Why, oh why, are we waiting?
This is the big question politicians of all colours should be asking – or singing – following a report published in the authoritative medical journal The Lancet revealing that in less than 20 years from now some 5.5 million people aged over 65 will be in need of social care.
The report, based on research by Newcastle University and the London School of Economics, says that over one million people will need 24 hour care to help them eat, wash, dress and use the toilet. More than half-a-million people will need help every day and almost four million people will depend on family and friends for some form of assistance.
Women, says the report, are likely to have higher levels of care needs and fewer years of later life free of social care. This is because they are more prone than men to disabling conditions such as arthritis.
The government, it will be recalled, tried to tackle the rising problem and cost of social care at the 2017 general election when its plans were blasted as a dementia tax and hastily withdrawn. Since then it has been promising and postponing announcing a new set of proposals – now scheduled to be delivered this Autumn.
Virtually the only positive thing the government has done since May 2017 is to place social care and the NHS together for the first time in one health and social care portfolio under one Minister.
At the same time the government should, in my view, have set up an all-party and expert commission on social care so as to more speedily deal with a crisis growing bigger by the day.
While the government and politicians of all parties procrastinate, councils throughout England are being forced by funding cuts to reduce their provision of social care. In the last eight years, we are told, councils have been compelled to cut their social care spend by some £7 billion, yes, £7 billion, and there is no sign of the pressures easing.
Indeed, we read of councils being on the verge of bankruptcy and total collapse unless they get an extra £3 billion from the government for social care alone in the next seven years.
In fact, all the signs are that demand will grow alongside the growth of an ageing population. So much so, we are now warned that the number of 85s and over who will need round-the-clock help will almost double in the next 20 years – up from 233,000 to 446,000.
So the longer the government delays delivering its social care plan the worse the situation is likely to be. And this latest study warns that we shouldn’t rely on our partners or unpaid carers and family members to meet our care needs.
Since being involved with the Carnegie Inquiry into the Third Age n the early 1990s, I have been advocating and pleading for the people in power to recognise that big changes were needed to meet the growing numbers of people living longer.
The latest prediction is that the number of over 65s will reach 14.5 million by 2035 – up from 9.7 million just three years ago.
Old versus young is no answer
This is yet another wake-up call for some action to meet a social care crisis that is with us here and now and it won’t be solved by bashing the oldies or playing off the older and younger generations against each other as a think tank called the Intergenerational Foundation (IF) loves to do.
Here they are again attacking universal benefits available to older people and saying that the free TV licence for the over 75s should be means-tested and only available to those on Pension Credit.
The IF claims it is unfair that younger people are funding older viewers. But like much in the phoney generational war, the claims very rarely tell the truth. The latest audience figures show that BBC viewing by the 16 -34 age group has dropped by over 50% in the last eight years,
Many so-called Millennials – those young people reaching age 21 since 2000 – are no longer using their TV at all to access programmes so they are not required to even have a TV licence. So it’s difficult to see how they are subsidising the over 75s if they don’t pay for a licence themselves.
More worrying is that the National Pensioners Convention, to which the Forum is affiliated, warned of a backlash when a couple of years ago the government transferred responsibility for free TV licences from the Department of Work and Pensions to the BBC.
At the time, the Convention said it was part of the Treasury’s wider programme of austerity cuts, but the blame if this benefit – said to cost the BBC £750m a year – should end would be targeted at the BBC which is also trying to save money.
Challenging the Intergenerational Foundation, Jan Shortt, the NPC general secretary, said: "The alarming increase in loneliness among older people will not be tackled by means-testing the free TV licence – and neither will it save that much money."
So our message has to be both to secure a social care policy and plan that meets the needs of our time and to reject the infantile attacks on universal benefits designed to stop older people from enjoying a longer and healthier life.
Monty Meth
Taking the NHS Pledge
As the NHS turns 70, Enfield residents were reminded that its continuing success depends not only on its amazing staff, but also on us, the users
Nationwide events to mark 70 years since the birth of the NHS included a celebration atthe Dugdale Centre, with jazz music and community singing as well as short presentations and even a birthday cake.
Monty Meth, Forum President, introduced the proceedings saying: "I am lucky enough to be able to go back 70 years to remember the printed leaflet from the government announcing the arrival of this new NHS which dropped through every letterbox in the country and which read: ‘everyone rich or poor, man, woman or child can use it and any part of it. There are no charges. No insurance qualifications. But it is not a charity. You are all paying for it mainly as taxpayers and it will relieve your money worries in time of illness’.
"Imagine what a relief this must have been to our forebears. Like winning the lottery – though then it was the Pools. It meant no more flag days for hospitals, no more relying on charity, no more worrying to pay to see the doctor."
Patient responsibility
John Wardell, Chief Operating Officer, NHS Enfield CCG (Clinical Commissioning Group) began by praising the work of all the staff, both clinical and non-clinical, throughout the NHS.
"We are one of the UK’s largest employers, with 1.5 million people in more than 350 different roles, and they have played an integral part in the success of the NHS.
"But we are also asking that patients take a pledge to use our services wisely and make the best use of our resources."
He explained that one of the main pledges patients should make is to attend appointments which they have booked. Data released by NHS Digital earlier this year revealed that £1bn is being wasted annually by patients missing appointments.
"We also have to look at how we take responsibility for our own health by, for example, taking the medication we have been prescribed, as well as exercising more and eating more fruit and vegetables."
He encouraged the audience to join their local GP’s Patient Participation Group (PPG) and to learn about ways in which we can volunteer at the NHS and other health and care organisations. (Not forgetting that you can also volunteer for the Over 50s Forum – contact the office).
John Wardell also highlighted the need for people to be blood and organ donors and to talk to their families about their decision. Donors can be up to 65 years of age. We can also offer to be part of a research study as a patient or as a healthy volunteer.
The beginning of the NHS
So how did the launch of the NHS on 5 July 1948 come about? Steve Iliffe, Emeritus Professor of Primary Care for Older People at University College London, explained to the audience attending the 70th birthday celebrations at the Dugdale that the idea of a centrally run, government funded health service was born after the Boer War.
"The authorities were concerned about how unhealthy the men were who were conscripted to fight," he explained. And with a European war likely, the National Health Insurance Act was passed in 1911. This gave free medical service to male manual workers only, but recognised the role of the state in providing healthcare.
He explained that World War 1 actually helped reduce infant mortality, with the introduction of rent controls, the falling birth rate, full employment and an improved diet through rationing. "It shows how closely social conditions are linked to health."
The Ministry of Health was founded in 1920, and an emergency bed service created in 1939 to bring all hospitals (and other institutions and houses turned into hospitals during the war) into a single system.
"So the public sector hospital system was born out of the wartime system," explained Professor Iliffe.
Praise
for the NHS
This
year marks the 70th anniversary of the National Health Service,
so now is a good time to reflect on the many benefits it brings – and how
important it is to protect and fund it
Any
70th birthday is a cause – or an excuse – for a great celebration by
family and friends. The old biblical span of our lives being three score
years and ten has long been surpassed and forgotten. And it is in no small
measure due to our National Health Service that we can no longer think that
70 means your time is nearly up.
So
what do we think about the NHS itself which this year celebrates its own
70th birthday on 5 July? Here in
Enfield we’ll be gathering a day earlier – at 10am on Wednesday 4 July
at the Dugdale Centre in Enfield Town – to mark one of the most remarkable
British achievements of my lifetime – the birth of the NHS in 1948.
A
remarkable achievement because Britain was still recovering from the Second
World War, virtually bankrupt; cities and factories flattened by bombing;
relying on Marshall Aid from the United States to lift the UK economy.
Despite the obstacles, one man had a vision of a national health service
based on four principles that remain till this day:
Free
at the point of use
Available
to all
Paid
for by general taxation
Used
responsibly
That
man was Aneurin Bevan, a man much vilified by the media, the medical
profession and opposition politicians in his day, but he was the first
Minister of Health to serve in the Cabinet of a British government – such
was the importance given to the creation of the NHS by the Attlee
government.
Enfield
Celebrations
We
are therefore delighted that the Enfield NHS Clinical Commissioning Group
– the provider of all the health services we use – is joining with the
Forum in celebrating this great occasion, giving us the chance to both
appreciate the services we have all enjoyed from the NHS and the chance to
pledge our determination to retain those four pledges listed above for
ourselves and future generations.
Among
the speakers at the 4 July celebration will be John Wardell, the CCG chief
operating officer, making his first public appearance since coming to
Enfield last December, and Emeritus Professor Steve Iliffe, a renowned
expert on living longer with better health.
Steve
Iliffe was the first professor of primary care for older people in the UK,
having been a GP in Kilburn for 30 years. Forum members may recall Professor
Iliffe coming to one of our best attended Civic Centre meetings when a
decade ago he led the National Institute for Health Research Programme into
Dementia. He also spoke at our 2016 conference on Prospects for Better
Ageing.
There
will also be a jazz group to start the day and the Enfield Community Singers
will be there with some songs from the 1940s and ‘50s and perhaps we’ll
have a sing-along too to make it an event to remember.
Winning
the battle
We
now too easily take for granted that we have a national health service free
at the point of use, forgetting that Britain was the first country in the
world to have such a scheme – and what a battle it was to overcome the
opposition of politicians and the medical profession.
“No
society can legitimately call itself civilised if a sick person is denied
medical aid because of lack of means,” said Aneurin Bevan as he was
piloting the NHS Bill through Parliament.
“I
have always felt a shudder of repulsion when I have seen nurses and sisters
who ought to be at their work, going about the streets collecting money for
hospitals. The system is repugnant and we must leave it behind.”
Well,
we’ve certainly left the flag days for hospitals behind together with, in
my own parents’ case, paying three or six old pence a week to belong to
the Hospital Savings Association (HSA) to c
Those were the good old bad old days, when our neighbours where I lived in Bethnal Green put off seeing a doctor for as long as possible; where the services of consultants and specialists were unknown to poor people; where I recall to this day Millie Brown - the girl next door – who died aged 17 from TB.
Living
longer
Contrast
this with my own case of going to the newly opened Older People’s
Assessment Unit at Chase Farm on a Monday morning in December 2015, being
transferred to Barnet Hospital the same day for further tests. By Wednesday
I was on the operating table at the Royal Free having three stents inserted,
then back to Barnet for a pacemaker to be fitted on Thursday and home on
Friday with a new lease of life.
My
story can be repeated, I am sure, in every family because, for all its
under-funding difficulties, the NHS is effective and efficient. It is second
to no other country in the world for its level of care and medical
innovation. Just consider life expectancy 1948 for men 66 years. Today 79.4.
Women 1948 - 71 years. Today it is 83.1.
Diseases
that would have killed in 1948 are now treatable and curable for everyone.
Think of polio, pneumonia and diphtheria. We now have hip and knee
replacements, hearing aids and cataract operations available to all; the
massive strides in cancer treatment. The list is endless.
The
result:
the number of UK centenarians has almost doubled since 2002 to reach
over 15,000, And we are told there are now over 600,000 people in their 90s
– the fastest growing age group in the country. At the same time one in
three of today’s babies will live to celebrate their 100th birthday.
So
let’s celebrate the NHS achievements by pledging to use their services
wisely: attend all appointments, call NHS 111 when you need medical help
fast but it’s not life threatening.
Visit the local pharmacist for advice on minor health matters and
sign up if you can for online services at your GP practice.
Monty
Meth
Fight for Fairer Funding
Enfield Council and the Forum are working hard to make sure the people running the Government’s current consultation on local government funding understand how unfair the existing system is for our residents
If we had the same spending power per head as inner London boroughs, it would equate to £50 million a year in extra central government funding. Which would be a massive addition to Enfield’s £230 million annual budget, says James Rolfe, the council’s Executive Director, Finance, Resources and Customer Services.
"The methodology was set ten years ago and takes no account of current circumstances," he told a conference entitled ‘Fairer Funding for Enfield: Making the Case to Government’. The days of deprived inner London and leafy outer suburbs are long gone, but the funding gives core spending power averages of only £681 for outer London boroughs compared with £842 for inner London.
He is also concerned that the current consultation makes no particular mention so far of population density or ethnic diversity and how they drive costs (although there is a focus on costs in rural areas). And the rate of population growth and homelessness also needs to be taken into account.
Doug Taylor, Leader of Enfield Council, said Government funding of local authorities was not just about the size of the cake – although this is also a huge problem as it has been significantly reduced (we now receive £100 million a year less than we did in 2010/11), it was about how that cake is sliced up.
"The Government is currently consulting on the future of funding so now it the time to make our case as powerfully as we can."
He praised the Forum’s efforts in collecting 10,000 signatures on the Fairer Funding petition, and our President Monty Meth spoke about the significant effort required to explain to people why the petition was important.
"We found some people had little or no idea of the effect these cuts were having. Maybe the Council should announce it proposes to turn off street lighting at 11pm or charge for green bin collections – at least that would provoke some reaction," he suggested.
But the council and council officers are only too aware of the underfunding. Joanne Laban, Leader of the Conservative Council Group said that the Fairer Funding campaign has always been supported by both parties. "I have lived in Enfield all my life and have seen a lot of changes in the nature of our outer London boroughs. Enfield has changed and our funding needs to be reflected in that."
The meeting was the only one in the country which invited a representative of the Ministry of Housing, Communities and Local Government, and Trefor Henman from the Local Government Finance Team took up the challenge.
He admitted that "the current methodology was considered out of date and complex" and that the Ministry was now tasked to "design a new relative needs assessment methodology by considering factors that drive costs of service delivery and how to put these together analytically into a new funding formula."
The basic principles of the review, which will set a new baseline for the 2020/2021 financial year, are simplicity, transparency, contemporary, sustainability, robustness and stability.
He says it is complex as the level of resources (eg council tax, parking fees, other income) as well as cost of delivering services (eg wages, council building costs) varies greatly across the country. "We also have to make sure that councils are not incentivised to game the system."
Several attendees also expressed concern about whether the level of total funding would be sufficient and if the length of the transition period was many years, how that could impact on councils like Enfield which are losers under the current system.
Monty Meth summed up the mood:" We should send a message from this meeting to the Chancellor that he should stop faffing around with all that fine talk of reviewing funding for councils. That could be a smokescreen for doing nothing unless it is matched by putting more money – real money – on the table.
"The Forum’s message is not just no more cuts in government funding to councils, but let’s have a root and branch shake-up, not a sticking plaster solution. We want to secure a solution that once and for all gives councils the money they need to do the job they are elected to do."
Beat the winter
blues
Come to our Winter Fair to learn how to keep warm and
healthy. We all need to do what we can to help minimise the effects on older
people of cuts to NHS and Public Health funding
We’ve no wish to add to the daily diet of doom and gloom about the lack of available beds in NHS hospitals; of patients on trolleys waiting for beds, waiting 12 hours to see a doctor; of operations being postponed for a month or more. The media frenzy only serves to emphasise how under-funded, under-resourced, under-staffed and over-stretched the NHS really is and how important it is to prepare ourselves as best we can for the harsh winter that’s been with us. We can all play a part in reducing the pressure on our GPs and hospitals by taking personal responsibility to protect ourselves from the ‘Flu and other winter ailments in this cold weather.
Our Winter Fair on Friday 16 February at
Enfield County School – advertised in this Newsletter – will provide plenty
of sound advice about keeping warm both indoors and outdoors; keeping active
by not sitting still for more than one hour, wear layers of light clothes
rather than one thick woolly – and if you feel unwell call your pharmacist
for advice.
We are
now being told that next winter GPs will be offering a new and improved ‘Flu
vaccine for the over 75s, following concerns that previous jabs have not
given enough protection to people in this age group.
The new booster vaccine, it is suggested, could
prevent more than 1,700 winter ‘Flu deaths among older people. It will help
the body’s immune system respond more effectively to the influenza virus.We
will be asking our MPs to question the decision of the Joint Committee on
Vaccines and Immunisation to make the new vaccine available only to the
over-75s when the committee says it is safe and likely to be cost-effective
in preventing ‘Flu in the over-65s.
This is a repeat of the same committee’s decision
to save money by not making a new shingles preventative vaccine available to
everyone over 70 and instead restricting its use according to age one year
at a time.
Public Health England
now believes that the ‘Flu vaccine administered during the 2016/17 winter
was only 41% effective in adults under 65 and it had “no overall effect on
older people”.This ‘Flu vaccine failure – coupled with fewer social care
visits to the frail elderly – helps to explain why deaths among older people
last winter jumped 40%.
The Office for National Statistics announced that
34,300 more older people died between December 2016 and March 2017 – the
second highest figure in the last five years and up from 24,580 in 2015/16
–probably due to the ‘Flu strain that hit elderly people.
The biggest increase in deaths was among the
over-85s – mainly women living in the poorest areas – while deaths caused by
respiratory problems were up 50%.
While it is true that the ‘Flu vaccine given in
the less severe 16/17 winter was not totally effective, it is also true that
too many elderly people in parts of Enfield live on low incomes in poorly
insulated homes. More than 13,000 Enfield families are living in what are
called ‘fuel poverty homes’ – a scandalous combination of low incomes, high
fuel prices, inadequate heating and poor insulation – homes lacking the
warmth that older people need.
Excess winter deaths (that is the number over those occurring in a normal month) accounted for 285 deaths a day in the 2016/17 winter – 11 deaths an hour – and here in Enfield the tally of excess deaths is about 100 every year. And this ‘Flu season could be as bad with Public Health England now telling GPs that the vaccine used by most of the NHS was not effective against the most common type of influenza strain. However, to those older people repeatedly refusing the ‘Flu jab we draw their attention to the Canadian Medical Association Journal which reported that even if the jab does not stop the elderly contracting the ‘Flu, it prevents the illness from becoming severe.
A ‘Flu jab three years in a row made it 31%
less likely that people would be admitted to hospital; 74% less likely to be
admitted to intensive care and 70% less likely to die.
Tackling fuel poverty is one of the government’s
legal objectives but too little is being done to make a difference. Indeed,
it has reduced the winter fuel allowance since 2012 and remains under
constant threat. It now covers less than a sixth of constantly rising
fuel bills and no policies have been announced to tackle fuel poverty – the
Energy Price Cap Bill is not expected to become law until late July, if
then.
That is why the Forum is supporting the call of the National Pensioners’ Convention for the government to create a Fuel Poverty Commission to end the scourge of excess winter deaths once and for all.
Safeguarding Enfield adults
December 2017The Enfield Safeguarding Adults Board is working to make sure that everyone in the borough knows how to recognise and report adult abuse and neglect
More than 1,140 cases were reported to the Enfield Safeguarding Adults Board (SAB) in 2016-17 – and 704 of them (49%) involved people aged 65 and over, reflecting the relatively high proportion of elderly people living in the borough. The most safeguarding concerns were raised by hospitals (259 cases), residential care homes (116 cases) and by social care staff (100 cases).
With 41,000 people aged over 65 living here - the 11th highest number in London - the Enfield SAB faces a challenging task in keeping people at risk of abuse and neglect, safe in their own home, in hospital or in one of the many care and nursing homes in the borough.
