Local press still not quoting Greens

The BBC rang me for a quote re a Lib Dem leaflet in Gloucester. Controversy surrounded a campaign leaflet which was sent out to gain Muslim support in the local elections in Gloucester. It apparently appealed to Muslims to vote for him - See some of my comment here.

Of course my recorded answer got cut very short on the BBC but The Citizen failed to even mention the Green party despite Greens having a candidate in the ward - every election I have to write to them top remind them - to be honest I am getting really fed up with it - I await a reply to my email below with interest!


I know it is difficult to represent all parties but your coverage in The Citizen today of the Lib Dem leaflet excluded the Green party from a quote re the leaflet. BBC Radio Gloucestershire were able to cover the four main parties views on this. I would urge that you please also could do this in future news items. It is hard enough for smaller parties to make our views known to the electorate without being excluded from such items.

It would also be great if you could perhaps cover issues like climate change that are going to have such a major impact on our County's economy and future. Scottish Friends of the Earth for example recently said that the Green party is the only party with policies that will tackle climate change: the Tories came bottom despite their green rhetoric.

I have already forwarded a list of candidate phone numbers to Lisa Bonnell. If you have any difficulties contacting them please phone me on my number below first or my temporary mobile number: 07817 456646.

All the best - Philip

Cllr. Philip Booth, Stroud District Green Party.

Update on health cuts

Tomorrow I've been invited to talk to the Randwick Women's Institute. One of the key topics they wanted to discuss was the recent health cuts.

Photos: Stroud Hospital and below Gloucester Royal

Over a year ago there was uproar in these valleys at the proposed closure of Stroud Maternity Hospital, Weavers Croft and cuts in other NHS. There were over 9,000 objections to the cut proposals and people took to the streets in vast numbers. Stroud Hospital League of Friends, Stroud Town Council and Stroud Maternity Matters organised protest marches which were supported by a very wide spectrum of citizens.

The “Save Stroud Hospitals” was formed and the District Council had a Task Force committee of which I was a member. Indeed my submission re the cuts was used to help the District Council's submission. The District Council made available £4000 to analyse the impacts of the NHS proposals to close Weavers Croft and the Tyndale centre and a further £4000 for Stroud Maternity Matters to assess the implications of the proposed closure of the Maternity. To get the latest info I spoke with Cabinet member Cllr Libby Bird who kindly gave me some of the following info which she'd used for another talk - the latest news re Weavers came from the press.

Maternity Hospital update

As noted previously on this blog the proposals were to close both Stroud and Cheltenham maternity Hospitals and locate both consultant led and midwife led births at Glos Royal Hospital. Stroud Maternity Matters commissioned Dr Suzanne Tyler to write a report - this was instrumental in winning the reprieve of the closure of the Maternity Hospital. Stroud being one of 15 in the country. Some mothers prefer a more natural approach offered by Stroud Maternity and are not keen on the high tech births offered in Gloucester.

It was in 1998 the Maternity hospital was last threatened with closure. At that time targets were set and these were met. So, how long will this reprieve last? They have just undergone a review and are subject to another one in 2 years time. However, it is open and delivering babies at the moment but we need to be watchful.

Other health cuts

The proposals were to cut the provision of in patient services and just have day surgery. This would mean the loss of the gynaecology and breast operations and some general surgery. Open it up with a private provider to supply some sort of medical provision and upgrades to the theatres as has happened at Cirencester. Usually private providers specialise in one or two types of procedures so the rest would be lost.

Fortunately all the proposals were shelved and the operating theatres should be upgraded this year at a cost of £0.75 million. Good news.

Weavers Croft

The proposal was still to close Weavers Croft and locate the facility at Charlton Lane in Cheltenham. However the latest news is that Health Secretary Patricia Hewitt has just ordered an independent review.

I hope the proposals are also overturned - it is perhaps the cruelest of all the proposed cuts in services. Patients will gradually loose touch with all things familiar surroundings and people. Practically impossible to visit without a car, as it is three bus journeys and a lot of elderly people don’t like to drive out of their immediate vicinity or don't have access to a car.

I heard a report that there was a bit of alarm recently when it was found that there were only 4 people in the 18 bed unit which is normally full. It was thought by some that closure had begun but the announcement will not be made until after the local elections. Apparently it is normal seasonal downturn but I've also heard rumours that some were asked to go to Cirencester? If so I would be deeply concerned - I would welcome any news from others on this.

Berkeley Hospital.

The proposals for provision in that part of the district were seemingly satisfactory. In that a new health unit would replace Berkeley hospital nearer the centre of a growing population in Cam and Dursley. A new doctors surgery is badly needed and could incorporate a 10 bed unit. People do not want to see the hospital close before the new provison is in place. Long term use of Berkeley hospital will need to be found.

Kings Fund Report

The District Council also commission the Kings fund to look at the possibility of setting up a Social Enterprise with partners to provide some form of health care in the district. This was supported cross party and a sum of £40,000 has been set aside to explore that possibility. See blog entry for 15th November for more info on this.

County Council provision

Blog readers will know about the new care homes to be provided in our district by the non profit making Order of St John. The County Council have given them a 25 year contract (replaces coverage care) and some of the provision is in several years time. Locally as noted before that includes Wyatt House in Paganhill which will be replaced by a new build 40 bed unit for Elderly Mentally Infirmed. See more re this on my 11th July blog entry.

Why is the NHS in trouble?

The NHS is facing a tough time indeed. I welcome the extra money Labour has put into the health service but their management of the NHS is misguided. Rampant privatisation of NHS services is causing fragmentation of care, reducing accountability and increasing costs. The sale of the NHS is happening faster than ever, through a wide variety of routes from PFI to Independent Sector Treatment Centres and contracting out NHS Logistics to the German parcel company, DHL which can now even use the NHS brand logo.

Spending on management consultancy has soared to £170 million this year when this should go to front line services, not corporate and shareholder pockets.

Alongside this the developing health care market increasingly damages the infrastructure of local services through disastrous payment mechanisms and pointless competition. Health care should not be a product to be bought or sold - but a right available to the sick and vulnerable members of a civilised society.

The public rightly react to cuts in services, but it is these underlying policies of marketisation and privatisation that are driving many of these cuts and it is these policies that we should also be protesting about. Sadly all three main parties support privatisation measures. I would urge people to challenge those politicians and support the national campaign group, "Keep our NHS Public" - sign their online petition at: www.keepournhspublic.com

Wolfowitz must go

I have been very pleased to read that Euro-MPs in Strasbourg have supported a Green proposal calling on the EU Presidency to push for the withdrawal of Paul Wolfowitz as President of the World Bank in the light of the current cronyism scandal.

Speaking after the vote, Green Party MEP Caroline Lucas said: "By digging in his heels and refusing to resign as President of the World Bank, Wolfowitz is dragging the whole organisation into disrepute and further undermining the credibility of its anti-corruption policy. The European Parliament has today added to the mounting pressure to end Wolfowitz's chequered tenure at the helm of the World Bank by calling on the EU Presidency to press the US government for Wolfowitz's withdrawal."

