Let Them Eat Cake

Published in The Guardian

Despite petitions and public protestations, The Prime Minister, Boris Johnson is sticking by his guns. The Health Secretary, Matt Hancock is insisting that the Government are already doing enough, with an array of other white men in suits telling us why he’s right, whilst ignoring the voices of over 2000 leading Paediatricians (what do they know, anyway?!).  Whilst Marcus Rashford calls them to account and celebrates the great swell of public support, they want others to step up to the plate and take responsibility. But there seems to be a significant difference to what the government believe they are doing about the issue, what local councils are receiving in terms of help and what communities are experiencing. Learning to listen is one of the core facets of compassionate leadership.

 

“Of all the skills of leadership, listening is the most valuable — and one of the least understood. Most captains of industry listen only sometimes, and they remain ordinary leaders. But a few, the great ones, never stop listening. That’s how they get word before anyone else of unseen problems and opportunities.”

— Peter Nulty, Fortune Magazine

 

Here in Morecambe Bay, I’ve had the privilege of hearing Trina, a brilliant member of the community in Morecambe, give her testimony to Heidi Allen MP and Frank Field MP from the select committee for the Department of Work and Pensions, and more recently to the Chief Medical Officer, Prof Chris Whitty, when he visited the Bay. Trina is an amazing woman. She keeps a freezer full off food in her front room to feed members of her local community who are on the ropes or have been sanctioned. She knows what it is to live with the experience of poverty and the complex issues involved. I love the way in which she fearlessly speaks truth to power:

 

“Ending up on benefits isn’t always as simple as losing your job. It can be the result of bereavement, illness, injury, or a breakdown in a relationship. It’s a culture shock. For me, one day I had a grand a week coming in. The next day I was applying for IS. It took 14 weeks for my payments to come in. 14 weeks where I still had to pay the rent, pay bills, feed my child. You default on anything on a contract. Worry about it later. And you sell all your ‘nice things’ for pence, to keep a roof over your head. Then the fridge breaks – or the cooker, or the washer – but you’re still only getting your IS payment, not housing benefit or tax credits. It’s different now, it’s all UC – but that’s harder, coz it’s all rolled into one so you don’t even get that small amount of IS. With no other option (you can’t get normal credit) you go to Brighthouse (or the current equivalent) or you get a loan from Deebank/Provident/Greenwoods. You pay 4x as much back in total, but it’s only £5 per week. Your credit rating gets worse because you’ve defaulted on all your ‘luxuries’ – contract phone, sky tv, landline phone. Debts become bailiffs knocking on your door, and if you hide from them long enough… county court judgements. You’re still trying to learn to re-budget on less than 30% of what you used to have. All whilst dealing with illness, bereavement, disability, or social workers on your case because you were a DV victim and the police involved them. You move house because you can’t afford the rent. Then you’re sanctioned. Because despite telling the job centre three times that you’ve moved, they sent your appointment letter to the wrong house. Or you were in hospital. Or your child was sick. You appeal, but they uphold the sanction. You try to re-budget again. Your ex-partner decides they don’t want to bother with the kids anymore. So they stop paying child support and disappear. The CSA/CMS ‘can’t find them’ despite you providing their address and phone number. You try to re-budget it again. If that doesn’t make you think twice about judging people in poverty, consider going through that – which was my experience in 2009 – in the midst of a global pandemic, when there’s no jobs, food has gone up 60% you’re frightened to leave the house in case you get sick….And the world and his wife are taking to social media to espouse how you’re a shit parent and need your kids taken off you, because no matter how hard you try to explain that you’re not a scrounger, they tell you that you should use your non-existent money to just make soup.”

Trina’s experience is replicated thousands of times over. And whilst national leaders tell us they have already done enough and it’s not their responsibility to ensure that children are fed, let us examine these claims, with some help from the BBC.

 

The BBC ask – How much money is the government spending?

By BBC Reality Check

 

“Earlier, when pressed on free school meals, the prime minister told the BBC “there’s £63m specifically to help deal with holiday hunger and with pressure on families,” referring to payment made to local authorities in June.

However, the £63m was for a “local welfare assistance fund” to “assist those struggling to afford food and other essentials” and was not just to feed children.

Guidance for the funding stated that the government “anticipates that most of the funding will be spent within 12 weeks”, meaning that it was expected to have been spent before the end of September.

In England, about 1.3 million children claimed for free school meals in 2019 – about 15% of state-educated pupils.

Analysis by the Food Foundation estimates a further 900,000 children in England may have sought free school meals since the start of the pandemic.”

 

SO – just to be REALLY clear – the £63 million the government are talking about has ALREADY been given to councils (in August) and has ALREADY run out (as by the government’s own admission it was only expected to last for 12 weeks from the time it was given). It amounted to 34 pence per child, per day (the maths is fairly straight forward – £63million, divided by £2.2million – the number of children now needing Free School meals, see above facts from the BBC and then dividing this amount by 84 days – that is the 12 weeks for which the funding lasted). The government keep saying that they have funded councils to fund FSM vouchers, but a) this is no longer the case – the money has run out (as the Conservative Leader of Warwickshire County Council informed the government) AND b) it was woefully insufficient anyway to provide adequate nutrition! This all matters because the government are telling us that they are doing enough, but they plainly are not.

 

The things is that most of us find it hard to comprehend the difference between a million and a billion pounds, because we never encounter that kind of money. I find this graphic from reddit really helpful because it demonstrates it in a simple form. £63 million sounds like a lot of money, until you compare it to the £12 billion the government have spent on an ineffective test and trace system. They seem to be able to find massive funds for public health schemes which are failing, on the one hand, whilst unable to do provide sufficient funds for programmes that we know make a very real difference, you know – feeding hungry children.

