The meeting heard three reports, one from Janet Shapiro – delegate from London Region NPC,
then Hornsey Pensioner delegates – Lourdes Keever and Argyros Arghyrou
There was a march with banners on Tuesday June 14th to the Winter Gardens. Beforehand the NPC banner had been taken to British Homes Stores in Blackpool to be photographed in support of those BHS employees whose pensions are at risk.
A brass band led the way to the opening rally that was opened by Blackpool’s deputy Mayor Gary Coleman. President Ron Douglas presided.
There were excellent speeches from John Hilary from War on Want, our very own Judy Downey of Relatives and Residents Association, Anthony Curley, youngest speaker National Youth Coordinator for Unite, Gary Fitzgerald of Action on Elder Abuse, Richard Burgon MP, Shadow Economic Secretary to the Treasury who stood in for John McDonnell.
Dot Gibson, NPC General Secretary, gave her usual rousing speech, pointing out that this Parliament’s slogan was “Standing up for all generations”. She listed the issues that we want to be included in the Commission for Older People promised by Jeremy Corbyn.
Janet attended the Public & Communications and Services Fringe meeting, the Women’s Working Party Fringe ‘Home Alone’, Wednesday sessions on ‘Pensions, intergenerational fairness and the baby boomers’, and ‘Is Digital exclusion age discrimination?’.
Lourdes Keever reports as a delegate Wednesday morning session ‘How Healthy is the NHS?’
I attended the above session. It was chaired by Jan Shortt with Dawne Garrett older People and Dementia Care Professional Lead RCN and Clive Peedell Leader of the National Health Action Party on the platform.
The session focused on the quality of care delivered to the elderly and what improvements are required to deliver an effective service. An additional focus was to look at the affects of privatisation and to consider what campaigners can do to defend the NHS. The session was extremely critical of what is currently happening in the world of Health. Diane Garrett pointed out how 62% of the hospital beds are taken by people over 65 years , delayed discharges are also higher within this category of patients. In terms of improvements she was able to point to the amazing developments in technology and pain management However there was little else. She also pointed out the huge variation in outcomes in different parts of the country. Quite clearly deprived areas have poorer outcomes. Targets have often aggravated the problem. The private sector can often start afresh and therefore can often present as being capable of delivering more effectively.
She strongly recommended that any solution should be based on a whole team approach especially for the elderly .
Clive Peedel referred to the work of Professor Marmot and went onto describe how austerity can drive up demand within the NHS. He identified the huge problems in A&E and the cuts in Social Care as having an extremely negative impact upon delivery of an effective service. He drew attention to the influence of the free market economy and deregulation brought in by Thatcher. This was later developed further by the Labour Party with the introduction of PFI, purchase provider spilt and payment by results. The latter has all been made worse by Lansley’s reorganisation. The focus from the platform was that health care investment should be seen as a stimulant for the economy. Integration of Health and Social Care was seen as the way forward in terms of developing new structures. The latter was enhance by a presentation from a representative of the National Pharmacy Association. He pointed to the document of Community Pharmacy and Beyond that focuses on the importance of delivering a face to face service , a package of care rather than pills. If access to the latter is diminished he warned that there would be consequences for both GPs and A&E.
The discussion that followed in the hall was very much centred on the failure of the present NHS to run an effective service and cope with the increase in demand for services. Very little hope was presented and no real evidence of solutions was presented.
Our delegates outside Blackpool Library
Wednesday Afternoon session : ‘The state of the social care sector and where the money goes’
This session was chaired by Dot Gibson with Matthew Egan Unite and Dr Diane Burns University of Sheffield as speakers. The session was due to consider the problems facing social care and to consider what steps are required to improve standards and access to social care services for all.
Matthew Egan referred to a survey that was carried out with regards to Adult Social Care. Results from paid carers include the following :
* 74% of workers did not have sufficient time
* 61% said that there was not enough time for the 90 plus
* 24% said that they had no time to take people to the toilet
* 49% did not have time to provide nutritional meals
* 85% do not have time for conversation
* 96% said that they were often the only person visiting.
