Jackie Doyle-Price: It’s time to establish a firm future for pharmacies – the unsung heroes of the coronavirus crisis

26 Jun

Jackie Doyle-Price is a former Health Minister and is MP for Thurrock.

Since the Covid-19 crisis began, pharmacies have been the face of healthcare on our high streets. While GP’s surgeries have closed their doors, 11,500 local pharmacy teams have stayed open, putting their lives at risk and working tirelessly to ensure the public can still access critical services and life-saving medicines.

Responding to extraordinary circumstances, many former pharmacists have returned to the frontline, and we have seen pharmacies open early, stay open on bank holidays and close late to meet increased demand. They have delivered millions of prescriptions to the most vulnerable, and provided face-to-face consultations to keep pressure off our hospitals.

We need to recognise their hard work and sacrifice – and get behind this less glamorous but critically important part of our NHS. Five pharmacists have already died of the Coronavirus, and many still cannot access sufficient PPE.
In the longer term, the virus will drive a reassessment of the role that pharmacies play in our NHS – but only if we can prevent thousands from being forced to close due the costs of staying open and address the need for better a funding system.

Since the outbreak began, pharmacies have spent upwards of £3,000 a month extra on staffing and £1,000 on safety and security costs. In a relatively low-margin sector, where more than half of pharmacies were in deficit before the crisis began, not recouping these costs will drive many to the wall.

The £350 million Government loan is a sticking plaster – repaying it will make many pharmacies non-viable. I am calling on the Government to turn this loan into a payment for our local pharmacy heroes.

This would be the first step in putting pharmacies on a viable financial footing. The second step will be to re-examine the pharmacy funding formula to ensure that they are appropriately financed. It matters because pharmacies are not only the unsung heroes of the coronavirus – they may also hold the keys to the long-term sustainability of the NHS.

As we look at how we organise and provide healthcare in a post-virus environment, we have a real opportunity to unleash the real value of a network that reaches into every part of the UK. 95 per cent of us live within 20 minutes of a local pharmacy and 1.6 million people visit one every day.

Pharmacies have a huge and still largely untapped role to play in supporting increased demand for healthcare driven by an ageing population, the obesity crisis and rapid advances in medical technology.

They already provide a large range of healthcare services, delivering a million flu jabs annually, providing access to emergency contraception, diabetes and obesity management, heart health MOTs, and help for the 24 per cent of adults who take three or more prescribed medications.

But many people are still not aware of how their pharmacies can help them. We need to raise their profile and make them the first port-of-call for non-critical ailments, so we can take more pressure off doctors and A&E. Pharmacies could also play a much greater role in prevention and public health – two keys to the future of the NHS. Post-Coronavirus, we need to look again at what our pharmacies can do.

We also need to start viewing them differently. The NHS establishment has often been somewhat leery of pharmacists, seeing them as a commercial partner rather than a critical part of the NHS family. Hopefully seeing our pharmacists step up during Covid-19 has put pay to that kind of thinking.

I am delighted to have been chosen as the new Chair of the All-Parliamentary Group on Pharmacy. Let’s put our cross-party support behind the unsung heroes of the coronavirus – and recognise that they are at the heart of our healthcare system.

Newslinks for Friday 26th June 2020

26 Jun

Sunseekers risk new coronavirus spike as beaches crammed

“Britain’s most senior doctor has said that coronavirus will flare up again if people do not enjoy summer more responsibly after official figures suggested that cases had stopped falling. The warning came as huge crowds gathered on beaches, largely ignoring social distancing, with police declaring a major incident in Bournemouth. Chris Whitty, the chief medical officer for England, said: “If we do not follow social-distancing guidance then cases will rise again. Naturally people will want to enjoy the sun but we need to do so in a way that is safe for all.”” – The Times

  • Crowds spark fears over UK’s ‘staycation summer’ – Daily Telegraph
  • Beaches will be closed if crowds ignore social distancing, Hancock warns – The Sun
  • Public order incidents increase in England as lockdown eases – FT

More travel:

  • Air bridges backlash: Pressure on Johnson to extend plan to all EU countries – Daily Telegraph

Comment:

  • Lockdown was so much easier when it was harder – Jemima Lewis, Daily Telegraph

Editorial:

  • Bournemouth beach mayhem should trouble Johnson – The Sun

>Today: ToryDiary: Don’t rule out a second lockdown

>Yesterday: Henry Hill’s Red, White, and Blue column: Sturgeon sets out plan to ‘unlock’ Scotland… one day before England

Sunak to weigh consumers’ response to easing before completing stimulus plan

“Chancellor Rishi Sunak will wait to see how the public responds to the “independence day” reopening of the hospitality industry in England on July 4 before deciding whether a fiscal stimulus – such as a temporary cut in value added tax – is needed to boost consumer confidence. Mr Sunak’s fiscal statement, originally scheduled for July 9, could slip back to the following week as the Treasury assesses the state of mind of the British consumer, including data from recently reopened high streets in England. No date for the House of Commons statement has been fixed. The more that UK consumers respond to easing of lockdown by spending rather than saving – including going to pubs – the less ministers will be inclined to cut taxes further given the £300bn plus deficit the UK is likely to run this year.” – FT

  • Britain’s biggest shopping centres including Lakeside and the Trafford Centre could close – Daily Mail

More:

  • UK puts $500m into satellite race – The Times

Comment:

  • The British government is about to sleepwalk into an unemployment crisis – Larry Elliott, The Guardian

>Yesterday: Local Government: Victory for ConservativeHome! Al fresco dining restrictions lifted.

