Breakfast in the Park

The “Inn the Park" is a rather wonderful cafe/restaurant in St James' Park and a good place for to eat amidst the summer finery of this beautiful London spot. I was breakfasting yesterday with Chris Hopson, who is not only the CEO of the Foundation Trust Network but an ACEVO member. He had full English though I went healthy with poached eggs and spinach. Thought I must set an example....

The FTN and ACEVO are set to launch a joint report on hospitals and charities working in partnership to deliver the NHS Mandate. So, Monday, 4pm. House of Commons. Jeremy Hunt is speaking. Already nearly 200 booked but if you are an ACEVO member and not yet signed up I'll squeeze you in!

But Chris and I are hatching plans to move this report on; ideas about how we can do work with hospitals to maximise the use of charity and social enterprise, get CEOs from both sides together and use our organisational resource to help facilitate all that. You will be hearing more from us both.

I'm working on my speech. Only 5 minutes allowed. So the usual Bubb punchy tub thumping stuff I suspect. And I'm sure Chris will keep me to time. After all the main event is Jeremy Hunt who is, I have to say, doing a good job as Secretary of State by putting patients first as his priority. The fact the surgeons are putting out details of their performance is a big step forward and congratulations due to the Royal College of Surgeons for this!

Spending Cuts again

So the Chancellor has spoken. More cuts. But importantly more cuts for the next 5 years whoever holds the reins of Government.

This Spending Review serves as a stark reminder that tough times are set to continue for the third sector and more importantly, for our beneficiaries. The additional £4 billion of welfare savings will impact beneficiaries and increase demand for our services at a time of restricted finances. The further 10% cuts to funding for the Department for Communities and Local Government, on top of 50% real-terms cuts since 2010, will have significant repercussions for sector income.

 So the Department for Communities and Local Government must enforce the Best Value Statutory Guidance ensure that councils do not seek to burden the voluntary sector with disproportionate cuts.

As it is clear that austerity will continue for the foreseeable future, it will be impossible to maintain adequate standards of services and support without accompanying reforms to public services to drive innovation and efficiency. You can't deliver the same level of service with less money unless you change the way you do it. The sector must challenge government to give it a greater role in service delivery, and use mechanisms such as the under-used Right to Challenge to make the sector’s case to commissioners.

I liked the statement’s emphasis on alleviating pressure on acute health services through investment in social care and better integration of NHS and social care services, as well as the £3.6 billion joint commissioning initiative between councils and the NHS. That's important, and excellent. Good for the DH in arguing their case on that. 

 We know our sector has a huge role to play in supporting service integration, through innovative and effective care and support interventions. I want to work closely with commissioners and other partners to support this aim. Ring us!

So for me the underlying message is; keep up the pressure for more open public services and more delivery through our sector. No good us bemoaning the cuts as both main parties have said they will stick with these plans. But the pressure on our sector's leaders continues. The next 5 years will continue the trend to fewer charities and for more mergers, consortia and alliances. But overall we may continue to grow as we become a major partner in public service delivery. So ACEVO will continue to lead the field in demanding service reform and change. And I’ll continue to bang on about it in my Blog!

Media

Rather a full on media day yesterday! "File on 4” (that splendid BBC Radio 4 institution)  were interviewing me on the Charity Commission and its failings. I was not coy. But then again "coy" is not a word one hears often in the same sentence as Bubb. It’s not just the failure of the Commission and its Chair over the Cup Trust, it’s the extraordinary lack of awareness that they  failed in their regulatory job. They fall back on process and the law. Regulators should be wary of using the "legal advice" defence as the CQC have recently discovered. But we have to work with the Commission in getting things right. And it is clear that a regulator with a case load of over 160,000 will be stretched. The cuts in their resource base have been shocking. I do not know how much of a cut they will take as a result of the spending review but further cuts will damage their ability to act decisively against abuse. It’s a shame they have so alienated many sector leaders by recent actions. Still, I’m seeing Shawcross soon to have this all out.

Then it was onto an interview with “Third Sector", our magazine of distinction and record. All ACEVO members get a free copy as part of their membership. I hope they enjoy my musings when they appear. And indeed the photo!  I had my haircut especially. I find it helps make me look younger!  Such vanity.

