PRIVATIZING HEALTHCARE
UK Private brokers earn millions finding care homes for NHS patients
Shanti Das
Sun, 15 January 2023
Photograph: Westend61/Getty Images
Private brokers are making millions of pounds a year finding care home beds for NHS patients who are fit to leave hospital.
Agencies are being hired to provide “discharge services”, finding suitable places for elderly patients amid pressures on the health system, Observer analysis shows.
Carehome Selection Ltd, the UK’s biggest social care brokerage, has expanded in the past five years and now claims partnerships with 150 NHS organisations and local authorities, with revenues of £20m, up about 75% compared with 2018.
In 2021, the most senior director of its parent company was paid £609,000, up from £138,000 in 2020, according to its latest accounts.
The agency is one of the biggest beneficiaries in a group of firms providing brokerage services, predominantly helping councils seeking places for patients stuck in hospitals.
A chronic lack of social care capacity means up to one in three hospital beds in England are occupied by patients who are ready to leave, with the backlog contributing to record ambulance and treatment delays.
Care home brokerages help identify suitable care home places so that medically fit patients can be discharged, freeing up capacity in overstretched wards. But such arrangements are usually made by the NHS and councils dealing directly with each other and local social care providers.
Daisy Cooper MP, health spokesperson for the Liberal Democrats, said the reliance on agencies was “a scandalous situation”. “The government’s failure to plan has left local authorities with no choice but to turn to private brokers for even the most basic of functions,” she said.
Carehome Selection says its services save money and speed up discharges. “Our service model includes evening and weekend working, so no time is lost,” its website says. The company says it has “close relationships” with care providers, which pay a fee when a service user is referred. Patients and their families do not pay.
Last week, the firm signed a three-month, £223,000 contract with Leeds city council to provide “brokerage services to find step down beds so people can leave hospital into care homes”. In July, it began a £243,000 contract with Bournemouth, Christchurch and Poole council to provide a “brokerage service for self funders” until March 2023.
In County Durham, the company is being paid to assess patients and help match them with suitable care home places. That contract, signed in April, is worth up to £1.95m over five years.
Carehome Selection was founded by a GP in 1995 and started working with the NHS 20 years ago. It has scaled up operations since receiving a £10m cash injection from investment firm BGF in 2018 and subsequently saw its revenue grow by 75% to more than £20m, delivering a “strong return” for investors.
In 2021, the company was acquired by private equity-backed Acacium, which also runs agencies supplying staff to the NHS and says it is “the UK’s largest healthcare solutions partner”. During the pandemic, Acacium – part of the Onex Corporation, owned by Canadian billionaire Gerald Schwartz – was criticised for charging up to £170 an hour for nurses, four times the approved framework rate.
The firm said at the time that “far from inflating fees” during the pandemic, it had “increased the availability of discounted rates, waived cancellation fees and capped travel costs to customers”.
Another NHS supplier offering discharge services said on its website that it helps “return patients to their homes safely, avoiding unnecessary delays”. Its service is for “hospitals who are experiencing a large number of delayed transfers” and councils facing delays “due to capacity issues”.
NHS trusts and local authorities are also paying agencies to assess patients’ care needs, analysis shows, including those waiting to be discharged from hospital or entitled to funding due to complex long-term health problems.
In one case, Leeds city council is outsourcing patient assessments to help it “clear the backlog of referrals to hospital social work teams”. The contract will see a consultancy firm assess 100 patients and is worth £40,000.
A spokesperson for the council said it was experiencing a significant shortage of social workers, which had affected hospital discharge teams. “In order to continue to support timely discharges, the council has secured agency staff on a temporary basis and is also trialling a brokerage service which supports the admission of people into residential care,” he said.
The council said its initiatives were being funded using an allocation from a £500m government fund announced in September to support hospital discharges. Local health and care organisations were told they could use the funding “flexibly” to tackle “the areas facing the greatest challenges”.
Related: Hospitals in England discharging patients into ‘care hotels’
Rory Deighton, director of the acute network at the NHS Confederation, said using private providers to help coordinate hospital discharges may not be appropriate in every case but could offer value for money and reduce backlogs.
A spokesperson for Carehome Selection said it “commits to and is paid based upon performance-based outcomes centred on accelerating speed of hospital discharge”. They added that clients using the service had reduced the average time to discharge medically fit patients from 10 to three days.
The Department of Health and Social Care said: “The purpose of the £500m discharge fund is to reduce the number of bed days lost to delayed discharge. It is for NHS trusts and local authorities to decide whether to access support from the private sector in improving flow through the health and social care system.”
Netanyahu is Israel’s own worst enemy. Why won’t western allies confront him?
Simon TisdallTHE GUARDIAN
Sun, 15 January 2023
Photograph: Ronen Zvulun/Reuters
Samir Aslan did what any father would do. When Israeli soldiers broke into his home at Qalandiya refugee camp last week to arrest his son, he rushed to protect him. The 41-year-old Palestinian was shot and killed. His death received scant notice, so frequent are such incidents. A reported 224 Palestinians were killed last year in the occupied West Bank, which suffered almost daily army raids. 2023 is shaping up to be even worse.
The main reason is a new ultranationalist, hard-right religious coalition government in Jerusalem that includes racist, anti-Arab ministers determined to annex all the Palestinian territories. Yet the response to this alarming, destabilising development from Israel’s western allies has been strangely muted. A few have issued veiled warnings. None has imposed the sort of sanctions or boycotts levelled in the past on political extremists in other countries.
The coalition’s objectionable plans raise a broader, uncomfortable question for the US and Europe reaching beyond the too-familiar abuses and impunity of military occupation. In short, can Israel still be considered a reliable, law-abiding ally that shares a set of common values and standards with the western democracies? Maybe this is why governments are keeping stumm.
In critical respects, Israel under prime minister Benjamin Netanyahu’s self-perpetuating leadership is a liability. It obstructs a two-state solution to the Palestinian conflict and scorns the UN and international law. It refuses to back sanctions on Russia over Ukraine. It rubbishes the 2015 Iran nuclear deal while threatening war. It sells spyware and arms to authoritarian regimes that abuse human rights.
