NW London NHS: If it's not an accident or an emergency, where should I go?

Guest blog by a Brent (would be) NHS user

Recently I have begun to feel that I might resemble a cod fish which has evolved to become smaller than its ancestors, so that it could slip through the holes in trawlers’ nets in order to avoid being made into fish fingers. Inadvertently I seem to have evolved into a life form that slips through the mesh of the NHS in North West London in 2013, albeit with less positive consequences that is the case for the above mentioned fish.

One of the several ailments that afflict my legs causes them to swell, then, if the skin breaks, fluid can seep out. About a year ago I had an outbreak but this problem which was effectively treated by the nurse at my local GP practice. For a while this entailed wrapping the leg in several layers of bandages which had to be changed about every two days since the leakage soon soaked through the dressings. Gradually the leg healed up and the leaking ceased, I was then able to treat myself at home with creams and a stocking bandage.

This self-medication worked well until about a month ago, when the leaking started up again. I tried to apply layers of more absorbent bandage myself, but my efforts weren’t very effective and the leg seemed to leak more and more. 

I rang my GP surgery but they couldn’t make an appointment for me for a week, but my bandages were soon both falling off and soaking wet, so I sought treatment elsewhere. I went to an NHS “Walk-in” Centre, about five miles from my home. The nurses there did what they could, but said that the “Walk-in” Centre did not keep a sufficient stock of bandages to treat cases such as mine and advised that I should be seeing my GP.

The temporary bandaging just about held out for four days until I was able to see the GP nurse again. The sopping bandages were removed and replaced with more extensive bandaging, but this too was wet through within a day, to the extent that one of my shoes was filling up with fluid whilst the bandaging was slipping down my legs, but the next GP appointment that I could now get was in six days’ time, so I decided that fresh bandaging was needed.

I looked at a full page advert from the NHS in free magazine posted to me by my local council. It was headlined “If You Are Unwell, Choose The Right Place to Go” (NHS Brent Clinical Commissioning Group  p.8 Brent Magazine, June 2013).  This ad detailed the various NHS services provided locally, but also emphasised the message: “Choose Well: Only Use A&E in an Emergency”.

I had already been to the GP and the Walk-in Centre, so I tried ringing up the Urgent Care Centre at a local hospital, (Central Middlesex), which was mentioned in the NHS advert. When I described my problem, I was told that the Urgent Care Centre was not the appropriate place for me and that I should go to the A&E in another hospital (Northwick Park in Harrow) as the local A&E in Central Middlesex was now “appointments only”.

This contradictory arrangement which might seem to imply that a patient should be clairvoyant enough to know of an emergency before it happened to them, placed me in a quandary. Harrow A&E is a fairly difficult journey, I could, I suppose, have phoned for an ambulance, but I did not consider my condition, no matter how unpleasant it was, to be an emergency and I did not want to waste the time of ambulance crews and A&E staff in dealing with it. So I was effectively house bound for about three days until my GP appointment came up. Luckily, I had enough food at my home to last out, otherwise I might have gone to the A&E for lack of groceries, rather than for any medical reason.

The GP treatment, when I got it was adequate and I have l also now been referred for specialist treatment, so I make no blanket criticism of the NHS, but there do, locally, at least seem to be some gaping holes in its net.

Recently I have seen and heard, media coverage that suggests that A&E’s can no longer meet the demand placed on them by many people presenting with non-urgent conditions, and it could be that such pleading might cover for pressure caused by A&E closures, when no adequate service for non-emergency cases, such as mine, seems to be in place.

I know that there a places in the world where there have never been ANY health services and I know that currently, in other parts of the world (like Greece and parts of Spain), previously adequate health services are being systematically destroyed by mad neo-liberal austerity policies. So my whinges, as a relatively affluent, educated British urbanite, are minor; but someone more disabled, and/or less articulate, and/or with less access to transport, might find things far, far worse than I did. Public adverts advising people to use services that don’t really exist are annoying at the best and potentially dangerous at worst.

Pus is squeezed from Brent's democratic deficit boil

Democracy, or the lack of it, featured strongly at Monday's council meeting. At the beginning of the meeting Keirra Box,  who hit the local and national headlines by pursuing missing Lib Dem councillor Rev David Clues down to his home of six months in Brighton with a pile of e-mails and letters from constituents that he had not answered, turned up to take his seat in the council chamber. The argument was simple - someone had to represent the residents.  When she questioned Paul Lorber, Lib Dem leader, after the meeting about when Clues would resign  he accused her of 'writing disgusting articles in the press' rather that recognising she was an angry disenfranchised resident.

