Sadiq Khan was Shooters Hill’s choice for London Mayor, taking 48% of the vote in the ward, against Zac Goldsmith’s 28% according to the breakdown by ward of the capital’s votes published by London Elects. The Green’s Sian Berry was third with 7%, followed by UKIP’s Peter Whittle and the Lib Dem’s Caroline Pidgeon. This compares to the 2012 result when Ken Livingstone got 46% of the Shooters Hill vote, against Boris Johnson’s 37%. Across the whole of London Sadiq took 44.2% of first preference against Zac’s 35%, so Shooters Hill was a bit more pro-Sadiq than the rest of the capital
Sian Berry got the most second preference votes, with 24%, though of course these votes don’t count under the system adopted. Only the votes of the top two candidates count, and Sadiq again beat Zac in Shooters Hill with 16% against 10%.
In the ballot for the Greenwich and Lewisham constituency member of the London Assembly, Labour’s Woolwich-born Len Duval once again out-performed the mayoral candidate, taking 52% of the Shooters Hill vote, well ahead of the Tory’s Adam Thomas on 19%. Green Imogen Solly was narrowly beaten into third place by UKIP’s Paul Oakley. The BNP and Britain First did not put up a candidate for the constituency member. Len increased his margin of victory from 2012 when he got 51% of the vote against the Conservatives’ 22%.
The turnout in Shooters Hill ward for the London elections was just 44.24%, excluding postal votes which made up some 22% of the total votes cast. Let’s hope this week’s referendum on whether to stay in Europe gets more voters voting.
One of the striking trends in the ward-by-ward breakdown of the elections for London Mayor is how the balance between the two major parties has changed in Greenwich over the last three elections. This is shown in the three ward maps below showing which party had most votes in each Greenwich ward in 2008, 2012 and 2016. Back in 2008 the borough was split between Labour North and Conservative South, with Shooters Hill ward very much on the cusp voting for Tory Boris for Mayor and Labour’s Len for London Assembly member. Over the course of the three elections Labour have had the largest share of the vote in more and more wards, moving southwards, until in this year’s mayoral election the conservatives had most votes in just three, and in the London Assembly ballot Len Duval narrowly topped the polls in Eltham North too.
UKIP have also seen an increase in support over these three elections. In the London -wide assembly member polls, where we vote for a party rather than a person, UKIP’s share of the vote in Greenwich has gone from 2.78% in 2008 to 5.67% in 2012 up to 9.35% this year. I understand that we may get a ward level break-down of referendum results: it’ll be interesting to see how this correlates with the parties’ polling in this year’s other ballots.
In the meantime, I’ve finished all my deliveries of Remain leaflets, and freed up Thursday to help with leafletting and reminding Remainers to vote. Fingers crossed that the nation sees sense.
Local group Divest Greenwich, who are campaigning for the Royal Borough of Greenwich to move £17million of their pension fund investments out of fossil fuel companies’ shares, are holding a launch event at St Alfege’s Church Hall on Thursday, 2nd July at 7.00pm. Why should Greenwich do this? Well, if we are to avoid catastrophic levels of climate change most of the reserves that fossil fuel companies hold, which provide the basis for their share prices, must not be burnt for energy. Divestment will have the twofold advantage of protecting the pension fund from consequent drops in fossil fuel company share prices as well as making a stand against the powerful lobbyists of the petrochemical industry. Thomas Greenwood, who wrote to tell me about the event, succinctly summarised the case for divestment:
The Greenwich Pension Fund has around £17 million invested directly in fossil fuel companies and more invested indirectly. Such investments carry a high degree of risk on ethical, financial and scientific grounds and the Pension Fund’s investments therefore expose the people of Greenwich to those risks.
Already, hundreds of institutions around the globe have committed to divesting from (ending their investments in) fossil fuel companies to the tune of billions of pounds, including the Church of England and the Rockefeller Brothers Fund. The Royal Borough’s Pension Fund can add significantly to this movement.
The reason we consider divestment such an important issue is because if global warming is to be limited to 2°C – the threshold for irreversible climate change – up to 80% of known carbon reserves must be left in the ground. Available evidence indicates that fossil fuel companies intend to burn enough reserves to push global warming far above 2°C, as they insist on searching for further reserves, often in the globe’s most ecologically sensitive areas. Around the globe, the first five months of this year were the hottest on record. We urgently need to act.
