Lewisham Hospital does belatedly well on MRSA: Are there lessons for us all?
A recent story has pointed out that Lewisham Hospital is winning the battle against the MRSA bug. The last three months have been infection-free, and this has resulted in the Government urging all NHS trusts to follow Lewisham’s successful programme. Great news! But has it been too late? And what does it say about embracing good practice from elsewhere?

A stringent screening programme of all adult emergency and non-emergency admissions for the bug began in October 2004. This has been complemented with extensive hand washing terminals throughout the hospital. In June 2005, a Healthcare Commission survey showed that Lewisham was the fourth-worst hospital in the country for MRSA so this is a major improvement. Yet could it have been better? And sooner? Between April 2001 and September last year, more than 220 people caught the infection while being treated at Lewisham. So there were cases of MRSA despite the screening programme being in place! And what became of Lewisham’s successful hydrogen peroxide trial in 2004? Developed in 1818 by Louis Jacques Thénard, hydrogen peroxide has been used by hospitals, in varying degrees, for decades, even before the arrival of the NHS in 1948: Retired nurse Cissie Ridings recalled using it for Ottorrhoea (discharge from the ear) in the War years. Ears were swabbed with hydrogen peroxide daily and if the solution bubbled, pus was present. Then the ears were mopped out with saline. One chief downside with it is that it can be corrosive especially in concentrated doses. It can destroy good tissue as well as areas of infection particularly where open wounds are being treated. In 2004, Lewisham Hospital took part in a trial where Dalek-like machines emitted peroxide as vapour. The company supplying the technology was Bioquell and they played a major role in the hospital’s MRSA `Search and Destroy’ policy. In one example, Bioquell points out that ten patients had MRSA in one surgical ward of twenty beds. A survey revealed that 35.7% of 28 surfaces and 27.7% of 18 air samples had the bug. The ward was emptied and cleaned with bleach for four days yet 16% of 65 surfaces still had MRSA. Bioquell were called in to decontaminate the ward using its peroxide-based Room Bio-Decontamination Service (RBDS). No adjacent areas experienced any leakage of peroxide vapour. The clean up allowed the ward to be occupied immediately afterwards, and RBDS was used in two other wards. But there are forms of hospital-associated infection that hydrogen peroxide reportedly struggles against: Bleach is apparently better than peroxide for some bacteria like Clostridium difficile, the biggest cause of hospital-acquired diarrhoea. Yet bleach could not shift the ward-based MRSA at Lewisham. But perhaps the biggest obstacle to ridding hospitals of infection is not choosing the right disinfectant: It is State bureaucracy. In December 2004, the Department of Health’s Rapid Review Panel lauded Bioquell in trial assessments in the fight against MRSA. However, one year later this newspaper reported that the same Ministry said more trials were needed before it could be rolled out to hospitals as standard practice. In fact, the Ministry went as far as to blame Bioquell for not making the business case to use them!

It seems to me that the State stands in the way of health care. Lewisham Hospital could have had an even better MRSA record but for the delay of Government in supporting the standard use of peroxide in combating MRSA. But there is another element to this argument. There is a major health sector today that literally caters to the public and has the hygiene problem licked. It’s the food industry. Not only are high standards of cleanliness rigorously imposed on workers, who must wear sterilised uniforms daily, but also visitors to plants. Malcolm Kane, is a food scientist with quarter of a century experience in managing food-related infection. He says: “Even a brief visit requires you to cover your head, take your shoes off on one side of a bench, swing your feet over to the other side and put them straight into a pair of freshly sterilised boots.” Professor Hugh Pennington, president of the Society for General Microbiology and a leading expert on hospital acquired infections, has stated that “the food industry certainly provides a model that could work in hospitals; what’s needed is more authority to push it”. Isn’t there a better way of rolling out technology, like Bioquell’s, which costs £100,000 a year to run per hospital yet can save lives as well as millions of pounds in MRSA claims? And would we all be prepared to support the fight against MRSA by volunteering ourselves to be `hygienically-cleared’ when we visit the hospital? Would Government support such an idea? I know I would, wouldn’t you?