Wolfowitz is on the brink. International support for him has collapsed - but the Bush administration is trying to prop him up. The organisation Avaaz has released a video spoofing the global TV programme "The Office"- with Wolfowitz in the role of the awful boss. Watch the video and sign up here:

http://www.avaaz.org/en/sack_wolfowitz

Over 40,000 from 189 countries have already signed the petition. Please consider adding your name.

Update 18th May: he's gone today!

Painswick library on front page of MI

The campaign to save Painswick Library is still going - the County has now given indications of support for a longer period. All good news...

Photo: cover of MI

When the threat first occurred I wrote a piece on this blog - this was picked up by the Editor of Managing Information magazine - a magazine that sells in over 70 countries looking at all things to do with information. This led to the editor coming to Painswick (see previous posts) and The April edition of Managing Information (which I have just received) carrying a feature on Painswick including the Gateway Project. MI are apparently keen to follow the story in future editions.

Let's hope this article and subsequent articles will be another way of galvinising support particularly from the County. The library is apparently the least used in Gloucestershire but it does have considerable support - and while the staff are great the building is in need of attention. It is clear where libraries are improved and made pleasant, usage increases. The Gateway project is a very positive way forward which looks at such improvements and widening the use of the building.

Photo: view of Painswick

I am concerned that already in some areas, although not Gloucestershire, there have been moves towards privatising library services. I don't want to see this being the first step.

The argument often goes that local councils are wasteful and inefficient, and therefore we need privatisation. In fact private companies who run library services give priority to the parts that make not only profit, but the most profit. Sometimes, in the short term in particular, it is quite possible that private companies run the service more efficiently, but private companies must make a profit – this is their raison d’etre, and this must be put above the wants and needs of the people in the local community. Thus, whilst local authorities might not run a good and efficient service (whatever it is that we mean by ‘efficient’ – but that gets us into another whole debate altogether), but at least it is possible for them to do this, as their main goal can be to satisfy the wants and needs of the people in the local community, if they should wish to do so.

Here's a great quote (sadly I can't find the author): “I like to think of our library as the civic ballroom of our community where citizens can practice that awkward dance of mutuality that is the very signature of a democratic culture.”

I welcome that the County has now given some reassurances over the future services, but it is clear that these commitments need to be extended and firmed up. Painswick is entitled to a properly funded locally-provided library service. More work is needed. As Tim Waterstone said:

"Libraries, at their best, are an extraordinary community resource, and a force for real good. They should be given every bit of the support and encouragement they need."

District leaders' sounding board: climate change and Peak Oil need to be central to approach

Last year the inaugural district leaders' sounding board was held. It is a group to promote issues relating to district councils. It is made up of various councillors - sadly no Green party councillor has a place so I wrote a while back to the chair and SW representatives calling for green issues to be taken more seriously.

Photos: Standish Woods a week ago - this weekend it is clear the Bluebells are fading fast

I got a reply but sadly lost all emails in a computer blip a while back. Only now have I managed to catch up. Here is my email to them:

Apologies for delay in responding to the replies to my initial email last year. I had a number of computer problems and lost all email contacts and emails. I would like to urge that the most important areas for the Sounding Board to address are how to tackle climate change and deal with Peak Oil.

Climate change I welcome news that the LGA has set up a "climate change commission". This will hopefully help local authorities - many councils are what could be described as "carbon criminals". I do not use the word 'criminal' lightly: the average Somali is about 100 times more likely to die from events caused by climate change than the average American, despite emitting roughly 16,000 times less carbon. We must cut emissions. Here are some key issues:
- bypasses are a big problem: costing vast amounts and increasing CO2 emissions
- airports. Councils often support airports (e.g. Liverpool) and Manchester owns its airport. Councils have to be far clearer in taking on the role of saying "enough is enough" (Uttlesford DC has just done this for Stanstead) whereas Cornwall despite having Beacon status in Sustainable energy plans to invest over £21 million on Newquay Airport.
- councils are usually very bad at green travel plans (shifting staff travel to walk/cycle/bus)
- councils are bad at planning (PPG13 and traffic generation). There is still very little car-free housing
- councils are missing the point on procurement. Procurement is getting more centralised and the main pressure is to cut the cost of purchases.
- councils with some honourable exceptions are not doing the carbon counting or eco-auditing that should be done to reduce carbon

The Nottingham Declaration is an important start but does not go far enough. Many Councils are now developing strategies and policies. My own Council for example, Stroud District Council has recently launched it's Environment Strategy which we hope will lead to significant changes. It calls for example for at least a 3% cut in emissions year on year in Council activities and accepts the need to review the policies each year. Other Councils like Kirklees and Woking have clearly gone much further.

Peak Oil Portland, Oregon became the first governmental body in the US to not only acknowledge that imminent peak oil is a reality, but also to publish a plan as to what the city should be doing to cope. The Portland Peak Oil Task Force have produced a succinct, outstanding report that should be read by every local official everywhere. While there will naturally be many local variations, Portland’s approach to the problem contains much that seems universally applicable. See: http://www.portlandonline.com/shared/cfm/image.cfm?id=145732

It is vital Councils start to address Peak Oil. I welcome news that the Leader of Stroud District Council has planned a talk on this to start to explore what needs to be done.

I look forward to hearing more about how the Sounding Board develops and would welcome your views on these issues. Cllr Philip Booth, Coordinator of Green Group on Stroud District Council, Stroud District Green party.

Election: green votes, canvassing and fraud

What with doing election press stuff and a busy few weeks of meetings I've not been pounding the streets canvassing as much as I would have wished. Some people are happy to leaflet and don't enjoy canvassing - I'm the other way round - I enjoy meeting people and listening to what concerns them - talking and sharing my passion for creating a better world - that sounds a little naff but that to me is what it is all about - and we can only do that by listening and doing it together.

Photo: Out canvassing

Anyhow Saturday saw me out in Rodborough with our candidate Phil Blomberg - a great guy committed to stopping the housing development on the Rugby fields, seeing more renewable energy new developments and much more - he is on the Parish Council - read more by seeing his election leaflet here. Greens have come second in that seat on the last couple of occasions - we are the best chance to bring about changes on the Council. I'll be out again today - it was good to meet folk - and even ended up with a very broken wooden gate that someone didn't want - it has already been recycled into part of the roof of a playhouse I'm building for my partners' granddaughter.


Green votes look set to rise

I was interested to read that an opinion poll showed voters feel they have more in common with Green Party MEP Caroline Lucas than any leading Labour Party figure. The poll, carried out by Populus published in the Times newspaper a week ago or so, asked more than 1,300 people to give leading figures from Britain’s four main political parties a score based on the extent to which they ‘share your values on social and environmental issues’.

Participants gave Caroline Lucas, who was named one of the top 100 ‘eco-heroes’ of all time in an Environment Agency survey last year, an average rating of 4.21 (out of ten), higher than either of the three Labour figures: David Miliband (3.95), Tony Blair (3.62) and Gordon Brown (3.61).

It is good to see Green politicians starting to get recognised - and it is entirely in line with the general rise in awareness of environmental issues and support for the Green Party in recent
years. In fact Green party membership is on the up - in stark contrast to that of the Labour party and the Green party vote is on the up - infact it has been going up for the last 3 general elections with a record local election last year. Green party candidate numbers are also on the up - this year we are fielding a record number of candidates - and amongst young people, we are one of the most popular parties - at universities our membership often exceeds that of other parties put together - e.g. LSE.

