Councils turn backs on care for older people

In the same week as MPs voted in favour of gifting the audit-failing European Union a massive and unjustifiable increase in funding of £7bn, it has been revealed that nearly three-quarters of local authorities in England are rationing social services to exclude tens of thousands of vulnerable people from help with the basic tasks of daily living.

The Guardian reports today that official figures obtained by the charity Mencap reveal the worsening plight of people who cannot wash, dress, prepare a meal or go to the shops unaided - a growing problem this blog has been recording now for more than a year.

It said the problem affected older people and adults with learning disabilities in areas where cash-strapped councils have decided they can no longer afford to provide services to everyone in need.

The information, from the Commission for Social Care Inspection (CSCI), found 73% of local authorities were planning to refuse care to everyone whose needs were not considered to be "substantial".

The government's definition of substantial covers people who "cannot carry out the majority of their personal care or domestic routines" and do not have anyone available to provide voluntary help.

It excludes people with "moderate" needs who may not be able to carry out several daily routines such as getting up in the morning, bathing and doing the washing up.

The CSCI found four local authorities intending to ration services even more tightly to provide care only to people whose needs are "critical".

Under this definition, people would not get support unless their life was in danger or they were at risk of serious abuse or neglect.

The four were Northumberland, Surrey, West Berkshire and Wokingham councils. They are about to be joined by the London borough of Harrow, which yesterday defended plans to tighten its eligibility criteria at a judicial review in the high court.

Dame Jo Williams, chief executive of Mencap, said: "These figures show the true extent of the crisis in social care. It is unacceptable in the UK in the 21st century that local authorities are refusing support to very vulnerable people with a learning disability who have no one else to turn to.

"Last month the government gave an increase of less than 1% for social services. Given rises in demand, we will just see more and more cash-strapped councils cutting back."

The tightening up of council funding means the number of households across England receiving local authority care fell from 528,500 in 1991 to 345,000 this year, despite growing numbers of older people.

The CSCI data showed rationing has become much tighter over the past two years. In 2005-06, 54% of authorities restricted services to people whose needs were deemed "substantial".

This increased to 62% in 2006-07 and - according to councils' official plans - would reach 73% by the end of March.

Gordon Lishman, director general of Age Concern, said: "Chronic under-funding of home care services means people are being deprived of the help they need until they reach crisis point ... We need a better system for paying for care to end the postcode lottery and the unfair way people on low and modest incomes are charged."

The Local Government Association said: "Councils want to provide the services vulnerable people need but are increasingly unable to do so because central government funding has not kept pace with the demands of an ageing population."

David Rogers, chairman of the association's community wellbeing board, added: "Ministers need to turn with urgency to the long-term overhaul of the future funding of adult care services ... It is unjust that people have to wait until their life is threatened, or suffer from a serious mental and physical illness, before they receive care.

"If society is to meet people's needs and aspirations, the social care system needs root and branch reform, giving individuals choice, independence, dignity and control over their lives."

Harrow council last night defended its decision to save £2m by withholding services from people in substantial need. Chris Mote, the leader, said it received less from the government than other London boroughs and had to concentrate support on the most vulnerable.

"We were forced to take action ... to balance the budget" he said.

MPs have a moral obligation to be far more responsible with scarce public money than gifting it to EU, which has a terrible reputation for waste, fraud and mismanagement.

They must choose to stand up for properly-funded care for vulnerable people and vote against the European Communities (Finance) Bill at its final reading in a few weeks time.

'Cost-cutting' a factor in loss of data

The Government has today been accused of putting cost-cutting ahead of security as the fall out from the HM Revenue and Customs scandal continues to escalate - reports the Daily Telegraph.

Internal HMRC emails show that officials were concerned about incurring additional costs after receiving a request by the National Audit Office for details of its child benefit database.

In an email dated 13 March, with all named blanked out, an NAO official said: "I do not need address, bank or parent details in download - are these removable to make the file smaller?"