Earlier Cllr  Lorber had attacked the Labour group for their failure to ensure proportionate representation on committees (membership being allocated according to each party's proportion of council seats) and also for the Council Leader's power to decide which opposition councillor to put on some committees.

On Monday the Labour voted for statutory members of the Brent Health and Wellbeing Board to consist of:

Five elected councillors, with voting rights, to be nominated by the Leader of the Council. Four councillors will be Executive members from the majority party. The fifth member will be from a opposition party. 

I am sympathetic with Lorber's criticism. This not only gives Labour a huge majority but excludes non Executive Labour councillors AND enables the Council Leader to nominate the opposition councillor. Similar issues occur with the Brent Housing Partnership, Brent Council's rather less than arm's length social housing provider.

All councillors need to be involved in policy making and there are some positive precedents for joint work on drugs, gangs, prostitution, domestic violence and female genital mutilation. Surely democratic principles should recognise that the ruling party or the Executive is not the source of all wisdom and that other members have much to contribute?

Substantial inbuilt majorities on committees where the real decisions have been made behind closed doors in the ruling group's pre-meetings means that real debate takes place outside the public arena and that the committees function as rubber stamping machines. Opposition members are powerless and backbench Labour  members do their lobbying in private.

There have been some changes at the Brent Connects local forum level (but only in some areas of Brent) which through Any Questions? style panels have brought about some more debate and today at the Brent Governors' Conference Cllr Pavey had a refreshingly open Q&A session with delegates, asking at one point, 'Tell me what Brent Council does badly, what are we doing wrong?'

However we need action at the Council decision making level to increase accountability and transparency and provide real participation.

Cllr Jim Moher on Monday, in putting forward a constitutional change, said that in the past Chief Executives and Senior Officers had too much power and had swept aside objections from members. However at the same time he supported the Council's decision to employ Christine Gilbert for an additional year when she had not been appointed by councillors and Muhammed Butt refused to give any information on the pay-offs to the previous Chief Executive and Finance Director. 

In addition of course Monday saw the barring of discussion on the Lib Dem's motion the issue of human rights in Palestine and Veolia's complicity in supporting illegal settlements in the occupied territories.  Veolia is in line for a 16 year £250m public realm contract in Brent - of course the motion should have been debated.

There is much that is wrong and if it is not put right many able people will decide that they can make a real contribution and create real change elsewhere and public cynicism about politics will deepen.

Monday's meeting was not a good advertisement for democracy or for local government.

 

Lucas: 'Weak and discredited' Chancellor condemning UK to a bleak future

The UK is being condemned to a 'bleak future' of yet more austerity and deprived of the huge benefits of the jobs-rich green economy by a 'weak and discredited' Chancellor, said Green MP Caroline Lucas today.

In the Comprehensive Spending Review announcement to the House of Commons earlier today, Chancellor George Osborne set out plans for £11.5bn more cuts to government departments for 2015-16 - as well as committing to further investment in high carbon infrastructure such as roads and shale gas.

RESPONDING TO THE CSR, CAROLINE LUCAS, MP FOR BRIGHTON PAVILION, SAID:

This government's broken austerity policies have fundamentally failed to get the UK's finances in order and improve people's lives, yet George Osborne has today chosen to condemn Britain to more of the same even beyond the next election.

With Ed Miliband now accepting the government's spending cuts for 2015-16 and supporting a cap on welfare spending too, any chance of the main parties challenging the austerity myth has been eradicated.

The failure of mainstream politicians to properly represent the British people and to hold to account the most incompetent Chancellor of modern times represents nothing short of a political crisis.

The way to address the deficit is not by further cuts to public services, including tightening the financial stranglehold on local authorities, or failing to get people into work and arbitrarily capping welfare spending regardless of need.

It is to invest in jobs - borrowing money based on record low interest rates - mount a serious crackdown on tax evasion and avoidance, and bring forward green quantitative easing to deliver investment directly into the infrastructure we urgently need for a more resilient, stable economy."

And yet again the Chancellor has rejected one of the best ways to create jobs in all areas of the UK - a programme to make all homes super energy efficient, funded by the recycling of carbon tax revenue received by the Treasury.

