Friday, 14 December 2012
Camden Council is failing
The West Hampstead Safer Neighbourhood Team asked the council to set up a dispersal zone covering the Lymington Rd and Lithos Rd areas of the ward in September. I attended a poorly advertised meeting at the West End Lane offices to discuss the boundary and helped to persuade the Council to accept a small change on the proposed boundary to include the area around Rowntree Close. A dispersal zone once in place gives the police extra powers to disperse gatherings of youths who are committing Anti Social Behaviour.
The zone was set up to run until mid-November and I secured a promise in September for a further consultation on a possible extension of time when we hit November.
Well November came and went without any kind of message from the Council, and last week's Safer Neighbourhood Panel meeting demonstrated that the police were not aware why the zone had ended in mid-November without consulting them.
It appears that the zone was a relative success because the extra powers were only used once. Local and no so local youths had read the notices displayed and decided not to cause any more trouble.
Nevertheless there was a need to evaluate the apparent success of the zone with local people. So I have today sent the following message to the Council -
"I want a full explanation why the Council officers feel it was appropriate to end this dispersal zone without consulting the Safer Neighbourhood Team, the local councillors or local residents groups. We have "policing by consent" in this country and if we are to use powers like these the Council needs to offer full engagement with the community so that we can all evaluate the relative success or failure of the dispersal zone and have a mutual agreement on a way forward."
My second concern is that I have been urging Council officers to work with Thames Water and Network Rail to find the source of a leak that has led to puddling water in Medley Road for over a year.
Two local residents and myself have had extensive e-mail correspondence with the Council and Thames Water for all this time trying to secure an answer to the problem.
I have discovered only today that the case file was closed at the Camden end last March with an officer failing to respond to an email from an affected resident. However, in the last couple of days Thames Water have identified a leak in West End Lane which is impacting on Medley Road. The leak is losing three litres of water per second!
This is now judged by Thames Water as an emergency (after a year of trying to shift blame onto Network Rail) and will involve the temporary closure of West End Lane, although as I write it is not known when this will take place...
The Council has a duty of care to its residents and should be making sure other public utilities carry out their responsibilities. Sadly Camden is simply not doing its job properly...
Tuesday, 17 July 2012
Getting a new school for West Hampstead will not be easy...
I attended Camden's Children, Schools and Families Scrutiny Committee last night and posed a number of concerns about Labour's plans to expand Kingsgate Primary School to provide more school places in the north-west of Camden. The Cabinet Member, and the Scrutiny Committee members had no answers to the points I raised.
I was sufficiently exercised about the lack of detail in the officer's report to the committee that then wrote a letter to the local press. The full text is below in case it does not get printed in full.
Saturday, 19 May 2012
Content? Almost...
I have always believed until now that when one was "content" then you had actually started a slow decline. I have always believed in setting new goals, making plans and writing daily lists of the tasks to be completed. So although I still do all that and we have big plans for the next three years, I am actually quite content right here, right now.
But I am not sure I should be scared or pleased...
One of the plans on my list is to move from my present flat in Kilburn to somewhere bigger to allow for Nana's ambition to produce a mini-me for my old age. This led me to think about the furore that local and national Labour Party figures have stirred up about the upper limits for claiming benefits the Coaliton Government are bringing in.
Having researched the local property scene recently, to see what my realistic options will be, there are whole areas of Camden which are clearly beyond my reach. I simply could not afford the higher mortgage payments. Market forces on property prices work against me.
However according to the Labour Party, these same market forces are not supposed to work against people claiming benefits. So a couple like us, both working and paying taxes, who cannot afford a mortgage payment to live in Bloomsbury, is not supposed to complain about paying our taxes so that another couple with a family can afford to live in the same desirable area, while their astronomic rent is paid for by Housing Benefit.
The Labour Party likes to claim it's on the side of the squeezed middle, but by its actions it should be judged.
