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If you're an early riser, and I know so many of you are…
… you will know there is a time of day that is only known to the Larks and the worm-catchers...
... when the sky starts to lighten-up.
It’s about half an hour before sunrise. The world is yawning. Stretching. A hesitation. A moment of uncertainty. Getting ready for the day. It’s a private moment. A time for reflection.
The sky starts to lighten.
The highest clouds catch the first blush of pink and a streak of tangerine appears across the horizon. The features of the fields and the trees, the roofs, the houses, the tower blocks start to show themselves.
It has a name. It’s called Civil Twilight and only occurs when the sun is exactly 6° below the horizon.
It’s the time of day when you stand with yourself… perhaps wondering, worrying, anticipating, dreading or looking forward.
It is the time of day when you know you are with the right person, or not.
It is the time of day when you know you are in the right job, or not.
It is the time of day when you know you are doing the right thing, or not.
It is the time of day for the sort of truth only you, can tell yourself.
If you have experienced that time of day, then you will know. There is no other time like it.
If a brief moment like that, so full of truth, can be translated, amplified into a moment in history… this must be the time.
The Civil Twilight in the long history of the NHS, from its rumbustious birth, the golden years, demolition by austerity, destruction by covid and the promise of a new dawn…
... we are up and waiting for the streak of warm colour.
It’s the moment when we must tell ourselves the blunt truth… carrying-on, soldiering-on, pushing-on won’t do.
The winter is almost here and we have a plan that is little more than, do what you did last year and make more effort.
That’s because there is nothing else that can be done.
The most frequent users of the NHS are the elderly. Because of tightening eligibility criteria the Health Foundation and others have estimated one in seven over 65’s have unmet care needs.
There are about 12m over 65s, that might mean an indeterminate number, up to 1.7m at risk in cold weather.
The changes to the Winter Fuel Payment eligibility, which limit support to those on means-tested benefits like Pension Credit, could leave around 2 million pensioners without this help.
These cuts mean some pensioners, particularly those slightly above the qualifying threshold for benefits or unaware of their eligibility, will lose up to £300.
Increases in the National Minimum and Living Wage, will result in additional costs that care providers will struggle to absorb.
For the domiciliary care sector, staffing costs typically account for 80-90% of total expenses.
Care England estimates that the NIC rise, alongside wage increases, could contribute to a £2.4 billion funding shortfall across the adult social care sector.
There are predictions of widespread financial instability in the sector.
The rise in NICs and wage increases, will significantly raise the cost of running GP practices. For some this could mean around £40,000 or more, depending on their size and staffing levels. Translating into diminution of services.
The availability of ambulances per 100,000 population in England is approximately 4.
France has seven. Germany has around 8-10 ambulances, Austria 15.
In the NHS there are almost 500 less full time ambulance staff compared to 2015.
Since the election, there is nothing that HMG has done to make any of this better or easier. In fact, it's worse.
Problems for; GPs, social care, benefits and ambulances, what more of a toxic mix could you least want - heading for winter.
The problems and the fault lines are starting to show themselves. There is no light in the early morning sky.
By now, a truth should be starting to dawn on you.
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