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Archive for the ‘Health’ Category

Thursday
Oct 29,2015

Seven months ago, I presented the Ministry of Justice with a 300-page report of the Independent Review I had led for them into the deaths of young people in prison. Published formally at the beginning of July, there is still no sign of the government’s response.
The problem of course, is not going away. In the first nine months of 2015, there were 69 self-inflicted deaths in prisons, twelve of which were young people under 24. Every single one of those deaths represents a failure by the British State to protect the people concerned. A failure that is all the greater because the same criticisms of the prison authorities occur time and time again.
My Review examined 87 cases in detail. Many of the young people’s problems and vulnerabilities, including mental health issues, had been evident from an early age. So why did so many of them end up in custody?
Billy Spiller was 21 when he died in prison in November 2011. His mother told us: “Throughout Billy’s life I tried to get proper care and support for him but the doors were shut in my face. From the moment he was sentenced to imprisonment, I knew that they wouldn’t be able to look after him. They should have diverted him from the courts or made sure that everybody in prison had training to deal with him.”
And then there was the case of Nicholas Saunders – 18 when he died in April 2011. His pre-sentence review had recommended a community disposal but the sentencing judge decided prison was the best option for him. The documents however, describing his vulnerability and a previous suicide attempt were not transferred when he was moved from HMP Woodhill to HMYOI Stoke Heath. Six weeks later, he was found hanging in his cell from a ligature attached to a light fitting. There had been a similar suicide from a light-fitting at the same establishment just a few years earlier.
Or the even earlier case of Joseph Scholes, 16 when he died in 2002. Joseph had a long history of vulnerability, repeatedly told staff he would kill himself and was never seen by a psychiatrist. When he did make a noose from a bed-sheet and hang himself from the bars of his cell, he left a message for his mother and father telling them he couldn’t cope and that “I tried telling them and they just don’t fucking listen”.
Let nobody be under any illusions, prisons and young offender institutions are grimenvironments, bleak and demoralizing to the spirit. The experience of being there is not conducive to rehabilitation. It is made much worse however, when coupled with the impoverished prison regimes caused by staff shortages – a situation that can only get worse with likely budget cuts. There also needs to be a fundamental shift in the philosophy of prison. The punishment imposed by the Court is the deprivation of liberty – once in prison, the primary purpose should be rehabilitation.
But the central message of my Review was that much more needs to be done to support young adults not only after they come into contact with the criminal justice system, but also before they get into trouble. Their problems are often evident from a young age – yet their difficulties are not addressed early enough or effectively enough.
The government’s Troubled Families Programme concentrates the efforts of all public agencies to resolve the problems of families which, if left unresolved, are a drain on the State’s resources. Why not adopt a similar approach to the needs of ‘Troubled Adolescents’?
Why not reinvest and redirect resources to the health and welfare system to resolve the issues creating the problems for the troubled child or adolescent before they ever enter the criminal justice systems? Or maybe invest in effective alternatives to custody if they do get into trouble? It will be money well-spent and will reduce the numbers in prison, enabling better support and rehabilitative efforts for those who do become prisoners.
Prison is a hugely expensive intervention whose so-called benefits are questionable. It has a relatively low impact on crime and rates of re-offending are high particularly among young adults. As the Prime Minister, Chancellor, Lord Chancellor and their colleagues wrestle with the upcoming Comprehensive Spending Review, you would have thought the solution was obvious: invest early in young people, and resolve their problems so they don’t get into trouble.
Delaying action until the resource position is easier is not an option. It would mean young people continue to die unnecessarily in our prisons. It will also mean we continue to waste countless millions of pounds in failing to rehabilitate those who could be rehabilitated, in locking them up when a non-prison option would be more appropriate, and in failing to intervene early on to prevent them from entering the criminal justice system.
Those tragic cases considered by our Review deserve as their memorial for somebody to listens. This time it must be different. We owe them no less.

