No, Brexit Is Not A Distraction From NHS Or Housing Crises

According to John Rentoul, writing in The Independent at the weekend: “Brexit is distracting the centre of Government – No 10, the Cabinet Office and the Treasury – from attending to the pressing problems facing the country.” You can see his point. The demands exerted by negotiating a Brexit deal in Brussels that neither party wants, while fending off a Remainer-dominated parliament in London, is hardly conducive to solving big and worsening domestic problems.

He is rightly sceptical about the government’s ambitions to build the millions of houses the country needs; and who isn’t outraged that 22,800 elective operations were cancelled in England as a consequence of ‘winter pressures’? But neither is the fault of Brexit. They are just the latest instalments in a long line of policy failures that existed long before that delicious jolt to the system intruded on the banal politics that existed before 23 June 2016. Does he really think that government would have got its trowel out by now and built the 250,000 homes a year it has been promising? Or that it would have got its act together and solved the social care crisis, and in turn solved one of the underlying causes of the NHS crisis?

No, Rentoul is wrong. Brexit isn’t a distraction from more pressing matters. However big the crises of housebuilding and in the NHS – and they are as considerable as they are longstanding – Brexit, and the crisis of democracy we face if it is not implemented will be that much bigger. But if we get it right – and it is a mighty big ‘if’ given the concessions already made by the UK negotiators – and those who seek to undermine it fail in their attempts to sabotage the popular will, Brexit has the potential to genuinely transform the agenda across public policy.

Even if it is thwarted as sovereignty and independence are sacrificed in the name of maintaining a relationship with the supranational body we are supposedly trying to leave, the popular sentiment behind Brexit can’t so easily be put back in its box. Whatever happens over the coming weeks and months, it has the potential to be the catalyst for replacing the managerial target-setting that has plagued public services for decades with a culture of political contestation over competing visions of our collective future. Policy-makers, once deprived of the shelter provided to members of the EU from their respective citizenry, will become more exposed – as they should – to the pressure to act that comes from the questioning and debate generated by the public’s critical engagement with those who govern in their name.

None of this is automatic of course. The disengagement of the masses from politics in the UK has been a decades long process with its roots in the failure of past political projects of left and right. Also, the technocracy, restraint and risk-aversion that played a part in voters rejection of the elites at home and abroad and their reawakening as political subjects, continues to dominate public life. And it continues to stifle progress in building lots more houses and ensuring fewer beds are blocked, as surely as it inhibits those negotiating our exit from the EU or failing to plan for our post-Brexit future. The stasis that was with us before the summer of 2016 is still there if less seemingly immovable. It is only by truly involving the people in the policy process – an old mantra amongst policy wonks curiously absent of recent – that we can finally shift it.

First published in Huffington Post

How to end homelessness

Until recently, homelessness would only come to public attention in the run-up to Christmas. But things are changing. Homelessness is now being openly discussed by politicians ‘after years in the policy wilderness’, says Patrick Butler at the Guardian. Politicians ‘seem almost to be trying to outdo each other’ with their schemes to tackle it, he says.

The Conservative government has pledged to halve rough sleeping by the end of this parliament, and to eliminate it by 2027. The Homelessness Reduction Act comes into force in April. It will impose new duties on local authorities – including to prevent and relieve homelessness for all ‘eligible applicants’, not just those deemed to be in priority need or ‘unintentionally homeless’. Housing First pilots have been announced to provide accommodation and wraparound support for the long-term homeless.

And yet the Rough Sleeping and Homelessness Reduction Taskforce, unveiled as part of last year’s autumn budget, has yet to meet. And some local authorities still stand accused of treating the homeless with contempt. Windsor council’s determination to clear the streets of homeless people before Prince Harry and Meghan Markle’s wedding in May caused controversy. The rise of ‘hostile architecture’ – with anti-homeless sprinklers, strategically placed bike racks and metal bars on park benches all making life even more uncomfortable for rough sleepers – has also, rightly, been met with hostility.

Then there was the recent death of a Portuguese man, a former model who had hit hard times and who was struggling with alcohol and mental-health problems. He had overstayed at one hostel and was awaiting admittance to another, but then he died while sleeping in the freezing cold outside Westminster Tube station – virtually on parliament’s doorstep. MPs took to social media. Labour leader Jeremy Corbyn tweeted that the ‘powerful can’t carry on walking by on the other side’; it is time we ‘took up the moral challenge and properly housed everyone’, he said.