Planning reforms which would have given Jenrick more power are halted

“Radical planning reforms that would have put extra powers in the hands of Robert Jenrick have been put on hold amid the lobbying controversy surrounding the Housing Secretary. The Telegraph understands that the Government was studying plans to take responsibility for some major developments away from councils and put Mr Jenrick in charge instead. Ministers believed the Prime Minister would include the proposals in a white paper on planning expected later this year, and had expected him to reference them in a major speech next week on rebuilding Britain after the coronavirus recession.” – Daily Telegraph

  • Minister sparks fury after backing Housing Secretary over decision to green-light £1bn project – The Sun
  • Zahawi hits back at Jenrick criticism – Daily Express
  • Tories accuse party HQ of ‘tacky fundraising operation’ – The Times
  • Jenrick faces questions over meeting with Israeli mining heir – The Guardian

Comment:

  • Conservatives are desperate to shut down the Robert Jenrick saga – Michael Deacon, Daily Telegraph
  • Row lays bare the rotten heart of the UK planning system – Simon Jenkins, The Guardian

>Today:

>Yesterday: Paul Carter in Local Government: We could see a housing recovery – if we give builders the incentives they need

‘Face the front and pay attention when schools reopen’, Williamson orders children

“Gavin Williamson has said that he wants all children to face the front of the classroom when schools reopen in September. The education secretary told Tory MPs that he was concerned that in many classrooms children were sitting at round or square tables facing one another. He said the approach was “wrong” and that he wanted to “get the class to pay attention to the teacher” when lessons resumed. Mr Williamson is preparing to double the size of teaching “bubbles” to 30 to get every child back to full-time education by September. Under the plans social distancing could be scrapped in schools.” – The Times

  • Pandemic promises to be unlikely saviour of ailing private schools – The Times

Editorial:

  • Johnson is going to take a serious hit if he fails to get all schools to reopen in September – The Times

>Yesterday: ToryDiary: The big speech Johnson makes next week should be about education

Patel demands to see Met Police chief after force was ‘reduced to a laughing stock’

“Priti Patel will demand a ‘full explanation’ from Metropolitan Police Commissioner Cressida Dick today after police officers were overpowered and forced to flee a ‘mini riot’ after a block party in Brixton. The Home Secretary is due to meet the UK’s top cop following a second night of unrest as the scenes at an illegal party in south London on Wednesday were repeated when police were pelted with objects further illegal gatherings in Notting Hill, Streatham and Tottenham overnight. Dame Cressida has been accused of turning the Met into a ‘laughing stock’ and abandoning ‘law abiding residents’ to ‘mob rule’ after a video showed revellers chasing away police officers in Brixton while screaming ‘run them out’ as 22 officers were injured – including two who needed a full body scan.” – Daily Mail

  • Home Secretary outraged at hate-filled louts as 32 police injured by mob – Daily Express
  • Brixton: Downing St condemns attacks on police – The Times
  • Police officers targeted in Notting Hill by violent mob for second night running – The Sun#
  • ‘Nightingale’ courts will tackle backlog of half a million cases – The Times

Civil service chief’s future in doubt as Johnson eyes Whitehall shake-up

“Mark Sedwill’s future at the centre of Boris Johnson’s administration is under threat according to cabinet ministers and senior Whitehall officials, who predict the influential head of the civil service could leave his job later this year. Sir Mark, who has held the post of cabinet secretary since 2018, has been “unhappy” during the past few months, according to senior civil servants, amid growing tensions inside Downing Street over its handling of the coronavirus crisis. Despite facing calls to resign over his trip to Durham during the UK’s Covid-19 lockdown, Mr Johnson’s chief of staff, Dominic Cummings, remains determined to shake up the civil service.” – FT

  • Cummings is right about civil service failings – Philip Collins, The Times
  • Chief of Staff must give ministers more latitude for the battle ahead – Fraser Nelson, Daily Telegraph

Hunt says ‘groupthink’ slowed coronavirus response

“The U.K.’s former health secretary claimed the country’s slow response to coronavirus is partly down to “groupthink” among top scientists and civil servants that led to a focus on preparing for pandemic flu rather than learning from previous outbreaks of SARS and MERS in Asia. Jeremy Hunt, who now chairs the House of Commons health committee, told POLITICO that if scientific advice presented to ministers was more “transparent,” the U.K. may have taken different decisions in the earlier stages of the coronavirus crisis. The U.K. currently has the third highest death toll in the world, behind the U.S. and Brazil. Neil Ferguson, a former top scientific adviser to the U.K. government, told a Commons committee on June 10 that the death toll could have been halved if the U.K. had locked down earlier.” – Politico

  • Hancock introduces ‘walk-through’ test centres following fierce criticism – The Guardian
  • Covid-19 antibody tests raise doubts over accuracy and utility, study finds – FT
  • Europe has seen a surge in coronavirus cases since easing lockdown, WHO warns – Daily Mail

Comment:

  • Testing failures leave Britain shrouded in fear – Jeremy Warner, Daily Telegraph

>Today: Maria Higson in Comment: The Coronavirus has already changed the NHS. Now it can be transformed for the better. Here’s how.