Sunday
Jun 15,2014

Shaz is 15 years old. This is how she tells her story: “When I was 12, I went on a family holiday to Bangladesh. As soon as I got out there were marriage proposals from my cousins. I started starving myself and was brought back. I couldn’t tell anyone. My brother said I was going to marry my cousin from Bangladesh if I didn’t he would kill me.” Shaz’s brother was only two years older than her, and was born and brought up in this country. Today forced marriage becomes a criminal offence. This is welcome and is the culmination of a long campaign by many organisations – including (declaration of interest) the Freedom Charity, whose Board I chair. Forcing someone to marry against their will is abhorrent, and is also widely regarded as a violation of internationally recognised human rights standards. Indeed, Article 16.2 of the Universal Declaration of Human Rights says: ‘Marriage shall be entered into only with the free and full consent of the intending spouses.’ Under the previous Labour government, the Forced Marriage (Civil Protection) Act was passed, enabling victims to apply for court orders for their protection. It became apparent however, that more was needed; which is why we were happy to support criminalisation being included in the Coalition’s Anti-social Behaviour, Crime and Policing Bill during the last parliamentary session.  Labour Peers successfully strengthened the measure as far as the principle of consent for people with learning difficulties was concerned, recognising that for some a forced marriage may take place without violence or threats. The big task remains education. We need to make sure that those at risk understand they have a choice. We need families and communities to understand that forcing someone into a marriage against their will is not just wrong. It is now illegal. Shaz was lucky. She tells how in January of last year: “I was at school when Aneeta from Freedom visited, we all leant about  forced marriage. I knew then I could get help. Freedom got me out. Now I live with my Foster Mum and Dad.” We are now approaching the long summer school holidays – a time when young girls often disappear on long family holidays and are forced into marriages overseas. It is even more important therefore to get the message across that forced marriage is wrong. That is why I, along with Labour colleagues and many others around the country, are marking the criminalisation of forced marriage by being photographed on Monday holding a Twitter-friendly sign saying #FREEDOM2CHOOSE.

Monday
Nov 18,2013

For the past six months I have been chairing the Lords’ Select Committee on the Olympic and Paralympic Legacy. And today, after 33 evidence sessions, hearing from 53 witnesses and taking written submissions from 67 organisations and individuals, we have published our report – with 41 recommendations.

So what are our main conclusions?

The Games themselves were an outstanding success, absolutely vindicating the decision by Tony Blair and Ken Livingstone to back London’s bid, as well as exceeding expectations and confounded the sceptics. That success was only delivered through incredible cooperation between the numerous organisations involved, the host Boroughs and virtually every Whitehall department. Since the Games however, the same political impetus and the imperative of a deadline no longer exist. As a result many aspects of the legacy are in danger of faltering and some have fallen by the wayside. There is a lack of ownership and leadership.

That is why we recommend giving a single Cabinet-level Minister overall responsibility for all strands of the legacy. Only someone with senior clout will be able to bang heads together across different departments, including Education with its role in school sport and funding, Health which is supposed to be getting us all more active and healthier, DCMS with its responsibility for the sports governing bodies – plus all the departments that should be working to deliver the economic benefits not only in London but across the UK.

In London itself, the Office of Mayor should be given unambiguous responsibility for holding and taking forward the vision for East London and the developments in the Olympic Park and the surrounding area.

East London has for over a hundred years contained some of the most deprived communities in our country. Too many still live in poor and grossly overcrowded properties or in temporary accommodation. Unemployment rates are among the UK’s worst and the skills gap means that local businesses cannot find the staff they need. Delivering the Olympics brought forward much-needed infrastructure improvements but making sure that all the potential new jobs and new housing are delivered will require laser-like focus and determination from the Mayor.

There is suitable land for housing in East London but it is not being used. One Borough says that the biggest problem is land-banking. In another, Barking and Dagenham, one site, part-owned by the Greater London Authority, has permission for 11,000 dwellings but only 300 have been built. There is much that the Mayor should be doing.

Stratford International has had £1bn of public investment to equip it for high-speed international rail services, but none stop there. It is time that the Transport Department persuaded the operators that at least some of their services should use the facilities, bringing in both travellers and business.

