America Don’t Do It!!

If I had a vote it would be for Hillary Clinton

Some people might wonder why I am commenting on the USA elections when I am a politician and citizen in the UK. Well there are two reasons. Firstly I have noticed that there have been more than 2,000 hits on my blog site from the USA already this year so I might just influence one or two people. Secondly however, the election in the USA will affect the rest of us just as the UK BREXIT vote caused tremors through the world economy and could do even more damage.

In my previous blogs about the USA I have always made clear that I am a critical friend. On my visits there I have been struck by the friendliness shown to visitors and the respect shown to our Country. I don’t believe that we should have followed you into so many wars but generally we stand together on the right side of the line. I am amazed that a so-called civilised country can allow almost unrestricted gun sales and allows capital punishment often of poorly defended people with limited mental capacity. I am amazed that a wealthy Country should so viciously debate free health care for all its citizens. BUT I do like you honest!!!

So I watched the first Presidential Debate with incredulity. I concentrated on listening to Donald Trump because he is a phenomenon that I find fascinating. The question that most of us ask over here (which was the same we asked about Sarah Palin) is, “How can such a stupid and nasty person possibly be a contender for the highest elected position in your Country?”

Someone here has analysed the speech patterns of Trump and apparently he has the speech patterns on an 11 year old. He seems unable to speak in complete sentences. He seems unable to keep the thread of a conversation going. He has little knowledge of the world outside America; how it works; who its key players are. He has no policies at all for inside your Country. He comes over as a charmless, racist buffoon.

We know that in this Country have has not kept his word. In at least three places in Scotland promises were made about building hotels etc around golf complexes which have not been delivered. He started off with money and has kept money but there is no evidence that he has made new money. We do not have a tradition here of publishing our tax returns when running for public office. In your Country there is such a tradition. There is no legal reason that he cannot do so but he refuses to do so. That must show a problem with his leadership and his concept of openness and transparency.

You may say that we have a Trump of our own – Nigel Farrage. But there are two differences. Firstly that Nigel Farrage would never have been selected by a credible Party as its candidate for high office. The second is that detestable though I find the man he is not illiterate or innumerate. He can string whole sentences together and he knows his maths although he chooses to ignore the results of it!

The USA like most of the developed world is suffering at least some crisis in its democracy. During most of the time that I have been in politics (50 years next April) most people have been part of an upward spiral in living standards, education and quality of life. For many of our citizens that spiral has at best plateaued and at worst has begun to spiral down. No wonder that people are looking at extremist people and crackpot notions as they see the very rich getting very much richer; the rich doing OK; the middle classes stagnating and the working classes falling behind.

Our societies must address that problem. When the top 1% of both our populations own as much in terms of wealth and assets as the bottom 50% there is a serious problem of distribution. You don’t have to be a communist or even a socialist to know that there needs to be a better, fairer distribution. A stable society is own where most of the needs of most of its people are met. Needs include a decent house, a decent job; a decent education; a decent environment. These things and more with a little left over for a holiday and some cash for relaxation.

The brash Anglo/Saxon way of doing things exemplified by your Country but glorified in ours does not leave to individual or community satisfaction. We need to learn from the Nordic Countries where a higher taxation level with less tax exemptions for the wealthy allows for better public services and for the highest levels of satisfaction with life in the developed world. Perhaps we could take that learning curve together?

I have no doubt that the election of Donald Trump will cause major problems in the relationships between your Country and most fog the rest of the World. Treating other Countries as American satraps will not develop joint working and cooperation required to develop trade and peace.

Hilary Clinton might not be the best ever candidate but she is sane, credible, knows her stuff and is well regarded outside the USA. Yes she is, in some ways, the establishment candidate. Sometimes however, being establishment does mean that you know how things work; how to get things done; when to be forceful; when to give way. It means that you have been thinking about a lot of things for a lot of time. Your conclusions might not always be right but they are hopefully informed and rational.

Okay rant over. It’s your decision not mine. It’s your Country not mine. Bur be aware that the World is looking to you as you make your choice. We are concerned about how it will affect us. We do hope that Hilary Clinton, the continuity candidate, will be the one that prevails.

 

 

Cuts to chemists ‘will hit poor most’

As many as 3,000 community pharmacies are at risk after the Department of Health announced it was cutting their funding by £170 million. The Government says the cuts are justified because there are “more pharmacies than necessary” in some areas, leading to a “clustering” of High Street chemists. But new analysis by the National Pharmacy Association says 40 per cent of those under threat are found in the UK’s top fifth most deprived neighbourhoods. In comparison, less than five per cent of those at risk are in the country’s most affluent postcodes.