Tory ‘revolt grows’ over end to child migrant deals

“Boris Johnson is facing a mounting rebellion from Tory MPs who want to guarantee the rights of lone migrant children to seek refuge in the UK. Six Tory MPs, including two former ministers, have put their names to a Labour amendment seeking to provide legal routes for unaccompanied children. Two schemes enabling them to claim asylum are coming to an end. One route known as the “Dubs scheme”, named after the former child refugee and campaigner Lord Dubs, was created in 2016 and allows lone minors with no family in the UK to resettle. However, it reached its 480-place capacity last month.” – The Times

Frost warns Barnier to ‘get real’ ahead of face-to-face showdown

“Britain’s chief negotiator David Frost has warned Michel Barnier to get real ahead of the pair’s first face-to-face meeting in months. David Frost hit back at the Frenchman’s claims No 10 is trying to cherry-pick a deal that would keep current access to the EU’s market. EU parliament leader: Johnson ‘seems unwilling to find compromise’ in Brexit talks. Both men will kick off an intensified round of talks at the Commission headquarters on Monday in a bid to strike a breakthrough… Mr Barnier has said a deal is within reach and he is ready to compromise if the UK follows suit.” – The Sun

  • EU parliament leader: Johnson ‘seems unwilling to find compromise’ in Brexit talks – The Guardian
  • Brussels plan to tie UK to EU car parts market – Daily Telegraph
  • Sturgeon warned: Extending Brexit transition period would HARM post-pandemic recovery – Daily Express

>Yesterday: Stephen Booth’s column: While UK-EU talks gather momentum, Britain should continue to diversify its trading relationships.

Starmer battles with Labour left after sacking Long Bailey

“Sir Keir Starmer was in a stand-off with the Labour left last night after he sacked his former leadership rival Rebecca Long Bailey. Moderates hailed the leader’s boldness after he dismissed Ms Long Bailey as shadow education secretary for sharing an article that contained an “antisemitic conspiracy theory”. But Corbynite shadow ministers saw the move as a declaration of war against the Labour left and were threatening to walk out.More than a dozen members of the Socialist Campaign Group, the hard left caucus in the parliamentary party, are on the front bench. Sir Keir initially refused to meet them last night to repair relations, but is expected to do so today.” – The Times

Comment:

  • Starmer is showing he is serious about reforming Labour – Tom Harris, Daily Telegraph

Editorial:

  • Starmer has shown leadership in cracking down on antisemitism – The Times

>Yesterday: Left Watch: Starmer sends a double message by dismissing Long-Bailey

Don’t rule out a second lockdown

26 Jun

We must live with the Coronavirus either until a vaccine against it is available; or until herd immunity, treatments or a viable antibody test reduce its force; or else until or unless it simply runs out of steam.

Which means the “new normal” – complete with face coverings in crowded places, more al fresco eating and drinking, no crowds at big events (at least for the time being), and so on.

Unless we are prepared to risk the NHS collapsing, which is a very distant prospect at the moment, but a long way from being an impossibility.

However, the combination of lockdown fever, furlough, Black Lives Matter, summer and the fledgling test and trace system don’t bode well.

You may well think that polls suggesting support for the shutdown and fear of the virus sit oddly with today’s pictures of teeming beaches at Bournemouth or celebrating crowds outside Anfield.

But those surveys may be out of date; or the respondents have may been telling the pollsters how they think other people should behave, or else different groups of people may have different attitudes.

What’s certain is that long periods of repression are sometimes followed by frenzied outbreaks of celebration, like the austerities of Cromwell’s Commonwealth being followed by the salaciousness of Restoration comedy.

Feast-to-famine, famine-to-feast lurches are built into the economic cycle itself, and woe betide those who proclaim  “an end to boom and bust”.

So it may be that while the dangers of catching the virus in the open air are negligible – as last month’s shift in the lockdown rules seemed to suggest – and Ministers therefore shouldn’t fuss about crowds on beaches…

…There is nonetheless a lotus-eating mood around at present, sustained by furlough, and people driven stir-crazy by lockdown are ready to meet and party and mix in relatively confined spaces.

The potential knock-on problems haven’t been helped by the police’s initial surrender to the logic of mob protest in London and Bristol.

Most people don’t pick up much from politics, but are very sharp in reading the signs of the times.  The disturbances two nights ago in Brixton and last night in Notting Hall may be an indication that weakness has consequences.

Twenty-two police were injured in the first incident – by way of comparison, six were hurt after the recent fascist thuggery in central London (a term we prefer to the more loaded “hard right”).

The Government’s planned response to any local outbreaks of the virus is to follow the South Korean model – or, nearer to home, the German one.

Some 650,000 people in North Rhine-Westphalia are back in shutdown after an outbreak at a meat factory (the combination of close working conditions, migrant workers, and cramped accomodation is a dangerous one).

Boris Johnson and Matt Hancock are hoping that a similar model will be implemented in a similar way if necessary. But that would depend on enough testing taking place and enough tracing working well.

Those traced must also be relied upon to social distance voluntarily and effectively.  If all that doesn’t work, we find it hard to see how a second and further national lockdowns can be avoided.

The very last thing anyone wants to think about as we emerged from such a shutdown is going back into it.  And we hope that it doesn’t happen.

But the fact is that the Prime Minister may not have been right when he said in May that “we have been through the initial peak – but it is coming down the mountain that is often more dangerous”.

The disturbing truth is that we may only be in the foothills of the climb.  Or, to change the image. we like to think that the Coronavirus is fading in the rear view mirror.  But it may only be a trick of the light.

Neil Shastri-Hurst: Turkey and Hungary cannot be allowed to continue to contravene the principles of NATO

26 Jun

Dr Neil Shastri-Hurst is a former British Army Officer, surgeon, barrister, and senior member of the Voluntary Conservative Party in the West Midlands.

Determined, bold, and ambitious. All adjectives that could be used to describe the vision NATO’s Secretary General, Jens Stoltenberg, put forward in a speech at the beginning of June. And yet, barely a mention in the newspapers. But whilst Covid-19 continues to dominate the news agenda, Stoltenberg’s speech should not be dismissed. It has the potential to significantly alter the position from which NATO seeks to operate.