The Pension Fund has a fiduciary responsibility to maximise returns which can be met whilst divesting. In April 2015 MSCI, the world’s leading stock market index company, found that investors who divested from fossil fuel companies would have made an average return of 13% a year since 2010, compared to the 11.8%-a-year return earned by conventional investors, including in the years before the fall in oil prices. Moreover, if decisive action is taken by governments to limit climate change and a large amount of carbon reserves are left in the ground, shares in fossil fuel companies are likely to drop significantly in value. As such, pension funds currently investing in fossil fuels risk exposure to this ‘carbon bubble’.
We believe our local government has a responsibility to divest from an industry that’s destroying our future. By remaining open to investments in fossil fuels, the Royal Borough of Greenwich is supporting the power, influence and activities of the fossil fuel industry. We would like to see the Royal Borough of Greenwich lead the way on sustainability and cease to invest in activities that are damaging for the environment and human race.
Divest Greenwich’s launch event will take place on Thursday 2 July from 7.00-8.30pm in St Alfege Church Hall.
The launch event will include a screening of the film Do the Math which is narrated by Bill McKibben, who is the author of a dozen books about the environment, including “The End of Nature” published in 1989. He is also the founder of climate change campaigning group 350.org. Another of the directors of 350.org is Naomi Klein whose book “This Changes Everything” documents how fossil fuel companies use their money and influence to campaign against climate change, but also the successes that campaigners against fossil fuels are having around the world. As easily extractable fossil fuel reserves have been used up extraction companies have had to move into more dangerous technologies, such as deep water drilling and fracking which have larger potential impacts on wider areas of the countryside and many more people. The only good thing about this is that it has increased and broadened the number of activists campaigning against these developments.
Labour candidates were the winners in the Shooters Hill ward in this week’s local government elections, with a 9% swing from Conservative to Labour in the percentage of total votes cast. Danny Thorpe continues as one of our councillors – he’ll reach his 10th anniversary on 29th July – and is joined by two new councillors Sarah Merrill and Chris Kirby. Fourth place in the poll was UKIP’s Les Price, followed by Michael Westcombe from the Green Party. The Greens more than doubled their share of the vote compared to the last local council election in 2010, while the Conservative share dropped by 9.6% and the Liberal Democrats’ vote share almost halved.
The pie chart above perhaps doesn’t give a true picture of the support received by different parties because the Greens and UKIP only put forward one candidate each for the ward, whereas three candidates stood for each of the other three parties. If I allow for this by factoring in the number of candidates per party then I get the following percentages: Labour: 42.8%; UKIP: 20.4%; Green: 15.7%; Conservative: 14.5% and Liberal Democrat: 6.6%
That 40.99% figure for turnout is particularly worrying. More than half of eligible voters didn’t vote, so even the candidate with most votes was only supported by about one in five of Shooters Hill’s voters. It also seems likely that quite a few ballot papers were spoiled. If the total number of votes is divided by 3 (the number of votes allowed per voter), the answer is 500 less than the turnout figure. Of course this may also be because some voters didn’t use all three of their allowed votes, but it could mean that 12.6% ballot papers were spoiled.
The data I’ve used for comparing the performance of parties at recent elections comes from the London Datastore created by the Greater London Authority. This contains a spreadsheet with the 2006 and 2010 local election results, and a set of pdfs with data from earlier elections. The percentages of the vote received by political parties in the Shooters Hill ward each year are plotted below, though these figures do not allow for parties fielding fewer than the allowed number of candidates. Prior to 2002 there was no Shooters Hill ward – the nearest equivalents then were Shrewsbury ward and Herbert ward, but I haven’t tried to work out the exact mapping to the current boundaries.
The results for the European elections that were held at the same time as the local elections haven’t been published yet, and I don’t know if they will be broken down to ward level. If they are I’ll update this post with Shooters Hill’s European decision.
After all the months of consultation, 24 public meetings with 1,330 attendees, 23 council and scrutiny meetings, 13 petitions with a total of 21,770 signatures, 2,323 questionnaire responses at a cost of at least £172,377, the decision on whether to close 10 London fire stations, including Woolwich, comes down to one individual: Boris Johnson.