As usual the Government is more concerned with money than value for money. As a Liberal Democrat I believe that we need to deliver more medical and clinical services much nearer to where people live. Quite rightly some clinical activity is being concentrated in bigger more remote units because that is where the specialisms can be created to ensure much higher success rates or to put it another way much lower mortality rates.

This is where the humble chemist can come in. We underrate the skills of the pharmacists on our High Street and we do not take advantage of that High Street location. Almost every pharmacy know has a range of consulting rooms whereby confidential discussion and minor clinical activities could take place.

Much of what the pharmacists can do is already included in their costs. Too often we queue for valuable GP time when the advice we need is readily available at the pharmacy. Too often people clog up the GP’s surgery instead of getting hat advice. Pharmacists are not GPs but they have a high level of training. They can un deratke a range of things like giving injections; taking blood samples; issuing morning after pills; advice on sexual health; smoking cessation.

Pharmacy Voice has recently issued a new proposals for joint working with the Heath Service and other partners which sets out in some detail four principles by which they could cost effectively expand their work:

1. Aiming to understand the patient’s experience. The pharmacists sees people regularly and understand the context in which people live. They can note decline they can understand the direction of a person’s illness. They can not only work in their shop but also in the community and in the person’s home.

This gives tremendous reassurance and continuity to a person’s interaction with the Health Service

 

2. Evidence based choice of medicines. Yes I also agree that pharmacists should have a wider choice in prescribing drugs based on their wider knowledge not only of medical conditions but the ability to monitor drugs usage and put that usage and drug in the context of the needs of the individual. This approach will actually save money as one of the major causes of waste in the NHS is inappropriate and over prescribing.

 

3. Ensuring medicine use is as safe as possible. Of course the safe and efficient supply of medicines must be the cornerstone of a pharmacists work.

 

4. Make medicines optimisation part of routine practice. Community pharmacists will provide a one-stop hub for people who use medicines regularly.

 

As I have met the various pharmaceutical bodies I have been impressed with their passion for providing enhanced services from their readily accessible premises. As I have repeatedly said the only way we can ‘save the NHS’ is by thinking through better the way it does business and change the culture of people who use its services. In the future those pharmacies can become mini health centres from which a range of services can be provided. There is a massive amount of NHS resource which should not be cut but expanded to provide cost-effective and localised delivery.

I pledge all the pharmacy bodies which have come together in Pharmacy Voice the support of the Lib Dems and especially Norman Lamb in developing their aims.

They can improve services; getting practice nearer to the individual in cost effective and local situations. What’s not to like?!

The NHS has to change

Our beloved Health Service must not be preserved in aspic but modernised to meet changed times and opportunities

 

I spent a very large part of my time at the Liberal Democrat Conference talking to various parts of the NHS and associated and related bodies as I am the national spokesperson for us in local government for health and social care.

I met organisations like the Royal College of Nursing; Pharmacy Voice; the Royal Pharmaceutical society; the Salvation Army; the Terence Higgins Trust; Arthritis Research; Independent Living for the elderly and many, many more. I also spent time with Lib Dem members including Dr Clare Gerada a former President of the Royal College of General Practitioners who has recently joined us after many years in the Labour Party.

They were all delighted with the announcement from Norman Lamb and Tim Farron that the Liberal Democrats not only recognised the financial pressures on the NHS but also realised that this must be met by the creation of a dedicated tax to pay for it.

Equally however everyone I met realised that putting more money in was only part of the answer. In the long term we need to crack down on waste and find very new ways of doing things. Its cultural change that we need in the debate (or regrettably none-debate) on health not organisational change.

I was intrigued to find out, for example that not only is the drugs bill the second highest item in the NHS bill but up to one third of the money spent is wasted or misapplied. People are prescribed too much; they are prescribed inappropriately; they don’t make effective use of their drugs; large amounts are simply chucked away as they become out of time. Just suppose we could change these things and we could save say 25%of the drugs bill. That would mean a saving of £5 billion or twice the current deficit. What really annoyed me is that the Government have failed to take action to deal with the ramping of prices for drugs coming out of patent. That alone would save £300,000,000 every year.