Labour has failed badly when it comes to meaningful action on climate change. It would seem people can see through the hype and are aware of the yawning chasm between the government’s rhetoric and reality - not just on climate change but on a whole range of social and environmental issues.”

The poll coincides with a Guardian/ICM poll which shows that nearly a third of voters have turned their backs on Labour and the Tories, with labour facing ‘wipe-out’ from many councils in next week’s local authority elections. The Green Party is polling at more than double its rating this time before the last election - I'm hoping we'll see more gains across the country.

Electoral fraud??

I came across a blog entry yesterday (29th April) on Conservengland re electoral fraud and more - one example being that the Times reports on an analysis by Britain’s electoral watchdog that it is estimated that there are at least 1m and possibly up to 3.5m people whose names appear on the electoral roll even though they are ineligible to vote.

The evidence does seem to be growing for the need for action on this. On my Ruscombe blog entry for 17th November I highlighted concerns over e-voting or electronic-voting and the international campaign raising awareness about the problems of this. Indeed we need action on all of this soon otherwise this will only discourage people voting even more - it is bad enough already when it seems like whoever you vote for the Government gets in.

Green drinks or Transition drinks set for 23rd May

Don't miss 'Transition Drinks' Wednesday 23rd May 7.30 in Nine Bar, 9 John Street, Stroud

Transition Stroud aims to establish community-based initiatives to deal with both the descent from peak oil and climate change. This most initiative is one of the most exciting things to hit Stroud for years. Groups are now meeting all around Stroud to look at energy, textiles, transport and more. You can also see more at our blog site.

Anyway all this good stuff and often no time to talk and share as so much in meetings - and how to get to meet and hear about others. It has been long suggested Stroud needs an informal Green Drinks - it was tried once but not with this broad group - the huge success of the Coffee House Discussion group each month shows it could work - now with Transition Stroud I think the time is right.

We are giving the first meeting a ago in May at the Nine Bar - see above - we then could make it the fourth Wednesday of the month. Meanwhile Nine are exploring the possibility of getting Stroud brewery and seemed very keen to support local enterprises; they already source some food locally. I understand coffee and other drinks are also served.

The idea comes partly from Green Drinks International who have lists of groups across the world who meet up monthly. They suggest newcomers who don't know people ask "are you green?" - perhaps we should make it "are you Transition Stroud?"

In other places it has become a great way of catching up with people you know and also for making new contacts. Everyone invites someone else along, so there’s always a different
crowd, making it an organic, self-organising network. These events are simple and unstructured, but many people have found employment, made friends, developed new ideas, done deals and had moments of serendipity.

Please pass details of this on to others - all welcomed. All are also welcomed to tomorrow nights' Coffee House Discussion on Nanotechnology :

Friday 27th April - The perils and possibilities of Nanotechnology. Whose afraid of the big grey goo? Is the grey goo scenario real? Do advanced technologies have a place in a greener world? What can nanotechnology do for you? Can nanotechnology make solar power affordable for all? New pollution, new health issues are the risks too high? Open to anyone - 7.30 to 9.30pm at Star Anise Arts Cafe at the Painswick Inn, Gloucester Street, Stroud.

See more re Coffee House discussions here:
www.glosgreenparty.org.uk/coffeehouse

Cows, Council, disability and access

Nearly late for Full Council as discovered some 6 cows had broken into the neighbours garden.

Photos: Neighbours unwanted visitors

It really wasn't as easy to tackle them as I could not discover a route back into the field. Fortunately I was able to contact the cows owner and did manage at least to get the cows out of the more formal part of the garden.

Then took a call from an angry parishioner as one of the other political parties had put political notices up on Highway signage in Randwick. I rang that parties HQ rather than make a formal complaint - it was a genuine mistake from a less experienced candidate.

Did get to Pre-Council Party Group meeting before the Full Council meeting - it was a wonderfully short meeting. It included celebrating Sheffies time as the longest serving councillor - he retires this month - also a letter from the Bishop congratulating the unsung work of public service folk like councillors and Glos-based Dan Robinson coming 9th in the London Marathon (first Brit home).

Green councillor Martin Whiteside did propose an amendment to try and ensure the report re the Local Development Framework spelt out that local peoples views are taken account of when developments go ahead at Brimscombe Port. There was lots in the report being proposed re consultation but not a recognition to really take account of residents views and it was noticeable absent in the Officers report re Brimscombe. Labour supported Martins moves but Conservatives and some Lib Dems didn't - the amendment fell.

Photo: Cows being encouraged to return to field

Conservatives have a point that there are policies re Community Involvement but we have seen people consulted over the canal for goodness knows how many years - each time the previous views are not acknowledged - people really wonder if they are ever heard. I am sure the intention is to consult and really take account of local peoples views but economic pressures are huge and while on some things this Council has a good record on consultation on others it does not. I would have preferred to see it spelt out and can't see why Tories were reluctant.

There always seems to be political manoeuvrings going on - and of course but it would in my view have done no harm to support this motion and reassured Brimscombe residents.

The motion up last was re access to Ebley Mill (see my post on 8th April) - Cllr Mattie Ross introduced her first motion - and full marks to her for raising this issue. The Tories response was to add an amendment to widen the remit so include more premises. A welcomed amendment - but infact some of it they would have to do anyway due to Govt guidelines. We await now until September to see the outcome of a report looking at costings and ways forward. As I've said before it is vital the District Council leads on this issue - they are doing lots of good things but much more is needed.

Some of their projects include close working with the Stroud & District Access Group, which was launched in March 2005 with support from Stroud District Council, (The former Stroud Access Group having disbanded in 2003). This aims to act as a mechanism to advise on and assess physical access issues across the Stroud District Council administration area. This group is a key partner in the Disability Action Network. See their website: http://community.stroud.gov.uk

The Disability Action Network (DAN) is new - in Stroud District there are a variety of groups and organisations that have been operating for many years delivering physical activity, education and assistance to people with disabilities. There are issues, however, preventing many disabled people from leading as full a life as they would like and so this group was formed to tackle and resolve these issues and provide a central point of enquiry on disability matters.

To this end, Volunteer & Community Action, Stroud District Council Sports Development and Stroud & District Access Group have been working in partnership to set up the DAN for the district whose aim it will be to link up and monitor key disability actions across the district in areas such as access issues, volunteering opportunities and lifelong learning, sport and physical activity.

The draft action plan was produced as a result of feedback received at the consultation event in October 2005 and subsequent meetings - I attended a couple of those meetings. Whilst far from comprehensive, it is a starting point, comprising a few tangible areas that DAN can take on board. The group, of which I am a member, aim to review this action plan annually, ensuring that the current needs and aspirations of the disabled community are adequately reflected.

Attendance at the meetings by people with disabilities is low. The aim is for the Network to be led by the people who live with their disabilities day-to-day and, as such, are the experts about what is required to improve things. Please if anyone is interested do get in touch - also an idea of a virtual email linked group is being considered for those who would be unable to attend meetings or find it difficult. If interested contact Development Officer, VCA, The Old Town Hall, The Shambles, High Street, Stroud GL5 1AP, Email: sdcvs@yahoo.co.uk, Tel: 01453 765600.