Worse still, perhaps, Netanyahu’s band of bigots is actively undermining Israel’s democratic institutions and civil rights, such as peaceful protest and LGBTQ rights. Many Israelis, both Jews and Arabs, passionately oppose the government. Senior politicians warn of “civil war”. Diplomats and generals are mutinying. But reckless, opportunistic Netanyahu doesn’t care.
Conventional imperatives for treating Israel differently from other countries read like this: Israel is the Middle East’s only genuine democracy – it must be supported. It is surrounded by hostile regimes seeking its destruction – it must be defended. Remembering the Holocaust, Europe and America owe the Jewish people an eternal debt – it must be honoured.
This ingrained thinking informs but does not excuse reluctance to confront the far-right zealots. Finance minister Bezalel Smotrich, leader of the Religious Zionist party, who advocates annexation of the entire occupied West Bank, is now in charge of settlement construction. One of his first acts was to seize $40m in Palestinian Authority funds.
Itamar Ben-Gvir, co-leader of the Jewish Power party who was previously convicted for inciting racism, is the new national security minister. He began by ordering a police crackdown on Israeli anti-government protests, banning Palestinian flags, and paying a deliberately provocative visit to Jerusalem’s most sensitive holy site.
Netanyahu’s coalition is moving quickly to tame the judiciary – the very same justice system that is prosecuting him for alleged corruption. Meanwhile, criticism grows risky. Zvika Fogel of Jewish Power last week accused opposition leaders Yair Lapid and Benny Gantz of “treason against the homeland”. Little wonder President Isaac Herzog felt the need to call for calm.
US president Joe Biden, a stalwart Israel ally, views upholding democratic values as the defining global struggle of the age. Netanyahu’s close association with democracy-destroying Donald Trump, enthusiastic endorsement of Brazil’s “wonderful” coup plotter, Jair Bolsonaro, and matey dealings with Russia’s Vladimir Putin and Hungary’s Viktor Orbán must have Biden puzzling whose side the six-term prime minister is really on. Progressive American Jewish leaders have similar concerns.
A shamefully supine approach is also being pursued by EU countries – and Britain.
Biden is sending secretary of state Antony Blinken to Jerusalem to investigate what’s going on, while Netanyahu is due in Washington next month. That will be interesting. Yet so far, the US has eschewed overt criticism. A shamefully supine approach is also being pursued by EU countries – and Britain. Visiting Israel last week, a Foreign Office minister, Lord Ahmad, blithely declared bilateral ties had attained “new heights”.
The idea that Israel is besieged by hostile regimes was true once, but no longer. It has proved many times it can look after itself. The so-called Abraham Accords with the UAE, Bahrain and Morocco reinforced an established trend towards coexistence, if not friendship, with the Arab world. Netanyahu hopes the Saudis will sign up next. Hateful anti-Israel ogres of yore – in Egypt, Iraq, Syria, Sudan and Libya – have all been vanquished, one way or another.
The big exception is Iran, which remains fiercely antagonistic. Sooner or later, Netanyahu will again threaten to attack Tehran’s nuclear facilities. War with Iran would inevitably draw in Europe and the US. Much though they abhor the regime, that remains contrary to their interests. They have successfully restrained Netanyahu – until now.
Likewise, an intifada-like explosion in the West Bank triggered by ministers’ attempts to regularise illegal settlements or collapse the Palestinian Authority, would be viewed as an avoidable disaster by the west. Yet there are signs an explosion is coming, evidenced by the recent violence and the rise of local Palestinian armed groups linked to Islamic Jihad in Gaza.
Related: Abbas allies fear new Israeli government intends to destroy Palestinian Authority
By endangering western public support for the state of Israel, undermining its democracy and confounding its alliances, Netanyahu and his hate-mongering cronies show themselves to be their country’s own worst enemies. While they divide and rule, the gulf with the west widens – and Israel weakens.
How ironic, after all the “blood and tears” shed since 1948 – to quote a former, courageous peace-making prime minister, Yitzhak Rabin, speaking in 1993 – if the final, fatal blow were to be struck from within. Rabin, remember, was subsequently murdered. His killer? A fanatical rightwing Jewish ultranationalist.
SCOTLAND
Charities hail domestic abuse campaign for shift from victim to perpetrator focus
Kerra Mowat
Sat, 14 January 2023
‘Is That Me?’, the latest campaign on abuse from the force, is aimed at men aged 18 to 25. (Image: Police Scotland)
CHARITIES have praised a police campaign tackling domestic abuse for its focus on the perpetrators – after previous efforts were criticised for “victim-blaming”.
Police Scotland launched the “Is That Me?” campaign just prior to the New Year, looking to tackle domestic abuse before it starts by encouraging young men to recognise red-flag behaviours.
The campaign urges people to reflect on their actions and seek help if they identify coercive control and worrying patterns that could escalate into abuse within their relationship.
The behaviours highlighted in the campaign video include stopping your partner from seeing their friends or family, restricting their freedom and insisting on monitoring their communications or whereabouts.
The primary message of the campaign, which appears at the end of the video, states: “At the start of a relationship, you don’t always see the man you might become. Attitudes and behaviour can turn a promising relationship into an abusive one.”
Police Scotland has come under fire in the past for a “victim-blaming” narrative behind its personal safety advice.
In 2021, a tweet posted to the Forth Valley Police Division account sparked backlash for instructing nightclub attendees to never leave their glass unattended and not to take drugs, to prevent their drink being spiked.
The tweet, which has since been deleted, was published in October, during a dramatic increase in the number of spiking cases being reported across Glasgow, Edinburgh, Stirling and Dundee.
She said: “This advert by Police Scotland is to be welcomed. Whilst women have to be aware of male controlling behaviour, this advert has put the responsibility for it firmly at the door of men.
“For too long, women have had to endure not only the problems of controlling behaviours of men, but have had to try and resolve it on their own. It’s time men joined in to tackle this destructive behaviour.
“If men view the advert and identify themselves in it or indeed identify other men who behave in this way, then hopefully they will do something to change.”
Caroline Bernard, head of influence at domestic violence charity Respect, echoed the importance of highlighting the perpetrators.
She said: “We’re pleased to see Police Scotland continuing the work to tackle misogyny and domestic abuse.