Westminster is Britain’s main hotspot for rough sleeping (217 were counted on one night last autumn). The official figures suggest street homelessness has doubled since 2010; 4,751 people were sleeping rough in England in 2017. But this is widely understood to be an underestimate, relying as it does on local-authority counts and, more often, estimates. Nor does it include similar rises in the numbers of people living in temporary accommodation, or, more controversially, the ‘hidden homeless’. A recent ComRes survey found that 41 per cent of 16- to 25-year-olds admit to ‘sofa surfing’.

The failure to build enough housing, or enough affordable housing, is often cited as a major contributor to the problem of homelessness. In January, Corbyn announced that a Labour government would immediately, upon being elected, buy every homeless person in the UK a house, even if that meant seizing properties left empty by developers. And yet, for all its grandstanding, the political class has consistently undershot the building of the 250,000 new homes a year – at least – that Britain needs.

House-building in the UK peaked at 183,600 in 2007. It reached a low of 75,350 in 2009 and is now averaging around 150,000 a year. This has lead to a backlog of unmet needs, unfit housing stock, and ever-rising prices and rents – key contributors to today’s unprecedented levels of homelessness. The new legislation will help, but it is only by building the government’s target of 300,000 houses a year now, and not, as planned, by the mid-2020s, that we can begin to ensure that nobody need fear losing their home.

Many argue that it is central government’s programme of austerity, including cuts to local services and to benefits, especially for 16- to 18-year-olds, who are no longer eligible for housing benefit, that has created the current problem. There is certainly a need to address the problems associated with changes to the welfare system, albeit without further fostering a culture of extended adolescence among the young. But blaming the Tories is too easy. The crisis of affordability, of rising housing costs and stagnating incomes, is a longstanding one. It is this that motors the evictions that are the leading cause of homelessness. To solve this problem, we need less grandstanding and more serious investment in infrastructure.

First published in spiked

Accommodating to Homelessness

As a society we have accommodated to homelessness. The homeless appear in the national consciousness once a year at Xmas. We associate the problem with cardboard boxes and the acts of kindly strangers, rather than seeing it as something that might be solved by better social policy. Not that I want to knock charitable feeling on the part of the public. Gloucester City Council has been running a much criticised poster campaign that urges people not to give rough sleepers any money because many of them are not really homeless. I don’t know about you but nothing makes me want to buy a rough sleeper a can of Special Brew more than being told not to by officialdom.

Frequently Asked Questions by Anthony Luvera and Gerald Mclaverty

There was outrage this month when Council Leader Simon Dudley asked the police to clear Windsor – prior to the eagerly anticipated Royal Wedding – of ‘an epidemic of rough sleeping and vagrancy’ to ‘protect residents and tourists’. He suggested they use 19th Century vagrancy law and its latter day equivalent the ASBO (Anti-Social Behaviour Order) to do the job. Russell Brand launched an online petition to ‘Show love to Harry and Meghan AND help the homeless’ by setting up a shelter in neighbouring Slough. It quickly attracted thousands of signatures, and Cllr Dudley is now facing a vote of no confidence.

But there is nothing unusual about the authorities harassing of the street homeless. Under pressure from campaign groups like the excellent Manifesto Club, local authorities and others using powers such as ASBOs (Anti Social Behaviour Orders) and PSPOs (Public Space Protection Orders) have now been told by the Home Office that they must not ‘target specific groups or the most vulnerable in our communities’. I’m of the view that the homeless should be a public nuisance, that’s how we know we’ve got a problem.

But what is the problem? There is a rarely acknowledged conflation of homelessnesses. It tends to be exaggerated by campaigners to include ‘sofa surfing’ young people and the ‘hidden homeless’ living, albeit not ideally, in overcrowded homes. Equally it is underestimated by government – so that the official homeless count includes only families who are granted public housing after being assessed to be ‘unintentionally homeless’ by local authorities. When Theresa May, not unreasonably, made this distinctions there was outrage.

