Jan 09 2007

Concerns raised over threat of A&E hospital cuts in Harrow

A&E must have catchment areas of half a million people suggests report

Bob Blackman, Harrow East Parliamentary Spokesman and London Assembly Member, expressed grave concern at reports that the 92 of England’s 204 Accident and Emergency departments could be axed – if Labour press ahead with plans to force A&Es to serve an area covering at least 450,000 people.

Currently A&Es typically serve an area of under 250,000 people, but NHS organisations are pressing ahead with plans to close down A&Es, saying that they have been instructed to by the Department of Health.  If A&Es are forced to serve 450,000 people, this would mean cuts of fifteen in London. The plans also fly flies in the face of recommendations by clinicians.

Bob Blackman said:
“Access to Accident & Emergency services is a vital component of the quality of NHS services. There is no clinical evidence which would justify shutting down A&E departments simply because they don’t serve a catchment population in excess of 450,000. Yet Whitehall bureaucrats are seeking now to justify closures on these grounds.

“Such closures are being driven by financial deficits – thanks to Gordon Brown, who has been controlling the NHS purse-strings. These latest Labour cuts to our NHS must be resisted, yet I fear the Gordon Brown – as Prime Minister – is merely going to offer more of the same.”

CURRENT NUMBER OF A&Es

There are currently 204 major (sometimes referred to as ‘type 1’) Accident and Emergency (A&E) departments in England, serving a total population of 50 million people. On average, each A&E department serves a population of 247,214.

 

Number of major Accident and Emergency departments

Population

Catchment population of each A&E

North East

14

2,558,308

182,736

North West

33

6,846,249

207,462

Yorkshire and the Humber

21

5,063,944

241,140

East Midlands

12

4,306,335

358,861

West Midlands

23

5,365,438

233,280

East of England

19

5,541,636

291,665

London

32

7,517,726

234,929

South East Coast

16

4,213,904

263,369

South Central

12

3,950,320

329,193

South West

22

5,067,794

230,354

England

204

50,431,654

247,214

The catchment populations of A&E departments in each of the NHS’s Strategic Health Authority (SHA) areas varies widely. In the North East for example, an average A&E department serves just over 180,000 people, while in the East Midlands an average A&E department serves almost 360,000 people.

CUTS ON WAY: NEW DEPARTMENT OF HEALTH GUIDANCE

The Department of Health has apparently ordered the NHS to design Accident and Emergency services so that each major A&E department serves a population of at least 450,000 people, but only in London and the South East. The guidance has been referred to in strategy documents prepared by local NHS organisations, and by the Department of Health’s director for emergency care.

A document prepared by the West Surrey NHS confirms that:

“Current Department of Health and Strategic Health Authority guidance suggests that to be viable in terms of patient need, patient safety, staffing numbers and clinical training requirements, a full A&E department in the future would need to be supported by a catchment population of between 450,000 and 500,000 people.”

Source: West Surrey NHS, Clinical options workshops, March 2007.

A staff briefing by the Surrey Primary Care Trust in March 2007 similarly confirms that:

“National guidance – full A&Es to serve a catchment population of 450,000-500,000 people.”

Source: Surrey Primary Care Trust, Creating an NHS fit for the future: staff briefing, March 2007.

IMPACT OF NEW GUIDANCE

If the guidance which insists that each A&E department serves a minimum of 450,000 people is implemented, then the number of A&Es required in each SHA area is listed below:

  • The North West will require only 15 A&E departments, rather than the 33 it currently has – suggesting that 18 will need to be closed or downgraded.
  • London will require only 17 A&E departments, rather than the 32 it currently has – a decline of 15.
  • The South West will require only 11 A&E departments, rather than the 22 it currently has – a decline of 11.
  • The West Midlands will require only 12 A&E departments, rather than the 23 it currently has – a decline of 11.
  • Yorkshire and the Humber will require only 11 A&E departments, rather than the 21 it currently has – a decline of 10.
  • The North East will require only 6 A&E departments, rather than the 14 it currently has – a decline of 8.
  • The East of England will require only 12 A&E departments, rather than the 19 it currently has – a decline of 7.
  • The South Central region will require only 9 A&E departments, rather than the 12 it currently has – a decline of 3.
  • The East Midlands will require only 10 A&E departments, rather than the 12 it currently has – a decline of 2.