Isn’t it time to hand over ALL Lewisham State schools to Haberdashers?
Last weekend saw The Sunday Times publish its new ranking of Britain’s best schools. Lewisham, which has sixty-nine primary and fourteen secondary State schools, has just two of them on this exclusive list. The other three are independents. And it is a mixed bag of results. While there are some encouraging signs of improvement, two Lewisham schools have dropped steeply. Another two have disappeared, although one is new. But is there hope of a brighter future, courtesy of Haberdashers?

The Times decides the overall ranking by looking at the academic performance of schools in Britain. It takes note of the overall SAT score from Key Stage 2 results of primary, junior and preparatory schools, and the GCSE and A level pass rate of secondary schools. Here’s the list of interest to Lewisham:

National 2006 rank (2005 rank)
Top preparatory schools
042 (054) Sydenham High School Junior School GDST
Top independent secondary schools
193 (121) Sydenham High School GDST
318 (284) St. Dunstan’s College
Top 500 secondary schools
248 (147) Sydenham High School
444 (319) St. Dunstan’s College
Top 500 State primary schools
391 (----) John Ball Primary
Top 500 State secondary schools
238 (273) Haberdashers’ Aske’s Hatcham College

Once again, the superiority of Lewisham’s independent schools over its State counterparts is clear to see. But they shouldn’t be passing the bubbly just yet: While Sydenham High School’s Junior School made it into the top fifty British preparatory schools this year, its secondary elders fell by a total of 173 places in the lists of top independent secondary schools and top 500 secondary schools. Fellow Lewisham independent secondary school, St. Dunstan’s College dropped a combined 159 places across these two lists. Worse still, St. Dunstan’s Junior School has vanished altogether (it was ranked 82 last year). Lewisham’s State schools had John Ball Primary making the top 500 State primary schools list for the first time at 391. Unfortunately, Prendergast School has disappeared from the list (it was at 209 in 2005). On the bright side, Haberdashers’ Aske’s Hatcham College jumped 35 places to 238 from 273 on the top 500 State secondary schools list. But while any improvement should be welcome, contrast the performance of Haberdashers’ stable mates in the independent sector:

National 2006 rank (2005 rank)
Top preparatory schools
001 (----) The Haberdashers' Aske's Boys' Preparatory School in Elstree
Top independent secondary schools
011 (004) Haberdashers' Aske's School for Girls in Elstree
024 (018) The Haberdashers' Aske's Boys' School in Elstree
130 (083) Haberdashers' Monmouth School for Girls
Top 500 secondary schools
011 (004) Haberdashers' Aske's School for Girls
026 (019) The Haberdashers' Aske's Boys' School
160 (103) Haberdashers' Monmouth School for Girls

Haberdashers’ can claim to have the best preparatory school in Britain and also has two secondary schools in the top thirty. Even its least performing ranked independent – Monmouth - is far higher than Lewisham’s top State secondary school, its cousin: Haberdashers’ Aske’s Hatcham College. What is happening here? Two Haberdashers schools: One independent, one State yet a huge gulf between them. Is it fair to compare? Is it too early to criticize? The two Haberdashers Academies in Lewisham have only been around for a short while in their current federal form, and yet they can claim great results in their own right: Hatcham had an A level pass rate of 99% with 5 students gaining Oxbridge places and 94% getting GCSE 5+ A* - C results. Meanwhile their Knights Academy (which did not feature in the Sunday Times list at all) scored passes at GCSE of 29% at 5+ A* - C which was an improvement of over 200%.

It seems to me that despite the challenge of reconciling the best practice of independent schools versus the aim to be as comprehensive as possible to the community, Haberdashers are making good headway. Last year, a lottery had to be proposed to ensure an impartial selection of new pupils since there were more than 2,500 children chasing 208 places at Hatcham. Then there was controversy earlier this year over the lateness of promised funds - £2million – for each of the Academies by the Haberdashers livery company. But now the results are in, and certainly Hatcham, a music-oriented institution (Knights is sports-driven), is doing well: Its ranking on the Times list is its best in the past three years. Plans are currently afoot to incorporate Monson Primary School into Hatcham. But are you thinking what I’m thinking? Wouldn’t it be great to see such a successful entity be given ALL the State schools of Lewisham to run?

