Hinterland - 30 September 2019

In Hinterland this week - businesses operate in challenging times, too few vaccinations, the psychological challenges of rural dwelling, rapid aids and adaptations for the elderly, more planned hospital investment but perhaps not anywhere near you and if you like a flutter on the gee-gees a heart warming tip from the turf? Read on...

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Quarter of rural businesses 'could be bankrupted by no-deal Brexit'

In recent weeks the parliamentary side show has become the main issue, this article reminds me that we are just a few weeks from all of this “sound and fury” becoming real. It tells us:

As many as one in four rural businesses could be left facing bankruptcy in a no-deal Brexit, and the staunchly Conservative rural vote may be in doubt as a result, the head of the UK’s landowners’ group has warned on the eve of the Tory party conference.

Farmers are particularly vulnerable to a no-deal Brexit because tariffs would be levied on exports, imports of cheap food could flood the market, and because decisions must be made now which will have an impact for the next year. Arable farmers are putting crops in the ground now for spring, and livestock farmers are preparing to breed sheep and other livestock for next year.

Tim Breitmeyer, president of the Country Land and Business Association, said farms and the rural businesses that rely on them were not in a position to absorb the shock of Brexit, and estimates suggested a large number would be in danger.

“Agriculture is not making very much money. In many cases, they’re losing [money] without the single farm payment [subsidy]. If you have a tariff to add to your problems, if you have increased costs to add to your problems, it’s only going to make matters worse and tip some businesses over the top,” he told the Guardian. “Now I don’t know whether that’s 15% or 25% but I’m absolutely sure there will be quite a few farming businesses for which it actually just tips them into receivership.”

Rural areas voted overwhelmingly for Brexit in the 2016 referendum, which Breitmeyer called a “protest vote for the fact that rural Britain got abandoned”. But the reality of new tariffs on exports, rising import costs, the crash in value of the pound and difficulties in employing migrant labour were taking a toll, he said.


Drop in vaccination rates in England alarming, experts warn

This article makes me worry about the erosion of our “herd” immunity.  It tells us:

Experts have expressed alarm at the drop in take-up of all routine childhood vaccinations across England, with a marked decline in rates against 13 different diseases, which leaves many thousands of children under-protected.

The UK recently lost its measles-free status because of the fall in rates of MMR (measles, mumps and rubella) immunisation. But the latest figures from NHS Digital for England in the year to the end of March 2019 show a loss of confidence for vaccinations more generally.

At the ages of 12 months, 24 months and five years there has been a marked decline in vaccination rates against 13 different diseases, including whooping cough (pertussis), diphtheria and meningitis.

Lives at risk from surge in measles across Europe, experts warn

Measles protection is down again – part of a protracted fall in take-up of the MMR jab that has led to outbreaks across Europe, which have then spread into England. Measles had been officially eradicated in the UK, but the World Health Organization recently withdrew its measles-free status.

Coverage of 95% of the population is necessary to prevent outbreaks. Among children aged 24 months, vaccination in England has dropped from 91.2% in 2017-18 to 90.3% in 2018-19. The rate has gone down each year for the last five years.


'They find the city intimidating': I help young people in rural areas broaden their horizons

A really interesting insight into some of the challenges facing people in rural settings…..

“If they miss one bus, it’s back to square one,” says Susie Pasotti. A neighbourhood officer for housing association Rooftop, Pasotti has spent four years supporting young adults with accommodation, benefits, and other services.

Travel options – or the lack of them – in the Forest of Dean, part of rural Gloucestershire, have a big effect on young adults seeking help. “If they’re given an appointment at 9.30am, anyone who has actually looked at the bus timetables knows they won’t get there on time,” she points out.

The small town of Cinderford, like many rural towns, lacks services for young adults. They have to travel 18 miles to Gloucester to attend assessments with the Department for Work and Pensions (DWP), probation appointments or college.

Many young adults have rarely left the local area independently before. Pasotti says some have told her they’ve missed appointments rather than face travelling to the city. “They find it intimidating. They worry about youths, or how to get to the appointment from the bus stop,” she says.

“For some, the thought of going to Gloucester is anathema. One young chap was quite confident but told me he couldn’t go to Gloucester. I was really surprised, but to him it was a big city like London.”

Like many housing officers, Pasotti is now trying to tackle more issues with fewer resources. Funding for public services in Gloucestershire was cut by more than £35m in 2018-19, while demand is growing. More young people are experiencing issues such as depression and anxiety, yet there is less money and fewer resources to support them, she says. The result? “There’s a lot more cannabis use, and self-medicating.”

