Tuesday, 27 June 2017

Ending zero-hours contracts in the care sector

Column in the Llanelli Herald on 14th June 2017

Care services are a vital source of relief and respite to many, and support thousands of people to continue living independently in their own home. But the services are under immense strain - not least because the workers employed within them are pressured into trying to do too much for too little, and aren’t being given the respect and stability they deserve.  

Anyone who has an elderly relative, or knows someone who relies on these services, knows that these terrible working conditions can often impact on the quality of care given. Rushed visits as care workers are pressured to fit too many visits in one day, with not enough time allowed for travel between the visits; and high turnovers of staff, which can be disorienting (particularly for older people), and which can impact on continuity of care that complex conditions so require.

This week, the Welsh Labour Government has committed to act. Ministers have launched a public consultation on a raft of policies that will help address many of these issues. These measures include requiring care providers to put in place realistic rotas that make allowances for the travel time required to journey between visits and that take things like heavy rush hour traffic into account.

The Welsh Government also want to address the abuse of zero-hours contracts. Under the measures proposed, care workers who have been continuously employed for three months will be offered the choice of moving to a minimum hours contract. Crucially, this will be a choice - protecting the right to a zero-hours contracts for those staff that prefer the flexibility such agreements can offer, whilst also offering greater security and certainty to those that want it.

Hopefully, these ideas will alleviate some of the stress faced by care workers, and will help protect the time they can spend with the people who need their help and attention. More than this, it’ll offer care workers greater respect for the vital support they provide.

The consultation on these measures is open until August 7th, and I’d encourage anyone who has views on how we can improve these services to get in touch. More details are available on the Welsh Government website.

Wednesday, 7 June 2017

Cutting corners to raise school standards

Published in Llanelli Herald on 2nd June 2017

About 40% of my working week is taken up sitting on two committees - the Public Accounts Committee (which examines the value for money offered by public bodies in Wales) and the Culture, Welsh Language and Communications Committee (that focuses on Wales’ arts, media and historical institutions, as well the Welsh language). They’re a crucial part of the functioning of the Assembly - holding our national government to account, scrutinising expenditure and examining legislation -  but it’s work that largely goes unnoticed. Partly this is because the work can be highly technical (sometimes my weekly briefings are more than 200 pages long); and partly because we just don’t do a very good job of publicising it.

Recently, however, a series of questions I asked the Welsh Government Director of Education caught the attention of the BBC. And with good reason.

Right now, students (and their parents) across Wales are facing a nail-biting time as exams are underway. But in a recent meeting of the Public Accounts Committee, Steve Davies (the lead official for education in Wales) admitted he held concerns that some schools are entering children prematurely in a bid to boost their ranking. In other words, some education authorities in Wales are pushing Headteachers to game the system, to ensure they reach the required number of C-level passes.

This is a concern not just because it’s creating a lot of unnecessary stress in the classroom, but it also isn’t pushing children to their best ability. Instead of being encouraged to hold off and reach for a higher grade, children are being left ‘bagged at C’. Mr Davies admitted that the volume of early entries was indicative of this premature pressure being piled onto students; Headteachers fearful of upcoming Estyn inspections, are entering pupils based on the school’s needs rather than those of the child.

It’s a shameful picture, and an unintended consequence of trying to raise school standards. I’m relieved that the issue is now getting the attention it deserves - and there’s a commitment to publish the findings of the review in the early autumn, before next years’ pupils are entered into their exams.
GCSEs are stressful enough, without having to question the motives of your school for entering you.

Hopefully action will be swift, and we can prevent further pupils falling foul of the system meant to serve them.

Kidwelly’s woes should make us all stop and think

Published in Llanelli Herald on 26th May 2017

Last Friday, I held a public meeting in Kidwelly on the parking and speeding issues faced by the town.

Though the meeting was not particularly well publicised over 50 people came out on Friday night to explain how much of an impact speeding cars and inconsiderate parking is having on their lives.

For example, people mounting their cars on pavements obviously doesn’t seem like a big deal to the driver but to parents with a pushchair or wheelchair users, this simple act of thoughtlessness can force them out into the road and into potentially dangerous confrontations with oncoming traffic.

Cars whose drivers choose to speed through the town is also a concern, particularly for those tackling the school run. With two kids of my own, I know how difficult it can be to juggle the multiple demands of the daily commute without having to contend with self-centred motorists. Split seconds can be the difference between mundanity and tragedy.

Many at the meeting were frustrated by the lack of progress - mine wasn’t the first meeting the town had held and they were quick to point out that little has changed. In part, that’s because of a lack of money, budgets are simply too tight to give every community the traffic-calming measures that are needed - and the complexity of the rules and regulations which affect anything which is done near the highway.

