Which City?

Sunday, 31 March 2013

At the end of Winter, is there hope for Spring?

We are still waiting for Spring, when new beginnings give us hope for the future. The persistent cold weather in the UK is almost a metaphor for the long dark winter of austerity which many are feeling, and which for some will deepen tomorrow when the first wave of benefits cuts bites.

On Easter day I woke with a sense that we are all in this life together, dependent through the cycle of birth and death on one another for our existence and our survival. Yet the system of monetary exchange which we use to make the world go round seems increasingly to divide us - the rich get richer, the poor never do.

After a Quaker Meeting which I attended in York today, I queued for coffee with a lovely Geordie  who I hadn't seen for a while. He told me he had been struggling and had been out of circulation for a bit, trying to prepare for the reduction in his income which would mean that from tomorrow he would treat 'every pound like ten pounds'. I don't know by how much the gap between Geordie's income and outgoings will grow as a result of bedroom tax, loss of specific benefit or requirement to pay Council tax, but it's enough to worry him deeply.

This week I went to my last meeting as an NHS Non-Executive Director 
and felt positive about how hard staff had worked in the most uncertain of circumstances to make sure that the handover to a plethora of new organisations goes smoothly. I am hopeful that the Clinical Commissioning Groups will work positively with provider NHS Trusts to form the backbone of excellent NHS services, but I am less sure that the commissioning landscape overall has any more clarity or stands a better chance of joining up effectively with social care and other vital public services. I asked the Director of the new Local Area Team of the NHS Commissioning Board (renamed NHS England as I spoke) what the process would be if somebody wanted to complain about their GP, and he was honest enough to admit that he wasn't sure. Patient access is a key requisite of a responsive NHS and a good companion of patient safety. 

I spent Wednesday morning in Doncaster with health, social care and voluntary sector partners talking about how to create a Dementia Friendly Community. This work, which is a joint venture by AESOP Consortium and The Open Channel is based on our work for Joseph Rowntree Foundation published last year as Creating a Dementia Friendly York. We heard from a woman who is caring for her husband who has Parkinson's and dementia with Lewy Bodies. They are a well-off, educated couple who need no financial support from anybody, but who are frustrated by the lack of consistent information and moral support which good coherent health and community services should provide to them as tax and community tax payers. It is not the money that's important, it's the understanding, fellowship and humanity that people need in their darkest moments, and rich and poor are no different in this respect. We all wondered how people living alone or with fewer personal resources were coping, and we realised that this is why too many people with dementia are in hospital or nursing care when they don't need to be, because there is not enough support in the community. We must turn this situation round before the NHS and local authorities are swamped - will CCGs be able to commission this change?

On Thursday I chaired a meeting of a national drug and alcohol treatment charity where I am a non-executive trustee. We reviewed the caseload of serious untoward incidents affecting people using our services over the past year. This included about 12 deaths. Almost invariably these were deaths, not always accidental, of heavy drug or alcohol users who risk their lives by their lifestyle. But they are also the sons and daughters, husbands, wives, mothers and fathers, sisters and brothers of many of us, and they have been unlucky enough to encounter addiction, whereas we have not. Some of these people would have led difficult, impoverished lives with or without addiction, but some could have lived well, happily, productively if things had turned out differently. 

This weekend I spent with friends in my hometown. Ironically, I went to a beer festival in a pub which I used to frequent as a teenager in the 1970s. My brother and I both drank there - I escaped addiction, he did not. We heard stories of our friends and their families which illustrate that alcohol is blighting the lives of people with good jobs and incomes, outwardly respectable and happy but suffering under a burden of habit and aggression. We are not all as we seem to be.

This weekend a group of Churches in the UK spoke out against the government for perpetuating myths about poor people -   that they are lazy; that they are addicted to drink or drugs; that they are not really poor; that they cheat the system; that they have an easy life; and that they caused the deficit.

How important it is that we speak truth to power, that we stand against the stereoptyping and blaming of vulnerable people, that we recognise addiction to be a curse and not an indulgence, that we understand how all of us can fall victim to the seductive draw of money, but that the rich have much more scope for exploiting others that the poor will ever have.

We are all in this together - isn't that what the Prime Minister would have us believe? Then yes, let us support one another, recognise or interdependency. Don't set us against one another, making us ever more distant and afraid. We will thrive through joint endeavour, mutual support and understanding but if we continue to punish the poor we waste their potential and impoverish our human spirit.

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