5 February 2018
During the winter months, the focus on the NHS is always more acute with more people admitted to hospital increasing pressure on beds. It gives the Labour Party the opportunity, every year that there is a Conservative government, to claim we are not investing enough in health and social care. Accusations that the Conservative Party is starving health and social care of much needed resources are the narrative. This is despite the fact that spending on the NHS has increased every year since it was founded; whether the country is in boom or bust; and the Government is allowing unitary and county councils to increase Council Tax by an extra two per cent to pay for social care.
Against this backdrop, Conservative-controlled district councils are quietly finding solutions to these problems themselves. Some are using their functions (housing, planning, environmental health, leisure, economic development, community safety, etc) more holistically to create circumstances that are more conducive to wellbeing, thus helping to prevent ill health.
Using these functions, districts and unitary authorities are creating age-friendly or dementia-friendly towns and villages, for example, that enable people to live independently at home for longer. Training front-line council staff as dementia friends, setting up dementia cafes and businesses, all enable people living with dementia to live more fulfilled lives and takes worry and anxiety away from their families.
Others are also specialising in social prescribing: non-medical solutions to medical problems; such as exercise and diet classes for people who are overweight, or debt advice for people suffering from anxiety. People make appointments to visit their GP at a cost to the taxpayer of £45 per visit for a whole range of issues where the causes are not medical even if the symptoms are. Social prescribing tackles the root cause of the problem which could be anything from loneliness, asthma caused by damp housing, to mental ill health caused by overcrowding or debt.
Loneliness is a particularly toxic problem that can manifest itself in a range of mental and physical ailments. It is estimated to cost the NHS £10bn per year. Some lonely people visit their GP more than once a day every day and spend hours talking to the receptionist. This chews up GP time and prevents more urgent appointments. Social prescribing can help find groups or voluntary work for lonely people to join, in a way that values their skills, as no-one wants to admit to being lonely.
Some district councils use public health or other funding to pay for advisors to work in GP surgeries or other settings tackling the non-medical causes of peoples’ problems and it is working – freeing up the NHS to do what it does best – making sick people better.
Nearly half of all falls occur in the home, so home adaptations to help prevent falls are vital in not only saving money but saving lives. Older people lose five per cent of their body mass every night they stay in hospital so preventing hospital admissions and speeding up discharge times are essential if they are to live fulfilled, independent lives again. Some districts have taken their home adaptations to hospitals and adapt peoples’ homes while they are being treated so they can be discharged as soon as they are clinically ready. A purpose built home for an older person, or an adapted home in an age-friendly town or village is an ideal place for an older person to live independently.
In Victorian England it was local government that tackled the causes of cholera and eradicated it for good by pressurising the water companies to clean up the water; clearing the slums and building better quality housing; and building parks, swimming baths and theatres to help with overall wellbeing.
Today we face a different health crisis, but like the cholera epidemic not all the causes are medical and the NHS is ill-equipped to solve it. Local government has the tools to do it; it has done it before; and Conservative-controlled district councils are leading the way in doing it again.