But residents are right to challenge this inaction, and it mustn’t be left for a tragedy to occur before due attention is paid. I will do everything I can to work with councillors and council officials to address their concerns.

But I also think there’s room for us to all take collective responsibility for this community’s woes.

Kidwelly is a stunning town. But its beauty is being blighted by the selfish acts of a few. People who can’t walk fifty metres further down the street, or who can’t arrive at their destination just five minutes later. Sometimes there might be legitimate reasons for this; often there aren’t.

And at moments like these, I find myself reflecting on how we have allowed the car to dominate our lives, to such a degree that 50 people will give up their Friday night plans to come and speak to me. Cars are a convenience, sure, and (since having to juggle the demands of being an Assembly Member) my family has two. But they now monopolise the environments we live in.

And too often we resort to tighter controls; expensive coping mechanisms that offer a physical barrier to what is essentially anti-social behaviour - parking permit schemes, pedestrian crossings, curb extensions and speed bumps. We opt for ever-more-expensive engineered solutions, rather than addressing the problem at source.

Getting out of this situation will take collective action, a collective promise to prioritise people over speed, our communities over convenience. I’m not suggesting that this would solve all of Kidwelly’s parking and speeding woes, and - as I’ve already set out - I am determined to try and tackle the issues that were raised. But with complex problems, the response must also be complex. Tackling these concerns will take more than a lollipop lady or a concrete bollard, it’s about each of us taking responsibility for the communities we live in. It’s less “me first” and more “us, together”.

Keeping patients in the dark in Burry Port

Published in Llanelli Herald on 19th May 2017

Hywel Dda Health Board have made the decision to close Harbour View surgery in Burry port in the light of the decision by Dr Lodha to retir

Doctors retire all the time and this should not have come as a huge surprise. But rather explaining to the patients of the surgery back in February what the options were for them when this single-GP practice hands back their contract to the Health Board, some patients have only just had letters telling them the surgery is to close in July and they are being ‘dispersed’ to Doctors as far afield as Kidwelly, Trimsaran, and Pontyates.

The problem is that nearby Doctors surgeries are ful

Needless to say there is huge local concern and on Tuesday night 250 patients attended a public meeting called by Nia Griffith and I, along with local County Councillors John James and Amanda Fox.

But despite our best efforts the Health Board would not attend to listen to people’s concerns and explain their plans.

As I drove to the meeting the Health Board called to confirm they plan to shut the surgery in the summer after a panel decided this was the best option. But as part of their decision-making it seems that this panel doesn’t seem to think that engaging with the public, and explaining the options, should be part of their role

The local Health Board have known about it since February, yet have failed to explore avenues that would lead to the surgery staying open, and haven’t yet officially communicated the closure to all of the patients. Instead of a categorical response, residents have been drip-fed information from various sources, including the beleaguered surgery staff and a pinned notice on the front of the door.

Let’s not kid ourselves about the underlying issue here - there is a shortage of GPs in Wales, as there is all over the UK.

GPs increasingly want to work flexibly or part-time, and are less keen on buying into a traditional practice (not everyone realises surgeries are basically private businesses that contract to the NHS). Younger doctors also tend to want to be in cities. In fact the model of a single GP practice - like Harbour View and Andrews St in Llanelli - is fading out because of all these reasons.

When a Doctor does retire the Health Board has been trying to keep surgeries going by bringing in Locums. When this happened in Kidwelly some were charging £1,500 a day, and stipulating the sort of work they would and wouldn't do.

Eventually Kidwelly has been able to recruit (not as many as they would like), by supplementing the doctors with other professionals like physiotherapists, nurse practitioners and a pharmacist - this is a sensible model as we don't need to see a doctor for everything).

But what the health board plan to do in Bury Port I do not know as they haven't told me, nor anyone else it seems. The lesson from Kidwelly was to involve patients from the beginning and to be open about the choices that the health board face - this lesson seems to have been quickly forgotten.

I’m meeting the Chief Executive of Hywel Dda on Friday to let him know about the public meeting and to ask him to personally intervene to ensure that people in Burry Port get easy access to the best health care, and are kept fully involved.

Improving Llanelli station

Published in Llanelli Herald on 5th May 2017

This week, Arriva Trains teamed up with a voluntary group, the Heart of Wales Line Development Company, to announce they will be trialling extended opening hours of the ticket office at Llanelli Train Station.

Ticket offices aren’t just about being able to purchase tickets - we’re used to using ticketing machines on platforms. It’s about local knowledge, someone we can go to for advice and help, a sense of station security and an ability to join-up public transport provision.

