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Posts Tagged ‘NHS’

“Two peanuts of hope in the crackerjack box of despair”

Friday, March 10th, 2017

There wasn’t a lot to celebrate in the 2017 budget, indeed we might say there wasn’t a lot in the 2017 budget, full stop, but we have found “two peanuts of hope in the crackerjack box of despair” (Homer Simpson 2006).  We will start with them and then offer a quick Community Links perspective on the three issues which have dominated all the other  media commentary. 

First, the London Devolution Agreement

The Agreement was announced and published alongside the main budget statement. It included:

  • Co commissioning of criminal justice services with substantial potential for reducing offending and for improving services for victims and offenders. To be finalised in June
  • Devolution of a number of health care powers. Further details expected next week
  • Devolution of the adult education budget from 2019/20 and the promise of “greater influence” over careers services.
  • Transfer of the budget for the Work and Health programme and a further commitment to a “strategic dialogue” on employment support.
  • Powers to pilot a new Development Rights Auction model for funding future infrastructure projects. This model is likely to provide very significant new funding.

There is lots more detail expected in the coming weeks but the headlines are encouraging with more power and more resources invested closer to home. Now the responsibility passes to London’s leaders for ensuring that devolution does not stop there but that local communities are fully involved in designing, developing and delivering these important services

Second, the “next generation” passage from the Chancellor’s speech

“If you talk to people from any background and any part of the country about their hopes and their aspirations for the future, you’ll hear a recurring concern for the next generation. 

Will they have the qualifications to find a job?
Will they have the skills to re-train as that job changes, and changes again, over a working lifetime?
Will they be able to get on the housing ladder?
To save for a pension?

In short, the question that concerns so many people is “will our children enjoy the same opportunities that we did”?

Mr Deputy Speaker, Our job is to make sure that they do.

That’s why we are investing in education and skills to ensure that every young person, whatever their background and wherever they live, has the opportunity to succeed and prosper. The proportion of young people not in work or education is now the lowest since records began that’s a good base from which to build. But it is only by equipping them for the jobs of tomorrow that we ensure they will have real economic security.”

We are with you on all this Mr Hammond, now what can we do about it? A Bill of Rights for the Next Generation perhaps?

Finally our view on the three topics that have attracted most attention:

Business rates: The coverage has focused on the prosperous areas that are of most interest to Conservative MPs. In Southwold for instance a sausage roll will apparently soon cost £8.17 if the butcher raises prices in line with the rates increase. Business rates are in fact a problem for any area where property prices have gone up which, of course, they have in east London, and it is a particular issue in areas which have been undergoing regeneration like Canning Town and Stratford. We don’t yet know the likely impact of the measures that the Chancellor announced yesterday but this is seriously alarming and an issue to which we will return.

NI increase for self employed. Hammond hits white van man” screamed the Metro front page yesterday morning. “Hammond hits highly paid barristers and consultants” would have been more accurate. As the Resolution Foundation have pointed out this is a progressive measure. Low earning child minders and window cleaners in Newham will benefit. The messaging was dreadful but the change is good.

Social care: No amount of spin could make £2b over 3 years for social care and £450m for the NHS sound like anywhere near enough to turn around the crisis in health and social care. Most expert analysis suggests it will fill less than half the gap. Of course Conservative back benchers worried about “trolleys in corridor” stories in their local papers know this too. What will they do now?

What are you for Mr Hammond?

Thursday, February 23rd, 2017

8 Months after he picked up the keys to No11 it is difficult to discern any clear pattern or purpose to Philip Hammond’s Chancellorship.

His most decisive action to date has been to cancel the annual ritual of a spring budget. The one he presents to the House in two weeks’ time will be the last. In future the budget is to be rolled into the autumn statement and delivered before Christmas. It’s a sensible reform but scarcely spectacular. On all matters economic the Chancellor has ceded visibility, if not control, not only to the PM but also to other ministers, particularly Boris Johnson, even to David Davies. March the 8th will be his moment in the sun and a chance to answer the question “what is Philip Hammond for?”

On taking office last July the new Chancellor spoke about a “new phase” for the economy. Contrary to some of the reporting at the time and some of the comment that has filled the void since then, he didn’t say that austerity was over but that it was “right to review the pace at which the government balanced the books.”  Is that review now completed? And if so will he be challenging the conclusion of the IFS Green Budget which claimed last week that “The rate of reduction (in levels of day-to-day public service spending) is set to speed up after this year, with cuts of nearly 4% due between 2016–17 and 2019–20”?

This matters because it is these kinds of numbers that have led Lord Porter the chairman of the LGA, to warn this week that services supporting very vulnerable people are “at breaking point”.  Lord Porter, the Conservative leader of South Holland in Lincolnshire, subsequently said he was “hugely disappointed” by the funding settlement for councils which was set out by the Communities Secretary in a written statement  to parliament yesterday: “As we continue to bring the deficit down” wrote Sajid Javid “local government, must continue to play its part”.

