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Monday, 18th June 2018

This is a Dark Age. And even the best of us can only light candles.

This is a Dark Age. And even the best of us can only light candles.

There are lots of reasons I am glad I was not born twenty years later. There’s an example below of one of the many. This is the latest sit rep on waits for the Surrey Child and Adolescent Mental Health Service:

“Assessment waits

o Across all Targeted services 757 children are on the waitlist for assessment by CAMHS One Stop,
o 478 of these children have been waiting up to 6 months and 266 have been waiting 7-12 months.
o A further 13 have been waiting 13 – 24 months.

Treatment waits

o 453 children are currently waiting up to 12 months for treatment
o 364 of these children have been waiting up to 6 months the remaining 89 between 7-12 months.
o 322 of these are children waiting for treatment on Behavioural, Emotional and Neuro-developmental Pathway.”

This set of figures is dated 14th June 2018.

There can be no defence for this position and surely no greater example of how our children are being let down.

As we commemorate the anniversary of the Grenfell Fire you have to wonder if the capacity of the “welfare state” to sustain the most vulnerable or to protect them from harm is resilient enough or any longer a comfort to sustain us through a dark night.

I am not pretending that when I was a child there was even a CAMHS service to be referred to, but the NHS was there, and I was never left on a waiting list for a year; nor that social housing was luxurious. But what shocks about the statistics above is that we know there are children in urgent need and we systematically fail to meet those needs.

What is shocking about the Grenfell Fire, pending of course the outcome of the enquiry, is that the fire was accelerated by cladding designed to prettify the building and in one of the richest Boroughs on the planet so many families displaced still have no permanent home.

Transformation is imperative.

An entirely appropriate response to Surrey County Council’s dire financial position, and to the failure of services to deliver, is a Transformation Programme currently being worked up, proposing radical solutions to deep seated problems which are more than financial. There is a systemic paralysis which disables decision making and fails to provide performance data, so people cannot be held accountable. Such performance data as there is, as above, chills the blood.

An inevitable fall-out from this transformation process will be redundancies- I have no idea how many but funding is very short so where possible the maximum has to be spent on front line services. One off costs for redundancies will have to be found but the revenue for future years can then be focused on services for the most vulnerable.

How things have changed.

Another reason I am glad I was not born twenty years later is that I went into a secure career, teaching, in 1975, and when I had to leave through ill health in 1995, when I was too ill to leave the house, I was looked after. I slowly got better and by 2000 was able to start a new career in the NHS. I belabour the detail because it was important- I had a teacher’s pension which compensated me for my breakdown and could then start another pension in the NHS.

I had a safety net around me.

Such securities are not available today to most people, and there is no longer such a thing as a secure career. An Academy in East Grinstead is looking to make teachers redundant, when we have a national shortage of them.  The highly skilled engineers who work for one of the world’s blue chip companies, Rolls Royce, find that 4500 of their number will face redundancy- mostly, apparently, in Derby.

How can we advise people to find secure employment and ensure they will be comfortable in their retirement?

I dwell on this because I find myself, chillingly, welcoming a slew of redundancies at Surrey County Council, and I am horrified- horrified that they are necessary- they are, and horrified that they will have an impact on hard working staff and their families.

The Times on 18th June publishes the details of a report from the Health Foundation Think Tank:
“Millennials are on track to become the first generation to suffer worse health than their parents when they reach middle age, a study has warned.

People in their 20s and 30s will have a higher risk of “lifestyle” diseases such as cancers, diabetes and heart disease in 30 years’ time because of their employment, relationships and housing, it says.

The trend is linked to long-term stress, anxiety, depression or lower quality of life, the report by the Health Foundation think tank says.
Millennials have been confirmed as the first to earn less than their parents’ generation. The report says that this may have health consequences because trends such as graduates taking non-graduate jobs, zero-hours contracts and the “gig” economy can reduce wellbeing.

It points to research linking insecure work and under-employment with higher instances of psychological stress, in addition to the prospect of lower lifetime earnings. Social media is also highlighted, with the report saying that people in their 20s have to manage friendships and romantic relationships in digital form as well as by conventional means. This is a significant change whose impact on young people’s transition into adulthood is unknown, the report says. It emphasises, however, that social connections are a key to wellbeing.”

Now I don’t suppose that the health of the miners or steelworkers whose lives were overturned in the eighties were immune from the illnesses derived from insecurity. But for people in their twenties it is hard to see how security and a safe place can be routinely found. The impact on their futures cannot be overestimated. Children and adolescents’ mental health is not supported, and adults in their twenties and thirties will require more and more support- and that demand cannot be met.

A New Funding Settlement

A new funding settlement has been announced for the NHS- the figures indicate that the 4% increase required to keep pace with demand will be undershot. But the other half of the safety net conceived in 1948 is social care- means tested and the responsibility of the County Council. Without a solution to the problem of underfunded social care the impact of the extra spending on the NHS will be hobbled- the frail elderly will be stuck in hospital, occupying beds that they don’t clinically need, because support packages to help them return home and live safely there cannot be afforded.

This is all significant because in my lifetime, beginning in 1952, the Welfare State has followed some kind of bell-shaped curve- a confident but careful start, a blossoming and highly developed growth, followed by a steady, but apparently permanent decline. This is not to say there was ever a utopia for all, as inequalities and class division were never absent. But the safety net was once strong, and now is terminally failing. And Universal Credit is leaving the most vulnerable begging for food and turning to loan sharks to survive.

This has many consequences of course, but for a County Councillor with responsibility to residents for overseeing the delivery of services it presents an unresolvable dilemma. Council tax is as high as it has ever been but services for which it pays are day by day declining. This is due to the enforced decline in Local Government Funding and a failure of any government to engage in a new national conversation.

This conversation needs to be honest and cover the real, underlying issues which no-one has the courage to address- how we pay for the increasing demand on social care and health, how large the “state” is, and who is responsible for my welfare and safety when I am ill, frail or old.

I wrote some months ago that the business of being a County Councillor is painful, and that the impact of the hardship and suffering of those who turn to me is sometimes too hard to bear.

As the Welfare State declines, our young people will never own a home and remain saddled with student debt. There is an increasingly thin net to catch us when we fall.

It is truly a dark age, and all I can do is light candles.