I could talk more about the Councils support re disability - like Ring and Ride and work at Stratford Park to improve access but it's time for bed and you can look it up on their website - lots of good things but still a fair way to go. Indeed lots of awareness - I mean look at the new cinema - terrible! Anyway looking out the window I am pleased to say at least in terms of cow access things seem to have been sorted and temporary repairs made to prevent more on the lawn. I am also pleased that my sprouting broccoli wasn't touched.

'AIDS for the bee industry'

Last week I was asked to a meeting with a campaigner in Stroud who wants to step down a bit from campaigning but wanted to pass on some information about bees and encourage more people to be aware of this issue.

Photo: Bluebells in Standish Woods and below hives at Hawkwood College near Stroud

In terms of bees, apiarists in both the U.S. and Europe have been increasingly concerned by rapidly waning honeybee populations - what has been described by an apiarist with the Pennsylvannia Dept of Ag. as 'AIDS for the bee industry'.

Last week some scientists concluded cell phones were to blame. The British researchers suggest that phone radiation could be disrupting bees' navigation systems: bees act differently around power lines, and a recent study found that up to 70 percent of bees failed to return to hives that contained cordless-phone docking units.

I also read that examination of the dead bees has found a high number of pathogens suggesting a massive immune system crash. The Varroa disease has been ruled out as being the cause, but other theories for the bees' departure have included mites, pesticides, global warming, and genetically modified crops, but so far, none has been definitively proved.

I read a report a while back that laid the blame with chemicals - many of them used in the hives and those present in the environment. But I have just been passed a report which quotes the President of the German Beekeeping Association citing drops in bee populations of up to 80% in some areas. He blames a toxin or agent that bees are not familiar with - German beekeeping officials are more specific about suggesting GM is to blame. This fits with other evidence - and now over 40% of US cornfields are GM insect-resistant crops. The implications of all this go beyond bee welfare.

Albert Einstein once said that: "If honey bees become extinct, human society will follow in four years."

Scary stuff, but bees have survived many serious threats we have thrown at them. I am of course concerned deeply - bees are having to contend with far too much - we can hope that the bees adapt to this latest twist or we can discover the cause and put an end to it - part of that answer must be a return to more organics and an end to dabbling with GM when we know so little about its effects.

One further possibility worth mentioning comes from Rudolf Steiner - at one of Steiners lectures a professional beekeeper, Mr Müller, who contributed to the lectures in the form of insights and questions, rebelled vehemently. He disagreed when Steiner explained the intricacies of the queen bee, mentioning that the modern method of breeding queens (using the larvae of worker bees, a practice that had already been in use for about fifteen years) would have long-term detrimental effects. Infact at the time Steiner is quoted as saying: "A century later all breeding of bees will cease if only artificially produced bees are used . . . . It is quite correct that we can’t determine this today; it will have to be delayed until a later time. Let’s talk to each other again in one hundred years, Mr Müller, then we’ll see what kind of opinion you’ll have at that point".

Seventy-five years have passed and the kind of queen breeding Steiner spoke of has not only continued, but has become the standard, and is now supplemented with instrumental insemination. What about the health of bees now? Michael Thiele in Germany writes:

· Honeybees are dying in those parts of the world, where these practices are common (USA, Canada, European countries);

· During a period of ten years, 75% of the beekeepers in Quebec, Canada vanished together with the bees (1987: 97,000 hives; 1997 only 30,000 hives);

· In 1997 many German beekeeping journals wrote, “Experts estimate the loss of colonies in Germany to be about 50%, some talk of 70%”;

· Over 60% of the American honeybee population has died during the past ten years.

There is a workshop on Biodynamic Bee Keeping 24th to 26th May in Ruskin Mill, Nailsworth. They will specifically be looking at disappearing bees.

Are we really all Green now?

A couple of letters in this weeks Stroud News and Journal had a go at Greens - my response is below although I suspect with the next day being elections it may not get printed. Papers are not obliged to stop printing letters but many local papers do at election times because of the enormous pressure from political parties to get their views across and respond to points being raised.

Photo: Stroud today already sorting out delivery of Polling Station paraphenalia.

Stopping the political discussion is strange as this is just the time that many local people get a bit more interested in what is going on around them. I would hate an editors job at election time!

Greens give the warmest welcome to moves by other parties to green themselves. Liz Peters says all parties are now 'green' (Letters 25/04/07), but there is 'green' and 'green'. Nationally we see Tories and Labour both supporting more road building, doubling airports, Trident, the war in Iraq and nuclear power and even blocking EU Environmental legislation. Scottish Friends of the Earth this month said Tories have the least firm commitment to environmental policies and that only Greens have policies to address the issues.

However the elections should not be about national politics. In terms of 'green' the District's Tory administration along with Council Officers are to be given enormous credit for the new Environment strategy which they consulted over in an exemplar fashion. The fact that they were willing to take on board Green party and others recommendations is hugely welcomed and democracy at it's best. However without Greens on the Council it would not be the policy it is now. Furthermore the challenges are still ahead.

We need more Greens to ensure the policies are delivered and continually improved: this is only the first small step to taking seriously the threat of climate change and dwindling oil supplies.

Sadly there still seems to be a lack of urgency and understanding about what we face. Other parties need to realise this is not 'just' the environment we are talking, about this is about our economic future, social justice and much more. Cllr. Philip Booth, Stroud District Green party

Stroud District councillor for the Randwick, Ruscombe and Whiteshill ward

Iranian Fish swims in Stroud

Having met Ahmad Nadalian yesterday afternoon I could not miss seeing him work before he caught the 11.20 train to London - especially as my car was in for MOT not far away. See my blog yesterday for more info and a link to his amazing website.

Ahmad also had a talk last night at Artspace that was apparently full so that some had to stand.

Ahmad started work this morning at 6am near Capel Mill (opposite Waitrose carpark on the otherside of the by-pass) - by the time I had got there he was finishing up.

The first series of photos here are of the fish he created out of berries from a nearby hedge - it looked stunning in the morning light - see more on his website about why he often uses fishes - as he said to me 'fishes have no borders'.

The berries reminded me of British artist Andy Goldsworthy who also uses nature.

I then have some shots of Ahmad working followed by two shots of his finished feet.

The feet look beautiful after the chippings were washed away - Ahmad says they weather very rapidly and I can imagine that in time many would not notice them. One set of feet face the water while the other a tree.

In my conversations with Ahmad we shared talk about the importance of art and how it can reach out to people in many exciting ways. I shared with him the British Waterway proposals and the varying views of the canal route that may lead to very significant changes at this site. I also talked more about the Ruscombe Brook Action Group (RBAG).

We also talked more about possibly doing something in the future next year around water - more of those potentially very exciting plans in a future blog.

I feel very fortunate to have met Ahmad and seen him at work. It is very special to have this internationally known Iranian artist leave pieces of his work here in Stroud. His 'River Art' is a powerful reminder that we need to look after our waterways - indeed one commentator said that his art might actually save the world. Certainly his pieces are full of environmental optimism - something we need now! He hopes to return so hopefully next time more people will be able to get involved.