NATO has been a powerful military alliance since its inception. National and international threats have not diminished over the last 70 years or so; rather they have grown. The current pandemic should not lure us into a false sense of security. The importance of a strong and effective military alliance, through the auspices of NATO, is fundamental to upholding the democratic principles we hold so dear.

However, in setting out a roadmap for the organisation for the decade ahead, its Secretary General has fixed his sights beyond that. He aspires to something much more ambitious. A shift to focus upon diplomatic and economic levers. A shift to operating more globally; beyond its current North Atlantic milieu. In essence, a shift to operating more politically.

Stoltenberg’s words will have been warmly heard in Washington. It was precisely this type of refocusing that the United States’ administration was pressing for when the alliance leaders met for the 70th anniversary summit on the 4th December 2019. It clearly acknowledges the growing threat that China plays in the wider global security challenges. That said, achieving this ambition will prove much harder than articulating it.

Whilst the focus of the Secretary General’s speech concentrated on the construct of a more political NATO – a NATO “using a broader range of tools”; both military and non-military – this ambitious vision can only be looked at in conjunction with the broader challenges facing the Alliance. Such a paradigm shift would necessitate a change in mindset from its member states.

NATO’s burgeoning inbox is frequently inundated with concerns posed by Vladimir Putin and Russian adventurism. This threat has not retreated. Putin’s posturing and strongman rhetoric continues to present a substantial risk to the Alliance. However, in recent years, there has been the development of a fresh danger. A danger posed by member states themselves. From Viktor Orbán in Hungary to Recep Tayyip Erdoğan in Turkey, there has been the emergence of a cohort of leaders who style themselves in the Putin mould.

The bedrock of NATO has always been its shared values. The alliance has been bound through a pledge of collective defence: each member state, a democracy that upholds the virtues of individual human rights. For the majority of the 29, this remains the case. However, a small, but vocal, minority within the alliance has strayed from this path. The principle of collective defence has diminished in importance for these nations.

The schism created by Erdoğan and his ever closer relationship with Russia are well documented. But Erdoğan is not the only leader who has chosen to pursue a more nationalistic political path. Casting one’s gaze to Hungary, we see a country that was once an exemplar of post-Cold War success; a former Communist regime that had succeeded in achieving a strong democracy.

But times have changed. Orbán has adopted an increasingly authoritarian domestic policy platform. However, from NATO’s perspective, it is Orbán’s adoption of a fragrantly pro-Russian foreign policy agenda that is even more worrying: one only has to consider Hungary’s attempts to progressively block and disrupt the cooperation between NATO and Ukraine in order to illustrate this. Whereas the sage heads sitting at the NATO top table recognise the malign influence of a Putin led Russia, Orbán and Erdoğan are amongst a powerful subset that willingly fail to do so.

It would be misleading to suggest that NATO, and its members, have always upheld its founding principles to the letter. Historically, member states have not always been governed under truly democratic principles. That said, the internal menace posed by the pro-Russian, authoritarian rule of some of its own members arguably presents the greatest threat to NATO’s integrity that it has suffered to date.

The importance of NATO cannot be underestimated. As recently as 2016, the Alliance set out its central mission: “to ensure that the Alliance remains an unparalleled community of freedom, peace, security, and shared values, including individual liberty, human rights, democracy, and rule of law”. However, such a shared set of values operates on trust.

This brings me back to Stoltenberg’s vision for NATO 2030. An ambitious vision must be coupled with a compelling argument that member states’ defence and procurement strategies must be centred upon NATO’s intended direction. In a post-pandemic world, with the global economy having taken a battering, putting forward a persuasive case may be all the harder. Maintaining the two per cent minimum of GDP contribution has historically been challenging for many members. The reality is that, with competing demands upon treasury departments, a not insignificant contingent will formally rescind upon their commitment.

But that may be the least of NATO’s problems. The majority need to stand up to the minority and challenge its offending behaviour. Nation states such as Turkey and Hungary cannot be allowed to continue to operate in contravention of the principles of the Alliance. The Washington Treaty contains no provision to suspend members who do not act within the democratic ideals of NATO. However, that should not deter action against those states that fail to adhere to these; political and economic sanctions, for example, may well have the desired effect in the long-term, if not short-term.

And so, I end where I started. This is a determined, bold, and ambitious vision of NATO in 2030. It will however require an even more determined, a bolder, a more ambitious argument to be put forward in order for it to succeed. To have any chance of success, NATO itself will need to reform. It will need to assure member states that the collective Alliance remains true to its founding principles. It must convince its members to stand up against those who show a disregard for human rights or seek to pursue a pro-Russian agenda.

There is a Russian bear sitting behind the desk of the Kremlin; for the survival of NATO we must not let its cubs play in our midst.

Iain Dale: The Jenrick row. What would the Daily Mail have against the former owner of the Daily Express?

26 Jun

Iain Dale presents the evening show on LBC Radio and the For the Many podcast with Jacqui Smith.

One of the grubbier aspects of Robert Jenrick’s woes at the moment is the position of the Daily Mail.

Yesterday, it printed four pages of bile against the Communities Secretary, with articles headlined as follows: “He sweated under the glare like a saveloy in a chip shop” – “Riddle of his £830k home makeover planners refused” – “This haughty and reckless Minister is now a drag on the Tories”.