However, a subsequent internal HMRC email stated: "I must stress we must make use of data we hold and not over burden the business by asking them to run additional data scans/filters that may incur a cost to the department."

According to the Daily Telegraph, the procedure to delete the details - which would have removed much of the threat of identity fraud - would have cost just £5,000.

When the NAO asked for further copies of the files for an audit in October, an official wrote: "Last time we had 100 zipped files on 2 CDs. Please could you ensure that the CDs are delivered to the NAO as safely as possible due to their content."

The CDs were then sent by a 23-year-old junior official from HMRC through courier TNT, neither recorded nor registered.

Following the release of the emails, Liberal Democrat acting leader Vince Cable accused the Government of putting "minor cost-cutting" ahead of security.

"IT experts point out it is possible to strip out data for a modest sum but the Government's short-sightedness has led to millions of personal details getting lost in the post. This is simply unacceptable," he said.

The news that this administrative disaster rested on a desperation by the Customs & Revenue service to save a matter of £5,000 puts the decision of MPs to lavish an extra £7bn of public funds on the audit-failing European Union in stark context.

MPs simply cannot justify giving such vast sums to an organisation - the "majority" of whose annual spending remains unverifiable by auditors - while witnessing these catastophic results of drastic cost-cutting at home.

Each MP who now exhibits such misplaced priorities and votes to approve the European Communities (Finance) Bill at its final reading in Parliament in a few weeks time will have to shoulder the blame for the consequences of public money running out, like those we've seen this week.

Norfolk: Bed crisis sparks hospitals alert

Hospitals across the east of England have been placed on "black alert" as staff and wards are overwhelmed by high patient numbers - reports the BBC.

Non-urgent cases have been sent home after up to 10 ambulances were left queuing outside one hospital.

Few or no beds are free at Queen Elizabeth Hospital, King's Lynn, and the James Paget Hospital in Gorleston, both in Norfolk.

People with minor injuries have been urged not to attend A&E.

The alert status means plans designed to enable staff to cope with major incidents, such as terrorist attacks and train crashes, are put into action.

At the Norfolk and Norwich University Hospital (NNUH), which announced it had reached the emergency status on Wednesday afternoon, managers worked with other agencies to discharge non-urgent patients from the 1,000-bed hospital to create space.

However, the hospital said that between 60 and 70 beds were still being blocked because patients who were medically fit to leave had no where to go.

Paramedics treated patients in ambulances outside the NNUH on Wednesday evening.

A spokesman for the East of England Ambulance Service said: "Most things we can manage - it only becomes critical to get someone out of the ambulance and into the hospital if someone is bleeding to death or in full cardiac arrest needing resuscitation.

"There were serious condition patients but they were being treated at the NNUH by hospital staff."

NNUH spokesman Andrew Stronach said there was no single incident that brought on the beds crisis.

"It's just general run of the mill problems, like chest pains, collapses, diarrhoea and vomiting."
The James Paget hospital and the Queen Elizabeth in Kings Lynn said there were sufficient beds, but a sudden change in the weather was putting extra pressure on them.

Norman Lamb, MP for North Norfolk, said the hospital was regularly well above the safe occupancy level of 85%.

He said: "If there was to be a flu epidemic this winter then we've got a major crisis.

"Across the country we're seeing occupancy rates increasing. There's also evidence that you run an increased risk of hospital acquired infections if you've got a hospital that's literally full.

"This is a serious problem and yet there appears to be nothing being done to increase the capacity to ensure that there's enough beds to treat patients."

Milton Keynes and Hertfordshire health officials have said they are not on alert, but Bedford Hospital has been on red alert since Friday.

In Suffolk, Ipswich Hospital said it had very few beds but was managing the situation and a spokesman for the West Suffolk Hospital said its alert had been caused by sickness bugs.

Norfolk MPs Norman Lamb and Henry Bellingham can fairly claim to be doing their best to ensure local hospital services have the facilities and resources they need to avoid situations like this developing - by opposing the payment of an extra £7bn to the audit-failing European Union.