The importance of the SAB’s work was confirmed by the March 2017 Care Quality Commission rating for Enfield which revealed that while 58% of nursing homes in the borough are good, 42% require improvement; while 75% of home care is good, 25% is inadequate and while 88% of residential homes are good, 12% need improving.
The Enfield SAB is a partnership organisation– which includes the Over 50s Forum – and is responsible for helping adults at risk not only to live their lives free of abuse and neglect, but also to feel safe and able to have their wishes and well-being respected, whether it be by family, carers or nursing staff.
Breaking the cycle
The SAB annual report says they are developing a local perpetrator plan;
they want to hold the perpetrators to account and break the cycle of abuse.
The SAB is expanding its focus to include people at risk of committing
suicide.
As required by the Care Act 2014, this is in addition to areas of abuse
which include discriminatory abuse, financial abuse and modern slavery.
Modern slavery is defined as being when people are forced to work against
their wishes, with no choice about what they do or where they live, for
little or no money.
Hydration Toolkit
Forum executive member Irene Richards is a lay member of the SAB and is one of their Quality Checkers gathering feedback on the quality of services elderly people in care receive. For example, they helped to improve hydration by visiting 20 care homes gathering information from staff and residents about their food and drinks. A ‘Hydration Toolkit’ was produced and distributed to all care homes in the borough, with a wallet sized hydration card to help identify and prevent dehydration.
One of the main goals the SAB has set itself for the coming year is ensuring that everyone in Enfield knows how to recognise and report adult abuse, to understand when to report a concern and when to call the police in emergencies. It will also focus on adult safety in the ‘provider market’ – Enfield having more than 100 nursing and residential homes - one of the highest in London.
24 hour helpline
The Safeguarding Adults Board has a special telephone line open 24 hours every day of the week on 020 8379 5212 for anyone concerned that they or someone they know may be experiencing abuse.
The SAB will also be present at the Forum’s Winter Fair on Friday 16 February with its own stall offering guidance and advice and the team will also run a workshop, possibly on identifying financial abuse particularly of elderly people.
What is abuse?
Abuse is when someone does or says something to make you feel upset, scared, frightened or hurt. You may be too scared to tell them to stop or even to ask for help from someone else.
Financial abuse
This is when someone takes your money or belongings without asking. Financial abuse can include stealing your money and being forced to pay for other people’s things.
Neglect
This is when people who are there to help you do not look after you properly. It can also be when your care and support is not enough to meet your needs. This can include being put in danger, not getting the medical help you need, being ignored – no one talking to you.
Hate crime
The police define Hate Crime as ‘any incident that is perceived by the victim, or any other person, to be racist, homophobic, transphobic or due to a person’s religion, belief, gender identity or disability.’ This definition is based on the perception of the victim or anyone else and is not reliant on evidence. In addition, it includes incidents that do not constitute a criminal offence.
If you go to the www.enfield.gov.uk website and type in ‘Safeguarding Adults’ in the Search bar, and go to the Safeguarding Adults Board page, you’ll find the ‘Safeguarding Adults Annual report for 2016-17’ as well as their current Safeguarding Adults Board Strategy.
The main Safeguarding Adults page also has a very helpful video on the page called Warning signs. They are updating the video with a version with Sign Language. The page also has a number of factsheets that may be helpful: on financial planning, preventing abuse and fraud and ‘Safeguarding, technology and you’.
Unfair tax on NHS hospitals
Cash-starved NHS hospitals are taxed fully while many private hospitals are eligible for rebates. How can this be fair?
More than one in four private hospitals are claiming charitable status giving them an 80% rebate in business rates worth some £52 million over five years. NHS Hospital Trusts, on the other hand, all have to pay in full, and will face a £366 million increase in rates over the next five years.
It surely is a mad world when our local under-funded North Middlesex University Hospital will run-up a deficit in this financial year at the same time as it is due to hand the government £2,361,332 in tax for business rates.
The North Mid is even paying £738,000 more than in 2016/17 due to the government’s revaluation exercise this year and it saw its business rates soar from £1,291,330 to £1,600,560 just because it opened a new, modernised maternity building offering better amenities to prospective Mums. As Victor Meldrew might say: "I don’t believe it".
A spokesman for the Royal Free London Group based in Hampstead, which includes Barnet and Chase Farm Hospitals, said the trust is considering all of its options, both in relation to appealing against the revised rateable values that came into force on 1 April 2017, as well as potentially pursuing the charitable relief route.
In 2015-16 their business rates tax was £2,870,777, rising to £2,955,000 in 2016-17 and the rates payable in this financial year 2017-18 will jump to £3,629,091. In the last five years Chase Farm Hospital has paid almost £2.5 million to the government in business rates – £60,000 more this financial year because of the government’s revaluation – money that could and should have been used to finance the building of the new Chase Farm if it had the same charitable status as private hospitals, free schools and universities, for example.
NHS Hospital Trusts receive no additional funding to offset the cost of business rates. They are all part of a long-running challenge to seek a similar level of charitable relief on business rates, similar to non-profit organisations.
"It is scandalous that NHS hospitals pay normal business rates but 26.9% of private hospitals, using charitable status, receive an 80% discount," says the Over 50s Forum, which is drawing the attention of Enfield MPs Joan Ryan (Enfield North which includes Chase Farm) and Kate Osamor (Edmonton covering the North Mid) to the anomaly.
"We’d like the MPs to ask Ministers how a private organisation like Nuffield Health, which runs 31 hospitals and 111 gyms charging £76 a month only with a 12 month contract (there’s one in Enfield) can secure charitable status and a business rates rebate, while our hospitals have a daily struggle to survive," said the Forum.
"If the answer is that private hospitals do not have shareholders and they reinvest all profits into their services, surely the same applies to NHS hospitals. We are told that dozens of NHS hospitals have written to their local authorities to try and claim the reduced business rates, but the Local Government Association rejected the claim, saying they are not charities recognised in law."
PS We note that the government has dropped its manifesto pledge to scrap the charitable status of private schools that do not help their state school neighbours. About half the 2,300 independent schools in England are registered as charities earning them favourable business rates discounts and VAT exemptions on fees.
More pain for patients unless…..
Come to a Forum meeting to hear our concerns about planned changes to health services in Enfield which will affect how and when you and your family are eligible for treatment
There will be a lot more pain for patients unless we all come together to stop the Enfield NHS Clinical Commissioning Group (CCG) – the main provider of health services in the Borough – upping the criteria before we can be treated by the NHS for a host of medical complaints, ranging from hearing loss to hernia problems, from the need for knee replacements to bunion surgery, prolapse womb to gallstones.
This so-called Adherence to Evidence-Based Medicine project (AEBM) is but the latest in a string of health service cuts which, if implemented, the Over 50s Forum believes, will undermine the founding principles of the NHS launched on 5 July 1948.
These were that good healthcare should be available to all regardless of wealth; that it meets the needs of everyone free at the point of delivery; and healthcare should be based on clinical need, not the ability to pay.
The Governing Board of Enfield’s CCG will be meeting in mid-September and may well decide to go-ahead with the AEBM programme unless we make our voices heard loud and clear – as many people have done at the minimal public consultation meetings held since March.
The CCG wanted to end the consultation on 30 March and implement their changes in June. Labour and Conservative councillors joined us in blocking this timetable.
Had it been implemented, Enfield residents would have been the pacemakers for misleadingly-called AEBM being introduced by all our North Central London linked CCGs in Barnet, Haringey, Camden and Islington, covering some 1.4 million people.
‘Adherence to Evidence-Based Medicine’ is misleading because we have neither seen nor heard of any authoritative supporting evidence from any consultants at local hospitals for the raising of thresholds over a range of medical conditions which, in effect, undermines the role of our GPs and consultants in exercising their clinical judgement as to when a patient needs referral and treatment.
We
know only too well that the NHS nationally is under-funded and we know
Enfield CCG is under intense pressure to make “efficiency savings” to
balance the books and make inroads into its £37.2 million deficit burden
– a burden imposed by years of under-funding a borough with an increasing
population and an increasingly ageing population.
NHS bosses are warning of projected losses of £234 million this year across the five North Central London boroughs rising to an uncosted £811 million by 2020/21 unless we accept their “efficiency savings” – plans that can only undermine the NHS as we have known it.
But the Forum does not accept that the answer lies in patients having to suffer in silence while their medical conditions worsens until some arbitrary-imposed criteria is reached that warrants NHS intervention.
If the CCG gets away with its AEBM plans, more cuts will follow as sure as night follows day because the pressures and financial demands on the NHS are growing by the hour. Just consider how life expectancy has changed since the NHS was created 69 years ago.
People living longer has brought dementia – unknown in 1948 – and now forecast to hit more than a million people in the next decade. Obesity cases, they say, are set to double, driving up diabetes, strokes and heart disease, but it was never on the scale it is today.
The NHS is a miracle – the world’s largest health service funded by general taxation – has adapted to all the new developments and medical discoveries. Hip and knee replacements unknown in 1948, more people than ever now recovering from strokes, cancer and heart disease.
So the financial pressures are bound to grow. As a nation we have to find a way to meet the ever-growing demand for healthcare – not seek solutions by cutting patient services or compelling more people to pay for a privatised service.
The Forum executive does not believe the answer lies in cuts and rationing health services as we have known them.
That is why we are calling this special meeting to hear your views on the future of health services in Enfield.
The meeting is open to everyone sharing our concerns about health services in Enfield. It will be held on Tuesday 15 August at 10am for a 10.30 start, at the Southgate Beaumont Care Home, 15 Canon Hill, N14 7DJ. The venue is a 10-minute walk from Southgate underground station and almost opposite the Cherry Tree pub and on the 121, W6 and 299 bus routes.
A government for the good of all the people
Our constitution states quite clearly that we are a non-party political group and recognised as such by the Charities Commission. It means we are not beholden to or linked with any one political party.
But we are free to comment and indeed campaign on political matters that impact on elderly people, such as pensions, universal benefits etc because these are matters in which politicians and government are the decision-makers.
In the 18 or more years that I have been involved with the Forum, I have consistently ensured our independence from all political parties, while at the same time seeking the support of their representatives where and when it helped us.
So our three Enfield MPs, representing the Conservative and Labour parties have all supported our Fairer Funding for Enfield petition. They have each informed the Enfield NHS Clinical Commissioning Group of their concern with the so-called Adherence to Evidence-based Medicine, which the Forum considers to be detrimental to ALL Enfield residents and a smokescreen for cuts in NHS services.
This is the first time that publication of our newsletter is appearing on the eve of a most important General Election on June 8. We have members of all political parties and of none and we obviously refrain from advising anyone how to cast their vote.
The Forum executive, however, strongly urges everyone to use their influence with friends, neighbours and relatives to vote not just in the interests of our generation, but for future generations who will live with the consequences of this momentous election.
Writing before the various party
manifestos are issued, as I see it this election is not just about the rocky
road to Brexit and the complex, quite unknown, result of leaving the
European Union.
“Government can and should be a force for good,” says Theresa May. “The state exists to provide what individual people, communities and markets cannot…..we should employ the power of government for the good of the people.” (6 October 2016)
So, with these fine words in mind I ask myself what is good government?
Good Government should be about the adequate funding of the financially starved NHS. It should be about ending the constant kicking into the long grass of any plan to deal with the growing numbers of elderly people needing social care, often suffering from incurable illnesses, living after decades spent in retirement that was never anticipated.
Remember the Dilnot Commission set up in 2010 which took years to come up with a plan for a £76,000 lifetime cap on care costs after which time the state would pay? Under the 2014 Care Act it was supposed to be in place by 2016 with the personal cap reduced to £72,000. Then it was delayed until 2020.
But on 8 March 2017, Chancellor Philip Hammond, announced that “shortly” the government would be launching another new Green Paper for consultation outlining new options for the long-term funding of social care.
Since then, the General Election has been called so we are back to square one waiting to see how the next government intends to tackle the long-term funding of a social care service.
Meanwhile, the Association of Directors of Adult Social Services – of which our own Ray James is a former president – says there’ll be a £4.3 billion funding gap for social care by 2020 and about 500,000 elderly people are no longer getting the care and support they need from cash-starved local councils.
Good Government should be about immediately ending the stupid arrangement whereby the NHS is administered by the Department of Health while another Ministry – the Department for Communities and Local Government – is responsible for Social Care. Surely it is time that heads were banged together so we had one budget to operate an integrated health and social care system for the 21st century.
Good Government should be about adequate funding for schooling our grandchildren and great grandchildren. I had a letter from an Enfield primary school head about the funding crisis now facing our schools where teachers are getting a 1% pay increase after years of a pay freeze. Our schools are being placed in a position that is financially unsustainable and the possible consequences could well be a mix of increased class sizes, staff cuts, reduced curriculum resources and activities.
I can hardly believe that our schools are each being asked to find about £10,000 under the government’s imposed Apprenticeship Levy scheme – a tax on a school’s wage bill – which business groups have urged be delayed because of increased costs at a time of economic uncertainty. And the local council is having to cut its grant aid to schools because it, too, is seeing its education grant cut.
Good Government should be about restoring the £600 million in funding cuts that have hit the Metropolitan Police which has led to a steep increase in gun and knife crime in London over the last year. Gun crime was up 42% and knife crime 24% – and the Met is expected to find another £400 million in cuts – always described as “efficiency savings’” by 2020.
Here in Enfield knife crime is rearing its ugly head with three fatal stabbings in six weeks in Edmonton, Enfield and Oakwood.
Gun crime has seen a 49% rise in Enfield, with a total of some 50 extra offences. Enfield police are working hard to fight this increase daily. They are particularly targeting knife crime across the borough, utilising metal detecting knife search arches and weapon sweeps. Assistant Met Commissioner Martin Hewitt says: “It would be a naive answer to say that if you cut a significant amount out of an organisation, you don’t have any consequences.”
Good Government should be about ensuring that everyone is entitled to a later life with a state pension providing dignity and security. We need a Brexit deal that will protect the EU health insurance card and the rights of UK pensioners living abroad. Various politicians, think tanks, academics and the media have been drip-feeding the line that older people’s pensions are the cause of many of the country’s problems – from the shortage of housing to the lack of hospital beds.
They shed crocodile tears in claiming that we are being molly-coddled at the expense of today’s working population and future generations. When the truth surely is that in battling to protect our pensions and universal benefits, we will be leaving them a platform on which to build a better life.
If we lose today, tomorrow’s generation will not forgive us.
Monty Meth Monty Meth
Hate crime: the rising menace
Thankfully the level of hate crimes in Enfield does not appear to be as high as in many other areas, but we need to be vigilant to ensure that it is reported – and challenged by all of us
Recently a short item in the Metro newspaper about an Enfield resident was headed: "Hitler is God man jailed for five years." He was, the article said, a father of three, who had a huge swastika tattooed on his chest. It was alleged that he posted racist messages online and had a bomb manual. He admitted publishing hate speech, possessing racist material and one terrorism offence. (24 February, 2017)
Fortunately, this was a pretty isolated case as Enfield has not seen the same increase of race hate incidents that many areas have experienced following the June 2016 referendum. Overall in London there was a 22% rise in race hate incidents which, in part, led Home Secretary Amber Rudd to announce a series of measures to tackle hate crime.
Entitled the Hate Crime Action Plan, the £60 million fightback project to challenge extremism in all its forms, led Ms Rudd to call on communities across Britain to "come together and stand united against those who use hate to divide us."
Enfield has its own Hate Crime Forum comprising the council, police, Enfield Disability Action, Enfield Racial Equality Council and the LGBT network constantly monitoring hate crime and encouraging people to report any incidents of verbal abuse, property damage, physical assaults or graffiti scrawled on property.
This has led to a 20% increase in local racial incidents being reported in the six months ending December 2016 compared with six months ending 2015, but in the ten weeks after the Brexit vote there was a decrease in racial incidents reported in Enfield. In Hertfordshire, for example, there was a 30% increase in hate crime between last July and September.
The Equalities and Human Rights Commission has said that a small number of people used the Brexit vote to "legitimise inexcusable racism and prejudice." A hate Incident is any incident which the victim, or anyone else, thinks is based on someone’s prejudice towards them because of their race, religion, sexual orientation, disability or because they are transgender.
If you, or anyone you know, has been called names, been bullied or had anything happen to them that you think may be because of one of these factors, then you should report this as a hate incident. Even if you don’t want the incident to be investigated, it is important that the police know about it, so that they can build up a picture of how many incidents are happening and where. This information can help police investigating other hate incidents.
The Metropolitan Police now has 900 specialist officers across London dedicated to investigating hate crime and here in Enfield our faith and communities officer is PC Steve Savell and he can be contacted via steven.savell@met.police
It is against this background that the Forum executive has invited Fiyaz Mughal, director of Faith Matters, to be the guest speaker at our AGM on Tuesday morning 30 May in the conference room at the Civic Centre. Faith Matters was launched in 2006 to help communities reduce conflict between faiths, improve community cohesion and counter extremism.
Let us make our voices heard in 2017
We need to continue to make sure that we hold the government to account for wasting public funds and prevent it trying to cut pensions
Because I read newspapers and watch TV news bulletins, my children and grandchildren consider me old-fashioned. It is claimed that 64% of news is now accessed through social media – the digital revolution – like Facebook, Twitter, blogs and other sources of information often found to be fake, with hoax stories like those that featured in the American presidential election.
So I prefer to stick to the printed word; the fact-checked article, for my information. Articles, for example, which challenge the waste of public funds that could be better employed supporting our cash-starved health and later life care services.
Take for instance the £285 million the government spent on building an airfield on the Atlantic island of St. Helena. Ministers claimed it was a “brilliant” project, completed on time and on budget.
The
only snag, not identified until it was too late, was that the winds over St.
Helena were always too strong to allow aircraft to leave or land on the
island. The sequel to this story was that the top civil servant involved was
awarded a knighthood in the 2017 New Year’s Honours. Can you just hear
Victor Meldrew with one foot in the grave saying: “I
don’t believe it”?
Or there’s the £500 million the Royal Navy wasted building five offshore patrol vessels it now finds it doesn’t need, while our newly knighted Defence Secretary, Sir Michael Fallon, blandly claims 2017 to be “the year of the Navy”
Or take the latest example of exorbitant charges for off-patent medicines being charged by rapacious manufacturers of generic drugs. In 2015 alone, the NHS spent an extra £262 million on the increased cost of some 50 generic medicines, the licences for which were sold to people who promptly used a loophole in NHS price regulations allowing them to implement larger price increases for newly-licensed medicines.
It seems the NHS has for years relied on the virtuous ‘free market competition’ to set the price of unbranded generic medicines, which left the licence-owner free to impose huge increases for products on which they had a virtual monopoly. And did you notice that the American pharmaceutical company Pfizer was recently fined £84.2 million for allowing the price of its epilepsy drug to be increased 2,600% (that’s not a misprint).
The government is only now – well after the horse has bolted – legislating for the health secretary to have some new powers over medicine prices, something I would have thought the NHS chief executive Simon Stevens should have noticed while he has been driving his nationwide 220 Clinical Commissioning Groups, such as the one here in Enfield, to cut their medicine bills.
Instead of sorting out the medicines price racket on his own doorstep, Mr Stevens, I am afraid, chose to join the cats chorus of those attacking so-called ‘pensioners perks’ by calling on the government to slash our bus passes and end the Triple Lock which guarantees annual increases in the basic state retirement pension whichever is the highest between earnings, price inflation or 2.5%.
