LOCALISM AGAIN
8 September 2008
Additamentum 8 September 2008
The King’s Fund has published a study Update to local variations in NHS spending priorities1. Details are here. This looks at the differences in adjusted per head spending by 152 primary care trusts in England on specifics such as cancer. There are disturbing variations in the levels of spending which are not fully explained yet and which I think are probably unjustified. The study reveals a postcode lottery in healthcare. In the study Cornwall and the Isles of Scilly trust is in the lowest quartile for spending on cancer and mental health and in the third quartile (the next to best) for spending on circulatory and heart problems. This is poor news for people in the first two categories who need help. It raises sharply the need for the advocates of localism to develop an effective answer to the postcode lottery aspect of localism.
The continuing news of local differences in the NHS raises questions. In what sense is a primary care trust local? How far can local people influence its decisions? Should the treatment you get depend on where you live or should there be national standards and requirements of treatment?
Original article 4 September 2008
Another example of what localism means in the world people live in: read the distressing story here and here. A man with cancer is denied expensive treatment by his local primary care trust. If he lived a few miles away he would get the life-extending medication because the neighbouring trust agrees it.
There are serious questions that the advocates of localism should answer. Is a post code lottery all right? If not, what do the advocates mean by localism?
These are my previous posts on localism:
A simple principle in Cornwall
LOCALISM IN CORNWALL: UPDATE
7 August 2008
See additamentum at end
ORIGINAL POST 21 July 2008
I have pointed out in previous posts that localism, devolving power to localities, can raise difficulties.
Two recent unconnected stories from Cornwall make the point.
In Illogan the local council has objected to new houses.
In Penzance some people have objected to a housing program for vulnerable people. The website of Providers of Accommodation and Services (PAS), the organisation involved with the Penzance story, explains that it has twenty two properties in Penwith district, housing almost one hundred vulnerable people. In the rest of Cornwall it has nine properties housing fifty nine people. Let me be clear: I think the work done by PAS (and its fellow, CTE) should be wholeheartedly supported. Penwith district council seems to have gone into constructive partnership with these organisations as a result of central government policy.
You can read more details of the Illogan story here Time has come to say ‘No more homes’ and the Penzance story here Dismay at council programme for alcoholics.
Of course new houses in numbers should be accompanied by improvements in infrastructure (and ideally amenities and more jobs) and housing for vulnerable people should be located carefully. However, with those provisos, both stories of opposition are depressing. This is what localism, empowering communities, can mean. Those who cheerily advocate more local powers, more decision making locally, should discuss the possibility that neighbourhood values might jar.
Additamentum 7 August 2008:
See this account of 6 August of a public meeting in Penzance about the scheme: Uproar at housing meeting.
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See here for details of the organisations involved with the housing for vulnerable people
See here for the account by Penwith district council of its partnership with Charles Terence Estates (CTE) and Providers of Accommodation and Support (PAS) in housing vulnerable single people.
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