However, Tony Wright MP for Great Yarmouth and Ian Gibson MP for Norwich North both voted on Monday to approve this unjustifiable extra multi-billion-pound spending on the wasteful EU, so can hardly claim to be doing their best for essential local services.

Local voters need only wait a likely 18 months for the next general election, to let them know what they think of such irresponsible decision-making.

'Inadequate care' in half of A&E trauma cases

Less than half the patients admitted to accident and emergency departments with severe injuries get adequate care - according to the Daily Telegraph.

A Government-funded report has found that 20% of hospitals have no dedicated trauma team and that care standards drop significantly at night, adding that trauma patients are being treated by inexperienced staff who display little urgency and make incorrect clinical decisions.

The Government is expect to seize on the findings to support a White Paper published last year advocating centralising trauma care in specialist regional centres, at the price of local A&E departments.

Critics suspect the proposals are more about cost-cutting than patient care and say the move could see 29 hospitals closed. They argue this will jeopardise the survival of patients, who will be put at risk by travelling the extra distance to a trauma centre.

Their fears are backed by recent research which suggested that mortality rates increase by 1% for every extra six miles travelled.

Commenting on the report, Dr Jonathan Fielden, of the British Medical Association, said: "It must not be taken to support closing local units, it should be used to improve patient care. There need to be more consultants employed in the NHS to lead trauma teams."

The report, "Trauma: Who Cares?", published today by the National Confidential Enquiry into Patient Outcome and Death, says hospital trusts must ensure a trauma team is available 24 hours a day with an experienced consultant as leader.

Sadly this is unlikely to be affordable while MPs splash so much public cash on the audit-failing European Union.

On Monday, MPs voted to approve a massive £7bn increase in funds, taking our annual EU payments to an astonishing £10.5bn gross every year.

But while the "majority" of the EU's spending remains unverifiable by auditors, and reports of EU waste and fraud continue, there is absolutely no justification for rewarding the EU with such a huge increase in payments.

No wonder the government is having to consider centralising trauma care in regional centres, instead of properly equipping local A&E departments. Where are our MPs' priorities?

Cash crunch will stop Forces doing their job, says ex-Army chief

The former head of the Army has warned that the Armed Forces are facing a cash "crisis" - reports the Daily Telegraph.

The news comes as, just two days ago, MPs voted to approve the government's pledge of an extra £7bn to the EU's budget, despite last week's revelation that the EU Court of Auditors has been unable to verify the "majority" of the EU's spending for the 13th year in a row.

Gen Sir Mike Jackson said recent spending commitments by the Chancellor were likely to prove insufficient to ensure the country's "national insurance policy", raising doubts over whether the military will be able to pay for future operations or major equipment projects.

Speaking to BBC Radio 4's Today programme, he said: "I detect, I fear, some crisis ahead in defence spending, if things go on as they are in terms of what we do, what we might have to do and the money allocated"

He hinted that there might be bad news ahead for one of the military's main procurement projects, such as new destroyers or submarines.

Since resigning, Sir Mike has also criticised the MoD's treatment of soldiers, particularly the standards of pay and living accommodation.

The MoD is currently battling with the Treasury over funding of equipment projects and "urgent operational requirements" of kit needed in Iraq and Afghanistan.

There are also worries that without proper funding the military is going to continue to lose substantial numbers of troops who are fed up with poor pay, accommodation and constant operations.

MPs need to think again about whether gifting the EU billions of pounds extra is either affordable or justifiable while a "majority" of its spending cannot be verified, in advance of the Third Reading of the European Communities (Finance) Bill.

Those who vote for such large-scale waste of public funds will then have to bear personal responsibility for the consequences of shortfalls of funds elsewhere, many examples of which are already in evidence.

London: Health summit paves way for abolition of traditional hospitals

A major health summit is taking place today will change the face of the NHS in London, reports the Evening Standard.