Frequently Asked Questions by Anthony Luvera and Gerald Mclaverty

Responding to Rosena Allin-Khan, Labour MP for Tooting, who claimed 2,500 children in her constitutency would ‘wake up homeless on Christmas day’, the prime minster rightly pointed out that this doesn’t mean that the streets of that South London district would be filled with homeless children. The constant reference to homeless children (Shelter claims a class-worth of children in every London school is homeless) is also cynically emotive. We need to deal in facts. These children are part of homeless households, not fending for themselves.

We need clarity if we are to find the solutions we need to end, or at least reduce, homelessness. But the figures, particularly for rough sleeping, are notoriously dodgy. According to Shelter about 9,000 people in England are sleeping rough on the streets, and another 9,000 on buses and in tents and cars. 78,000 households are living in temporary accommodation and there are around 300,000 homeless people across Britain. But if you look at the figures produced by local authorities (via headcounts and estimates), there were 4,134 people living on the streets in 2016, i.e. less than half the Shelter figure though still double that recorded in 2010. But whatever the correct figures are, behind the homelessness problem is longstanding multiple policy failure. From housing and welfare policy to mental health services things are going badly wrong and have been for some considerable time.

It is estimated that we need to build at least 250,000 homes a year (in the post-war period we were averaging 300,000). And yet we undershoot this by some margin year-on-year – house building in the UK peaked at 183,600 in 2007, reached a low of 75,350 in 2009 and is now averaging around 150,000 i.e. half of what the country needs. This is leading to a backlog of unmet demand, unfit housing stock and ever rising prices and rents. We don’t need to build affordable housing. We need to build so much housing that it becomes affordable.

But homelessness is not just a bricks and mortar problem. Mental health patients can find themselves homeless if they are discharged without the support they need. The number of homeless households categorised as a priority because of mental illness has gone up from 3,200 in 2010 to 5,470 in 2017. Homeless Link claims that 44% of homeless people have a diagnosed mental health problem. But, and this should cause us to doubt the robustness of mental health figures too, it also claims that 23% – nearly a quarter! – of the general population also have a mental health problem. So we have exaggeration here too.

A Soldier’s Story by David Tovey

According to Shelter eviction is the biggest single cause of homelessness at the moment. Welfare reform, the withdrawal of housing support, benefits freezes and benefits cuts are all widely understood to be having a considerable impact on people’s ability to afford to pay their rent. But it is also estimated that 70,000 young people (18-24 year olds) across Britain have claimed to be homeless in the past year. They are part of the ‘hidden homelessness’ problem, it is argued, made worse by their no longer being eligible for housing benefit. Here I have a problem: both with the suggestion that so many young people really have nowhere to go, and with the idea that the state should step in.

There has been a stark failure to build the housing we need. That must be tackled with some urgency until we are building well in excess of a quarter of a million homes a year. We also need to ensure that care and support is targeted at those who most need it; and that our sprawling, complex and clunky welfare system is up to the job of helping people when they need it without nannying young people into an extended state of adolescence.

If we are to address the problems that underlie the recent rises in homelessness, we need to be able to have frank debates about the welfare system and attitudes to the young, while recognising the complexity of the problem and the multitude of individual circumstances that can lead to the experience of homelessness, and without this becoming an excuse for inaction or a lack of ambition. Trying to address the growing issue of homelessness is difficult but it needn’t be intractable.

This is the text of my contribution to Rough Justice: A Public Discussion organised by Liverpool Salon with the Museum of Homelessness, at Tate Liverpool on 23 January as part of State of the Nation: Exchanges on Homelessness.

Why fearmongering about child abuse helps no one

The NSPCC has claimed that child sexual abuse referrals have risen by nearly a third over a year.

In 2016-2017, the charity made an average of 90 referrals a week to the police and social services, as a consequence of 4,677 calls made by members of the public to the charity’s phone service, Childline. This was up from 3,578 the previous year.

The NSPCC’s dramatic announcement came after the Local Government Association (LGA) reported that around 500 child-protection inquiries have been started every day across England and Wales in recent years. In 2016 there were 172,290 inquiries, rising to 185,450 in 2017. The LGA warned of a ‘tipping point’, as local authorities struggle to cope with increasing demand while funding is cut. As a result of all of this, the National Police Chief’s Council (NPCC) has also complained of a ‘strain upon officers’.

