Why does Hammersmith and Fulham Council ban vaping?

Research has established that there are no health risks from “passive vaping”. There is no law against vaping in public places. It is a highly effective method for smokers to give up. Yet Hammersmith and Fulham Council bans vaping on its premises – without being able to give any proper justification for doing so.

I wrote to Debbie Morris, the Director of Human Resources as follows:

“I was concerned to see from this FOI response that “staff and visitors are expected to vape outside” from Council premises.

https://www.apps7b.lbhf.gov.uk/cus/servlet/ep.getImg?ref=D387184&st=NOHEADER&auth=10051

Please note that Public Health England argue that we should make a distinction between smoking and vaping.

https://www.gov.uk/government/news/vaping-in-public-places-advice-for-employers-and-organisations

I would propose that council staff should be encouraged to give up smoking by being allowed to vape from their desks. Please may I have your comments.”

She replied:

“Thank you for your email dated 7th November. In response to your query ‘that council staff should be encouraged to give up smoking by being allowed to vape from their desks.’

“Vaping is covered under the same restrictions as cigarette smoking under the current workplace policy. All policies are regularly reviewed according to latest evidence. HR and Public Health are committed to a joined up tri-borough approach and policies relating to vaping will be reviewed jointly due to the rapidly emerging evidence base.”

H&F Council refuses to back defibrillators scheme

shaun-bailey-100x100Some residents may remember that Shaun Bailey was the Conservative candidate for Hammersmith in the 2010 General Election. Unfortunately he didn’t make it but the good news is that this year he was elected a member of the London Assembly and he has already produced an important report about saving lives for Londoners.

He says:

“Placing defibrillators in disused and redundant phone boxes is a fantastic way of getting life-saving devices into highly visible and easily accessible locations.  My research found 10,211 people suffered a cardiac arrest in London in 2014/15 and, despite the London Ambulance Service having some of the best performance ratings in the country, survival rates remain as low as nine per cent.”

The cost would be relatively modest and Hammersmith and Fulham Council has a huge annual Public Health budget of £22.7 million which is overwhelmingly wasted. So I wrote to the Council’s Director of Public Health Mike Robinson proposing that the Council back the scheme:

Mike,
Please advise:
1. Whether your team provides any training in secondary schools for pupils in First Aid and specifically cardiopulmonary resuscitation and using Automated External Defibrillators.

2. Whether there are any plans to fund from your budget the adaption of redundant telephone boxes in Hammersmith and Fulham for defibrillators. I gather BT offer a scheme of selling the phone box for a pound and the cost of installing the defibrillator is around £1,000.

My questions were prompted by reading this report which provides more
background:
http://glaconservatives.co.uk/wp-content/uploads/2016/07/Never-miss-a-beat.pdf

Best wishes,
Harry

The reply I got was as follows:

Dear Cllr Phibbs,

Thank you for your enquiry regarding the potential use of public health budget to support initiatives for increasing the availability of and the training in the use of defibrillators in community settings.

Although this is clearly an initiative that has been found to have some benefit in aiding in the acute response to cardiac arrests, and is something that has had recent Government support as well as from organisations such as the British Heart Foundation, available public health budget is currently targeted where possible on primary prevention and not for acute response.

Therefore, in response to your questions:

1.This is not something the public health budget is currently used to support and therefore no public health funded initiatives currently take place that support or provide training in secondary schools for pupils in First Aid and specifically cardiopulmonary resuscitation and using Automated External Defibrillators.

2.There are currently no plans to use the public health budget to fund the adaptation of redundant telephone boxes in Hammersmith and Fulham for defibrillators.

Please let me know if you would like to discuss further.

Regards

Mike Robinson

A very disappointing response. Really just a policy of inertia. The challenge should be for the £22.7 million to save as many lives as possible. But the Council just leaves the bureaucrats to drift along while the councillors supposedly in charge collect their allowances. A terrible failure of leadership.

