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Preventative Services

Yes, OK, it's a Scotland-related blog again but WRVS's take on the need to shift resources and money away from acute health care and residential care and towards community-based preventative services for older people in Scotland holds good for England and Wales.

The point is this: whilst there will always be a need for services that deal with problems after they arise, the more we can grow services that stop preventable problems from arising in the first place, the better lives older people will lead. And there's now a sizeable body of evidence that preventative services are cost efficient, with the potential to save the public purse millions of pounds.

That's what's likely to be of most interest to the Finance Committee of the Scottish Parliament, to whose inquiry on preventative spending this submission by WRVS was made.

Posted by Andrew Jackson

It's Big, it's Societal, it's the Big Society!

It's here! The Big Society is here! Well, the announcement is anyway and the Big Society Bank and the four 'vanguard sites' across England, for, lest we forget, the Big Society is England-specific as the policy areas it is connected to are devolved to the Scottish Parliament and to the Welsh Assembly. On that note, it will be interesting to see what happens when someone in England cooks up a proposal to somehow bring a reserved issue into the Big Society Big Top but for now it's "Cry 'Big Society for Harry, England, and Saint George!"

David Cameron has pretty much characterised the Big Society as the legacy of his time in office so he needs it to work. Given it can only work if 'the people' make it work I admire his faith. With 53,000 volunteers WRVS knows a thing or two about supporting people to do things for themselves. So, will it work? Well, I am not an apologist for any political party but let's first put to bed the myth that the Big Society is about a) replacing paid positions with volunteers and b) dismantling the welfare state and leaving us all to fend for ourselves. It's just not. Voluntary action, of whatever kind, is never and will never be engaged effectively if people feel they are being obliged to act as part of some mass-dumping-of-public-services exercise by a government who sees community action or third sector groups as some sort of surrogate private sector, whose fangs are being let loose on Nye Bevan's baby because it's leaders couldn't get International Megacorp Plc to savage it sufficiently. Volunteers, whether engaged formally in organisations like WRVS or informally as community activists, may act out of necessity but that doesn't mean they're a bunch of easily-fooled suckers who are going to form a new phalanx of amateur social workers or community nurses as, meanwhile, the dole lines lengthen. Nor does it mean they're a secret army of laissez-faire right wingers eager to bring services into their own personal private sphere.

The third sector, particularly in local communities, has always grown into the gaps in UK society because no-one else was doing anything about issue X or problem Y. It is also no longer the case that the third sector is made up solely of volunteers. WRVS has over 2000 staff itself. In other words the Big Society is not about throwing people into the unemployment bin. OK, OK, I can see that if you sweep away the local public-sector-provided nursery then you have a gap and it's that kind of thing that some people fear but I have to say that, leaving the example of nurseries as just that, an example, it's not clear to me either a) that this (i.e. a massive cull of essential services) will inevitably happen or b) just why we have ended up thinking the state should provide all the things that it currently does, even though many of them are great and I love 'em. But many isn't all. And besides, if you look at the 'vanguard areas' there's stuff in there about running a local pub and setting up bus services; both usually private sector ventures. In fact I am not aware that any of the mainstream political parties still tout the idea of some sort of anti-third sector, anti-charity, socialist, state-must-provide-all model and they haven't for decades now. What I do know is that it is simply nonsensical to suggest that the talents, abilities, enthusiasm creativity, invention and drive of 'ordinary people' (oh, save us from that term of reference!) should be suppressed because 'the state does that'. What counts is the outcome, not the method. Look at it this way; if the Big Society boozer is crap, no-one's going to drink in it are they? Likewise, the idea, even in the current financial mess we're in, that the state will withdraw public services en masse and leave vast deserts of need is fatuous. Even people who traditionally vote Tory rely on such services to the extent that they'll feel the bite and shout about it. Cameron wants a second term without the Lib Dems, he can't afford to drop votes anywhere.