The general conclusions was that the care was delivered like a conveyor belt, no dignity for anyone concerned. Recently, £2 billion has been taken out of the system and this from a sector that has always suffered from underfunding. The present service is predominantly run by the private sector . With regards to commissioning , very little attention is given to the monitoring of the contracts created. Also, there was a clear statement coming from the speaker as to how we fail to value our care workers. How this could be changed was posed. The use and value of the Ethical Care Charter was suggested as a start in the process.
Dr Burns is a lecturer in the School of Management at Sheffield University. She has done research on the quality of care existing in residential homes. She pointed out how care provision has evolved over time and now 90% of care provision is run by private companies. There is presently, a crisis in residential care as a result of the financial squeeze and several companies believe that they are in danger of going bust. The sector has always had its problems but these have been aggravated by the following :
- LA’s have frozen the rate willing to be paid for a bed and this has led to a 5 to 7% fall in real terms
- Introduction of the national minimum wage
- Providers have increased the rate for self funders in response to the cuts made by LAs.
It was suggested that Care homes will certainly be closing as a result of the above and some have already done so. There was also reference to the issue of the financial business model adopted by the sector as having a damaging impact. Apparently, the model that is used is one where care homes are bought and then leased back. The model is a debt based financial form of engineering. Tax is not paid on debt so this model of sale and lease back is deliberately adopted to increase return on capital. Furthermore, following such forms of implementation we end up with a standardised product. The model usually includes fifty to sixty rooms , everyone eats together etc. Three questions were asked by the presenter :
- What is the place of this debt based model and the implications ?
- Should the fifty to sixty bed model be the template ?
- How do we mobilise political attention ?
With regards to integration the presentation raised concerns including the idea that the NHS could suffer. There also was an argument put forward for the increased use of social workers within the field of Adult Social Care. Other than that there was very little put forward that would help us work to change the model. The conclusion was that we needed to concentrate on the politics of change working for a properly funded health and social care system free at the point of delivery. More investment is required to build more provision . The idea of collectives was suggested where people sell their own homes and then buy in. The Green House project was mentioned. Also if any new model is created training has to form a fundamental part of the process as well as a culture of respect for the elderly.
The question and answer sessions in both sessions raised more problems than solutions. There also was little discussion about how we can campaign for change. Maybe the NPC needs to consider how we campaign in this area and work for more effective models to be put in place.
Janet Shapiro comments: In relation to Lourdes’ last point, the NPC has a Fair Care Campaign, with its own booklet.
Delegate Argyros Arghyrou gives his own opinion about to the conduct of sessions. To clarify – Pensioner Parliament is held in order to glean the experiences of pensioners from all over the UK; enough time is allowed so that attendees to get a chance to speak. This informs both NPC officers and the speakers.
On Wednesday there were six sessions and on Thursday one: each lasting 2 hours. In the morning and afternoon we had the choice of three sessions, each with a chair and two to four speakers.
It was a democratic structure; the chair introduced the subject; after the speakers gave their presentations the audience were invited to ask questions or make brief statements. Speakers had to take notes and attempt to take notes on a multitude of questions. In my opinion this ‘democratic structure’ failed. Why did it fail ?
Primarily because too much time was spent on allowing too many of the audience & participants to ask their individual questions, leaving little time for the speakers to make considered answers. Two hours is not a long time when the subjects are of intense social, pragmatic and philosophical content.
What then is the pragmatic solution ?
Have a strict timetable (announce this to the audience from the beginning):
introduction 5-10 minutes,
15-20 minutes questions. Answers : 30 minutes.
Chair : comment 5 minutes. Then repeat as above.
By this means a BALANCE is achieved. Democracy in a balanced disciplined structure. When Teaching one is also Learning.