And it’s been like that for days. It’s quite clear that it has little to do with the rights and wrongs of the case. It’s all bound up with the fact that their arch enemy and rival, Richard Desmond, is the one who stands to gain from the housing development on the Isle of Dogs.

He is, of course, the owner of the Daily Express until 2018. Now, given that the Express is hardly the paper it used to be, and the Mail’s circulation is now many times that of the Express, you might think the Mail would ignore it, in the way that Waitrose wouldn’t worry about the competition from the local independent Minimart. But newspaper owners have long memories and carry grudges longer than elephants do.

The original accusation of “cash for favours” has quietly been dropped. I wrote in this column last week that no politician is likely to be bought for £12,000, especially when the money wasn’t even a donation in the conventional sense – it bought tickets at a fundraising dinner.

The trouble is that there has been a drip of information ever since, culminating in Robert Jenrick publishing 129 pages worth of emails, texts and letters between him and Desmond, or his department and Desmond.

And on Wednesday, The Times published what it thought was a massive new angle whereby Conservative councillors in Westminster were alleged to have overturned a planning decision on Jenrick’s Westminster home in 2014. He only became an MP in June 2014, so it’s not clear what the accusation is here.

Downing Street are standing by their man, just as they did with Dominic Cummings. The letter from the Cabinet Secretary to Steve Reed seeks to close the matter down, but the fact that it was sent only hours after Jenrick released all the different communications with Desmond probably didn’t help, and it certainly hasn’t ‘drawn a line’ under it all.

Jenrick expended a lot of political capital with his parliamentary colleagues over this three home lockdown situation back in April. He’s expended a lot more over the last few weeks. He must hope that Number Ten remains staunch and that there is nothing else for the Mail to latch on to. But the warning to other ministers is clear. And, frankly, it should always have been clear to Jenrick. When it comes to Desmond, sup with a very long spoon.

– – – – – – – – – –

The fourth anniversary of the Brexit referendum passed this week with comparatively little comment.

On the actually Brexitversary on Monday night, I made the mistake of doing a phone-in on it. I started off by saying that I didn’t want to refight the referendum, but I might as well have saved my breath.

Remainer after Remainer phoned in, all seemingly having been to the same debating school, where they had been taught not to engage in a debate and instead just barge their way through without any recognition that there might just possibly be another viewpoint. It was like going back in a time machine.

By the end of the hour I had almost lost the will to live. In real life, my experience is that most moderate Remainers have long ago come to terms with the fact that we have left, and it’s up to the whole country to make the best of it.

I’m far more optimistic than that. It’s not a case of tolerating the new post-Brexit world, it should be a matter of embracing it. And after Coronavirus is over (assuming it ever is), I think there will be new spirit of entrepreneurialism in this country, which will able us to do great things, both domestically and internationally.

I can’t prove it, and there always will be those who attribute any bad bit of economic bad news to Brexit, but I am genuinely excited about the future.

– – – – – – – – – –

The end is in sight. The Government has advised those of us in vulnerable groups that we can emerge from isolation from the beginning of August.

This means I can leave the comfy confines of my bedroom and resume broadcasting from a proper studio at last. It will have been 137 days since I last did that.

I’ve rather enjoyed broadcasting from home and recording lots of podcasts on Zoom, taking part in video conferences on Teams or BlueJeans, but I am relishing some degree of normality returning.

The one thing I am certainly not looking forward to is wearing a facemask from the moment I step on to the train at Tonbridge each day. But I guess I’ll get used to it. Because it will be part of what we now have to refer to as the ‘new normal’.

Maria Higson: The Coronavirus has already changed the NHS. Now it can be changed more for the better. Here’s how.

26 Jun

Cllr Maria Higson represents Hampstead Town ward in Camden. She works professionally as a strategist for a major London teaching hospital.

As the Covid-19 crisis moves to its next phase, the conversation is already turning to restarting elective care, and the lives taken indirectly in shutting these essential services. However, with ongoing pressures exacerbated by the impacts of the virus, now is a unique opportunity to innovate healthcare provision – not simply to go back to a system which was already struggling to cope.

Public goodwill towards the NHS has never been higher. If the weekly clapping (accompanied by cheering, pan-banging and bell-ringing) doesn’t show this, the speed at which 750,000 citizens volunteered is surely a strong indicator. The idea of awarding the NHS the George Cross is neither unwelcome nor surprising.

This goodwill is not misplaced; the NHS has stood up to the test of the Coronavirus with aplomb. To take just one example: by April 3rd, the necessary workforce, equipment, and space for over 2,500 additional adult critical care beds was found – an increase of over 50 per cent on pre-virus UK levels (and this excludes the Nightingale hospitals). This precious resource has provided headroom throughout the crisis, with over two thousand beds reported as available during the peak.

However, once the crisis is over and the media has moved on (following in the footsteps of Brexit coverage), what next for the NHS?

The pressures faced are as stark as ever, and the macro-trends are concerning. The UK population age 65 and over is due to grow 45 per cent by 2050; the average health spend of this additional 5.7 million people will be over four times as much as those aged 0-64. The potential impact on public health expenditure is enormous under any scenario, and that’s before considering the social care implications of our ageing population.

Covid-19 adds long-term pressures both directly and indirectly. Of the thousands of intensive care survivors, up to 45 per cent may require rehabilitation support. In parallel, projections show up to two million people becoming unemployed following the crisis, with serious implications for physical and mental health. We will also need to contend with the backlog of elective care not provided during the pandemic.

Given existing, predicted and Coronavirus-related pressures, we cannot simply insist that the NHS goes back to its old practices; we need our non-virus healthcare services to resume, but in a different way. However, if we really want change in our healthcare services, we need to do more than talk about “transformation”; we need to truly shift the mindset of politicians, professionals, and the public to NHS services.