Cllr Andrew Brown: World TB Day – Important Globally and in Hammersmith & Fulham

andrewbrownA guest post from Cllr Andrew Brown

Today, 24th of March, is World TB Day. This is of particular significance this year, as tuberculosis has become for the first time in many years, the deadliest infectious disease, killing 1.5 million people last year. TB has overtaken Aids/HIV as the leading infectious killer, and that is partly because it is a difficult disease to deal with. It is not easy to diagnose and its treatment is lengthy requiring over six months of treatment with multiple pills every day. TB is also a disease of the developing world, so unfortunately has not attracted as much funding from government or the pharmaceutical industry for the development of new treatments and vaccines.

What is particularly concerning about TB is that in some countries, the levels of the disease that are resistant to some or virtually all antibiotics is becoming worryingly high. If this trend continues, TB could become as much of danger in 21st century Britain as it was in the 18th century.

I was privileged to attend the All Party Parliamentary Group on Tuberculosis events in Parliament yesterday, and have a personal connection to the academic side of TB, as my first job after finishing my university studies was for the Faculty of Medicine at Imperial College researching the impact of the Global Fund for Aids, Tuberculosis and Malaria’s funding in the developing world.

The Global Fund, like the Gates Foundation is an incredibly important NGO that is doing important work to help eradicate diseases worldwide. As a conservative I am extremely proud of the support that this Government has provided to the Global Fund, being the third largest donor. This is extremely important this year, as the Global Fund raises money through replenishments, and this year is a replenishment year.

But what does this have to do with Hammersmith & Fulham? Many of you may be surprised to know that TB has unfortunately become a problem again in the UK and in particular in London. Whilst the incidence has fallen since 2011 due to action taken by the Government and the NHS it is still a concern, especially for some of London’s most deprived communities.

Hammersmith & Fulham unfortunately has on average 43 cases per year (2012-2014). This may not seem a lot, but compared with the national average of around 12 per 100,000 population, H&F’s is twice that at 24.2 per 100,000. I am going to write to the clinical commissioning group and the council to ensure that we are doing all we can to reduce the incidence of TB in H&F.

TB is something we have the knowledge and treatments to eradicate globally, especially if we address anti-microbial resistance. Let’s make a start by eradicating it Hammersmith & Fulham and across London.

H&F Council spent £777,000 on “Personal Health Plans” – one person gave up smoking, 15 drank less, six lost weight

I have written before about my concerns that the £22.7 million spent by Hammersmith and Fulham Council on public health fails to achieve value for money. When I asked for a budget breakdown it included the following item – costing £777,000 a year:

“Delivery of personal health plans – individual goal oriented planning and support for 1,560 people a year and 1,800 community health checks delivered each year; the service helps people to lose weight, become more active, reduce alcohol use, stop smoking and eat more healthily, and is focused on areas of deprivation.”

That’s pretty expensive. Just under £500 a head. But to get an idea of whether it was good value for money I asked a further query:

“How many of the 1,560 people that we have funded personal health plans have drunk less, lost weight or given up smoking as a result?”

The results:

15 people reported reduced alcohol consumption.

1 person gave up smoking completely.

6 people reported reduced weight.

Of course there will be other health targets. But these are pretty obvious ones and the figures are derisory. It works out at £37,000 a time for each of those 21 achievements. Furthermore how many of those outcomes would have happened anyway regardless of signing up to the personal health plan?

This is the context in which the Council claims there is no money available from the Public Health budget to promote shingles vaccine. Or restore drinking fountains. Or provide dust suppressant spray on the roads to reduce air pollution. Or provide hypnosis for pregnant women to give up smoking or residential rehab for drug addicts. Or provide blood pressure tests for middle aged men. Or peer support for mental illness.

Or really just about anything at all that might be of greater real, practical value than the £777,000 for the Personal Health Plans. It would be quite a challenge to think up a less effective way of spending the money.

H&F Council still refuses to take practical action over poor shingles vaccination rates

Cllr Lukey: Refusing to take practical action.

Cllr Lukey: Refusing to take practical action.

Last week I reported on the terrible news that Hammersmith and Fulham has only half vaccination rate for shingles as the national average.