However, when we look at actual intervention, the picture is somewhat different. The number of children subject to intervention by the authorities through a Child Protection Plan (CPP) has also been rising. Official figures from local authorities, provided by the NSPCC, show that CPPs have risen from 42,850 in 2012 to 50,310 in 2016. But, crucially, only five per cent of cases in 2012 related to instances of sexual abuse, falling to 4.8 per cent of cases in 2016. Neglect and emotional abuse were by far the most common categories of abuse dealt with by CPPs.

This disparity, between the large increase in referrals made by the NSPCC and a modest increase in suspected sexual abuse, is striking. Despite the increasing volume of referrals made by the NSPCC, there is no evidence to suggest that a third more children are being sexually abused. What’s more, the NSPCC also states that much of the abuse it deals with happens online. Of course, online child sexual abuse is serious and should be dealt with – but it is not the same as physical sexual abuse.

Nevertheless, the upward trend in NSPCC referrals is still taken as evidence that we’re in the midst of an epidemic of child abuse. The damage done to families who are unfairly treated with suspicion is regarded as a price worth paying in the pursuit of protecting children. But this relentless obsession with child sexual abuse is having a corrosive effect on families and communities. Instead of protecting children, the NSPCC is fuelling a moral panic which will divert resources away from tackling the rare, but serious, cases of child abuse that do occur.

First published in spiked

Another Christmas of crisis for the NHS

‘Tis the season for NHS tales of woe, featuring ‘bed blockers’, diverted ambulances and long waits on trolleys in hospital corridors. That the NHS is in crisis again as winter takes hold is as inevitable as Christmas itself.

This time around the cause of the Christmas non-cheer around the NHS was triggered by the stepping down of Lord Kerslake, from his chairmanship of King’s College Hospital Trust, following a decision by NHS Improvement to put the trust into financial special measures. While the government cynically sought to blame the trust’s problems on Kerslake and his team, he argued in the Guardian that ‘fundamentally, our problems lie in the way the NHS is funded and organised’. Massive overspends, recruitment crises and crippling pressures on services are indeed commonplace across the NHS.

‘The government and its regulator’, he says, ‘are simply not facing up to the enormous challenges that the NHS is currently facing’. And this isn’t just about funding. Despite an extra £2.8 billion promised in the Budget for struggling health trusts (short of the £4 billion a year demanded by NHS chief executive, Simon Stevens), and the £350million announced in the Budget to address winter pressures (coincidentally the same amount that was plastered on the side of that Brexit bus), the problems in the NHS persist. They will not be fixed, it seems, by simply throwing more money at them.

From primary care to home care, young people’s mental health to dementia care, the system is in meltdown. The number of patients waiting in A&E for more than four hours has more than doubled in as many years. The number of ‘long-stay patients’ in hospitals has also increased, largely as a result of an absence of care provision in the community for those who are fit enough to go home. And with bed occupancy levels now approaching 95 per cent, the likelihood of yet another Christmas log-jam in NHS hospitals is increasing.

Crisis preventative measures, such as encouraging people to have the flu jab and to consult their pharmacist rather than their GP if they have a minor ailment, are reportedly having an impact. And yet the overall demand on services is still intensifying as the resources at the NHS’s disposal become more scarce. You know things are bad when an article in the British Medical Journal could — only half tongue-in-cheek — blame the ‘highly dedicated and responsive GP, Dr Brown Bear’ in the kids’ cartoon Peppa Pig for ‘fostering unrealistic expectations about family doctors’.

We need to go beyond the usual to-and-fro of NHS cheerleading on the one hand, about how much Brits ‘heart’ it, and NHS doom-mongering on the other hand, where the spectre of its imminent privatisation is constantly being raised. People like Stephen Hawking aren’t helping when they lend their name to a legal dispute against the establishment of accountable care organisations (ACOs), which they say herald the beginning of the end for ‘our NHS’, when in truth they are just institutional arrangements designed to integrate ‘silo’ services across the health and care system.

But Hawking is right that we need ‘proper public and parliamentary scrutiny, consultations and debate’ in relation to the NHS. As is Kerslake when he says: ‘We desperately need a fundamental rethink. Until then we are simply kicking the can down the road.’ Instead of obsessing over paper targets, or targeting peoples’ lifestyles and behaviour through the health system, the political class needs to engage the nation in a debate about the future of the NHS. Whether that ends in radical reform or starting all over again is open to question — but we know for sure we cannot continue with the crisis-ridden and cash-strapped status quo.

First published in sp!ked