Derek Wall speaking on economics and the environment at Balcombe

The video below was taken yesterday at the Reclaim the Power camp at Balcombe. Taken in a tent where another workshop was also in session on a hand-held camera the quality is not the best - but I think the quality of what is said is worth the effort of viewing.

Feeling the power at Balcombe

I spent a stimulating afternoon down at Balcombe today where the anti-fracking protest camp has been reinforced, a mile or so further down the road by the Reclaim the Power camp. It was noteworthy how many young people were present as well as many families.

Reclaim the Power state:

It's clear that if w want to change the way we power our lives, we need to change who has power over our lives. The two are so closely connected.

Reclaim the Power is about building the links between people and campaigns that can work together to stop the dash for gas and create a sustainable safe future where our common needs of not just energy but also health services, education, food, transport and freedom  of movement belongs to us and ar accountable to us and not profit and corporate greed,

Another power is possible, and we can all be part of creating it.

Certainly the positive and friendly atmosphere in both camps, and the willingness to engage in comradely discussion, made me think another power is possible.

Reclaim the Power camp plan

Workshop discussion

Impromptu concert

Workshop tent

Straw bale urinals

Portable solar panels

The 'Kids' Space'

Sign at the roadside protest camp

Roadside agitprop

A friendly welcome awaits locals at the Green Party tent

Police guard the entrance to the drilling site

Butt poses key questions on future of NHS provision in Brent for Executive endorsement

The Brent Executive will be asked to retrospectively endorse a personal submission made by Council Leader Muhammed Butt to the Independent Reconfiguration Panel. The IRP was gathering evidence on the Shaping a Healthier Future plans for health services in North West London which include the closure of Central Middlesex A &E  and submissions closed  yesterday.

Th IRP will report to the Secretary of State on September 13th and his decision will be made in October 2013.

Muhammed Butt's Submission

I am writing to you to express my views on the Shaping a Healthier Future programme (SAHF). It is accepted that the NHS needs to change and services have to evolve but I have some serious concerns with the proposals as they stand, and whether they can really deliver improvements to health care in North West London within the planned timetable for implementation. I support the referral that Ealing Council has made to the Secretary of State for Health that will see the Shaping a Healthier Future proposals reviewed by the Independent Reconfiguration Panel. It is important that the plans are subject to robust and independent scrutiny and that the modelling and assumptions built into the proposals are properly tested.

Out of Hospital Care

SAHF makes it clear that changes to out of hospital care are essential if it is to deliver the planned changes to acute care. The general princip le of transferring services from acute to community locations with investment in primary and community care, where appropriate, is welcomed. People should not have to travel to hospitals for routine care or to manage a long term condition.

That said, I am concerned about whether the proposed changes can really be delivered, and even if they are, will they deliver the reduction in demand for acute services that SAHF claims?

I have seen no guarantees that out of hospital care will get the investment in the near future that is needed to ensure that SAHF can deliver improvements. The business case outlines the level of out of hospital care investment required, but in times of financial pressure and constantly shifting priorities, I need cast iron assurances from all of the CCGs in North West London that this money will be allocated to out of hospital services that underpin SAHF no matter what other challenges are faced in the coming years. 
 

The Decision Making Business Case (DMBC) is clear that commissioners and providers should not undertake reconfiguration of hospital services until out of hospital care is shown to be working and have sufficiently reduced demand on acute services. But I need clarity on exactly what the thresholds are for the reduction in demand that will need to be met before the reconfiguration of acute services is allowed to begin, particularly on critical services such as A&E.

I also need to be convinced that delivering more and more services out of hospital will be cheaper for the NHS. There is an assumption that this is the case, but I have seen no evidence to support it. One of the benefits of providing services in a hospital setting is the critical mass that can be achieved by locating services in one place. For some services, such as maternity, we will see a reduction in the number of places services can be offered.

For other services, we will see an increase in settings as services are delivered away from hospitals. The CCGs need to demonstrate more clearly how out of hospital services will be cheaper.