“By directly addressing perpetrators in this campaign, they are encouraging self-reflection and accountability without instilling shame or judgement, a strong approach to getting perpetrators to seek support to start to change their behaviour.
“We know that prevention and early responses to domestic abuse are vital in stopping that abuse from escalating.”
Every year, Police Scotland responds to more than 60,000 domestic incidents, more than 80% of which involve a male perpetrator and a female victim.
Despite this huge number, the Scottish Crime and Justice Survey estimates that less than one in five domestic abuse cases are reported to the police.
Between 2021-2022, there were 118 incidents of domestic abuse recorded per 10,000 population.
Dundee City (172), West Dunbartonshire (161) and Glasgow City (147) had the highest incident rates per 10,000 population.
Detective Superintendent Gillian Faulds, spokesperson for domestic abuse for Police Scotland, said: “We’re hoping that this campaign will influence young men and their behaviours at a very early stage, and ultimately stop them from becoming domestic abusers in the first place.
“We realise that the domestic abuse can be gradual and it’s not always obvious in a victim’s relationship that they are a victim at an early stage, but what we will say is that there’s only one person responsible for the abuse and that’s the abuser themselves.”
The campaign comes after the Scottish Government released research results regarding the revolutionary Domestic Abuse (Scotland) Act 2018.
The legislation, which came into force in April in 2019, expanded the definition of domestic abuse in Scottish criminal law. Offences now encompass coercive control, and emotional and psychological abuse, as well as physical and sexual abuse.
On Tuesday, a report was released concluding that the legislation “better reflects victims experiences”.
The report includes research conducted by Glasgow Caledonian University, the University of Edinburgh and the Scottish Government, revealing that the majority of women surveyed felt that engaging with the criminal justice system in reference to domestic abuse was “the right decision” for them.
The report showed that between April 2019 and March 2021, out of 672 domestic abuse proceedings, 595 (89%) resulted in convictions.
Justice Secretary Keith Brown said: “I am absolutely resolute that we must treat all domestic abuse victims appropriately and with compassion – the vast majority of whom are women.
“We are already making significant improvements and its very encouraging that this report found our new laws have better reflected victims’ experiences.”
In February 2022, the Scottish Government published the Vision for Justice, since which increasing progress has been made including £48 million in victim support funds, £53m in justice recovery funds, and the funding of the Caledonian System, a behaviour programme for men convicted of domestic abuse offences.
In 2023, the Scottish Government also intends to introduce a Criminal Justice Reform Bill, abolishing the “not proven” verdict, and a bringing in a statutory right to anonymity for victims of sexual offences.
NIMBYSolar farm planned near prized landscapes meets fierce oppositionStuart MintingSat, 14 January 2023 
A plan to power almost a third of the households in North Yorkshire’s expansive Hambleton district with clean renewable energy by creating a solar farm has met with a wall of opposition.
While Lightrock Power and Econergy say their proposal to generate 45,000 MWh of electricity per year at Woolpots Solar Farm, near the ancient village of Husthwaite, could power 10,146 homes in Hambleton, the site is in the shadow of the North York Moors National Park, the Howardian Hills Area Of Outstanding Natural Beauty as well as ancient village conservation areas.
As a consequence, the plan being considered by Hambleton District Council on Thursday has seen organisations ranging from Historic England to the Civil Aviation Authority raising serious concerns.
Following a local outcry the scale of the venture was cut to an area of farmland the equivalent of about 500 Olympic swimming pools.
The firm’s application states the development has been designed to minimise visual impact on the landscapes overlooked by the national park and AONB, glint and glare and impacts on heritage assets.
It adds: “The development will make a substantial contribution to the overall supply of affordable low-carbon renewable energy, making a contribution to the aims of the UK Renewable Energy Roadmap, UK Solar PV Strategy, UK Clean Growth Strategy, Draft Integrated National Energy and Climate Plan and the legally binding Net Zero 2050 emissions target.”
Some residents of nearby villages have backed the scheme, saying it would “help to eliminate carbon emissions and reduce the price of electricity generation”.
Farmland near Husthwaite Picture: GOOGLE
Supporters of the scheme have claimed solar panels are one of the least disruptive methods of energy production, and argued that “compared to planting trees they have very little effect on the land”.
However, of the hundreds of responses over the scheme, the overwhelming majority are fiercely opposed to the development.
Historic England, which initially raised concerns over the solar farm leading to the “coalescence of the surrounding conservation areas and settlements”, said the revised scheme would create an unacceptable amount of harm to heritage assets and village conservation areas.
Objecting to the plans, the Campaign for Rural England said the farm would lead to a significant loss of top quality farmland. Many objectors have said the high grade agricultural land is needed for domestic food production, at a time when food security has become even more pressing.
Both the national park authority and the AONB said the solar farm would represent an incongruous large-scale development in a rural landscape.
Meanwhile, the Civil Aviation Authority has raised concerns over the safety of aircraft in the area from the solar panels’ glare, particularly as 33 small single engine aircraft are hangared at nearby Baxby Aerodrome.
Recommending the scheme be refused, planning officers said the cumulative impact on productive farmland, the aerodrome, landscapes and heritage assets meant the scheme’s significant public benefits did not outweigh the harm they would cause.
After the rampage: Brazil’s new leaders to fight hard in wake of ‘insane’ coup attempt
Tom Phillips in Brasília
Sat, 14 January 2023
Photograph: Adriano Machado/Reuters
Sônia Guajajara should have been making history last Tuesday afternoon, being sworn in as the head of Brazil’s first ministry for Indigenous peoples at a ceremony at the presidential palace in Brasília.
Instead, with that building wrecked last Sunday by thousands of far-right extremists, she sat in her office overlooking Brazil’s similarly ransacked congress, reflecting on the stunning attempt to overthrow one of the world’s biggest democracies.
“It was truly frightening … such insanity,” said the 48-year-old politician who hails from the Amazon and worked as a cleaner and nanny before becoming a leading Indigenous activist.
“They say they are patriots who are fighting for Brazil … [but] this is terrorism … and this was engineered by people with economic and political power,” Guajajara said, as her government battled to identify those behind the most serious outbreak of political violence since the end of the military dictatorship in 1985.