The consultation did result in some changes to the London Safety Plan: Clapham and New Cross fire stations would remain open, East Greenwich fire station would gain an additional fire engine and Chelsea fire station would keep its two fire engines. I couldn’t find anything in the consultation report and revised safety plan that mentioned the commitment made at the Greenwich consultation meeting to reconsider the closure of Woolwich Fire Station in light of the expected massive increase in the population of Woolwich Riverside. Coincidentally the day after the report was published I received a letter from the Royal Borough of Greenwich informing me that they had given planning permission for a further 2,032 homes in the Arsenal site – this is the plan for a series of blocks of flats up to 22 storeys high along the river front. That’s 2032 homes on top of the thousands already being built in the Arsenal site, just down the road from the fire station.
It seems from the consultation report that public opposition to the closure of Woolwich Fire Station wasn’t as strong as for others in the capital. Only 156 people signed the petition to save Woolwich Fire Station, compared to over 8,000 for the 3 petitions to keep Bow Fire Station and over 6,500 for those to save Clapham. Also no-one specifically mentioned Woolwich in their response to the questionnaire: other fire stations were named by respondents opposing their closure. The consultation meeting back in May was dominated by politicians, it was even commented during the meeting that very few “ordinary citizens” asked questions, though this may have been influenced by holding the meeting in Greenwich rather than Woolwich.
The YouGov analysis of the responses to the consultation questionnaire showed that an overwhelming 94% of respondents opposed any fire station cuts, graphically illustrated in the snippet from the report below.
Despite the opposition the Fire Commissioner presented the new plan, but the London Fire and Emergency Planning Authority (LFEPA) voted by 9 to 8 to reject the proposed cuts. Their e-mail on the subject said:
A majority of LFEPA Members (by 9 votes to 8) approved the following amendments – That:
1. The Authority instructs the Commissioner to delete from the Fifth London Safety Plan, supporting documents and appendices all references to station closures, appliance reductions and consequential operational post reductions, including reductions in Fire and Rescue Units, reductions in crewing levels of Fire and Rescue Units, alternative crewing of specialist units and reductions in officer numbers, and to make the subsequent changes that are necessary.
7. This Authority recognises and respects the single clearest issue raised during the consultation process: that Londoners do not want to see local fire stations closed. The Authority notes that the 1.2% Council Tax cut implemented by the Mayor came at a cost of £9.4million and that the Mayor’s plan to cut it by 10% over his four-year term will cost a further £70million making some £80million in total. Consequently the Authority calls on the Mayor to reconsider his policy of a 10% council tax cut and instead work with officers and members of the London Fire and Emergency Planning Authority to develop an approach that preserves London’s fire cover, saves London’s fire stations and balances the budget into the longer term.
The decision now rests with the Mayor of London, though a tweet from the London Fire Brigade Union yesterday reported that he is “minded” to overturn the LFEPA decision and close the fire stations.
Boris Johnson has written to the London fire commissioner, indicating he is ‘minded’ to overturn the fire authority’s rejection of cuts.
I’m not sure exactly what politicians mean when they are “minded” to do something. Have they just not quite made up their minds? Have they decided but are trying to avoid the criticism that a bad decision will attract? Whatever … it is starting to seem likely that Woolwich Fire Station will close after a hundred and twenty six years of operation.
“In 1914 a suffragette plot to blow up the water reservoir on Shooters Hill was foiled” – an intriguing tweet from @TOWIWoolwich about the Greenwich Heritage Centre‘s new free exhibition on suffragettes in Greenwich set me on a hunt for more information. Which reservoir were they talking about I wondered – was it the Shooters Hill water tower, or one of the reservoirs on Woolwich Common or Jacob’s Corner, or even that under Oxleas Meadow? Who was responsible for the plot and how were they foiled?
A quick search of the web using the DuckDuckGo search engine didn’t help, so off to the library to consult Bagnold and W.T. Vincent – nothing. I did find some useful information at the Heritage Centre. They have a fascinating folder about the suffragettes in Greenwich which includes a copy of an interesting and informative little booklet by Iris Dove, entitled “Yours in the Cause, Suffragettes in Lewisham, Greenwich and Woolwich”. This mentioned the alleged plot, and gave slightly more information – a date: June 1914.
The Freedom of Spirit exhibition is well worth a visit. As well as telling the story of the life of Blackheath- born suffragette Rosa May Billinghurst there are displays about the suffragettes’ campaigns and the authorities’ reaction. One case holds one of the force-feeding tubes that were used on imprisoned suffragettes who were hunger striking. It’s not surprsing broken teeth resulted from the ceramic mouthpiece. I’d never heard of the “Cat and Mouse Act“, under which extremely weak hunger-striking prisoners could be released until they were well and then rearrested.