I suggested that the Council could make a difference by using a relatively modest amount from its £22.7 million Public Health budget with practical measures to increase the take up of the jab.

The Council could write to all qualifying residents to urge them to take the jab. They should back this up with visits. They could fund the NHS to make it as easy as possible – for instance offering the vaccination on site in sheltered housing accommodation and indeed in residents’ private homes. They could also pay for the vaccine itself for borough residents aged 73-77? (At present those who were 70, 71, 72, 78 or 79 years old on the 1st September, 2015 qualify for a free vacine from the NHS.) Preventing elderly residents from getting this very unpleasant disease would actually save the Council money in terms of the adult social care budget.

I have wrote to Cllr Vivienne Lukey, the Cabinet Member for Health and Adult Social Care urging her to take action. I’m her reply read to me like a collection of excuses for doing nothing very much at all. She rejected my proposals – but didn’t offer any very tangible alternative – apart from holding lots of meetings. Here is her reply in full:

“Dear Cllr Phibbs,

Thank you for your email. Shingles is a horrible condition – you may have had family experience of this, as I have. Prevention is better than cure and I am determined that we get our health partners to improve on past performance.

I am unclear as to whether you have misunderstood the letter from Stuart Lines or have chosen to disregard what he has explained. NHS England has both the duty and the budget to commission GPs and NHS providers to carry out immunisations . There is no funding for this within our Council Public Health budget, which (as you well know)  is being cut by the Government. Given the other pressures on our funds, it makes no sense to me to attempt to take on a job which other bodies are paid to do so I cannot accept your original suggestions. I realise you put forward  these ideas before you had been briefed about statutory duties and am sure you were trying to be helpful.

But of course we will want to do the best we can to reduce shingles in our borough. We have an absolute commitment to defend our NHS services and improve health outcomes for our residents.

What we will do is to use our health and wellbeing leadership role to hold our partners to account and use our Council , voluntary and independent sector communication channels to encourage take up by educating residents about the consequences of getting shingles and signposting them to immunisation. I have asked for further work to be undertaken about eligibility for the vaccination (since it is restricted to older people) so we can see whether we need to lobby the Government for wider access.

We  set up a multi agency partnership group last summer which is led by the Council, and attended by myself and Cllr Holder. It has developed new ways of publicising  immunisation across the sectors and increasing take up in a wider range of venues and at weekends. This has proved a very effective forum for pressing NHS London Public Health officials and GP management for a proactive and sustained programme , which the Council can in turn promote. As Stuart Lines explained to you in his letter, this  will be our vehicle for driving up performance.

Thank you for taking an interest in what we are doing.

Best wishes

Cllr. Vivienne Lukey
Labour Councillor for Fulham Reach Ward
Cabinet Member for Health and Adult Social Care”

I have replied as follows:

Thanks, Vivienne.

I do think that your reply is quite disgraceful.

Just because we do not have a statutory requirement to do something does not preclude us from doing it. Nor do I accept that there is not the funding available given that there is £1.8 million unallocated from the Public Health budget for this year and that much of the total £22.7 million budget is ineffectively spent at present.

While you say that you wish to reduce the level of shingles in our borough you fail to back any practical measures for doing so but instead offer bureaucratic waffle.

Best wishes,
Harry

Cllr Joe Carlebach: H&F Labour councillors reject plea to engage with vulnerable residents

joecarCllr Joe Carlebach is a councillor for Avonmore and Brook Green Ward and the Hammersmith and Fulham Vulnerable People’s Champion

It’s a mad world!

The words of the song by Tears for Fears ( a band of the 1980s for those of you who are too young to remember them!) came to mind last week at the Hammersmith and Fulham full Council meeting. If you have never been to one of these meetings, they are usually three hours of solid political banter with occasional glimpses of debating prowess on the part of both parties.