In the days since the insurrection – which came just a week after the leftist veteran Luiz Inácio Lula da Silva took office as president – the scale of the alleged plot to overthrow Brazil’s democracy has become clear.
Lula’s administration has accused hardcore supporters of his far-right predecessor, Jair Bolsonaro, of attempting to stage a coup by storming the presidency, congress and supreme court. They believe that was aimed at encouraging security forces to rise up, allowing Bolsonaro to return from the US – where he has been since the eve of Lula’s 1 January inauguration – to retake power.
On Thursday, federal police reportedly found a document in the wardrobe of Bolsonaro’s former justice minister, Anderson Torres, which allegedly outlined a plan for the former president to seize control of the supreme electoral court to overturn October’s election, in which Lula won by more than 2m votes.
“Brazilian democracy has been unquestionably tarnished and is at risk,” the commentator Mauro Paulino warned on the GloboNews television network.
On Friday night, the supreme court announced Bolsonaro would be investigated as part of the inquiry into the alleged attempt to topple the country’s new government. Bolsonaro’s lawyer denied wrongdoing, calling the former president a “defender of democracy”.
Torres, who was security chief in Brasília at the time of the attacks, was arrested on Saturday morning after flying back to Brazil from the US – where he was purportedly on holiday when the rebellion took place. The former justice minister, whose arrest was ordered for alleged acts of omission, has denied involvement, claiming he planned to shred a document that had been taken “out of context”.
“Deep down, I think we have so many good intentions that we didn’t believe something like this might happen,” said Celso Amorim, one of Lula’s closest aides, in his office in the presidential palace on Wednesday afternoon, with hundreds of troops and an armoured vehicle stationed outside to prevent a repeat invasion.
Amorim, who was Brazil’s foreign and defence minister during Lula’s 2003-2010 administration, said he hoped the uprising had been nipped in the bud. “But I can’t rule out attempts, here and there, that will need to be prevented if possible, and repressed if necessary,” he said.
“We need to be really vigilant,” Amorim said. “We can’t just think it was something that happened and is over and that’s it.”
Many fear Brazil’s moment of danger is far from over given the support for Bolsonaro within the security apparatus, notably the armed forces and military police. Many believe such support partly explains the security failure that allowed extremists to run riot through Brazil’s capital.
Brazil’s new minister of Indigenous people Sonia Guajajara, new Minister for Racial Equality Anielle Franco, President Luiz Inácio Lula da Silva, and his wife, Rosangela ‘Janja’ da Silva arrive at the Planalto Palace for Guajajara's swearing-in ceremony in Brasilia on 11 January. Photograph: Sérgio Lima/AFP/Getty Images
Polls show an overwhelming majority oppose the turmoil. But 58 million voters backed Bolsonaro in the 2022 election, many of whom have embraced baseless social media claims that the vote was rigged in Lula’s favour.
In his first extended interview since taking office, Lula hinted at such nervousness, promising a “thorough screening” of those employed in the presidential palace because of suspicions that “hardcore Bolsonarista” staff and military officials had helped insurrectionists storm the building.
On Friday, Lula’s foreign minister, Mauro Vieira, told the Observer he believed the government now had “absolute control” over the situation, after making more than 1,800 arrests. “My impression is that the manner in which the government reacted will discourage any kind of new adventure because the punishments will be increasingly severe,” he said.
But details of last weekend’s rampage give a sense of the rightwing rage that have gripped parts of Brazilian society since Bolsonaro’s election in 2018 – and which will not disappear overnight.
Amorim said his office had emerged relatively unscathed when hundreds of extremists blitzed the building at about 3pm on Sunday, after surging through police lines. Lula’s official photographer and aide, Ricardo Stuckert, was less fortunate. His office was ransacked. Rioters ripped open computers and stole the camera Stuckert had used to document Lula’s 2022 campaign.
Related: How a far right assault on Brazil’s democracy failed
“They didn’t leave a thing,” said Stuckert who stayed in the palace until Monday to chronicle the destruction in a viral video. He remembered his shock on arriving back at the sacked palace with Lula at about 8pm on Sunday. Sitting in the palace by a masterpiece by the painter Di Cavalcanti, which had been slashed seven times, he said: “The feeling I have is that we are going to have to really fight so that our children and grandchildren are able to live in a country without violence.
“I think many of the people who came here to destroy the palace didn’t even know what they were doing to democracy,” he said. “It’s those who are behind all this that we have to worry about – the people who are bankrolling those people to do what they did.”
Nearly a week after the Bolsonarista mutiny, details of the identities of the alleged orchestrators are beginning to emerge. Speaking to the Folha de São Paulo newspaper, the environment minister Marina Silva said part of the “enraged mob” hailed from the Amazon and included pro-Bolsonaro militants with links to illegal deforestation, mining, land-grabbing and fishing. Their anger was based on frustration that Bolsonaro’s era of “guaranteed impunity” was over, Silva said.
Other criminals hailed from south and southeastern states such as Paraná, Minas Gerais and São Paulo, where Bolsonaro also enjoys strong support.
Several pro-Bolsonaro lawmakers have been accused of inciting the violence on social media, and Brasília’s suspended pro-Bolsonaro governor, Ibaneis Rocha, has been questioned by federal police over his role in the security failure. Rocha has denied wrongdoing.
Guajajara will represent Brazil’s 307 Indigenous groups in her new job. “This is also an attack on our very presence in the government,” she said of Lula’s decision to bring Indigenous, black and female officials into his administration, to the frustration of Bolsonaro’s largely white, male movement. “It’s an attack on diversity – an attack on a democracy which has broadened, bringing us inside.”
Guajajara returned to the palace 24 hours after her cancelled swearing-in to take up her historic job. She took to the podium to address ministers and Indigenous leaders, including Yanomami shaman Davi Kopenawa.
Related: Lula suspects pro-Bolsonaro staff helped mob enter presidential palace
“We are here today, for this ceremony of courage, to show that destroying the presidential palace, the supreme court and congress will not destroy our democracy,” said Guajajara, flanked by the black favela activist Anielle Franco, who was being sworn in as racial equality minister. “Never again will we allow our country to suffer a coup.”
The audience applauded as Guajajara spoke, but outside, the heart of Brazilian democracy had been flooded with fire engines, police cavalry and special forces amid fears over fresh violence.