Mr Stevens goes for the cheap headline saying the savings from pensioner benefits should be used to fund adult social care. Like so many others, he doesn’t say what should replace the Triple Lock – and that’s the big challenge we need to make every time we hear or read these attacks.
There are some who say state pension increases should be linked to a Double Lock – to prices or earnings and ending the 2.5% guarantee. But what would that achieve if as freely forecast price inflation is expected to reach 2.6% or even 3% in the next year or so? And when Transport Minister Christopher Grayling defended the 2.3% increase in rail fares which kicked off 2017 he brazingly claimed this was below the current increase in earnings. Believe that if you like.
So there’s no easy answer to the Triple Lock and I’ll never get fed up in arguing that every attack on current pensioner income is an attack on the income of all future generations of pensioners.
The pretence that cutting income from today’s pensioners is for the benefit of today’s working population is a myth. Just like the myth governments tried to sell in the 1960s and ‘70s that if the miners didn’t ask for a pay rise it would help the nurses.
So my message for 2017 is: let’s continue to make our views known. Make our voices heard loud and clear and let’s defeat those who seek to divide us from future generations of pensioners. They are, after all, our own kith and kin.
Monty Meth
Brexit kerfuffle starts pensions panic
We need to protect the Triple Lock for the sake of future generations of pensioners as much as for older people today
Unpredictable, uncertain, unplanned, unchartered – how else would you describe going into the New Year 2017 when nobody can be in any doubt that we are now entering the most complex period of government decision-making in our lifetimes.
Never mind the awaited Supreme Court ruling on whether Parliament should have a say before initiating Britain’s exit from the EU, the Daily Telegraph on 21 October was already telling its readers: "Brexit is perhaps the single biggest and most complex political and governmental task any peacetime prime minister has faced."
Brexit may indeed end in that wonderful new world we are promised – but meanwhile in the world in which we live now, we see that the government’s budget deficit is on the rise again.
Instead of having a budget surplus of £10.4 billion by 2020 we are now warned to expect a deficit of £14.9 billion. The Institute for Fiscal Studies believes that tax revenues will then be £31 billion lower than Treasury forecasts – and pensioners are first in the firing line to make up the shortfall.
This is the background to the siren calls to scrap universal benefits such as the Triple Lock which guarantees a state pension increase of at least 2.5% a year as being unaffordable. Along with the winter fuel allowance and free TV licences for the over 75s, they are the top targets for cuts.
I have seldom
read a more economically illiterate report than that issued by the 11 MPs on
the Work and Pensions Select Committee who claim the Triple Lock is
"inherently unsustainable".
The report claims that, if nothing is done, the state pension will grow
faster than wage increases and so account for an ever-greater share of
national income. It says: "In particular, we find no objective
justification for the 2.5% minimum increase."
That 2.5% will give people on the full state pension of £119 a week an extra £3 next April at the same time as inflation is widely tipped to rise by 3-4 % as prices rise, partly as a result of the Brexit exchange rate fall in sterling.
Can these MPs and the media hounds echoing their call to "kill the lock" not see that if wages only rise by some 2% and the state pension by 2.5% at the same time as inflation increases by 3% or more, then both pensioners and today’s working people are going to have less disposable income?
So instead of seeking to divide us from the younger working generation, we argue that cutting the value of the state pension will inevitably harm the next and all future generations of pensioners. If we lose today, they will lose tomorrow.
Remember too that the UK state pension is ranked the 32nd lowest out of 34 countries in the OECD; that 6.5 million older people have an income of less than £11,000 a year; that millions still need means-tested top-ups just to get by; and one in seven pensioners still lives in poverty. So much for branding us "golden oldies".
We are thinking too of today’s working-age population, the majority of whom will not have final salary pensions that many pensioners today enjoy; indeed they find it hard to save for any pension when housing costs are so prohibitive.
The 2.5% guarantee of the Triple Lock is the only protection they have when they come to retire. So, in campaigning to hold on to what we have secured, we do so to protect future generations.
We’ve seen more attacks recently on older people by so-called inter-generational think tanks claiming that we have escaped the years of austerity and have deliberately – yes, they say deliberately – accumulated housing wealth at the expense of our children and grandchildren.
Here’s the Inter-generational Foundation issuing a report saying older people have saddled the younger generation with an excessive bill for state pensions while grabbing an ever-greater share of NHS spending – that’s the inflammatory language they use to create divisions between us and future generations of pensioners.
The housing crisis hasn’t been caused by pensioners, but because we sold off millions of council houses and every politician accepts that we haven’t been building enough affordable homes.
Wages are so often too low and jobs insecure and we have an economy largely built on house-price inflation. This is what the think tanks should be addressing.
Poorer pensioners still need that winter fuel allowance which is also under attack. Remember that recent winter when a staggering 43,900 older people died from cold- related illnesses. Energy bills continue to rise, and spells of prolonged cold weather and poor housing still mean that older people are particularly vulnerable.
When it was first introduced, the winter fuel allowance covered around a third of the average fuel bill. Now it hardly covers an eighth. But the real reason why we have so many additional benefits for pensioners is because our state pension is so low.
We are an easy attack target only because we are living too long for some people. In 1985 – the year when the first mobile phone call was made – there were 3,420 people aged 100 or more.
By 2015 the number of centenarians had grown to 14,570. In 1985 there were just 130 people aged 105 and over. Last year there were 850 – marvellous if you are in good health. Terrifying if your health is poor.
For years, successive governments and all political parties have been urged to address these and similar social care issues – and we all know the result: that health and social care is now facing the worst ever financial crisis and successive governments pass the buck to their successors.
So my message for 2017 is don’t sit back and leave it to the politicians. We need to stand firm and act as the watchdogs, the guardians, the pacesetters to maintain, protect and enhance the prospects for a better life for our ageing population – not just for today’s generation of older people – but also for those that will follow us.
Monty Meth
We’re all being fleeced - both old and young
If you listen to people such as the Intergenerational Foundation, we oldies are ripping off our own children and grandchildren by securing a state retirement pension – dubbed the triple lock – guaranteed to increase by at least 2.5% every year at least until 2020.
Instead of playing off one generation against another (the old game of ‘divide and rule’), I want to show how both old and young are being swindled by a devious Treasury. We would, I believe, be better off battling together than slagging off each other based on the false premise that we are saddling the younger generation with an excessive bill for state pensions, while grabbing an excessive share of NHS spending.
In June 2010, the then Chancellor, George Osborne, replaced the Retail Prices Index (RPI) with the lower Consumer Prices Index (CPI) and, according to figures recently released by the Department of Work and Pensions, the basic state pension would have been £1.15p a week higher by 2015 if the government had not switched from RPI to CPI.
By April 2015 it would have been £117.10 a week rather than £115.95 – so £58.90 a year more. So the total loss to someone receiving the full basic state pension over the five years since the triple lock was introduced has been £163.80 – hence we believe that maintaining the triple lock, but linked to RPI rather than the lower CPI, will be the best protection for both today’s pensioners – and for the younger generation and future beneficiaries of all we achieve.
But craftily, the Treasury has not used the lower CPI inflation rate to fix the interest payments on tuition fee loans of our 530,000 university students. They pay the higher RPI rate of interest on their loans – currently 1.6% plus three percentage points which means 4.6% interest for the current academic year.
So the oldies’ pension is being cut by using the CPI yardstick while our youngsters – the future entrepreneurs and wealth creators on whom we are told Britain will depend – are being saddled with the higher RPI interest payments on their student loans.
Hence my claim that both young and old are being screwed. We’ve a long road to travel before we see an end to the inequality and injustice we hear so much about.
We can all see that the knives are out to end the triple lock which we are told is unaffordable or unsustainable. Even the so-called progressive Fabian Society has joined the cats chorus claiming that ditching it would save £5 billion a year by 2030.
Astonishingly, they want to see the pension linked just to the increase in earnings. You may well ask ‘what increase?’ when we are told that since the financial crisis of 2007-08, real wages in Britain have declined by more than 10% – the largest fall in any developed economy in the world.
Meanwhile, Baroness Ros Altmann, who left her job as pensions minister following the departure of the Cameron government, has added her voice against the triple lock by suggesting it should be cut to a double lock – linked to either price inflation or increased earnings, whichever is higher, so ending the guarantee element of the triple lock.
What the media and the academics too often forget is that many pensioners still live a hand-to-mouth existence. A report from Independent Age found that the over 75s have incomes on average £59 a week lower than younger pensioners and that one in five live in poverty.
Nearly 750,000 pensioners have no income other than state benefits and one third of the over 75s have savings of less than £1,500. And more than one million pensioners have no savings at all. So not all pensioners are ‘golden oldies’ living the life of Riley.
When the state pension went up by £3.35 a week this year, the poorest pensioners receiving the pension credit had a rise of only £2.02 a week – prompting the question
"why are the poorest always treated as second class citizens?"I am grateful to
Daniel Finkelstein – Lord Finkelstein – who is also a Conservative Party peer and well connected to government ministers, having been a key member of their Central Office research staff, for setting the record straight on so-called ‘wealthy pensioners’.Writing in The Times on 24 March 2016, following Iain Duncan Smith’s surprise resignation from the Cabinet, he said: "There was a hint in IDS’s resignation statement that the real problem was all the money going to rich pensioners because they vote Tory. Well, let’s examine this for a moment.
"Pensions is the area that has provided the biggest saving of all because of future increases in the state pension age. But leave that to one side. Who are these rich pensioners who are supposed to carry the rising benefit bill on their back?
"The reason for allowing pensions to rise is that pensioners were a very poor group and on average still are. They are also as a group much less able to find work to offset any reduction in benefits.
"Only 4% per cent of pensioners are higher rate taxpayers. The amount of money that might be produced by means testing the winter fuel allowance is tiny."
I don’t know how many the 4% amounts to, but Daniel Finkelstein’s argument is worth remembering to counteract those who will always be attacking pensioner benefits until the general election in 2020.
Monty Meth
Fight to save prescriptions
Pressure from the Forum is helping fight a local CCG directive to make patients pay for over-the-counter medication that used to be prescribed by a GP.
Has your doctor asked you to buy medication which you have received on prescription in the past?
If so, the Forum would like to hear from you. We are fighting a directive from the Enfield Clinical Commissioning Group (CCG) to local GPs that they should stop prescribing medications that can be purchased at pharmacies and supermarkets without a prescription.Since first issuing the directive and in response to Over 50s Forum protests, the CCG has posted a new letter telling all GPs to
"use your professional discretion to identify patients for whom it may be necessary to prescribe occasional over-the-counter items."But that basic premise – that most patients should pay for over-the-counter medicine rather than get it on prescription is still in place – and opposed by local GPs. GPs have told us that they still believe that, alone in North London, the local CCG is trying to restrict their duty to prescribe the necessary medications. They warn it could set a dangerous precedent and undermines the NHS principle that medicines should be freely available at the point of delivery.
The Forum objected to the original CCG directive which we believe virtually imposed a blanket withdrawal of free prescriptions for many items that could be bought without a GP prescription. It would have singled out the poorest and most vulnerable patients in the community who are entitled to free prescriptions. There are many thousands in the borough receiving income support; unemployed people receiving job seeker’s allowance; low income pensioners qualifying for pension credit, families with children under 16 and young people still in education.
At a top-level meeting with CCG directors
, the Forum said the CCG should not try and save money by hitting and hurting the one section of the community least able to bear the brunt of withdrawing free medications – and being told to buy them instead from a pharmacy or supermarket. The CCG should instead launch an across-the-board, borough-wide, self-help and self-care campaign to help reduce the £1 million a year spent by the NHS on GPs prescribing products which can be bought at a pharmacy or supermarket.The Enfield CCG now says it realises that there are a group of vulnerable patients for whom not prescribing an over-the-counter product may be counter-productive, but it adds that
"resources released by this initiative could be used to commission services that require more complex treatments."In a statement to all GPs,
Dr Andrew Green, the BMA’s General Practitioners Committee (GMC) prescribing sub -committee chairman says: "restrictions which call for GPs not to prescribe any drug available over-the-counter go too far and could put GPs in breach of regulations."We must remember that drug companies have got many previously prescription-only medicines re-catergorised over recent years, and it was never intended that these drugs would then cease to be available with a prescription.
"Any GP refusing to prescribe a drug that they had decided was clinically indicated would be in breach of their contractual duties, and might even face action from the GMC for failing to treat properly. All patients need individual consideration and prescribing if appropriate,"
said Dr Green.The Over 50s Forum has told the Enfield CCG bosses that it will continue to press the government and NHS England to end the under-funding for both the CCG and the separate public health arm serving the borough which is forcing them to take decisions that can ultimately lead to more costly outcomes if people have to receive a more expensive prescription-only medicine or go to A&E.
"We know that this summer in particular many Enfield patients have suffered from hay fever and needed eye drops costing £4.69 for just 5 mls; a nasal spray at £9.99 and allergy tablets for £3.99 . That’s £18.67 and for someone on a low income that’s really hard. Especially when a patient in neighbouring Haringey or Barnet will get the same items free,"
said Monty Meth, Forum President.
>Hillsborough: Are there lessons for the Forum?
June 2016
Hillsborough: Are there lessons for the Forum?
I suspect that the unlawful killing judgement secured by the 96 bereaved Hillsborough families and their moving response to a 27-year campaign for justice was a talking point among many Forum members and their families – as it was in millions of homes throughout the country.
For me, it certainly brought back many memories and rammed home many lessons not least of which is realising just how important it is to keep banging away at something, be it to right a wrong or help to make life better for our fellow citizens.
My memories go back to being at that same Hillsborough stadium in 1981 to see Spurs play Wolves in a similar FA cup semi-final – and where the very same crowd problems occurred.
What happened in 1989 was a complete replay of events in 1981 – too many people trying to squeeze into too tight a space.
In 1981 there were the same problems well before kick-off, the same substantial crush in the middle of the terrace which we now know as pens 3 and 4 that were installed in 1985 ostensibly to avoid people bring crushed.
From our seats we could clearly see into the street holding large crowds of Spurs supporters still outside singing and queuing to get in while that part of the stadium reserved for the Wolves supporters was significantly less crowded. That caused me to wonder why Spurs having the much bigger support were given the smaller terrace.
Apparently in 1989 Liverpool were allocated 24,000 tickets and Nottingham Forest 29,000. I assume it was the same in 1981.
Why
was the club with the larger support given fewer tickets and allocated the
smaller terrace? It was illogical as was the use of just seven turnstiles to
secure entry for some 10,000 people.
About 10 minutes into the 1981 Spurs v Wolves game – almost the same time sequence as in the 1989 disaster – the crush became too much. Fans spilled off the terrace and I suspect doors were opened in order to relieve the crush and the rest of the game was played with a significant number of Spurs supporters sitting around the touchline.
How close to a disaster we were that day I don’t know but what we do know is that 38 Tottenham supporters suffered injuries serious enough to be admitted to hospital with broken arms, legs and ribs.
And unbelievably, the same crowd problems happened at the same ground in 1987 and 1988 but the host club, the Football Association, the police and local authority turned a blind eye with the horrific outcome for those 96 brave and bereaved families.
On a lighter note, referee Clive Thomas gave the most ridiculous penalty in the last minute to Wolves when Spurs were winning 2-1. The replay took place at Highbury and we won 3-0 which remains one of my best memories of being a Spurs supporter.
While reminiscing about 1981, I’ve followed with tremendous admiration the 27-year campaign for the truth to be told about what happened in 1989 and for justice to be given in place of the lies and cover-ups dished out by some sections of the press and politicians.
Heroically, the victims’ families refused to be fobbed off, ignored, pilloried or rubbished by anyone.
I am not for one minute suggesting that Forum campaigns reach the scale or importance of the Hillsborough 96, but I do feel their amazing display of unity, determination and discipline shows what ordinary folk can achieve if they feel strongly enough, motivated enough and stick together in campaigning and making the case for something they passionately believe in.
The Forum, in my view, is now heading for some choppy waters and it is going to need all our time, energy and resources to combat the consequences of government cuts in funding for the local authority, which have already been felt by many voluntary groups in the borough.
That is why the Forum will be supporting the cross-party Fairer Funding for Enfield campaign (see also p9) seeking to restore some justice in the way this borough is treated by a Whitehall machine which allocates our council £496.10 per head of population while Westminster gets £917.59 per person, Hammersmith and Fulham receives £900 and Kensington and Chelsea £815 – when all the boroughs carry out the same tasks.
There is also a new and and dangerous threat looming in the funding of local health services. The Enfield NHS Clinical Commissioning Group is now under orders from above to produce a recovery plan which includes making ‘savings’ of £17.1 million by the end of March 2017 and we need to ensure that cuts of this size are not introduced at the expense of patient care in the community.
We have to make our voices heard. Compel the decision-makers whether in government or the NHS to recognise that Enfield – the 12th most deprived out of London’s 32 boroughs – needs to be treated fairly and will not be discriminated against.
And with your support we can and will make a difference.
April 2016
Time to battle for a better deal for Enfield
These se are challenging times for government – both national and local. Here we are after eight years of austerity being told by Chancellor George Osborne that he must make further spending cuts because once again “the storm clouds are clearly gathering in the world economy”. And by the time you see this Newsletter, we’ll all know what he meant.
Forget the chat about the EU referendum for a minute, all the talk is about more efficiency cuts and greater savings. Meanwhile, the budget deficit which you’ll recall was originally to be cleared by 2015 still stands at some £70billion, dimming hopes of that elusive budget surplus by 2020. And talk of balancing the economy towards exports and manufacturing is as far away as ever.
Here in Enfield, I am just staggered to read that government funding to the council now works out at £496.10 per head of our growing population. Can somebody please tell me why Westminster will be getting £917.59 per person, Hammersmith and Fulham £900 and Kensington & Chelsea £815 for carrying out the same statutory tasks?
Why is Enfield always near the bottom of the pile? And isn’t it about time that all our political parties dropped the nit-picking and got together with our three MPs, local businesses and the voluntary sector to lobby, demonstrate and had a joint deputation to the Treasury to get a better deal for Enfield? Since 2010 we have already lost more than £120 million in real-term funding from Whitehall – and almost certainly there’s more to come every year until 2020. Against this background of low funding just consider some of the problems that have to be dealt with.
We are told that 60% of Edmonton’s children are living in poverty. Enfield has the highest number of children – over 21,000 – living in poverty of any London borough. In 2015, Enfield was ranked the 64th most deprived borough in England out of the 326 local authorities and out of the 33 London boroughs we are the 12th most deprived.
I have often spoken out about giving our youngsters the same opportunities that people of my generation had, yet I’m now told that the education support grant per pupil in Enfield is to be cut by almost 12%, from £87 per pupil to £77.
I seem to recall Ministerial claims that the education budget – like defence and health – is being protected from spending cuts. But, because no allowance is being made for inflation or other increased costs, it means that some schools will have to cut their staffs and not replace the teachers so vital for the community.