Woolwich was a centre of support for women’s right to vote, with both the local council and labour party strongly in favour. Many people travelled from Woolwich up to London for speeches by suffragette leaders and demonstrations.
London; Tuesday, June 16.- A plot by militants to blow up the Metropolitan Water Board’s reservoirs in the Woolwich District was communicated to the authorities last night. These reservoirs supply a large part of the Eastern district of London, and their destruction would cause widespread inconvenience.
As a result of the information, a large force of police guarded the reservoir all night.
Perhaps the local papers would have more details of the plot, I thought, so armed with a precise date I headed back to the Heritage Centre where they have drawers full of microfilmed copies of local papers going back to the nineteenth century. Trying to resist being deflected by interesting articles about a 1914 Woolwich Photographic Club outing and comparisons of Woolwich in 1914 with 1893, I scanned through to find the suffragette plot. The Kentish Mercury from June 19th 1914 was sceptical about the reports, which must have appeared in the London newspapers too:
MILITANT SUFFRAGISTS AND THE WATER SUPPLY
A RUMOURED “RESERVOIR PLOT”
A daily contemporary announced on Tuesday that a plot by the “fool-furies” who are known as the “militant Suffragettes” to blow up the Metropolitan Water Board’s reservoirs in the Woolwich district had been communicated to the authorities. It was added that these reservoirs “supplied a large part of the eastern district of London” and that “their destruction would entail widespread inconvenience”. If the writer’s information in regard to the plot is no better than his knowledge of London’s water supply, there is little ground for alarm. As a fact, the reservoirs referred to, which are at Plumstead and Shooters’ Hill, are of altogether minor importance. Nothing is known of the “plot” at the offices of the Water Board, but, in any case, the reservoirs and works of the board are always well guarded, and it would be a difficult matter indeed to do them any serious injury.
But the Kentish Independent and Kentish Mail from the same date reported that the stories were based on an innocent enquiry:
THE RESERVOIRS RUMOURS
HASTY JUMPING TO CONCLUSIONS
Some excitement has been caused during the week through stupid rumours published by certain of our London contemporaries that Suffragettes had threatened to blow up the reservoirs of the Woolwich district
It appears that a few days ago a young lady appeared at the water tower on Shooters Hill and asked a number of questions of one of the residents near by. How much water did the tanks hold? and where did the supply come from? and other queries were amongst those asked. The questioned one immediately jumped to the conclusion that his fair questioner must be a Suffragette, who had in view a dastardly attack upon the water tower with a bomb. The rumour soon spread, gathering picturesque and unveracious embellishments as it went along, and someone was soon found to telephone the exciting incident to the London “dailies”, who naturally made the most of it. From enquiries made by a “Kentish Independent” representative it is found that the supposed “wild woman” was a teacher making harmless enquiries so as to be able to give a lesson to her class on how our houses are supplied with water. Innocent of the alarm her questions had given, she subsequently appeared at the water tower with the children, but was not allowed within the enclosure.
It seems the reservoir plot was just a teacher researching a lesson about water supply! However the Heritage Centre’s exhibition is a reminder of the suffering endured by many suffragettes in the battle for the vote – such a shame so many people don’t use it.
London Fire Brigade have recently published the results of their modelling of the impact at ward level of the proposed reductions. They summarised the results as:
The new modelling indicates that 40 wards would move from within target to outside target as a result of the proposed reductions. However, those 40 wards would join 267 wards in London that are currently performing outside target.
The target time for the arrival of the first appliance at a fire is six minutes. The first appliance figures for Greenwich wards are shown in the table below, together with the increases and the percentage increases. For Shooters Hill there is an increase in first appliance arrival time from 6 minutes 35 seconds to 7 minutes 1 second, an increase of 26 seconds, just over 6.5%. The new time is just over a minutes over target, or 17% over. It may not seem like much, but every second counts if your home is on fire.
The worst impacts in Greenwich are in the Woolwich Common ward, where the response time increases by nearly 20%, and Woolwich Riverside with a huge 50% increase. Both these wards will no longer meet the 6 minute target after the change, whereas they do now.