Trolleys in corridors have become a familiar picture on the front pages this winter and such has been the level of disquiet on the government’s own benches that the Chancellor will surely have something in the budget for the NHS. Anything less will risk mutiny. But doctors and hospitals are part of an ecology of care that reaches out through domiciliary services, reduces need through strong public health programmes and builds resilience and wellbeing through a diverse range of community services.  So the question is not about whether Mr Hammond responds to the crisis but about whether he sticks a bandage on the creaking fabric of an acute sector that faces irreconcilable trajectories of demand and resource or  becomes the first chancellor to really grip the necessity for prevention and for a cross government “need reduction strategy” stretching beyond the NHS, into other arms of government, particularly local government, and on to the community sector where some of the most effective (and cost effective) work is already going on. Our own work on a community development approach to the early detection of cancer for instance has increased the take up of cancer screening appointments in east London by 15%.

Clinicians at the huge and ferociously overworked London Hospital just down the road from Community Links tell me that one in five beds are taken up by patients whose condition is caused by, or seriously exacerbated by, diabetes. We know that more than half of all Type 2 diabetes can be prevented or delayed by simple life style changes and the most basic early action. Ultimately it is only a sustained investment in this kind of preventative work that will enable our hospital, and the many others like it, to deliver the high quality acute services that they should be delivering.

The budget that the Chancellor is writing could buy enough new trolleys to placate his own side of the House for a few months more or it could set out the simple but ground breaking measures for the longer term transition to a preventative economy that I suggested in my address to the All Party Parliamentary Group last year  and that we have detailed in the various publications of the Early Action Task Force. It’s time to decide Mr Hammond. What are you for?

The best day ever

Tuesday, July 31st, 2012

8-year old Mia took part in Friday’s opening ceremony in the section “Second to the right and straight on till morning.”

Olympic Opening Ceremony“We got to dance on the beds. We don’t normally dance on beds so it was quite a surprise. The bit I was in was about naughty children that were in hospital. The message was don’t be scared if you have to go into hospital and about how important hospitals are. I think that every person if they are a tiny bit sick or really sick should go to the hospital and no hospital should make people pay for the hospital’s help because if people can’t afford it they will just get sicker and sicker and might die.

“The show looked really fantastic with all of the lights. There were spotlights coming on from all of the parts of the stadium. And there were lights in the duvets and the lamps. There were about 300 beds. The nurses were really nice. All the children were either wearing a nightie or pyjamas. I was wearing very comfortable pyjamas and they put my hair into high pigtails. I really liked my costume because and it kept me warm on the cold nights when we were out in the stadium practising. We did so much practising but it was worth it because at the start after about three rehearsals we had done, I got a bit confused but they really helped me out so I learnt what I needed to do. I kept all the plans a secret because the person organising it said it to us specifically that this is like a birthday surprise so please don’t tell anyone. People, like my Uncle I think, said to me I’ll pay you a thousand pounds if you tell me, but I didn’t because I would have felt awful.

“Whilst we were waiting to go on I was so frightened and excited. The other girl on my bed said to me “Calm down, keep big deep breaths” but then after I had calmed down she said “We’re going to be on stage in a minute and 2 billion people are going to be watching us!” and that made me feel really nervous again. It was a nightmare when we were coming out into the stadium. But when we got out it was great and I wasn’t nervous at all. You couldn’t see the crowd, just the lights waving about. But you could kind of hear of the crowd. It was just cheering madly. And I was saying ‘get ready’ and then the music came on. It was so exciting.

“On the day of the ceremony, my Dad asked me what would happen if something went wrong and he told me “Keep calm and carry on” but I said to him “Dad, we have done so much practising, nothing is going to go wrong.” I was right. When it got to the end I just thought “why did have it be over so quickly?” I just wanted to do it over and over again because it was so good and I’ll never be able to do that again.

“When I got home I watched it on the TV and saw all the beds coming out and it looked amazing. You couldn’t see all that when you were in it. But I wasn’t on the TV and I was a bit disappointed about that. But watching it and knowing I was part of it did make me think this is the best day ever. Thinking about it now, I wish we hadn’t done it yet and it was going to be this Friday. I’ll remember it for all my life. I will pass it down to my children and great grand children because it was so special to me because not many people got to do it. I got to meet Danny Boyle and he thought of all those things and organised all this and it was very good.”

Understanding the social and emotional needs of teenage parents

Thursday, September 15th, 2011

The Teenage Pregnancy Journey: cover report imageAt Community Links, we strongly believe that people who experience a problem understand it best. Our recent Participatory Action Research funded by Newham’s Health Improvement Partnership Programme on the social and emotional needs of teenage parents in the borough has found that the informal supports many parents rely upon are not always there for pregnant teens and teen parents.