“The coup attempt is not over,” said one government insider. “It is still very much on.”
Rail companies given 'permission' by transport secretary to make new offer to unions this week
Sun, 15 January 2023SKY NEWS
The transport secretary has given rail operating companies "permission" to make a new offer to railway unions this week as the government hopes for an end to months of strikes.
Mark Harper told Sky News' Sophy Ridge that he had given the companies a "revised mandate" to go into negotiations in the coming days, saying there had been "big changes" in the government's approach since he took over the role from Grant Shapps.
But he said it was "important now that we give some space" to the two sides "to try and reach a conclusion".
Transport secretary quizzed on Sophy Ridge - politics update
Labour's Peter Kyle said the remarks showed there had been "a wasted year" under the previous transport secretary, who "refused to engage or even meet with unions" when the strikes began in 2022.
The RMT, along with other rail worker unions, have staged strikes across the country since June over jobs, pay and conditions.
Two of the unions involved covering smaller numbers of staff have reached settlements, but the RMT and train operating companies are still at loggerheads, especially when it comes to proposed reforms that could close ticket offices and increase driver-only train numbers, meaning no guards on board.
Mr Harper said this week's offer "would cover both pay and reform" in the sector, but denied reports the government had scaled back demands over driver-only trains.
"They've been in existence, frankly, since I was a teenager, which I'm afraid quite a long time ago," he told Sophy Ridge.
"Our general position on reform is that reform is still incredibly important, because by having generational reform on the railways... we generate the savings to pay for the pay awards to staff and still have a financially sustainable railway."
Read more:
Fresh wave of strikes this month - who is taking action and when
Nursing union threatens biggest strike yet
The transport secretary insisted that the two sides have "made some progress" and pointed to his own interventions as a boon to talks.
"We've made some progress and I hope we can make further progress," he said. "I want to stop these damaging disputes. They're bad for people who work on the railways and most importantly for passengers and the wider economy.
"I think we've made a big change since I became transport secretary and hope to make continued progress. I've made the changes that I think are necessary to get us on a path to that."
'Missed opportunity'
Mr Kyle praised Mr Harper's involvement but criticised the time it has taken for a transport secretary to get into the talks.
"The government sets fares... the time scales... the stations that each train has to stop at," he told Sophy Ridge.
"So the idea that for the entire summer when all of this unrest was fermenting between staff and unions and the government that Grant Shapps refused to engage or even meet with unions? It was a really missed opportunity.
"He should have been round the table, he should have been engaging, the government should have used the influence it has to try and broker some of these deals.
"So it's good that he's starting to now. But it is an acknowledgement we've had a wasted year."
Rail unions are far from the only sector taking industrial action, with nurses, ambulance workers, bus drivers and civil servants among those staging walkouts over the coming days and weeks.
Teachers are also striking in Scotland from tomorrow, with the results of ballots from other teaching unions in England expected to drop on the same day.
Mr Harper said "anything disrupting children's education will be very regrettable", especially after the impact of COVID.
And he said education secretary Gillian Keegan was meeting with unions "to listen to the concerns that teachers have got" and try to avert strike action.
UK
Teachers’ unions promise new strike ballots if walkout numbers miss threshold
The NAHT’s ballot over pay is the first in its 125-year history.
Michael Savage Policy EditorTHE GUARDIAN
Sun, 15 January 2023
Photograph: Peter Titmuss/Alamy
Teaching unions are warning they will be forced to reballot their members over strike action in the coming months if ministers continue to resist a “sensible solution” to the crisis in teacher recruitment and retention.
Three unions had been threatening walkouts over pay, which they say has led to teachers and teaching assistants making the “heartbreaking” decision to leave the profession. Last week it was revealed that despite about 90% of NASUWT members voting in favour of industrial action, the turnout, 42%, was below the required 50% threshold. Two more unions, the NEU and NAHT, will announce the results of their ballots on 16 January.
While hopes within the unions remain high that the strike action will be approved, some unions are warning that the strong support already demonstrated for strike action means they will feel obliged to launch a new attempt for walkouts should pay talks fail to progress.
Paul Whiteman, general secretary of the NAHT, told the Observer that heads and teachers would expect their unions to keep fighting.
“I think it’s fair to say that just because a technical threshold hasn’t been met, the disputes don’t go away,” he said. “Members will still be expecting their union to find a solution with the employer. If a sensible solution isn’t reached, there’s always the possibility that members will vote in a second ballot, with those thresholds being met. If there is any relief the government might be feeling, they should think again.”
Paul Whiteman, general secretary of the union NAHT. Photograph: Isabel Infantes/Alamy
Unions are already concerned that ballot papers may not have reached all members, and the effects of postal disruption will also be examined if the 50% turnout threshold is not met.
Whiteman warned that the erosion of pay over a decade was now putting huge pressure on teaching staff’’s vocational drive, with “heartbroken” teaching assistants now regularly being offered major pay increases to move into retail jobs.
“We’ve got this stupid situation at the moment in which highly skilled, very well-trained teaching assistants can garner more money working in a supermarket than they can looking after vulnerable children. Headteachers tell me that teaching assistants or support staff often bring them their resignation letter in tears. They have to leave the job they love and the children they love to support and are heavily invested in, because they can’t make ends meet. And supermarkets are able to pay them significantly more.
The teaching crisis isn’t so apparent because people don’t die in school. But they don’t get educated either
“At the moment there are huge numbers of children who don’t have a subject specialist teaching them. We don’t have enough maths teachers, we don’t have enough physics teachers, and we are finding it difficult to replace headteachers.
“The same crisis that you see in health is happening in education. The reason it isn’t so apparent or so dramatic is because people don’t die in school. But they don’t get educated either. If we don’t invest in that education, it has a very long-term impact on our country’s ability to be a major player on the world stage.”
More talks are expected between teaching unions and the Department for Education this week, despite a lack of progress so far. Some hope ministers will use discussions over the coming year’s pay deal to resolve the ongoing dispute over last year’s settlement. Most state school teachers in England and Wales had a below-inflation 5% pay rise in 2022.