We are now facing our first increase in council tax for six years which will be just 1.78% because the levy we have been paying for the 2012 Olympics will be reduced by £12 in this coming financial year and another £8 in 2017/18. But there will be an additional 2% precept imposed at the behest of the government to help meet the rising cost of adult social care.
Based on an estimated 94,317 council taxpaying households in the borough, this is expected to raise some £2 million a year and I think we have to assume that there’ll be council tax increases of 1.99 % and a social care tax of 2% every year until 2020.
Interestingly, a recent survey showed that 74% of people were willing to pay extra tax to ensure that social care workers were paid the new national minimum wage starting this month which will go up by some 7%. So most of that extra £2 million will go to meet the higher wage bill as labour costs are 70-80% of the cost of care provision.
Ray James, the council’s director of health, housing and adult social care, told the Forum that this £2 million is greatly needed, although it does not fully meet the increase in demand for, and the cost of, adult social care in Enfield. The money shrinks but the number of people being helped doesn’t budge.
“The number of older people requiring care and support in Enfield has grown by about 3 to 4% per year in recent years. What has become particularly noticeable is that not only are people living longer but they are often doing so with much more complex needs.
“In Enfield we will continue to do all we can to ensure that older and disabled people get the care and support they need, when and where they need it. Inevitably, with more people requiring support and less money to do so there are difficult decisions ahead,” he said.
I know what Ray James means about the cost and needs problems he faces for when I was having my new pacemaker checked, the man in front of me was 102 years old! And this is just one example of the consequences of an ageing society and the social and economic problems that our policymakers have ignored for decades.
Ministers see the longevity figures from the Office of National Statistics but fail to react with new and positive policies to, for example, the 72% increase in the 14,450 centenarians in the last decade – some 780 of them aged 105 and over. In the next five years, the over 65s will go up by over a million and the over 85s will be the fastest growing sector.
Here I am just entering my 91st year when I should be full of the joys of a long and good life being gloomy when I am told that the health and social care system is crumbling. And if it is bad today what are the prospects facing our young people and those with young families?
Will they be living longer and healthier lives and will they have the money to enjoy a long retirement without the final salary pensions that have now virtually all passed into history? At the same time, governments will have to find the money for mounting health and later life budgets that inevitably follow from an ever-ageing population.
A recent conference called by the International Longevity Centre (ILC-UK} warned that:
• Without action to better support more disadvantaged social groups and communities, the gap in life expectancy between the wealthy and the poor will continue to increase.
• Without action to address the current funding and workforce shortages in health and social care, the future needs of our ageing population are unlikely to be met.
• Without action to build more houses, and houses which are adapted to the needs of older people, the housing shortage will continue.
It seems to me that our decision-makers just live in hope that we oldies will just go away. All the talk about demographic change and an ageing society has been with us for 30 or more years and it is here to stay. Instead of moaning and groaning that like old soldiers we ought to just fade away, why can’t the powers that be see the benefits we bring instead of seeing us as a burden?
Monty Meth Monty MethFebruary 2016
Biggest pension rise for 15 years
The ‘triple lock’ ensures that the rise in the annual state retirement pension will be the biggest single increase since April 2001 – but this is not a time to be complacent
Thanks to the 2010-2015 coalition government’s introduction of the ‘triple lock’ (to determine whether the rate of the annual state retirement pension increase should be linked to the rise in prices, earnings or 2.5%), pensions will go up in April by 2.9% or £3.35 to £119.30 per week for a single person to match the rise in average earnings.
Less well-off pensioners will get a rise of £4.40 a week as the means-tested pension credit rises to £155.60 a week (single) and £237.55 (couple). But more than a million pensioners who are slightly better off and receive what is called the ‘savings element of pension credit’ will keep just £2 of the £3.35 rise.
This is the first time the pension has been linked to the increase in earnings since the 1970s when the link was abandoned by Mrs Thatcher’s government. It is the biggest single increase since April 2001 when the pension went up by £5 per week for single people following the rise in prices.
The Conservative government elected last May was the only major political party to pledge both the continued support for the ‘triple lock’ link to pension increases and to maintain the current band of universal benefits for pensioners, though it is shifting the near £700 million cost of free TV licences for the over 75s to the BBC until 2020 - and there’s no guarantee what happens to free TV licences after that.
And we do not lose sight of the fact that at the same time as the Cameron government is doing the right thing for pensioners, it is hitting the working poor with cuts in their already low living standards, thus adding to the inequality, despair, frustration and hardship for millions of families.
And, according to the economic forecasters, the coming year will see earnings growth pegged back to around 2%, so next year’s pension increase is likely to rely on the 2.5% guaranteed by the triple lock. And just seven days into the New Year we saw Chancellor Osborne warn that Britain’s fragile economy faces a "dangerous cocktail of new threats".
Politicians from all parties must have been embarrassed when they read a recent report from the Organisation for Economic Co-operation and Development (OECD) which said that British pensioners faced almost the worst fall in income in the world when they retire. An average UK worker relying on the state for their pension income receives about 38% of what they had been earning. Only workers in Chile and Mexico fared worst.
The OECD said that Britain spends just 5.6% of its total income on public pensions compared with an average 7.9 % by other developed countries. But the politicians will no doubt argue that this excludes the cost of universal benefits such as the Freedom Pass, free prescriptions, winter fuel allowances. free eye tests and TV licences for the over 75s.
It is because the continued maintenance of these universal benefits are subject to the whims and decisions of individual politicians – and are not subject to parliamentary legislation like the state retirement pension – that we need to be on our guard against those who constantly seek to attack these benefits.
So, as we can now see that the government is sticking to its manifesto pledge to maintain universal benefits, it would be churlish on our part not to publicly place on record our thanks to the three Enfield MPs in the 2010-15 parliament, Nick de Bois, David Burrowes and Andy Love who met Forum deputations and we know they pressed the Chancellor to maintain the full range of universal benefits.
We also thank those who supported our 8,000-plus petition to the MPs and particularly those who collected signatures in the borough because it is worth recalling that it all helped to secure the benefits we are now receiving.
There is no doubt that before this Parliament ends in 2020 we shall be called upon to campaign again to defend what we have won — not just for ourselves but for all future generations of pension
Monty Meth
Social problems facing us in 2016
This may seem a little early to thank all our Forum members – and some 10,000 Newsletter readers – for the tremendous support given to the Over 50s Forum this past year, and to wish you all well during the coming festive season, but this is the last newsletter until February 2016.
So what can we look forward to in the coming year? I think a major public debate is desperately needed to seek a broad consensus on the many social problems facing all age groups and all communities right across the country starting with health and social care that should be guaranteed to every citizen, from the cradle to the grave, free whenever it is needed.
Our
three main political parties are great democratic institutions but of each
of them it surely can be said that they
make promises that are then not kept. In the absence of a written
constitution and a bill of rights we have no reference point; no guarantees
that services or benefits cannot be changed or cancelled at the whims of
this or that politician.
At this year’s political party conferences, we heard appeals to look for the best in people, not the worst; that everyone should be treated as being of equal value and that people always achieve more together than they do when they are at each other’s throats.
We heard pleas for kinder politics, for less personal abuse, but I would suggest this can only be achieved if there is agreement across the board to cut out the insults and knockabout Punch and Judy stuff.
So where would I start? Seldom, if ever, have I felt more angry, sick and frustrated as I was when I read that homeless young people in London unable to find beds in emergency hostels, are being given bus tickets by a charity allowing them to sleep on all-night buses. The number now sleeping rough in London is far greater than hostel places for the homeless.
St Mungo’s, a charity that I and other Forum members help to support, reports that the homeless numbers have increased in London by 55% since 2010 and it will get worse due to rising rents, cuts in benefit allowances and reduced funding for the homeless charities. Surely, acting together we can do better than that, but not I fear when housing benefit is removed from all 18-21 year olds come next April, when we are warned this will create yet more homeless people.
Or take the sudden interest our politicians are showing in the need to build more houses. First we encouraged the sale of council houses and prevented councils spending their income on building replacement homes. Then we encouraged foreign investors to come into central London and buy up blocks of land, driving out local people. The result: There’s a three bedroom so-called affordable flat in Hackney priced at £1million – and that’s classed as “affordable” because it is priced at less than 80% of the marketable rate.
Any day of the week you can pick up a newspaper and be greeted by headlines such as: “NHS is like a train just before a crash” or “Hospitals run up debts of almost £1 billion” above reports that two thirds of hospitals are now in debt and warn that many are getting into deeper financial trouble with a deficit of more than £930 million in the first three months of this year alone.
Hospitals granted the coveted Foundation Trust status – the so-called gold standard of excellence – have accumulated a deficit of £349 million. This is 35 times the £10 million they were expected to show and all the Department of Health appears to say is that these trusts need to get better at balancing their books!
Against this background, all we hear from Ministers is the need for the NHS to achieve two targets. Firstly, to secure £22 million of savings by 2020 and secondly to have GPs available throughout the country seven days a week from 8am till 8pm. No matter how absurd and unrealistic the targets are, Ministers keep up the pretence that things are getting better.
They are not so rosy if you listen to Andrea Sutcliffe, the chief inspector of adult social care, who has warned that huge cuts in funding and failure to deal with a rising ageing population have left the social care sector under stress and strain with £4.6 billion being cut from social care budgets in the last five years – and introducing the new minimum living wage will only add to the crisis unless government helps to bridge the financial gap.
So this then are just some of the social problems facing us in 2016 which will need to be tackled across the political divide if we want to enjoy not just a longer life, but a longer and healthier life which has always been a top Forum priority.
Predictions that we used to see about youngsters born today living to be 100 are now being regularly upgraded. We have now gone from living to 100 to today’s newborn working until they are 100 years old and living till they are 120.
So on that note I think just wishing you all a happy and healthy 2016 will have to suffice as being more realistic.
Monty Meth
Dividing the generations is dangerous
The Forum campaigns for the rights of older people – to protect the pensions and benefits for both today’s and future generations. But we do not believe this means that younger people should be denied the new Living Wage and face other forms of discrimination.
Should we be angry by the way the recent budget is dividing the young from the old? Does it reflect the way so many politicians are out of touch with ordinary families? What possible justification can there be for excluding the under 25s from the new National Living Wage starting next April? Do our politicians really understand how hard it is for young people to make their way in life with a good job, decent pay and the chance to own their own home, as so many of us aspired to when we were in our early 30s ?
We are, of course, grateful for the triple lock that guarantees our state pension will increase by at least 2.5% for the next five years – or by the increase in average earnings or prices if they are higher – but why scrap the maintenance grants for less well-off students worth up to £3,800 a year? We couldn’t live without our Freedom Pass which you will see expires on 31 March 2020, but why does the government intend taking away the housing benefit from all 18 -21 year olds even though charities all warn it will lead to an increase in homelessness? We would be angry if we lost our free prescriptions or winter fuel allowance, but why will the new national living wage – which they say will be £9.35 an hour by 2020 – not kick in until you are aged 25? Why not at 18 or 21 when youngsters need all the help they can get and when they are old enough to fight and die?
Today’s over 55s are said to be the home-owning generation, as younger people struggle to buy and fear higher mortgage payments are on their way – only 40% of 25 to 34 yearolds are now buying their own homes compared to 67% in 1991. If we ‘oldies’ feel like the “I’m alright Jack, never had it so good” generation having for the most part enjoyed full employment, access to pensions and seen our house values increase, how must the under 25s feel with the way they are being treated by the recent budget when there seems to be so little fairness between the older and younger generations?
There is now a think tank called the Intergenerational Foundation charged with researching fairness between the generations. It says they are shocked by how much the government is building up intergenerational tensions. Previous governments have also done it, but this budget has been particularly harsh on young people, and particularly generous to older people, they say. Since 2010 there has been a 10% reduction in young people’s prospects across a range of measures including housing, education, health, income and debt, says the Foundation, which adds that we are piling debts on young people while denying them the prospect of buying their own homes. And the number of jobless young people is three times higher than in Germany. So are we witnessing a new form of discrimination based on age against our under 25s? And, if so, could it be related to the recent general election showing a 78% turnout of the over 65s compared with mere 43% for the 18-25s?
It is, however, crucial that the idea of older people having escaped the effects of austerity at the expense of the younger generation is not allowed to be accepted as fact – not when the latest figures from the Department of Work and Pensions show that almost two million pensioners are still living in poverty with an income less than 60% of that enjoyed by the rest of the population. We should not forget the staggering amount pensioners pay in direct and indirect taxes to the government, such as VAT, council tax, tax on insurance for cars, homes and travel etc and now the windfall from cashing pension pots.
It is estimated to account for more than 30% of pensioners’ incomes or £47.26 billion last year and equal to £6,500 a year from retired households. By April 2019, the Treasury expects the taxman to be taking almost £51 billion a year from pensioners. Remember too how the uprating of the state retirement pension was changed from the Retail Prices Index to the Consumer Prices Index – resulting effectively in a 1% cumulative cut every year which adds up to a fair old whack over a lifetime.
Enfield needs community participation
Collaboration between the council and the community is key to the success of Enfield, says Rob Leak, Chief Executive of Enfield Borough Council. And that collaboration needs to include all sections of the community, he told attendees at the Enfield Borough Over50s Forum’s AGM at the Civic Centre in May, where he gave a personal view on the future of the
“If some people lobby for their position and the rest of the community is silent, than that one voice prevails. We need to find a balance for the good of the community. The political body works better where a wide range of people are vocal.”
He admitted that, as we all know, money and resources for the council are declining, so the council is in the process of “simplifying in order to create better services that cost less”. As part of this ‘journey’, the council is reorganising to reduce the number of ‘silos’ which result in residents being passed around between different people and departments when they are looking for information.The aim is that no resident should have to speak to more than three council people. Under the present system, the record was 38. Rob Leak said, with some understatement: “We realise we need to be much more listening, open and transparent.”
He says there are a lot of good thing happening in Enfield but he admits that in the future there will not be the money “to provide the width and depth of social services that we do now”. The rapid increase in Enfield’s population also poses challenges. It has grown to 320,000 compared with 270,000 people 12 years ago. And the population could rise to 350,000 by 2020.Therefore the council needs the community to get involved in making the really difficult choices that are ahead. The role of the community is to:
1) articulate the need and 2) positively help the council in very difficult circumstances to make the choices that are the best for our community.
Monty
Meth, Forum President’ echoed Rob Leak’s call for more community
participation. He made the point
that people also needed to make their views known to their MPs as so much of
the funding for services is controlled by Parliament. “Look
at the example of the Public Health money allocated to Enfield compared with
other boroughs. We need people to write to newspapers and to their MPs. We
are not angry enough!”
Rob Leak commended groups like the Forum for making sure that people’s voices are heard. “Lobbying is the main thing. Voice is what works in a democracy. No voice equals no democracy. And the voice needs to be long-term and persistent – that is what wins through.”
May/June 2015 Public
health deserves fair funding The
government grant awarded to Enfield Council – the body charged to deliver
a wide range of services to raise health standards in the Borough –
remains unchanged from last year. The government
grant for Enfield public health for the 2015/16 finanical year will be
£14.257 million. This is 13.6% below the accepted target figure set for
Enfield in Whitehall which takes into account the relative needs of Enfield
residents.The Enfield allocation works out at £43 per head compared to, for
example, £133 per head for Kensington and Chelsea residents, £114 per head
for Hammersmith and Fulham, £84 per head in Lambeth and £68 in Haringey. The House of
Commons Select Committee on Public Accounts, in one of its last reports
before Parliament was dissolved on 30 March, commented that by not
changing the distribution of money, the Department of Health was not getting
local Public Health bodies to their target allocations quickly enough and
the present funding inequalities were persisting. It warned that if the
next government did not ring-fence future grants there is a risk that
spending on Public Health will decline as councils come under increasing
financial pressures. This means the twin aims of strengthening Public
Health’s capability in all local authority areas to tackle health
inequalities and reduce the burden on the NHS would be undermined. In its
first year of operation, the grant awarded to Enfield Council was
19.7% below the target allocation needed. Its many tasks included
tackling obesity, smoking, drug abuse and heavy alcohol drinking; promoting
physical activity, a healthy diet and sexual health, and to support the
wellbeing of our children – especially the ones with greatest needs. Enfield
Council’s Public Health team recently produced an excellent annual Public
Health report called ‘Mind the Gap: Reducing the gap in life expectancy’,
which presented detailed information on the battle to reduce inequalities in
the Borough and outlined the partnerships the Public Health team have formed
with a range of organisations including UCL Partners, the Academic and
Health Sciences Network, the British Heart Foundation and Cancer Research
UK. The report also presented the
success of the strategy to date. Over 3,500 more Enfield residents have
their blood pressure under control than in 2008 and smoking prevalence is
down to 15.8% (about the same as New York). According
to Public Health England’s Longer Life tool, Enfield has the lowest
premature mortality of its peer group of 15 local authorities. The annual
Public Health report described increases in life expectancy in the Edmonton
area, with a major reduction in inequalities for women in Enfield. Although
the coalition government repeatedly claimed that it increased the health
budget between 2010 and 2014, this clearly excluded the Public Health
segment of the health service in Enfield. So
we can give notice to Enfield’s incoming MPs that this is an issue high on
our post-election agenda. March/ April 2015 Where should Enfield cut costs? Enfield
Council is facing a difficult time as it attempts to set the budget for this
year and deliver a plan for a four-year balanced budget. "We
are looking at all aspects of the budget to increase efficiency but we need
to make savings of £80 million over the next four years,"
Doug Taylor, Leader of the Council,
told Forum members at our monthly Civic Centre meeting in January. The
plan is to cut £35m this coming financial year and then £10-15m in each of
the following three years. The Council’s current budget is £253m net, so
it is obvious that difficult decisions need to be made. To help the
audience understand the problem, everyone was given a list of the council’s
main ‘service expenditure items’
and asked to indicate where they would make cuts. There were 30 services
with options to reduce 1) not at all, 2) not very much, 3) to some extent or
4) a great deal. It
soon became obvious that it’s a tough choice. Is it better to cut support
for children and young people in care or funding for adults with mental
health issues? Street cleaning or leisure services? Food safety or trading
standards? Or cut all of those and maintain funding for something else like
housing or services for older people? One member of
the audience asked if it was possible to simply cut the same percentage
across all services. Andrew Stafford,
Cabinet Member responsible for finance, explained that wouldn’t work as
the level of cuts needed would leave some services unviable. And the council
also has statutory requirements to maintain some services at certain levels. Andrew
also pointed out that no authority had attempted a referendum. "Council
tax is not popular as you get sent a bill and have to pay it. People don’t
seem to view increases in income tax or VAT in the same way." The
council is making efforts to increase efficiency, including joint
procurement of some outsourced services with Haringey and Waltham Forest and
moving more services online."We
benchmark against other boroughs and continually look for suggestions –
including from the borough’s residents – to help us balance the budget.
It would be particularly good if people came up with some big ideas and more
creative ideas," said Doug. But
he admits it is a no-win situation. "Reductions
in funding from central government mean councils are going to make cuts that
impact on services. We are just trying to consult as widely as possible so
that we know the residents’ priorities and concerns." Of
course, it is not all doom and gloom and we should remember there are many
projects being undertaken to improve the lives of Enfield residents. For
example, the council has built a new combined medical centre, library and
community facility at Ordnance Road (an area where 50% of residents are not
registered with a GP) and will spend money on a new Eco-park in Edmonton to
help cut air pollution in an area of low life expectancy. We should also
celebrate the fact that we still have 17 libraries in Enfield, more than any
other London Borough. January/February 2015
Enfield Council is
still underfunded to deliver public health, especially in contrast to other
London boroughs.
