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Sunday, 3rd December 2017

Doing the right thing well………………

Doing the right thing well……………….

It has been a challenging and upsetting few weeks. I had to make a difficult speech in the District Council chamber because I was sick of people accusing others of lying- in this case about planning policy.

I haven’t very often heard councillors call others liars, and it does leave a very nasty taste. I had to speak out because it wasn’t right to suggest that the Administration at TDC was lying over the housing numbers or seeking to be deceitful to residents. Rational debate is the only way to create policy or amend it, and certainly the only way to apply it. It can of course be driven by passion, as many of my contributions are. But the facts have to anchor the debate.

I had to say that I thought the Administration was making the best of the very challenging policy environment that the government has created, not least about Green Belt policy, and that if I were Leader I would have taken much the same approach. It was neither constructive nor fair to accuse them, as certain councillors have done, of lying. Nor is their approach on this issue inept- I have certainly been quick to call ineptitude out if it has been there in the past.

The government has clear internal divisions on Green Belt policy- certainly between the Chancellor and the Prime Minister, and yet the council has to make a plan that will pass an Inspector.

I was roundly thanked for my contribution in the Chamber, but I had an uneasy feeling and was far from buoyed up. I knew that a consensus in the Chamber was impossible and that into the space between the protagonists would creep doubt, cynicism and contempt for politicians. No one benefits from that; we all lose. And so of course it has proved. If one person is responsible for “politicking”, somehow we all are guilty of the same crime. It makes doing the right thing in the right way very difficult.

The County Select Committee for Children and Education was another difficult meeting. A carefully choreographed Powerpoint presentation by Surrey Commissioning Officers, The Commissioning CCG and the provider presented some dreadful facts about children’s mental health services with a straight face and a proclaimed reliance on failed systems to put things right.

Here are some of the painful numbers:

36% of children referred by professionals were rejected for a treatment pathway. Children need to be suicidal to get an early treatment pathway apparently.

52% of children waited over 3 months, 23% over 6 months, for assessment.

After assessment, 85% offered treatment were seen in under 3 months, 46% under a month.

So if you are one of the unlucky ones (and not self-harming yet) you could wait over 6 months to be assessed and up to 3 months to start a course of treatment.

I was shocked that none of the presenters actually seemed to care about this appalling state of affairs. The commissioners have issued a Performance Notice, (NHS speak for writing a hundred lines- or worse, taking money away and not paying the agreed price.) While you might do that with a failed roofer, taking money away from an NHS Provider just makes things worse- the reason the contract performs so badly is that the number of children who need treatment was severely underestimated when the contract was let, so there is not enough money in the system anyway. Which is not to say that the provider has perfect systems, it’s just that this sorry saga- re-tender a contract at less money than is required to deliver it properly, offer it to a provider with performance standards which are impossible to meet with those resources and then beat the provider up very month at the contract management meetings and assure people that “there are robust measures in place to bring performance in line with the contract standards.”

Only the NHS seems to use the word “robust” nowadays, and then only to sound macho about a series of inexcusable failures. The contract performance folk dance has gone on in the same way, with the same issues, for year after year, while children grow old and damaged, their youth lost to despair, their education a memory masked by misery.

If only we could all share the rage that I and my fellow councillors felt on hearing all this. How can we turn our rage into action in a system which is so badly failing. It is a truth universally acknowledged that a system is perfectly designed to produce the outcomes it does. Performance notices and all that clap trap won’t help children be treated before their despair ruins their lives.

There is a significant injustice too in that the County Council is accountable to its electors while the CCGs are accountable for their financial performance mainly, and not to an elected public body. So they can seem to get away with murder by negligence. Still, there are “robust systems in place”, which is good to know.

I sat at the Corporate Parenting Board this week, which is a body concerned to ensure that Surrey’s Looked After Children are properly cared for, that they have the right health checks and have access to the same opportunities as other children. Health checks were apparently way behind schedule. Health representatives said all the same sorts of things.

Until children’s services are run as one organisation where health are accountable to the County Council, things will not improve. Partnership working is supposed to deliver the right outcomes by ensuring health and social care work as one- they don’t and won’t while they are differently accountable. Partnership working becomes a sophisticated way to dodge the bullets and look after your back.

This week also Ofsted published the letter recording its findings from a visit to Children’s Services at the end of October. It is published on their website.
The Cabinet Member’s concerns are that:
• “there is not a shared understanding of thresholds within and across our teams.
• children are not being seen often enough.
• children can wait too long to get the help, care and protection they need.
• managers are not consistently effective in driving plans for children.
• there is not always follow up on what needs to happen to keep children seen, safe and heard.
There must now be a step change in how services work together, with all our partners, for children in Surrey. The focus will be on:
• assessments of children identifying needs and risks and capturing the child’s voice, and including effective, direct work with children and families.
• the wishes, feelings and lived experiences of children, reducing drift and delay for children in our system.
• the application of thresholds so that the right people work with the right children at the right time.
• management oversight, giving clear and consistent advice and direction so safe and timely decisions are made for children.
• staff supervision as a right but also a responsibility so that there is quality time for reflection, challenge and support.
• frontline practitioners being safe, supported and professionally stretched, with the skills, knowledge, tools and time to do the very best job possible for children.”

It is hard to fault the Cabinet Member’s assessment of what the letter says and what must be done; she is a caring and committed councillor who really knows her brief.

But it is a sorry tale, and I am concerned that there is an implication that we need to keep challenging the front line to improve their performance. I don’t believe that children’s social workers get up in the morning to do a bad job, nor do I believe in the policy of “The beatings will continue until morale improves”, but there needs to be a look at the size of caseloads, how recording notes of visits might be done without seeming laborious and how shared perceptions of levels of risk can be developed in a way which involves the social workers and children on the front line.

The continued Ofsted concerns reflect very badly on the County Council, and time is running out for it to demonstrate that it can develop and manage safe services. A full inspection in January will be make or break.

It has to be said that with the Council failing demonstrably in a number of areas, something radical really needs to be done. I proposed a possible solution in my last blog episode. I haven’t changed my mind.

Finally, something really sad has happened and I have been badly affected by it.

Former colleague, District and Parish Councillor David Gosling has died suddenly of a heart attack aged 47.

He was a committed councillor, full of integrity, and did his job so well for the 8 years he served. We only spoke briefly after he left the council, and too rarely. I try to remember if I told him how much I admired and valued him as a colleague. I hope I did, but I can’t remember the words. He did the right things well. I hope he knew that.