats" agenda that successive governments and media organisations have pursued for years can lead to.
As we prepare for the report of the Dilnot commission on the future of care funding (currently due in July), we are still somewhat in the dark over how the big questions - such as the balance between individual and state contributions to any future funding system - will be settled.
However, among the comparatively smaller issues, it is clear that improving people's access to financial advice about care will be a key recommendation.
On that score, care insurance company Partnership, who is very vocal on this issue (see our interview with its managing director of care, Chris Horlick), has called for councils to face a duty to signpost people entering the care system to accredited independent financial advisers (members of the Society of Later Life Advisers) and believes that hospital discharge managers should face this duty too.
This relates to a recent finding that the market in so-called immediate needs annuities (insurance products in which you pay an up-front sum and have your care needs covered for life) could grow sevenfold. This was from a report from Partnership, which provides these products at an average cost of £85,000. It says the missing ingredient is better financial advice.
Of course, Partnership would say that but it is clear that, whether people want to buy its products or not, better financial advice on care can only be a good thing.
However, among the comparatively smaller issues, it is clear that improving people's access to financial advice about care will be a key recommendation.
On that score, care insurance company Partnership, who is very vocal on this issue (see our interview with its managing director of care, Chris Horlick), has called for councils to face a duty to signpost people entering the care system to accredited independent financial advisers (members of the Society of Later Life Advisers) and believes that hospital discharge managers should face this duty too.
This relates to a recent finding that the market in so-called immediate needs annuities (insurance products in which you pay an up-front sum and have your care needs covered for life) could grow sevenfold. This was from a report from Partnership, which provides these products at an average cost of £85,000. It says the missing ingredient is better financial advice.
Of course, Partnership would say that but it is clear that, whether people want to buy its products or not, better financial advice on care can only be a good thing.
With elections in Northern Ireland less than a month away, politicians have been told that the social care system is "creaking at the seams," reports the Belfast Telegraph.
At a meeting this week, Age Northern Ireland's chief executive Anne O'Reilly warned resources were tied up in residential or nursing homes, and people with moderate or low-level needs were not having them met (sound familiar?).
One interesting point made by the first minister, Peter Robinson, is that 98% of social care services are delivered by the public sector i.e. health and social care trusts, an interesting contrast to the rest of the UK.
He questioned whether this meant Northern Ireland was being left behind.
At a meeting this week, Age Northern Ireland's chief executive Anne O'Reilly warned resources were tied up in residential or nursing homes, and people with moderate or low-level needs were not having them met (sound familiar?).
One interesting point made by the first minister, Peter Robinson, is that 98% of social care services are delivered by the public sector i.e. health and social care trusts, an interesting contrast to the rest of the UK.
He questioned whether this meant Northern Ireland was being left behind.
Acute mental health and specialist education provider the Priory Group has acquired Craegmoor, a major provider of autism and learning disability services, for an undisclosed fee.
Priory says this will make it "the market leader in the mental healthcare, specialist education, autism and learning disability sectors".
It is also planning to expand existing older people's care services run by Priory and Craegmoor.
It is clear that Priory sees itself as a big player in the NHS market that will be initiated by the government's health reforms (though it may be watching with interest to see how far current plans to inject competition into the market are watered down in the light of the government's "listening exercise").
Behind this new care giant is global private equity firm Advent International, which took control of Priory earlier this year.
Large providers and private equity ownership are two things that make some people in social care uneasy.
However, given the recent concerns over Southern Cross Healthcare, it looks like that this group is in healthy financial shape - Priory saw its profits increase by 10% and is also succeeding in reducing its debt levels.
Priory says this will make it "the market leader in the mental healthcare, specialist education, autism and learning disability sectors".
It is also planning to expand existing older people's care services run by Priory and Craegmoor.
It is clear that Priory sees itself as a big player in the NHS market that will be initiated by the government's health reforms (though it may be watching with interest to see how far current plans to inject competition into the market are watered down in the light of the government's "listening exercise").
Behind this new care giant is global private equity firm Advent International, which took control of Priory earlier this year.
Large providers and private equity ownership are two things that make some people in social care uneasy.
However, given the recent concerns over Southern Cross Healthcare, it looks like that this group is in healthy financial shape - Priory saw its profits increase by 10% and is also succeeding in reducing its debt levels.