The Guardian: a national treasure

The journalism at the Guardian these days is more than first class. It’s outstanding. Bringing us the Snowden revelations about the disgrace of our Secret State, and now the horror of the covert Met Police operation against the Lawrences. Amusing to know that there are snoops out there who are even now reading my Blog. Will be good for them. Indeed it is not the first time I have been snooped on.

I discovered some years back, from the memoirs of a former spy for BOSS that they had been watching me!

In the 70s I was the Secretary of the Medway Town's Amnesty International Group (my very first third sector job; and as a volunteer to boot!). We were active in supporting the "Pietermaritzburg 13" imprisoned on Robben Island. I knew and supported a number of their relatives who had fled to the UK, and obviously harried the wretched apartheid regime. I regard this as a badge of honour. Good luck to Edward Snowden who has shown courage in revealing just how far snooping has gone.

When you have an over powerful State ready to spy on all of us, having intrepid journalism is ever more essential.

And whilst on the subject of newspapers, the story about the BMA in the Times is a hoot. So these guys think that competition is unacceptable but they are happy to see us all paying charges for health care. One of the core points made in the report of the group I chaired on “choice and competition" was that the core principle of the NHS; that it is a free and universal service will be undermined if we don't accept that greater choice and competition will help ensure better use of scarce resources. So don't be fooled by the BMA; they have demonstrated their true colours. They don't believe in a free NHS. This is the underlying principle of the 1948 reforms. Let's defend that to the hilt. Ironic that an organisation that represents the private Sector (doctors are not public sector employees but self employed contractors) has such a bizarre view. There is in fact nothing wrong with doctors as private contractors. The BMA needs to stop this campaign on charging now.

End of rants!

Public sector corruption?

We are lucky that this country has a very low incidence of corruption- in the sense of money changing hands for contracts etc. - unlike the record of so many other countries. But it seems we do suffer from a form of corruption that is demonstrated by a culture that puts organisation and staff before purpose. The NHS, whilst admirable in so many ways that so many of us are glad of, has a culture that is corrupted. It is a form of corruption when a report exposing failures that led to children's deaths is suppressed. Coming on top of Mid Staffs this may expose a wider problem in the system. 

The CQC scandal is only part of a wider problem that sees patients as a lower priority than the welfare of the organisations' staff. It should be unthinkable that a regulator charged with guaranteeing patient safety did the opposite. It is hard to credit that whistle blowers were treated in the way they were. That the one non exec on the Board was subject to a campaign of vilification. Let's wish David Behan, the new CEO well in cleaning it all up.

But the signs are that the culture is changing. Public pressure will help. A growing understanding that the NHS can be flawed and that there are good and bad hospitals. I'm clear the majority of managers and staff are dedicated professionals who do a good job, which the emerging CQC scandal undermines. But its time to reform the culture. Jeremy Hunt is on the right path in demanding more openness and more information given to patients and citizens. Deference to doctors is dying out and there are many in the system who want change; those in the NHS Alliance for example are good models and there are CCGs around the country who will start to get increasingly insistent on change. Our sector can help this process by ensuring people have access to information and are given advice about how to use it. How about Citizens Advice Bureau services expanding to tell people the best doctors, surgeons and hospitals to go to?

In the meantime, back from Liverpool I've been back at my old college (Christ Church) for our Gaudy: a chance to catch up with contemporaries from my year of 1972; now amazingly 40 years on. A sobering thought that I am unlikely to be at a future gathering in another 40 years time. Indeed as time moves one ones contemporaries start dying out! Hopefully I shall make the next Gaudy in 7 years time. But thereafter; who knows? The Dean gave an elegant address poking fun at the fashion for impact and outcome analysis as opposed to the sheer value and importance of the education process itself. Useful that David Willets MP, the Uni minister- a contemporary of my brother from 1974, was sitting close by. There is value in the study of classics, even if the “outcome” desired by the accountants who like to add things up is more intangible. And amusing to note that this near 500 year old organisation managed to run without any governing statutes for centuries. Henry V111 didn't get round to them before he died. His son had a go but didn’t manage them before he died and then it just got forgotten. The place did in fact manage to operate quite successfully without. The good old English tradition of “common law" sufficed!

So let me leave you with 2 images from the Gaudy as I spend my Friday recovering from the events of last night.