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'Eastbourne’ Housing

Mon 16th April

You may have been wondering what ‘Eastbourne’ Housing is all about and what it 665_DSC_1482.JPGmeans for your town over the coming few years. To explain, meet local GP Dr Ian Allwood. Ian has lived most of his life in Stratford, and with raising his young family and meeting the needs of his patients, he has an understanding of what affects us all – in particular quality and availability of healthcare.

Q – Hi Ian, thanks very much for this interview. Can you give us a simple background to healthcare budgets both here in Stratford and more generally – say across the country?

The NHS budget is allocated using a complicated formula that is designed to take account of the needs of the population, adjusted for factors such as age and deprivation.
This formula is used by the Department of Health to allocate money. Currently this is given to Primary Care Trusts, whose responsibility is to buy or “commission” healthcare for their population. In the future, this commissioning responsibility will be transferred to groups of GPs, called CCG’s.

The formula takes account of factors such as age and poverty, with older and more deprived populations receiving more money. Some experts believe that the formula takes more account of deprivation than it does of age. This results in areas such as Stratford, with a relatively older but more affluent population, receiving less than they really need.

If you imagine that older affluent people would be covered by private health insurance, that generally doesn’t happen. Private health care demand is going down and as you get older, it becomes very expensive. It is mainly now an occupational benefit – a perk of a job.


Q – So what does the budget for our area actually cover?

It covers all our health care needs, not just the cost of Doctors, Hospitals, Surgeries, District Nurses but also the long term care needs of some groups of patients. It includes something called Continuing Health Care (CHC), for people with conditions like dementia or severe learning difficulties, where people need long term care. People who need CHC have complex needs. Some may be cared for at home, others will need to be cared for in a nursing home.

Wherever people are cared for, if they need CHC, this is very expensive. To give you some figures, The total NHS  budget works out at around £1700 per person each year. The cost of Continuing Health Care can be anything from about £400 to over £1000 – per week!

There are two other areas people might be wondering about. CHC is  nothing to do with Personal Health Budgeting and the Social Care Budget is different. Its managed by Warwickshire County Council and its partners and it covers the means tested support for people whose problems are more social than health-related.

Q – So what is the situation like in Stratford now?

Our population is older than the National average – already, we have 25% more over 65s than the national average. In the next 21 years, the number of over 75s is forecast to double and the over 85s treble. In Stratford, in particular, developers are looking to maximising their returns by building care homes which are targeted at the very wealthy and there are companies who specialise in running these sorts of facility. At the moment it is easier to get planning permission for this type of project than it is for the sort of accommodation we really need – more affordable housing for young and old.

What many of our older residents really need are places which offer assisted living - ‘Extra Care’ – the modern version of a residential home. They are developments which are designed to enable older people to live independently for longer – offering help with care, meals and services like entertainment, exercise etc as well as individual units for people to live in. People who are in the early stages of dementia, for example, can manage very well in this sort of accommodation.


Q – What problems are there – or could there be?

As our own population ages, we really need places they can afford to move into. People who can afford to, are moving into the expensive “retirement” accommodation being built. So Stratford is “importing” older people from all over the country whilst our own local elderly population often have to move out of the area to find affordable accommodation they need.

If we have significant inward migration and these new residents end up needing CHC, this disproportionate demand could put an enormous strain on health budgets, affecting the services we all need. This could result in longer waiting times for hospital care or cuts in community care. This is because the healthcare budgets are not adjusted adequately to reflect high demand for CHC.


In summary, our population needs a balance of affordable accommodation to live in as their needs change. We need affordable housing for young and old so that we have a balanced, vibrant community. If we allow the uncontrolled development of expensive retirement accommodation and nursing homes, Stratford will become an importer of wealthy older people – “Eastbourne Housing”. This will mean that our own population of older people will be forced to leave the area because of lack of affordable housing and everyone could suffer because of stretched health and social care services.

We all need to work together to ensure that this doesn’t happen. We are working with public health experts, the county council and social services to create a plan that ensures that there is a balanced approach to development of housing for older people, focussed on local need, not driven merely by the potential profits for individuals and private companies.

Thank you Ian for your time and for your thoughts. Gathering evidence is going on all the time and we hope you are your fellow Medical Practitioners are able to show and influence everyone concerned about the problems we already have. We hope thatStratford residents will give this web site their own experiences and comments.     

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