London Fire Brigade have also organised 24 public meetings in different boroughs to discuss the Safety Plan. In Greenwich this will be held on Wednesday 29 May from 7-9pm at Lecture Theatre 315, King William Building, University of Greenwich, 30 Park Row, Greenwich, London SE10 9LS. Seems a bit odd that it’s the day after the consultation ends. I get the impression that attendees at the equivalent meeting in Southwark were vociferously opposed to the cuts. I can’t imagine Greenwich will be less vociferous.
Question: Why are you reducing the size of the Safer Neighbourhood Teams?
Answer: We’re increasing the number of police in the Safer Neighbourhood Teams.
Question: The Safer Neighbourhood Teams work really well, why are you reducing their size?
Answer: We’re increasing the number of police in the Safer Neighbourhood Teams.
Later still ….
Question: I’m against the reduction in the number of officers in the Safer Neighbourhood Teams, why are you doing it?
Answer: We’re increasing the number of police in the Safer Neighbourhood Teams.
I felt a strange mixture of confusion and deja-vu by the end of the Mayors Office on Policing And Crime (MOPAC) consultation event at the end of January. We had been told that each Safer Neighbourhood Team would be reduced in size from two police officers and three police community support officers (PCSOs) to one police officer and one PCSO. We had also been told that the number of officers allocated to SNTs in Greenwich would be increased by 88 (and that we should be grateful for that). Why the difference? No-one was saying, even after a direct question about how SNT resourcing works. It was quite easy for the panel to avoid questions because the chair had cunningly combined questions into groups of three before they were answered, so some questions just weren’t addressed. We did find out that the Deputy Mayor for Policing and Crime had to attend a large number of consultation events (poor chap), but not what was so interesting on his mobile phone. We’re also going to have sheriffs apparently. Hopefully the Sheriff of Shooters Hill won’t meet Robyn Hood in Oxleas Woods.
I think what was being proposed was that each individual SNT would have fewer officers assigned permanently to it, but there would be a larger pool of officers who would be temporarily assigned to individual SNTs on an as needed basis. It would have been nice to learn how this would work in practice, but the consultation event was kept strictly to one hour, which wasn’t really enough to cover all the issues raised by the new Police and Crime Plan 2013-2017, which also proposes the closure of Woolwich and Greenwich police stations.
The MOPAC consultation event made me wonder whether it was worth responding – will it make any difference if everyone says they don’t want police stations to close, or will they just go and do it anyway? There is a recent precedent with the consultation about the South London Healthcare NHS Trust and the proposal by the Trust Special Administrator to close Accident and Emergency at Lewisham Hospital. Despite the majority of respondents saying they were against the proposal, and despite 25000 people marching through Lewisham to object, and despite nearly 35000 people signing a petition against the proposal, the Secretary of State for Health, Jeremy Richard Streynsham Hunt, decided to do it anyway.
The Transport for London consultation about the Thames river crossings and the possible closure of the Woolwich Free Ferry seemed to be better than others inasmuch as their reports on previous public feedback suggested that some notice was being taken of our input. But now we hear that Greenwich Council is trying to get the power to build a bridge at Gallions Reach whatever we say and whatever TfL decide!
What a lot of consultations! And it can be quite hard work to respond to them: the TSA draft document about South London Healthcare was some 373 pages of largely impenetrable management gobbledegook; not an easy read. Is it worth the effort when it seems that politicians treat the result so cynically? Yes, I think it is as it is one of the few ways possible to make our views known. But politicians shouldn’t complain about public disengagement with the political process, such as low turn out at elections, when they themselves fail to engage with the public when they get the opportunity.
One last consultation to mention, as it will shape future planning decisions in Greenwich. As the council’s e-mail about it said:
Royal Greenwich is preparing a new planning policy document called the Core Strategy with Development Management Policies. This document will replace the existing planning policies for the Borough (the Unitary Development Plan) and will be used by the Council to help shape development up to 2028.
I found the Unitary Development Plan very useful as a means of making reasoned objections to proposed property developments – it lays down the policies that the planners use to decide what can be built where – so it’s important that its replacement is suitable for the same role. As the Planning Consultation Portal says:
When it is adopted, the Core Strategy with Development Management Policies will become the key strategic planning document for Royal Greenwich. It will be used to help shape development and determine all planning applications.
Key features of the proposed strategy are explained in the latest draft document. They include:a significant number of new homes by 2028 the creation of two new mixed use urban quarters at Charlton Riverside and Greenwich Peninsula West. Strategic and development management policies will be used to guide development applications in the borough. These cover a range of topics such as open spaces, infrastructure and environment and climate change.