The Observer has been told that most state schools in England and Wales will have to close completely on several days in February and March if the country’s biggest teaching union, the NEU, votes for industrial action. The NAHT’s ballot over pay is the first in its 125-year history.
A Department for Education spokesperson said: “After two years of disrupted education for children and young people, families will be relieved that teachers from NASUWT did not choose to strike. The education secretary has arranged further meetings with union leaders to avoid harmful strike action. We have already met the unions’ request for a further £2bn for schools both next year and the year after in the autumn statement, and given teachers their highest pay award in 30 years.”
UK
High inflation is to blame for these strikes, not trade unions
Torsten BellTHE GAURDIAN
Sun, 15 January 2023
Photograph: Guy Bell/REX/Shutterstock
Strikes are all the rage. You’ll have noticed, if you want to take a train (or pass your driving test to avoid doing so). This is visible in official data, with 417,000 days lost to industrial action in October – high compared with the 450,000 lost a year during the 2010s. But taking a longer term view, strikes are heading down, not up: around 7m and 13m days a year were lost in the 80s and 70s respectively.
Recent research argues that strikes have fallen as debt levels rose from the 1980s on, because workers became wary of striking if loss of pay and fear of losing their job put them at risk of missing loan repayments. This is interesting but overstates debt’s role.
A better guide to the decline of strikes comes from current examples. High inflation is the trigger, raising the stakes for employers and workers negotiating pay, just as it did in the 70s. In contrast, the past few decades of low inflation meant fewer strikes.
Today’s industrial action is concentrated in the public sector. Why? Partly because of slow public sector pay growth, but also because that is where trade union presence is strongest after overall membership rates more than halved from 53% to 23% between 1980 and 2021.
Good luck having a strike without a union, so industrial action has shrunk. Some argue that’s a good thing, but fewer strikes don’t come free. Our own work shows that unions raise wages (union members earn 6% more than non-members in the UK and new research finds a 3% premium in Germany) and reduce wage inequality. We want to see the back of some things, such as double-digit inflation or bad employers, but not trade unions.
Torsten Bell is chief executive of the Resolution Foundation. Read more at resolutionfoundation.org
Pat Cullen: 'We are prepared to strike all year if we need to'
Harry de QuettevilleTHE TELEGRAPH
Sun, 15 January 2023
Pat Cullen - Andrew Crowley
Next week, renewed Royal College of Nursing action will see a second round of nurses’ strikes, with thousands walking out again, on consecutive days, after the Prime Minister declined an offer of a 10 per cent deal on nurses’ pay.
But although Pat Cullen, the General Secretary of the RCN, has accused the Health Secretary Steve Barclay of being a “bully-boy”, and insists that current talks must alleviate an NHS crisis that is causing patients to die unnecessarily “every day”, she has dealt with far worse.
Having started her career in Belfast at the height of the Troubles, Cullen is no stranger to tough-nut men and negotiations on which lives hang. Indeed, back in Northern Ireland in the early 1980s, there were times, she says now, when as an agent of the state – though just a nurse – she was viewed with mistrust, possibly even as a spy.
“I was moving around the Shankill Road, dominated by the [Loyalist paramilitaries] UVF, then coming back into the [staunchly Catholic] Falls Road. Doing that multiple times a day raised suspicion. It was the time of the hunger strikes, very difficult.”
Were there moments of danger, when she felt she was suspected of being an informer? “Absolutely. Particularly when you were moved, new to the area.” To smooth her passage, talks were held to establish her bona fides – what Cullen delicately calls “informal interviews with significant community leaders”.
I think of other bullyboy men, this time with guns. In those days, of course, if negotiations didn’t work out it was her own life that was on the line. So Cullen is not new to playing for high stakes.
Nonetheless, many said she had set the stakes far too high when nurses demanded a 19 per cent pay rise ahead of two days’ strike action last December. Prime Minister Rishi Sunak dismissed the bid as “obviously unaffordable”. Ministers noted grimly that more than £9 billion would have to be spent if such a settlement was extended across the whole NHS. The Government was offering 4 per cent, a £1,400 annual bump – though Barclay has since conceded that will have to increase.
Cullen now seems more accommodating, with hints that 10 per cent might seal the deal. But that does not mean she is climbing down. The RCN, she says, will extend strikes well into the second half of the year if necessary. The pickets will stay, she insists, “for as long as it takes for this Government to do the right thing for nursing staff. If we have to reballot our members after six months [to secure a mandate for more strikes], then that’s what we will do.”
Not only that, Cullen also vows strikes will get bigger, saying that RCN members at trusts which narrowly voted against current strike action are now clamouring to be reballotted, because they want to join the industrial action. This second round of nurses’ strikes will affect 55 trusts across England, up from 44 before Christmas.
“We’re talking about very significant trusts,” Cullen notes. According to the Nuffield Trust that could double the size of strikes. And the last walkouts saw 15,000 appointments cancelled. “All options [for action] are on the table,” says Cullen.
Then there are nurses’ other demands. More pay, says Cullen, would be “a step in the right direction”, but it is by no means the end of the matter: “This is about much more than pay.”
First up, is a mass recruitment drive “to fill the 47,000 unfilled, vacant nursing posts” to relieve pressure on those already in the job (the Nuffield Trust says there are 17,000 unfilled posts on any given day).
Then, Cullen wants “a separate pay structure for nursing, because the current structure is not working.” That structure – known as agenda for change – splits NHS roles by seniority into nine bands. Nurses start in Band 5, on £27,055. The average nurse wage was £35,989 a year before the last pay settlement. That’s slightly above the average national salary, according to the ONS, which is £33,000.
“Nursing is not an average job,” says Cullen, who notes that in other countries nurses are paid one-and-a-half times or double the national average. By contrast here, she says, they start low and get stuck low, marooned in Band 5, without the chance to progress up the pay scale.
There’s more: travel expenses. “Our nurses are spending up to £500 a month travelling, simply because they cannot afford to live close to their place of work,” she points out. Beyond that, there is “the debt that our student nursing population joins our profession with, we need to find ways of addressing that as well”. A report by the House of Commons last year found that the average student debt for nursing – which since 2009 has required a degree – is £35,000.