The challenges don’t stop when young people find work. Many struggle to manage a budget, often falling into arrears. As soon as they get a job, they have to pay up to £60 a week more in top-up rent, as well as council tax and other bills. “It’s a real eye-opener,” says Pasotti. Fines and arrears quickly build up if young people don’t pay their bills on time.

It all makes Pasotti’s job harder. “We don’t want a whole raft of people thinking it’s going to be easier if they stay on benefits, because as soon as they work, they can’t afford the rent,” she comments. “That’s not good for your mental health. Day in day out, it limits confidence.”

Despite the challenges, job satisfaction comes from the small measures that can have a big impact on people’s lives: “What seems like a little achievement, such as someone calling the DWP themselves to sort out an issue on their own, is a big deal,” says Pasotti.


Home refits: Wales leads the way on rapid response home adaptations

With our high proportion of vulnerable old people who are often challenged to stay in their own homes sustainably this is a really interesting example of good practice worth replicating more widely. The story tells us….

After a bad fall at home, Linda Jones spent three weeks in hospital. Fearing she might fall again, the discharge coordinator at the Royal Gwent hospital in Newport arranged for an assessment of her house. Within 48 hours she had a handrail in the hallway and grab rails in the downstairs toilet.

While there is nothing odd in making minor home adaptations to prevent falls – the single biggest cause of hospital admissions of older people – the speed of this intervention is unusual. All too often, applications for even the simplest practical aids are held up for months in the mistaken belief they require approval by an occupational therapist.

survey last year by the Equality and Human Rights Commission found the average wait for an adaptation was 22 weeks – eight weeks for a decision, then 14 for installation – with some local councils taking more than a year.

New guidance aims to tackle the problem. Adaptations Without Delay, commissioned by the Royal College of Occupational Therapists (RCOT) and drawn up by the Housing Learning and Improvement Network, sets out a decision-making framework to grade different types of adaptations and advise when they can be authorised and installed without going through the full process.

“Adaptations play a crucial role in prevention and need to be delivered in a timely manner,” says Karin Bishop, RCOT director of professional operations. “We need a radically different approach to address the delays.”

The guidance praises the approach of Care & Repair Cymru, which supports 13 Welsh care and repair agencies that carry out adaptations and operate a rapid-response service authorised to undertake minor works costing up to £350 and grant-funded without a means test.

More money is available for adaptations than ever before. With ministers now recognising their value in helping keep older and disabled people out of hospital and residential care, funding for disabled facilities grants, which pay for adaptations, has risen by 8% in England in 2019-20, to £505m. The aim is to make 85,000 grants this year, more than twice the number five years ago.


Government plans 40 hospital projects and a mental health services pilot

In these febrile times it looks like more cash may well be available for the NHS (although few rural settings feature in this list!). Lets wait to see what actually emerges…. This article tells us:

The government has pledged £13bn for 40 hospital projects across England in the next decade, at the start of the Conservative party conference.

The plans include a £2.7bn investment for six hospitals over five years.

A new approach to NHS mental health treatment is also to be trialled in 12 areas of England - with housing and job support alongside psychological help.

The government says £70m is being invested and the NHS will build more ties with charities and local councils.

About 1,000 extra specialist staff will be recruited in 12 pilot sites, with expertise in a range of mental health issues, the government says.

Under plans drawn up by Health Secretary Matt Hancock, £13bn will be spent on creating "new" hospitals - either with entirely new buildings or revamping existing structures to improve facilities.

Mr Hancock said it was "the largest sum that has ever been invested in the NHS" after the extra £33.9bn the government has committed to spend on the health service up to 2023.

The six hospitals to benefit from the £2.7bn in funding are: 

  • Whipps Cross Hospital, in Leytonstone, east London 
  • Epsom and St Helier Trust 
  • West Hertfordshire Trust 
  • Princess Alexandra Hospital Trust 
  • University Hospitals of Leicester Trust 
  • Leeds Teaching Hospitals Trust. 

A further 34 new hospitals will receive £100m in initial funding to start improvement projects, including Addenbrookes Hospital in Cambridge, the Queen's Medical Centre in Nottingham and the North Manchester General Hospital.

The remaining projects, including up to a dozen smaller rural hospitals, would be completed over the second half of the next decade.


And Finally                                        

Shetland Pony Grand National at Newmarket won by boy, 12

As we enter the ground rush of Brexit a diverting story of shaggy endeavour to bring a smile to you face. This article tells us:

A photo-finish was needed to determine the winner of the Shetland Pony Grand National.

Zak Kent, 12, was handed the victory beating second place rider Lucas Murphy by a nose-length.

Thirteen riders took part in the charity race at Newmarket Racecourse over a distance of two-and-a-half furlongs - four miles shorter than the fully-sized race at Aintree.

Rules dictate the jockeys have to be between nine and 14 years old and be under 5ft tall.


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


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