In the meantime if you've not yet discovered Ahmads' blog click here.

Ahmad Nadalian: environmental artist from Iran works in Stroud

I heard at very short notice that Ahmad Nadalian was due to be talking about his River Art
(represented at the 50th Venice Biennale) in Stroud last night - by some strange coincidence it was the night of our talks on water and our local brook so I couldn't go. However I was determined not to miss meeting this extraordinary guy if it was possible.

Photo: Fiona and Ahmad at Capel Mill yesterday

I contacted local artist Fiona Meadley who I heard was organising the event and managed to join Ahmad at the newly developing Artspace in John's Street - it really is already a massive, massive improvement and is indeed going to be a very fitting centre for arts in Stroud. Anyhow Ahmad was kind enough to listen to my enthusiastic talk about the Ruscombe Brook project (Click 'RBAG' Label below for more info) and share some of his own experiences and journey.

Ahmad inscribes symbols on rocks in situ all over Iran and other countries on his travels (including Italy, Germany, Spain, USA, Uzbekistan, Lebanon). The fish (his main symbol) is his emblem for the human soul, thirsty to experience life. He works with local residents in doing his carvings, and had already carved work in the river in Chalford earlier that day.

"My fundamental concern is the search for harmony with nature, with ourselves and the universe."
Ahmad Nadalian

Photo: Ahmad exploring Capel Mill site for possible carving work.

After our talk we walked with Fiona down to the canal where Ahmad explored the site for doing another possible piece of art. I hope to go later this morning to see if he decided to do anything - if so I'll post another blog.

His website is essential viewing - love the inspiring images and work:
http://www.wwwebart.com/riverart/index.htm

The extraodinary mysteries of water

Fascinating talk on the 'Nature of Water'

The Ruscombe Brook Action Group held a public meeting at Randwick Village Hall on Wednesday 25th April 2007 (this evening).

Photo: Julian Jones, Water 21

As the group's Secretary, I outlined progress so far on improving the brook while Julian Jones from Water 21 talked about developing plans for improving the local brook further with help from a Glos University Masters degree student (See last post re RBAG by clicking Labels below for more on that). Water 21 are joining with RBAG in what looks set to be a very exciting partnership to seek sustainable solutions 0- they have already confirmed £3,000 towards developing a plan.

Photo: Simon Charter

Mysteries indeed

The key speaker of the evening was local water expert, Ruscombe resident, Simon Charter who talked on 'The Nature of Water' and gave many demonstrations and slides on the fascinating qualities of water. There was also lots of local food and apple juice - all very nice indeed.

Simon Charter illustrated some of the mysteries of waters' structure using the work of Theodor Schwenk, a German pioneer in water flow research (see book cover left). Schwenk's work arose out of wanting to revitalize the municipal water supplies of Europe's cities and he was the first to document the more hidden nature of water, particularly the relationship of water's rhythms and movements found in its flow. Schwenk was able to see correlation between water's movements and water quality, which he demonstrated through a Drop Picture Method.

In the talk Simon used slides to illustrate this approach where a sample of water is photographed while it is brought into motion by dropping into distilled water (see left). Minute changes in water quality register as changes in the flow patterns observed in the pictures. Water's ability to move and form delicate, sensitive patterns reveals it as living water. The rosette patterns, were found more vividly in better quality water while degraded/polluted water or water not allowed to move freely the vortex formation is greatly diminished, or non-existent.

Simon also demonstrated how vortex move - stirring the water then adding dye to show how it moves up and down in quite extraordinary and unexpected ways (see left). Slides also showed the incredible patterns that could be created (see left).

Another experiment showed the patterns occurring when a brush was moved in a straight line through water (see left). Simon didn't propose explanations but rather left us to wonder - and wonder I did.

Perhaps most staggering for me to witness was the effect of one drop of washing up liquid on the way water moved. Simon had two large trays of water and created a wave in both (see left) - it was beautiful to look closely at how it moved - and as one of the audience noted, very restful to watch - the ripples and smaller waves going back and forth up the tray.

Simon then added one small drop to one tray (see left), didn't stir it in but made the same waves by lifting the end of the tray very gently. The tray with this small drop behaved so very differently - the waves breaking up quicker and without the wonderful patterns. It is really quite a surprise to see the effects of one tiny drop - and of course an argument for reducing detergent use or going for detergent-free laundry balls - see RBAG offer of a 10% discount on such balls by quoting 'MRUSCOMBE10' at www.ecotopia.co.uk - apparently Environmentally friendly versions of detergent do the same but may not persist so long?

It is of course also support for improving our local brook and putting an end to sewage and the rest getting in it.

One of the issues raised by the audience was about Masuru Emoto, a Japanese researcher who shows photographs of the water molecules resulting from his worldwide research on the effect of ideas, words, and music upon the molecules of water.

The result were staggering - the photo left is of a frozen water sample from the lake at Fujiwara Dam, in Japan - the water's structure is dark with no crystalline formations.

The next photo left is the same water sample photographed after a priest made a one-hour prayer practice beside the dam. I have seen the book 'Messages from Water' and it does seem quite amazing.

Others in the audience including an ex Environmental Health Officer and a Sustainable Drainage Consultant added weight and support for Sustainable Urban Drainage Systems - which Julian Jones had pointed out earlier are called 'Best Management Practice' in the US.

An extraordinary evening that really makes you think about water on all sorts of different levels. I want to write lots more but no time...

Further details of RBAG and how to join their next meeting on 30th May can be got from Philip Booth on 01453 755451

Election means nuclear news is cancelled

As it is local election time the local press go into their state of ignoring news releases - hence no local nuclear news for people. I've recently sent out a couple of unsuccessful news releases re Oldbury - our local reactor - some 16 miles from Stroud. I also bring news re Burnham before it hopefully will get into press in Somerset at least.

Photo: Oldbury power station

Oldbury to restart in summer

Firstly there was the news that this dangerous old plant would be restarted - see my news release here.

Oldbury reactors have been shut since maintenance in June 2005 raised concerns over the safety of its graphite core. Last year I, along with other Greens, helped Radio 4's flagship investigative programme File on Four look at information obtained under the Freedom of Information Act - this shows a catalogue of incidents from leaking cooling system pipes, cracks in boiler tubes and cracks to the graphite core. Oldbury has the worst weight loss of any UK reactor core and independent nuclear engineer John Large has said this could lead to a catastrophic nuclear-fuel fire and release of radiation. Why on earth take the risk? This is putting profit before safety."

Were organs of former nuclear workers at Oldbury nuclear power station secretly been removed?

The Radio 4 Today programme revealed that nuclear workers at Sellafield and other nuclear sites had organs and tissues removed from their bodies at post-mortems apparantly without the knowledge or permission of their relatives. This occurred from 1962 to as late as 1992. Stroud District Green party campaigners asked whether Oldbury workers were subject to this process. See here.

Edward Courtney dies

It was good to finally see Edwards death have a place in the Western Daily Press today and apparently the Gazette are also doing something this week. He was one of my greatest sources of info on nuclear matters and I feel his loss greatly. See Glos Green party note here and my previous blog item here.