If Whoopi can do it for Lewisham arts, why can’t it be done for Lewisham business?
Angie Le Mar, the Choice FM DJ and comedian has recently succeeded in getting top American star Whoopi Goldberg to be patron of her new performing arts school in Lewisham, due to be opened in 2008. Great news but where is the equivalent excitement in Lewisham business education?

Lewisham girl Angie has known Whoopi since 1998 after interviewing the comic and actress on the release of her book, called…well…Book. The two got on very well and this development of their relationship can only be a good thing for Lewisham. Bravo! Wouldn’t it have been nice to see a similar development in the area of business education in Lewisham? Why business? Well, last year Lewisham businesses contributed £80.3m to the borough’s coffers in rates, just £2.5m behind the amount raised via council tax (the largest contribution is £221m from central government). If local residents rightfully claim for key support, our businesses should also get some too. A major business success helping to develop the entrepreneurial spirit of the borough would be a good story. The country is already switched on to exciting primetime business shows like `The Apprentice’ and `Dragon’s Den’ so it wouldn’t be a difficult idea to sell. True, there already is a Junior Greenwich, Bexley & Lewisham Chamber of Commerce. The Chamber of Commerce teamed up with the Greenwich Education Business Partnership (EBP) to promote this concept. The Junior Chamber will resemble the Adult Chamber with a focus on Fair Trade. Participating schools are invited to send up to four students to represent them on the junior board. The idea calls for meetings each half term with support from both the Student Chamber and the Adult Chamber. The aim is to enable pupils to understand how to run an effective and profitable business but with due regard to acceptable moral standards. Yawn.

It seems to me that while it is good for the Chamber to get involved with schools, it could do a lot better. And it need not reinvent the wheel. When I was at school in Jamaica in the mid 1980s, that country’s Chamber of Commerce introduced the American Junior Achievement Programme to the country. For some 15 weeks each year, students in schools across the island started, ran and wound down companies in a big contest against each other. Awards were given for profitability, innovation, professionalism etc. I picked up one after presiding over a school company that made rock cakes. We returned JA$2 investments to students with JA$18 on top…those were the days! And Junior Achievement has a presence in the UK. The British office is called Young Enterprise but there’s no sign of the Chamber of Commerce among its patrons. If Jamaica did it over twenty years ago, why can’t Lewisham do it today?

Education, education, education: Lewisham College’s disregard for the past part 2 of 2
Hey, that’s groovy. It’s a gas. In fact, it’s cool-o-roonie. Far out, man. Gimme some skin. That’s rad. Bodacious even. Can you dig it? Er, no I can’t. And no I haven’t been tripping either. But dated slang is perhaps a more revealing metaphor as to why British education is where it is today than you may realise. And why institutions like Lewisham College do not help when they embrace questionable teaching practices while dismissing past methods that worked.

Every generation seeks to put their stamp on their time. That’s fine with slang, and if it’s clever, it can sometimes add permanent colour to language. But it can be disastrous when fashion is applied to more than just street talk. Robin Ghurbhurun Lewisham College's director of e-learning says `There is an expectation from the students coming through - they are living in a digital world with YouTube and MySpace and iPods and Xboxes and the last thing they want to do is walk into a classroom that looks like it's from the 18th century'. My previous post demonstrated how traditional British education is still successful in our former colonies while new fangled ideas like elearning are struggling in this country. Mr. Ghurbhurun is not breaking new ground here: His predecessors in the State system have also been children of their times and sought to support contemporary ideas. In the area of State education, this has been going on since 1833. In his excellent book `The Welfare State We’re In’, James Bartholomew lists the key milestones:

1833: Government grants are first issued to charitable, church schools to give a bit of help. Then more grants are given.

1839: Government inspectors are appointed to examine schools to ensure grants go to suitable institutions.

1870: Government’s Elementary Education Act is introduced by W.E. Forster to help fill perceived gaps in independent schooling. Independent schools start collapsing, as they cannot compete with the new Government free schools. This was not what Forster intended.

1876: Government’s Elementary Education Act as framed by Lord Sandon prevents employers taking on children who have not come from Government-certified schools. More independent schools are forced to close.

1880: Government makes elementary schooling compulsory for children aged five to ten.

1902: Government’s Education Act as designed by Arthur Balfour makes secondary schooling mandatory as well.