You may have missed a little piece of news from yesterday which ran: A care home in Telford has failed nearly all the essential criteria for registration, according to a report by the Care Quality Commission.The St. George's Park Centre care home failed 15 of the 16 essential criteria against which home's registration is measured. The inspectorate's statement read: "People smelt of urine and faeces and looked unkempt and dishevelled."
That in itself is fairly shocking, but perhaps even more concerning is the lack of coverage this has received in the media. We too did not do a news story on it, that's because it's no longer really 'news'. A quick glance through the latest press releases of the CQC show this kind of story is rather common.
But it seems strange that this story has not done the rounds. It has the requisite human elements and some good numbers to quote to boot. Usually the Daily Mail and the Telegraph are all over this kind of thing.
I suspect that this incessant drip drip of negative care home stories has raised the bar for what is shocking. Or perhaps it is that journalists are less keen to run with this after the BBC showed a similar story circulated by the CQC contained inaccuracies late last year.
Care provider organisations have also been rather concerned of late over the regulator's willingness to highlight bad practice. Although, to be fair, they probably would never be keen on the negative press this gives their members. But they have a point when you consider the regulator's annual report last week highlighted yet another year on year improvement in standards, which has been the story for over half a decade.
The prevalent opinion within the sector is that the CQC wants to look tough in the press.
Whatever their reasons for highlighting poor practice (and their subsequent crack down upon it) at this point it's becoming increasingly hard to justify when it doesn't get much public attention and also does little to motivate improvements.
Image by hapal on Flickr
The legal challenge against Birmingham Council's plan to cut its adult social care budget and move to a 'critical only' threshold will be heard in the High Court on 14 April.
The case is brought on behalf of a 65-year-old woman with significant learning disabilities called Ms A and three other vulnerable service users on the grounds that the council's consultation was unlawful.
The case was initially brought when Birmingham was considering its controversial plan to cut the threshold to 'super-critical' only, though it latterly changed its mind on this.
Solicitors Irwin Mitchell, who are acting for Ms A say this is the tip of the iceberg.
It it is acting for a number of other social users across the country who are threatened with the removal of much of their social care support.
The case is brought on behalf of a 65-year-old woman with significant learning disabilities called Ms A and three other vulnerable service users on the grounds that the council's consultation was unlawful.
The case was initially brought when Birmingham was considering its controversial plan to cut the threshold to 'super-critical' only, though it latterly changed its mind on this.
Solicitors Irwin Mitchell, who are acting for Ms A say this is the tip of the iceberg.
It it is acting for a number of other social users across the country who are threatened with the removal of much of their social care support.
Prescriptions for anti-depressant drugs rose by more than 40% over the past four years, according to the BBC, which has found one cause to be economic woes.
This is hardly surprising as the link between money worries and good mental health is well known. Community Care has quoted research published by University College London in 2007 that found that one in seven men developed depression within six months of losing their job.
The extent of the rise is surprising however considering the government is meant to be rolling out talking therapies, which in theory should curb usage. The BBC said that in the last year alone referrals for talking therapies rose four-fold to nearly 600,000.
However the roll-out has been known to be patchy in the past.
So what's happening? The Royal College of GPs says that GPs are getting better at diagnosing depression. while Depression Alliance UK says that people are more willing to discuss their problems, suggesting a lot of the stigma has been lifted.
So can the NHS cope with this surge in demand? That depends on whom you talk to. The department of health claims that its roll-out of talking therapies to all groups, as expressed in its new mental health strategy will help many more people.
However many within the sector point to a service that will struggle because of the combination of the NHS reforms and the £15bn to £20bn savings over a four-year period, which is known to be hitting mental health services hard.
Combined with this DH has axed the National Mental Health Development Unit, which helped roll talking therapies out in the first place.
This is hardly surprising as the link between money worries and good mental health is well known. Community Care has quoted research published by University College London in 2007 that found that one in seven men developed depression within six months of losing their job.
The extent of the rise is surprising however considering the government is meant to be rolling out talking therapies, which in theory should curb usage. The BBC said that in the last year alone referrals for talking therapies rose four-fold to nearly 600,000.
However the roll-out has been known to be patchy in the past.
So what's happening? The Royal College of GPs says that GPs are getting better at diagnosing depression. while Depression Alliance UK says that people are more willing to discuss their problems, suggesting a lot of the stigma has been lifted.