Senior managers and doctors are meeting to draw up plans that will abolish traditional hospitals.

They are finalising a major consultation document that asks every Londoner to decide if GPs should move into big polyclinics.

Patients will be asked a series of crucial questions - signed off at today's meeting - that will lead to the massive changes next year.

They will be asked about the centralisation of services such as trauma care, treatment of children and the care of stroke victims should be centralised away from local hospitals into so-called "specialist" centres.

And whether more maternity departments should be run by midwives instead of doctors.

The consultation will be launched at the end of the month and is likely to trigger battles to
save local services.

Bosses have refused to name the hospitals and surgeries that should close and are consulting on "ideas" first.

Robert Creighton, chief executive of Ealing primary care trust, and one of the leaders of the consultation, said: "We want to get people's views about the proposals and we intend genuinely to listen to what the public have to say."

But doctors have warned that the plan is being driven through. Dr Stewart Drage, head of Londonwide Local Medical Committees, said: "We have reservations about this whole process. We are concerned that the local input is going to be very limited."

It comes as campaigners find out the results of a consultation to downgrade Chase Farm hospital in north Enfield.

Thousands have been fighting plans to move A&E and maternity services to Barnet and North Middlesex and make Chase Farm a community hospital.

The summit meeting into changes across the capital - taking place at the Sofitel hotel near St James's Park - could mean the plans for Barnet and Chase Farm change again.

The proposals are based on plans drawn up in the summer by junior health minister Lord Darzi, who is now leading a nationwide review of the NHS.

Questions must be asked as to whether these changes are being driven more by attempts at cost-cutting than to enhance patient care.

With MPs voting an extra £7bn to the European Union completely without justification on Monday of this week, public funds for essential services are becoming increasingly tight.

It's time MPs looked again at the real priorities of those they represent, before they give final approval to this multi-billion-pound funding increase to an organisation that has failed its annual audit for 13 years and is beset by reports of needless extravagance, waste and fraud.

Come next year, it'll be no good MPs posturing in protest against hospital closures in their constituencies if they've voted to waste such vast sums of public money on the EU. They will be personally responsible for the money running out, and themselves can expect to pay the price at the ballot box.

State borrowing to rise as Treasury left with little 'wiggle room'

The Government is on course to exceed its borrowing targets by as much as £4bn this year, as public finance data came in much worse than had been expected - reports The Times.

Analysts said that the public sector net surplus was £993 million in October, compared with expectations of £3 billion, putting a dampener on the health of Alistair Darling's forecasts as the economy enters the second half of the fiscal year.

The Chancellor forecast in his Pre-Budget Report that public borrowing over the year as a whole would reach £38 billion. But the Institute for Fiscal Studies (IFS) said yesterday that the figure could reach £42 billion if present trends continued.

PriceWaterhouseCoopers predicted that the State would borrow £40 billion this year and next.

The IFS said that the overshoot in borrowing was because capital spending was growing twice as quickly as the Treasury forecast.

John Hawksworth, head of macroeconomics at PriceWaterhouseCoopers, said: "At this point in the economic cycle, the public finances should be improving in order to provide some 'wiggle room' in the event of a future cyclical downturn."

"The fact that they are getting worse will be of concern to the Treasury, since it suggests possible structural weakness and a potential need for further tax increases or greater spending restraint looking ahead."

In this context, the apparent enthusiasm of the government and many MPs to spend an extra £7bn on paying the European Union's extravagant and largely unverified bills looks particularly ill-advised.

Those MPs who vote approve these extra payments when the final vote in Parliament on the European Communities (Finance) Bill comes will consequently have to bear major responsibility for the tax increases or other public spending restraints impacting on their constituencies that analysts are now saying will have to come if the public finances continue to worsen.

Such irresponsible decisions to throw billions more pounds every year into such a black hole of waste, extravagance and fraud cannot possibly come without a price.