Following previous public consultations on the Draft Core Strategy with Development Management Policies we are due to begin our 12 week consultation period on the Proposed Submission Version on the 19th February 2013.
Health – Life Expectancy, Incapacity Benefits claimant rate Economic security – Unemployment rate, Income Support claimant rate Safety – Crime rate, Deliberate Fires Education – GCSE point scores Children – Unauthorised Pupil Absence Families – Children in out-of-work families Transport – Public Transport Accessibility Scores Environment – Access to public open space & nature Community – Elections Turnout
The average value for England and Wales for this measure of well-being is zero, which is what the Shooters Hill value for 2010 worked out to. Shooters Hill had the third highest score in Greenwich, as can be seen in the spreadsheet snippet below, but was 270th out of 625 London wards. The highest Greenwich well-being score was +5 for the Eltham North ward and the lowest, -14, for Woolwich Riverside, which was 619th out of the 625 wards across London.
Compared to other boroughs Greenwich residents don’t do so well, as the map snippet below shows, with most wards having a well-being probability below average. Well-being probability values are higher in some nearby boroughs such as Bexley and Bromley. Not surprisingly the London ward with the highest well-being probability was Knightsbridge and Belgravia in Westminster borough, and the top ten included 4 wards from Merton, 3 from Richmond upon Thames and one each from the City of London and Kensington and Chelsea. In general the indicators of well-being have a negative correlation with indicators of deprivation, such as the Ward Level Indices of Deprivation published by the GLA, but also with individual data items such as the Income Support Rate and the Unemployment Rate. In simple terms, the more deprived the ward, or the higher the level of income support or unemployment the lower the well being probability and the lower the indicators of well being such as life expectancy.
The life expectancy data were particularly striking indicators of the differences between wealthy and poor areas of London. The Greater london Authority’s well being figures are based on an average of the male and female life expectancy figures; a more detailed breakdown of ward level data is contained in the ward profiles dataset. In the gender averaged life expectancy figures people living in the Shooters Hill ward have the longest life expectancy of any ward in Greenwich, with the 2005-2009 life expectancy of 82.1. The lowest in Greenwich is Glyndon ward at just 75.3 – a difference of nearly 7 years! The highest life expectancy across London is an ancient 96.4 years in the West End ward of Westminster borough, and the lowest a mere 74.1 in the East Ham ward in Newham. So people in one of the wealthiest areas of London can expect to live over 14 years longer than we in Shooters Hill, and over 22 years longer than people living in East Ham!
The Greater London Authority criteria I’ve used are not the only way of measuring well-being. The Office for National Statistics also have a programme to develop measures for national well-being, which is graphically represented in their Wheel of Measures. This programme was kicked off by David Cameron in 2010. The ONS use a larger set of data items in their well-being assessment:
Individual well-being, e.g. Percentage with medium/high rating of satisfaction with their lives overall Our relationships, e.g. Average rating of satisfaction with family life (1-10) Health, e.g. Healthy life expectancy at birth, Percentage who reported a long term illness and a disability What we do, e.g. Unemployment rate, Percentage who were somewhat, mostly or completely satisfied with their job, Percentage who volunteered more than once a year Where we live, e.g. Crimes against the person, Percentage who felt very or fairly safe walking alone after dark Personal finance, e.g. Percentage of individuals living in households with less than 60 per cent of median income after housing costs Education and skills, e.g. Percentage with five or more GCSE’s A*-C incl English and Maths, Percentage of UK residents aged 16 to 64 with no qualifications The economy, e.g. Real household actual income per head, UK public sector net debt as a percentage of GDP, Inflation rate (as measured by the Consumer Price index) Governance (involvement in democracy and trust in how the country is run), e.g. Percentage of registered voters who voted The natural environment, e.g. Total greenhouse gas emissions (millions of tonnes), Air pollutants – PM10 (000’s tonnes), Energy consumed within the UK from renewable sources
Although the UK’s use of a well-being index has been criticised as being too woolly, and the ONS approach to the contributory metrics seems a bit scatter gun, I’m in favour of using other measures than GDP to assess how we are doing as a country. I’ve always been a bit uneasy about the idea that growth has to continue year after year. We can’t grow forever; eventually we will fill the planet and raw materials will start to run out. The idea that economic growth is more important than health or the environment seems very short sighted, and if followed to its ultimate conclusion would mean that one day we will only be able to see the great animals of Africa on a David Attenborough documentary. I also sympathise with the Skideslkys’ concern about insatiable, socially-generated conspicuous consumption: the observation that in wealthy countries such as the UK those who have enough to live on comfortably continue to work long hours to be able to acquire the latest gadget, or a bigger car or wider TV. The Skidelskys also define a “good life”, a kind of well-being at the personal level.