1917: Government grants are given to Oxford and Cambridge Universities for the first time. Both are assured there would be no loss of independence.

1918: Government’s Education Act, brought in by H.A.L Fisher, abolishes all fees for children in State elementary schools and raises the age of compulsory education to fourteen.

1944: Government’s Education Act, as created by `Rab’ Butler, pays more money to church schools, and in return, achieves control over most of them.

1961: Government creates the first State university: Sussex. Other universities become more dependent on Government.

1963: Government’s Robbins Report recommends that higher education should be available to all who qualify for it.

Many of these initiatives were created with the best intentions in mind. It originally only wanted to fill small gaps in an otherwise impressive school system that operated without State help. Over nearly two centuries, the Government has totally swamped the education system, and in many instances expropriated property paid for by charities, churches and generous donors. We now have a dreadful school system that forces many worried parents to spend twice on educating their children via the independent sector. Those that get left behind risk becoming functionally illiterate.

It seems to me that there’s nothing wrong with creating new fashions as long as you don’t try and reinvent the wheel every few years or so. And if you must, then be prepared for the next generation to undo your good intentions with their own ideas. But at least in the case of language you can easily choose whether you want to use it or not. Unfortunately, when the Government wants to get trendy, it often loses the plot and at best, shows it’s out of touch and at worse, causes misery by forcing millions to conform to outdated and crackpot ideas. And because you can’t do much about it other than try and be the next Government; that can be a real bummer, man.

Education, education, education: Lewisham College’s disregard for the past part 1 of 2
Robin Ghurbhurun Lewisham College's director of e-learning says that his students live in a digital world and `… the last thing they want to do is walk into a classroom that looks like it's from the 18th century.’ Why is it that when people speak about educational reform they dismiss the past as if it is something to be embarrassed about? The truth is that we ignore the successes of old at our peril.

Tony Crosland, the education secretary of the 1960s said `If it’s the last thing I do, I’m going to destroy every f**king grammar school in England, Wales and Northern Ireland’. There has been a war on traditional teaching for many years and while Mr. Crosland was quite colourful in his intent to overhaul education, it didn’t start there. The Government has been tinkering away at education for the past 170 years. What has it given us? In the year 2000, seven million functional illiterates: That’s one in five of all UK adults. In January of this year, the rate across the UK is said to be between 10 and 15 per cent. In poorer areas, it is a lot higher. How can you acquire knowledge if you can’t even read? Was it always this way? In his excellent book `The Welfare State We’re In’, James Bartholomew looks at the past. In 1803, Thomas Paine’s `The Rights of Man’ sold one and a half million copies while William Cobbett’s Address to the Journeymen and Labourers sold 200,000 copies in two months. Samuel Bamford `the weaver poet’ said that Cobbett’s writings `were read on nearly every cottage hearth in the manufacturing districts of South Lancashire’. This was achieved in the schools that Lewisham College is now trying to rubbish in favour of elearning. And what has been the track record of elearning at institutions of higher learning like Lewisham College? UKeUniversities Worldwide (UKeU), an online university for the British higher education sector, was launched in 2000 by then Secretary of State for Education, David Blunkett. The UK government gave it £55 million and expected additional private sector investment. The first online courses were launched in March 2003, and by November 900 students had been recruited. It was predicted that there would be enrolment of one million students by UKeU’s tenth year of operation but actual student take-up proved disappointing. The private sector investment never materialised. Finally, the Higher Education Funding Council for England said UKeU was unviable in April 2004 and closed the venture.

It seems to me that before Lewisham College attempts to promote e-Learning as some kind of cure-all while dismissing tried and tested methods of teaching, it ought to pause for thought. British schools were once the envy of the world. Former colonies like Hong Kong and Singapore are places where education techniques originating from the reviled 18th century are still present. They teach maths much better than the UK these days. How did it go so wrong? Who’s to blame? I point my finger at the Government.

F**k the IT! Where’s the passion?
As Gordon Ramsay returns to Channel 4 this evening with arguably his best TV format to date - `Ramsay’s Kitchen Nightmares’ - I can just imagine him getting worked up over a computer education project underway at Lewisham College’s `interactive kitchen theatre’. “An interactive what? For F**k’s sake, I don’t f**king believe it”, would probably be his reply.