I think the Big Society will work. I've worked in the third sector for 15 years, several of which I spent as a community development worker with small local groups. I think people are marvellous and will always surprise you. In fact, if I have a criticism of the initiative it's really only that the way it's been presented means you'd be forgiven for thinking we haven't got an extensive, vibrant third sector across England already, because we have, as NCVO will tell you. The Big Society initiative may help that sector make an even greater contribution to England but just as it's not going to replace the public sector, it's not going to replace the third sector, it's just going to give it a hand.

As for the National Citizen's Service, you'll have to give me time to digest the proposal. Remember, I'm up in Edinburgh, reading tonnes of stuff about what the Scottish Parliament is up to so forgive me if I can't chew over the English stuff as fast as you'd like!

One last thing... I'd love to know that 'you' exists, which blogger wouldn't? So if 'you' are really out there why not post a comment? Disagree with me, call me a closet Tory, an idiot, a numbskull or tell me my analysis is spot on and I write prose that Dickens would envy but, either way, send something! After all, in the words of The Feeling, "I love it when you call but you never call at all!"

Posted by Andrew Jackson

Tea with the Queen

My last post was certainly over-optimistic about how likely it was the Queen would be able to give me a wave at the Royal Garden Party, which I've just attended (13 July). I'm not very good at estimating numbers in crowds but there must have been a couple of thousand people there.

The Royal Archers acted as human cordon but spaced far enough apart so that folk could see as the Queen made her way from the back door of the Palace of Holyroodhouse, through the lavish gardens and to the Royal Tea Tent, which has a replica crown on top of it, seriously! (It's rather kitsch actually). On the way various people were presented to her and, for obvious reasons, that included quite a few soldiers as the rest of us looked on.

What would normally be a short walk thereby took an hour. It was a beautiful sunny afternoon, the sandwiches, cakes, lemonade and tea were great and the surroundings were, naturally, impressive. I never, in a month of Sundays, imagined I'd attend such an event but life's full of surprises. Anyway, these last two posts have been made in the spirit of a summer interlude.

Now I have a submission to the Scottish Labour party's policy consultation to write. Perhaps that'll be the subject of next time's blog. Or maybe the UK Government will have released further details about 'Ageing Well' by then. Ah, policy detail, doncha just love it?

Posted by Andrew Jackson

Meeting Her Majesty

In a wee departure from the usual policy-heavy stuff, this week I thought I'd let you know that I'm going to meet the Queen on Tuesday 13 July. She's WRVS' patron in case you didn't know or hadn't guessed Well, I say 'meet', I've been invited to the Royal Garden Party at the Queen's Edinburgh residence Holyrood Palace, along with hundreds of others. I'd like to think she'll say hello but who knows? I'll blog about it but in the meantime here's my other Queen story:

My car once broke down near Holyrood Palace. The gearbox seized and it was completely undrivable. Luckily for me, the Queen was about to arrive so the area was crawling with police officers, who, when they discovered my car was 'kaput', physcially pushed it up a side street for me! Security risk you see but it got me out of a jam. And as I was walking home who should pass by in her Rolls Royce but Her Majesty! I wonder whether I'll get as close this time. Maybe I could tell her that story. What do you think?

Posted by Andrew Jackson

Death by a thousand cuts!

WHOOAAA! Danny Alexander, Chief Secretary to the Tresury, has told Cabinet colleagues to get ready to find 40% budget savings from their departments. This is in order that the Government can spread the overall 25% cuts unevenly across the whole portfolio of its activities and protect some departments like health.

There's a big picture question about what this means for Britain but sticking to my "wee windae" remit and with no disrespect to public sector colleagues (I was one once): for organisations in the third sector, like WRVS, we will have to wait and see what this means for third sector services and practices. Simply put there's a fork in the road here and its a choice of either a) embrace the third sector way of doing things (and I include the full range of community groups, social enterprises etc in that) and turn the crisis into a massive opportunity for an expansion of the third sector justified by its demonstrable people-centred ethos, added value and efficiency b) retrench, retrench, retrench: take public services back in-house, preserve state provision as the core preferred method and show external providers the door. There are pros and cons to either approach, of course, but with some arguing that we're now looking at a paradigm shift in the way we support vulnerable people (older and otherwise) in the UK, I suggest this is going to push us further towards a sea change rather than simply meaning an extended period of tinkering with the mixed model of 'a bit of this and a bit of that' which characterises the current landscape.