Research shows that such a programme would be far better for job creation than his alternatives and deliver urgently needed reductions in carbon pollution, help end fuel poverty and drive down household energy bills too.

 ON THE GREEN ECONOMY, CAROLINE LUCAS SAID:

Osborne claims that he is unwilling to 'make the children of the future pay for the mistakes of the past', yet by ignoring the warnings on climate change from the international scientific community, economists and environmentalists, he is doing exactly that.

Last night, President Obama outlined the urgent need to act on climate change and the benefits this would bring the American people in terms of manufacturing, jobs and protection from the impacts of climate change.

By committing the government to reckless spending on polluting high carbon infrastructure such as roads, airports and shale gas instead of investing in the jobs-rich green economy through, for example, renewable energy and energy efficiency, George Osborne is denying the British people those same huge benefits - and a more positive vision of the future.

Community protest as police lose CCTV evidence of unprovoked racist attack in Willesden

Guest blog by a group of concerned local residents:

At 5.20am on Sunday 9^th June, 5 white men pulled up in a black luxury car near Willesden Bus Garage on the High Road and attacked two young men of African descent, who had just got off a bus from central London.

One managed to avoid being punched in the face and was separated from the other, who was punched to the ground and kicked repeatedly.

Three witnesses across the road shouted out and ran across to his defence; the men got into their car and drove off shouting. The victim was taken by the police to hospital with bruises under his eyes and later had a broken tooth removed.  One of the witnesses, Robin Sivapalan, a local trade unionist met him later at Northwick Park hospital and brought him to his house to recover.

On chasing up the incident later that day with police at Wembley, Robin was informed that the case had not yet been allocated to an investigating officer, nor had it been logged as a racist attack. He stressed to the police officer that the assault could well have been far more damaging had there not been an intervention from the public, that the attackers posed a threat to all Black people - not just the particular victim in this case - and that this was possible backlash to the Woolwich incident.
 

Robin and the victim went to a local business where they were shown the CCTV footage which caught the entire attack, with the car, from two cameras and they informed the police that the evidence was available.

 It took till Thursday for the police to call the victim, and the investigating officer failed to reply to any of the messages left by Robin. By the following Thursday the CCTV footage had been lost. The police had been told that they were welcome to collect the recording equipment themselves while the footage was still retrievable.

The police attended the business on Wednesday 19^th and discovered one set of footage had been deleted. They only collected the recording equipment and called in witnesses after DS Williams had been informed by Robin that the second set of footage had also been lost and that he would take the matter further. On Tuesday 25^th June the police issued an appeal for witnesses via the Kilburn Times providing the wrong time and location of the assault, with no mention that it was a racist attack.

The case has been brought to the attention of Aslam Choudry, Brent Council’s Lead member for Crime Prevention and Public Safety, also a councillor for Dudden Hill where the incident took place. He has raised it with the police Borough Commander Matthew Gardner and the Council Leader, Muhammed Butt.
 

Local residents in Brent are holding a picket at Wembley Police Station, 6pm, Thursday 27^th June, calling for meeting with the Borough Commander that will provide accountability for this failure to act. 

A spokesperson for the residents said:

We don’t believe this is an isolated incident of hate crime in the area. At Brent Council’s commemoration of Lee Rigby, the Borough Commander proudly informed us that there had been no recorded incidents following Woolwich, yet we can see here how the police fail to treat these attacks as hate crimes and are happy to lose the evidence when it handed to them on a plate.

With a spike in Islamophobic and racist attacks around the country, it is shocking that in a Borough where the majority of us could face such an attack, the police can display such complacency and disregard for our concerns. This is exactly the form of institutional racism that is in the media again this week, with the discovery of the police’s attempts to smear Stephen Lawrence’s family.

Christine Gilbert confirmed as Brent Interim Chief Executive for another year

Brent Council last night approved the extension of Christine Gilbert's appointment as Interim Chief Executive until after the elections in May 2014.  See my previous story LINK

The move was opposed by Paul Lorber, leader of the Liberal Democrat opposition, who said that there was no reason why the appointment of a new CEO should not be made not. He declared that he did not accept the reasoning behind the officer's report which argued that a delay would provide stability and safeguarding of the Council's reputation over the period of the move to the Civic Centre and the May 2014 local elections.

He said that the interim appointment had been made by officers in consultation with the Leader of the Council and that members should be fully involved if a candidate capable of working with any prospective leader were to be appointed. He also said that the new post holder should be on the council's payroll rather than have his or her salary paid into a private company.