So can the NHS cope with this surge in demand? That depends on whom you talk to. The department of health claims that its roll-out of talking therapies to all groups, as expressed in its new mental health strategy will help many more people.
However many within the sector point to a service that will struggle because of the combination of the NHS reforms and the £15bn to £20bn savings over a four-year period, which is known to be hitting mental health services hard.
Combined with this DH has axed the National Mental Health Development Unit, which helped roll talking therapies out in the first place.
Prof Steve Field, former chair of the Royal College of GPs, is to chair a panel of health experts who will lead the two-month "listening exercise" on the NHS reforms.
The announcement was made at a hospital in Surrey as prime minister David Cameron, deputy prime minister Nick Clegg and health secretary Andrew Lansley presented a united front in a bid to save the controversial health and social care reform bill.
Lansley told the assembled doctors and nurses that the exercise would look at four areas of concerns, including competition, and would be a "genuine opportunity" to shape the future of the NHS and that they will listen.
What is unclear is whether there is social care representation on the panel or whether this will lead to substantive changes. The language used suggests not.
Cameron said this was a natural time to stop and reflect and improve rather than charging ahead but then added that it was about making strong reforms even stronger and it was about explaining the reforms to people.
"We will make real improvements and we will be able to dispell some of the myths," he said.
Lansley said he took responsibility but said that it was because people had failed to understand the purpose of the bill, though he also acknowledged there are some concerns.
Clegg added: "I genuinely believe the ideas will protect the NHS."
The announcement was made at a hospital in Surrey as prime minister David Cameron, deputy prime minister Nick Clegg and health secretary Andrew Lansley presented a united front in a bid to save the controversial health and social care reform bill.
Lansley told the assembled doctors and nurses that the exercise would look at four areas of concerns, including competition, and would be a "genuine opportunity" to shape the future of the NHS and that they will listen.
What is unclear is whether there is social care representation on the panel or whether this will lead to substantive changes. The language used suggests not.
Cameron said this was a natural time to stop and reflect and improve rather than charging ahead but then added that it was about making strong reforms even stronger and it was about explaining the reforms to people.
"We will make real improvements and we will be able to dispell some of the myths," he said.
Lansley said he took responsibility but said that it was because people had failed to understand the purpose of the bill, though he also acknowledged there are some concerns.
Clegg added: "I genuinely believe the ideas will protect the NHS."
That is the claim today from the College of Social Work.
This is an issue we have covered extensively in the past in Community Care - including through our research into social workers' views on personalisation - but for the College of Social Work - which in its short history as a shadow body has not been the most outspoken of beasts - to be coming out and saying this is a big deal.
This is an issue we have covered extensively in the past in Community Care - including through our research into social workers' views on personalisation - but for the College of Social Work - which in its short history as a shadow body has not been the most outspoken of beasts - to be coming out and saying this is a big deal.
Kate Green Mp has written a very passionate piece over at Progress Online about the impending cuts to disability living allowance.
She writes:
She writes:
"The real worry among disabled people is that this may be deliberate - that they're seen as 'undeserving', with only the most profoundly disabled worthy of state support. Given the shopping list of cuts to such support, it is hard to disagree. Disability has always brought with it a heightened risk of social exclusion, poverty and stigma, and Labour worked hard to address this, learning from the early outcry at our own plans for benefits cuts. Not all our polices enjoyed full support from disabled people (the work capability assessment and employment and support allowance were, it must be admitted, unpopular Labour inventions, serving the right objective of helping more disabled people into employment, but poorly executed at the start). But our ambition and goals were right.Let's see if the rest of her party agrees.
"Now the Conservative-led government turns the clock backwards, and its values too are truly revealed. The indifference to the structural inequality that disabled people experience offers a starkly clear example of the way that this government believes its obligation is to help only those in deepest need.
"Politically this must be made to come back to bite the government, very, very hard. But the responsibility rests with Labour"
Today's You and Yours on Radio 4 (at 12noon) will consider the treatment of older people in the NHS through an interview with elder abuse and social care law expert Michael Mandlestam.
The government will begin its attempt to save its controversial health and social care reform bill today as it launches its "listening exercise".