Want a bell weather? Watch what local government is saying: LGA, COSLA, WLGA

Posted by Andrew Jackson

Talkin' Healthy Volunteering in NHS Scotland with WRVS

In Scotland volunteering in health is a hot topic, built explicitly into the Scottish Government’s strategy for the NHS and, naturally, WRVS is involved.

Andrew Jackson, who sits on the National Action Group responsible for implementing the NHS volunteering strategy, recently gave an interview to primo political magazine Holyrood, talking about just how volunteers can improve the health of others and of themselves.

Posted by Andrew Jackson

Who cares about social care? Volunteers, that's who!

Taking off my Scots bunnet just for now and putting on my English... er... Bowler hat? Top hat? What do folk wear on their heads down south these days? Well, anyway, whatever you wear to declare your Englishness imagine that I’m wearing that because I’m blogging today to talk about social care in England and what the UK’s coalition government are going to do about it, once they have got over the trauma of David Laws departure. If ever there was a story that could use the word ‘rocked’ without sounding wildly inappropriate, this was it. But I don’t have time to go there today. If his replacement, Danny Alexander, MP for Inverness, Nairn, Badenoch & Strathspey (that’s basically the Highlands for you guys) the here-today-gone-today ex- Scottish Secretary, now Chief Secretary to the Treasury, does anything exciting maybe I’ll use his Scottishness as an excuse to blog about him. But moving swiftly on...

OK: there’s a quartet of big headlines under the social care policy heading. There’ll be a Commission on long term care to report within a year, barriers between health and social care will be broken down, theree'll be more use of personal budgets and more use of direct payments. This is set in the context of the rest of the coalition agreement which includes a bigger role for the third sector in public service delivery, help for older people to live at home longer through adaptations and community support programmes (though it doesn’t specify what this will look like in practice), more spending on the NHS, more opportunities for public sector staff (presumably including NHS staff?) to run services themselves using the cooperative model, pensions re-linked to earnings, retirement age up to 66 by 2016 for men and 2020 for women and so on.

So what? Well, anyone with an interest in social care should, while keeping an eye out for the development of all these policies, get off the blocks as soon as there’s an announcement of the Commission chair and get on the blower to him/her to have their say (and if they’re really influential they should be calling the Health Secretary, Andrew Lansley and Paul Burstow MP, Minister of State for Care Services and making some suggestions about who the chair should be). It seems that, while, according to the coalition agreement, the Commission will have to consider both a voluntary insurance scheme and the Wanless recommendations, all other bets are off. The Commission was a Lib Dem policy, the Tories already had theirs worked up, so I guess we can take it that they couldn’t jointly agree on a social care policy or on any of the numerous proposals that have come out in recent years. We know this because if they had, well, they would have said so wouldn’t they?

Commissions are traditionally a way of ‘kicking something into the long grass’, as they say in political circles (i.e. if we talk about it for long enough everyone will forget about it and we won’t have to do anything) but this time the issue is too immediate and important for that, as well as there being a huge question mark over how its paid for. With an ageing population there has to be some sort of change to the English system to make it work for people, which may or may not contribute to solving the country’s economic woes, meaning it will cost the state less, although it really will have to will have to be economically viable if it stands any chance of going ahead. It seems certain that, whatever proposals emerge or are accepted, it will involve greater cost to individuals who need care. Why? Well, Liam Byrne’s (Labour ex-Chief Secretary to the Treasury) note to David Laws (you know who he is) saying "Dear chief secretary, I'm afraid there is no money. Kind regards – and good luck!" might have been flippant but it was basically true. Just how this ends up being squared with the social care budget remains to be seen but squared it will have to be.

But here’s a thought for you: WRVS runs on volunteers and the impact they can have in the social care arena has been made clear in a recent report. We may not run what you’d think of as ‘social care services’ but our services occupy a space very close to them and it’s obvious that if people can stay independent, healthy and happy in their own homes for longer and therefore don’t require NHS or social care services as soon as they otherwise would, pressure on health and social care budgets is eased.