Burnham breast cancer excess 70% over ten years

Also today I hear that newly released figures show that Burnham North has suffered a seventy percent excess of breast cancer mortality over the decade to 2005. Greens haven't yet done a news release on this as it seems pointless when the papers refuse to pick the story up - hopefully as the Stop Hinckley group have released lots of info the Western Daily may pick it up. Anyhow I enclose below some of their info - yet more evidence to shut these reactors down for good.

The Office of National Statistics figures were analysed by Dr Chris Busby from Green Audit, who was commissioned by campaign group Stop Hinkley. The new statistics confirm a worrying trend first discovered in research by Dr Busby in 2000 where Burnham North stood out from 150 Somerset electoral wards studied for cancer deaths with twice the expected number.

In 2002 a doorstep health survey by local group, Parents Concerned About Hinkley, PCAH and analysed by Dr Busby also showed breast cancer incidence was 85 percent above average together with excesses of leukaemia, kidney cancer and cervical cancer. The PCAH survey, considered a breakthrough in community epidemiology, was the subject of a row with the Government body charged with auditing radiation-linked health trends, COMARE who later softened their criticism based on their faulty understanding of the large 1,500 sample size, one third of all the Burnham North residents.

The South West Cancer Intelligence was then prompted to conduct a study which also showed a thirty percent excess of breast cancer registrations between 1990 and 1999. When they added three more years' figures up to 2002 their overall thirteen year pattern still showed a statistically significant 21 percent excess. Although SWCIS attributed this rise to efficient breast cancer screening, campaigners argued that good screening should reduce mortality from the illness which is worryingly excessive.

Dr Busby said: "This clearly shows that the breast cancer cluster in Burnham North is a convincing phenomenon and is clearly, in my opinion, related to releases or a release from Hinkley Point. Since radiation causes cancer through mutation we might expect some effect on infant mortality in the area around Hinkley Point and we are now looking to see if that is the case in a study covering West, Mid and North Somerset."

Jim Duffy, spokesman for Stop Hinkley said: "The figures speak for themselves and all sorts of white-washing have not stood up to reasoned examination. Some environmental cause is triggering these cancers and logic points to Hinkley's constant sea and air discharges of radioactive particles upwind of the town: a good reason to shut down these crumbling reactors."

Church initiative on green consumerism a distraction?

I just picked up on another blog - Dorothea's 'Conservengland' a story in yesterdays' Christian Today which reads:

Photo: Standish Woods last weekend

Prime Minister Tony Blair joined the Church of England this week to launch a campaign urging consumers to make drastic cutbacks on their carbon emissions. Eight major companies helped form a powerful new coalition led by Blair, the Church of England and environmental groups to call on households in Britain to cut their carbon emissions by more than one tonne in the next three years....

....Dr Richard Chartres, Bishop of London, said: "The Church of England is officially committed to 'cutting the carbon'. Since the launch of the Church's Shrinking the Footprint campaign more and more congregations are seeing the connection between caring for God's creation and embracing a greener way of life. We are glad to be partners in this common effort because it is true that 'We're in this together'. We are working to engage both with our own members and those of other faiths. One fresh contribution is the publication today of a practical guide for individuals entitled 'How many light bulbs does it take to change a Christian?' "

This is all good news and a welcomed initiative to help consumers use their purchasing power to embolden decision-makers - but it is also a distraction from the need to take action at a Government level - see my recent post re Friends of the Earth (21st April) and their view that only Greens understand and have policies to tackle climate change.

Green consumerism is all very well but what we really need is for us to all consume less - that message keeps getting lost amongst all the glossy info about M&S new 30 degrees wash labels and insurance discounts for greener cars.

I hope that this initiative will lead to more action locally - as blog readers will know I've had contact with the Diocese over their policies (see Label below re Diocese for previous posts) - and am still in correspondence over the Vicarage in Cashes Green - why no greener houses there? I have a meeting with one of the Diocese committees later in May when they will kindly let me talk for 15 mins.

The Church is in a great position to be a real leader in this, I hope this doesn't distract us from what really needs to happen.

Councillors talk 'Play' - and learn 'Karate Kid' move

I should be out helping Greens to be elected - canvassing and leafleting but there was a Policy Panel last night and as the only Green not standing in this election it fell to me to go - and very glad I was too. There was a presentation about Stroud's bid to claim money from a national fund to support 'Play' initiatives - all good stuff, well presented - shame only 5 out of 51 councillors were able to make it.

Photo: Museum where last night's meeting was held - great Wisteria

Stroud District Council has done much work looking at this and where priorities should be. They picked three projects which still have to be approved by Cabinet before being put forward for approval - if accepted they will start early next year.

The three projects are:
- 2 Play Rangers funded to provide activities
- 3 MUGAs (Terrible name for Multi-Use Games Area) and a boulder wall (we can't know where until after elections)
- Significant improvements to Stratford Parks Skate Park

The Stroud Peer Education Project were there to help cross-examine councillors on the projects and gain our opinions.

The Peer Education Project is a group of some twelve 14 to 22 year olds who each year work with young people - and adults. It was initiated by young people to act as a self-support group in which they could discuss the issues affecting them including substance abuse but has grown to be much more. The main activities of the project include running interactive workshops and consultations for young people on issues such as drugs, sexual issues, bullying, diets and self image - they were a wonderfully enthusiastic group who had given up their time to support this project for young people in their District.

One of the warm-up activities of the evening did have a few of us struggling - I can't describe here but it included all of us swinging arms and calling out 'Monkey' and going "PHwaaaaa" as we did the 'Karate Kid' move. Download more info re Stroud Peer Education Project.

Anyhow one issue I raised is that of Natural Play areas - click on the label link below to see my previous comments on this (especially 2nd October blog entry). Coincidently I came across David McCord's "Every Time I Climb a Tree" poem last week - not enough tree climbing goes on nowdays! Here's the final stanza of the poem:

And then I skin
The other leg
But every time I climb a tree
I see a lot of things to see
Swallow rooftops and TV
And all the fields and farms there be
Every time I climb a tree
Though climbing may be good for ants
It isn't especially good for pants
But still it's pretty good for me
Every time I climb a tree

Anyway after meeting and talking of 'play' I managed to get to Vine Tree for a drink - and met there Sheila Bliss, Randwick Wap's new Mayor for this year - now that is serious 'play' and more.

Ruscombe resident nearly makes Glos 100

Martyn Brabbins, Cheltenham International Festival of Music artistic director lives in Ruscombe with his family. He didn't make Gloucestershire's Top 100 in The Echo/Weekend Citizen chart this weekend, but he was listed amongst those "who didn't quite make it..."

Photos: Standish Woods - look amazing

Martyn was associate principal conductor of the BBC Scottish Symphony Orchestra between 1994 and 2005 and has worked with most of the major orchestras in Britain.

"Martyn Brabbins is one of Britain's leading and most versatile conducting talents, widely respected for his flawless musicianship, artistic integrity and programming skills."

Intermusica' have this quote about him and also lots more about his work on their website here. I've not seen him in action but have heard his sons' band play locally.

Such charts as this Top 100 are a bit of nonsense and fail to celebrate the many thousands whose contributions deserve to be celebrated - indeed this papers Top 100 seems to consist mainly of sports folk, celebrities, politicians and royalty. How about next year celebrating the many unsung heroes in our community?