Overall, the total number of A&E departments in England will fall from 204 to 112 – a decline of 92.

The calculation is achieved through dividing through the population of each SHA area with the catchment populations which the Government wants each A&E to serve – 450,000. This is spelt out in the table below:

 

Population

Forecast number of major Accident and Emergency departments if each serves 450,000 people

A&Es downgraded or closed

North East

2,558,308

6

8

North West

6,846,249

15

18

Yorkshire and the Humber

5,063,944

11

10

East Midlands

4,306,335

10

2

West Midlands

5,365,438

12

11

East of England

5,541,636

12

7

London

7,517,726

17

15

South East Coast

4,213,904

9

7

South Central

3,950,320

9

3

South West

5,067,794

11

11

England

50,431,654

112

92


NO HEALTH GROUNDS TO SUPPORT CUTS

The figure of 450,000 appears to have been plucked out of thin air, and is not the minimum recommended catchment population made by leading clinicians.

In March 2006, the Royal College of Surgeons of England published Delivering High-quality Surgical Services for the Future, which recommended a minimum catchment population of 300,000. It said that:

“The majority of acute hospitals currently have, and are likely to continue to have, a catchment population of approximately 300,000. Some rural hospitals do not reach even this population mass, and yet are still required to provide as full a range of services as possible…There needs to be, in the first instance, strategically planned reorganisation so that, where feasible, smaller hospitals are able to merge to achieve a catchment population of at least 300,000.

Source: Royal College of Surgeons of England, Delivering High-quality Surgical Services for the Future, March 2006.

Other leading clinicians decide not to define a sustainable Accident and Emergency department with reference to a hospital’s catchment area, at all – but rightly use the number of actual attendances to define demands on a hospital. The British Association for Emergency Medicine and The College for Emergency Medicine, for example, demand that:

Hospitals with attendances at A&E in excess of 40,000 per year should have, “immediate access to the key supporting specialties to allow an emergency department to function safely. The following should be available on site: intensive care, anaesthetics, acute medicine, general surgery, orthopaedic trauma. There should be rapid easy access to child health (preferable on-site), 24-hour access to imaging (including CT scanning) and laboratory services available on-site”.

Even those hospitals with fewer than 40,000 attendances at A&E per year should continue to retain A&E services, provided that, “they are able to demonstrate their effectiveness, safety and quality”.

Source: British Association for Emergency Medicine and The College for Emergency Medicine, Way Ahead 2005, 2005.

Jan 08 2007

Watford Junction to Cut Inter-City Services

Cllr Bob Blackman AM has slammed the Department for Transport over it short sightedness and stupidity for its proposal to dramatically cut the number of Inter City trains that will be stopping at Watford junction station.

Commenting on the proposals, Cllr Bob Blackman AM, Parliamentary Spokesman for Harrow East said,

“The proposals, would limit day long-long inter city calls at Watford Junction to the Birmingham route only. The remainder of the routes would be served by just a few trains stopping at Watford Junction on Monday to Friday – northbound only in the early morning, and southbound only in the evening.

“According to London Travel Watch, the catchment population for the inter-city services from Watford is around 1million people. Those who want to travel north will be forced to firstly travel in to London and board at Euston. Likewise those wanting to travel south will have to travel past their homes and travel into London before heading back north to get home.

“I would urge all residents in Brent and Harrow, who will be affected by this change, to write to me at Cllr Bob Blackman AM, City Hall, The Queen’s Walk, London, SE1 2AA, highlighting their concerns and frustrations so that I can pass on their letter to the Department for Transport and show them how ridiculous these plans are.

“The downgrading of Watford stations is complete and utter madness.”

Jan 07 2007

Concern at ‘paparazzi’ tax inspectors spying on homes across Harrow

Council tax revaluation taking place by stealth across England warns Bob Blackman 

Councillor Bob Blackman expressed concern at reports of “paparazzi” surveillance being covertly rolled out by the Valuation Office Agency – an arm of Inland Revenue. In a stealth council tax revaluation exercise, every home in the country faces photographs of their home – inside and outside – being stored on a computer database, in order to identify features which could be taxed.