WRVS – and thousands of other voluntary organisations – arose from an initial spark, an upsurge of energy and effort, a passion and a readiness in people to tackle social problems for themselves, to look after each other as opposed to waiting for the government to do it. And in many, if not all cases, such organisations started out without a brass bean in the bank. But they still got on and did things, thanks to voluntary effort.

Now, neither I nor WRVS are suggesting that the state should be let off the hook, to be allowed to do less and less while making us do everything for nothing yet still ratcheting our taxes up (Prime Minister Dave will tell you that’s a fundamental misunderstanding of his ‘Big Society’). No. What I’m suggesting is that if we can recognise that there is a tremendous energy out there for mutual support it needs to be developed in tandem with good state services – whoever delivers those, either the state directly or someone on behalf of the state – to make sure people get what they need and so we can make the best use of our money. If we face massive service cuts because the state hasn’t got the money - and, regardless of the rights and wrongs of how we ended up in this mess and who is really to blame and who will suffer as a result, let’s be clear: the state hasn’t got the money - shouldn’t we be thinking creatively about how the shoulder of voluntary action can best be turned to the wheel rather than ending up being exploited or mistaken for a substitute for paid jobs or, possibly even worse, just being discounted because of a lack of understanding about the potential role volunteers and the voluntary (third, charitable, social enterprise, whatever) sector could, can (must?) play.

I’m not suggesting we can run things like specialist cancer care on wide eyed enthusiasm and people who can manage to be around on alternate Tuesdays and Fridays and, God knows, sometimes even the most straightforward tasks involve hacking through reels of red tape and someone might have to be paid to do that, but there are many services and activities, social care being a good example, which could benefit from much more extensive volunteer involvement. And that energy and willingness is out there.

Look at it this way; if the alternative is saying goodbye to these activities forever or ending up with second rate services, hobbling along with only pennies in their pockets, what have we got to lose?


Posted by Andrew Jackson

Putting People at the Heart of Care

Frantic. That's what it's been like. Frantic. In a job like the one I do for WRVS (Media and Public Affairs) the General Election is somewhat akin to the football World Cup in terms of all-bets-are-off madness, tension, excitement, TV gawked at, radio earwigged too, newspapers poured over,websites scanned, tweets and blogs and every-online-thing else sucked up, junk food guzzled and tea made (I'm not a coffee drinker, that really would send me over the edge). There are those that would find this level of interest in politics rather sad. In fact, I'm one of them but I have learnt to live with myself. And, for the avoidance of doubt, I am just as excited about the real World Cup 2010 that will take place in South Africa in June.

And its far from over. The now traditional 'congratulating of the new Ministers' which charities tend to do these days (i.e. a bunch of letters, usually suggesting a meeting that vaguely resembles some sort of date, to talk about how they can work with Government for the benefit of the people the charity supports) takes up some time. Then there's the policy detail itself. Ordinarily, the analysis of party manifestos that people like me and my colleagues do pre-election would serve as the basis for understanding what the new Government will get up too but in the uncharted choppy waters in which we are now swimming, that analysis only blows up the life raft so much. The tiny little eight pager that Dave and Nick put out last week was but a sliver of the forthcoming doorstopper that will arrive next week.

The official coalition document will get down to much more detail about the full range of policies (although not to the level they will eventually need to be worked out to). Only then will the true picture of Britian's future will emerge. Although I should point out that 90% of the policies this tome will contain are essentially for England and to a lesser extent Wales. It seems to me that few people in England really understand just how much policy is devolved to the Scottish Parliament (no disrespect intended; I'm English born and bred, the son of a Scottish faither and an English mither but I now live and work in Edinburgh).

From a WRVS point of view the two biggies are care and volunteering. Both devolved. And in the case of care, the Scottish Government is tanking ahead with proposals for a Self-Directed Support (SDS) Strategy and a Bill, in response to which WRVS has offered some comment, which you can read here. SDS is similar to Individual Budgeting and Direct Payments are a part of it. It advances the 'personalisation' agenda in Scotland, which is a big feature of the English care landscape and looks as if it will only grow in importance across the UK. That's certainly what the manifestos were suggesting in all their various UK, Scottish and Welsh editions - that was an innovation that quadrupled my bedtime reading for a week or so!

