Hinterland - 03 December 2018

In Hinterland this week - Some thoughtful reflections on: the NHS, house building, poor Northamptonshire, GPs, migrant workers and Christmas trees! Read on.....

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NHS chiefs look to scrap four-hour A&E maximum wait

This is very powerful evidence of how practical and appropriate action is frustrated by expectation driven “immovable” targets. It tells us:

NHS bosses are considering a shake-up of A&E care that could lead to patients with only minor ailments no longer being guaranteed that they will be treated within four hours.

Under the plans being examined, people with non-urgent medical needs would be advised to seek help at a GP surgery, walk-in centre or pharmacy instead – or face a long wait in A&E.

Senior figures in the NHS are also looking at bringing in extra targets to complement the four-hour waiting time standard under which the most urgent cases are seen within an hour.

Sources close to NHS England’s development of its forthcoming longterm plan acknowledged that any change to the target, which is popular with patients, risked creating a backlash. Government ministers, in particular the chancellor Philip Hammond, have made clear that they do not want to see changes to the NHS’s time-bound guarantee to patients. They do not want to approve anything that would lead to accusations of the ditching of the four-hour target.

https://www.theguardian.com/society/2018/dec/02/nhs-four-hour-maximum-wait-patients-minor-ailments-miss-out


'UK housebuilding revolution': £65,000 prefab homes go into production

I find this story and its potential to drive a knife into the heart of the affordable housing crisis in rural England thrilling! It tells us:

The UK is entering a new era of prefab homes with the opening of a Yorkshire factory that will build fully-fitted three-bedroom homes with a price tag as low as £65,000.

Eight houses fitted with kitchens and bathrooms will roll off the production line every day in Knaresborough, to be loaded on to lorries for delivery across the country. Experts have hailed it a revolution in British housebuilding that would slash the 40 weeks it could take to build a traditional home to just 10 days.

The factory cost of a two or three-bedroom home would be from £65,000 to £79,000, although that excludes the cost of land, on-site assembly and connecting the home to services, which could double or triple the final price.

The plant, operated by the UK company Ilke Homes, said it would produce 2,000 houses a year, rising eventually to 5,000, which would catapult it into the top echelon of volume housebuilders in the country.

Meanwhile, the insurance company Legal & General has built a vast factory outside Leeds which it said would build 3,500 homes a year, with the first two and three-bedroom homes being delivered in the past few weeks. It said it intended to build similar factories in locations across the UK, which would turn L&G into a bigger builder than Persimmon or Barratt Developments.

https://www.theguardian.com/society/2018/nov/30/uk-housebuilding-revolution-65000-prefab-homes-go-into-production


Tory-run Northamptonshire county council bailed out by government

The Northants saga continues:

The government has in effect bailed out Tory-run Northamptonshire county council after giving it unprecedented permission to spend up to £60m of cash received from the sale of its HQ on funding day-to-day services.

The highly unusual move – accounting rules normally prevent councils using capital receipts in this way – means the crisis-hit authority is likely to escape falling into insolvency for the third time in less than a year.

Ministers gave the go-ahead for the bailout after commissioners sent in to run the council issued a stark warning that without a cash injection, Northamptonshire would be unable to meet its legal duties to run core services such as social care.

Opposition councillors called it a political move to save ministers from having to directly bail out the council. Labour group leader Mick Scrimshaw said: “It is clearly politics. The Conservative government did not want the political embarrassment and for that reason they have been allowed to use these capital receipts.”

Northamptonshire declared itself effectively bankrupt in February after it realised it could not balance its books. It declared insolvency again in July after a review revealed it had understated the extent of its financial problems. It must make good a £70m deficit by the end of March to avoid insolvency for a third time.

Although the council has already set in train a draconian cuts programme for the current financial year to try to overturn the £70m budget shortfall, the commissioners said this alone would not be enough to prevent insolvency.

https://www.theguardian.com/society/2018/nov/29/tory-run-northamptonshire-county-council-bailed-out-by-government


GP surgery closures 'will see 3 million patients lose out in the next year'

This story spells disaster for many older people living in isolated rural communities where the loss of the GP may well mean a move out of their home if they can no longer access services without a long drive. The article tells us:

GP surgery closures will see 3 million patients lose out in the next year, according to a survey by the Royal College of General Practitioners.

A total of five per cent of GPs reported their practice was likely to close within the next year - equating to over 350 practices in the UK.

It comes amid widespread concern over the ability to fill roles in the sector as more and more GPs retire early or move to work in the private sector.

The poll of GPs found more than a third (37 per cent) of vacancies in their practice had been open for more than three months.

The results were described as "gravely concerning" by the College's chairwoman, Professor Helen Stokes-Lampard.

She said: "All GPs are overworked, many are stressed, and some are making themselves seriously ill working hours that are simply unsafe, for both themselves and their patients - it is making them want to leave the profession.

"This is having a serious impact on many of our patients, who are waiting longer and longer to secure a GP appointment. But it also means we don't have the time we need with patients."

https://www.telegraph.co.uk/news/2018/12/02/gp-surgery-closures-will-see-3-million-patients-lose-next-year/


Bar on low-skilled immigrants will hurt UK, say bosses

I see trouble ahead with this proposed bar on workers – many of our rural communities are desperately short of the agricultural and food processing labour they need. This story tells us:

A new immigration system that places severe limits on low-skilled immigration risks inflicting “massive damage” to livelihoods and communities, one of Britain’s most senior business figures has warned.

Carolyn Fairbairn, head of the Confederation of British Industry, issued her sternest warning to date about the new “global system” being drawn up by the government, which is expected to place major restrictions on visas for low-skilled workers. The business community, she said, was very concerned about suggestions that migrants earning under £30,000 a year might struggle to win the right to work in the UK.

“This idea that there’s a £30,000 cap below which is described as low-skilled and not welcome in the UK is a damaging perspective for government to have for our economy,” she said. “People earning less than £30,000 make a hugely valuable contribution to our economy and society, from lab technicians to people in the food industry.

https://www.theguardian.com/politics/2018/dec/02/cbi-warns-low-skill-visa-cap-carolyn-fairbairn


And Finally….

Christmas tree growers urgently prepare for climate change after summer heatwaves wipe out a third of new crop

Now here’s a sad unintended consequence of that wonderful summer heatwve we experienced – this story tells us:

Met Office scientists have announced heatwaves will soon become the norm in Britain, with summer temperatures shooting up by over 5C within decades.

Farmers of all stripes were hit hard by this year’s unpredictable weather, with reports of arable crops ripening early and warnings of lettuce and broccoli shortages.

Among Christmas trees, recently planted saplings with smaller roots were left unable to suck up enough water from the parched ground.

“Trees planted in the last two years have suffered significant losses … because the weather was unseasonably dry and hot,” said Adrian Morgan from the British Christmas Tree Growers Association.


About the author:
Hinterland is written for the Rural Services Network by Ivan Annibal, of rural economic practitioners Rose Regeneration.

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