We all know they are comfortable about the filthy rich. They did little in office to close the loopholes which allow multi-millionaires to pay little or no tax, and we know it wants to protect those claiming Housing Benefit to stay in desirable parts of Inner London. But what does it promise for the working tax payer? When offered the chance of a coalition with the Liberal Democrats in 2010 it flatly refused to consider raising the income tax threshold to £10,000 because it wants about half the population dependent on state hand-outs for at least part of their income. It is this dependency culture they have always fostered which prevents so many from making the change back into work from a life of benefits.
Meanwhile I will have to find a place to live which I can afford after paying my taxes. And it won't be in Bloomsbury....
Thursday, 5 January 2012
My personal criticism of the UK Border Agency
I have not blogged for several months because my last blog, about the joys of being newly married, were interrupted by the UK Border Agency which insisted my wife had to return to Ghana to apply for a settlement visa from there rather than from the Agency’s offices in Croydon.
This should have been a simple enough task, especially as the initial application was done online before my wife left for Ghana, and we had compiled an impressive list of original documents for her to present to the High Commission in Accra.
We had systematically found documentary evidence to support every assertion made in the application, managing to include my birth certificate, a reference to my flat purchase in 1998 to prove I owned a property, a copy of my last tax return to show how much I earned (with supporting bank statements), my wife’s degree certificate and journalism certificate plus a statement from NARIC, a recognised agency in the UK, that guaranteed that a degree from the University of Ghana was equivalent to a Batchelor’s degree here.
The most important piece of evidence was a job offer letter that my wife had received from an employer where she had volunteered for 5 weeks before returning to Ghana. The job offer was conditional, of course, on her obtaining a settlement visa.
The tone of the application form for such visas is one of hostility, with references throughout which imply “we hope you are not coming here to claim benefits”. Well no, I was earning enough to keep her anyway, and we had the proof that my wife wanted to work and had a job offer in an institution where her background and knowledge of community languages in Ghana could prove useful.
So we thought it should be plain sailing. But no.
The processing of settlement visa applications is done in a strict chronological order, and my request for my wife’s application to be fast-tracked because of the job offer was deemed to be “not a compelling reason for fast tracking”.
My wife had been told in Ghana it would be 12 working weeks from the time of submission to get an answer, which put the likely date for her visa to be processed into early January. The answer I got three times from a civil servant in Accra was that it would be resolved by 31st December.
Extracts from an email exchange with this official in the High Commission in Accra are rather telling. I wrote - “You still have not responded to my email messages. Is it the official policy of the Foreign and Commonwealth Office to fail to respond to email messages from UK citizens?
The reply I got (eventually) was this - “For your information, the UK Border Agency’s publically (sic) available guidelines state that correspondence should be replied to within 20 working days of receipt.
I appreciate that this may not be the response you were hoping for.”
It was bad enough getting the same stonewall answer again, but to hide behind a pathetic response deadline of 20 working days at a time of electronic communication suggests that our old colonial outposts need to be dragged kicking and screaming out of the culture of the 1960’s into the 21st century. In local government we have made great strides to improve response times to enquiries. Ten working days is often the target and the actual response times, such as in Camden, are often shorter.
However, not to be brushed off like this I tried to use the good offices of a number of local and national politicians to see if they could intervene on my behalf. Being used to intervening on behalf of constituents as a councillor I found it a frustrating experience asking for help in this way and finding a poor response from most. Glenda Jackson my local MP has very polite staff who tried to help, but when Glenda phoned me directly after a few email exchanges she appeared to me to be both unhelpful, and rather dismissive.
Various Members of the House of Lords who were listed as part of the parliamentary committee for Ghana were tried. David Steel, Navnit Dholakia and Paul Boateng were all either dismissive or too easily accepting of the status quo.
A letter to the office of the Deputy Prime Minister went unanswered for weeks until I get a composite reply, which referred to the other enquiries made on my behalf by others. The only politician who appeared to take the issue seriously was Sarah Ludford the Liberal Democrat MEP for London, who rightfully challenged the first response she received.
Why was I so angry? Besides missing my wife which was torment enough, applying for a settlement visa as a spouse of a UK citizen involves not only filling in an application form with supporting evidence, but a fee of around £850 payable in cash in the local currency. It occurred to me that if any Commission had a backlog of applications they also had a lot of fees collected which could be used to appoint more temporary workers to clear the backlog or to offer overtime to existing staff. But that it seems is too logical, too modern, too concerned about improving systems. That would be about an agency accepting that it is providing a public service rather than simply administering a legal procedure.