Just over a week ago, it was reported that an `eKitchen’ at the college is being used to teach cooking. Cameras zoom in on dishes being prepared while the images are relayed to flat screen monitors on each student’s desk. Footage can then be recorded and edited into `e-learning chunks’ says Robin Ghurbhurun Lewisham College's director of e-learning. These `chunks’ can be accessed later on DVD or online over the web. Ghurbhurun explained: "There is an expectation from the students coming through - they are living in a digital world with YouTube and MySpace and iPods and Xboxes and the last thing they want to do is walk into a classroom that looks like it's from the 18th century." The college seems to think that the technology had something to do with a number of its students – including some from Jamie Oliver’s Fifteen foundation – getting good NVQ1 results. The college is so taken up with the concept that it will be used for…wait for it… beauty and construction students.

It seems to me that these `progressive’ ways of teaching have not necessarily been a good thing overall. Take the wealth of cooking shows on TV, not to mention the recipe books they spawn. Although popular in terms of sales, they have not made the requisite jump to changing behaviour: A survey earlier this year said that while there are 171 million cookbooks in the nation's homes, 61 million remain unopened and on the shelves. Apparently, the average Briton makes a mere 35 of the 1,000 recipes they have in the home. That’s a lot of wasted trees. What makes Gordon Ramsay so riveting to watch is his no-nonsense and fully hands-on energy. He’s old school in his temperament, and utterly demanding of those under his tutelage. You either allow him to break you down and rebuild you up into a fine, hardworking chef and/or restaurateur. Or you stay broken and quit. I guess if you can’t stand the heat…And what’s Lewisham College’s dig at 18th century classrooms all about? See my next post.

Wounded, but not dead: Executive Mayoralty may still bounce back with a little help from its friends
As the celebrations wind down at the stunning reversal of Mayor Bullock’s determination to close down the Ladywell Pool to make way for a new school, it may be tempting to think that this type of borough management is on its last legs: Didn’t people power triumph in the end? Indeed, it was a great result for democracy but it is not the beginning of the end. The Mayor has a formidable ally coming to his rescue: Central government.

Last month, Mr. Bullock and fellow Mayors from across the country, including Ken Livingstone Mayor of London, were present at a seminar hosted by none other than the Prime Minister himself. Tony Blair said it was a bit odd that the Mayoral project had not been more widely adopted across the country. He added that wherever mayors had been introduced it was striking there was no serious popular call from the local community for the experiment to be abandoned (come on Nick Ingham, you’ve got to do a Max Calo!) Our Mayor and his brethren called for more power to be given to them in the area of neighbourhood police budgets, bus services, local primary care trusts, employment and economic regeneration companies. It seems likely that Mayors, like Mr. Bullock, will probably get that power. This was highlighted in a white paper published the following week entitled Strong and Prosperous Communities - The Local Government White Paper. Published by the Department for Communities and Local Government, the paper sets out a vision of empowering authorities. Among the lofty goals is this aim: If we are to continue to improve public services we need to give local authorities and their partners the freedom and powers to meet the needs of their communities and tackle complex cross-cutting issues like climate change, social exclusion and anti-social behaviour (page 11 volume 1).

It seems to me that Lewisham has a lot to worry about. It was hardly encouraging to learn (see my post of November 2) that the pro-Mayor and well-funded think tank, the New Local Government Network, has our own Mayor Bullock as a Board member. Now he has the support of central Government to boot as well. This was a man who said he believes that as Mayor he has the freedom to act independently of the council as a service provider. Mr. Bullock may have lost the battle over Ladywell Pool but has powerful support for the war that lies ahead: Full executive control over Lewisham: Be afraid. Be very afraid.

Ladywell Pool saved: A remarkable victory for Lewisham and Max Calo
At last night’s Mayor and Cabinet meeting, the Mayor of Lewisham Steve Bullock performed a surprising U-turn and effectively saved the Ladywell Leisure Centre by opting for the Lewisham Bridge Primary School site for a new secondary school. This brings to an end some two years of controversy over the future of Lewisham’s biggest swimming pool, and while the roll call of protestors is long, the activism was chiefly piloted by Max Calo, who deserves the fullest of praise.