 

With food bills possibly set to rise as the prospect of a no-deal Brexit becomes all the more real, the problem of hunger, not only for those already in poverty, but for many more families, currently just about holding it together will be felt ever more acutely. History teaches us that widespread hunger leads to civil unrest and sometimes even revolution. Now is not the time to remain entrenched in ideology. Now is the time for humble listening, and a change of heart. When the people are unable to buy bread, beware of the detached and senseless arrogance that cries, “Let them eat cake!”

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Why The Loss of Public Health England Really Matters

from the HSJ

Yesterday, I tweeted that I think Dido Harding, the Chair of NHS Improvement and newly appointed head of the newly established National Institute for Public Protection (NIPP), which is to replace Public Health England (PHE), is a good leader. I say this, having met her and few times, through the NHS Assembly and her genuinely humble desire to listen and treat people with kindness.  It caused quite an interesting discussion and there has been widespread criticism of her appointment.

 

Last week I did my yearly updates of the mandatory online training required in the NHS. Part of this included my ‘fraud awareness’ and this focuses, particularly on the Nolan principles – an ethical framework under which we are required to work. If these principles are not followed, people can quite rightly lose their jobs and even be sent to prison. The principles apply to all people who work in public life, not just the NHS and are as follows:

 

1.       Selflessness

Holders of public office should take decisions solely in terms of the public interest.

2.       Integrity

Holders of public office must avoid placing themselves under any obligation to people or organisations that might try inappropriately to influence them in their work. They should not act or take decisions in order to gain financial or other material benefits for themselves, their family, or their friends. They must declare and resolve any interests and relationships.

3.       Objectivity

Holders of public office must act and take decisions impartially, fairly and on merit, using the best evidence and without discrimination or bias.

4.       Accountability

Holders of public office are accountable for their decisions and actions to the public and must submit themselves to the scrutiny necessary to ensure this.

5.       Openness

Holders of public office should act and take decisions in an open and transparent manner. Information should not be withheld from the public unless there are clear and lawful reasons for so doing.

6.       Honesty

Holders of public office should be truthful.

7.       Leadership

Holders of public office should exhibit these principles in their own behaviour. They should actively promote and robustly support the principles and be willing to challenge poor behaviour wherever it occurs.

 

from The Guardian

The decision to disband Public Health England, (which is recognised internationally as a world leader in the realm of Public Health) and the appointment of Dido Harding into her new role (even though I do really like and respect her) are not aligned with the Nolan principles and I believe therefore that the Secretary of State for Health and Social Care, Matt Hancock has some serious questions to answer, which are absolutely in the public interest. Each of those questions should be framed around the Nolan principles and are a part of the accountability required in such a momentous decision. It’s not that Dido Harding (who called for more integrity in NHS leadership) is necessarily the wrong person (although many feel that she is). It’s the way the appointment was made that makes everything so murky and this is a great shame.

 

Public Health England must not be used as a scapegoat in the forthcoming independent enquiry into the UK’s response to Covid-19. We must also better understand where and how its other vital functions will be performed. As Jeanelle de Gruchy, President of the Association of Directors of Public Health, has so eloquently argued, the NHS is not currently set up to do this work. There is the potential that the newly established Integrated Care Systems (ICS’) across England, which bring together public sector partners, including the NHS and local government could hold the responsibility, but this would need to be funded adequately and appropriately AND would require a legal framework, which is currently lacking. We simply cannot afford to lose the vital functions of prevention, child health and other huge programmes previously co-ordinated by PHE. With further financial issues ahead for local government, the idea that public health prevention will remain a priority, when we have already seen the roll back of this since 2010 is unrealistic. If this happens, rather than ‘levelling up’, the great promise of the Prime-minister, Boris Johnson, we will see a worsening health inequality gap and those in our poorest communities struggling even more.

 

We need urgent answers to urgent questions. But more than this, we need a government who are willing to act with integrity, openness and through the proper mechanisms of parliament. Announcing major changes to the functions of public sector organisations through the press and the refusal to follow good processes in redesign are seriously unwise and unfair. Trust in this government is waning and they could do a great deal more to rebuild that trust, if they care to do so. The loss of Public Health England matters, not only because it does such incredibly important work beyond public protection, but because of the manner in which it was disbanded and what this means about how government is functioning.

 

When Matt Hancock made his speech about his new NIPP yesterday, he finished his Q&A session by talking about the “Holy Trinity” of Academia, Government and the Private Sector. I see very little that is holy about this triad, especially if the Nolan principles are flouted. The Trinity I know is full of love and truth…..I wonder what the consequences of this clear ideology will have on the future of the NHS. I fear the answer is not in the public interest.

 

 

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Should The Schools Go Back on June 1st?

Share This: Tweet Is the decision to send some of our children back to school on June 1st the right one? What are the factors that have been considered and how has the decision been made? I”ve been asked these questions a number of times and they bother me at several levels. They bother me [Continue Reading …]

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A Vision for Population Health and Wellbeing – All Together We Can

Tweet If you haven’t yet had the chance to read the Kings Fund’s vision for population health (and it’s the kind of thing that interests you) then I would heartily recommend that you do so. (https://www.kingsfund.org.uk/publications/vision-population-health). It is a real ‘Tour de Force’ and deserves some significant consideration. I like it because it doesn’t hold [Continue Reading …]

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Solutions for the NHS Workforce Crisis

Tweet This week, the Kingsfund, one of the most respected think-tanks on health and social care in the UK declared that the current NHS staffing levels are becoming a ‘national emergency’.   The latest figures have been published by the regulator, NHS Improvement, for the April to June period.   They showed: ■   11.8% [Continue Reading …]

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