From speaking to local passengers about what they want out of the station, it’s obvious to me that the facilities simply aren’t open for long enough - the fact that the station is closed on a Sunday is far from ideal.

So I’m glad that throughout May the booking office on Great Western Crescent will open from 6.15am  to 5pm Monday to Saturday, and between 11am and 5pm on Sundays. Currently, the ticket office closes at 12.40pm Monday to Friday, 1.30pm on Saturdays and doesn’t open at all on Sundays.

If it goes well the longer hours could be made permanent and the rail development company will get a portion of the additional ticket sales to allow them to employ staff and offer additional services to promote greater use of the Heart of Wales Line.

The way to get more people travelling by train to make it a more attractive option than taking the car. Part of this is making the stations welcoming places by offering a wide variety of facilities - such as toilets, food & drink and manned platforms.

I’m a little concerned that it may be a self-fulfilling prophecy to say at the end of what is a fairly short trail that extended hours aren’t justified due to a lack of use. These changes need time to improve passenger numbers. Will a month be enough? We’ll soon find out.

In the meantime, spread the word. The more people that use the station throughout May, the better chance we all have of getting a permanently improved service for our town.

Raising our game to help families with autism

Published in Llanelli Herald on 28th April 2017

It is estimated that Around 700,000 people in the UK are on the autism spectrum. It affects how a person communicates with, and relates to, other people. It also affects how they make sense of the world around them.

It is a spectrum condition, which means that, while all autistic people share certain difficulties, their condition will affect them in different ways. Some autistic people are able to live relatively independent lives but others may need a lifetime of specialist support.

The Welsh Labour Government has just announced an additional £7 million investment into the new national autism service for Wales, which will provide lifetime support for children and adults.

The Integrated Autism Service offers help with emotional and behavioural issues, support to access leisure and improved diagnostic assessment. It was set up last March and will be rolled across Wales by next year thanks to a total of £13 million of investment by the Welsh Government so far .

There’s been an immediate improvement in the appalling waiting times for families in the Hywel Dda area. But the situation is nowhere near good enough. It needs to keep improving, and I’m confident that it will.

The funds will help deliver the target of a 26-week waiting time from referral to first appointment for children with autism and other neurodevelopmental conditions, along with speeding up access to support.

Speaking as someone with personal experience of how difficult it can be for families living with autism.

Recently the National Autistic Society Cymru said that service provision for the 34,000 people with autism and Asperger syndrome in Wales is "patchy". Crucially the Welsh Government’s new plan focuses on improving assessment, diagnosis and support for people on the autism spectrum. It will be led by the new integrated autism service, which will be based on the National Institute for Health and Care Excellence’s best practice standards and will include a focus on multi-disciplinary working, ensuring people with autism receive joined up services and support.

Like all well intentioned plans the way it is rolled out and resourced is the key, and that’s something we’ll have to keep working on but the new £7m funding is a significant step forward.

But the things that can make the biggest difference is how we all understand the condition, and the
people who are affected by it. And that’s something we can all make an effort to do.

More Doctors for Llanelli

Column published in the Llanelli Herald on April 7th 2017

We had good news this week about an increase in the number of GPs that are being trained.

As family Doctors retire, and more and more opt to work part-time, many local surgeries have been struggling.

Welsh Labour Health Secretary Vaughan Gething launched an incentive scheme to offer £20,000 to trainee Doctors who sign up to areas that have shortages.

This week we heard that the scheme has helped bring a 16% increase in the number of trainee GPs.

The campaign has focused on marketing Wales as an attractive place for GPs and their families, to train, work and live by highlighting the benefits and opportunities offered by a medical career in Wales.

Developments like the new ‘Front of House’ model at Prince Philip Hospital and the planned ‘Wellness Centre’ at Delta Lakes complement this message by offering opportunities for Doctors to research and develop while they practice as GPs.

As well as highlighting what a great place Wales is to live the campaign offers to pay the exam fees of trainee Doctors. And students who sign up to train in specialist areas that have shortages will get further financial incentives on the understanding they remain in the area in they trained for one year of practice afterwards.

There are still spare training places and efforts will continue to fill them. The early signs are very encouraging with the number of GP training places filled at the end of the first round of recruitment currently stands 84 per cent - compared to 68 per cent at this stage last year.

The next phase of the campaign is being launched next month and will target nurses in primary care, secondary care and the care home sector and will launch in May. Future phases of the campaign will target pharmacists and allied health professionals.
As well as getting more people to become Doctors we need to modernise the model of the way local surgeries work. I met with Llanelli GPs recently and they are trying a number of ways of changing the way they work by building up clinical teams around them. So instead of just having a family Doctor surgeries will increasingly offer the services of a physiotherapist, a pharmacist, a paramedic and a nurse practitioner.