When a close friend of mine was pregnant, I was amazed how her friends organised together to help out. At the babyshower, a sign-up sheet was passed around for friends to volunteer bringing a cooked meal every night over the first two-week period after birth. These visits gave friends an opportunity to see the newborn baby, and took some pressure off the new parents.

Another close friend took up the responsibility of sending news and status of the parents and baby to broader social networks via emails for the first two weeks. People were welcomed to send greetings to the new parents directly, and were able to find out how the baby and the parents were doing without the parents having to respond directly to every message. The new parents could focus instead on caring for the baby, without being cut off from friends and social networks. This informal support really helped them to adjust to their new roles while staying connected to the community.

This type of support is one of the things teen parents need most in their lives, but it is often not available. When starting the project, we brought together a group of teen parents, and put them in charge of conducting research into their journeys and experiences from pregnancy to caring for the child. We started by exploring their own experiences, and from their stories, we identified the key themes within the research topic. These teen parents then received training to become peer researchers to go out and engage other teen parents in the borough to explore their experiences. We also held focus groups with professionals who had supported teen parents or pregnant teens before. Some key themes were identified in the pregnancy and parenting experiences of teens in Newham, namely reluctance in accessing formal services, importance of informal social support, and a need for social connection.

Reluctance in Accessing Formal Services
Our research found that Newham pregnant teens and teen parents don’t always access formal supports such as prenatal classes, parenting courses, or parent and toddler groups. This reluctance seemed to be due to the lack of appropriate materials; attitudes and skills of the professionals; and the absence of their peers. Social stigma of teenage parents also contributes to disengagement of formal services. We found that younger teen parents tend not to ask for help when they have difficulties with child-caring, because they do not want to be judged as incapable of taking care of their babies. Facing stigma and a lack of age-appropriate engagement without a community of peers often leaves teenage parents feeling disenfranchised and alone to face the difficult challenges of caring for their newborn babies.

Importance of Informal Social Support
The families of teen parents – especially their own parents ­often play a major role in providing support such as finance, housing, and advice on caring for the baby. Family members also offer practical assistance by taking part in various daily parenting tasks and emotional support from a sympathetic and experienced perspective. Teen parents often found that their relationships with family improved once their child was born. The parents and family of teenage parents became more accepting and this acceptance fostered the development of a closer relationship. Teen parents also noticed a change within themselves becoming more mature and more responsible. In turn, families then tended to treat the teenage parents more like an adult.

The research found that relationships with friends tended to be the opposite. Friends can become distant due to a variety of factors. Initially, friends can distance themselves once they find out that the teen is pregnant. Those who stay as friends might visit to see the baby in the initial period, but unless a very strong relationship or bond was built before the teen parents became pregnant, friends tend to disappear after the teen parents have the baby. This is partly due to the fact that the context – time, place, or activities – in which the friends of teen parents socialise isn’t suitable for the baby or the teenage parents anymore. Teenage parents and their friends no longer share a common framework for socialising, and being absent from school means teen parents can be forgotten by a circle of friends who do not tend to have the awareness, understanding, capacity, or interest to provide support for parents with young babies.

Need for Social Connection
The teen parents we talked to cited a real need for a space or activities that would allow them and their toddlers to socialise and connect to each other. Most of them did not have any opportunities to meet with other teenage parents, and were lacking opportunities to socialise. This, and the fact that they may have lost contact with many friends, meant they were quickly becoming socially isolated.

Many teenage parents in Newham do not attend parenting groups because they do not see their peers at these groups and do not find the activities relevant or exciting. For example, many of the young parents and toddlers groups, even though they are advertised for young parents, tend to have parents who are in their mid 20s to early 30s. Teen parents do not really feel that they belong and will often feel that they stand out being the youngest parents there. There is desire amongst teen parents to connect to other teen parents who share similar experiences. Improving Teen Parents’ Informal Social Network Because teen parents often feel disenfranchised by formal services, community will become a more important part of their support network, particularly for those who do not have a strong family support or are ostracised by their family. There is a need to focus on building the capacity of the community – families and friends – of teenage parents to support them through the difficult period of child-caring. The community needs to know how to reach out to teenage parents to offer support, what needs teenage parents have, what kind of help they can offer, how to provide emotional support, and finally where to find child-caring information.

I will never forget they way my pregnant friend’s friends came together to offer her support, partly because I, who haven’t had the experience of parenting, would never have known what kind of help to offer. It is thanks to those friends who have had the experience to come up with these ideas and bring the community together. Teen parents are a particularly vulnerable population that needs precisely this kind of informal social support from the community.

Download a copy of the research report.

More information: WeiHsi.Hu@community-links.org

This article first appeared in Parenting UK News Bulletin, issue31, June 2011. Published by Parenting UK