Finally, Cullen wants legislation in place that absolves nurses of responsibility for ensuring safe levels of staffing. That, she says, is up to politicians in Westminster, “not with ward sisters battling every day to try and fill vacant posts”. Without such safer nursing laws, she insists, if something goes wrong it is the ward sister who gets clobbered. It is a bit rich, she argues, for the Government to push through anti-strike laws enforcing a minimum safe service, when nurses have long been calling for minimum safe staffing levels.
But therein lies the nub of the matter. The Government is focused on doing more with existing staff, on productivity and efficiency, and the RCN’s priority is numbers: numbers of staff, and the numbers on their pay packets. So far, it has led to a dialogue of the deaf.
Cullen has met Barclay twice, and each time the meetings proved fruitless. At the beginning of this week, Sunak appeared to signal a softening attitude – hopes for a settlement soared, only to be dashed again. The problem, says Cullen, was that unions were asked to “find efficiencies from within the NHS, so that [Barclay] can go to the Treasury. In other words: ‘You find the money and we’ll see if we can do a deal.’”
Cullen describes the proposal as “absurd”. “We’re not in a position to find the money from the system,” she says. “We don’t manage the system.”
She is, however, happy to consider productivity improvements. “We’re always looking for opportunities for efficiency. But it’s very, very difficult to look for efficiency savings when people are constantly trying to mitigate risk every day.”
Government talks with the nurses seem to have become a battleground between the sexes. Cullen’s “bullyboy” comments enraged Barclay and, in what soon becomes apparent is not an unusual tactic, she softens her tone without entirely withdrawing her claim. “I don’t want to personalise it because that will be wrong of me to do. Barclay and the PM have very difficult jobs,” she says.
“But they have to also understand that I’m leading a profession that’s 90 per cent female and sometimes their actions lead this profession to believe that there is a macho or bullyish approach to how they make decisions.” I ask for an example. She says that nurses are patronised by those who “devalue caring”, who dismiss it as “women’s work” which is not skilled, and “doesn’t need to be a graduate profession. Those sorts of things are not helpful when you’re in a period of negotiation where you’re trying to build up relationships and trust.”
By her account, Barclay – without wanting to personalise it – emerges as something of a boor. “It’s his job to listen to me. He has a responsibility. And when you feel constantly that he is turning his back on the profession, it leaves all of us feeling rather nervous about where we’re going.” A ministerial spokesperson has rejected that description, saying Barclay has “utmost respect for nurses”.
Talks have not become so bitter as to be called off, though. When we meet – on Wednesday – Cullen’s office is trying to firm up a meeting with Barclay for the following day. She strongly hints that a one-off, cost-of-living payment effectively bumping up the 2022 pay deal, as mooted last week, would – in tandem with a rise of around 10 per cent this year – be enough to call off strikes. “I’ll seriously consider that.” As yet, though, the “Government is just so far away from what our members are expecting and requiring.”
Yet what precisely is the dispute about: pay or conditions? In the past, Cullen’s principal complaint seems to be about a crumbling NHS preventing nurses caring for their patients and “doing their job properly”. But an extra £3,500 a year in nurses pockets would do nothing to change that. Better pay, she counters, would help with staff retention and recruitment. And that would improve conditions.
I wonder what those conditions will look like if she follows through on her threat to pursue strikes throughout the year. Will the public still be onside? “We haven’t abandoned our patients,” she claims, despite the cancelled treatments. “We’ve been very careful about our derogations. Every survey that comes out shows the trust the public have in our profession, that was certainly borne out on every picket line that I visited on the two days.”
It’s true. Public support is strong, though it is not limitless. When strikes were first announced last November, 59 per cent of Britons supported the nurses’ strikes. A month later, as action got underway, that fell to 50 per cent. There is now some evidence that support is rising once more. After more than a century strike-free, it’s quite the gamble.
Yet Cullen is adamant it is the right thing to do – “It is not about me,” she says. “This is not my strike.” It was the members – the RCN represents around 300,000 nurses, around two-thirds of the profession – who were “very, very clear”. That may be true, but the fact is that this is the second time she has defied tradition to call a strike, after leading a walkout in Northern Ireland in 2019 as the union’s chief there. In April 2021, she was appointed General Secretary of the whole RCN.
Pat Cullen - Andrew Crowley
It is a sequence that makes her sound like a militant throwback. But in her blue suit, with her cautious, almost nervous manner, finding the precise words she needs, she seems anything but a firebrand. Instead, perhaps as a result of her upbringing, she comes across as committed, but modest.
She was born in 1965, the youngest of seven children, six of them girls. Her father, Paddy, was a farmer in County Tyrone, who died when she was 13. Still, she had “a really happy childhood” until, to her huge distress, Annie, her mother, died suddenly when she was 18.
The pain of that loss was somewhat softened by the comfort of her siblings, the oldest of whom – Bridie – is 20 years her senior. Five of the six girls became nurses working in Ireland, including Petra, just 18 months older than Pat, to whom she remains devoted (“She’s my best friend as well as a sister. There’s never a single day goes by that I don’t call her as I leave the office”).
It was Petra who helped Pat pass her 11-plus, a result that secured a place in Loreto Convent Grammar School in Omagh. But, by her own admission, she found the convent regime difficult, so she returned to college in her hometown of Carrickmore. From there, she became a trainee nurse. Degree-less, she would today, of course, be rejected by the profession.
She started in Holywell psychiatric hospital in Antrim, ending the practice in which patients were routinely punished by having precious personal items removed. Then she moved to West Belfast, beginning her delicate mission as a community nurse across the sectarian divide. Soon she was head of nursing at a local healthcare trust, and by her early 30s she had joined the Department of Health as Nursing Officer.
She only joined the RCN seven years ago. Three years in, she led her fellow members in Northern Ireland on strike. No one doubted the justice of their cause. Because Stormont had been so frequently suspended, pay deals had simply not been passed. Nurses found their pay far behind peers on the mainland. In the end – Barclay take note – the pickets and public pressure forced a deal, not just for pay but also safe staffing levels.
When she arrived at the top of the RCN, whose governing council was male-dominated, she was greeted by scandal. Tales of sexual misconduct were rife. Cullen commissioned a report whose findings, which were leaked last October, made grim reading: the RCN’s annual conference was damned for its booze-fuelled “sexual culture … in which the risk of exploitation is significant”. The council was accused of bullying and harassment. Allegations flew of “abuse, grooming, preying”.