The decision will now mean that the Ladywell pool will remain open until a promised replacement is built in Loampit Vale in 2010. Previously, Ladywell was due to be knocked down next year to make way for the new school, and Lewisham would have had to wait three years, possible more, for a replacement. Residents were not happy at the prospect of going without this leisure facility considering Lewisham Council’s track record of delay: The old Downham pool closed in 1995, and amid delays that even baffled the Mayor, its replacement in 2007 will be three years later than planned. The pools at Forest Hill closed in March this year due to health and safety concerns, but the final report into its problems will not be completed until later this month. Small wonder that the Ladywell pool became a sore issue for electors during May’s local Government elections. Many pro-Government councillors in the area lost their seats as protestors vented their anger through the ballot box. It was a major element in turning Lewisham into a municipal authority with no overall political control.

It seems to me that in an age of cynicism about politics, it is still possible to defy the odds with a well thought out and properly executed grass roots campaign. Max Calo made this his fight with an excellent website. He did his homework and built up an impressive array of allies across the political spectrum. His relentless push to uncover Council reports and relevant research into the issue kept him forever relevant. He needed no political party to give him `leverage’ or `ownership’ of an issue. He went out there and did it, and his influence was borne out of his determined and focused contribution. He stands out as a role model for all those who tire of politics as usual. Well done, Max.

Lewisham and PFI: Better than privatisation for whom? Part 3 of 3
As this mini-series wraps up, it is worth reflecting on the efficiency of PFI projects because Lewisham, like much of the rest of the country, has quite a few of these public service programmes of its own. Unfortunately, although it will take some 30 years to thoroughly analyse them, a number of schemes have already shown to be wanting.

George Monbiot has spent many years investigating PFI in the health sector – an area where Lewisham Hospital has an interest, as its new clinical wing will open soon. Four years ago he wrote about Cumberland Infirmary, which was Britain’s first PFI-funded hospital. Despite being declared “a doss house” by doctors who looked at the construction plans in 1997, the Government pressed ahead. Within weeks of opening in June 2000, pipes were splitting, flooding the place with water and sewage. There were problems with the ceilings and windows. And not enough beds – 75 fewer than the facilities it replaced. The chief executive of North Cumbria Health Authority didn’t think they were related to PFI – just teething problems. This year, Liam Halligan reported on Channel 4 how it cost one PFI hospital £333 to change a light switch! There is no incentive to create a quality service or cut costs as PFI contractors are not subject to competition, and commercial confidentiality built into PFI contracts make it hard to expose flawed conditions that work against both the taxpayer and user of the service, even after the fact.

It seems to me that a major rethink on how we provide services to the public is in order. There is no such thing as a free lunch but look at the figures again: Taxpayers face paying out £150billion over the next thirty years for over £49billion of PFI projects to date. And at his last budget, the Chancellor of the Exchequer announced ANOTHER £26billion worth of PFI projects. Is it worth it? Is this the best Britain can do with precious resources? Better than privatisation? Certainly for a number of businesses with PFI contracts, and traders in the £4billion per year PFI share market. And better for today’s politicians, claiming prudence by keeping this horrendous cost of public service expansion off the normal accounting books (only for future generations to face). But there must be a reckoning…

Lewisham and PFI: Better than privatisation for whom? Part 2 of 3
More and more big public sector projects are being carried out with Private Finance Initiative money, and Lewisham is no exception. Police stations, hospitals, schools, and even a train station among other projects in the borough have all been touched by PFI. Touted as being value for money and more modernising than privatisation, who really has it been better for?

The biggest PFI project in Lewisham to date – the £202m DLR extension – was part of the National Audit Office survey sample in its PFI debt refinancing and equity report. This was produced after it was revealed that gains from refinancing PFI debt were not, in many instances, contractually obliged to be shared with the related local authorities. This followed after George Monbiot’s revelation over four years ago that Octagon Healthcare, the private consortium building the Norfolk and Norwich hospital, was in a position to extract £70 million from the scheme, before it had taken a single patient. This windfall came as a result of debt refinancing. Roll on four years, and new PFI contracts have explicit clauses in dividing up refinancing gains – small wonder they have decreased since the scandal broke: The NAO said the Government would have rights to only £137million since 2004. Not get the money in one go, mind you. Spread out over years. And in some instances, previous PFI contracts have extended their lifespan by means of squaring things up with contractors: Further enhancing their value on the trading market (PFI share dealing, worth some £4billion annually, is not affected this way, only PFI debt refinancing). George Monbiot cynically believes refinancing clauses were even deliberately left out initially so as to entice PFI contractors in the first place!