While there appears to be a general consensus of support across CCGs in North West London for the provision of out of hospital care, the provision of this falls to individual CCGs and individual Out of Hospital Care Strategies. A failure to deliver an Out of Hospital Care Strategy in any one CCG areas could have a knock oneffect on neighbouring CCGs, particularly if it affects demand on shared acute care services. For example (and this is hypothetical), if Harrow CCG fails to reduce demand for acute services, how will this affect Brent residents using Northwick Park Hospital where services could be under extreme pressure? Similarly, in these times of stark finances and shifting priorities, if one CCG decided to reduce its commitment to out of hospital care, it is not clear what the effect would be on neighbouring boroughs and shared acute service provision.

GP Support and “Hubs”

The Out of Hospital Strategy underpinning SAHF cannot succeed without GP support and I note that one of the key issues listed in the panel’s terms of reference is the consideration of GP’s views. I have seen no evidence of grass-rootsGP support for the changes, particularly in relation to out of hospital care (I refer to GPs themselves rather than the CCG). Although GP events took place, the DMBC gives limited reference to them, despite the report’s acknowledgement that Health Scrutiny Committees in North West London had made it clear that they expected to see evidence of GP support.

It seems to be a general assumption throughout the decision making process that the support of CCGs should be taken as implicit supportof GPs. This is an erroneous and dangerous assumption. Shaping a Healthier Future relies heavily on additional out of hospital services and without the full buy-in and cooperation of GPs SAHF will face serious, if not insurmountable, challenges. I ask that the IRP challenge the CCGs to provide the full details and results of the GP engagement activities that were undertaken to demonstrate that there is GP support for their proposals

Besides the lack of evidence of general support fro m GPs, we have seen little evidence that GPs will be prepared to make changes to the way they work or provide additional services/support that is required. SAHF and the CCGs needs to satisfy the panel that the GP elements of the Out of Hours services can be delivered, and what the back-up alternatives are in cases where it proves they cannot.

One of the key elements of the Out of Hospital Strategy is the provision of additional local medical centres (“hubs”). Yet purpose built centres that already exist in Brent have not fulfilled their potential. Monks Park Medical Centre for example remains under-occupied and consequently underused. Similarly, I understand that the NHS Brent has failed in the past to encourage a GP practice (the Willesden Medical Centre) to relocate into the Willesden Centre for Health and Care (one of the designated hubs) despite considerable efforts. I urge the panel to fully investigate SAHF's claims that the proposed centres will really be able to deliver on their promises across NW London and particularly in Brent.

Evidence from Brent to date suggests that efforts to move GP practices into purpose build medical centres have not succeeded and that they remain committed to working from their existing premises. Why should SAHF change this?

Given that “hub” medical centres are a central component of the Out of Hospital strategy underpinning SAHF, I need to see more clarity on exactly what services are planned for each hub. In particular there needs to be clarity on exactly what services will be provided at Willesden Centre for Health and Care and for Wembley Centre for Health and Care, which are already large medical centres in Brent and two of the designated hubs. I also want to see assurances that no existing services at these sites are going to be removed.

GP access is already a serious issue in Brent, particularly in the south of the borough, and previous attempts by the PCT to address this have had little success. Since SAHF is dependent on increasing GP access I urge the panel to establish with the CCGs (particularly Brent CCG) what evidence they have that that their new attempts to increase GP access will succeed where previous attempts have failed. Without this A&E attendances and acute demand will continue to rise.

Changes to acute care

I have seen little tangible evidence to support the models for individual services leading to reduction in demand on acute services. I acknowledge that there will be an element of risk in the modelling of any service reconfiguration, but the scale of change is huge and the impact of the Out of Hospital services not producing the required reduction in acute demand could be catastrophic. To this end I urge the IRP to establish what mitigation plans there are if the model fails, either for individual parts of the reconfiguration or for more fundamental modelling of the reconfiguration as a whole.