More planning applications today

This month due to the local elections it means we don't get a DCC in May so we get two days of Development Control Committee in April - and two lots of the papers and two lots of minutes - quite a challenge to read the lot - it takes a fair few hours to look over them and then some like todays Hunts Grove application can require seeking out further info from Officers.

Photo: Orchid in Standish Woods at the weekend

I wont go into the details as you can get them all on Stroud District Council's website including a webcast of both meetings.

If you watch you'll see I today raised a fair few issues re the Hunts Grove application - considering current legislation and policies this Outline Planning permission is a great start and went through virtually unanimously. Among the issues I raised were tightening it up re energy efficiency conditions and 20 mph for the whole site is now an 'Informative'. Indeed if it all goes through smoothly this could be a very positive development indeed - yes there are difficulties and some of those are caused by the huge number of homes each District has to build......but house building can be for another blog item!

Self-Management Courses for People Living with Long-Term Illness

When I was starting to get better from ME/CFS I got involved in Self-Management Courses for People Living with Long-Term Illness - after my brief talk today at the local Arthritis Care group someone asked for more info and I thought I would post stuff here....it was infact Arthritis Care nationally who provided the training in London for the self-management course leaders like myself.

Photo: Beech tree leaves yesterday

The idea is that these self-management courses give people with chronic illnesses the opportunity to also become experts in managing their conditions. Anyhow some of this stuff below is now out of date as some health authorities are now also organising schemes and I've seen courses advertised in Gloucestershire.

‘Within every patient there resides a doctor and we physicians are at our best when we put our patients in touch with the doctor inside themselves’
Albert Schwetzer (1875 - 1965)

I still consider it is a crucial way forward - although after my own experiences of running these courses I am not wholly happy with the way it is delivered using volunteers - 'though I still consider there is a truth to the statement: If you think of the patient with a chronic condition as the Cinderella in the health system then lay led self management is the golden slipper.

1 in 3 adults lives with a long-term illness - in England.
Two-thirds of people aged 75 and over have a long-standing illness or disability.
Many live with more than one condition - particularly older age groups.

Here's something I wrote a long while back on this:

Living Well courses

There is an increasing awareness of the need to respond to the challenge presented by the incidence of long-term conditions. We know answers will not just lie with technological medical interventions but rather with learning to our manage chronic diseases. People with long-term chronic conditions have known this for years - it is the daily management of our symptoms which can help to determine the quality of our lives.

Research consistently shows that a key component of successful management of long-term illness is the inclusion of the patient as partner in care. Patients provide individualised information about their condition while health professionals provide general information. Both are necessary for effective management.

One approach to enable this partnership is self-management education - such programmes have been around for many years - an important element being participants learn from each other and become more confident in their ability to manage their disease.

One of the most successful schemes in Self-Management has been the course pioneered by Kate Lorig and I’d like to briefly go over how it came about.
History

This chronic disease self management course started life as the disease specific Arthritis Self-Management Course. The unique and attractive feature of it was that Professor Kate Lorig and her team at Stanford University started by asking people with arthritis what they wanted to know in order to cope better. They then consulted health professionals and conducted an extensive literature review. This led to a manual being produced that was a distillation of expert opinion research and experience.

Professor Lorig’s experiences of developing courses for people with arthritis and then other conditions such as diabetes and HIV was instrumental in the development of this more generic course aimed at all people living with chronic conditions. She recognised that people with long-term conditions are dealing with similar issues on a daily basis, these include pain management, stress, low self-image and developing coping skills. A more generic manual was produced.

In the UK in 1998 the Long Term Medical Conditions Alliance held a joint conference with the Royal College of Physicians looking at how self-management of long term conditions could be extended. Following this they secured funding for the Living with Long-term Illness (LILL) project which meant that a first rate coordinating function could be undertaken to involve a range of different disease groups in self-management courses.

Research was undertaken into different Self-Management courses. Kate Lorigs ‘Chronic Disease Self-Management Course’ was chosen as the best way forward.

Why the Kate Lorig Model?

Tried and tested and over 100 research papers
Experience of lay led delivery
Across three continents
Ideal vehicle for partnerships
Distillation of expert opinion

Prior to this Arthritis Care in the UK had set up their Challenging Arthritis courses and this led to them taking a key role in establishing the training. Since the 1998 conference an increasing number of organisations including the ME Association, British Liver Trust, Diabetes UK, Haemophilia Society, Depression Alliance, National Endometriosis Society, National Osteoporosis Society and the British Polio Fellowship became actively involved. Just recently MS Society has joined.

Partnerships have developed with a range of NHS and Social Service providers and between charities moving away from a disease specific focus. For example the course I ran in Bath was with a tutor from the British Liver Trust and was funded partly by the local Primary Care Team.

Underlying Assumptions to this approach

- People with chronic conditions have similar concerns and problems
- People must deal with not only their disease(s) but also with the impact these have on their lives
- Lay people with chronic conditions when given a detailed tutors manual can teach the programme as effectively if not more effectively than health professionals
- The process or way the programme is taught is as important if not more important than the subject matter that is taught

The tutors
This is what is known as a ‘high challenge high support volunteering’ approach. In other words it requires loads of effort and commitment from the volunteers and the sponsoring organisations. But it also gives support so that volunteer tutors can;
- achieve personal growth and the development of transferable skills
- opportunity to give back to others coping with a chronic condition - this is one of the main reasons quoted for getting involved and certainly part of my motivation. I also hope that it will be a step closer to returning to paid employment.

About 400 volunteer tutors deliver the Challenging arthritis course in the UK. However there are only about 50 tutors trained like myself, nationally delivering the Self-Management course for people with chronic conditions. 13 of these are fully accredited (ie been assessed on 2 courses) with the others in the process. Another 30 are planned for this year.

Some have delivered this course to a single disease group where others have delivered it to mixed disease groups. In both tutors like myself and the participants walk together discovering new skills and techniques to break the vicious cycle of fatigue, pain, depression, frustration and anger which is often part of living with a chronic condition.

All the tutors have experience of living with a chronic condition and meet a set criteria, before undergoing a four day residential training programme which covers;
- all the material in the manual that has been put together for presentation with various group exercises and discussions
- how to work in an adult group setting
- how to market and deliver a course in a local community

As tutors, we must also experience and internalise the messages of the training ourselves, in order for the training to be effective. It is the beginning of the process whereby we become better self managers. Indeed on the courses tutors often find they learn lots. This has certainly been true for me.
Complement healthcare provision

Another attractive feature is that the courses are intended to complement and provide added value to existing health care provision, not to replace it. Compare the figures....
Added value to health care
15 - 30% reduction in symptoms with self-management
40 - 60% relief with best health care
55 - 90% when used together

Tutors maybe experts at managing our own conditions but we do not set ourselves up as experts to participants - if issues arise we refer them back to the health care teams.

The US National Arthritis Plan: Public Health Policy indicates that self-management is not an optional extra or a luxury. It is an integral part of being able to cope on a daily basis with a condition that is not going to go away. Patients who have been on the course will use resources better and thus be a lesser strain for the NHS.