As for the promised “cultural legacy”, the term only appeared twice in more than 500 pages of written evidence and the only tangible thing mentioned by DCMS Secretary Maria Miller was the world tour of the inflatable Stonehenge that she described as “a fantastic way of bringing Britain to life overseas.”

As far as sports participation is concerned, the step-change improvement hoped for did not occur. If anything, the slow steady improvement seen since 2005 has faltered. Facilities at grassroots level need to be improved and we received much evidence telling us that the Coalition’s scrapping of School Sports Partnerships was a big mistake.

Although we hunted for White Elephants among the facilities created for the Games, we didn’t find them. But the unseemly squabbling of West Ham United and Leyton Orient football clubs over the Olympic Stadium was most unedifying. It is important that more effort is made to ensure that this national asset is put to good use with maximum possible community use, including possibly by the club that was unsuccessful in the bid process.

That is the overall lesson of the report: the London Games were a huge success but much more still needs to be done to ensure the nation gets the maximum possible return on its investment.

 

Monday
Jul 29,2013

Two issues today highlight the way this Conservative-led LibDem-supported Coalition Government operates.

Fees of up to £1200 to bring an employment tribunal case are being introduced today.  This is allegedly intended to prevent so-called vexatious claims from being brought.  The reality is that for the first time since employment tribunals were introduced in the 1960s there will be charges imposed to deter those who have been badly treated or exploited by their employers.  The fees discriminate against the weak and the low paid.

Less important, but symptomatic of the way this Government pays lip-service to engagement and consultation are a series of consultation exercises launched in the last few days with closing dates for response at the end of August or in the first week of September.  Good practice would be that consultations should be open for up to three months – five weeks over the peak holiday period is designed to stifle responses.  The consultations cover such matters as pensions fro retained firefighters, the housing transfer manual, and various notices under the Gas and Electricity Acts (and yes, I don’t know what these are about, but they are no doubt complicated and take time to understand their implications).

I am not surprised by the Tories, but I hope the LibDems are ashamed of themselves.

Thursday
Apr 18,2013

A few weeks ago I asked “How often does Boris Johnson speak up for Londoners?”  The answer seemed to be not very much.  I had tabled a question in the House of Lords:

To ask Her Majesty’s Government what representations they have received from the Mayor of London in the last year on (1) health services in London, (2) housing provision in London, and (3) the impact of changes in welfare benefits on the people of London.[HL5797]“

The response I got was as follows:

The Parliamentary Under-Secretary of State, Department for Communities and Local Government (Baroness Hanham): The Department of Health has held a number of discussions over the last year with the Greater London Authority, London Councils and the Local Government Association about the London Health Improvement Board. We recognise that there is potential for delivering health improvement services on a city-wide basis in London. The London Health Improvement Board has been meeting since July 2011.

The Localism Act conferred on the Mayor of London responsibility for housing, economic development and Olympic legacy in London, in addition to existing responsibilities over transport, planning and the police. Therefore, the mayor is responsible for housing and regeneration policy in London. The Department for Communities and Local Government has regular conversations with the Mayor of London and the Greater London Authority regarding housing provision in London. Over the last year these conversations have focused on a broad range of issues, such as funding and delivery of affordable housing, increasing investment in the private rented sector, getting surplus public sector land back into use and dealing with homelessness and rough sleeping.”

The answer was – as I pointed out –  notable in what it does not say.

There is no indication that the Mayor had spoken up on behalf of Londoners about the state of London’s NHS and the piecemeal closure of services that is taking place all over the capital.

And there was no mention whatsoever in the answer (despite its specific inclusion in the question) of any representations made by the Mayor on the impact of changes in welfare benefits on the people of London.

So I concluded:

“Boris Johnson has made plenty of public statements about not being nasty to bankers and the iniquities of high tax rates but apparently has little to say about the cuts in welfare and housing benefits that hundreds of thousands of Londoners will face in the next few weeks.”

However, in the interests of fairness, I thought I should seek further clarification in case the omission from the answer was a mistake by civil servants.

After all, this was the Mayor who in October 2010, while he was running for re-election as Mayor, had likened the effects of the housing benefit changes to “Kosovan-style ethnic cleansing“.