An example of a proposed service change that causes me concern is the provision of maternity beds at Northwick Park. Under the proposals there will be an increase from 69 to 70 beds by 2015/16, but a 20% increase in births atthe site. This appears to be based on the questionable assumption that a 15% reduction in average length of stay can be achieved by 2015/16. I ask the panel to establish what provision has been made if North West London Hospitals fails to deliver the numbers proposed?

Previous attempts to reduce acute demand through faster discharge have been unsuccessful and I would be interested to hear why SAHF believes it will succeed where previous attempts have failed.

I am particularly concerned about the deliverability of the proposals - maternity is one example. Changes on the scale proposed by Shaping a Healthier Future would ideally be carried out in a stable and highly functioning health system. But, we know that the NHS is in crisis, and North West London is not immune to this

.

Central Middlesex Hospital

It will come as no surprise to you that I am concerned about the future plans for Central Middlesex Hospital. Central Middlesex serves the south of Brent, which contains areas of significant deprivation and poverty. Has there been any research done on the evening closure of A&E at Central Middlesex that is already in place, and its effect on Northwick Park, St Mary's and other neighbouring hospitals? Northwick Park’s A&E Department is already failing to perform adequately or safely. Unless out of hospital services deliver a marked reduction in the use of Northwick Park’s A&E, the removal of A&E services at Central Middlesex could cause Northwick Park hospital to reach breaking point.

I note that North West London Hospitals and Brent CCG both support the plans for the closure of A&E at Central Middlesex but that does not alter the fact that there is a genuine, strongly felt public opposition to this plan which cannot be ignored and I urge the panel to give this strong consideration when they consider the proposals.

It is proposed that Central Middlesex be an elective hospital with an Urgent Care Centre. However, there is a complete lack of information on precisely what elective services will be delivered at the site, and what catchment area they will serve. It is also unclear what the UCC will provide despite plans for a standard UCC offer to be developed across London. A working group set up to develop plans for UCCs has,to the best of my knowledge, not published any proposals. I need to see clarification from Brent CCG on its plans for services at Central Middlesex Hospital and assurances on its long term viability as an NHS hospital before I can support the proposed changes.

Northwick Park Hospital

Northwick Park has struggled for some time to deliver an adequate or safe A&E and has one of, if not the worst, “four hour waiting time” performance in the country. It has recently had a crisis summit focussing on A&E leading to the imposition of an “Implementation Plan” to address the issues. Is it really prudent to give extra A&E responsibilities to a hospital that has shown itself incapable of delivering adequate A&E services to date and what is being put in place to manage these increased risks? The recent risk summit at the Trust highlighted the depth of the problems that currently exist and I have serious concerns about how you can transform a system which is already in crisis.

In addition, the response to the current A&E crisis at Northwick Park has been to utilise facilities at Central Middlesex. What back-up options will there be in the future once Central Middlesex’s emergency facilities have been removed?

Equalities and Population

Many residents of the south of Brent suffer deprivation and hardship. It is an area with a high proportion of BME residents and residents with English as a second language. We have sought assurances from SAHF that these communities will not be unduly disadvantaged by the reconfigurations and particularly the closure of Central Middlesex A&E.

In particular we have sought clarity on the travel implications for both patients and residents. To date we remain dissatisfied that sufficient consideration has been given to this. Clinical priorities are cited as being more important, but we should not ignore the fact that the mental health and recovery of patients can be dependent on regular visits and support from family and friends and I urge the panel to push for clarity on the effect that the changes would have on low cost transport options for patients and visitors, particularly in this deprived area. We would similarly seek assurances from Brent CCG that it will take seriously the public transport implications to the medical centre "hubs", which besides being an equalities issue, could reduce the numbers of patients using these services.

Conclusion

I want Brent Council to work constructively to challenge our NHS colleagues. I am not opposed to change without good reason, but I remain concerned at the lack of clarity in key areas, including: 

 

• The ability to deliver better out of hospital services

• That Northwick Park Hospital will be able to provide additional acute services for an expanded population

• The future of Central Middlesex Hospital. Despite the Shaping a Healthier Future plans being published a year ago, I am no closer to understanding what will be delivered from the Central Middlesex Hospital once it becomes an elective centre.

