Liberal Democrat leader and Deputy Prime Minister Nick Clegg, together with Care Services Minister Paul Burstow, today announced the new “No health without mental health” strategy, which re-prioritises mental health services and outlines how a new emphasis on early intervention and prevention will help tackle the underlying causes of mental ill-health.

It sets out how the Government will work with the NHS, local government and the third sector to help people recover and challenge stigma. Central to these plans is an additional investment of around £400 million to improve access to modern, evidence-based psychological therapies over the next four years.

At least one in four people experience a mental health problem at some point in their life and mental ill-health represents up to 23% of the total burden of ill health in the UK – the largest single cause of illness. NHS spending on schizophrenia for example is more than the spend on heart disease or cancer.

Hopefully the new strategy will be a step in the right direction in helping the many millions of people affected by mental ill health. With the right interventions and the right time, we can really help.

Rick

Commenting on the report on mental health services in England released today by MIND for the We Need To Talk coalition, Liberal Democrat Minister of State for Care Services, Paul Burstow said:

“The We Need to Talk Coalition is right to set out the state of mental health services that the Coalition Government has inherited. There is much still to be done.

“I am determined that in future mental health is treated with the same importance as physical health.

“We have already signalled our commitment to mental health by committing £70 million this year to roll psychological therapies out to more people.

“The Government understands that there is no health without mental health.  That is why we will publish a new mental health strategy this winter that will tackle these issues.”

I welcome Mr Burstow’s commitment to mental health, but I worry that the government’s decision to put local NHS commissioning in the hands of unelected, only marginally accountable GPs might run counter to it. They will control the purse-strings, and if they choose not to commission good quality mental health support, what will we do then?

The previous government’s commencement of the Increasing Access to Psychological Therapies programme was great, and the news that there will be a continuation of funding now is also great. There are going to be a lot of people suffering very stressful times as the cuts bite. Stress and depression are two massively common illnesses which cause misery and worklessness. We need to commit to fighting them, even if it costs money up front, because it will surely save money and make lives better in the long term.

Rick

Liberal Democrat Minister of State for Health, Paul Burstow held a consultation session with Conference delegates on the Health White Paper the other day.

I criticised Mr Burstow a few weeks ago about an obesity policy which I thought was neither liberal nor sensible, and pretty much devoid of any actual ideas. Unfortunately, I have similar reservations about his words on the Health white paper.

Talking about the white paper, Mr Burstow said “We were among the first to argue for patient choice and empowerment, first to demand more autonomy for health professionals, first to push for more social enterprises in health and care, first to insist on joined up health and social care and first to make the case for community politics, where decisions are taken by or close to the people they affect most. Every one of these causes runs through our White Paper.”
He’s right. The white paper is a triumph for those who want lots of Lib Dem manifesto things in the coalition agreement. I think though that our policy was muddled and wrong to begin with. It seeks to be everything for everyone, and doesn’t tackle the key issues or questions facing the NHS.

It’s a shame that during the general election campaign nobody asked me which of our policies I didn’t agree with (since I think it’s impossible for any politician to agree with everything his party stands for), because if someone would have done, I’d have said it was our health policy. It’s muddled and contradictory, and Mr Burstow talks of our successes when I’m far from sure they exist.

Patient choice is a good thing, but only on two conditions. First, that the core NHS service is consistently high performing, and second, that more than one choice appeals. I don’t think either condition has yet been met. Some NHS services have been vastly improved under Labour, but there is still too much inconsistency, and the decision of the coalition to exclude the NHS from cuts may be popular, but ducks the obvious scope for efficiencies that must exist in a service as big as the NHS.

The second condition hasn’t been met either. Given the choice about what type of NHS people want, many run a mile from the types of social enterprises and alternative providers our policy is also advocating. The case has yet to be made for alternatives, and it needs to be. It’s the same with clinical autonomy, which is a noble ideal but often runs counter to what patients want. GP commissioning, for instance, was warmly welcomed by doctors but roundly criticised by patients groups.

Mr Burstow talks about an insistence on integrated health and social care, which is again a good idea (if a fairly obvious one). Working in the sector as I do though, I don’t see it all the time, nor do I see how it can happen when both NHS and social care providers like Councils are scrabbling around for anything to cut, and not necessarily doing it in a joined up way.

And the call for more democracy in local health services is, again, a principle I share. Our policy though, calling for locally elected Health Boards, isn’t the best way to do it. We already have locally elected people who are close to the communities they serve. They’re called Councillors, and they have nowhere near enough real decision making power. Why not give them some by broadening their remit to include health? Creating another phalanx of elected people is unnecessary and confusing, and likely to be as ineffective as Foundation Trust Boards of Governors, many of which are little more than talking shops full of frustrated people who care but have no influence.

I think our policy needs to be tighter and clearer on its vision. That might mean some difficult decisions. There’s certainly more work to do.