Prime minister David Cameron and deputy prime minister Nick Clegg are joining forces with health secretary Andrew Lansley and will answer questions from medical staff as they seek to show that the government is responding to concerns about plans to hand much of the NHS budget to GP-led consortiums.
This "listening exercise" will include the establishment of a panel made up of experts that the three will claim is independent and will be listened to.
I will know its composition, terms of reference and how its independence will be assured at midday today, so as of yet I don't know if there is any social care representation on the panel.
However clearly doubts over its independence will remain until it has made its recommendations.
It's unclear what sorts of changes the panel will recommend. Clegg has called for "substantive changes" though Lansley has appeared to indicate that the changes would not be far-reaching.
Prime minister David Cameron and deputy prime minister Nick Clegg are joining forces with health secretary Andrew Lansley and will answer questions from medical staff as they seek to show that the government is responding to concerns about plans to hand much of the NHS budget to GP-led consortiums.
This "listening exercise" will include the establishment of a panel made up of experts that the three will claim is independent and will be listened to.
I will know its composition, terms of reference and how its independence will be assured at midday today, so as of yet I don't know if there is any social care representation on the panel.
However clearly doubts over its independence will remain until it has made its recommendations.
It's unclear what sorts of changes the panel will recommend. Clegg has called for "substantive changes" though Lansley has appeared to indicate that the changes would not be far-reaching.
Jenny Edwards, Chief Executive of Homeless Link, explains why we must stop communities from suffering from cuts to services for homeless people.The funding cuts are uppermost in my mind. A report Homeless Link published last month, showed that services for homeless people are under threat in four in 10 local areas.
Grant Shapps, the Housing and Local Government Minister spoke at our parliamentary reception, together with the Opposition spokesperson Alison Seabeck. Both are deeply concerned at the approach in some areas, with services Supporting People services being slashed.
Services that enable homeless people to rebuild their lives have taken years to build up and transformed tens of thousands of lives. Our work is seen as an international model. Communities that once experienced the blight of homelessness saw dramatic change.
Research commissioned by Government shows housing related support pays for itself, generating net savings to the public purse by avoiding costly acute services.
Continue reading Maintain investment in Supporting People, urges Homeless Link..
Sorry folks but it's the Andrew Lansley show again.As reported yesterday the health secretary announced a "natural break" in the progress of his health and social care reform bill - or as The Guardian headlined it: "Andrew Lansley scrambles to save coalition's NHS reforms".
What is clear is that Lansley has been left isolated and it's anyone's guess if he can survive. My guess is the prime minister may regard it as convenient to remove him once the bill has gone through Parliament. Michael White's critique of Lansley's uncomfortable afternoon in Parliament is useful reading in this respect with the suggestion that Cameron may feel the best course of action for the bill's salvation is the removal of Lansley himself.
And if that weren't enough, now the Public Accounts Committee is warning that the health reforms threaten accountability and transparency over spending and hence that the National Audit Office may have to be reformed to keep pace with the health reforms, says The Guardian.
The Guardian also has a useful critique of what should happen next gathered from various bodies. If these are to be summed up it's remove the competition elements from the bill; reduce the pace of the changes and introduce accountability into the GP consortia.
However if you want to see where the government is heading read this blog from former Lib Dem MP Evan Harris. His views are to an extent backed by insiders who confirm negotiations are being carried out on issues around GP governance and accountability and issues surrounding privatisation.
Meanwhile in The Daily Telegraph Tory backbencher Dr Sarah Wollaston, who is also a former GP and a member of the health select committee, calls for a rethink on the proposed role of the economic regulator, Monitor and to rethink on the fragmenting of the NHS.
Finally former Labour health adviser Paul Corrigan has written his take on the health select committee's report on NHS commissioning.
Chairman Stephen Dorrell is well respected in Parliament and Corrigan suspects that legislation is already being drawn up to form the committee's recommendation of NHS commissioning authorities, which would include social workers sitting on the board.
What is clear is that the break gives the coalition time to get the restive House of Lords on side by listening to Lib Dem big hitters like Dame Shirley Williams.
Picture from Flickr.com courtesy of NHS Confederation
As anticipated health secretary Andrew Lansley has announced a delay in the progress of the health and social care reform bill through to the House of Lords.
Lansley told the House of Commons that the government proposed to "take the opportunity of a natural break in the passage of the bill to pause and to listen."