It seems to me that for all the evil privatisation is made out to be, especially in the area of public services, there is a lot to be said about how sinister PFI deals are. At least with privatisation, and I am not advocating it as a cure-all, once the deal was done then at least the taxpayer was freed of the burden of supporting the service. Could you imagine British Airways, BT, the railways, British Gas and the other utilities being run today under PFI? In operation since 1992, PFI deals have promised a quick fix to public service investment needs but they carry a big cost - £150billion to taxpayers over the next three decades, and they do not have to be efficient…

Lewisham and PFI: Better than privatisation for whom? Part 1 of 3
This borough has a number of major Private Finance Initiatives; a development tool that the Government considers “…a small but important part of the Government's strategy for delivering high quality public services.” Indeed, the then- Chief Secretary to the Treasury, Alan Milburn MP, crowed how the previous political administration offered mere privatisation but modernisation was this Government’s gift via PFIs. But who is in the position to say PFI’s are better than privatisation? The answer might surprise you.

Among some of Lewisham’s high profile PFI deals include the £202m DLR extension, the £67m Lewisham Hospital clinical building, the £120m police station project that also included Bromley as well as Deptford and Lewisham, the £61m contract for Crofton and Forest Hill secondary schools and Greenvale special school, and the £16m Downham Lifestyles scheme. Much of Lewisham’s projects may still be too recent to throw up concerns (it will take at least a quarter of a century to fully assess their value) but there have been some worries: There are £7m worth of NHS cuts aimed at Lewisham despite the new hospital wing (see my post of November 3). There was only PFI resources available to build the new Lewisham Police station, possibly the largest one in Europe. No other option was available to the police. Mayor Steve Bullock was alarmed at the two year delay of the Downham project contract being signed.

It seems to me that PFI has an invincibility about it that pushes other budgetary and planning considerations to one side. The Government is hell bent on pursuing it. Nationally, there have been over 700 PFI contracts worth over £49 billion signed since 1992 – and 500 of them are now operational. Why the zeal? The costs of PFI projects are kept off the Government books since it is not public borrowings yet the Government can claim the credit for big public infrastructure projects. The contractors are happy because they can project future payments for their own borrowings over a 30 year period. Adept re-negotiation and even refinancing has resulted in them making back their money very early in the life of the contract. They hold the physical assets but not the liabilities and are free to even sell on their interests in secondary markets worth £4billion per year. And all this is underwritten by the taxpayer. So why should private companies bother with the risks of privatisation? Pass the bubbly please…

Lewisham doctor shakes his fist at Government demo but so what?
On Wednesday, Dr. John Wood, a consultant orthopaedic surgeon from Lewisham, made news by railing against Government plans to cut back the NHS. He was part of thousands who descended on Parliament to protest these measures. Dr. Wood said: "I have three sons and I have two nightmare scenarios. One, as an orthopaedic surgeon, is that they come to me and say, 'Daddy, I want a motorbike'. The other is that they come to me and say, 'Daddy, I want to be a doctor'." But is this the best he can do?

People who work in the NHS are having a tough time. While Government crows about new hospitals – the new Lewisham Hospital extension built with PFI money will open its doors soon – there are oddly timed cuts to boot. This borough is facing £7 million in cuts before the new wing opens. "It's one big jigsaw puzzle," Dr. Wood said, "and all the bits are falling apart." My problem is not with the sentiments raised – they’re spot on. I take issue with the fact that as one of this country’s best-educated professionals, doctors, like Dr. Wood, are punching way below their weight and leaving the mucky fighting of policy to less qualified people like me. The reason why we’re in the mess we are with the NHS is that people like Dr. Wood have allowed politicians to tinker at healthcare. There are exceptions: Dr. Richard Taylor the Independent MP for Wyre Forest, campaigned on the local issue of proposed service cuts at Kidderminster Hospital in 2001. He defended his seat successfully in 2005. But where are the other doctor MPs?

