Manchester’s care system under stress as patient diagnosed ‘suffering from climate change’

Something momentous happened in the climate and health sphere this week. Before you ask, no, I’m not talking about the climate change question in this month’s health scrutiny meeting (more on that later). I’m talking about the news breaking that a patient in Canada has been diagnosed as suffering from ‘climate change’. The British Columbia patient, who has asthma, diabetes and heart failure, was diagnosed with climate change during this summer as heatwaves and wildfires ravaged the region, causing breathing issues and dehydration for the patient. The doctor who gave the diagnosis, Dr Kyle Merritt, said “If we’re not looking at the underlying cause, and we’re just treating the symptoms, we’re just gonna keep falling further and further behind.”

Climate change is a heath issue. It is and will increasingly be a health crisis. I read that article and thought about the closest that wildfires have been to Manchester since I’ve lived here – the Saddleworth Moor fire of 2018. That fire was shown to ‘substantially degrade’ air quality across Greater Manchester, causing 3.5 excess deaths per day for the 7 days the fire burned. These events will become more frequent because of climate change, and we better start factoring the healthcare needed into our health and social budgets as soon as possible. Social care jobs are also an opportunity to grow a workforce of good, green jobs for the future.

Picture of burning moorland with smoke travelling East across northern areas of greater Manchester
NASA satellite image of the Saddleworth Moor fire and smoke in 2018.

Anyway, we’re actually here to look at the health scrutiny meeting. This one was quite dry, with large chunks taken up by budget discussions and updates from the Manchester Local Care Organisation and Better Outcomes Better Lives Programme. I’m not an expert in the health world, and especially not in the weird management world of our underfunded systems, where human experiences slip into euphemistic buzzwords and confusing metrics, and there was a lot of that here. I honestly could not tell you if they’re doing well or not (which I suspect is the point) and I get the sense that neither could the scrutiny members. We did get a climate question though!

November’s Health Scrutiny Committee Summary

The meeting opened with urgent business on mandatory vaccinations in health and social care. The mandate was brought in at very short notice and covers more staff than expected, and the full implications are not yet understood. The UK is already struggling in recruiting and retaining people in these sectors and this mandate will just make it harder for Manchester.

The next item was the budget position. Manchester has experienced disproportionate cuts to its health and social care budgets from the government over the last ten years, and the government has no clear plan for adult social care planning into the future. We will understand the future better after further government guidance that will be released on Christmas eve (for some reason). The budget for social care is looking better than expected, but a question from Cllr Leech revealed that this underspend is caused by a drop in care home residents because of COVID deaths and people moving out of care homes because of the pandemic. Looking further ahead, the budget will start to severely dry out towards 2024-25, and the deficit will need to be made up with piecemeal funding pots.

We had some good scrutiny here from Cllr Hussain, including among many other things a question on why climate change has not been factored into the budget. The answer left quite a bit to be desired, looking exclusively at emissions from health and social care and even more narrowly the travel and buildings emissions from corporate partners as the largest part of those emissions. I would really like to see the kind of big-picture answer that incorporates adaptation and understands the climate emergency as an inequality and injustice issue. Maybe, hopefully, we’ll get a glance at that bigger picture in the new year when the climate change item comes to the health scrutiny committee.

We whipped through the COVID update with the report taken as read (a real sign of the times) before moving on to the Manchester Local Care Organisation (MLCO) update and Better Outcomes Better Lives programme. I can’t tell you if this programme is going well or not honestly. Maybe? Stuff like getting people out of hospital beds faster and giving better treatment by using a lighter touch feels like a red flag, but I’m not embedded enough in the system to know. There were some decent questions here from Cllr Newman, who asked if the success of the Better Outcomes Better Lives programme was being overemphasised, and from Cllr Hussain, who talked about the delays he experienced in adapting his home last year for a family member versus the speed with which the adaptations were cancelled after that person’s death. With this, and some brief discussions on the work programme, the meeting was drawn to a close. Next month the committee will be hearing an update report on the delivery of the Our Manchester Carers Strategy and the Suicide Prevention Local Plan.

Manchester City Council has six scrutiny committees, which are supposed to be a watchdog on the bosses. These committees meet, in public, monthly to “scrutinise.” But it usually doesn’t work out like it should. CEM’s Team Scrutiny Fabulous is trying to change that, and we could use your help. You can read more here.

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