Forum members attending a budget workshop gained a better
understanding of the tough choices facing Enfield Co
Council tax contributes about £100m (30% of the budget) and the level has
been frozen since 2009/10, so maybe that could be raised, someone else
asked. But that is not the answer either. At the
moment, central government contributes the equivalent of what would be
raised by a 1% increase. Councils could raise council tax by up to 1.9% (if
agreed in a borough-wide referendum) without incurring any penalties, but
would then lose that 1% contribution.
You’ll know the old saying: ‘Another day; another dollar’. Well, here we are entering 2015 and I reckon the same can be said of another new year. A fresh start, another set of opportunities and challenges – and some old ones too that still need to be dealt with.
We moved into Enfield back in 1962 the same year as American country singer Wynn Stewart released his single: ‘Another day, another dollar; that’s what I’m working for today. Another day, another dollar; sure can’t buy my blues away’.So the start of another New Year is a good time for me to reflect on these last 52 years in Enfield and, more importantly, to think about what lies ahead for our children, grandchildren and even great grandchildren – and similar thoughts, I’ve no doubt, will be crossing the minds of us all at this special time of year.
In just over four months time we’ll be having a general election and I’d like to think it will set the agenda for the next decade or more, so making this a year to remember. An election year that will set the scene for the kind of country we want our offspring to grow up in and enjoy, just as so many of my generation have experienced. Full employment, pay rises every year, the chance of owning your own house – contrast this with the prospects facing many young people and young families today. Imagine what it must feel like working on a zero hours contract, not knowing how much income you will have this week, next week. No sick pay, no holiday pay, no company pension to look forward to.
A recent survey by the insurer LV revealed that young people expect to have as many as nine jobs over their working life – twice as many as their grandparents. The ‘jobs for life’ concept has become virtually extinct – and they can expect to work well into their 70s.
The Trades Union Congress claims that only one in every 40 new jobs created since the recession began over five years ago is for a full-time employee – most new jobs have been part-time or for the self-employed. While the older generation bemoan the low income currently earned from our savings, young families fear an increase in the very same interest rates would see them struggle with mortgage payments.
I suppose there have always been scandals to rock our confidence, but I can’t recall the Daily Mail ever running a front page headline like ‘Why aren’t these crooked bankers in jail’ when the Financial Conduct Authority merely fined five banks £2.6 billion for driving down the value of the pound against the dollar and rigging the foreign exchange market against not just the big multinationals, but the likes of you and me.
What message does this send out to the next generation struggling to make headway? Do you think we have got our priorities right when we are supposed to have cleaned up the banks after they needed £150 billion of taxpayers’ money from across the world to keep them afloat, while people endured six years of economic recession and austerity?Just when we thought we were on the road to recovery, the warning lights are said to be flashing again on the global economic dashboard and the Financial Times in its main editorial on 11 November said: ‘None of the major parties has come close to setting out an answer to Britain’s fiscal dilemma. At the very least, they should come clean with voters about the nature of the questions that need answering’.
So, if 2015 is really going to be a landmark year – an agenda setting year for the next generation – I’d ask the next government whether they can ignore the largely unreported findings of the Intergovernmental Panel on Climate Change that the world has just 16 years to avoid a carbon emissions calamity.Now, in case you feel I’m straying into forbidden territory, can I say that from the day we became the Over 50s Forum we’ve always said we are ‘non-party political’ – not ‘non-political’.
The difference is that as a Forum we do not support any one political party, but we reserve the right to comment on matters that are deemed to be political, because it is politicians and governments that make the policies we are concerned with. Whether this be on pensions, or the health service, or universal benefits such as the bus pass and winter fuel allowances, free prescription charges and free TV licences for the over 75s.
And it is local government – our councillors – that decide on a vast array of services in Enfield ranging from care for the elderly and people with disabilities and mental health problems, to libraries and leisure centres; from housing the homeless to repairing roads and footpaths – all matters of concern to the older people we seek to represent.
Elsewhere in the January/February 2015 Newsletter you will see how we have had a very friendly and productive dialogue with Enfield’s three MPs and we are now having the same discussion with the council on its 2015-16 budget. All of them regard the Forum as an important non-party political voice of older people in this borough and so I hope this understanding will continue during the years ahead, because there is still so much to do if our hopes that the next generation will do better than us is going to be achieved.
November/December 2014
What’s my crystal ball saying?
The festive season is fast creeping up on us and 2015 is just ahead. No doubt we’re all saying “where did 2014 go and what will the New Year bring?” Well, we do know there’s going to be a general election in May and, other than our birthdays making us all a little older, there are a few other things we can be sure about.
I’m no prophet but you can be pretty sure that the NHS will stumble from crisis to crisis as its financial problems get worse and waiting lists get longer – and now there’s some wiseacre reported in the Daily Telegraph (10 October) saying that the money to pay state retirement pension will run out in a year or so.
But let’s first have some better news – but only if you are already a home-owner or have a mortgage to buy one. Britain’s biggest property website called Rightmove has predicted that of all the boroughs in London, Enfield will see the greatest increase in house prices over the next five years.
It says average prices in Enfield will rise 39% from £381,000 to £531,000 - equal to an increase of £575 every week for the next five years. The report claims to be “the most comprehensive house price forecast of its kind ever created based on property and economic data, rather than opinions and short-term market factors.”
While existing homeowners may believe they are in line for a windfall, people in rented homes and young families striving to get on the homeowning ladder, will want to hear about more homes being built at affordable prices – not just promises – and not that interest rates and their mortgage payments will go up next year.
To counter this news, which will please some and yet increase the inequality divide between different communities and parts of Enfield, we have another prediction from a so-called influential think tank, the Centre for Policy Studies (CPS), that the Government’s cash reserves, funding state retirement pension payments will run dry next year.
To add to the worries of younger people, the CPS claims to have discovered a “serious flaw” in the National Insurance Fund that will mean future state pensions will be “derisory” unless urgent action was taken. It even suggests that the under-35s should be prepared for the state pension to be scrapped.
I’m told that in the 1980s, the National Insurance Fund regularly received a Treasury grant because there wasn’t enough in it to pay people - but nobody ever claimed it was unsustainable. The fund still has a surplus - not as big as it once was, but bigger than in the ‘80s. During the recent recession obviously less National Insurance payments went in and more unemployment benefits went out.
It strikes me that some of these research reports are so much poppycock designed just to get their name in print. Take this story in The Times (11 October) which said that men with large feet are more likely to have extramarital affairs than those with average feet taking seven to nine shoes – so I’m in the clear then. I’m a size eight!
IllicitEncounters.com – a dating website for married people – claims to have polled 3,128 men and found that those with feet above size ten were more than three times more likely to stray than men with smaller feet - and to prove it they quote Bill Clinton ( size12), Tiger Woods (size 10) and Hugh Grant (size 11) as love cheats with big feet.
Not to be dismissed so lightly, however, are the warnings coming thick and fast from think tanks, surveys, polls and letters from medical experts all warning that the NHS and social care services are at breaking point and things cannot go on like this. An NHS deficit of £30 billion is predicted by 2020 – a funding black hole that has to be filled if we are to keep pace with a growing and ageing population.
So are we surprised when The Times runs a front page story (13 October) headlined: “NHS reforms our worst mistake, Tories admit.” It goes on to say: “Senior Tories have admitted that reorganising the NHS was the biggest mistake they have made in government. David Cameron did not understand the controversial reforms and George Osborne regrets not preventing what Downing Street officials call a ‘huge strategic error’. The prime minister and the chancellor both failed to realise the explosive extent of plans drawn up by Andrew Lansley, when he was the health secretary, which one insider described as ‘unintelligible gobbledygook’.”
It is what our Forum has been saying ever since the coalition government, which promised “no top down reorganisation”, floated the Health and Social Care Bill which became law. And this will be at the top of our agenda when the Forum meets the three Enfield MPs at separate meetings in Westminster on 5 November.
And it will remain at the top throughout 2015 as we campaign to ensure that we leave to future generations an NHS still true to its founding principles of healthcare for all, provided according to need and not the ability to pay.
Over 50 – time to start a second life
Reports issued by the Office for Budget Responsibility (OBR) are not the best leisure time reading, but they do contain some information nuggets well worth digesting. The OBR was created by the Chancellor, George Osborne, as the independent watchdog of the country’s economy. What it says about the future often determines government policy today – or it should do.
So when the OBR talks about "demographic pressures" it means us – you and me – and when it warns that by 2064, 27% of UK citizens will be 65 and over, compared with just 12% in 1961 and 17% now and that the number of over 85s in Britain will almost quadruple in the next 50 years, with one in 12 of us pushing towards 90 – you can guess what’s coming.
For the OBR this is not good news. To them it’s a problem. And we partially solve it by raising the state pension age to 70. And if, as seems likely, the ageing population is greater than the planners envisage (they are forecasting a million people in Britain aged over 100 by the 2050s) then the state pension age will be 75 or even higher.
Notice how it is always a flat rate, across-the-board retirement age that is proposed. No mention of a flexible retirement age depending on your state of health or the type of work you have been doing.
On the one hand we are now being told that old age begins at 80 for our generation – 20 years later than in the 1950s due to people following a healthier, more active lifestyle and working later in life. We are also told that the peak age for gym use has reached 66, with that age group working out 20 times more than teenagers.
With fitter bodies, more active minds, a get-up-and-go spirit, it is said that a new "second life" awaits the over 50s who are now making an annual contribution to the UK economy of £300 billion. Over 50s women alone spent £6.7 billion last year on "fashion", it is said.
Yet there are some media pundits and politicians who brand us as the have-it-all generation. They want us to "curl up and bust", retire and go away. They need to be continually reminded that pensioners are an asset, not a burden to this country.
Nearly two million grandparents, for example, have given up a job, reduced their hours or taken time off work to care for grandchildren, according to an Ipsos Mori poll commissioned by Grandparents Plus, Save the Children and the Family and Childcare Trust.
Some 40% of grandparents who look after their grandchildren – approximately 2.3million people – say they do so to allow the child’s parents to get to work and 17% – nearly 1 million – do so because parents cannot afford childcare.
Back in the 1980s or thereabouts, employers up and down the country could not get rid of their "older workers" quickly enough. Voluntary early retirement was the norm and the company that employed anyone over 50 was the exception. Now they are begging us to work till we drop.
Moody’s, the United States-based credit ratings agency on which governments, banks and businesses depend for financial guidance, is warning that from 2020 economic growth will be 0.9% lower across the world because of "ageing populations", meaning less trade and wealth will be generated.
In the 1950s, life expectancy was about 66 for men in Britain and 70 for women. Today, the figures are closer to 79 and 83 respectively with big increases in costs for pensions and health care needing to be largely met by a shrinking working age population.
To bridge the gap the OBR made one suggesti0n that won’t please the politicians especially with a general election on the horizon. They dare to remind us that the more working age immigrants we have coming in and generating more consumer spending power and taxation revenue to the government, the easier it will be for the rest of the population to meet this "ageing revolution".
Successive governments have known what was coming. Back in 1989 – 25 years ago – I was involved with a Carnegie UK Trust research project which identified a new phenomenon – the growing number of people in their Third Age which we identified as being between 50 and 74.
The politicians failed to consider, let alone introduce, policies that could meet the needs of a super-aged society. They pigeon-holed the problem, passed the buck to their successors, with the result that too many people today have a fear of growing old.
They need reminding that every year pensioners add £40 billion more to the economy in taxation than they take out in benefits. This is the message the National Pensioners Convention will be sending out both on the United Nations’ Older People’s Day on 1 October and when it lobbies Members of Parliament on 5 November.
July/August 2014
On
21 May – on the eve of the recent local council elections – the Enfield
Gazette & Advertiser ran a double-decker headline right across the page:
‘Cameron
promises funds for primary care after hospital services removed’.
What
funds and when was not disclosed. Whether Mr Cameron is confused by the
4.35% increase in funding previously awarded to the Enfield Clinical
Commissioning Group (CCG) is unclear. But somebody should tell the Prime
Minister that Enfield CCG is still under-funded by £20 million a year and
that money for primary care is allocated by NHS England and there’s been
no sign of more money for Enfield GPs.
Speaking
recently to a director of NHS England, I was told how frustrated they are
with government announcements being made without any consultation. For
example, when answering Prime Minister’s Questions in Parliament on 13
May, Mr Cameron said there’s now a named GP for frail and elderly
patients. Now what’s that old saying about ‘the
wish being father to the thought’?
Somebody
should have told Mr Cameron that the plan announced last January to
introduce named GPs for all elderly patients from April had
been delayed.
We are now told that GPs have been given until 30 June to inform all their
patients aged
75 and over
who is their ‘dedicated
GP personally accountable for their care around the clock’.
After
30 June, every patient reaching the age of 75 must be notified of their
named doctor within 21 days. The named accountable GP will “deliver a
multi-disciplinary care package that meets the need of the patient, ensure
that the physical and psychological needs of the patient are recognised and
responded to by the relevant clinician in the practice; ensure the patient
aged 75 and over has access to a health check”.
So
if you are aged over 75 and have not been informed of your named GP, please
ask your surgery why they are lagging behind. If you get no satisfactory
answer, please let the Forum office know your name and that of your surgery.
In
his interview with the Enfield Gazette & Advertiser, Mr Cameron also
said that plans to increase GPs hours across the country would help fill the
void left by the closure of the A&E department at Chase Farm Hospital.
Perhaps
somebody should tell the Prime Minister that Enfield CCG did not get any of
the £50 million Prime Minister’s Challenge Fund to improve GP access. A
wide variety of ideas are to be trialled including longer opening hours,
better use of technology, appointments through e-mails and video
consultations and more flexibility with access.
GP
practices in Barking and Dagenham, Havering and Redbridge were the only
London surgeries awarded new money to improve access to primary care. They
will offer weekday appointments between 6.30pm-10pm, with extra urgent
appointments at the weekend, in addition to normal GP opening hours.
Meanwhile,
the Royal College of General Practitioners (RCGP) representing GPs is up in
arms and warning
that our local surgeries are ‘teetering on the brink of collapse’.
It is claimed that the government raided the GP budget to help pay for the
reorganisation of the NHS that was not in any political party manifesto for
the 2010 general election – and so nobody voted for it.
GPs
claim they receive just 8.39% of the NHS budget although they have first
contact with 90% of NHS patients. Although doctors at the recent British
Medical Association conference rejected the idea of charging patients up to
£25 to consult their GP, it was a sign of the growing financial crisis
facing the NHS.
Not
so long ago, Lord Warner, the former health minister, proposed a £10 a
month membership fee to save the NHS from bankruptcy.
I
repeat, our own CCG is under-funded by £20 million a year. The NHS still
faces a challenge to save £30 billion by 2020. The Trust Development
Authority, which oversees
all hospital budgets, is said to be running a £240 million deficit and
another NHS quango, Monitor, is seeking budget cuts at hospitals awarded the
coveted foundation status.
The
NHS used to receive a real increase in funding – that is above inflation
– of some 3% a year. It is now regarded as a special case by getting an
increase in government funding tied to inflation – 2.41% last year – but
not enough to cover rising demand by an increased and ageing population when
costly new treatments are becoming available.
Mr
Miliband says that he will see we all get a GP appointment within 48 hours,
without telling us where the money and staff is coming from to meet the
bill.
The
NHS model we have grown to love and admire can, in my view, only be
sustained with an injection of new money year on year. It
is something that should be at the top of our general election agenda come
2015.
Monty
Meth
May/June 2014
Can
we be trusted with our pension pots? From
April next year, pensioners will no longer be forced to buy an annuity with
their pension savings. Is this a sensible way to treat grown-ups, or will it
lead to large-scale pensioner poverty? Lord
Turner,
the former head of the Pensions Commission and the Financial Services
Authority, says that Chancellor George Osborne’s decision to hand retirees
the freedom to withdraw their entire pension pot in cash from next year
means many could squander their savings. (Sunday
Telegraph March 30) “There’s
a danger that people don’t realise how low the state pension is.
Fundamentally, when the state single pension comes in, it will keep people
out of absolute poverty, but they need to know that’s all it does.”
He says the move risks leaving millions of pensioners close to poverty in
later life. George
Osborne said people should be trusted to make the right financial decisions
– it was their money and up to them how they decided to spend it. Pensions
minister Steve Webb said it was people’s choice whether to buy Italian
Lamborghini sports cars but later admitted that the average pension pot was
£25,000 so “not
many people will be buying sports cars”. “It
is people’s own money,”
he said. “We
are not going to cast them adrift. We will guarantee them guidance,
information, education but ultimately we are making sure they have a decent
state pension but if they want to spend their money sooner rather than
later, we are treating people as adults.” We
fight for fairness
Pension changes will give
future generations more choice, but they do not benefit the majority of
today’s pensioners Despite
all the recent happy, clappy headlines about a ‘pensioners
bonanza’
and a ‘pensions
revolution’,
this is the right time to remember that today’s 11 million-plus pensioners
were not the big winners from the March budget. In
fact, we have been the big losers from the coalition government and Bank of
England’s decision to keep interest rates low for the last five years. True,
that from January 2015, if you are aged 65 and over and have £10,000 to
spare, you will be able to buy a new “pensioners bond” with an expected
interest rate of 2.8% for a one year bond and 4% for a three year bond, but
the interest is taxable. That’s it, for those of us now collecting the
state pension. The
idea that all older people have vast amounts of money just waiting to invest
doesn’t take into account that 29% of pensioner couples have less than £1,500
to their name. Record
low interest rates of 0.5% set by the Bank of England have deprived savers
of £326 billion, says the campaign group Save Our Savers. And the National
Pensioners’ Convention says that 55% of all pensioners receive less than
£10 a week income from savings because interest rates are so low. Budget aimed at 50 and 60
year olds Yet
lazy press and radio commentators glibly talk about today’s pensioners
being the budget “winners”
when with a general election now just one year away the budget was really
aimed at the next generation of pensioners – people now in their 50s and
60s who from April 2015 will be given the chance to decide for themselves
what to do with the pension money they have invested to provide an income
for their retirement. Big
deal! Before
we throw our hats in the air, let’s place on record what today’s
pensioners have lost. The
freezing of the age related personal tax allowance for pensioners is to
continue for at least another two years – and indeed, it may never be
restored, if the Treasury introduces just one ‘fits
all’
personal tax allowance. Additional
support for pensioners through the tax system introduced by Winston
Churchill in 1925 have virtually been wiped out, saving the Chancellor £3.3billion
by 2016-17 – and costing pensioners between £285 and £322 a year after
tax. Increases lower year after
year The
coalition has also changed the inflation measure by which state pension
increases are calculated from the Retail Prices Index to the lower Consumer
Prices Index, ensuring that pension increases will be lower year after year.
