Picture…

primary_care_training_vagrant

I never expected a queue on a Sunday morning but there it was… the Sunday supplement, latte-brigade, there in their hundreds. North Face jackets, gilet vests, Todd loafers and chinos.

Inside, a black and white world of unremitting suffering and poverty. Skeletal children, broken bodies, eyes so pained there were no tears left to cry.

The Don McCullin photographic exhibition at Tate Britain is not for the faint-hearted. There’s a sign outside; Expect Disturbing Images.

Nothing could prepare you for what this man has pushed through his lenses for 1/125th of a second and exposed for ever, in exquisite monochrome.

Wars on the other side of the world, starvation, closer to home, Northern Ireland and the most shocking of all… the horrors of homelessness and vagrancy, right here in the 1970s.

Cruelty, inhumanity, ugly, unbearable. Every generation needs a McCullin. He is now in his 80s. As far as I can tell, fit as a flea but contents himself with still-life, landscapes and lampooning the upper crust.

After an hour at the exhibition I was drained. What a lifetime of it does to you, I can’t imaging. You must lose all faith in politics, government and the concept that every man is a brother, every woman a sister, every child is yours…

Where would McCullin point his camera these days?

Syria? He’s been there and Beirut. The carcasses of bombed-out buildings and images of hollowed-out people sheltering in them. What’s changed?

Here? There’s nothing for him to see, is there? We have record levels of employment.

Really? Believe me… if you are poor and if you’re old, nothing has changed.

Between April 2017 and March 18, The Trussell Trust’s food-bank network distributed 1,332,952 three-day emergency food supplies to people in crisis. 13% up on the previous year.

484,026 of these went to children.

Government says we have record levels of employment.

The local authority headcount, really little more than an informed estimate, tells us 4,677 people were found sleeping rough in England on a single night in autumn 18. They didn’t count 12,000 sleeping in cars and tents.

Government says it will end rough-sleeping by 2027.

And, we already know, just under a million elderly, frail people, who once got help from social care, no longer get it because, pressed for funds, LAs have cranked up eligibility criteria. Adult social-care faces a workforce gap of 200,000.

That’s why so many show up in A&E and that’s why the NHS is spending a fortune on in-reach and other schemes to get people back to their homes, safely, only for them to turn-up again.

That’s why, expect no magic from ‘new money’ coming into the NHS. The neglect of NHS workforce development means it will be spent on agency, over-time and bank. What’s left will be used to prop-up what’s left of social care.

We are promised a delayed, Green Paper on the future of adult social care funding. When I interviewed him, No18 looked me in the eye and said to expect it, soon. Useless answer.

If, whoever has written it, can get agreement on what to consult on, and assume the document is out by April this year, thinking is unlikely to crystallise before December.

Then a further period of analysis, takes us into 2020. Then a White Paper, consultation, discussions, say September 2020, then Parliamentary holidays, then a draft Bill.

Parliamentary time for debate and scrutiny, in competition with whatever Brexit delivers us and an election in May 2022. Don’t hold yer breath…

This’ll be a matter for political manifestos at the next election… whenever it comes.

There is one answer to the crisis in social care and the hidden poverty that drives families to food banks, yer granny to A&E and people like you and me, to living on the streets…

.. we have to pay a bit more. But…

… right or not, Labour, with a reputation for financial profligacy are frightened to go into an election promising higher taxes. The Tories have mainly wealthy, middle-class MPs who want a low-tax US-style economy and fend-for-yerself-services.

Brexit-beguiled, brutal Britain… not a great picture.

Contact Roy – please use this e-address – roy.lilley@nhsmanagers.net
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Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.