Friday 29 November 2013

Comet Sail

A previous comet

See the story and text of a letter which I and 49 other charity CEOs have sent to Iain Duncan Smith about the effect of the Bedroom Tax on disabled people here.

I'm not sure myself that I agree that this charge - or more accurately benefit reduction - should be called a "tax" by its opponents but that is to split hairs. Whatever you think of the wider argument about how much space benefits can reasonably pay for in people's homes it is plain wrong to take money away from vulnerable disabled people who have need for space and for whom moving house would cause disruption and dislocation.

In practice the effect of the benefit reduction for most people (who will not be able to move) will simply be to reduce their income below that which was means-assessed for them - in other words they will have less to live on than IDS's own department thinks they need as a minimum. No, I don't understand either.

Besides there is more to it even than that. Retrospective law is generally regarded as oppressive and unfair because people couldn't obviously know the rules before they were dreamt up. I suggest that similarly it's not fair to tell people who are settled somewhere, often for many years, in a home which they chose - or had chosen for them - according to the rules which applied at the time...

"No, sorry, you shouldn't have been allowed that home and now you will have to get out - or you can stay but you won't have enough money to live on".

Just how long would the list be of things which the Government might reasonably cut first before they got to this?


How long indeed?

Apparently the comet in today's news known as "Ison" (story here) sailed "close" to the Sun yesterday i.e. only a million miles from it. We are 93 million miles from the Sun, luckily I guess, though I can't help thinking 80 million miles might be more comfortable and permit year-round short-sleeves, sea-bathing and long cocktails?

Now just pick any of the distances mentioned to get the length of the list.

Wednesday 27 November 2013

Parthian Shot

It was uplifting to see the parting shot of the Welsh public services Ombudsman Peter Tyndall who, after years of fighting the corner of people trying to make sense of getting help simultaneously from both health and social services, said the apparently unsayable and suggested the two should be joined up - not just talk to each other, not just "share budgets", but merge into a single structure which would then be unambiguously responsible for vulnerable people.

I have met Peter several times and he was always attentive to Hafal's advice about assisting people with a serious mental illness. He's a wise man with his own mind and we should listen to him.

This is what he said...

"We need to be much better at delivering integrated packages of care than we are at the moment and that will need structural change. Many more people are living in the community and receiving support... Often that support is coming from private or voluntary bodies; on the other hand, you have nursing care from the district nurses, occupational therapists and physiotherapists and so on. We need to look at that as a single joined-up entity instead of the fragmentation we currently have.

"It's all very well to say to people to share budgets and so on, but why do you have separate budgets in the first place? Why do you have separate agencies in the first place? I think that's a historical accident and it needs to be corrected."

Amen to that, though not really an historical accident, I would say. The origins of social care as a separate undertaking were not accidental but a worthy effort by the post war state to see caring for people as a wider mission than treating health problems - and of course much good has been done as a consequence. I am not in the business of attacking social workers.

But here is a difficult truth. Citizens never asked for a separate social care agency and to this day they don't understand the point of having separate health and social care structures.

The argument for separate agencies has been made strongly over the years - not by consumers but rather by well-meaning busybodies, not least mental health organisations who to this day wring their hands about the distinction between "social" and "medical" models of mental health care. In practice patients do not understand this argument and find it bewildering, not because they are stupid but because these false distinctions have no relevance to the real lives of people seeking help to recover from their illness.

In fact a mistake was made from the outset (with the benefit of hindsight) and it would have been much more practical - and make much more sense to the public - to have broadened the concept of health (and so also the mission of health services) to embrace social care needs, child and adult protection, etc. This would also remove much of the stigma and public suspicion about social work.

And there is now an opportunity to put this right as I have previously pointed out here.

Mr Tyndall has gone to Ireland to be their Ombudsman - good luck to him and them - and we are left with his advice ringing in our ears. The Welsh Government has reiterated its policy of encouraging cooperation but not supporting structural change. But we've tried that for years and it doesn't work.


