'Social prescribing' a plaster on the wound of social and economic inequality?

 

The agenda for tomorrow's Community and Wellbeibg Scrutiny Committee includes some very important and complex items and it is hard to see how in the limited time available they will receive the full scrutiny and discussion that they merit.

One item is the report of the Task Group on Social Prescription that perhaps deserves a meeting of its own.

The video above from Hillingdon, Harrow and Brent UK outlines the aims of social prescription, an approach advocated by Theresa May, that is now being widely adopted and extended. The Task Group's recommendations would systematise its implementation in Brent.

In his Forward to the Task Group Report Cllr Ketan Sheth, the Committee's Chair says:

Social prescribing has been identified as being potentially key to addressing health inequalities across Brent, as residents who live in areas of high deprivation are more likely to have worse health outcomes due to socio-economic factors. To enable social prescribing to effectively tackle Brent’s deeply entrenched health inequalities, its resources and funding must be distributed fairly, so that residents who are more likely to be impacted by health inequalities have sufficient opportunities to access the support they need.

The socoiologist Basil Bernstein wrote regarding the pressures on schools to address society's ills that 'Education cannot compensate for society'. One could argue now that 'GPs cannot compensate for society', even with the aid of social prescription.

Advocates of social prescription will point to the fact tht many visits to GPs  are about issues that affect health, such as poverty, poor housing, loneliness, Referral to voluntary agencies to address these are of benefit to the person concerned and frees up the GP's time to address medical issues.

The Task Group outline the context:

 Rebecca Brown in 'The Ethics of Social Prescribing: An Overview' in a paragraph entitled 'A band aid on a bullet wound?' wrote:

Social prescribing emerges from a recognition that, often, health problems arise in the context of challenging personal and social circumstances. Serious efforts to combat NCDs may necessitate significant structural changes to current social practices and structures. Work on the social determinants of health has established the links between social deprivation and poor health outcomes, and suggests that the pervasive effects of social inequality on health, beginning at birth and persisting throughout someone’s life, are unlikely to be addressed simply through social prescribing. It should be noted that social prescribing requires a vibrant voluntary and community sector to flourish; more disadvantaged areas may have fewer community assets, thereby potentially contributing to Tudor Hart’s inverse care law.

The worry is that key social determinants of health are not tackled through broader social reform; instead, social prescribing is used as a smoke screen for change without addressing some of the more fundamental issues contributing to health inequalities within society. This might be an ungenerous interpretation of the motivation behind social prescribing, but it places an onus on those tasked with implementing social prescribing services to ensure such interventions are properly evaluated and not used to deflect attention from remaining problems, and from undertaking other (potentially politically unpopular) solutions. More optimistically, it is plausible that social prescribing could form a basis for political willingness to begin to tackle the engrained problems of social deprivation and health inequality.

Much social prescribing is aimed at older people but a recent article in the Nursing Times looks at younger people's mental health where the 'prescription' is often outdoor social and physical activities.

This approach to mental health is currently endemic in the Western world, reflecting the neoliberalism within the wider systems of society (Timimi, 2021). The idea behind it is that you as an individual are responsible for your own actions, feelings, wellbeing etc. So if you’re not feeling better after engaging with the interventions offered, the fault lies with you, rather than the breakdown of society around you.

The increase in social prescribing also correlates with cuts in the public sector, with things previously readily available, such as food vouchers, now only obtainable with a prescription from your GP.

My fear is that the current move towards social prescribing is just another plaster on the gaping wound that is the current state of children’s mental health. The social prescribing academy in the UK concedes that the sparse evidence base for this type of intervention makes it difficult to know where best to focus resources.

The danger of people feeling worse if the 'prescription' does not work for them is cited in other reviews and it is clear that more systematic research is needed to evaluate the approach.

The Task Group report gives an example of a social prescription with a positive outcome:
 

A GP Surgery makes the connection with the cost of living crisis:

 

Social prescribing perhaps has some parallels with foodbanks in that it performs a useful and necessary function in an unequal society but at the same time addresses the symptoms rather than the causes of inequality.  Political action is required to address the causes.

Brent Council's housing companies report increased delay in re-letting their properties and below target rent collection

Brent Council has two wholly-owned housing companies i4B and FWH both of which have a large number of voids (unlet homes waiting to be re-let) and lower than expected rent collection levels.

The poor re-letting performance comes at a time of great housing need with evictions from private rented housing at a high.  The Council has recently relaunched a scheme focusing on empty homes in the borough and the need to bring them back into use LINK and it appears that quite a lot of such homes might be its own.

i4B

 FWH

 A task group has been set up to address these issues.