I therefore tabled another question in the House of Lords this time more specific that elicited the following response:

Lord Harris of Haringey:

To ask Her Majesty’s Government, further to the Written Answer by Baroness Hanham on 5 March (WA 397-8), what representations they have received from the Mayor of London, separately from the London Assembly, specifically on the subject of the impact of changes to welfare benefits on the people of London.[HL6517]

Lord Freud: We are not aware of any representations received in the past year from the Mayor of London, separately from the London Assembly, on the impact of changes to welfare benefits on the people of London.”

So the Department of Work and Pensions is not aware of ANY representations from the Mayor in the last year.

This demonstrates how little he really cares about what is now happening to many Londoners.

All he was prepared to utter was a single lurid soundbite in one of his rare media interviews. And then nothing.

No attempt to use the formidable statistical and information resources available to him at the Greater London Authority to put the case to his colleagues in Government.  Nothing at all.

Perhaps what it means is that now he has been re-elected he no longer feels the need to represent the interests of Londoners as his focus has moved on to winning over the Conservative MPs he needs for his next objective – to succeed David Cameron as Leader of the Conservative Party.  And not many of those Tory MPs care about hard-pressed Londoners damaged by the Government’ s policies on benefits.

Friday
Mar 29,2013

The House of Lords is now in recess for Easter.

However, forthcoming business for the period after the recess has now been published and on the 24th April the House will be debating the highly controversial “competition” regulations for the National Health Service.  That is likely to be the main business that day.

However, before the main course there is an aperitif: “Consideration of the 5th and 6th Reports for the Procedure Committee”.  The first of these contains some proposals to repeal three standing orders of the House.  The standing orders concerned date back to 1699, 1678 and (wait for it) 1675.  The Committee points out that these orders are now obsolete (in one case they were made redundant by statute over 300 years ago and in another by an Act of Parliament of 1840 – 173 years ago).

So there is no rush then …..

Wednesday
Mar 27,2013

The focus of that Eddie Mair interview was the question of Boris Johnson’s fitness for further office.  There was no real discussion of how well he has actually done in his current job as Mayor of London.

In the earnest spirit of inquiry I recently tabled a question in the House of Lords:

To ask Her Majesty’s Government what representations they have received from the Mayor of London in the last year on (1) health services in London, (2) housing provision in London, and (3) the impact of changes in welfare benefits on the people of London.[HL5797]”

The response I got was as follows:

The Parliamentary Under-Secretary of State, Department for Communities and Local Government (Baroness Hanham): The Department of Health has held a number of discussions over the last year with the Greater London Authority, London Councils and the Local Government Association about the London Health Improvement Board. We recognise that there is potential for delivering health improvement services on a city-wide basis in London. The London Health Improvement Board has been meeting since July 2011.

The Localism Act conferred on the Mayor of London responsibility for housing, economic development and Olympic legacy in London, in addition to existing responsibilities over transport, planning and the police. Therefore, the mayor is responsible for housing and regeneration policy in London. The Department for Communities and Local Government has regular conversations with the Mayor of London and the Greater London Authority regarding housing provision in London. Over the last year these conversations have focused on a broad range of issues, such as funding and delivery of affordable housing, increasing investment in the private rented sector, getting surplus public sector land back into use and dealing with homelessness and rough sleeping.”

The answer is notable in what it does not say.

There is no indication that the Mayor has spoken up on behalf of Londoners about the state of London’s NHS and the piecemeal closure of services that is taking place all over the capital.  I doubt whether the remit of the London Health Improvement Board covers the configuration of health services in London and I have asked another question to clarify this.

And there was no mention whatsoever in the answer (despite its specific inclusion in the question) of any representations made by the Mayor on the impact of changes in welfare benefits on the people of London.

Boris Johnson has made plenty of public statements about not being nasty to bankers and the iniquities of high tax rates but apparently has little to say about the cuts in welfare and housing benefits that hundreds of thousands of Londoners will face in the next few weeks.