Bhutan is credited with being one of the first countries to downplay GDP as a measure of success, in favour of Gross National Happiness – their measure of well-being. As wikipedia says: “The four pillars of GNH are the promotion of sustainable development, preservation and promotion of cultural values, conservation of the natural environment, and establishment of good governance.” The Bhutanese use GNH to guide their policies; one reason they are supporting conservation initiatives such the Tiger Corridor which featured in a BBC TV programme recently. Bhutan is also one of the most photogenic countries I’ve visited, so I’m pleased to have the chance to use some of my photographs of the Pholay Molay dance at Wangdue Phodrang Dzong in Bhutan.
The campaign to save Lewisham Hospital’s Accident and Emergency Department have organised a march to object to the SLHT Administrator’s recommendation to close it to help sort out financial issues at the South London Healthcare Trust, which includes our local Queen Elizabeth Hospital.
Why should we be concerned? Well apart from the effect on the health of people living near Lewisham Hospital who will have to travel much further if they need emergency medical help, and apart from the outrageous unfairness of closing a facility in a financially stable hospital to solve a problem elsewhere, and apart from the real terms reduction of the health care budget for south-east London and the flawed consultation process it will also add to the pressure on Queen Elizabeth A&E and increase the waiting time for patients there.
The proposed closure of the Accident and Emergency Department at Lewisham Hospital has provoked the most concern of the proposals in the 373 page draft document from the Office of the Trust Special Administrator (TSA). The document was supposed to address the budget problems of the South London Healthcare NHS Trust, which includes our local Queen Elizabeth Hospital, but has instead addressed the south east London health system as a whole. A campaign to save Lewisham A&E has been started and has held its first meetings; it is organising a “Link Hands Round Lewisham Hospital” protest event to be held on 24th November meeting at 2.00pm in Loampit Vale. A petition supporting Lewisham A&E and maternity services has been started by MP Heidi Alexander. It currently has over 12,000 signatures, and the number is increasing by hundreds every day.
The TSA proposals have been well covered by mainstream media such as BBC News, and local bloggers such as Transpontine, 853 and the Blackheath Bugle. The Bugle includes guidance on how to answer the sometimes leading and sometimes misleading questions in the TSA online response form. For example Question 13 doesn’t explicitly ask if you are in favour of the closure of Lewisham A&E, rather:
Q13. How far do you support or oppose the proposed plans for delivering urgent and emergency care in south east London? The following shows how urgent and emergency care would be delivered:
Emergency care for the most critically unwell – King’s College Hospital, Queen Elizabeth Hospital, Princess Royal University Hospital, St Thomas’ Hospital
Urgent care – Guy’s Hospital, Queen Mary’s Hospital, Sidcup, University Hospital Lewisham
I’ve tried to read the TSA report, but it’s very hard going, full of acronyms and terms that are meaningful to NHS insiders but not to others. It’s disappointing because as a numerate, reasonably well educated person I expect to be able to understand such documents. It’s also full of bean-counter management speak – I lost count of how many times the phrase “financial challenge” was used – and totally based on the concept that the NHS is a market with hospitals represented by a profit and loss account and expected to return a surplus of 1% of their budget each year. Why on earth would a hospital have a surplus – to give it back to George Osborne? And how can a hospital accumulate debt from year to year – the only way it can pay it back is by reducing its spending on treating patients. It’s the kind of approach Michael Sandel criticised in “What Money Can’t Buy: The Moral Limits of Markets” – wider questions aren’t considered, and for a national institution like the NHS, which is part of some of our most painful and saddest and sometimes most joyful experiences, an analysis that considers the beans more than the humans is incomplete.
The data tables in the report contained a few facts that I haven’t seen mentioned elsewhere:
The TSA is proposing cuts in the numbers of doctors and nurses in the South London Healthcare Trust hospitals – on page 51 it proposes cutting 140 out of 862 doctors and £14m out of the £98m budget for nurses pay. By my reckoning this equates to about 320 nurses losing their jobs, based on the headcount in the Trust’s latest accounts. The accounts also show that they had lost 144, or 6%, of their nursing staff between 2011 and 2012.