During Covid-19, service innovation suddenly became possible at break-neck speed. For years, the NHS has been calling for a greater prevalence of remote consultations, allowing patients to be seen quicker and without the risk of attending hospitals; where these had previously been resisted, they have now become commonplace. The NHS App – launched and rapidly expanded under the tech-loving leadership of Matt Hancock – saw a 111 per cent increase in registrations in March 2020. Patients have embraced new service models; this shift needs to stick long after the Coronavirus is over.

The causes of this recent rush towards remote care are clear: closed services, constricted travel, and concern of contracting the virus in healthcare environments. However, as these drivers subside, we need to consider what was stopping people from shifting to them pre-virus.

A core issue of remote GP consultations is that residents can still only register with one practice at a time – which means that signing up to an app-based service such as Babylon cuts you off from face-to-face GP care completely.

However, an app can’t measure blood pressure, take samples, or listen to your chest (at least not yet). Surely the most effective model for an individual’s care would be a hybrid one, in which remote appointments could be used where possible, with the back-up option of requesting a visit to a local surgery; this is not an option under the current restrictions. The one-registration rule was created to allow for a single location of health records, but now that technology allows people to hold their own records – readily accessible on their mobiles – it’s time we scrapped it.

Whereas remote GP services are readily available but not necessarily taken up by patients, remote hospital outpatient services are often not even available as an option. Many hospitals have started to implement new models such as telephone or video appointments and community clinics, but the pace of change pre-COVID was frustratingly slow.

In 2019, the Shelford Group of leading hospital trusts wrote that change should be driven, in part, at regional and national levels. Whilst many hospitals have created innovative solutions, it is prohibitively expensive to expect each organisation to invest individually in the development and implementation of these schemes. The national Outpatients Transformation Programme – still yet to be formally established – must be an NHS priority, either to provide much-needed support to existing partnerships or to lighten the load by sharing best practice and cost.

Funding and resources will need to both enable and follow these new structures. Critically, there will be a large infrastructure cost. The ‘NHS England Med Tech Funding Mandate’ makes organisations responsible for investing in innovation expected to deliver same-year savings, but central funding schemes must be increased and made more readily accessible for major investments.

Implementing new technologies will require a workforce with additional skills and an open conversation between professionals and politicians to tackle our existing workforce shortage.

It will also require a shift in where the workforce sits. The benefits of at-home consultations will only be maximised if follow-up care can also be done in the community or even better in the home as well. In February 2020 just 21.1 per cent of nurses and health visitors worked in the community – down from 24.2 per cent in February 2010. A lack of community nurses contributes to the centralisation of care into hospital settings. We must act to reverse this trend.

Finally, we cannot expect all models to work first time round – successful entrepreneurs often have failures amongst their successes, and we need to give the NHS room to take risks as it improves. One anaesthetist summed up much of the issue in describing the need for “permission” (and a common understanding of it) to try new ways of doing things, and the average tenure of an NHS Trust CEO is just three years – not enough time to implement a major transformation. Politicians need to provide professionals with the air-cover to innovate.

Of course, these are just some of the changes needed to help our NHS services to survive. To truly alleviate the pressure, we need to improve public health, and Boris Johnson is absolutely right to be launching a national anti-obesity drive. However, whilst we’re starting on that journey – which will surely be decades-long – we must continue to protect our NHS past Covid-19 by ensuring it is free to make the step-change towards sustainability it desperately needs.

Andrew Carter: A zoning system is needed to build the homes we need

26 Jun

Andrew Carter is Chief Executive of Centre for Cities.

You can almost guarantee that, however mad British politics gets, solving the housing crisis is never far from policy makers’ minds.

In Downing Street, Dominic Cummings and Robert Jenrick are reportedly working on a plan to ramp up homebuilding numbers as part of our recovery from the economic damage done by lockdown. I understand that very significant reforms are being suggested to Britain’s post-war planning rulebook.

Significant reforms are certainly needed. The shortage of homes, particularly for younger people who need move to our most high-demand cities and towns for work, remains one of the largest domestic challenges that we face as a country. It fuels huge social divisions: while homeownership remains a distant dream for many young people, existing homeowners – mostly older and living in urban south east England – have amassed huge fortunes in housing wealth.

Without a proper plan to fix this problem and help the younger generation, no political party should be confident about its own long-term survival. The Government must come up with a bold solution to get Britain building the homes we need, where we need them.

All too often our analysis of the housing crisis boils down to criticising the people operating around it: greedy developers; box-ticking town planners; selfish NIMBYs or frivolous millennials impulse-buying too many avocados to save for a deposit.

We say that if only these people changed their behaviours – built more, saved more, thought more about the next generation – then we wouldn’t have a housing crisis. This is a flawed view; the problem with our planning system is the system itself.

Most town planners that you speak to will quietly admit that the planning system is designed to prevent development, not permit it. Its discretionary case-by-case nature rations the development of land and chokes off the supply of new homes in the places where we need them most – close to jobs. Instead, it forces councils to build new homes where it is most politically expedient, not where they’re needed.

The consequence of this? Just four per cent of suburban neighbourhoods supplied 45 per cent of new homes in the past decade, while one in five neighbourhoods built no new homes at all. Some places have particularly poor records: in Oxford for example, no neighbourhood has built more than 25 homes a year in the last decade and as a result, many of the people drawn there for work and study struggle to afford decant housing. If this does not change our prosperity will suffer and the inequalities that we see in this country will become even more entrenched.