  • Two million homes already snapped by stealth: Covert photogrpahy is already under way by the council tax inspectors, despite the supposed delay in the English council tax revaluation. New figures have revealed that in the last year, the number of photographs of homes stored on the system has soared from half a million to over two million.
  • Estate agents collaborating in privacy raid: The Valuation Office Agency is also using taxpayers’ money to obtain information on the outside and inside of people’s homes – by buying up the data from estate agents, Rightmove. Unsuspecting homeowners are putting their property on the market without realising that the tax inspectors are using it to find out how to hike up council tax bills.
  • Tax spies armed with clipboards and long-distance cameras: The ‘Health & Safety’ manual of the council tax inspectors reveals that they are being armed with telescopic lenses & cameras, clipboards, laser pens and location plans and maps of every home. The inspectors are instructed to record any abusive or hostile behaviour by householders. They have the power to impose £500 fines, via the courts, on any household who refuses entry or obstructs the state snoopers.
  • Scrap these powers says Opposition: Conservatives are pledging that the next Conservative Government will abolish the powers of the inspectors to enter people’s homes and gardens.

Bob Blackman said,

“I am very concerned that the privacy and property of honest, law-abiding citizens is under threat from paparazzi-style council tax inspectors.

“There is already public unease at Labour plans for a compulsory national Identity Card Database and the new Children’s Database. The Government is now rolling out a property photo database to match and conducting a council tax revaluation by stealth across the country.

“Not only are civil liberties under threat, but I fear the photographs taken by these tax inspectors will be used to hike taxes on family homes – by taxing features like conservatories, extensions, gardens and patios. Conservatives are campaigning against these plans to send camera-wielding inspectors into Harrow’s bedrooms, bathrooms and gardens, and we will abolish the snoopers’ powers of entry.”

Notes to Editors

TAX INSPECTORS SNOOPING ON YOUR HOME THROUGH ESTATE AGENTS

The Valuation Office Agency, an arm of HM Revenue & Customs, is using taxpayers’ money to grab information on the outside and inside of people’s homes – by buying up the data from estate agents Rightmove. Unsuspecting homeowners put their property on the market without realising that the tax snoopers will be using it to hike up council tax bills.

“Mr. Pickles: To ask the Secretary of State for Communities and Local Government what property attributes and datasets the Valuation Office Agency’s market comparable reporting tool licensed from Rightmove holds.

Mr. Woolas: “Market Comparable Reporting Tool” is the name given by Rightmove.co.uk plc to its database of properties that were advertised for sale on the Rightmove website. The Valuation Office Agency has access to this information, which for each property was freely available publicly for the period during which it was being marketed.”

Hansard, 23 January 2007, col. 1731W.

“Mr. Pickles: To ask the Secretary of State for Communities and Local Government whether the data provided to the Valuation Office Agency by Rightmove.co.uk includes the provision of photographs of properties.

Mr. Woolas: Rightmove.co.uk plc does not provide data to the Valuation Office Agency (VOA) but makes information accessible to VOA staff through a web link. This information includes photographs of properties, but such photographs are only for viewing and are not copied by the VOA.”

Hansard, 18 January 2007, col. 1327W.

TWO MILLION PHOTOGRAPHS ALREADY HEAD – AND RISING

The Valuation Office Agency is also rolling out a computer database of every property in Britain. In May, the database held half a million photographs. The Government now says that the database holds over two million photographs.

“Mr. Pickles: To ask the Chancellor of the Exchequer how many domestic properties in England have photographs allocated to the address by the Valuation Office Agency as part of their council tax valuation records.

Mr. Woolas: I have been asked to reply. Of the 22 million domestic property records in England, some 2.5 per cent. (549,000) have a photograph or photographs attached.”

Hansard, 15 May 2006, col. 713W.

“Mr. Pickles: To ask the Chancellor of the Exchequer how many photographs are stored on the Valuation Office Agency’s central database.

Dawn Primarolo: There are 25 million records for business and domestic properties there are 2.2 million photographs as at 20 November 2006.”