The UK Border Agency has been under attack a great deal in recent months, with one senior official resigning after a spat with the Home Secretary about apparently relaxing border controls in the summer.
In my experience it requires a serious root and branch review of all its systems.
To complete the story, my wife was asked to collect her documents, including the visa, on 28th December. When she received her passport back it was clear the visa had been approved on 23rd December, too close to the Christmas break to allow her to enjoy Christmas in the UK with her new British family.
My wife arrived at Heathrow on the morning of 2nd January and I am now a much happier man, but my criticisms of the inefficient UK Border Agency are still legitimate and should be pursued by politicians in Government, or by those aspiring to represent us.
Tuesday, 6 September 2011
What I did on my holidays - got married...
Friday, 8 July 2011
Didn't we do well, or did we?
This is the latest article I have sent for publication to Liberator magazine.
"John Bryant argues that while the campaign led by the Social Liberal Forum has secured some significant changes to the Health and Social Care Bill there remain some lingering doubts...
Since my last article on the fortunes of the Health and Social Care Bill after the Liberal Democrats Spring Conference in Sheffield, we have had an official pause in the Bill’s legislative journey, a listening exercise, a report from the Future Forum, and publication of amendments to the Bill.
Liberal activists have also attended the Social Liberal Forum’s first one-day conference on 18th June, which received feedback from Evan Harris, one of the key campaigners for change.
My own modest role in the campaign for change was to convince Camden’s Health Scrutiny Committee to make a submission to the listening exercise, setting out support for the 25 amendments that the Social Liberal Forum was promoting at the time. Since then there have been various claims that the vast majority of these suggested changes have emerged as formal amendments to the Bill.
So that’s all right then?
Well I think the gushing self-congratulations that have been published in recent weeks need to be tempered a little.
Not everyone in the NHS family of interests has declared its happiness with the result of the listening exercise. For the second time this year the BMA voted at its annual conference (following a critical emergency meeting in March) to support a motion calling for the Bill’s withdrawal, despite a call from its leadership not to be too critical now the Bill was to be amended.
At the SLF Conference Evan Harris was critical of the Future Forum’s report as it was littered with anecdotal references without a coherent analysis of the feedback it received from the many respondents to the listening exercise.
There was also an example of the classic bureaucrats’ answer to every problem by creating more committees. The Future Forum argues that, “there should be a strong role for clinical and professional networks in the new system and multi‐speciality clinical senates should be established to provide strategic advice to local commissioning consortia, health and wellbeing boards and the NHS Commissioning Board.”
A clinical senate may well be a useful adjunct to the more formal commissioning landscape, but something similar already exists outside of formal NHS structures. One example is “UCL Partners” which is a research body bringing together clinical leaders in Foundation Trusts in my part of North London to think through the best way of providing clinical pathways for specialist acute services. Its work in helping to shape the development of Hyper-Acute Stroke Units has led to the new “HASU” based at University College London Hospital. This is now reported to be the third best performing HASU in the UK with rapidly improving survival rates compared to the old regime.
So while such innovations as “clinical senates” may be useful I am not sure that giving them a statutory role will make their contribution even more valid than it is at present. The key to progress here is to ensure that clinical recommendations on patient pathways from such informal bodies are given effective scrutiny in public by scrutiny committees either at borough or regional level.
I am not entirely convinced by the Future Forum’s statement “We have heard many people saying that competition and integration are opposing forces. We believe this is a false dichotomy. Integrated care is vital, and competition can and should be used by commissioners as a powerful tool to drive this for patients.”
In developing an integrated care pathway for Stroke patients in North Central London the clinicians presented a case for UCLH to be the HASU, while other hospitals such the Royal Free in Hampstead would develop and expand their rehabilitation service for supporting patients in the period following the first three critical days after a stroke. Had a competitive approach been followed both UCLH and the Royal Free would have had good claims to be the HASU and a lot of time and money would have been wasted to judge between competing bids. So in my own local example working together to create a well-organised integrated care model produced the desired improving health outcomes, without competition being involved.