Clearly the bureaucratic case-by-case nature of the current planning system is a major hurdle to our ability to supply the homes that we need, where we need them. You can see alarming parallels in our own system with the ‘shortage economies’ of the former Eastern Bloc, where production was tightly controlled by the rationing of permits.

Tinkering around the edges is not enough. To solve the housing crisis and build the homes needed we should introduce a brand-new flexible zoning code, designed by the UK and devolved governments, to guide local authorities and city regions in the development of their own local plans.

Under this new code, any proposals that comply with a zone-based local plan and building regulations would automatically be granted planning permission. Areas would be zoned according to density – ranging from light residential up to industrial.

There would still be opportunities for public consultation under this model, but they would be frontloaded into the writing of the plan rather than giving the public effective sign off on every single development.

I appreciate that removing much of the public consultation element of the planning process would be a controversial move for many people, but the current system is simply too bureaucratic and unresponsive to allow for enough new homes to be built.

Many of the most common concerns that people have about development, such as aesthetics and density, could be addressed in the drafting of the local plan. So, for example, if people wanted to ensure that any new developments in their area were medium density mock-Georgian terraces they would still have the opportunity to do this under a zone-based system, but at the very beginning when the plan is developed.

A stable home need not be unaffordable, as it is for many people in Britain today. Our housing crisis is the result of a political choice that results from our tacit commitment to sustain a bureaucracy that deliberately undersupplies new homes. This fuels inequality between prosperous places and struggling one, between homeowners and their children, and between the haves and the have-nots.

We can change this with a more flexible zoned approach to development, but it requires genuine political will to make it happen. With a majority of 80 and no election on the horizon, the time is right for the Government to seize this opportunity to end the housing crisis.

Yet if it balks now and our housing crisis worsens, it will further entrench our economic and social divides and make Britain an even more unequal place.

You can read our new report ‘Planning for the Future: How flexible zoning will end the housing crisis’ here.

Starmer sends several messages by dismissing Long-Bailey

25 Jun

One doesn’t imagine that Sir Keir Starmer will be terribly sorry to have dismissed Rebecca Long-Bailey from her post as Shadow Education Secretary.

He sacked her after the Salford MP, who was the hard-left candidate in the most recent Labour leadership contest, retweeted an article by Maxine Peake which contained, predictably enough, anti-Semitic conspiracy theories.

By taking prompt action, Starmer has taken another opportunity to draw a sharp distinction between himself and his predecessor on the antisemitism issue, which remains a stain on Labour’s reputation.

It also illustrates the waning strength of the Corbynites. Including Long-Bailey in the Shadow Cabinet might have seemed a deft nod to party unity in the immediate aftermath of the vote, but since then the hard left’s rout through the institutions has continued apace.

Yet the implications aren’t all internal. The Labour Leader probably hopes that observers will contrast his willingness to dismiss senior colleagues with Boris Johnson’s reluctance to do the same, especially with Robert Jenrick still in the headlines.

Benjamin Obese-Jecty: It’s time the Government did right by Commonwealth veterans

25 Jun

Ben Obese-Jecty is a former British Army Infantry Officer and stood as the candidate for Hackney North and Stoke Newington in the 2019 General Election.

As we approach Armed Forces Day on the last Saturday of June, the nation will have the opportunity to celebrate our service personnel and show gratitude for the role they play within our society.

Though our operational footprint has reduced significantly over the past half-decade, the Army’s role in the Government’s coronavirus response has seen an uncharacteristically high domestic profile not seen since their mobilisation for the 2012 London Olympics.

The British public holds an affinity for the Armed Forces that is an integral part of our national identity. But over the past two decades as the Armed Forces have struggled to meet recruitment targets it has increasingly relied upon service personnel from the Commonwealth to reduce this manpower deficit. The Royal British Legion puts the number at in excess of 6000 personnel, with circa five per cent of the Army’s strength alone comprised of soldiers from the Commonwealth.

Whilst these personnel face the same hardships and hazards on operations as their British colleagues, those who leave the Armed Forces do so without the automatic guarantee of residency or citizenship of the nation for which they have served. Following several high-profile instances highlighting the pitfalls of the process for Commonwealth veterans, it is vital that we seek to redress the disadvantage that the current system places upon them.

In the United States, non-US citizens become eligible for naturalisation following an honourable discharge from military service. The cost to those who have served is a mere $85 administration charge in return for full US citizenship.

Upon joining our Armed Forces, personnel from Commonwealth countries are granted ‘exempt immigration control’ status. However, it ceases to apply immediately upon discharge. The recent court case brought by eight Fijian veterans against both the Home Office and the Ministry of Defence has revealed the administrative complexity for those former service personnel who wish to remain in the UK following the completion of their service.

Given the current focus upon racial inequality, and the similarities with the Windrush scandal that it evokes, the Government has an urgent need to address this longstanding issue less it becomes a topic that expends yet more political goodwill. But how can this be achieved?

Current rules state that Commonwealth veterans qualify for Indefinite Leave to Remain (ILR) after four years’ service, but in order to action this they must immediately apply to the Home Office upon discharge. Many Commonwealth veterans have found this opaque and not made sufficiently clear during the discharge process.

It would be both more efficient and inclusive to automate the application, making it a standard step of the discharge process, one that can be made opt-out rather than opt-in and ensure that no veterans are left without having exercised their option whilst still in uniform.

The issue is further complicated by a five-year residency requirement that excludes military service prior to 2014, owing to exemption from immigration control and potentially leaving some former service personnel outside the criteria. Addressing the gaps in this structure will ensure that all veterans have been given due consideration.