And remember, pensioners pay council tax and the VAT man’s 20% on
virtually all goods and services we buy. The
placing of universal pensioner benefits – other than the state pension –
such as the winter fuel allowance, free TV licences for the over 75s and
concessionary travel in what is called the ‘welfare
spending cap’
means that the best that can be hoped for is increases matching the rise in
inflation, though gas and electricity prices are expected to grow much
faster. Older people twice as
likely to vote So,
because older people are twice as likely to vote as younger people, come the
general election, to give the impression that today’s pensioners gained
from the budget at the expense of younger people is something we have to
vigorously reject. Though
this may well be the reason why David Cameron was again reported in the
press on March 25 as suggesting that pensioner “perks”
would be protected if the Tories win the coming general election. I
can think of many reasons why the changes in pension rules – so acclaimed
by the media and politicians – may have been announced. If people withdraw
their pension pot to pay for the social care they may need in later life,
that will relieve the government of some of its immediate responsibilities. Unemployment high amongst
50+ Another
reason for the pension changes may be to deal with the problem of
unemployment – currently 393,000 amongst the 50+ age group who, if they
are unable to find a job, but are a long way off collecting the state
pension, may well use their pension money to fund the gap years. So
many people, said the Sunday Times (March 23) are expected to “exercise
the new freedom”
to take their pension money that the Treasury is predicting a £3billion
increase in tax revenues from pensioners from 2015-18 because 75% of the
withdrawn pension money will be taxable. The
truth is that nobody really knows how many people will take their pension
savings, how quickly they will blow them, how long people will live for and
how many will end their days on a state pension worth less than a third of
average earnings and unlikely to get much better Our
state pension remains one of the worst in Europe, It has been kept that way
by successive governments who preferred to hand out a winter fuel allowance
or a free TV licence, which can be withdrawn at any time, rather than have
an adequate state pension paid to everyone based on the financial
contributions made through national insurance and the contribution made to
creating the seventh richest nation in the world. By
Monty Meth March/April 2014 Hands off universal benefits David
Cameron’s promise to retain the “triple
lock”
protecting the state retirement pension for the life of the next parliament,
means that both our main political parties are now guaranteeing to increase
the basic rate pension by the highest of average earnings, average price
increases or 2.5% until 2020. While
we thank our three Enfield Members of Parliament for supporting
the Forum’s campaign to retain the triple lock guarantee, the next
15 months will determine
the fate of the other so-called pensioner benefits – the winter
fuel allowance, free TV licences for the over 75s and the highly coveted
concessionary travel pass. Interestingly,
The Times reported on January 6 that Mr Cameron was “minded”
to renew the commitment he made in 2010 to
ensure that all pensioners
retained their benefits until 2015 - for the life of the next
parliament. There
is clearly a battle going on inside the Cabinet with work and pensions
minister Iain Duncan Smith leading the drive for pensioner benefits to be
included in the tightly controlled welfare budget. It could lead to many
benefits being means-tested to keep costs down as the pensioner numbers
grow. Labour
has already said it will embark on the slippery slope of means-testing by
removing the winter fuel allowance from pensioners with the highest income,
although it is expected to raise less than £100 million a year for the
Chancellor, It
is against this background when there is everything to fight for that ‘Hands
Off’
a new nation-wide campaign has been launched defending the need for benefits
such as the winter fuel payment and the bus pass. The
‘Hands
Off’
campaign, which has already been backed by some of the most influential
older people’s organisations in the UK, aims to safeguard benefits such as
the winter fuel payment, bus pass, free prescriptions and TV licences after
the 2015 general election. Following
comments made by the main political parties at Westminster indicating these
benefits may be under threat, the campaign will emphasise their importance
in achieving a decent standard of living for millions of pensioners across
the UK, whilst also highlighting the costs and barriers associated with
means-testing such benefits. People
of all ages are being encouraged to sign an online e-petition and to email
their local MP via the campaign website at www.handsoff.org.uk.
The ‘Hands
Off’
campaign is being officially backed by the National Pensioners’
Convention, Age Sector Platform in Northern Ireland, the Welsh Senate of
Older People and the Scottish Seniors Alliance. Dot
Gibson from the National Pensioners’ Convention said: “The
real reason why pensioners need additional benefits such as the winter fuel
allowance and the free bus pass is because our state pension is so poor. “Yet
despite this, every year older people add an extra £40bn to the economy in
taxes, volunteering and unpaid caring. Universal benefits help to keep
people active, independent, warm in their homes, healthy and involved in
their communities. “Removing
universal benefits isn’t about saving money or about stopping millionaires
from getting a free ride on their local bus – it’s about undermining the
welfare state and the principle that services should be available to
everyone in retirement. “People
who make these allegations seem to conveniently forget that many of
today’s pensioners experienced real hardship during the war years and all
of us can remember the austerity of the post-war period. Universal
benefits need to be defended not only for today’s pensioners, but for the
pensioners of tomorrow as well. “Pensioners
are tired of feeling like a burden on society; we make a huge contribution
and that surely should be recognised,”
said Dot Gibson. For
more information on the campaign, visit www.handsoff.org.uk To
sign the petition visit www.handsoff.org.uk/e-petition You
can help by: •
Visiting the www.handsoff.org.uk website •
Signing the online e-petition •
Writing an e-mail or letter to your local MP •
Following the campaign on Twitter @supporthandsoff •
Pledging your organisation/group’s official support for the campaign by
emailing info@handsoff.org.uk •
Promoting the campaign amongst your family and friends (anyone of any age
can support the campaign) Monty
Meth January/February 2014 2014 Time to start the fight back now The
bells hadn’t started to ring the old year out, never mind the New Year in,
before top of the brainwashing agenda for 2014 appeared this headline in The
Times: “Pensioners
better off as downturn hits workers hard.”
You
don’t need a crystal ball to know that throughout this year the ground is
going to be prepared by the leading politicians of all three main parties,
economists, media pundits, think tanks etc. for an attack leading up to next
year’s general election on what is loosely called “pensioner
benefits,”
as though we haven’t worked and paid for everything we have today.
According
to the official Office for National Statistics (ONS), since the banks went
bust in 2007 leaving government to bail them out with £37 billion of
tax-payers money, working households have seen their incomes fall by 6.4%,
but the income of pensioners has risen by more than 5%. Our Chair, John
Ball,
had a letter published in The Times on December 6 challenging the ONS
figures, which though correct, do not tell us anything meaningful about the
living standard of individual pensioners.
Without
questioning how the ONS figures were arrived at, or what they do or don’t
take into account, it was the cue for The Times report to say:
“Experts
(unnamed, of course) said that the figures would add weight to the argument
in favour of abolishing winter fuel payments and free television licences
for better-off pensioners. The issue of means-tested pension benefits will
be an important battleground in the next election with the main political
parties scrambling to find something to offer working households.”
So
let the battle commence.
Our campaign to defend pensioner benefits is not a selfish campaign for
ourselves; it is being fought for all future generations of pensioners, now
having to wait until they are aged 68 or 70 before joining our ranks. We
want them to enjoy a long life in retirement with financial and social
security that they in turn can pass on to their children and grandchildren.
I
don’t want them to pick up a newspaper and see headlines such as “UK’s
state pension one of worst in developed world.”
(Evening Standard 26/11/13) or “Only
Mexicans have a worse state pension deal than the British.”
(Daily Telegraph 27/11/13).
We
should all challenge those who glibly claim pensioners have never had it so
good. So
they require to claw back our “generous
benefits.”
We need to remind them that as part of its austerity cuts programme the
government has changed the inflation link for calculating increases in the
state pension from the Retail Prices Index to the lower Consumer Prices
Index, designed to produce a lower pension increase year after year. Come
April the pension goes up 2.7%. If it was still linked to RPI it would be
3.2%.
Faced
with a 0.5% bank rate for the last four years, it is estimated that
pensioners have lost some £100 billion in interest on their savings and
that more older people than ever before are being dragged into the
inheritance tax net. Rising house prices are making them liable as the IHT
allowance has been frozen at £325,000 since 2011 and will remain there
until 2018, while the Chancellor’s much-trumpeted 2007 IHT promise that it
would be set at £1million remains a dream.
And
then there’s the freeze on age-related allowances which had been in place
since introduced by Winston Churchill in 1925, before being suddenly
withdrawn last April, hitting nearly 4.5 million pensioners, while saving
the Treasury an estimated £3.3 billion a year.
Pensioners
aged 65–74 now have their age-related tax allowance frozen at £10,500 a
year and £10,660 a year for someone aged 75 and over. This will remain the
case until the ordinary tax allowance reaches these levels. Over 114,000
people signed a National Pensioners Convention-backed petition against this
cut which has led to pensioners losing between £285 and £322 a year after
tax.
We
do not doubt that the increase in life expectancy has led to age-related
increases in the cost of health care and pensions, but we reject the
simplistic, repetitive suggestion that the austerity cuts imposed on
pensioners have been negligble.
We
expect our political leaders to be more responsible than to play off one
generation against another. We expect them to recognise the economic
contribution that older people are making such as the free childcare made by
grandparents valued at £3.9 billion a year which helps six out of ten
working Mums. This is just one part of the estimated £40 billion a year we
contribute to the economy in income tax, VAT, volunteering and social care.
Cutting
the benefits of so-called “wealthy
pensioners”
is not going to meet the challenge of an ageing population when the number
of pensioners is set to grow to 16.1 million in the next 25 years. Or the
number of over 80s will more than double to 6.2 million.
Instead
of short-term cuts, we need to plan for the long-term future of everyone,
young and old. If we stick together we can win together. Monty
Meth November/December 2013 Support
our petition and show the NHS belongs to the people ‘The
NHS belongs to the people’ is the grandiose title given to a 24 page
document issued to both celebrate this year’s 65th birthday
and to alert us to the need for change if the NHS is to survive
another 65 years. There is an ageing population – the 100 Club of
centenarians has grown fivefold in the past 30 years, so there are now
12,320 men and women of that hardy generation that survived two world
wars. The
government now predicts that there will be 22,000 people over the age of 100
by 2020 and as many as 280,000 by 2050. A quarter of all children born today
are expected to live beyond 100. That’s the good news. Not so good is the
fact that longer life brings more long-term illness, more hip and knee
operations, more mental illness – and all this will cost money. Despite
the obvious and enormous challenges that lay ahead for government --
whatever its political colour – the document’s authors say: “We do not
believe it would be realistic or responsible to expect anything more than
flat funding (adjusting for inflation) in the coming years.” That
is the pessimistic, negative view of ten newly-appointed top executives now
controlling the country’s health and care services who, in effect, are
running the NHS and relieving Jeremy Hunt, the Secretary of State for
Health, of his responsibilities for seeing that our healthcare services are
able to meet the needs not just of an ageing population, but of everyone
from the cradle to the grave. Who
are the people who say there’s to be no real increase in health care
funding? There’s the chief executives of the Care Quality Commission, the
Health and Social Care Information Centre, Health Education England,
Monitor, Public Health England, NHS Trust Development Authority, NHS
England, the National Institute for Health and Care Excellence, the co-chair
of NHS Commissioning Assembly steering group and the chair of the LGA
Community Wellbeing Board. They
say they want to design a new and revitalised NHS that serves current and
future generations as well as it has served those in the past. But they want
us to accept that this can be done without any increase in funding when we
are told that Enfield has been under-funded by successive governments for
years; when the life expectancy gap is 13 years between east and west of the
borough and when we know that the new Enfield NHS CCG is already feeling the
draught in its quest for funding from NHS England to commission services at
local hospitals. That
is why the Forum has launched a petition to secure more funding in the
coming years for the Borough’s two main providers – public health headed
by the council and acute hospital services commissioned by the CCG. We
cannot really accept NHS bosses telling us that the NHS belongs to the
people with one breath and then saying there’s no increase in funding with
the next breath. We need to have our say on where the money should be spent
particularly when the government is talking about shelling out £50 billion
or is it £80 billion on the HS2 train link between London and the North –
taking 20 minutes off the journey to Birmingham. Or
should we have our say on whether we spend £20 billion up to £100 billion
on a new Trident missile carrying submarine fleet patrolling the oceans 24 x
7 all year round? Some people might even want to question the £7 million a
year subsidy given to MPs and peers to run the restaurants in the Palace of
Westminster. If
the funding allocation for health services in Enfield .is pegged with just
an inflation adjustment, cuts are bound to follow. That is why people are so
willingly signing our petition. People
can also sign the petition on line at www.enfieldover50sforum.org.uk/petition.ktm
but we need many, many more signatures to make an impact. If everyone gives
just a little time and effort we can make that vital difference to the
funding allocation for health services in Enfield – and please send your
completed forms to the Forum office. Monty
Meth September/October 2013 Help
us to secure the “triple lock” for pensioners of the future Live longer with more years of good health Add healthy years to longer lives - that’s the major campaign theme our Forum will be launching on Friday July 5 at an important conference to be held at the Dugdale Centre in Enfield Town. Keynote speakers are coming from the International Longevity Centre – UK and the new Enfield NHS Clinical Commissioning Group (CCG). Mar/April Come April 1, a watershed will be reached in the 65-year life of the NHS. So this is the right time to reflect on the burial of Enfield NHS Primary Care Trust and the birth of a completely new regime bringing changes and challenges we will all have to grapple with and understand. Jan/Feb 2013 Get
healthy, stay healthy, live longer That’s the message
taking pride of place on the Forum’s agenda for 2013. The challenge we
have set ourselves is to get many more people to see the benefit of using
exercise and physical activity as a means of achieving a healthier lifestyle A combination of
fantastic facilities available at our newly-modernised leisure centres and
an expanding programme of gyms in the park have almost certainly made
Enfield one of the top places in the country where taking exercise either
indoors or in the open air is the easiest road to better health. But are we taking full advantage of these facilities
when in many parts of the country budget cuts are forcing swimming pools and
sports centres to close? New evidence is
emerging that stepping up exercise levels among the over 50s is likely to
cut your chances of a heart attack in later life. Just two and half hours of
moderate activity a week appears sufficient to suppress inflammation in the
body and so help the heart to grow old healthily. The evidence
coincides with completion of the £10 million upgrading of our leisure
centres which is now being matched by more outdoor gyms in our parks, each
costing an average £35,000 for the apparatus and resurfacing – and they
are proving exceedingly popular while being regularly used by both young and
old. The importance of
physical exercise has been dramatically illustrated by new research carried
out by Dr Alan Gow, senior research fellow in the University of Edinburgh
Centre for Cognitive Ageing and Cognitive Epidemiolog,y, and Dr Mark Hamer,
associate professor of epidemiology and public health at University College,
London. In separate studies
they demonstrated that brain shrinkage – a key sign of memory loss and
dementia – is less with people exercising regularly and also that exercise
protects the heart. The positive long-term effects of leading an active
lifestyle also reduces the inflammation which contributes to heart disease..
Currently the
following Enfield parks now have outdoor gyms: Elsynge Golden Jubilee,
Craig, Broomfield, Ponders End and Albany (only three pieces of equipment as
part of a playground upgrade). Apparatus for Bush Hill Park and the Enfield
Playing Fields is in the process of being ordered “I believe these
Gyms in the Park are the ideal way of exercising and of course they are free
to users. It is part of this Council’s health agenda to place this
apparatus in parks where they are requested. If Forum members have any ideas
where they can be placed then please contact me
at the Civic Centre, Silver Street,
Enfield and we’ll see what we can do. The Residents Priority Fund
has been extremely helpful in funding these projects,” said councillor Chris Bond, the cabinet member for
environment. “Basic kit for the
outdoor gyms consists of approximately ten individual pieces of apparatus -
normally a mix of arm/leg/strength equipment, but the Friends of the Park
usually have the final say. The equipment is incredibly well used all year
round and probably by on average 100 users per day in Pymmes and Broomfield,
for example,” said senior
projects partnership manager James Downing. Dr Gow’s evidence
that exercise is critical for brain health is based on long-term research
involving 638 people born in 1936. Results showed that after three years
people who participated in more physical activity experienced less brain
shrinkage than those who barely exercised. Those doing more
exercise also had greater volumes of grey matter in the brain, showing that
fewer brain cells had died. Dr Gow’s findings were published in Neurology,
the journal of the American Academy of Neurology and followed MRI scans over
the three-year study. Dr Gow said: “Our
results show that regular exercising in old age is poetentially important to
protect the brain as we age.” Age
UK head of research, Professor James Goodwin, advisory board
member of the journal ‘Ageing Horizons’ at Oxford University who
also sits on the UN Agenda for Ageing panel, said this research is exciting
as it provides vital clues on the way the brain ages and how we can tackle
mental decline. “If we can
definitely establish that exercise provides protection against mental
decline, it could open the door to exercise programmes tailored to the needs
of people as they age. “We already know
that exercise is important in reducing our risk of some illnesses that come
with ageing such as cardiovascular disease and cancer. This research
re-emphasises that it really is never too late to benefit from exercise.
“So whether it is a brisk walk to the shops, gardening or competing in a
fun run it is crucial that those of us who can, get active as we grow
older,” said Professor Goodwin. The simple message being relayed to us by the health
professionals is that it is especially important for older people to be
physically active because it contributes to successful ageing. Donning those
gardening gloves, even picking up a paint brush can go a long way to looking
after your heart health. Nov/Dec
2012
Newsletter The case for universal benefits More than 7,000 people have signed our
Defend Pensioners Benefits petition – and completed forms are still coming
in. Pride of place must go to Peter Armstrong, chair of the Friends of
Jubilee Park, whose members collected more than 1,750 signatures and they
are still counting! This is by far the best response we’ve had to a
petition and demonstrates the strength of feeling in support of universal
benefits. It is time to take the gloves off, time to
make a stand and defend all pensioners against the drip, drip attacks from
the press, politicians and so-called think-tanks, all seeking to undermine
or even end entitlements such as the free bus pass and winter fuel
allowances. It is a clever campaign, seeking to lull
us into total complacency as we are all being assured there’ll be no
changes before 2015. But what happens after that? Can we get the same "no
change" assurances from the politicians that were given to
us before the last general election? It is a clever campaign in that it seeks
to pose totally false questions such as: Why should millionaires such as
Lord Sugar get a free bus pass or Sir Paul McCartney get the winter fuel
allowance? Of course, there’s no evidence that they claim these benefits,
but it is being used as a weapon to end benefits going to every pensioner
and to introduce widespread means-testing. This will really only save real money if
support is withdrawn from anyone with an annual income of little more than
£7,500. The idea that benefits should only be withdrawn from "wealthy
pensioners" is flawed. When I challenged Nicholas Boles MP,
the newly-appointed planning minister and one of the main advocates of this
change, to define "wealthy"
he replied: "currently
those earning more than £42,475 a year." But writing in The Times (October 1), Dr
Ros Altmann, director general of Saga, says only 2% of pensioners pay
top-rate tax. Even the top 20% of single pensioners have an average income
of just over £20,000 a year. The government’s own estimate given in a
parliamentary reply showed that: 6.4 million pensioners have an income below
£10,500 a year and pay no tax 4.5 million pay tax at the standard rate 94%
of pensioners have an income of between £5,200 and £40,000. So targeting so-called wealthy pensioners
alone will not produce the revenue to solve the nation’s economic woes.