Labour's majority, assisted by the vote of Barry Cheese who appears to be a semi-detached Lib Dem at present, ensured that Christine Gilbert, wife of ex-Labour MP and Minister Tony McNulty ensured kept her Brent job along with her second job with Haringey Council.

Officers gag debate on human rights and Veolia at Brent Council meeting

As Lib Dem councillor Ann Hunter commented last night it was ironic that on the evening that Brent Council bestowed  the  Freedom of Brent on freedom fighter Nelson Mandela, councillors were denied the freedom to put a motion on the issue of Veolia's complicity in the illegal occupation of Palestine.

Hunter quoted Mandela's statement that 'our freedom is incomplete without the freedom of the Palestinians' and later asked what Mandela would have made of a situation where, at the end of the council meeting, he was greeted by the horrific sight of  the 'rainbow' group of councillors being  shepherded into separate buses for African, African Caribbean, Asian, Jewish or white buses. That was what happened to Palestinians on the segregated buses run by Veolia in the occupied territories.

The Lib Dem motion that was not allowed to be debated read:

Council notes that:

•  the Israeli settlements in the West Bank, including East Jerusalem, contravene international law.

• the resolution of the UN Human Rights Council adopted on 14 April 2010 expresses grave concern at: “The Israeli decision to establish and operate a tramway between West Jerusalem and the Israeli settlement of Pisgat Zeev, which is in clear violation of international law and relevant United Nations resolutions.”

• Veolia is a leading partner in the CityPass consortium contracted to build and operate this tramway.

• Veolia placed recruitment advertisements for tramway operatives in 2010 discriminating against the recruitment of Palestinians by requiring Hebrew “at a mother tongue level” and “full army service/civic service” which is undertaken by very few Palestinians.

• Veolia is also supporting illegal settlements in Occupied Palestinian Territory with other services: namely running bus routes that discriminate against Palestinians and link illegal settlements in the Occupied West Bank to Israel and owning and operating a 33 hectare landfill site, Tovlan in the occupied Jordan Valley, which takes refuse from illegal settlements in the West Bank and from Israel. 

• that a written parliamentary answer from the Minister for the Cabinet Office, Francis Maude, on 23rd May 2012 stated that “a company may be excluded from a tender exercise, for example where a company … has committed an act of grave professional misconduct in the course of their business or profession.”

This Council therefore recognises that Veolia’s involvement in these activities amounts to complicity in violations of international law and constitutes grave misconduct in the course of Veolia’s business under any reasonable interpretation of that term.

Council calls on the Leader and Chief Executive not to sign or allow to be signed any new contracts or renewal of any existing contracts with Veolia or any other company complicit in breaches of international law so long as taking this action would not be in breach of any relevant legislation.

Council notes that acting on this call would not contravene the provisions of the Local Government Act 1988 because no reliance is being placed in this resolution on any of the prohibited non commercial matters set out in section 17(5) of the 1988 Act. Further, as there is nothing in the Local Government Act that prohibits the Council from making the decisions called for in the resolution it would be unlawful for the Council to falsely exclude those matters from consideration when making a decision about  contracting with Veolia, given the discretion that the Council is required to exercise under Regulation 23 (4) (e) of the Public Contracts Regulations 2006.

Councillors Hunter, Lorber, Hopkins and Hashmi

As Ann Hunter pointed out this is a very similar motion to that approved by Labour's Brent Central General Committee. The officer's letter repeated the stone-walling statement used to refuse information to Bin Veolia in Brent campaigners which is issued to anyone communicating with the council about the issue:

Dear Councillor

I am writing to advise you that the proposed Liberal Democrat Group motion on Veolia which was circulated to members on Friday cannot be debated and voted upon by the Council at its meeting tonight.

As you may be aware, advice from counsel has been sought in relation to arguments concerning the involvement of certain companies in the Veolia group in various enterprises linked to the Israeli settlements in the West Bank, including East Jerusalem.  The clear advice is, amongst other things, that there are no grounds for excluding Veolia ES (UK) Limited from the current procurement of the Public Realm contract on the basis of “grave professional misconduct” in accordance with Regulation 23(4)(e) of the Public Contracts Regulations 2006.

Motions which are illegal, improper or irregular are not permitted and in consequence it will not be appropriate to debate or vote on this Liberal Democratic Group motion.