Basically SDS means handing control of care to the person who gets that care to a greater or lesser degree, depending on how that person wants to play it. It means really putting them at the heart of it. If they want to, they can decide what they need and who provides it and they control the budget, which gets given to them, usually by the local authority. It's the Scottish Government's hope that SDS will be the main way care is delivered in future and that almost certainly means a pretty radical shift away from monolithic care services provided by the state or by large private or third sector providers, to a greater variety of smaller more tailored services. It's more or less a market model and WRVS's interest lies in providing the kind of great, volunteer delivered services that, while not exactly 'care' services in the formal sense, can complement such a system and make sure older and disabled people can continue to live independently in their own communities, fully plugged into the life of those communities, rather than being isolated, lonely and stuck for a friendly ear or someone to help them get out and about. So, if you're interested have a read. And hang on for some more General Election related blogging coming here soon! Promise!

Posted by Andrew Jackson

Too busy to blog: or why meeting the First Minister of Scotland meant I was offline

I have no idea what the form is for bloggers in general but I am aware that some of the most successful (ie widely read and influential) political bloggers are successful because their blogs are constantly current. These folk appear to have either hours of spare time every day or are so mentally – and possibly physically - hyperactive that they can toss off the daily blog as quick as a wink and get on with doing whatever else it is that they do.

The reason I haven’t blogged for so long - fun as it is, and it really is - is because I’ve been struggling to come up for air from under the current stormy sea of work in the actual world. Up in Scotland WRVS is experiencing a mini-flood of visits by Scottish politicians to WRVS services or by WRVS to various public events and it all takes organisation, preparation and of course, some performance on the day/night.

In this last fortnight (that is the last half of March) alone, we have seen:

• The First Minister of Scotland, Alex Salmond MSP, MP, welcome WRVS Chief Executive Lynne Berry – with a supporting cast of Angela Geer, Head of Older People’s Services UK, Margaret Paterson, Head of Older People’s Services Scotland and... er... who else was there, oh yes, me! – to his official residence in Edinburgh, Bute House, to talk about WRVS’ work.
• A visit to visit our Auchinairn lunch club by the Labour leader in the Scottish Parliament, Iain Gray MSP, plus his Scottish Parliamentary colleague, deputy spokesperson on finance and skills David Whitton MSP (don’t let that junior shadow post fool you; Whitton’s one of Labour’s policy-brains and ex-right hand man to two previous Scottish Parliamentary leaders). Hats off to the patient older people who are members of the club and all credit to the volunteers, particularly Eleanor Swann, and to Local Service Manager Jackie Gallagher and Service Delivery Manager Alison Love (I promised I'd include a thanks on the Blog so there it is!).
• WRVS talking about the future of older people’s care on BBC Reporting Scotland TV news and BBC Radio Good Morning Scotland, which for those unfamiliar with the UK’s northern nation is much more like being on the 6 o’clock news and Radio 4’s Today than it is being on ‘North West Tonight’. (Scotland isn’t a region after all, he said, waving his Saltire!
• WRVS at the British Irish Council Ministerial dinner in Edinburgh (that’s representatives of every administration in the British Isles) delivering a speech about volunteering, voluntarism and handing back power to people and communities to better support older people.
• Our tireless Scottish staff continue to help plan what is now approaching a dozen visits by MSPs to our Scottish services to make sure MSPs understand what WRVS is all about in their constituencies and how much our volunteers matter to the places they live.

And since I last blogged we had a phenomenally successful reception in the Scottish Parliament on 10 February that saw around 50 WRVS volunteers, various WRVS staff, including Lynne Berry, Angela Geer, Margaret Paterson and the Scottish Service Delivery Managers, meet and talk to 45 MSPs (making it one of the most highly attended Parliamentary events I have experienced in my eight years working in this field) and a host of public and third sector luminaries about what WRVS does. I measure success here by the number of people who turned up and the fact that they were buzzing about what they’d learned about WRVS.