Rick

There were four debates on the order paper for the Council meeting last night.

One was from the Lib Dems about how the Council could use a new coalition government directive and make money generating its own renewable energy. Unfortunately we didn’t get to that because it got to half ten and we were all losing consciousness with tiredness, so adjourned. I like to think it would have been passed, and hopefully we can make progress on that agenda regardless.

Another was a largely uncontroversial one about voter registration. Although I think the Labour proposal that we voted for isn’t perfect (the main problem being that they suggested house to house enquiries which cost money we don’t have), it can’t be denied that the current system isn’t working and needs changing.

The third was about Local Area Partnership grants, which have been cut. This is very bad news as LAP Grants have provided much needed funds to improve our local area. In Prestwich grants have seen projects like Prestwich Festival, the Farmers Market and the Graffiti Clean Up – to lose all of this would be a disaster. Obviously this is one of the first wave of many cuts, but we called last night for an all-party approach to finding alternative funding sources, and for prioritising this expenditure and making more cuts elsewhere. We received cross-party support for this approach, which was great. I hope they can be re-instated.

And there was a debate on Fairfield Hospital, the maternity unit at which was to close. In the general election campaign the Conservatives promised to keep it open, and have now ordered a review of the closure.

The back story about who is to blame for what is complicated. The hospital itself is run by Pennine Acute Hospitals NHS Trust, but the decision to close the unit was made as part of a county-wide review of maternity provision, led by the Strategic Health Authority and the local Primary Care Trusts. At the same time, Councils and their Scrutiny committees had their say, as did local MPs. This murkiness makes it pretty easy for anyone to take credit and apportion blame pretty much anywhere they like, and pretty difficult to know who is actually responsible for what. Democracy that confusing really isn’t democracy at all.

What was clear was the strength of feeling that the decision to close Fairfield Maternity was wrong. I agree with keeping it open and have campaigned to do so.

The Conservatives put forward a motion praising the review into the closure, and although I thought it would pass quite easily, Labour out-thought me and proposed an amendment recognising that reviewing closure isn’t necessarily the same thing as keeping the unit open. Cue a lengthy debate, all sides saying how wonderful Fairfield is but the Tories getting very defensive about actually living up to their promise and keeping it open.

If the review finds the same findings as before, it will still close, and that’s a broken promise.

We voted for the amended motion calling on the government to keep its promise and keep the unit open. Labour and Lib Dem combined votes equalled 22, and the Tories had 23. The Mayor (who was a Labour Councillor and will go back to being one after his year in office) took the unusual step of voting to tie the scores, and then using his casting vote to pass the amendment.

That wasn’t the only novelty in the debate, although hopefully Mayoral interference doesn’t become as common as a couple of other things now featuring in more and more Council debates. First off we have whooping, cheering and applause after speeches, which renders the Council chamber less like a meeting room and more like the studio of the Jeremy Kyle Show. I think it’s a bit silly, and although it might make the whoopers feel a bit better and a bit more smug about their argument, lest we forget that Bury Council has less power than the Micronesian Ambassador to the UN, and that they whoops actually don’t mean anything.

We also have an odd trend developing whereby every time there’s an amendment suggested, one group or another (mine included) suggests a five minute recess. This isn’t just a recess in the meeting, it’s also a recess in the space/time continuum, as I’ve never seen a five minute recess last less than 15 minutes. Quite why we have to leave the room to discuss tactics when it’s quite possible to either share amendments in advance or just make our minds up there and then is beyond me. It’s all obviously part of a conspiracy to keep us all from going home.

Anyway, after the whooping and cheering and clapping and adjourning, the amendment about Fairfield got passed, and after an hour of talking about it we all agreed that we wanted the maternity unit to stay open.

Which was exactly what we all thought when we started!

Rick

Liberal Democrat Health Minister Paul Burstow says the new NHS 111 service will benefit patients. The Coalition Government announced the intention to establish NHS 111 in the Health White Paper in July. The new service is being piloted in four areas before being rolled out in 2013.

Commenting Liberal Democrat Health Minister, Paul Burstow said:

“NHS 111 will build on NHS Direct but will go further providing a much more integrated service for the public.

“Unlike NHS Direct NHS 111 will be free to call.  Where NHS Direct can only signpost other services NHS 111 will be able to book a GP appointment and go straight through to local out of hours services.  If you do need an ambulance the 111 service will cut out the need to go through the 999 service assessment.

“NHS 111 will ensure people are put in touch with the right health professional first time.  By doing that the new service will reduce the pressure on 999 services and A&E departments.

“This is a simple, cost effective idea: from 2013 people can ring 111 for non life threatening health concerns and 999 when it is a matter of life or death.”