Hansard, 16 January 2007, col. 1025W.

There is no limit to number of photographs that the database can hold.

“Mr. Pickles: To ask the Secretary of State for Communities and Local Government what the technical limit is of the number of photographs that the Valuation Office Agency’s digital photography application can hold.

Mr. Woolas: There is no technical limit on the number of photographs that can be held by the Valuation Office Agency’s digital photography application.”

Hansard, 19 June 2006, col, 601W.

TELESCOPIC CAMERAS NOW PART OF THE INSPECTORS TOOLS

Conservatives have obtained the health & safety manual used by the council tax inspectors – which shows how all the council tax inspectors are equipped with cameras and laser pens:

A manual highlights the recommended equipment that council tax inspectors should use – including three different types of tape measure, the latest laser measuring equipment, and telescopic viewers “for long range measurements.”

(VOA, Practical Health & Safety: Surveying Equipment, 2005).

The full list what they are told to have for their inspections is as follows:

To successfully undertake inspections for Council Tax purposes, you will need the following equipment:

  • 20m tape and/or Laser measuring device
  • Clipboard, pens & pencils, eraser
  • Supply of dwelling survey sheets VO 9072
  • Personal Alarm
  • Location plans/street maps
  • Identity Documents
  • Camera

– You should be issued with your own personal 20m tape. The availability of laser measuring devices in offices may be limited therefore you may have to book one out for your inspections. Check your local office practice. If you do take a laser tape, make sure it is in working order before leaving the office and that the batteries are not flat.

– All staff on outdoor duties are issued with a personal alarm. If you do not have one, ask your line manager. Check it is in working order before leaving the office.

– You must carry your Identity card (VO 9053) and Authority to inspect (VO 9056) with you at all times. Make sure your authority is up to date and signed by the relevant Listing Officer.

– As with laser measuring devices, the availability of cameras in offices may be limited so you should your local office booking procedure if you are not issued with an individual one.

– Of course you will be provided with a briefcase to carry this equipment…

Avoid contentious discussions e.g. the rights or wrongs of the Council Tax system. Do not offer any advice regarding payment of Council Tax…

“You must adopt a methodical, systematic approach to inspecting dwellings to ensure you obtain all the necessary information in the most efficient way. Always start your inspection by taking a quick look around the outside of the property (or around all the rooms in a flat) to get a feel for what you’re dealing with. You should then draw your sketch plan on the survey sheet, decide on the required measurements, take your measurements working from front to back and record on the sketch plan, complete the dwelling codes, complete the remainder of the dwelling survey sheet and finally take a photo”.

Valuation Office Agency, Practical Health & Safety: Council Tax Referencing Best Practice.

The council tax inspectors should also involve noting whether the householder is potentially abusive or violent when conducting the internal inspection.

“There needs to be a more consistent approach to incident reporting, by raising awareness amongst staff that reporting is viewed as important by management. There should be a policy of learning from incidents. For example, all incidents involving violence must be investigated, and a robust stance taken with those abusing, threatening or assaulting referencers and valuers viz. always report to police for legal action… Improve records on client files of all appropriate incidents including potentially violent information” (VOA, Practical Health & Safety: BMI Recommendations, pp. 3, 8).

The Valuation Office Agency has spent almost half a million pounds (£438,749) on purchasing 2,126 digital cameras, for these tax inspections and surveys.

Hansard, 30 November 2005, col. 587W.

£500 FINES FOR OBSTRUCTING THE SNOOPERS

If any householder tries to obstruct the council tax inspector from entering their home, they can be fined £500 and have a local police record.

“Mrs. Spelman: To ask the Secretary of State for the Home Department whether an individual prosecuted in the magistrates court for intentionally delaying or obstructing a Valuation Office Agency representative conducting a council tax valuation inspection would receive a criminal record if convicted.

Hazel Blears: A person who intentionally obstructs a valuation officer commits an offence and may be liable on summary conviction to a fine not exceeding level two (£500) on the standard scale. This is not a recordable offence and will not be recorded nationally on the police national computer, but will be recorded on local police and court records.”

Hansard, 6 December 2005, col. 1106W.

Released by: Bob Blackman

Date: 26th March 2007

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