The number of wealthy pensioners is being deliberately exaggerated – hence
our claim that the attack on pensioner universal benefits is in essence a
smokescreen to attack and hurt some of our most vulnerable older people. This is not a party political issue. While
coalition Cabinet ministers such as Nick Clegg and Iain Duncan Smith
publicly use the wealthy pensioners argument to attack universal benefits, a
Guardian headline (October 4) also said: "Labour looks at curbs on
universal benefits to pay for social care." It quoted Liam Byrne, the shadow work and
pensions secretary as saying: "There’s
always been a balance in the welfare state between universal benefits and
targeted benefits, and I am afraid as part of Ed Balls’ zero-based
spending review that balance has got to be looked at." Politicians of every colour must know that
the money saved in attacking universal benefits would be too little to have
any economic impact. To raise a larger sum of money the net would have to be
cast much wider and set at the level of pension credit – around £7.500 a
year. Yet it is widely acknowledged that a
means-tested system of paying benefits costs about ten times as much as
universal payments. It will require the introduction of a large army of
bureaucrats to administer the system which would eat into any savings from
scrapping universal benefits. It is also well documented that pension
credit and other benefits have failed to reach the very people they are
intended to help because a combination of pride, distrust, privacy and
complexity prevents some two million eligible people from claiming what is
rightfully theirs. In fact, £4.5 million of means-tested pensioner benefits
went unclaimed in 2008-9. And the same would no doubt apply if the
bus pass and winter fuel allowances were means-tested with the result that
yet more elderly people would find themselves becoming lonely and ill,
creating even more pressure on an already over-burdened health and social
care service - and no doubt adding to the 26,156 excess winter deaths among
elderly people in 2010-11. What about the argument that the cost of
pensions, welfare payments and health care for elderly people at around
£136.2 billion a year is too big and we haven’t taken our share of the
cuts that are mainly falling on younger families? In the national and local
taxes we pay, our spending power including VAT, formal and informal
volunteering and through providing unpaid care, it is estimated that older
people now contribute some £175.8 billion a year to the national economy. So older people are in fact making a
significantly higher annual contribution of some £40 billion a year to the
national economy than we take out. And many Forum members have told us that
if they lose the bus pass they would have to cease volunteering and unpaid
caring. In addition, older people are being hit
every year by seeing their annual state pension increase linked to the lower
Consumer Prices Index. So its value will fall an expected 10% every decade,
for ever. And there’s even suggestions that pension increases might in
future be linked to the even lower wage increase index – meaning even less
spending power for pensioners. Judge for yourself what this would mean. Food
prices have shot up 28.7% since August 2007. Average weekly pay on the other
hand has increased by less than 10%. We know too that the value of hard-earned
pensioner savings is shrinking. Which? the consumer watchdog, found that 865
out of 1,092 savings accounts actually reduced in value due to inflation and
poor interest rates. We have seen the winter fuel allowance reduced,
age-related tax allowances frozen, cuts in social care. So we are bearing
our share of the government’s austerity programme. And if ministers and the media are truly
outraged by the super-rich claiming benefits, why not use the tax system on
those say with incomes of £100,000 plus to claw back the money, instead of
resorting to mean-testing millions of pensioners, while at the same time
cutting the taxes of the super-rich? Let’s remember that the £10 Christmas
bonus and the paltry 25p extra weekly pension at 80 were only introduced
because the state pension was so low, being among the lowest in Europe.
Successive governments of every political colour have used these and other
universal benefits to save them from improving the basic state pension
system. In defending them now we are putting a marker down for the next
general election – politicians beware of pensioners voting power. Monty Meth Sept/Oct
2012 newsletter Loneliness
the hidden threat to good health Loneliness
should be considered a major health issue and yet, unlike smoking, obesity
and excessive alcohol, it is still being widely ignored by the health
professionals. Yet thousands of single, elderly, people live lonely lives,
in a home where the phone seldom rings; where there’s nobody for company Our
Forum was one of the first to register its support for the Campaign to End
Loneliness which has now launched a new digital toolkit for local health
organisations and councils, enabling them to improve the way they tackle
loneliness among elderly people. It
follows international research which found that loneliness can lead to poor
mental health including depression and dementia, hypertension,
cardiovascular disease and general cognitive decline. Socially isolated and
lonely adults are also more likely to require early admission to residential
or nursing care homes. The
research revealed that: •
Those who are lonely are at the highest risk of the onset of
disability •
People
who are deaf or blind are at considerable risk of loneliness •
51% of people aged 75 and over live alone •
Over 5 million people say that TV is their main companion •
Nearly one in ten older person feels cut off from society With
up to 10% of older people in the UK estimated to be intensely lonely and a
further 20% mildly lonely, health officials are being urged to do more to
identify those at risk of loneliness and take action to tackle the problem. With
an estimated 17% of older people being in contact with family and friends
for less than once a week and 11% less than once a month, it is felt that
GPs have a particular responsibility to observe the adverse effects of
loneliness among their patients. They
can quickly identify signs of depression and the lack of physical activity
and can use their influence to make tackling loneliness an equal public
health priority as smoking cessation and reducing obesity. The
new loneliness and isolation toolkit will enable health and wellbeing boards
to identify those most at risk and help prioritise the hardest to reach.
More information about the toolkit can be found at
www.campaigntoendloneliness.org.uk/toolkit Forum
fights loneliness Through
its many social activities and meetings, the Forum offers everyone the
chance to participate and engage in friendship with other people. So there
is really no need for anyone to feel out of touch, cut off from the rest of
us, feel trapped in their own home. We
have a poetry group, a book club, an after school hours woodworking and
handicrafts class and a knitting circle. Every Monday morning there is an
Over 50s film club at Cineworld, Southbury Road and Monday to Thursday there
are special Over 50s activity days at four leisure centres in the borough. Yes,
we do also understand that people can’t be active all the time. Felicity
Green, a one-time top Daily Mirror columnist, said when she was widowed:
“I’ve plenty of people to do things with, but no one to do nothing
with.” Not everyone wants to share their house with lodgers or take in
students, but we can still do all we can to stop loneliness becoming an
unsung health hazard. We
have a list of clubs affiliated to the Forum offering the widest possible
range of sporting and other activities. And we have trips to London venues
making good use of the Freedom Pass. And whenever we can find the funds, we
organise a special event for people living alone. So there really is no need
to be lonely when the Forum is around. Monty
Meth July/August
2012 Newsletter They
are all at it. Pick up a newspaper ranging from the so-called left wing
Guardian to the right wing Sun or The Times in the middle and they are all
telling the government it is time to “ditch the rich
pensioners.” Then there’s the
politicians, Nick Clegg from the Lib-Dems, Lord Warner, the former Labour
Health Minister and Iain Duncan Smith, the Tory work and pensions secretary,
all singing the same song that it’s time to end free bus passes, scrap
winter fuel allowances and cut
free TV licences. Firing
ammunition are the “think tanks” mostly staffed by
bright young university graduates who like to make the headlines by what
they call “blue sky thinking.” The Social Market Foundation, for example, wants to cut out free
bus passes for everyone and free TV licences and winter fuel payments to “better off pensioners” to help fund a £50 billion infrastructure investment. The
Nuffield Trust wants to see
“middle class pensioners” pay more taxes or lose the winter fuel allowances and free bus
passes to help meet the rising cost of social care for the elderly
or they want to make pensioners that work pay National Insurance again. So
here’s the so-called “rich and middle income” pensioners being asked to find the money to both rescue the economy
from the doldrums and fund the mounting cost of caring for the aged. Yet a recent
Ministerial reply in parliament recorded that 25% of pensioners had an
annual income of £10,400 or less; 47% had an income between £10,400 and £20,800.
Of the remainder, only 6% of pensioners about half a million people - had
incomes of over £40,000 a year. So what we are seeing
is this mounting rhetoric to cut back on pensioner benefits by the age-old
attempt to split and divide retired people, weaken our resolve, so that come
the next election the promises made by the politicians before the May 2010
elections can be quietly buried. Let’s just remind ourselves of the words in the coalition
agreement signed by Mr Cameron and Mr Clegg. It says: “The Government
believes that older people deserve dignity and respect in old age, and that
they should be provided with the support they need. That means
safeguarding key benefits and pensions and taking actions to make it easier
for older people to work or volunteer. We will protect key benefits for
older people.” No mention here of
segregating rich, middle income and poorer pensioners – getting us to
argue amongst ourselves about whether the winter fuel payment should be
means-tested. And at the same time we would be forgetting that in fighting
to retain what we now have, we are seeking to ensure that future generations
of retirees will continue to enjoy the benefits we have secured. So it is timely that
the Forum is now circulating a petition launched by the National Pensioners
Convention protesting at the unfair attacks being made upon us and calling
on Parliament to oppose any changes in the benefits we have campaigned for
over the years. As
part of this campaign, the NPC will be urging all its supporters to join a
mass rally in London on Saturday 20 October to send a “hands off” warning to the
politicians of all three main parties. The
Daily Telegraph says “the
cost of welfare payments to pensioners” is £100 million and
adds “that a significant part of which goes to those who do not need
it”.
No mention here of the annual loss in state pension increases already
being taken from us by the switch from the Retail Prices Index to the lower
Consumer Prices Index in measuring inflation; no mention either of the
freeze on age related tax allowances. No credit is given to
the fact that we paid National Insurance contributions for
all our working lives, paid our taxes and are still contributing
massively in so many ways to the country’s economy. For instance, people
over aged 65 already account for a third of all carers providing more than
50 hours of care a week. At the same time the
value of informal child care by thousands of grandparents is put at around
£4billion a year. In total, it is estimated in a University of London
report that the over 65s made a positive net contribution to the economy in
2010 of £40 billion and that is after deduction of pension, welfare and
health service costs
and this will probably reach a staggering £80 billion by 2030. That’s
more than enough to pay for all the so-called “perks” for today’s
pensioners
and all those coming after us. Monty Meth May/June 2012 Newsletter Don’t
blame us for living longer–
we’re putting more into Britain than we take out! It’s
about time that we hit back hard against that unholy alliance of politicians
and economists who claim that older people are a burden on the country
because we are part of an ageing population, pushing up the cost of pensions
and health care to unaffordable limits. This is the
dangerous line trotted out by our Office of Budget Responsibility (OBR) –
a quango created to advise Chancellor George Osborne – and the
International Monetary Fund (IMF) which apparently takes no account of the
economic benefits contributed to the economy by older people. It’s
dangerous because it places our generation against our younger families. David
McCullough, the new head of the WRVS which has some 48,000 social care
volunteers, said: “When the NHS was founded half the population didn’t reach 65. Now
we are living much longer, this is something that is a triumph rather than a
disaster”. The WRVS
produced a powerful in-depth report - barely reported in the national press
- which found that in 2010, the over 65s through their taxes, spending
power, provision of social care and the value of their volunteering, made a
contribution of at least £40 billion to the UK economy. We helped the
country financially through our spending money, bequests to organisations,
gifts and donations to worthy causes – and invested savings. Britain has
some six million unpaid carers and Carers UK in a 2011 report said this was
saving the government an average £18,473 a year for each of them – a
total of £119bn. Here in Enfield, there are over 29,000 people living in the borough who
provide unpaid care for their family, friends or neighbours. Based on the
above calculation that means they are saving the government approximately £473
million a year. Also
in Enfield there are 2,695
volunteers – including many Forum members – who have so far received the
100 hours a year LBE volunteering award and the scheme is still running and
saving the council and government even more money. And there are countless
more unpaid volunteers in local schools, hospitals and voluntary groups
beavering away week after week. There
are some 822
carers in Enfield who freely give more than 50 hours care a week, 2,850
carers provide care for 20-49 hours per week and the remaining 16,641 carers
do so for under 20 hours per week. 11% of carers say they suffer from poor
health because of their caring role, which is never noted by those eager to
denigrate older people. The
WRVS estimates that by 2030 the positive net contribution of the over 65s
will grow from the current £40 billion to £77 billion, because people will
remain healthier for longer and thus creating more opportunities to work
longer, pay taxes and increase volunteering. About 5.6
million people receiving the basic state pension pay income tax yet this is
never mentioned. In fact, for them the recent £5.30 a week increase was
reduced to £4.24 after tax was deducted. And well over one million
pensioners are higher rate taxpayers – all putting money back into the
Treasury coffers. Dot
Gibson, general secretary of the National Pensioners Convention, says that
we all need to start appreciating the contribution older people make to
society. “The figures show that
after the state has paid pensioners, for example, in pensions and bus
passes, they are still making a net contribution of £40 billion. “Many
carry out voluntary and charity work of some kind, while others care for
their grandchildren or their spouses, families and each other. The state
does not do that. Old people are making a massive contribution to society
that is too often hidden.” Every year more
older people are getting involved in community organisations, taking on
formal volunteering roles that are estimated to save the economy at least £10
billion a year. Alan Walker,
professor of social policy at Sheffield University and director of the New
Dynamics of Ageing says:: “It is
time that British society caught up with the remarkable changes taking place
among the older population, by creating the possibility for active and
healthy ageing to be the norm. “Age
is still invariably associated with decline. Look at the adjectives used to
describe ageing – retired, dependent, redundant. That kind of term implies
that older people are on the sidelines, somehow useless.” In fact, more
over 65s are working than ever before – and paying their taxes. In the
last ten years the number in work has shot up by 358.000 - from 418,000 to
776,000 - according to the Office of National Statistics. Commenting on the
figures, the Spectator magazine said the idea that over-65s are a burden on
the young does not stand up to scrutiny “The
changing nature of the British workforce has not just meant Polish plumbers,
but also British pensioners behind the tills of Tesco. Indeed, many
employers prefer to hire pensioners because they can be relied upon to turn
up on time and don’t turn their noses up at work.” One in eight
women now work past the age of 70, while one in ten men do the same. Despite
these facts and figures we have the OBR issuing reports that produce press
headlines warning of tough times ahead to pay for an ageing population and
Britain faces an era of austerity as it grows old. The Washington-based IMF
tells its 180 plus member countries to act now to reduce the huge cost of
ageing populations which for the UK would mean public debt rising by £750
billion. Our answer must
be to show the positive contribution we are making every day. We are the
first generation of older people to be healthier, more active, more
independent, better educated and skilled than any previous over 50s
generation. Without us Britain would be a lot poorer and it’s time this
was more widely recognised. Monty Meth There
will be plenty to cheer this year with the Olympics and the Diamond Jubilee
celebrations for H.M The Queen, diverting us from the gloom on the economic
and jobs front. But there’s something else we’ll be welcoming and
that’s the great news : Ten
million people alive today will live to be 100 or more years old. And
this includes 1.3 million of us who are already aged between 51 and 63. The
statistics from the Department of Work and Pensions make wonderful news for
families, but they are all too familiar and frightening for the politicians,
economists and actuaries who
have to live with the consequences and are among those who fail to cheer
because they are doing all too little to meet this new phenomenon. Ten million people are now aged
65 and over in the UK. By 2034, 23% of the population will be over 65 and of
them 3.5 million will be over 85. In
1911 there were just 100 centenarians living in England and Wales, a figure
which grew to 9,000 in 2006 and represented a 90-fold increase over the
previous 100 years. There was a fourteen-fold increase in male centenarians
and a 23-fold increase in female centenarians over the last 50 years of the
20th century. The number of people aged over
100 is expected to nearly double between 2030 and 2035, when it is projected
there will be 97,300 centenarians in the UK. It is then expected to more
than double again during the next decade, to stand at 202,100 by 2045. The
Office of National Statistics estimates that by 2066 there will be at least
507,000 people in the UK aged 100 or over, including 7,700 super
centenarians who are aged 110 or over. By 2080, there may be 626,900 people
aged over 100. 21,000 of these will be over 110. Even
the conservative estimates for the growth in the number of the oldest old
will have a significant impact on services. Yet whilst policy makers seem
aware of the growth in the number of people living to 100, there has been
little or no explicit exploration about the impact of the growth in numbers
of the oldest old on public policy. The
International Longevity Centre UK has studied this massive achievement in
ageing and concludes that centenarians represent one of the fastest growing,
although least understood, sections of the population. They
want to see more understanding and research undertaken into the health and
social care, housing and wealth, quality of life, housing and the impact of
disability on the oldest old and whether they will live to be centenarians
– which will create its own impact on society. Is
anyone out there, for example, considering that centenarians are the most
likely of any group to be living in residential care and to have exhausted
their financial resources to pay for a long stay? Or
put another way, how can we make sure that the increase in life expectancy
by centenarians and the oldest old will be matched by an increase in
healthy life expectancy, now only considered to be enjoyed until the age of
63 – after that too often it is just more
pills and potions! It
is not as though the politicians are unaware of these developments.
Professor Tom Kirkwood, director of Newcastle University’s Institute of
Ageing and Health and one of the world’s leading experts in this field
says: “Human life expectancy
continues to increase at the rate of two or more years per decade – or an
amazing five hours each day. People often say that how long and healthy they
will live is all determined by their genes. “This leads to the fatalistic
attitude that the body is programmed to age and die, driven by some inner
biological clock. In fact, genetics accounts only for about a quarter of
what determines the length of life. “Three-quarters is controlled
by factors that are under individual control, such as nutrition and
lifestyle, says Professor Kirkwood. And
the final word comes from Yale University’s Dr Becca Levy urging
us to be positive about ageing health. Challenge
the negative messages spreading alarm and despondency about ageing. Find
ways of being useful to others. Help your friends deal with any problems.
Help an organisation to meet the needs of
your community. By
making a contribution to the
wellbeing of others, a contribution will be made to your own wellbeing, says
Dr Levy. Despite
the outlook for the next six years being one of promised austerity and cuts,
we are told that the NHS budget is protected and remains broadly unchanged.