It seems to me that for decades the medical profession have been feted and fawned over while successive Governments have closed more and more community hospitals. It started at the birth of the NHS. Aneurin Bevan, the minister responsible for the NHS, won over sceptical doctors – 88% were opposed to the new service in January 1948 for fear of loss of independence (how prescient) – by allowing them to treat private clients in NHS hospitals. Did they sell out? Six months later, 90% of doctors signed up to the NHS (thanks to the BBC for this little bit of history). So the chickens have come home to roost. But that’s little comfort for the rest of us. Professionals like Dr. Wood were able to protest on Wednesday as colleagues covered for them back in the clinics. I’m sure similar support would come forth if they decided to campaign not just OUTSIDE Parliament but INSIDE it as well…

No sign of RoboCop, the monkey or a member of the Board: Welcome to the NLGN’s sanitized MayorSpeak
Last month, there was a report on the international website CityMayors.com declaring how England’s few elected mayors “score highly on accountability”. Ray Mallon, Stuart Drummond and our very own Steve Bullock, Mayors of Middlesborough, Hartlepool and Lewisham respectively, got very nice write-ups with not even a hint of their, ahem, interesting backgrounds. Too cynical a view you might say, until it’s revealed that the NLGN wrote the piece. Who?

The New Local Government Network (NLGN) was founded in 1996 by a group of senior local government figures whose aim was to make local government more relevant and credible to local people. It would be distracting to perhaps mention that Ray Mallon was once known as `RoboCop’ a no-nonsense ex-policeman with an eventful career in law enforcement or that pretending to be a monkey elected Stuart Drummond. And Mr. Bullock? He just happens to be on the board of NLGN. As does Barry Quirk, Chief Executive of Lewisham Council. None of this is mentioned in the story, of course. Would it change the perception of the reader? Perhaps not. To their credit, the website’s political editor wrote a more realistic account of this country’s Mayoral experiment on the same page in the sidebar.

It seems to me that any local effort to drum up support for a referendum to get rid of executive Mayoralty in Lewisham will have to contend with the significant resources of the NLGN: They commissioned MORI polls from as long ago as 1998 to bolster support for executive Mayors. But in their zeal, they can also throw up gems like this: In Lewisham, Mayor Steve Bullock, believes that as Mayor he has the freedom to act independently of the council as a service provider; he is Mayor of Lewisham not just Leader of the Council. And as this he is widely accepted amongst the local partners in his area. Independent of the Council? Widely accepted among local partners? That will go down well with some 28 (and more?) of our Councillors. Not to mention supporters of Save Ladywell Pool and critics of the future Lewisham Gateway. You have all been warned…

First there were cows: Could a bullock be next?
It was reported this week that Lewisham Council’s idea of dressing up their recycling bins in New Cross to resemble cows has resulted in a 60% jump in collected rubbish. Apparently the black and white Friesian cattle-like designs egg people on to `feed’ them with garbage. What other bovine designs could be used to spur people on to recycle more? Hmmm…

Mayor Steve Bullock, who was proud to trumpet his green credentials in his last electoral campaign, is championing this project. He seems quite keen: "Moo Cross is a great way to get people recycling and help make Lewisham even greener. We want people to see more than just recycling bins and warm to them. I’m urging local people to take care of the cows and fatten them up with plastic bottles, cans, card, paper and glass." Moo Cross? Pull the udder one (groan). Jokes aside, Lewisham Council, has the unenviable position of being the third worst London borough for recycling, as well as being in the bottom ten local authorities nationally, so things can only get better. And perhaps, a golden opportunity has presented itself for our Mayor.

It seems to me that given the anger of those who want to see the end of the Mayoralty system Lewisham has, Mr. Bullock can capitalise on both his name and the seething for a greater good. He could encourage his photograph to be stuck on recycling bins across the borough with a sign saying `Feed me, I’m hungry’. What a productive way to channel the pent up frustration of those determined to see the end of executive Mayoralty! By inviting them to shove garbage into his open jaws! Who knows? Lewisham could eventually jump over, not the moon (sorry) but the local authority of St Edmundsbury in West Suffolk to become the nation’s top recycler…