=whew!=

So while I love blogging, I am not enough of a desk jockey to be able to do it as much as I’d like. After all, if anyone inside or outside WRVS is going to be interested in what we’re up to, we have to be up to something! But blogs are about opinion as well as fact, so next time I'll try to get worked up about something and let rip, right here, with some entertaining invective!

Posted by Andrew Jackson

Working for ‘The Man’ Every Night and Day?

Recently the National Pensioner’s Convention (NPC) slammed a recommendation by the Equality and Human Rights Commissions (ECHR) to raise the default retirement age (the age at which you can be legally required to retire whether you want to or not) to above 65 years old. Based on a (presumably representative) survey of “1,494 men and women aged 50 to 75 across Great Britain” the ECHR said:

“The majority of workers over 50 (62 per cent of women and 59 per cent of men) want to continue working beyond state pension age” and “Working longer is not a burden borne purely out of necessity: those who have elected to work longer are happy and enjoying what they do.”

Not so, say the NPC, “Britain's biggest pensioner organization; representing over 1000 local, regional and national pensioner groups with a total of 1.5m members” (NPC website). They say the “proposals have failed to properly quantify issues such as the rate of unemployment and availability of work, the rights of younger people to find a job, the quality of the jobs older people will be offered (and will be prepared to accept) and the loss to wider society if pensioner volunteers (currently undertaking unpaid caring and charitable work) were otherwise in paid employment.” The NPC raises the issues of those people who want to retire; the need for an “improved state pension system” and says “removing the default retirement age would condemn the very poorest in our society to carry on working until they die”.

A clear division of opinion then, which appears to boil down to whether you consider being able to work longer to be a form of freedom or a form of oppression; whether you have a vision of yourself still bestriding the narrow earth like a Colossus or whether you’re going to end up walking under the huge legs of others, peeping about (if you’re curious, it’s Shakespeare’s Julius Caesar I’m mangling here).

I must say that I was surprised by the vehemence of the NPC’s position. I don’t read the ECHR proposal as saying: “you must work past 65” and they don’t explicitly refer to the UK Government’s planned rise in the age at which you will be allowed to draw a state pension (67 by 2034, 68 by 2044). Nor do they say employers would have to keep you on no matter how bad at your job you were. In other words, the immediate consequence of their proposal would be merely to give to those for whom 65 appears (as it always has, in fact, been) an arbitrary age at which society deems some people “too old to work” the right not to be retired at the behest of another for no other reason than that they have had one birthday too many. In other words, the right currently enjoyed by the likes of judges, politicians and, indeed, the self-employed. It wouldn’t take away an individual’s right to choose to retire nor would it get rid of the situation that I would have thought might bother younger people looking for work a bit more, namely the fact that currently you can claim a state pension at 65 and keep on working if you can find suitable work. Personally; I have no problem with that ‘anomaly’ but I can see how a young person might see it as like being allowed to claim unemployment benefit at the same time as having a job i.e. “make up your mind, auld yin, are you retired or not?”

Whether someone is “too old to work” because society thinks they’re a clapped out old donkey or because it thinks it’s time they should be rewarded with a life of leisure; it doesn’t change the fact that currently people can “be retired” at 65 with no comeback; a little bit like in the movie Logan’s Run where folk were exploded when they hit 30 to keep the population down inside the post-apocalyptic bio-dome. If I were an employer I’d hope to have better performance measurement criteria in place than age alone. If someone’s crap at their job it doesn’t matter of they’re 26, 36 or 66 does it? Get shot of them! And if someone is brilliant, wouldn’t you want to keep him or her on, yea, even unto the nonagenarians?

Look at this way; I’m 39 and relatively fit. Arnold Schwarzenegger is 63. You’re about to be mugged. Who would you rather see coming up the street to help you? “Aha”, you say, “Arnie’s an exception”. But that’s exactly the point. And that’s why we need to account for individual choice: whether it’s to work or retire. After all, eventually, we’ll be gone for good and none of us will be back. No hasta la vista baby!

Posted by Andrew Jackson