Indeed, Prime Minister David Cameron said on December 7 it would actually
increase every year during the life of this Parliament. So that’s alright
then, but what’s the real outlook for Enfield? Here
we are a diverse, multi-cultural community of some 300,000 people with
universally acknowledged inequalities in wealth and health between the east
and west of the borough. Yet
we have the third lowest funding for public health in London at £57.7 per
head of population against an average of £87.4. Just think what that £30
gap – equal to £9 million a year - could do to close the 10 year
difference in life expectation between Edmonton and Hadley Wood – one of
the worst differentials in London. Across
all health services in the borough, we are under-funded by an estimated £70.5
million a year. But instead of getting funding commensurate with
boroughs of a similar size and health needs, NHS Enfield has to make
cuts of £11.2 million in the current financial year to finish in April with
a deficit of £18.8 million. Instead
of expanding the health checks programme to identify early warnings of
stroke, heart attack or diabetes, controlling
blood pressure and cholesterol and increasing the depth and reach of
the stop smoking programme - smoking is the cause of up to half of the
difference in life-expectancy - we are seeing budget cuts and far too little
emphasis on prevention and stopping people from smoking. Our
GPs are under severe pressure to cut the medicines bill, to encourage
patients not to use NHS prescriptions for over-the-counter medicines for
those patients they assess can
afford to pay. They are being told that every time they send a patient to a
consultant it costs the NHS £141 and every time a patient attends A&E
the bill is £71. And
that pressure will grow if under the new system our local GPs are given a
local health spending annual budget which the Forum has been told will be in
the region of £20 -£25 per head – and is less than they are now
receiving. No
doubt this all comes under the heading of “efficiency
savings”. But take the case of our Forum member Mr K. He is a patient
at a Winchmore Hill GP practice. He developed
carpel tunnel syndrome a few months ago and his GP doubted whether
the practice could afford the necessary operation. The
practice applied to the North London group of primary care trusts and
recently it had a reply from their headquarters
at Stevenson House in Camden denying him the operation as it wasn’t
urgent. He
is in pain and has some sleepless nights and there appears to be no other
treatment. So he can either join a lengthening waiting list or pay himself
for private treatment – and that example can no doubt be repeated time and
again. So
we want our local GPs to join with us in demanding adequate funding in 2012
to do their job. This is in their interests and ours. They need the money to
provide a top-rate health service and we need them to have the resources to
provide top class patient care. Meanwhile,
a row is brewing between the BMA representing the majority of GPs in England
and the government over plans that are likely to lead to support services
for clinical commissioning groups (CCGs) in England being provided solely by
large commercial organisations after 2016. Primary
care trust (PCT) clusters are now forming commissioning support units and,
from 2016, would be encouraged to form social enterprises and partner with
the private sector, rather than remaining part of the NHS family. The
BMA said in a statement that in view of the implications of the recently
published Department of Health document ‘Developing
Commissioning Support: Towards Service Excellence’, BMA Council: ·
publicly announces
its opposition to the whole Health and Social Care Bill ·
calls for rapid
organisation of a public campaign of opposition to the Health and Social
Care Bill. November/December 2011 Newsletter Pensions:
Government moves the goalposts Linking
the basic state retirement pension to a lower inflation measure next year is
estimated to save the government about £250 million – equal to a loss of
nearly £21 by each of the nearly 12 million pensioners. This
has arisen because the government without any warning or consultation has
switched the inflation calculator from the retail prices index (RPI) to the
lower consumer prices index (CPI). The inflation increase calculated for the
year to September 2011 was 5.2% for CPI and 5.6% for RPI – the highest
inflation of any major Western economy – and it is the CPI figure that
will be used to calculate most state benefits. The
RPI September increase was the biggest for 20 years and reflected the
soaring price of essentials such as food, heating and lighting. It means the
cost of living is rising well ahead of wage increases averaging 2.5%, thus
squeezing living standards even harder. The
state retirement pension for an individual is currently £102.15
a week. If it is linked to the September CPI figure it will go up by
£5.30 next April to £107.45 against £5.85 had the RPI figure been used.
The difference does not look great, but cumulatively it adds up to a tidy
sum – and this loss lasts for as long as your pension is paid. “This apparently small
technical change will have big long-term effects,”
says Paul Johnson, director of the Institute for Fiscal Studies. This
decision to move the pension goalposts has been challenged in the courts
through a judicial review hearing at the end of October, the result of which
was not known before our Newsletter was printed. The
second moving of the goalposts could come if the strong hints reported in
the press that different criteria from the link with the September inflation
figure should be used to calculate the 2012 increase in benefits. The
Daily Telegraph reported on 19 October that: “Downing
Street refused to rule out using an average of inflation over the past six
months to set benefits… the final decision is something that happens in
the autumn,” a spokesman said.. Under
the headline: “Setting benefits by
inflation is unfair,” the
Telegraph estimated it will cost up to £2 billion in extra benefit costs
next year if what the paper insultingly calls “state handouts” rise in
line with inflation. That could mean benefits rising by triple the average
wage increase It
reported that senior MPs as saying this would be unfair and that a lower
rate of inflation should be used to calculate next year’s benefits rise.
The Telegraph quoted Mr James Wharton, a conservative MP on the Commons
public accounts committee, as saying: “the
CPI figures were distorted and calling on the coalition to find a new
measure of inflation for updating benefits. “We need to find a measure
that takes into account not just a snapshot of inflation for one month,
which may be artificially high, but reflects the prices that people are
actually paying.” But
then contradicting this line of thinking, a Telegraph editorial said that
for older people, particularly those on fixed incomes or reliant on savings
income, the figures are disastrous. “Rarely
has prudence been more severely punished.” The
Times reported that any change in using the September inflation rise to
calculate pensions and benefits increases “would
risk a damaging battle with pensioners.”
It quoted Ros Altmann of the over 50s group Saga as saying that
abandoning the September yardstick would be “short-termist
and dangerous.” David
Smith, chair of the National Pensioners Convention (NPC) in Devon, said in a
letter published by The Times that a single pensioner’s weekly guaranteed
minimum income is £137.35, but the official poverty level is £178 a week
and 83% of pensioner households receive the majority of their income from
state pensions or benefits. The
NPC’s three main policy points are: ·
Raising the state
pension for everyone above the official poverty level of around £178 a week
(60% of median population income before housing costs) ·
Introducing
good quality care through a national care service, funded through general
taxation ·
Helping pensioners
combat fuel poverty by paying a winter fuel allowance of £500 to all
pensioner households September/October 2011 Newsletter
Millions
more to face fuel poverty The
number of households in fuel poverty – meaning they spend more than 10% of
their income on energy bills – has been estimated to reach one in four
this coming winter. That’s 12 million people and it follows the latest
hike in prices announced by the energy companies. Fuel-poor
households increased by 1 million to 5.5 million between 2008 and 2009. And
they are sure to rise again following increases of 18% on gas prices and 11%
for electricity being imposed this coming winter. Household energy bills
have rocketed by 71% in just over five years and it is estimated that 15% of
middle-class homes are in fuel poverty. There
are just six major energy supply companies controlling 99% of the UK energy
market. There’s a mass of different tariffs and so-called discounts for an
on-line account, direct debit, duel-fuel
customers – and to add to the confusion there’s the inconvenience of
cold calling salesmen knocking on our doors
at night with “money saving”
offers. Many
Forum members will be customers of EON, the German-owned utility group, and
they will see their energy bills rise by an average 15% this winter – gas
goes up 18.1% and electricity by 11.4%. People with dual-fuel contracts face
a 15.2% rise with an average householder paying £1,250 a year – twice the
amount they were paying six years ago. The
increased energy charges will be felt at the same time as the government is
cutting the winter fuel payments scheme. Pensioners aged 80 and over will
get £100 less this year and households with at least one person over 60
will lose £50. People
living in fuel poverty are more likely to suffer from poor health. Living in
a cold home can be a health risk including depression, stress, falls, high
blood pressure strokes and heart attacks. Forum
member Major Peter Horsfall MBE, who served with the Coldstream Guards for
34 years, has written to the Prime Minister saying: “I know all about the “national debt” but you could not have cut the winter fuel allowance at a worse
time. The cost of fuel has doubled in recent years”, Incomes
have not doubled and although the energy companies blame the increase on
rising wholesale prices - which
they are passing on to consumers – the fact is, according to Consumer
Focus, wholesale prices are one third lower now than they were three years
ago. Mike
O’Connor, chief executive of Consumer Focus, the industry watchdog, said: “Many
consumers worry how they will afford to keep their homes warm this winter,
given other price rises and flat
or falling incomes. Customers will feel they didn’t get the benefit when
wholesale costs were low. Wholesale costs are around a third lower than
their 2008 peak yet consumer prices have reached an all-time high.” There
is mounting pressure on the government and the energy industry regulator
Ofgem to investigate profits and prices by referring the Big 6 energy
suppliers to the Competition Commission. Meanwhile, accountants BDO
have been told by energy regulator Ofgem to look at the trading
profits of the Big Six, their wholesale prices and
their hedging practices and see if they are justified in raising
prices. There
are calls too for a total ban on doorstep selling by the energy companies
after Southern Electric was found guilty of deliberately misleading
householders. An inquiry in 2008 found that 48% of gas customers and 42% of
electricity customers were worse off after switching supplier through a
doorstep pitch. There
is also a need to clean up the hotch-potch of variable tariffs so that
people have a clearer understanding of what they are getting for their money
and consideration could be given to the introduction of a dual-heat
pensioners tariff, subsidised by the Big 6 energy companies and the
government. Monty
Meth NB.
All British Gas and electricity customers are being offered free loft and
cavity wall insulation. They say £1 in every £4 spent on heating is wasted
because of poor insulation. Call 0800 107 5646 for details July/August
2011
Newsletter No
matter which way you look, the Government is seeking to rewrite the rules on
pensions. In fact, they have already changed the rules on calculating future
inflation-linked increases in the state retirement pension without warning,
negotiation or consultation. The measure now being used is the lower
Consumer Prices Index (CPI) rather than the long-established Retail Prices
Index (RPI). This
affects not only the 12 million old age pensioners, but all those receiving
pensions from service in the armed forces, many of whom retire at the age of
40 and can well live another 40 years or more. It affects the retirement
pensions of the police, teachers, doctors and fire-fighters among many
others. This is a clear case of cutting existing entitlements in spite of
ministerial assertions that no such cuts are being made. The
Armed Forces Pensions Society calculates that the change in indexation from
RPI to CPI will mean a disabled double amputee 28-year old corporal will
lose £587.000 by age 70; a 40-year-old Royal Marines sergeant will be £212,000
worse off by age 85 and a 40-year-old squadron leader will lose an estimated
£319,000 by age 85. And the widows of servicemen killed in Iraq and
Afghanistan will also see their aggregate pension income vastly reduced. Pensions
are now top of the public agenda because the government wants to see
everyone employed by local or national government increase their pension
fund contributions by about 50%; work for more years before retirement and
then get a lower pension by changing their pensions from one based on final
salary to a person’s career average earnings. And this at a time when
there is a two-year pay freeze and inflation is almost 5%. In
addition, some 2.6 million women who thought they would reach pensionable
age at 60 are being told by the government that they will have to wait
longer under plans to raise the women’s pension from 60 to 65 by 2018 and
then in 2020 the pension age will be 66 for both men and women. The
Forum asked David Burrowes MP, parliamentary private secretary to Oliver
Letwin, the Cabinet Office Minister, to arrange a meeting with Mr Letwin
about the pension changes, but this was not possible to arrange. So a small
deputation will meet Mr Burrowes to convey our opposition to changes which,
it must be said, affect all pensioners – not just public sector workers as
the press pretends. Call the office if you would like to join the
deputation. Nor
are the planned changes anything to do with the financial deficit which the
Government plans to clear by 2015. If the government has its way the pension
changes are for all time – though the switch in inflation indexation from
RPI to CPI has to be approved by Parliament every year. Pensions
is the one issue when we can truly say: “we’re all in this together”
no matter how hard the media tries to play one section off against another.
The pretence that it is hard-working taxpayers in the private sector who are
funding the pensions of public sector workers, teachers, civil servants and
others needs challenging. For
example, we read that the local government pension scheme – covering our
council workers – is a fully funded scheme which is well in the black. Far
from being unaffordable the average annual payout is just £3.800 a year,
but for women it is less than £2,800 – a mere £6 per week! The NHS
scheme has more going into it than is paid out. And I gather the government
has refused to allow the teachers’ pension fund accounts to be published.
Is there something to hide? Was
anything said about these plans to change the pension arrangements before
the general election last May? Not only were leaders of both coalition
parties silent, they positively denied having ideas about changing
index-linking and now we learn that the change from RPI to CPI is expected
to lead to a 25% reduction in the value of pensions come the retirement of
young people. And
if the government insists on using the lower CPI to measure pension
increases why does it allow the rail, energy and water companies to use the
higher RPI as the inflation measure to increase prices? As
we try to separate fact from fiction in the long-running pensions saga it is
worth reminding ourselves that we paid national insurance contributions for
30 years or more when working so that we could have a decent pension on
retirement. We were robbed for 20 years when Mrs Thatcher changed the
pensions increase link from average earnings to prices – and now we are
being robbed again by changing the link from RPI to CPI Monty
Meth
He
said his budget would help “responsible”
pensioners who had been getting a bad deal from annuities and that
the
shake-up, which will allow people on low incomes to draw down their funds
without paying punitive tax rates, had been welcomed by a wide range of
consumer groups.
It has been well-established that people here lag behind many European countries, Canada, New Zealand and Australia in the number of years of good health we have before we face long-term health problems or disability. Now the facts have been presented in a major new report by the Institute for Health Metrics and Evaluation based in Seattle, USA.
It revealed that in countries with similar levels of affluence. the UK ranked 12th out of 19 in the years we can enjoy of healthy life expectancy. It means that while life expectancy itself is getting longer, the years of healthy life in which we are free of major illnesses or disability have not really changed in the last 23 years.
While life expectancy has increased by 4.2 years in the UK over the last two decades, we can only count on 68.6 healthy years of life before long-term problems or disability sets. Spain topped the league table with 70.9 years of healthy life before disease or disability takes its toll.
Italy came next in the league table with 70.2 years of healthy life and third was Australia with 70.1 years, leaving Britain’s performance of 68.6 healthy years exactly the same as in 1990. It has been described as “shocking” by health minister Jeremy Hunt who called on all the new CCGs who took over responsibility for local health services on April 1, to take action in tackling the five big killers - cancer, heart disease, stroke, respiratory and liver disease.
These five diseases alone account for some 150,000 deaths a year among the under-75s in England and the Department of Health calculates that 30,000 of these lives could be saved if we were doing as well as Sweden. The study also revealed that Britons lose more years to disability than many other countries, including people in Thailand, Mexico and Romania.
“For too long we have been lagging behind and I want the reformed health system to take up this challenge and turn this shocking underperformance around,” said Mr Hunt. Hospitals, GPs and local councils now responsible for all public health matters are being urged to play their part in catching up with the rest of the world by 2020.
While the health professionals have a major role in securing that improvement, a great deal can be put down to the way we live – our diet, drinking alcohol excessively, smoking, all play a part .. along with the lifestyles people are forced to follow in the community due to income inequality, unemployment and poverty.
The government is reported to be in favour of introducing new regulations for cigarettes to be sold in plain packs, but it appears to be back-tracking on plans to introduce a minimum price for alcohol to curb excessive drinking and anti-social behaviour. Cases of cirrhosis of the liver – largely blamed on alcohol - rose by 65% since 1990.
A recent wide - ranging House of Lords inquiry heard startling evidence of the scale of life expectancy changes ahead. Their “Ready for Ageing” report expects that the 20 years from 2010 to 2030 will see a 50% increase in people aged 65 or over and a doubling of people aged 85 and over.
The predicted resultant increased demands for health and social care include:
people with diabetes up by over 45%
people with arthritis, coronary heart disease, stroke each up by over 50%
people with dementia (moderate or severe) up by over 80% to 1.96 million
people with moderate or severe need for social care up by 90%
This will undoubtedly increase the financial pressures on the NHS and on public funding for social care – and in two decades there will be a doubling in the number of households where disabled elderly people need informal care from their family and friends, said the House of Lords committee.
By 2030, men aged 65 will expect to live another 23 years, to 88 and women another 26 years to 91 so people should be enabled to extend their working lives if they wish to do so as a vital part of the response to increased longevity
The Lords’ report warns that public expenditure on social and health care for older people may have to rise to £12.7 billion by 2022 – an increase of 37% from £9.3 billion in 2010 – just to keep pace with demographic and cost increases.
“The challenges are by no means insuperable, but no government has so far had a vision and a coherent strategy,”says the Lords’ report which recommends, among other more controversial ideas, a ten-year NHS budget to enable them to plan ahead and for the pensions industry to make provision easier to understand so that people get a better idea of the income they will retire with.
We are told that more than half as many extra older people will be living with three or more long-term health problems by 2018 compared with 2008. It is to bridge this gap between our health span and our total life span that we have called our important Add Healthy Years to Longer Lives conference on July 5, which I hope many of you will attend.
Be more active – feel better – live longer
Just over six months ago we saw the creation of the NHS celebrated in that memorable Olympic opening ceremony, only to be followed by the new Health and Social Care Act 2012 being introduced by a government promising “no top down reorganisation”, but which is now giving us a new look NHS that will have to tackle the nationwide fall-out from the shattering Stafford Hospital scandal.
Behind the fine words of “rising to the challenge of delivering better quality care in a tighter financial environment” lies a host of new boards and hundreds of highly paid directors and managers. We list a few of them, but new ones are regularly seeing the light of day.
We now have a National Quality Board, chaired by Sir David Nicholson, to ensure that patients have the central role in the oversight, scrutiny and design of high quality services. Sir David will also chair the National Commissioning Board (NCB) which former health minister David Owen says is the largest quango ever created.
With a budget of £126 billion, it will control some 211 Clinical Commissioning Groups around the country - including the GP-led Enfield NHS CCG - that will be taking over the work of the soon to be disbanded primary care trusts. By mid-December the NCB was employing 604 people.
Among the job titles and salaries we have noted are a chief executive - £220,000, director of patient experience - £132,500, deputy medical director - £132,500, director of the chair and chief executive’s office - £120,000, director of insight (whatever that means) - £102,500, director of customer relations - £115,000
There’s an organisation called Monitor to regulate all NHS-funded care and it will issue licences to hospitals seeking Foundation status, meaning they are completely independent, profitable and free of any central control or direction. And helping them will be the NHS Trust Development Authority checking the performance of NHS hospitals and help them to achieve this Foundation status.
There’s also to be a National Institute for Care and Health, setting standards for local public health and social care; the Care Quality Commission is being retained and we’ll have a Health Service Ombudsman handling complaints from individuals.
On top of all this there’s to be a new network of local Quality Surveillance Groups due to go live on April 1 acting as a forum on health and care. Its remit is to share intelligence and information, be open and honest in ensuring all health and care sectors co-operate at every level of the system.
In its recent mid-term review, the coalition government promises that the measures contained in its new Health and Social Care Act will help deliver: “better health, better care and better value for money, encouraging greater focus on preventing ill-health and empowering local communities to plan services according to local priorities.”
The benefits they hope to achieve from this reorganisation are:
* Greater consistency and fairness in access and provision for patients, with an end to unjustifiable variations in services and a reduction in health inequalities
* Better health outcomes for patients as primary care clinicians are empowered to focus on delivering high quality, clinically-effective, evidence-based services
* Greater efficiencies in the delivery of primary care health services through the introduction of standardised frameworks and operating procedures.
Our Forum has pledged to help achieve these aims, but it takes two to tango. And it is no secret that we are far from content with the level of consultation involving patients and the public in the new forms of health care delivery now being locally planned.
We heed the strong words of the Prime Minister that the patients’ voice must in future be taken seriously. So the new local Healthwatch organisations must be fit for purpose; robust, independent, credible, effective and unlike its three predecessor bodies which lacked the power to protect patients.
When discussing the public inquiry report into the despicable patient neglect at the mid-Stafford hospital, both Mr Cameron and Mr Miliband agreed that the big and continuing increase in the ageing population will bring new challenges to the long-term care provided by the NHS
If there is one lesson we all need to learn from the appalling negligence and deaths on a massive scale in the Stafford hospitals scandal, it is that honesty and truth must be paramount. The powers that be in Enfield need to know that this Forum will not be bullied into silence by anyone.
Hands
off pensioners’ benefits
The
biggest change to the pensions and benefits system so far implemented by the
coalition government has been through the switch in linking increases to the
lower consumer prices index, rather than the retail prices index.