Let’s take obesity. In simple terms 95% of people who are obese are so because they eat and drink the wrong things. Let’s say that by doing the right things with those people we could have that amount. That’s another £2.5 billion saved. But of course in this discussion the statement is easier than the solution. They might be eating the wrong things because of poor labelling; because they can only afford cheap food or because they are depressed. We need to work with them to deal with the causes of obesity and not the symptoms. It could eb that in this case the Government could intrdocue effective labelling so that people knew what they were eating nd what effects that the food would have ont heir diet.

Let’s take the elderly. Too many people are in hospital beds because they cannot be properly looked after at home before or after necessary medical treatment. The costs of keeping someone in a hospital overnight are roughly the costs of supporting them in their own home for a week. Quite simply in this context we are spending far too much on hospitals (where people don’t want to be) and not enough on care in their homes or communities where they do want to be.

Where can one stop? Drugs; tobacco and drink still are huge drains on the NHS. People turn up to A and E because their GP practices cannot give them an appointment. GP practices are full because we don’t use the skills and premises of High Street Chemists enough. My view of the Health services because I was told this time and time again of things which help prevent illness and or can provide better, cheaper solutions to a range of problems.

We need to have that thought in our heads very much in the next few weeks when the NHS launches its 44 STPs in England. The STPs are supposed to a review of the NHS which looks carefully at the current state of the provision of clinical and medical services in light of the pressures on the service. This process could not have been handled more badly if they had set out to make a bollocks of things. The public will now be consulted on plans which have already been decided upon. The reaction will be overwhelmingly negative. Of course it will as there has been no laying of the ground by giving information to councillors and the public.

Some hospitals will need to close. This can and should be done if we are to do the sorts of protractive and pre-emptive things mentioned above. The way we provide services has changed massively and could change more. The biggest waste of money in the system is the failure to use pharmacies properly. We have people going vast distances for a range of services which could either be provided directly by the pharmacists or in the premises of the pharmacist.

The danger will be that we automatically go in to save institutions when what we need is to have a clear understanding of the clinical needs and opportunities in terms delineating how and where that service is delivered and by who. Buildings are not the Health Service, people are the Health Service. We need to make access by the public to professionals closer to where they live and we need to develop care and support services which are in many cases more important than pure clinical services and drugs.

We in Liverpool should know that better than anyone. The first medical officer of health was appointed by Liverpool way over 100 years ago. People in Liverpool were dying from Cholera. The rich built themselves a good water and sewage system. They kept dying because no-one had provided the same services for the poor. There was a very clear understanding that health was a community issue and needs community solutions.

My fear is that the NHS which is such an important part of our lives will be the subject of accusation and blame over the next few months. The health debate will not be a sound one as we discuss just structures and finances. Yes the Lib Dems have led the way with our tax proposals but we have been clear that we need the debate. Spending more on what we do now and the way we do it will ultimately be self-defeating. It’s part of a solution but not THE solution. Any politician who thinks and says that money is the answer is a fool or a charlatan. Let’s have that proper debate.

I have looked into the belly of the Labour Beast (it isn’t pretty!)

On 17th July I wrote a blog about a Compass meeting held the night before when one of the speakers about creating a ‘progressive alliance’ was Labour MP, Lisa Nandy. She was in the news again yesterday when she shared a platform at the Lib Dem conference with Caroline Lucas the 50% Leader of the Greens.

The Guardian reported on this and in a boring bit of the conference (constitutional amendments if you want to know) I followed the comments underneath the article and I would have been applaaled at the comments from people inside her own Party had I not spent some time on my holidays following similar Guardian and Labour list threads. I regard Lisa as a first class, principled MP. She is competent, knowledgeable and concerned. She is NOT a Lib Dem and she made it clear she has no intention of leaving the Labour Party. FAir enough, I have no intention of leaving the Liberal Democrats. BUT she is clearly an MP with whom I could make common ground on a number of crucial issues.

However to any me rest of the Labour Party she is the devil’s spawn. The vitriol poured on her, usually anonymously, by people claiming Labour membership was unbelievable. Just the willingness to reach and talk to people from other Parties was enough to damn her in the eyes of dozens of trolls. The fact that Labour and Lib Dems (and others) might make common cause on some issues was the final straw for dozens of others.