Feedback from health care professionals is that these courses enable their patients to meet them in a much more informed manner. One Scottish consultant calls it the ‘anti-winging course’.

They have in some areas created an active informed group of patients willing to participate in consultation on purchasing decisions and the development of health care provision.

In line with Government thinking

The course is also compatible with the government’s priorities for improving the health of the nation and challenging social exclusion. For example, learning self-management skills can in many cases substantially improve the quality of life for people living with long term conditions such as heart disease and stroke as well as arthritis.

Following the Governments’ White Paper in 1999, Saving Lives: Our Healthier Nation, the Chief Medical Officer has set up a Task Force to design an Expert Patients programme to address the needs of the very many people in the country with a chronic disease or disability. They have already looked very favourably on this course.

The Task Force is itself a partnership of people who are living with chronic conditions, voluntary sector organisations working in this area, health and social care professionals and carers' representatives. The Chief Medical Officer chairs the Task Force himself, such is the importance he places on its work. It is due to be published very soon.
The course

Topics

Goal Setting
Cognitive Symptom Management
Relaxation
Anger, Fear and Frustration
Fitness / Exercise
Better Breathing
Fatigue
Nutrition
Living Wills / Power of attorney
Communication
Medications
Making Treatment decisions
Depression
Informing your Health care Professional
Future Plans

Every minute of the course is scripted. The courses are two and half hours long each week for six weeks. They are delivered in community halls or other suitable local venues.

The process has a beginning and an end so as not to encourage dependency of participants. It is about giving people the tools to use in their daily lives.

The classes are always taught by two leaders who have a chronic condition. For example, this year I will run a course with a tutor from the Haemophilia Society while the course in Bath I mentioned was witha tutor from the British Liver Trust. On that course in Bath we had participants with ME, heart conditions and MS.

Role modelling is an essential part which makes it difficult for a participant to say ‘You cannot know what it is like’

Every week except for the first week starts with feedback of how participants have got on with their individual action plan. Something they want to do not what they think they should do and something achievable. Moving to action not being passive recipients of information is the aim of the course.

The primary aim of the course is not to impart medical information, but to facilitate the development of self-management skills such as problem solving and goal setting. This ability to manage and control various aspects of the condition like fatigue and pain increases participants confidence.

Self-management is not primarily about conveying information, it is about developing confidence and motivation so as to effectively manage.

For example in relation to exercise, we know that about 70% of nursing consultations include something about exercise, but the compliance rates are dire. We know from our research findings that up to 12 months after the course participants are still exercising and in the US they have shown that up to four years after the courses participants are still using many of the techniques discussed.

In essence it is about true empowerment where people are given the tools to make decisions and take effective action in order to accomplish a specific behaviour – a belief that you can make a difference improves.

Other models

There are models otherthan this one. The LILL project coming out of the 1998 conference with the Long-term Medical Conditions Alliance, that I mentioned earlier, found that there are over 30 self-management interventions used across the country. You can read more in their report, ‘Partnerships for Successful Self-Management’ (February 2001)

The programmes fall into two main groups, professionally led and lay led. The majority of lay led programmes (ie 11 of the 13 organisations) are using the Lorig chronic disease self-management course.

Research

There is considerable research to show that self-management of chronic conditions, when delivered in addition to standard care, benefits participants. Group and individualised approaches have similar effects, although individualised contact with health professionals is more costly.

In the UK all the research int the Lorig course has been undertaken by Professor Barlow and her team at the Psycho-Social Research Centre at Coventry University. Monitoring and evaluation of all the courses in the UK was being done primarily with questionaires going to participants before and after the courses then again after months but they also interviewed people, have asked participants to keep logbooks and have held focus groups.

What the research at Coventry shows is a decrease in pain, depression, fatigue, less anxiety and fewer visits to and better communication with doctors. And a sustained use of self-management techniques.

Coventry University Research findings

Attendence on courses was high with 69% remaining at the final week
Participants self-evaluation demonstrated very high satisfaction ratings, 91%
Four months after the course participants reported statistically significant increases in; perception of disease control, use of self-management techniques (ie cognitive symptom management, communication with GPs), health status (ie mental health)
Four months after the course participants reported statistically significant decreases in; fatigue, anxious mood, health distress, visits to specialists
Participants also showed improvements (not statistically significant) in symptom control, shortness of breathe and depression
Tutors reported increases in self-efficacy
Research data is consistent with US research

As you can see the content of the courses are developed on sound evidence based research which demonstrates positive long-term outcomes. The ongoing research findings feed into the dynamic process of developing the content of the courses. To protect the integrity and efficacy of this process, the courses may only be delivered after formal training and under licence from Stanford University.

The most recent data from a five year research project in America of more than 1000 people who participated in a CDSMC reflects the research findings here.
Chronic Disease Course research findings. Stanford University, US

Increased confidence in dealing with symptoms
Increased use of exercise
Reduced levels of fatigue and disability
Reduced hospitalisation
Improved communication with physicians

www.stanford.edu/group/perc/bibliog.html

What participants have said

‘The course has given me my life back’ ‘There is no magic pill, but the course gave us the necessary skills to start rebuilding our lives and believing in ourselves again...The course has given me back my confidence and the skills to make the management of the condition something I can now have some control over’ ‘I shared my feelings in a safe, contained environment and learnt coping strategies, and breathing techniques which I use several times a day’ ‘Somewhere within the six weeks the light bulb goes on. The message is really powerful, the answer has got to come from within you’ ‘The visual evidence is clear that each one of us has made improvements with the management of the condition’

The future

As you have seen there already exists a great deal of research and experience within the voluntary sector of developing and managing lay led Self-Management Programmes. It would be great to see these further developed to compliment government priorities for health and lifelong learning.

I hope I have also shown you that in this approach where people with long term conditions take the lead, we have been able to increase individuals ability to feel more in control of their condition and that this is the key factor to maintaining long lasting positive behaviour change.

Another aspect of the potential for added value is the compatibility between this programme and the government’ s priorities for improving the health of the nation and challenging social exclusion. For example, learning self-management skills can in many cases substantially improve the quality of life for people living with long term conditions such as heart disease, and stroke. The course will also save the NHS money in terms of fewer visits to GPs and in terms of having healthier people with chronic illnesses.

The project continues to grow. There are several tutor courses planned for this year, a project with an inner London Health strategy group to develop a programme for the Bengali community and a health action zone to create a comprehensive programme across a whole region.

What is needed now is support to take this work forward.

To build on the superb coordinating role by Long-term Medical Conditions Alliance which enables information to be shared and for charities to work together
For Arthritis Care to be supported in their role as a lead training organisation working with other interested organisations.
For more effective partnerships with health authorities, primary Care Groups Healthy Living Centres
For partnerships with health professionals and other voluntary organisations so that lay led self-management is seen as part of a package of provision including drugs, therapy, hospital treatment, professional led education

No-one ever became empowered by being told what to do when to do it and what to think or say. It is a long journey that never ends it is a jigsaw of experiences and exposures that can be challenging and frustrating and nearly always enriching.

Those of us with a long term condition do not have a choice about managing we can do it passively or proactively. We can let it control us or we can take control over it. Self-management techniques are at the forefront of hospitals without walls solutions the country is turning to with mounting urgency.