The problems facing the i4B, leading to a suspension of acquisition of new properties, are outlined in a report to Cabinet LINK:

1.     The 2022/23 Business Plan outlined that i4B’s primary aim is to improve the Council’s affordable housing offer through the acquisition and letting of properties in Brent and neighbouring boroughs. A Development Strategy was agreed alongside the 2022/23 Business Plan with the aim of utilising remaining and potential future funding to develop a portfolio of affordable new build accommodation which:

·  Supports the Council’s Housing Strategy and relieves housing need;

·  Supports the financial viability of the Companies; and

·  Is feasible and realistic.

2.     The strategy was implemented during 2022/23. However, this has been impacted by the current economic environment, principally higher global inflation rates driven by COVID supply chain issues and the war in Ukraine. In the UK, skills shortages and a tight labour market are adding to these pressures.

3.     The Company’s ongoing street property purchase programme has been significantly impacted by increased interest rates, which reduce the amount i4B can spend on new acquisitions. As of January 2023, i4B has purchased 21 properties in the financial year against an initial target of 48. The Board has agreed to a pause on committing any new loan funding and to therefore suspend the acquisition programme until May.

4.     During 2022/23, i4B also carried out a pilot of purchasing adaptable properties to meet high demand from homeless families requiring adapted accommodation. Additional funding of up to £100,000 per property was allocated to the pilot, but i4B’s price caps have proven restrictive, especially as i4B primarily operates in the south of Brent where the majority of properties are flats and terraced houses and therefore not typically suitable for adaptation. Therefore, a large amount of additional funding would be required in order to make this a viable purchasing stream for i4B. Due to the significant amount of funding required, the Council is now exploring alternative options for housing this Cohort; options involving i4B are being considered as part of this. 

 

i4B’s primary aim is to improve the Council’s affordable housing offer through the acquisition and letting of properties in Brent and neighbouring boroughs. i4B has available finance and aims to ensure this is spent in a way that adds maximum value to the Council, whilst also being feasible and supporting the Company’s financial viability. i4B has currently suspended new offers on street properties to focus on acquiring a new build scheme during 2023/24. During 2023/24, i4B will work with partners to appraise schemes, and will look to re- enter the market later in the year.

 The financial position of the company has been hit by the cost of the Granville New Homes refurbishment:

The cash position of i4B is initially positive but reduces over two years due to the cost of the refurbishment works to the Granville blocks. The cash balance then remains broadly stable for five years to 2030/31 as rental growth offsets the cost of decarbonisation works through the stock. From 2031/32 onwards cash balances start to increase as rental growth continues and capital costs associated with the decarbonisation works end.

i4B is forecasting positive cash balances of around £0.5m for the five years up unto 2030/31. These balances are relatively small in terms of the size of the organisations. As a result all the stress test scenarios modelled in the business plan put the organisation into deficit. The business plan sets out that further work will be required on contingency plans to ensure the organisation can maintain its financial viability. 

 

Regarding Granville New Homes the FWH report notes: 

 On the 4th April 2022, the transfer of 110 properties at Granville New Homes was completed – 84 social housing units, 1 leasehold unit, and the freehold for the site (including the Tabot Centre) were transferred to the Council’s HRA, and 25 intermediate units were transferred to i4B Holdings Ltd (i4B).

Decarbonisation of housing stock to reduce heating costs and meet climate targets is an issue for both companies:

i4B

The decarbonisation of i4B’s stock is set to be a major capital expense for the Company. During 2022/23, i4B commissioned a programme of stock condition and energy surveys, which outlined the requirements and estimated costs for bringing i4B properties up to an Energy Performance Certificate rating of B. The results of this work have been received, and i4B now have EPC data for all of its properties. A decarbonisation strategy for the Company will be developed during 2023/24, which will outline works that will be undertaken to improve performance. This may include stock rationalisation in some cases.

The company has also applied for the Green Homes Grant, and the managing agent of the grant is working to book in surveys with tenants with the view to completing a programme of energy efficiency works at properties by the end of 2022/23, in order to improve the Energy Performance Certificate (EPC) rating of properties to at least a C.

FWH 

 The decarbonisation of FWH’s stock is set to be a major capital expense for the Company. During 2022/23, FWH commissioned a programme of stock condition and energy surveys, which outlined the requirements and estimated costs for bringing FWH properties up to an Energy Performance Certificate rating of B. The results of this work have been received, and FWH now have EPC data for all of its properties. A decarbonisation strategy for the Company will be developed during 2023/24, which will outline works that will be undertaken to improve performance. This may include stock rationalisation in some cases.