An odd bit of press from the “one press release a week if you’re lucky” Lib Dem media centre today:

Commenting on the 10-fold rise in the number of obesity-related surgeries carried out on the NHS in less than a decade, Liberal Democrat health minister Paul Burstow said:

“Over the last 13 years we’ve become the country with the highest rate of obesity in the whole of Europe.”

I like to imagine that he said that in between bites of a Big Mac Meal whilst funnelling pints of ale down his gullet and ordering a Chinese takeaway. But I doubt it.

Regardless of his culinary status at the time, he continued: “Obesity related surgeries are procedures that can transform lives, save lives and save money for the taxpayer.

“The 10-fold increase in less than a decade shows the last Government failed to get a grip on public health issues.

“We are committed to a real drive to consistently deliver public health messages about changes in lifestyles that people can make, both in diet and exercise, that can significantly reduce the need for these procedures.”

I was slightly confused by that press release, since on the one hand it says how great obesity related surgery is, but on the other criticises the increase in obesity related surgery… But I get the point that obesity itself is bad, and that more survery for obese people means more obese people in general.

Which is fine, but I think the approach in the press release is not exactly fair on the previous Labour government, nor does it really reflect the type of small-government liberalism that the coalition professes to be about.

Nobody doubts that obesity is a growing problem (pardon my pun). But there’s only so much that our solution of ”consistently delivering public health messages” can do. Labour could, and perhaps should, have done more to tackle this problem. But I don’t think the coalition has started well in terms of righting any Labour wrongs. We could be doing lots more. 

How about reversing the cuts in free swimming, or having some targeted investment in local leisure centres so that they can be realistic, cheaper alternatives than private gyms? How about better lighting and security in parks, or exercise equipment in parks? Or better enforcement of traffic laws that would make it safer for cyclists? All of those would make exercise easier. We might not be able to afford them right now, but we could at least mention them.

On the food side, how about working with retailers, not necessarily to tax bad foods, but to make good foods more appealing. Ready meals are often discounted or made buy one get one free. Why not more bags of fruit and veg? Double Clubcard points for every carrot? I dunno, but it’s a start. We need people in the Department of Health to come up with innovative ideas. People like Paul Burstow.

Granted, Labour did none of the things I suggest above, and maybe deserve some criticism for it. But we now have much better food labelling and a greater understanding of nutrition than we did in 1997, and things like the need for 5-a-day have entered the public consciousness far more than they were before. I’m not sure we’ve done anything in government yet.

Increasing obesity is a worry, and we need to sort it out. I think Labour were unfortunate to be in government when games consoles, the internet, multi-channel TV, 24 supermarkets and lots of other things developed to make exercise less appealing and slobbing out more attractive. To blame them entirely is silly “old” politics, and I don’t like it. People do stupid things like get fat. Government can only do so much, and should only do so much. We shouldn’t blame the government for people being stupid.

For goodness sake, there’s enough to have a genuine go at Labour at without making stuff up like this. 

I don’t think the solution to the obesity problem is to blame Labour and say we’ll tell people a bit louder to be good. It’s not sensible, nor is it liberal.

We accused Labour of being excessively nannying, and yet now we accuse them of not being nannying enough when it comes to public health messages? We should make our minds up, at the same time as coming up with an actual plan to tackle this problem.

Rick

Tonight I visited Bury Hospice at the invitation of the Chief Executive, to view their plans for a new facility, and to meet some staff and take a tour. It was a very informative and enjoyable hour and a half, for which I’m grateful.

The visit started in slightly surreal fashion, I must admit, as I arrived just when two other local PPCs were leaving from earlier appointments. It was clearly some kind of politician’s open day, as Michelle Wiseman the Tory PPC for Bury South, and Maryam Khan the Labour PPC for Bury North were in the lobby leaving as I was going in. I did fear slightly that the coming-together of three opposing political forces in one place unexpectedly would result in some kind of time/space vortex occurring, but thankfully there were no black holes to be seen. It was though the first time Maryam and I had met, which was a shame because I didn’t have chance to even say hello. I’m sure our time will come though. This politics lark is weird like that – candidates come to recognise their opponents names so well and yet sometimes barely ever see each other.

I had never been to the Hospice before, which is not something to be proud of when it’s clear that this is a wonderful and respected facility giving a very high level of care to local people reaching the end of their lives. I am glad I went tonight, and although the tour was only a brief one I did have a long chat with the Chief Exec about the Hospice, its relationship with the NHS, its funding challenges and the need for donations to keep it going. As someone professionally involved with the NHS and voluntarily involved in a charity myself, I know how hard it is to deal with those two things, so doing so in unison and on a massive scale as the Hospice does is extremely tough. The people involve deserve our thanks and respect for the service they provide.

Rick 

A government survey was published today, which revealed that only one in 20 people take the recommended amount of exercise. I can safely assume that I am, shamefully, not that one in twenty.