“It was a very difficult time,” admits Cullen. “We let our members down, and I’ve apologised on a number of occasions to them for letting them down.” A new council is now in place, and Cullen says that if a follow-up report identifies “any reason to have a criminal investigation”, she will refer colleagues to the police.
There is scandal elsewhere in her purview too, though one she is keener to talk about. Nurses are being recruited, she says, from so-called “red list” countries which, often wracked by poverty, desperately need the healthcare workers themselves.
Officially, the Government has banned such hiring drives. Worse, Cullen says, she understands “these nurses are arriving… and having their passports confiscated by social care providers, and then told if they wish to leave and break their contract, they have to pay a penalty of as much as £14,000 to actually get out and return. I do believe that there’s modern slavery being operated in some parts of our healthcare system.”
Moreover, Cullen says she raised the matter last year with Jeremy Hunt, when he was chair of the Health and Social Care Select Committee: “He acknowledged very clearly that it was absolutely wrong.” But nothing was done. “Times move on,” says Cullen. “He found himself in a different post.” Such tales only underline how hard recruitment can be.
I stand up to leave. Cullen will soon be making her daily call to Petra, these days more emotional than ever. Five years ago, Petra was diagnosed with cancer. Despite what Cullen calls “a little bit of a setback”, she is now “brilliant, everything moving in the right direction.” It can’t be easy being unwell and in healthcare. Cullen smiles, telling of how her sister pestered Enda, Cullen’s husband, who is a GP, and her son, Shane, a doctor, for information after her diagnosis. You can’t pull the wool over a sick nurse’s eyes.
Inevitably, though, the community that surrounds the RCN General Secretary most powerfully is a community of women. And we drift back again to her time navigating the Shankill and Falls Roads, as tense and bloody as any hospital ward.
“There was internment, men were on the run. So the people who helped us through were the women of both communities. It was so hard but they were incredible. They were strong. It was the women who got us through. I’ve learned so much from them.”
Public support for NHS strikes soars amid warnings they put ‘lives at risk’
Camilla TurnerTHE TELEGRAPH
Sun, 15 January 2023
NHS strikes doctors nurses ambulance workers industrial action - Guy Smallman/Getty Images
Public support for striking NHS staff has increased, despite warnings that walkouts put “lives at risk”.
Doctors and nurses are the only professions for which there is now more sympathy for industrial action compared to six weeks ago, a new poll found.
It came as nurses in England prepare for a fresh round of strikes for two days next week, with union bosses saying they have been “left with no choice” after their demands for a pay rise were not met.
Members of the Royal College of Nursing (RCN) already held two strikes in December, which resulted in 30,000 operations and appointments being cancelled.
On Jan 10, Grant Shapps, the Business Secretary, said that striking ambulance workers were putting “lives at risk” as he proposed new laws requiring minimum levels of service from ambulance staff, firefighters and railway workers during industrial action.
However, a poll, carried out by Redfield & Wilton Strategies for The Telegraph, revealed that 59 per cent of British voters said they support strike action by doctors and nurses when asked this week. This is up from 50 per cent when the same question was asked on Nov 30.
Meanwhile, support for all other professions that voters were asked about ebbed away over the same time period.
Public backing for striking rail workers fell from 51 per cent six weeks ago to 45 per cent this week, after a series of crippling walkouts in recent weeks which wreaked havoc on the country’s train network.
Support for striking civil servants dropped from 42 per cent to 35 per cent after the military was called in to cover for Border Force staff walking out over Christmas.
The British public appeared the least sympathetic to lawyers and barristers going on strike, with just over a quarter, 26 per cent, saying they would support them to walk out, down from 38 per cent last time.
Last August, criminal barristers voted to go on strike indefinitely over pay, but they ended it in October after accepting the Government’s improved pay offer.
Philip van Scheltinga, the director of research at Redfield & Wilton Strategies, said: “In the past month, striking nurses have done better than striking rail workers in gaining sympathy from the public.
“For starters, their strikes have been comparatively less disruptive to the public. Hospitals have kept running, while trains have been shut down completely.”
He pointed out that nurses have run a better information campaign regarding their strikes, adding: “They’ve taken great advantage of the rarity of nurses strikes, their primarily female workforce, the unpopularity of the Government – their direct employer – and the public’s predisposition to view the NHS favourably to begin with.”
Junior doctors are threatening to strike for three days in March if they win a ballot on industrial action. The British Medical Association has already said that junior doctors are “very likely” to vote in favour of strikes, as part of a campaign to see pay rise by more than one quarter.
Dr Vivek Trivedi, the co-chairman of the body’s junior doctors committee, said: “The NHS is facing a crisis like no other: patients waiting in corridors, staff breaking down in tears during shifts, and doctors simply not able to offer the care patients deserve.
“The public can see this is not a situation that can continue. They, like doctors, are crying out for a government that will address the crippling staffing shortage that led us here.”
Pat Cullen, the general secretary of the RCN, said: “The public have been unwavering in their support for nursing throughout this dispute. After months of digging in, the Government needs to listen to what the public wants and get round the table and negotiate. The public supports our strike action. As they know, when nurses speak, they speak for patients.”
In an interview with The Telegraph, Ms Cullen said the union would keep striking for “as long as it takes” and expand the walkouts to more NHS trusts unless the Government gives ground.
“If we have to reballot out members after six months [to secure a mandate for more strikes], then that's what we will do,” she said.
She said that RCN members at trusts which narrowly voted against the current strike action now wanted to be reballoted to join the walkouts.
In the interview, Ms Cullen also said that Rishi Sunak and Steve Barclay, the Health Secretary, had at times alienated the female-dominated nursing profession by giving the impression “that there is a macho or bullyish approach to how they make decisions”.
“Those sorts of things are not helpful when you’re in a period of negotiation where you’re trying to build up relationships and trust,” she said.
Speaking about Mr Barclay, she said: “It’s his job to listen to me. He has a responsibility. And when you feel constantly that he is turning his back on the profession, it leaves all of us feeling rather nervous about where we’re going.”
The Department for Health and Social Care declined to comment.