Kathy Robinson

Senior Solicitor

Labour Mayor Bobby Thomas confirmed that the Labour group had received similar advice when  they wished to discuss the issue. However, when Paul Lorber, Lib Dem group leader tried to move a motion to suspend standing orders to discuss the basis of officers' advice he was accused of hypocrisy in an incandescent outburst by Muhammed Butt, Labour leader of the Council, who accused him of hypocrisy because when leader of the council he had 'happily signed a contract with Veolia'.  Butt dismissed the suspension of standing order move as 'frivolous'.

Lorber argued that elected councillors should challenge the officers' advice.  He had sought the basis of the ruling and had asked for a copy of the counsel's advice but officers' had failed to provide any evidence. He said that the issue had been debated in many councils across the country but officers had deemed councillors not capable of making a decision on the issue. Mayor Bobby Thomas lost his temper and began shouting at Lorber when Lorber suggested that Labour councillors were being invited to vote down the suspension of standing orders without hearing any information on what the challenge was about.

To a cry of 'Mandela - freedom of speech' Labour voted down the motion to suspend standing orders.

Michael Pavey reneges on anti-academy promises

Cllr Michael Pavey, only months into his new job as Brent's lead member for children and families, tonight reneged on his promises of opposition to academies made when he was standing for the position.

Making a statement at the full Brent Council meeting he  said that Gladstone Park Primary  was not a failing school, has suffered a blip, and results were improving. It was a shame that it was being forced to become an academy and instead it should have been supported in its improvement strategy. He welcomed the Parents Action Group campaign and commented that this was' community action at its very best' BUT he respected the governing body's approach to the CfBT.  He said. 'If we have to have an academy these are the sort of people we should support'. He went on to say  that this was the time to 'bury the hatchet.' (referring I think to both Copland and Gladstone Park).

On Copland he said that he was pleased to announce that the DfE had approved the council's application to impose an Interim Executive Board headed by Grahame Price of St Paul's Way School LINK and said that there had been a 'terrible situation' at Copland with two thirds of the lessons inadequate and it had been failing the most vulnerable pupils. After the IEB the next step in the 'radical surgery' that the school required was academy conversion.

No sign of any fightback on forced academy status and what amounts to the privatisation of our schools and their removal from local democratic accountability.

Brent Council should heed Mandela on the Veolia issue

This evening, as Nelson Mandela is reported to be in a critical condition, he will be honoured at tonight's Brent Council meeting with the Freedom of Brent.

It is hard today to remember that Mandela was not always a popular figure in this country and weas denounced as a terrorist by Margarter Thatcher whose government continued to sell arms to the apartheid regime.

A previous Labour Council in Brent, back in the 1980s, attracted controversy for supporting divestment from South Africa and boycott of companies that were alleged to support the apartheid regime and doubtless faced  opposition from council officers. They bravely stood up to the criticism and used every strategy in the book to implement the policy.

Now Palestine is as important a moral and human rights issue as South Africa was then and the present Brent Council has been asked by more that 2,500 people to support the Palestinian human rights struggle by removing Veolia from the current £250m Public Realm procurement. Campaigners accuse Veolia of  'grave misconduct' in its activities in the occupied territories of Palestine which provide infrastructural support to illegal Israel settlements.

President Nelson Mandela himself said at an event celebrating the International Day of Solidarity with the Palestinian People::

The so-called ‘Palestinian autonomous areas’ are bantustans. These are restricted entities within the power structure of the Israeli apartheid system."

I have come to join you today to add our own voice to the universal call for Palestinian self-determination and statehood. We would be beneath our own reason for existence as government and as a nation, if the resolution of the problems of the Middle East did not feature prominently on our agenda.

When in 1977, the United Nations passed the resolution inaugurating the International Day of Solidarity with the Palestinian people, it was asserting the recognition that injustice and gross human rights violations were being perpetrated in Palestine. In the same period, the UN took a strong stand against apartheid; and over the years, an international consensus was built, which helped to bring an end to this iniquitous system.

We know too well that our freedom is incomplete without the freedom of the Palestinians.

Bishop Desmond Tutu after visiting Palestine said:

I have been to the Occupied Territory and I have witnessed the racially segregated roads and housing that reminded me so much of the conditions we experienced in South Africa under the racist system of apartheid.

As the Council honours Mandela tonight they should consider the Veolia issue in the light of their own history and that of the anti-apartheid struggle.