The health budget for south-east London seems to be decreasing in real terms over the next five years – at least that is my reading of the table at the bottom of page 37 – at the same time as the population is expected to grow by 6%. The annual increases on the £3 billion budget are less than 2% a year – less than the rate of inflation and with no allowance for population growth. This when the government has pledged to increase health spending by 1% a year above inflation.
The income that hospitals receive will decrease each year as a result of a government imposed nation-wide “tariff deflation” of about 1 to 1.5%. The tariff is the amount the hospitals receive for each admission or medical procedure and they are expected to improve efficiency each year to cope with this reduction in their money.
The justification for recommending Queen Elizabeth Hospital gets an extra £12.2 million a year towards its £33.7 million PFI costs seems to be that QEH spends 16% of its budget on PFI contracts compared to a national average of 10.3%. So the additional money brings the cost to the national average percentage.
I was slightly surprised that health budgets are decreasing – my understanding was that efficiencies are needed because health service inflation is higher than RPI inflation, but I thought that money saved from efficiencies would be used to compensate for this excess inflation. Apparently not – there seems to be less money each year for the next five years.
Another big surprise was the report’s findings about how closing Lewisham A&E would affect the time it would take patients to get to an alternative Accident and Emergency department. It says on page 68:
173. The proposals for emergency care outlined in this draft recommendation would increase the journey time to reach an A&E across south east London by an average of approximately 1 minute for those in an ambulance, 2 minutes for those using private transport and 3 minutes for those using public transport.
Three minutes extra using public transport – I just don’t believe it. Admittedly the report does hedge its bets on travel time – on page 69 it says that public transport travel time for Lewisham residents would be 40.8 minutes, whereas on page 25 of Appendix H it says the incremental travel time from Lewisham to Queen Elizabeth Hospital is 37 minutes by public transport with no traffic.
Overall the impression given by the report is that it is trying to justify its chosen option for the future of the health service in south-east London. The appointment of someone to manage the merger of Lewisham Hospital with Queen Elizabeth before the consultation has completed doesn’t give confidence that our comments will be listened to.
Ploughing through various turgid documents about NHS funding made me wonder how the £105.9 billion NHS budget is distributed to the different areas and hospitals – how is it decided that the NHS in south east London should have £3 billion to spend? Google wasn’t my friend, so I contacted Her Majesty’s Treasury, who replied within a couple of hours saying that I would need to contact the Department of Health for details of the method used to distribute the NHS budget, but pointing me to two documents that might help explain NHS funding.
The first document was A Junior Doctor’s Guide to the NHS, which included the diagram to the right. The DH is the Department of Health, SHA is Strategic Health Authority – in our case London SHA – and PCT is Primary Care Trust – for us this is Greenwich PCT, which controls the budget and commissions services from the NHS Trusts, such as the South London Healthcare NHS Trust that this whole thing is all about. I assume there should be a blue line showing money flowing to the NHS Trusts. I know this is a gross oversimplification, just from the list of different organisations in the TSA report, but it gives the broad flow of money to the hospitals.
Of course it’s already out-of-date because the PCTs will be replaced by GP-led CCGs – Clinical Commissioning Groups – under the current government’s NHS reorganisation.
The second document was the Department of Health Annual Report and Accounts 2011-12 – 230 pages of figures and bean-counter language. However it does include some information about how the NHS budget for different regions (and countries) in the UK is decided. It says on page 61:
A weighted capitation formula determines each PCT’s target share of available resources, to enable them to commission similar levels of health services for populations in similar need, and to reduce avoidable health inequalities. The formula calculates PCTs’ target shares of available resources based on PCT populations adjusted for their age distribution, additional need above that accounted for by age, and unavoidable geographical variations in the cost of providing services.
So broadly it’s based on the number of people who live in an area, how old they are and any special needs – this sounds very like the “health needs target index” mentioned in Appendix H of the TSA report (the Health and Equalities Impact Assessment – scoping report). But it doesn’t say how these factors are taken into account in the distribution, and it only goes to Strategic Health Authority level, i.e. it gives the budget for London but not south east London. Interestingly in 2010/11 the budget for each person in london was the highest in the country at £2163 per person per year.
I’m still waiting to hear from the Department of Health – they give themselves 18 working days to respond to any questions.