An interesting article by Patrick Diamond of the newish Equality and Human Rights Commission, the new generic body that has taken on overseeing action on race, gender, disability and other equalities (in a pamphlet about equality, diversity and localism). The argument is that equality is promoted by developing a strong sense of belonging in a local community. Other articles about the role of local authorities in promoting equality, for example in child care services and other services that aim at social wellbeing, argue that equality stems from commitment to a diverse local environment.

Solace: the Society of Local Authority Chief Executives http://www.solace.org.uk/index.htm

Equality and Human Rights Commission: http://www.equalityhumanrights.com/en/Pages/default.aspx)

Diamond, P. (2008) How ‘place’ shapes equality and equality shapes ‘place’. in de Groot, L and Mason, A. (eds) How Equality Shapes Place: Divesity and Localism. London: Solace Foundation.

Because I’ve been away on holiday and this blog is not published outside the Hospice yet, I have not been posting daily, but now I’m posting the backlog.

Pics of the St Christopher’s building works, in solidarity with colleagues who are working in difficult conditions, so that things can be better in the future.

Crossed off the map (another area of the hospice inaccessible):

Another study on poverty collects up a range of previous studies and shows that cancer patients and their families struggle with the benefits system, and have few sources of advice. Again, part of the picture is that health and social care professionals do not see it as their role to help people with this, but people’s financial stability is basic to a satisfying life and being able to benefit from healthcare.

Wilson, K. and Amir, Z. (2008) Cancer and disability benefits: a synthesis of qualitative findings on advice and support. Psycho-Oncology. 17: 421-9.

Pics of the rebuilding at St Christopher’s, now under way, in solidarity with all colleagues working through a difficult time, to make things better in the future:

Dig this?

An interesting paper in Palliative Medicine, reanalysing the British Household Survey to find that while 90% of people in the last year of life saw a primary care professional and a third spent time in hospital, more a third reported financial strain in their lives. The proportion receiving attendance allowance (payable to people over 65) was low compared with wider studies. The suggestion is that primary care professionals could have pointed more people at benefits they were entitled to. I see this as an example of the failure of healthcare services to integrate their social care responsibilities properly into their roles. Social benefits and social care are not just someone else’s responsibility.

Hanratty, B., Jacoby, A. and Whitehead, M. (2008) Socioeconomic differences in service use, payment and receipt of illness-related benefits in the last year of life: findings from the British Household Panel Survey. Palliative Medicine. 22: 248-55.

Pics of the rebuilding at St Christopher’s, now under way, in solidarity with all colleagues working through a difficult time, to make things better in the future:
The Chapel is moving (God moves in mysterious…)

A supplement in Guardian Public (July 2008) makes a distinction between service innovation (which is ‘sluggish’) and clinical and technical innovation which is not. It seems this is from a seminar of managers and people from business schools telling themselves that these professionals just don’t get what they’re trying to do.

In another article, the BMA is said to believe that the government’s central control is the problem: ‘Let the professions lead, hand in hand with the public, and you’ll see the progress our patients want.’ (Clarke-Jone, J. (2009) At the sharp end of change. Guardian Public July 2008: Supplement: How to embed innovation in healthcare. 6-7. Probably the BMA means the medical profession, possibly with a curtsey to nurses; I wonder how they’d feel about some social aims to remove health inequalities in there.

The problem is that good management is needed, but it needs to be done well, and what professionals fear is that constant change is destabilising and prevents them from getting on with the day to day job. Any organisation has this discontinuity between the managers who need to keep the show on the road and the managers who need to look to the long-term. Even doctors are managers, most of them are much more conscientious managers that people who are managers that only manage are, because they have to do a meticulous job and carry the can if they don’t. But doing a meticulous job for the people who are here now requires a different mind set than people who are pushing for the next concept. They ought to have a different mind set, we should accept it and build a management system that respects both.

The production organiser for the musical I’m appearing in writes to urge us to learn our lines, even though it’s difficult for us older people; she and I are the same age, over 60. I think saying things like this encourages discrimination against older people. As far as I know, all the evidence is that it’s a ‘use it or lose it’ scenario, so actually learning our lines is good for our overall ability to remember. Looking up the valuable http://www.helpguide.org/ site (it seems to be something to do with American Rotary, who knows why, or perhaps they just fund it) which gives advice on all sorts of personal mental health things, I found some useful tips of keeping your memory capacity green: http://www.helpguide.org/life/improving_memory.htm . Apparently a good move is to take lots of aerobic exercise, on the ground that this improves oxygen in the brain, and to exercise your brain by doing new things or old things in new ways. They suggest showering and dressing with you eyes shut, just to make your brain work harder.