During the aforementioned court case a spokesman for the MoD stated that the department “makes clear to foreign and Commonwealth recruits into the forces the process by which they and their families can attain settlement in the UK, and the costs involved”. Whilst that may be the case, the £2389 per person cost for ILR is significant and confers no advantages or prioritisation for military service, in stark contrast to the costs of attaining full US citizenship.

Given that this disproportionately affects Commonwealth personnel from the lower ranks who may struggle to meet the costs involved, we should seek to waive these fees in return for their commitment to having served the country.

There will be those who have not pursued the legal right to remain in the UK following service due to the prohibitive costs they stood to incur. From my own experience, leaving the Army and embarking on a new career without the familiarity and structure of the military is a daunting enough prospect without the unnecessary additional hurdle of regularising your immigration status. To do so at a cost of thousands of pounds, via either a loan or use of their resettlement package, sets our Commonwealth veterans at an immediate disadvantage that could easily be mitigated.

Lastly, we should seek to broaden the scope of the changes to those who have already left the service; those who through choice, owing to the prohibitive expense, or administrative oversight, have been left without the status of ILR either here or in the country of their birth. Whilst we can do little to atone for the inconvenience and disruption caused to those who have been forced to return home, we can offer those eligible the opportunity to reapply retrospectively under the criteria outlined above, and allow them the opportunity to fulfil the potential plans they had prior to leaving.

Additionally, we should also consider how we can facilitate reimbursing those who have already had to outlay the fees required to stay. Given the comparatively low numbers of those affected, the gesture of goodwill would go some way to allowing our Commonwealth ex-service personnel to start their post-service careers on an equal footing with their fellow former servicemen and women without the burden of incurring a financial penalty for the privilege.

The status of Commonwealth veterans has been addressed by MPs on a number of occasions. Johnny Mercer, the Minister for Defence, People and Veterans, has been forthright in bringing veterans’ issues to the fore and ensuring that they are given the correct focus. However, there are still significant inequalities in how we treat some of those who pledged to defend this country.

As Conservatives, our admiration and respect for the Armed Forces goes hand-in-hand with the values we wish to uphold. As a Veteran I would like to see those I have served alongside given the same opportunities that I have enjoyed in forging a new life for themselves following their military careers.

There is arguably no greater service to the nation than defending it as a member of our Armed Forces. We owe those who have served, at the very least, the same basic privileges that they have risked their lives to defend.

Henry Hill: Sturgeon sets out plan to ‘unlock’ Scotland… one day before England

25 Jun

Sturgeon unveils timetable for ‘mass unlocking’ of Scotland

Nicola Sturgeon is planning a major easing of lockdown restrictions, the Daily Telegraph reports, including lifting a five-mile travel limit and opening up access to holiday homes.

In proper devocrat fashion, this new regime will kick in one Friday, July 3rd – the day before Boris Johnson’s own changes take effect south of the border.

This comes as the Scottish Government faces continuing criticism over its handling of schools, with its plans for so-called ‘blended learning’ coming under attack from both the press and SNP politicians. Scientists have also attacked the evidence base (or lack thereof) underpinning Nicola Sturgeon’s approach to lockdown.

(The Welsh Government is not doing any better, with their Education Secretary unable to say when schools will reopen and likewise committed to ‘blended learning’.)

Local government in the spotlight

The Scotsman reports that several Scottish councils are facing severe financial black holes as a result of the pandemic. Three council have deficits adding up to hundreds of pounds per resident – the highest is £411 – which adds up to hundreds of millions of pounds in total.

This is the latest twist in a long-running battle between the Nationalist administration at Holyrood and Scottish local government. Arch-centralisers, the SNP have been using Scottish Government financial support to reduce the independence of councils.

In Wales, meanwhile, the Centre for Welsh Studies has published a new report which suggests that the Shared Prosperity Fund – the UK-administered scheme which will replace EU funding post-Brexit – should be administered by Westminster and local councils, rather than being handed to the Senedd.

This proposal will doubtless outrage the devocrats, who are consistently opposed to letting Westminster control UK-level policy in the way that Brussels controls EU-level policy. But if the SPF is to become an instrument for strengthening the Union, keeping it out of devocrat hands is essential.

DUP again press Johnson on post-Brexit border arrangements

Their moment in the Commons sun may have passed, but the Democratic Unionists are still trying to hold the Prime Minister’s feet to the fire over his promises to Northern Ireland.

Speaking at yesterday’s PMQs, Sammy Wilson challenged Boris Johnson over the fact that the Port of Larne is reportedly making preparations for extensive customs infrastructure, ready to receive shipping from the British mainland.

In response, the Prime Minister said that “I can tell him absolutely, categorically that there will be no new customs infrastructure”, citing the Withdrawal Agreement’s recognition that Ulster remains inside the British customs territory.

Abolish the Assembly get their first MS

After a few months of growing media attention, following some good poll showings and the defection of their first councillor, the Abolish the Welsh Assembly Party (‘Abolish’) have secured their first representative in that institution.

Gareth Bennett, an independent MS who previously served as leader of UKIP’s Assembly group, has now signed up to the group. (And if you want an idea of why devosceptics might be rare in Welsh political life, check out the extraordinarily aggressive interview he got from Wales Online).

Apparently Abolish, which recently launched a membership programme, will consider it a good result if they win three seats at the next Senedd poll.

(In other devosceptic news, I spoke to David Leask at the Herald on Sunday about why opposition to devolution appears to be waxing during Covid-19. Most of my section seems to be missing from the online version, but it may return.)