Norman Lamb, the Lib Dem Shadow Health Secretary, said:

“This data shows there is a ticking time bomb with potentially disastrous consequences both for individuals and for the NHS.

“Lack of exercise leads to increased risk from diabetes, heart disease, strokes and cancer which means misery for so many families.

“If we fail to redirect resources into preventing ill-health, the NHS will face bankruptcy. It is imperative that we change direction.”

It’s all very important, as I try to convince those colleagues of mine who refuse to take the stairs in our three-floor office block.  But my own problems are brought starkly into focus when I realise that the overriding thought that goes through my head when reading that quote from Mr Lamb is “Ooh, a nice roast lamb would be lovely round about now.”

We all need to do lots more exercise – myself included. We’re all supposed to do 5 lots of 30 minutes per week. I don’t, but I should. I do however, vastly exceed the government’s recommended weekly packets of crisps allowance, and have been known to run to the shops to buy some.

I have a serious new years resolution in the pipeline which sees me start doing the running I stopped doing when I got elected to the Council. Gone are the days when I strode around Prestwich and Whitefield like a gazelle (admittedly a slightly podgy one). In their place are sedentary evenings listening to 12 year old Tory Councillors prattle on about political theory whilst Bury crumbles. Annoyance, sadly, doesn’t burn half as many calories as jogging.

Thankfully I may be aided in my quest to be thin for my wedding (on 7th August 2010…) by the election campaign(s) which are happening between now and then. There will definitely be a local election on the first Thursday in May. The General Election may be on the same day, or it may be before, in which case there’ll be two mammoth loads of leaflets and letters to distribute. All that brisk walking is actually a great form of exercise.

It is one of the fringe benefits of campaigning that we can work off the pounds as we wrack up the votes. People can lose over a stone in a long campaign, and get much fitter whilst they do it. I always think more people should be out at election time supporting the party they believe in. Now there’s another reason – it’ll get us healthier and help stop what will definitely be a big problem for the NHS in years to come.

And, if you help us leaflet, we give you a party at the end of the year! This Sunday it’s the Bury Lib Dems Leafleters thankyou party, where we all gather together and eat mince pies to undo the months of good exercise. I am looking forward to it despite that though, as it gives me the chance to see and say thanks to everyone who’s helped us this year. Next year will be the most important for the Bury Lib Dems in a long, long time, and we appreciate the help of all of our supporters.

Rick

I suspect that the only people who read local political blogs are other local politicians, and I’m no exception to that rule. Occasionally I look at Conservative PPC David Nuttall’s, and it was whilst doing so the other day that I was alerted to the existence of Bury Speakeasy, a very worthy charity helping people with a condition called Aphasia.

My Grandpa suffered from Aphasia towards the end of his life, and when I read about Bury Speakeasy on David’s blog I contacted them to say how good it is that they are providing a service for people with Aphasia today in Bury.

Aphasia is a condition affecting a quarter of a million people in the UK. Many are stroke victims, but it can also affect people who have suffered head trauma, brain tumour or other neurological illness. Aphasia doesn’t affect intellect, but the condition means that those with Aphasia have difficulty communicating and dealing with language. It can manifest itself in a number of ways, and it affected my Grandpa who died in 2006. He had trouble speaking and understanding others speaking to him, and it really affected his quality of life in his final few years.

Not many people know about Aphasia, which is a problem for people who suffer from it. You can find out more from the Bury Speakeasy website or from Speakability. Bury is lucky in having a good Stroke service locally, and the Bury Speakeasy charity is almost unique outside of London. Anyone with Aphasia is welcome there, even without a medical referral, regardless of where they live.

Funding for organisations like Speakeasy is always challenging, particularly in tough economic times. I am glad I’ve found out about the organisation, as this is a condition I am particularly interested in, and it’s good that an organisation like this exists close to home.

Rick

For reasons beyond my comprehension, the world doesn’t stand still when I’m on holiday. In fact, lots of things have gone on in Prestwich whilst I’ve been away.

One of them is that a Planning application has been lodged by Care UK for the siting of a mobile Health Clinic at Tesco for a period of seven years. Yes, that’s right. Someone wants to stick a clinic in Tesco’s car park, so that you can shop for an x-ray as you shop for your spuds.

Details are sketchy at present but presumably it will be one of those mobile testing clinics – where you can get your blood pressure checked out or perhaps have more serious matters checked/tested for problems. I’ve got no problem with these at all, but we have an NHS walk-in centre up the road, and there’s talk of a LIFT centre, which would be an even better local NHS facility. Why are the NHS now looking to pay the private sector to set up shop in a supermarket car park until 2016? We’ve got a credit crunch on, haven’t we?

And I wonder how much Tesco are getting out of this… Perhaps enough for them to re-instate the recycling facility they’ve just had removed from the very same car park?

All a bit worrying…

Rick