Labour launch petition on fares and ticket office closures

The message below comes from a Labour Party source but I thought worth sharing with Wembley Matters readers. HOWEVER A WARNING There is a major reservation that I have concerning the petition. By signing it you leave yourself liable to be contacted by the  Labour Party or its elected rpresentatives and can only opt out by writing to a very small print postal address. I think it would be much more ethical to enable signatories to opt out electronically. There have been some concerns about people's names appearing on Labour Party websites locally, interpretable as endorsement, without their knowledge.

On Monday it was revealed that Boris Johnson plans to close every ticket office at TFL stations in London. It will mean no ticket offices at Wembley Park, Wembley Central, Northwick Park, Kilburn, Queens Park, Queensbury etc.

The effect will be dramatic. Firstly it will mean no human presence to help out when things go wrong – ticket machines out of order, Oyster Card lost or stolen etc. Secondly it will make stations less safe, particularly for older commuters and travellers. Thirdly it will make access to travel for disabled passengers in Brent even harder than it already is. Fourthly it raises serious questions over whether there will be enough staff at stations to cope in an emergency situation and lastly it will result in up to 6,000 job losses. Disastrous all round!

On top of this the Mayor looks set to raise fares above inflation yet again for 2014. Under Boris Johnson fares have become the highest in the world. A single bus journey is 56% more and a zone 1-6 travelcard is £440 a year more expensive. The Mayor is asking Londoners to pay more for less.

Sadiq Khan, Shadow London Minister has launched this petition – www.GreatToryTrainRobbery.co.uk and given the statement below:

Boris Johnson has an abysmal record of hiking fares year on year that has contributed enormously to the cost-of-living crisis in London. London fares are now the most expensive in the world. Since Boris became Mayor the cost of a single bus journey has increased by 56% and the price of a zone 1-6 travel card has increased by £440 a year. He must recognise that Londoners are struggling and that their budgets can’t keep stretching forever and freeze fares at least at the rate of inflation for 2014.The Mayor can afford to do this; all that is missing is the political will.”

On top of this, the Mayor plans to give Londoners a worse service for their money. On Monday his secret plans to close every ticket office in London were revealed. His plans mean you will get no help if your oyster card doesn’t work, or is lost or stolen. There will be no help for tourists who need advice or disabled passengers who need assistance. It raises questions about whether there will be enough staff at stations to deal with emergencies and will result in 2,000 job losses. This is one of the worst examples of breaking a manifesto promise I have ever seen in London politics. No wonder the public are so cynical of politicians.

What future for the Brent Town Hall memorial plaques?

Memorial garden outside Brent Town Hall

Brent Council is due to come back to me regarding the future of the memorial trees and plaques in the garden area outside the Town Hall now that it is to be refurbished as the Wembley French International School (see below).

The Council's attitude towards heritage and posterity has been under scrutiny in the light of the fate of  Dollis Hill House,the Old Willesden Library, the Palace of Industry and Oxgate Farm.

These plaques have been neglected and are in poor shape but nonetheless represent Brent Council's concerns with our wider history and as such merit some consideration.

Still time to comment on Wembley French International School plans for the Town Hall

School plan with Annex

Plans for the Wembley French International School which will occupy the redundant Brent Town Hall have largely met with approval from heritage organisations as they preserve many of the features of the Grade 2 listed building.

The prefabricated buildings and garages  at the back of the Town Hall will be demolished along with the print room, a former mortuary which was added to the original building. A new L-shaped annex to the north east (dark orange on plan) will be constructed with a canopied link to the main building and entered via The Paddocks.

Changes of use include the Mayor's Parlour becoming the headteacher's office, the Paul Daisley Hall a gymnasium, the Council Chamber a lecture theatre, the stage a drama studio and the committee rooms a study and exam space. Th retractable walls and parquet flooring of the committee rooms will be retained.

Two MUGAs (Multi-use Games Areas) are planned for the area north of the building but what is likely to be controversial is a running track in front of the Town Hall. Also controversial the plans will  require the removal of some trees. Some of the trees at the front of the Town Hall  have been planted as memorials and have plaques attached, It is not clear whether these will be retained or transferred to another site.