"Parting shot"? Pub bores with a classical education will tell you that the origin of this expression is the practice of ancient Parthian (Parthian = parting, geddit?) cavalrymen pausing as they ride away from an enemy to fire arrows back.

Complete nonsense, of course, invented by some wind-up merchant in Victorian times. "Parting" just means "departing" as any fule kno.

Friday 15 November 2013

Up 4 It!

At the launch yesterday

Excellent launch for our pioneering new "Up4It!" Early Intervention Service in S E Wales - in partnership with the Aneurin Bevan LHB. Thank you Big Lottery for the grant and thanks too to the Minister for backing this tough and demanding initiative.

Nothing controversial about educating all young people (or all people) about mental health (but that won't stop people developing serious mental illnesses like schizophrenia or bipolar disorder); nothing much controversial about supporting people with an established history of serious mental illness; but intervening at the earliest stages of psychosis, especially with children, is difficult ground on which we will have to tread with great care.

But then the whole idea is to combine sensitive clinical help with a determination to sustain young people's engagement with normal processes of education and getting into work, etc: hence this uniquely close partnership with the LHB.

There is also a very important, if secondary, consideration, namely the argument for such a service in terms of health economics. Purely preventive health initiatives have their place though they are notoriously elusive in terms of proving cost-effective. This is especially true in mental health - for the simple reason stated above that the common serious illnesses, which use up 80% or more of mental-health-specific resources, are not preventable by provision of advice to the public. However, the potential for saving resources through early intervention is another matter!

But, as I say, that would be secondary to saving lives literally and qualitatively...

Health and Social Services Minister Mark Drakeford AM, Professor Siobhan Mclelland - Vice Chair Aneurin Bevan Health Board, me, Team Leader Early Intervention Service Shane Anthony and John Baird, Consultant Psychologist

Wednesday 13 November 2013

Guest, Keen, and Nettlefold

Foghorn Leghorn, the Deep South's most famous free-range rooster - contented...but fictional

I have happy memories of keeping chickens in my back yard. I especially remember three indulged layers called Guest, Keen, and Nettlefold (I lived in the steel heartland of the Northern Valleys then) which Mrs Blog would bring into the dining room after meals so that they could peck clean our plates, an eccentricity which meant we didn't see some dinner-party guests ever again.

Anybody who has kept hens knows that they won't lay eggs - or they lay far fewer eggs - if they are unhappy or distressed. Further, birds being grown for the table won't put on weight so quickly if they are unhappy. Nothing very surprising about that really.

And yet people are surprised to read today (see the story here) that mass-produced, caged birds are happier than free-range ones which endure all the anxieties of bullying, accidents, and not getting to the food on time.

But it's not surprising. That's why free range eggs and chicken cost much more than the industrially-produced ones which are happier and therefore more economical.

So ignore the millionaire foodies who wring their hands and try to intimidate poorer folk into buying expensive but actually less "welfare friendly" food products. Instead just go about your shopping with a clear conscience and wonder at the strangeness of life.

Monday 11 November 2013

The Haftas

Hafal Wrexham - best film

Rather a hectic weekend so only now getting around to considering Hafal's 2013 "It's a Wrap!" Conference last Thursday in Builth Wells. Quite a day with over 200 present and a vast range of activities including music workshops, Tai Chi, and user and carer rallies. A really successful event thanks to Emma and all the many others who ensured our guests had an informative and fun time.

And then of course there were "The Haftas" - an awards ceremony celebrating the work of filmmakers who took part in this year's Lights! Camera! ACTION! campaign. This involved a quick change for me from Hafal-branded smart(ish) casual to formal black tie in order to hand over the rather classy awards.

Go to our very own channel democratically known as Hafal Telly to see all the films and a short film from the event too which gives some clues about what we'll be up to next year - more about that soon.

Jake - for coolness under fire - see the out-takes scraped from the cutting room floor here

To read the Lights! Camera! ACTION! campaign report go to this link.

Company Sec Nicola Thomas orders a G&T from a passing waiter