Julia Manning is Chief Executive of 2020Health.
• Improve health and mental health outcomes?
• Stimulate personal and private investment in health and social care or opportunities for job creation? Is this good for our economic health?
• Promote information and education to encourage good choices?
• Help older people?
• Reduce inequity, encourage caring and enable strong families?
• Help other countries? Have they worked in other countries?
Economic and personal health go hand-in-hand. You cannot have a healthy society without a healthy economy, and overall we are concerned that this speech lacked the radical ideas necessary to create both jobs and well-being.
Having just survived a turbulent Health and Social Care Bill, and with the legal repercussions of the gruelling Mid Staffs Inquiry delayed by the report being postponed until the autumn, another Health Bill was not likely. But everyone expected, nearly a year after the Dilnot Commission had reported, for there to be a Bill on the funding of social care. However this crucial but demanding obligation has been postponed and what we have been given is a Draft Care and Support Bill, a tidying up exercise of existing law, a potential anti-localism centralisation of eligibility criteria for social care and a plan to embed the fear and uncertainty for both the poor without assets and the middle-classes with one main asset, their home. The re-jigging of who gets to wear ermine is of miniscule concern to the public compared with the epic proportions of the people’s dilemma: what will happen when they can no longer look after themselves. Giving the new proposed quangos the benefit of the doubt, whilst this Bill could, in part, improve health outcomes, having avoided the key question will mean that personal or private investment is not stimulated by a new clear funding framework, neither will the social care jobs market benefit despite the rising need and older people are left in the lurch.
The Pension Bills are necessary and probably don’t go far enough if we are to return to economic health. We forget that in the early 1900s, the pension was a safety net in case you lived for longer than you could work. In 1948 when the NHS was born, still 50% of people died before they were 65 years old. Now it’s just 18%. Public sector pensions have promised what they can’t deliver, and we’ve known this for years. So the government deserves full credit for pressing on with reform, although the terms are still too generous. If teachers and doctors do go out on strike, I hope the headlines will be full of the pay-outs that they will still get; the public will be furious. Likewise the Enterprise and Regulatory Reform Bill is necessary and important but the impact will be in the detail. The plethora of pointless requirements for businesses to tick-box impacts every sector. We hope that part of this Bill will ensure that previous processes of identifying futile
Meanwhile the Children and Families Bill is a welcome attempt at “Cutting red tape and delays in giving early specialist support for children and young people with Special Educational Needs (SEN) and/or disabilities – the biggest reforms for 30 years.” Having in the past had to take a young girl I was mentoring to a private SEN assessment, paid for by kind-hearted friends, to speed up her statement and in-school support, this is welcome recognition that the system isn’t working – especially for those without pushy parents. Much in this Bill ticks our ‘reduce inequity, encourage caring and strong families’ box; the flexible parental leave sends the message that both parents are important to a child’s upbringing, and we look forward to greater detail on other components. You cannot have a healthy society without robust family support.
On Afghanistan, the rhetoric is wishful in the extreme. “We are working closely with the Afghan Government, Afghan civil society organisations and international partners to improve the status of women, so they can participate as fully as possible in a future, peaceful Afghanistan.” With a president who has declared that women can be beaten and segregated, and in the light of recent horrific attacks on school girls, there is a long way to go. The robust commitment of 0.7% GDP to International Development is welcome although it’s a shame it is not to be enshrined in law. Travel to any developing nation and you will see remarkable achievement with incredibly small means. Much of what we donate gives life, hope and sustainable jobs. We go back centuries in our legacy of sharing expertise – from Jenner’s discovery of the smallpox vaccine (which he deliberately did not patent) – to subsequent more modern immunisations which have led to the transformation of health, educational attainment and life prospects. We should be proud of our generosity. Finally, we like the Changing the Rules of Succession to the Crown. With the greatest British monarchs having been women, this Bill is centuries overdue.