Previous reports have said this could be for as long as three months.
The decision come in the midst of under-fire NHS reforms that have led to almost universal criticism surrounding competition, the powers of the health and wellbeing boards and the accountability of the proposed GP Commissioning Consortia.
As to whether this will lead to any changes in the unpopular bill I wouldn't hold your breath. Lansley said there will be no major changes, that he had listened and continued to insist this was the right path.
As proof of this he said 220 commissioning consortia had applied for pathfinder status and 90% of local authorities had applied to be early implementers of health and wellbeing boards.
However he admitted: "We recognise the speed of progress has brought with it some substantive concerns, some of these concerns are misplaced or based on misrepresentation but we recognise that some are genuine. We want to continue to listen and to engage."
The delay gives time for the government to re-present the reforms and to try to win over a critical House of Lords, where the reforms, as currently presented are likely to receive a mauling.
In response Labour's shadow health secretary John Healey said the reforms were fundamentally flawed, had no public mandate and were driven by ideology. while Denis Skinner called on him to resign.
Lansley told the House of Commons that the government proposed to "take the opportunity of a natural break in the passage of the bill to pause and to listen."
Previous reports have said this could be for as long as three months.
The decision come in the midst of under-fire NHS reforms that have led to almost universal criticism surrounding competition, the powers of the health and wellbeing boards and the accountability of the proposed GP Commissioning Consortia.
As to whether this will lead to any changes in the unpopular bill I wouldn't hold your breath. Lansley said there will be no major changes, that he had listened and continued to insist this was the right path.
As proof of this he said 220 commissioning consortia had applied for pathfinder status and 90% of local authorities had applied to be early implementers of health and wellbeing boards.
However he admitted: "We recognise the speed of progress has brought with it some substantive concerns, some of these concerns are misplaced or based on misrepresentation but we recognise that some are genuine. We want to continue to listen and to engage."
The delay gives time for the government to re-present the reforms and to try to win over a critical House of Lords, where the reforms, as currently presented are likely to receive a mauling.
In response Labour's shadow health secretary John Healey said the reforms were fundamentally flawed, had no public mandate and were driven by ideology. while Denis Skinner called on him to resign.
Looks like the Care Quality Commission's planned increase to provider regulatory fees will hit small home care providers quite badly.
As we reported last week, the fee rise and the fact that it was confirmed just three days before it came into force roused predictable anger from providers.
However, we have since heard from Naaps - the umbrella body for small community providers - that those providing home care on a small scale will suffer rise in annual fees from £621 to £1,000.
Said Naaps: "This could derail some of the most innovative micro-enterprises such as Barbara, who intends to keep her domiciliary care business very small, in order that she can personally provide the first two weeks of care to each new older person she supports and thereafter have fortnightly one to ones as she monitors the outcomes of her service and the individual's changing needs and wishes."
The organisation is also concerned that it will stifle personal assistants from coming together to form small home care providers.
As we reported last week, the fee rise and the fact that it was confirmed just three days before it came into force roused predictable anger from providers.
However, we have since heard from Naaps - the umbrella body for small community providers - that those providing home care on a small scale will suffer rise in annual fees from £621 to £1,000.
Said Naaps: "This could derail some of the most innovative micro-enterprises such as Barbara, who intends to keep her domiciliary care business very small, in order that she can personally provide the first two weeks of care to each new older person she supports and thereafter have fortnightly one to ones as she monitors the outcomes of her service and the individual's changing needs and wishes."
The organisation is also concerned that it will stifle personal assistants from coming together to form small home care providers.
It's full steam ahead for the government's plans to cut disability benefits, two announcements have made clear.
Cuts of 20% in the state's spending on disability living allowance for working-age adults are on course, despite widespread opposition in consultation, the Department for Work and Pensions said today.
And incapacity benefit claimants have started receiving letters informing them that their eligibility will be reviewed under the much-hated work capability assessment (WCA) over the next three years. A third of this group is expected to be found fit for work and thereby switched to jobseeker's allowance, losing them about £25 a week and leaving them at the mercy of the government's tough sanctions regime for people deemed not to be doing enough to find work.
These letters must be causing a lot of worry to social care clients who receive them. But it's also worth stating that the government is rolling out this system without having published a full evaluation of a pilot reassessment process that it has carried out in Burnley and Aberdeen.