My approach to Council meetings has always been one of constructive engagement. It is an opportunity, when in power, to listen to what the opposition has to say and, when in opposition, to constructively hold the administration to account. This is what I believe residents would expect. So it was with sadness and surprise that in a debate on a motion about the Administration’s new Area Health Forums I tabled what I thought was a constructive unpolitical amendment, and it was voted down!

These new forums do, on the face of it look like a positive development. I would support any opportunity where residents have the chance to express their concerns and views on all aspects of health care in our borough to health care providers.

I know from painful experience that residents from vulnerable groups have a disproportionately difficult time gaining fair access to health care. I have worked on many cases where this has happened and I am confident there are many cases out there that I do not know about with exactly this experience. It was in light of this that I tabled the following amendment to the motion, expecting (perhaps naively) that all Councillors would feel able to support it.

For your information here is the exact text of my amendment. For those well versed in the intricacies of Council life, this was an addition to the Administration’s text, not altering it in any other way:

Amendment to Special Motion 7

– The Council recognises that the health needs of our vulnerable residents are often complex and diverse requiring specific detailed multi disciplinary care solutions.

– The Council will make every effort to ensure that invitations are extended to the Neighborhood Health Care Forums to groups representing our vulnerable residents and in particular those representing and working with children and adults with all forms of disabilities as well as the frail elderly.

I am still at a loss to understand why this amendment was voted down.

One of the main reasons given on the night was that these forums are for individuals not groups. I have to say, having worked with many of the groups representing vulnerable people for many years, they are almost entirely made up of service users and families of people with disabilities, complex needs, the frail elderly etc. So for me this reasoning is not correct nor does it sound reasonable. Our residents will make their own judgement.

I would like to end with the statement that I started with which is in opposition I have done my best to take a constructive approach to ensure that the needs of vulnerable people are addressed. However (I say again) I also believe it is the role of the opposition to hold the Administration to account when the situation merits it. That is how good democracy works.

The rejection of my amendment was very disappointing and I would go so for as to say incomprehensible. The real losers of this disagreement will be the very people we are all trying to help, namely the most vulnerable residents in our borough and that is deeply regrettable.

Ever the optimist I am hopeful that the administration will experience a change of heart and see sense. As Martin Luther King said “We must accept finite disappointment, but never lose infinite hope.”

H&F Council rejects allowing electric cars to use bus lanes

A Nissan Leaf

A Nissan Leaf

I wrote last week about the urgent priority to encourage motorists to switch to electric cars. At present air pollution kills 72 borough residents a year – as well as diminishing the quality of life for the rest of us. A big switch to electric cars would be transformational. A significant incentive could be allowing electric cars to use bus lanes. So it is disappointing that Hammersmith and Fulham Council has rejected the idea.

Edward Stubbing, a Transport Planner for the Council’s Transport and Highways Department writes to me to say:

“Modelling suggest that there is a eight fold increase in fully electric vehicle ownership year on year, as such the bus lanes are likely to quickly become congested with electric vehicles over time as the level of ownership quickly rises. Bus lanes are currently used by both buses and Taxi’s in recognition of the shared mode of transport they represent. Introducing other vehicles into these priority lanes would likely damage the effectiveness and advantage of these modes of travel.”

He concludes:

“As such at present it is the view of officers that the benefits of allowing electric vehicles into bus lanes, does not outway the disadvantages it would cause other road users.”

Now there can be a more general argument about whether bus lanes are an overall benefit in terms of traffic congestion and passenger journey times. In Liverpool most bus lanes have been abolished to ease traffic congestion for motorists. The length of time for bus journeys only increased fractionally and the number of bus passengers actually increased. At Holborn tube station passengers were asked to stand on both sides of the escalators – instead of walking on the left and standing on the right. This meant congestion was eased as capacity increased. One can see the same logic provides a case for getting rid of bus lanes.

On the other hand perhaps Mr Stubbing is correct and that allowing electric cars to use bus lanes would increase overall journey times. I think he’s wrong – but let us suppose he is right. What is more serious? That a bus journey takes a minute or two longer or that air pollution continues to cause us to die an year earlier than we otherwise would and means we are wheezing and spluttering before it finally finishes us off?