 

The two companies and Brent Housing Management will all be affected as landlords by the Building Safety Act 2022 which includes the  introduction a Building Safety Regulator and a new regulatory regime that applies to the planning, construction and occupation of higher risk buildings, government powers to regulate construction products, new regulations for the safety of construction products, and protection of leaseholders in respect of the costs of remediating building safety defects in their properties.

There is plenty of material here that merits further examination by the Scrutiny Committee. 

ACCOUNTS

i4B

FWH 

 

Time and Tide, Treasure and Trash – mudlarking for London’s history. March 17th St Andrew's Church Hall, Kingsbury

Guest post by local historian Philip Grant

Mudlarks scavenging beside the Thames, from a 19^th century engraving.

 

In the 18^th and 19^th centuries it was not unusual to see boys from destitute families searching through the mud of the heavily polluted River Thames. They were looking for scraps of anything they could sell, bones, metal or coal, to make a few pennies and put some basic food on the table. They earned the name “mudlarks”, after a bird (officially a magpie-lark) that makes its nest from mud, which sailors returning to the Pool of London had seen on voyages to Australia.

 

Modern mudlarks search the shores of the Thames as a hobby (with permits from the Port of London Authority), looking for interesting objects which provide details from London’s history. These can date back to Roman times, or earlier, and any find of archaeological interest is reported to the Museum of London. One of these mudlarks is giving a talk at Wembley History Society on Friday 17 March:-

 

Many of the items which today’s mudlarks uncover are not treasure, but modern rubbish which has found its way into the river because too many of us don’t dispose of it the way that we should. But with practice, and advice from experienced mudlarks, a trained eye can often spot something older, and even have a good idea of what it might be. It will be fascinating to learn from Monika what she has found, and to see a selection of these items.

 

Monika engaged in her mudlarking hobby.

 

Wembley History Society welcomes visitors, not just to its members, to its talks, so that any local resident, young or old, who may be interested can enjoy them as well (there is a small charge, to help cover costs). Details are on the poster displayed above.

 

Philip Grant

Power up local communities to hit climate targets, urges Green New Deal report

From Caroline Lucas' webpage

Powering up local communities with cleaner community energy, local food supplies and strengthened public transport networks is essential if the UK is to hit its 2030 climate targets, according to a new report by the All-Party Parliamentary Group on a Green New Deal, co-chaired by Green MP Caroline Lucas and Labour MP Clive Lewis. 

The report marks the culmination of the APPG’s ‘Local Edge’ inquiry, which held evidence sessions to explore best practice solutions at a local level to reduce carbon emissions across three sectors – heat, energy and buildings; food, land use and nature; and transport and air quality – and to identify regulatory changes needed in order to enable local initiatives to reach their potential, scale up, replicate and flourish.  

The UK’s Nationally Determined Contribution (NDC) has committed to cut carbon emissions by 68% below 1990 levels by 2030. While the Government has set bolder carbon reduction targets for 2035 and 2050, meeting the 2030 target represents Parliament’s most immediate challenge – which will be impossible to reach unless it devolves significant powers and resources to a local level, the report argues. 

Caroline Lucas, Green Party MP for Brighton Pavilion, said: 

We know that every home can be its own power station. But now we need national Government to power up communities with the finance, resources and regulatory frameworks to help them scale up and thrive. If we’re going to meet our immediate climate targets and secure a liveable future – with warm and comfortable homes, renewable and affordable local energy, healthy and low-carbon food, and cheap and clean transport – we urgently need to put Green New Deal policies into practice, with local people and communities at the forefront.

The report links climate aspiration and constitutional obligation – offering a joined-up response to the polycrisis of a climate emergency, cost of living scandal, energy crisis and constitutional dilemma. 

Evidence sessions held by the inquiry discovered examples of transformative local initiatives around the country – but found communities were held back by the absence of the necessary national regulatory frameworks, and finance required to scale them up and reach their full potential. The most progressive examples follow a pattern in which national governments set out statutory climate obligations, but allow localities to determine how best to deliver them. 

One of the most transformative proposals would be for the Government to make its commitment to a 68% reduction in carbon emissions on 1990 levels by 2030 a binding obligation on all public sector organisations and agencies for all their spending, programmes and projects. 

Amongst other recommendations, the report calls for a European-style ‘right of local supply’, promoting the development of more localised energy communities, by allowing community renewables generation schemes to sell directly to local people; changes to grid access charging in favour of more localised energy systems; and energy efficiency funding to be restored to at least 2012 levels.

The report also demands an end to tax allowances for the use of fossil fuel vehicles. Lessons from cities such as Manchester suggest that conflicts between communities and commuters can be minimised if integrated, affordable public transport alternatives are on offer. 