The small primary school (one form entry) will be in the East Wing and will largely be segregated from the secondary school sharing only the dining room, sports hall, studio and adminstration.

The secondary school of 900 pupils (11-18) will be in the West Wing.

The current Town Hall Library will be retained as the school library and it is proposed that it could be used by neighbouring schools. It will retain its Kings Drive entrance.

The existing bar will be demolished to expose the walls but the glazed roofing pavilion will be retained after a plea from English Heritage. The refreshment room will become a cafeteria.

It is envisaged that Institut Francais will provide after hours language classes for local schools and adult learners at the school.

The school will be fee paying and run by a board of trustees.It will follow the French curriculum and pupils will be taught in French and English.

The hours will be from 7.30am until 6.30pm with sports activities restricted to 8.30am until 6.30pm. A breakfast club will run from 7.30am.

Car parking will b reduced from the current 107 spaces to 46 with 78 cycle places.

The Planning Application can be found HERE It will not be decided before August 22nd, 2013

'Failing' Copland gets much improved A level results

The Kilburn Times LINK reports improved A Level results at Copland Community School. Copland was labelled 'Inadequate'  by Ofsted last term, its headteacher and governing body sacked, an Interim Executive Board imposed by Brent Council, forced academisation process started by the Department for Education, and the new management took competency procedures against many teachers.

Black vote decisive in Brent Central and Hampstead and Kilburn parliamentary contests

There was a ripple of amusement at Ealing Planning Committee last night when the Ealing Planning Officer referred to Cllr Zaffar van Kalwala as 'the Brent MP'.

Van Kalwala's hat is indeed in the ring for the Brent Central parliamentary candidate selection as is that of Dawn Butler and many others include Patrick Vernon. This afternoon Butler is co-facilitating a Voice Editor's Forum in Wembley on the issue of 'Is Labour losing the Black vote?'.

This follows the survey carried out by Operation Black Vote LINK on how Black and Ethnic Minority voters could influence the outcome of the 2015 General Election.

Dawn Butler lost against Sarah Teather in 2010 in the third biggest national swing against Labour despite Labour winning back seats on Brent Council to take control. Barry Gardiner increased his majority in Brent North in a campaign which played more to his personal prominence and following than to his Labour affiliation. Both Brent Central and Brent North have a majority of BME voters.

The OBV analysis for Brent Central in summary is: Brent Central MP: Sarah Teather Party: Lib Dems 2010 Majority: 1,345 (Ultra Marginal) Nearest challenger: Labour BME Voters in 2015 - Adjusted Figure: 61,609 Majority Seat: BME Voters 57.9% Total BME Population: 84,180 (61.2%) Asian Voters: 24,186 Black Voters: 28,591 Largest BME: African BME Impact: Very Significant

Clearly the BME vote will be of vital importance and will be a consideration when Labour starts the Brent Central parliamentary candidate selection process after the Labour Party Conference in September.

Hampstead and Kilburn where Glenda Jackson has a majority of only 42 and has stood down is also labelled an 'Ultra Marginal):   MP: Glenda Jackson Party: Labour 2010 Majority: 42  (Ultra Marginal) Nearest challenger: Conservative BME Voters in 2015 - Adjusted Figure:32,802 Total BME Population: 44,819 (34.5%) Asian Voters:12,491 Black Voters: 11,764 Largest BME: African BME Impact:  Very Significant

The report describes Brent North, which at 70.6% has the third highest BME population in the country, as 'Safe' for Barry Gardiner:  MP:Barry Gardiner Party: Labour 2010 Majority: 8,028  
Nearest challenger: Conservative BME Voters in 2015 - Adjusted Figure: 69,015    Majority Seat: BME Voters 70.6% Total BME Population: 94,300 (73.4%) Asian Voters: 49,261  1Black: Voters 12,836 Largest BME: Indian

BME Impact: Very Significant

The full report can be downloaded HERE