I wanted to seek further clarification from the Government by asking:

“Further to WA 5797, does the absence to a reference to representations from the Mayor of London in respect of changes in welfare benefits on the people of London mean that there were no such representations”

but have been told that that would be against the rules.

Instead, I have asked again what representations the Government has had from the Mayor specifically on the subject of impact of changes to welfare benefits on the people of London.

I await the answer, but I expect I know it already: Boris Johnson is more concerned about the very wealthy and about big bonus bankers than those who have to rely on what is left of our social security system.

 

Tuesday
Mar 26,2013

There are a few politicians who are so well-known that they are referred to a almost universally by their first names. Maggie Thatcher was one; John Major and David Cameron are not. It seems to be a requirement for those who become Mayor of London – think of the Ken and Boris show.

Jeremy Hunt clearly thinks he is part of that select band. His introduction to the Government’s response to the Francis Report on the events at Mid-Staffordshire Hospital is signed with a rather inappropriate flourish simply by him as “Jeremy”.

Perhaps this is intended as a subtle signal that he is available either as a replacement for the Prime Minister or as the next Conservative Mayoral candidate……

Monday
Mar 18,2013

This morning the Public Accounts Committee published a coruscating report on the continuing problems that HM Revenue and Customs have in answering the telephone.

On Saturday thousands marched through North London to protest at changes in the services offered by the Whittington Hospital.

What links these two events?

The answer is a former car parts company, Unipart, that now sells its services in promoting “efficiency” to public bodies.

Unipart advised HMRC on their processes.

Unipart advises the Whittington Hospital on how to cut its costs and shed staff.  One of the major proposals management there is implementing is to change the way in which the public can “interface with” the Hospital.

Excessive delays in answering the phone by HMRC are serious, but they are not usually life-threatening.

Answering telephone calls from patients and their relatives in a hospital may be.

The danger is efficiency proposals that work well in an industrial setting may not be suited to a public service on which the lives and well-being of people depend.

Friday
Jan 11,2013

Yesterday afternoon I initiated a short debate in the Moses Room of the House of Lords on the biological threats facing the United Kingdom, specifically I was asking “Her Majesty’s Government what arrangements they have in place to protect the residents of the United Kingdom against biological threats; and what measures they are taking to promote the international regulation of biological weapons and to ensure that security standards are sufficient in laboratories engaged in biological research around the world.”

The National Risk Register has in its top tier of risks facing the UK major natural hazards, such as a flu pandemic, but also includes as a serious threat in that top tier of risks a biological attack by terrorists.

As Lord Tony Giddens pointed out later in the debate:

“There are three sets of factors which make biological threats far more menacing than they were for previous generations. The first of these … is work in scientific laboratories that is designed to unpack the basic building blocks of nature but which can have spin-offs of a dangerous kind. … Secondly, there is the disruption to or destruction of the world’s ecosystems, releasing pathogens from their normal hosts. The process is normally known as zoonosis and it is one that is fraught with implications for human beings. Thirdly, … we have globalisation which can transmit pathogens almost immediately from one side of the world to the other.”

But the other big change that I had highlighted was the speed of technological advance that has taken place in the last ten or fifteen years in respect of genetic manipulation and as I explained:

“viruses are very simple. They are simply a capsule, often with perhaps 10 or 12 genes within them. The changing of just one gene within a virus can have a very profound effect on what that virus does: how easily it is transmitted, the extent to which it can be transmitted from an animal to a human being or between humans, and the consequences for the organism that is infected.

In fact, in 2001 the Journal of Virology published a research paper that demonstrated a whole number of ways of modifying the mousepox virus. This new virus was so effective that it overwhelmed the immune system of the test mice, causing massive liver failure and eventually killing the subjects. That reaction occurred even if the mice had been vaccinated against the mousepox virus. That was a legitimate scientific experiment—an effort to control the mouse population in Australia—but it demonstrated that a quite small change in a single gene with comparatively simple techniques could have major consequences.