Some of the report’s other key recommendations include: 

• Planning law must be aligned with net zero climate targets and they should be specifically included in local plans. 
• Local authorities must be given a statutory duty to cut transport emissions in their area by 68% by 2030. 
• The duty to deliver integrated public transport services should be returned to local authorities. 
• The ECO energy efficiency programme should be replaced with a revised version of Warm Zones – developing whole-area, rather than individual, approaches to energy conservation. 
• All carbon subsidies (to fertilisers and fuel) must be swapped into support for regenerative and organic farming. 
• A new Local Food Investment Fund should be established to provide strategic support across the UK for investment in localised agri-food infrastructure and enterprise.  
• The 15-acre minimum size threshold for applications to DEFRA’s community supported farm schemes should be scrapped. 

Because of the UK’s over-centralised approach to energy generation, storage and distribution, specific recommendations were made to the energy regulator Ofgem. The report calls for Ofgem to open its Innovation Funding to promote more localised ‘combined heat and power’ systems; to switch to an average cost pricing system that favours more localised and lower cost renewables; and to prioritise the lowest carbon/lowest marginal cost supplies, ending the current situation in which wind turbines can be stood down to keep power stations running. 

The full report can be found here.

Carnival mood as Brent teachers stage 'Education Festival' on their second strike day

 

Following a supportive speech from Barry Gardiner, MP for Brent North, strking teachers paraded along Olympic Way this morning, accompanied by colourful parachutes, musical instruments and whistles, for an Education Festival in Arena Square.

Representatives from local schools spoke along with the NEU Co-Secretary, Jenny Cooper, Roger Cox from Brent Trades Council and myself from the Green Party Trade Union Group.

The carnival atmosphere left little doubt that this strike is far from over. 

Nursery teacher Lucy Cox, dressed as a pink rabbit, addresses the crowd

At the end of the Festival, in a powerful moment,  NEU members held up posters demonstrating their opposition to racism and support for the  Resist Racism national demonstration to be held on Saturday March 18th.

 

 

Determined teachers stage second Brent strike. Plenty of public support.

I joined the picket line at Ark Academy, Wembley, again this morning on the NEU's second strike day and their determination remained strong. The  morning news about Gavin Williamson's opinion of teachers and their unions was well-timed to increase their determination.

We were joined by Labour councillor Ihtesham Malik Afzal. There was plenty of public support from passing pedestrians and vehicle 'tooting for teachers'.

REMINDER: Education Festival, Wembley Park, tomorrow 10.30am to 1pm

 

BRING your placards, whistles, bubbles, musical instruments and, if you like, in World Book Day fancy dress for our competition- 3 book token prizes! BRING families, children, friends, etc   RALLY with speakers   ACTIVITIES WITH A CARNIVAL FEEL: face painting, bubbles, music, parachute games, storytelling and more.   COMPETITION FOR BEST WORLD BOOK DAY COSTUME

BREAKING: Supreme Court ruling today should help campaigners fighting for protection of green spaces

From Good Law Project

 

The Supreme Court today ruled in favour of a Good Law Project-funded case which will help to protect green spaces from being sold off where there is opposition from local communities. The ruling sets a new precedent for how public green spaces are sold by local authorities in the future. 

Greenfields Community Group, led by campaigner Dr Peter Day, in Shropshire, has been fighting for almost six years over the land, arguing that Shrewsbury Town Council should have consulted residents before selling off the green space.  

Last June, Shrewsbury Town Council apologised "unreservedly" over the sale of part of Greenfields Recreation Ground and promised to buy the land back. The council was instructed by its lawyers not to buy it back until the Supreme Court judgment.

The campaigners will now hold the council to account over its pledge so that the local community can once again use the space for recreation.

In handing down the ruling, Lady Justice Rose said:

It is our view that [Shrewsbury TC] must put robust procedures in place to ensure that an oversight such as this is not permitted to recur. Where there should be any future sale of land [Shrewsbury TC] must be able to demonstrate that [it] has taken sufficient steps to establish the legal status of that land and act in accordance with all relevant legislation prior to sale. [Shrewsbury TC] should consider whether it has the legal power to proceed with any future disposals and, for the sake of good governance, should formally document the powers on which it has relied when making any such decisions.

Legal Manager of Good Law Project, Ian Browne, said:

We are delighted with today’s Supreme Court ruling which will set a precedent to help safeguard green spaces across the country from being sold off and the rights of communities to enjoy them for generations to come.

Shrewsbury Town Council failed to consult the local community about the selling off of the land and it has led to a protracted legal battle which should not have been necessary in the first place.
 

We are thrilled to have backed the tenacious efforts of Greenfields Community Group and Dr Peter Day to secure this landmark judgment, which means that Shrewsbury Town Council will now have to meet very strict criteria before they are able to sell off any green spaces in future.