Justice? No, it’s criminal lack of foresight

image from www.yourkenttv.co.uk

I know this is an age of austerity but it’s amazing what these cutback look like on the ground.  It’s also worrying the lack of joined up thinking amongst those with the power to make the cuts.

Don’t worry, I’m not naive.  I know there’s no masterplan, no overview of how and on what cuts are made.  That’s the problem in believing in local decision-making though, is that you do kind of expct some sort of consistency in the local area.  I’ll show you what I mean.  As you may have noticed because I’ve blogged about it a bit, Ashford in Kent is one of the growth towns in the UK.  Here’s what Ashford’s regeneration agency “Ashford’s Future” has to say about it:

Key facts about Ashford:
The fastest growing town between London and the Continent
Plans to create 31,000 homes and 28,000 jobs by 2031
Around £2.5 billion planned investment
37 minutes to London via the high speed rail link
Paris in 2 hours and Lille in under 1 hour from Ashford International
Exciting shopping opportunities in the extended County Square shopping centre and the Designer Outlet
Some of the best leisure facilities in the South East including a multi-million redeveloped leisure centre and international standard athletics stadium
Excellent and expanding education facilities including a multi-million Ashford Learning Campus for further education
2 million sq ft of commercial office development
Office rents 68% lower than in London and 40% lower than in the South East
House prices 28% cheaper than in London and 14% cheaper than the South East average
Fantastic countryside, including part of the Kent Downs area of outstanding natural beauty and extensive areas of woodland
Easy access to beautiful countryside, charming villages and the south coast
And – 85% of Ashford residents value the quality of life in Ashford

So what’s the problem?  Out on Saturday, I heard the story of a 15 year old, wrongly arrested for shoplifting in Ashford Town Centre. As ths is town gossip, I’d be delighted to have facts corrected, of course.

The police cells at Ashford police station have been closed.  This means that said 15 year old was apparently taken all the way to Folkestone for questioning. The way the story was told to me, once it had been acknowledged that it was a case of mistaken identity the 15 year old was released.  But he’s in Folkestone, 20km (12 miles) from where he was taken.  Fortunately he was sensible enough to point out that he was under 16 and get the police to get his parents to come and collect him.  But carting a 15 year old 12 miles from home on a mistaken basis, with no obligation to return him to his original location?  That doesn’t seem like an intended consequence, nor in line with the standards of child protection we’d expect from public authorities.

So then we learn that the closure of the custody suite is to be used as a justification for closing Ashford’s magistrates court.  Describing the court as “underused“, the money saved by not doing maintenance recently is also given as a reason for transferring magistrate court functions from Ashford to Folkestone and Dover.

But a letter in this week’s Kentish Express (not online, will see if it is still available) from a former Magistrate sets out the cost errors in the assumptions that this would save money, including the extra fuel and travel time of all the Ashford-based solicitors alone (NB there are only a couple of solicitors firms handling court work in Folkestone, and none in Dover).

One local solicitor pointed out the propensity of magistrates to grant bail to those kept waiting long in the day.  Another firm, Griffin Law, which is involved in the campaign to save the courts says:

The closure of a [...] Magistrates Court in Ashford is particularly ill thought through, given the government’s intention to grow the population of Ashford and surrounding villages.

And that’s exactly the point.  While it might be a short term saving to close the older magistrates court based in Ashford, it is Ashford, not Folkestone, which is well placed in terms of transport links (road and rail), Ashford that is designated the growth town, Ashford that is to expand so substantially.
It is therefore not the case that the population of the south east kent area is best served by moving the justice functions to Folkestone. Even now, Ashford is bigger than Folkestone.

This is a short-sighted decision, exactly the sort of thing that the level of cuts needed in public spending are likely to bring about, but without the careful holistic thinking that we might have hoped would be in place given the amount of time and warning the various different public bodies involved have had to think about it all.

It would also be great to see Ashford’s MP taking a leading role in fighting this sort of nonsensical decision that could potentially affect quality of life in Ashford.

Oh, and the international standard althetics complex Ashford’s Future mentioned?  That’s not being used properly – no compatitions etc. being attracted to the area – so that’s in line for closure too.  What a waste.  The Facebook campaign on this one is here.

Really radical healthcare

I’ve just seen the letter from the Prime Minister and Deputy Prime Minister to public sector workers asking for how and where cuts should be made.
Focussing the media vocabulary on cuts is missing a trick.
It sounds as if the interest is solely budget deficit reduction.  But this is not the whole story – the solution should also deliver a good service for the public.

Today’s proposed reform to the NHS is not perfect but is long overdue.

While some things (like getting a consultant’s appointment within a fortnight, or a doctor’s appointment within two days, including after work and at the weekend) have been great, I’m still not clear how some of the targets made any sense.
Anything that resulted in patients being admitted to hospital for a few hours in order to avoid an A&E waiting time target being missed is a nonsense.
After all, if you’ve ever tried to get discharged from hospital (as we did with my baby son), it can take 12 hours and a lot of tears and turn into a Kafkaesque nightmare.
I’ve also never understood the Value for Money argument for the Primamry Care Trusts – as far as I have seen their job is to duplicate letters coming to patients from the GPs surgery and from the local hospital (an extra letter from the PCT each time I got one regarding smear test appointments, for example).

But the Private Sector Lite idea that has been proposed is really not that radical.  Look, if you truly want money to follow patient, it needs to mean a real market in the public healthcare system.
Scary rightwing idea?  Not at all.  The model here is France and Belgium.

In Belgium, an insurance-based system (with a decent fallback for those in need) is run by mutuals.
That means no expolitation by insurance companies trying to screw their own customers and avoid paying out a la USA.
While each mutal has a different “ethos” (I used Mutualite Socialiste the first time I lived there, Partena the second, and my husband Mutualite Chretienne) essentially they all do a similar job and don’t have shareholders getting rish off the good health of the scheme’s participants.

What makes the Beligan system seem so radical if you are a Brit is that any genuinely quality provider can sell services within public healthcare system.
The ground floor of most of the apartment blocks on the big boulevards in Brussels feature a number of brass plaques.
Each building offers one or two GPs, or a gynocolgist, a physiotherapist, a dermatologist, a sports therapist…

Reputation counts – GPs are not in control, offering their patient one or two choices of hospital-based appointments – they provide a referral for a specialist and the patient chooses who they want to see.  The mutual says up front how much of the treatment they will refund depending on how public/ private the specialist is – an appointment at a private hospital will be partially refunded (at say 60%) whereas one at a public hospital might be refunded at 85%.

Oh, and in Brussels, it is possible to self-refer if necessary.
The mutual might not refund the appointment, but the truly free market means that it is possible to find someone to see you if you can’tget a referral but are worried about something.

So ultimately members of the public determine where money goes.
Public health with a bigger role for the patient – now that’s radical…