These techniques are becoming more straightforward and all sorts of legitimate research is taking place in these areas around the world. Some of this could have the consequence of rendering a vaccine ineffective; some of it could confer resistance to therapeutically useful antibiotics and antiviral agents in pathogenic organisms; it could increase the virulence of a pathogen, or make it easier for that pathogen to be transmitted; or it could perhaps alter the range of hosts for that pathogen. A whole number of things are now technically possible that were not easily doable 10, 15 or 20 years ago. Entirely legitimate research on genetic manipulation and modification is of course going on all over the world for entirely benign purposes.

The question that I want to pose is: how well regulated around the world is that research? How confident can we be that other countries are applying the sorts of restrictions that we would wish to see? Some pharmaceutical companies may have an interest in carrying out experiments and developing their techniques in countries where the regulatory regime is far less intense than it might be in our own country.”

Biological weapons are outlawed under the Biological Weapons Convention, which has been signed by virtually every country in the world.  However, as I pointed out:

“although countries have said that they accept that they should not be developing biological weapons, the world has not set up what we might consider to be any effective system for monitoring compliance or verification. Some of the biggest and most powerful countries—the United States of America, for one—are extremely dubious about setting up any external system to monitor their own compliance and do not necessarily see the need for a supervisory body.

The US, for example, clearly has no official bioweapons capability but has constructed a huge research base, in many different centres around the United States, under the National Biodefense Analysis and Countermeasures programme. That is undertaking, no doubt quite properly, genetic research, development and testing. However, if the United States says, “We are not happy with our compliance with the Biological Weapons Convention ever being tested by anybody else”, it is very difficult to see how that could be enforced on other countries.

Scepticism also persists about whether Russia’s offensive bioweapons capabilities have been completely dismantled. There are, I think, five Russian military bioweapons facilities which remain closed to outside inspection. Many of the officials linked to their current defensive programme are the same officials that developed Soviet offensive capabilities during the Cold War. There is a question again about how secure those facilities are, particularly as we know that regimes change and that certain parts of the world become less stable as things move forward.”

I also warned that:

“There is clearly a risk that stocks of materials developed for one purpose could be misused or fall into the hands of terrorist groups or, potentially, rogue regimes.”

And concluded as follows:

“In responding, can the Minister first say what is being done to improve supervision of these matters? Secondly, what is being done to regulate the security of scientific establishments, including those that hold stocks of pathogens? It all ends with a fundamental question. We are at risk, as a nation, from a pandemic of whatever sort and from whatever origin, whether naturally or unnaturally occurring. Are we really satisfied that our emergency and health services are able to withstand that?”

The Minister who responded was Lord Wallace of Saltaire who acknowledged that:

“This is an important subject, and both a domestic and international one. We are concerned with the potential of a terrorist attack and the very distant potential of a global state attack. … We are also concerned with the possibility of accidental release from badly secured laboratories.”

Being a LibDem Minister he could not avoid taking the opportunity to snipe at his Conservative Coalition colleagues, saying:

“This is an area of domestic and international overlap. I would not discourage noble Lords from pointing out, as we deal with the intensely emotional issue of the defence of British sovereignty from European and other interference, that this is one of many areas where you cannot have entirely different British and foreign issues. We have to have international co-operation and, as far we can, regulation.”

He did confirm that:

“The Government are deeply committed to protecting the United Kingdom from biological threats. That requires us to have strong measures at home and co-operation abroad.”

but warned that:

“There is resistance to a strong international compliance programme … it is not simply from the United States, let alone from the American pharmaceutical industry, but from a range of other countries that I will not go through. For many of them it is a question of sovereignty and, for one or two south Asian countries, of suspicion of the West. There are limits to what we can achieve and we have to work as far as we can through education, co-operation and providing assistance. I also note that we are working with our partners inside the European Union through the establishment of centres of excellence with regional centres around the world to build this level of co-operation.”

His basic message was:

“There are some real problems here … this is a very complex area.”

And he concluded  – rather strangely for a Government Minister – with:

“I shall finish by saying that we need to keep on challenging our Government and even more so other governments.”

We?!

So I suppose those of us who took part in the debate were being told: keep on nagging us and maybe we (the Government) will finally take this as seriously as it deserves.

If you want to read the full debate it is here.