The Future Forum report later backtracks on the competition issue with this -
“Most importantly, the Bill should be changed to be very clear that Monitor’s primary duty is not to promote competition, but to ensure the best care for patients. As part of this, they must support the delivery of integrated care.”
Without specifying clearly how integrated care models are to be created by using competition, it begs the question that this report was surely designed to please both Conservative and Liberal Democrat members by providing a fudge between the different forces in favour of either competition or integration.
The more detailed report on Choice and Competition sets out some principles for a new Framework which are - Delivering choice; Encouraging collaboration and integration; Market making; Improving outcomes; Personalising care; Reducing health inequalities; Enabling informed citizens.
The most worrying of these for me is the principle of “Market Making”. The later section devoted to this talks about new entrants to the market, but concentrates on the creation of new social enterprises rather than admit the existence of the elephant in the room - the possibility of many more services being commissioned from the independent sector.
The Government’s formal response to the Future Forum appeared to take on board of many of the fears of Liberal Democrats, ruling out cherry-picking and competition on price. However it is noticeable that the summary on Choice and Competition also states “we will phase in the extension of Any Qualified Provider”. What the “extension” might entail could be anyone’s guess, but if you are naturally sceptical of anything the Tories put forward with regard to competition in health services I would remain alert to future interpretations of this throw away line.
One of the big worries regularly expressed by both providers and patients is that competitive tendering by clinical consortia (even on quality rather than cost grounds) could put some well-loved institutions such as Foundation Trust hospitals out of business, because without a certain level of core business they may become unviable.
So even assuming that most of the new amendments to the Bill are supported across the Coalition and are welcomed in the Lords, there is still more that Liberals should be doing.
As this Liberator was being prepared, Liberal Democrat conference representatives were being urged by SLF activists to put their names forward in support of a new motion for the Autumn conference. This was drafted by Charles West and calls for all the new NHS structures created by the Bill to have a common duty when commissioning services to “avoid the risk of a transfer of such income or case-load as to undermine the ability of existing providers to provide emergency, complex case and intensive care services, and to provide education, training and research.”
It also suggests that Monitor's duty to prevent anti-competitive behaviour, which is against the interests of patients, is matched by a duty to prevent anti-collaborative behaviour for the same purpose.
So what else should Liberals be doing? Besides supporting SLF motions at conferences Liberals can be doing some useful work at a local level too. Many principal local authorities have created shadow Health and Well-Being Boards and it is through these that Liberal Democrat councillors can argue for better integration of health and social care providers as they redefine patient pathways. They can also argue for much greater transparency of decision-making by all local providers, including Foundation Trust Boards.
Members of Scrutiny Committees could also challenge Board members of emerging clinical consortia to avoid engaging arms length organisations from the independent sector to carry out commissioning functions. PCTs were forced to shed around half their staff this year because of Andrew Lansley’s decisions to cut management costs, but the remaining postholders should be those with the expertise to understand the intricacies of health contracts. Retaining the transactional task of commissioning as an in-house function of consortia by them directly employing their own (hopefully ex-PCT) staff is something that Liberal Democrat councillors could and should be arguing for.
Liberal activists not serving on Councils should continue to make their voices heard through their local press, urging local editors to spend some time on investigating the various interests that are hovering in every community to get a slice of the NHS cake.
I ended my last article on these issues by alluding to a “reasonably managed muddle”. I am not yet convinced we will achieve anything better than this, despite the good work done by campaigners on improving the Bill. The Future Forum report attempts to look in two directions at the same time and while many of the amendments to the Bill are welcome, it is the behaviour and motivation of the key players in every locality which will need to be closely monitored over the coming months.
JOHN BRYANT
(John has been a member of the Liberator Collective as “William Tranby” for about 20 years. He is currently a Camden councillor and Chair of its Health Scrutiny Committee, and is also Vice Chair of the North Central London Joint Health Overview and Scrutiny Committee.)"