Metropolitan borough « Dr Alf's Blog

Metropolitan boroughs, London boroughs and non-metropolitan unitary authorities are shown (the remaining areas are shire counties) (Photo credit: Wikipedia)

Dr Alf is right to worry about the risks of Local Authority shared services centres because the real problem of lack of local authority worker productivity (32%) and the number of local authorities, constabularies and fire commands is not being addressed.

Nor is the problem of too many local authority layers of Government being addressed, nor the burgeoning problem of Adult Social Care, which now consumes 55% of county council, unitary authority, metropolitan borough council and London Borough Council budgets.

The steps needed are clear:

1) Abolish districts and boroughs and outsource all their functions to a rotating panel of providers

2) Reduce UK county councils, unitary authorities, metropolitan borough councils, London Borough Councils and City Councils to 15 (England, Wales, Scotland and Northern Ireland)

3) Reduce layers to five, and impose headcount restrictions to stop bogus grades re-emerging as happens now

4) Apply Lean EFQM to all services, recalculate headcount required fire all those surplus to requirements staring at the top with the 4000 or so council chief executives who are essentially not needed. In practical terms, this will mean firing 55% of all local authority workers

5) Reduce constabularies and fire commands to 15 and repeat the process but in the case of the police keeping the overall budget intact and using layering and procurement savings to fund cleverer detectives and more bobbies

6) Merge Adult Social Care into the NHS and get rid of Adult Social Care directorates in councils

7) Centralise all purchasing with a rotating panel of auditable providers changed once a year

8) Bring in random spot checking of all local authority workers bank accounts and in the case of senior officials, Chief Executives etc audit the accounts of their wives, girlfriends, partners, mistresses, children and relatives, forbid them from setting up foreign trusts

Catch and bring to justice two or three of the worst examples of corruption (there could well be many) and make sure that the sentences on conviction are draconian and that all monies are recovered in the full glare of publicity and with Dominic Littlewood the bald headed presenter given full scope to pontificate on the matter in a television programme

9) Bring in variable tax on foods, identify Adult Social Care recipients early, insist that people lose weight and stop smoking before they are given Adult Social Care or NHS operations.

Aggressively re-enable all Adult Social Care recipients so that only those truly in need of such help actually get it.

Apply gastric band and stomach stapling to the morbidly obese and prescribe Tai Chi for them once they are thinner

10) Merge all call centres and dispatching centres into CRM driven,web enabled shared services centres

11) Outsource whatever is left over

John Gelmini

Metropolitan boroughs, London boroughs and non-metropolitan unitary authorities are shown (the remaining areas are shire counties) (Photo credit: Wikipedia)

This is the latest of several blogs in which Dr Alf has highlighted the problems associated with care for the elderly.

The Chinese will deal with things pragmatically but will not shirk their responsibilities because of their very different tradition of venerating or trying to venerate the old.

The problem in the UK is that too many old people did not plan for their retirement and have too little money to pay for their care, which is of course “free” to the Scots who are being subsidized by taxpayers in England under the Barnett Formula.

Secondly, too many people throughout the UK want to abrogate their duty of blood and honor to their parents and want the state or a local authority to pick up the burden.

They imagine wrongly that they have already paid for this through their taxes and they imagine, if they have no money that “someone else” will pick up the tab.

They complain loudly about the treatment meted out to elderly people in care homes but do not want to pay and in most cases do not want their comfortable lives disrupted by an elderly parent.

They claim to worry about dementia but eat and drink themselves into ill health and fail to take basic preventative measures.

They, if they are old enough or cavalier enough, take or took part in drug taking in the 1960’s and then wonder why their previous debauched lifestyles or those of their “flower child ” parents have transformed into the dribbling parodies of the people they once were, making no sense and reliving their childhoods whilst filling up doctor’s surgeries and the streets with their Bactricar mobility scooters.

We are now at the point where 55% of local authority budgets are being spent on Adult Social Care recipients within County, Unitary, Metropolitan Boroughs, City Councils and London Boroughs.

This leaves 45% for all other services at a time when the tax base is too small and growth,as it has been since 1946,is still too low.

People are still not ready to face up to these difficult issues to the point where in one survey the UK public simply found the whole matter too distasteful to discuss.

Certainly they are not ready for a rational Oklahoma style debate on Adult Social Care and what healthcare they are prepared to fund either via the NHS or privately.

Already the Government is telling doctors to make lists of people with less than 6 months to live and from Lord Falconer‘s “Assisted Dying Bill” is moving towards Dutch style euthanasia in stepped increments.

Other decisions are being made in secret but because the public is not willing to handle the truth; the politicians who are weak and prone to lying are doing what comes naturally by concealing their deliberations under a welter of weasel words.

The British public do not want robots used in care homes to bring down the costs, they do not want the elderly without relatives shipped out to Goa and Thailand but they do not want to step up to the plate and buy long term care insurance or do as my sister and I did with my late father, grieving over the loss of my mother after he had a stroke and became demented—Look after him whilst still working.

Soon the chickens will come home to roost and unpleasant choices will be made for them whether they like it or not.

John Gelmini