Given the widespread misgivings about the WCA, confidence in the reassessment process surely requires that the system has been shown to work at the pilot stage. (Actually, to be fair, the DWP has published this on the pilot process - a single page that tells you the proportions found fit to work, somewhat fit to work and not fit to work.)
(Image on Flickr from Between a Rock)
Health Secretary Andrew Lansley is to make a statement to the Commons later this afternoon his flagship health reforms, following mounting criticism of the plans.
According to The Guardian he will update MPs on a review of his plans to create new GP-led consortiums.
The statement comes amid mounting disquiet about the job he has done in selling the reforms with the Prime Minister's favourite thinktank Policy Exchange calling for the breakneck pace of the reforms to be reduced, which many reports now suggest likely as well as a delay in its introduction to the House of Lords.
The Guardian has a really good story on who to blame for the mess the reforms now find themselves in. Although Lansley is the key target, the Prime Minister, it says must accept some of the blame for not recognising earlier they were going badly awry.
Nigel Edwards, chief executive of the NHS Confederation has written a good blog where he concludes that the reforms lack a compelling narrative on why the reforms are necessary, despite the case for change being strong.
According to The Guardian he will update MPs on a review of his plans to create new GP-led consortiums.
The statement comes amid mounting disquiet about the job he has done in selling the reforms with the Prime Minister's favourite thinktank Policy Exchange calling for the breakneck pace of the reforms to be reduced, which many reports now suggest likely as well as a delay in its introduction to the House of Lords.
The Guardian has a really good story on who to blame for the mess the reforms now find themselves in. Although Lansley is the key target, the Prime Minister, it says must accept some of the blame for not recognising earlier they were going badly awry.
Nigel Edwards, chief executive of the NHS Confederation has written a good blog where he concludes that the reforms lack a compelling narrative on why the reforms are necessary, despite the case for change being strong.
There is increasing gossip within health and social care sources over how long Andrew Lansley can last as the health secretary.I was at a mental health event on Thursday evening and among many topics of conversation was the question of Lansley's future with the smart money suggesting he is set to be moved within weeks as a result of the poor handling of the NHS reforms, maybe soon after the local elections.
Indeed the Guardian's story today puts credence on this view with it talking of sources telling it that the Prime Minister, David Cameron, is no longer listening to Lansley but to the NHS chief executive Sir David Nicholson.
Cameron is also due to announce a delay to the bill to beyond Easter at a joint event involving himself, the deputy prime minster Nick Clegg and Lansley, possibly for as long as three months.
Meanwhile the leaders of a Liberal Democrat revolt against the reforms will release their 23 detailed demands for sweeping changes to the bill.
What is clear is that politically Cameron has to do something and to save his credibility may be prepared to remove Lansley. I can only wonder at how galling it is for Lansley to see his reforms criticised on a daily basis. But there does come a point when something has to happen and with Lansley showing no signs of that political necessity - pragmatism - Cameron has been forced to step in.
Picture from Flickr.com courtesy of NHS Confederation
Yesterday, Mencap confirmed that Scott Watkin, co-chair of
the government's Valuing People Now programme for people with learning
disabilities, will be taking a post as national learning disability spokesman
for the charity.
This goes some way to confirming that the national directors post will be cut
along with the rest of the national delivery team for the programme, which was cut
last month. Unless of course you are the Department of Health who
maintain: "We are still finalising future arrangements for the co-national
directors."
Of course it's possible that they will be keeping these posts, or perhaps Anne
Williams, the other national director, will continue alone.
I can't believe the DH does not have some sort of plan in store but I
find it hard to believe that having scrapped the rest of the central team they
will feel inclined to employ a high level (and consequently expensive)
executive post like this.
Image by ContentAction on Flickr
Carers in Wales can expect local authorities to take into consideration their needs when planning services and consult them on their plans, under regulations published today.
The draft regulations are still in the consultation stage, so to make your view heard just take a look at them and drop the Welsh government a line.
The draft regulations are still in the consultation stage, so to make your view heard just take a look at them and drop the Welsh government a line.
About the Adult Care blog
The Adult Care blog looks behind the policies, practices and personalities involved in the care of older and disabled people for any hidden truths, helpful tips or humour. It is written by Community Care’s adults’ services beat editor Mithran Samuel. |
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