I spent some time on my holidays following up similar threads and if I had any thoughts about the possibility of a wide scale ‘progressive alliance’ they were dispelled by the filth spewed out. They and not the Lisa Nandy grouping are the people who will will drag Labour down because they represent a way f life and a style of politics that is alienation to the vast majority of the people of the U.K. Tree souldmates are not fellow socialists but the likes of English Demcrats and Britain First whose method of political discourse is shouting louder and louder and making comments that are shriller and shriller. Perhaps we should put them all in a  big room where they can enjoy themselves with insult competitions and the man with the biggest gob!

Facing facts this behaviour will lead to major problemfor Labour. IT would appear from a. Wide number of reports that this new members, mostly in the Momentum grouping, don’t do much except lack meetings, engage in Polemic discourses and attend rallies. That’s a pity really. As a Lib Dem I really hope that they do take to the doorsteps. It would guarantee us success in ward after ward and constituency after constituency.!

As our Leader Tim Farron said yesterday the tragic death of the Labour Party is bad for everyone. We could now be condemned to 25 years of Tory Government which following Bexit will lead our country back to the mediaeval ages. The Corbynistas appeal to a maximum 20% of the vote. How do we know that? Not by looking at opinion polls, not at the number of people coming to rallies but the number of people casting real votes in real elections. almost uniquely for the main opposition Party Labour are going backward in the number of votes cast and the number of council seats gained. it is abundantly clear know that when those real votes are casting is only in very, very safe Labour seats like Hackney that Labour votes hold up. In almost very other part of the Country  Labour are doing very badly indeed. Not only failing to gain seats but very quickly losing them.

The Times had a very interesting article on Labour in Liverpool Riverside last week. It might give us a clue as to how quickly Labour will disintegrate. I suspect that nationally it will be a year until the selections for the new parliamentary seats start as they are so many major boundary changes. BUT council selections are likely to start quite quickly even though in Liverpool there are no council elections next year. how safe are the relatively small number of Councillors who are part of the Progress movement in the face of Momentum take over of the constituency Party. ? How soon will sane and sensible (but misguided) Labour Councillors get de-selected to be replaced by the sort of loonies elected by Militant in the 80s who caused so much damage for our City. How will existing Labour Councillors trim their approach to the absurd to stave off a deselection threat?

That damage has already started. It is clear that Corbyns bag carrier Steve Rotherham got selected by Labour on the back of the Momentum movement which he has assiduously courted. His’Manifesto’ was threadbare. I strongly suspect it will be filled with the absurd nonsense of protest and confrontation rather than dealing in a pragmatic with the policies needed to deal with urgent and pressing problems.

This is alloutside my control so I shall now return to my own conference where dissent is encouraged but dealt with an a courteous and diplomatic fashion. Where we are united behind our Leader and where we have just adopted a range of vital policies which would massively help the whole of our Country but particularly the most disadvantaged. We have gained 18,000 new members since June 24th. Just as we believe that our Country should take in more asylum seekers are Party too is prepared to accept asylum seekers fleeing from terrible civil wars and violence in what was once a great socialist party!

Singing gaily off we go…..

The Bird is soaring!!

Now I know that this is a Scottish song about going off to a wedding which I will NOT be doing this weekend. It does, however, express the feelings of the thousands of Lib Dem delates who are now on their way to the Party Conference in Brighton which starts later today with an extended bout of drinking (sorry political dialogue and discussion)!!

Why are we so happy? Because things are going our way in so many ways the most important of which is the impressive numbers of local election gains we have made this year. We made 45 gains in May and since then have added 14 more with gains from all Parties except the Green Party which has had no elections to defend! Last night we gained a seat in NE Derbyshire which had been a ‘black hole’ in the best of times. Our vote there went from 0 to 38%. Our vote in Newcastle went up by 18%. Our vote in Shropshire did not increase. It is often difficult to get the vote up when you are on 60%+ anyway! For the second week in a row the big losers were Labour followed closely by UKIP which has all but disappeared in terms of real votes. The Green performance has been mediocre in the few seats they have bothered to fight.

The Labour and Tory votes are particularly interesting. In wards and areas where they are already strong their vote usually increases or at worst drifts down slightly. In marginal wards their vote appears to be plummeting and in Labour’s case appears to be in free fall. This was perhaps best seen in Mosborough (Sheffield) last week where 3 weeks after a huge Corbyn Rally Labour lost a seat badly to the Lib Dems. This brought about anguished blog articles and tweets from Labour MPs and activists with widely differing views about why this happened.

So the message is that in real elections where real people express real votes the Lib Dems are doing well. Every extra vote we get and especially every seat we get gives more confidence to our rapidly expanding membership. The confidence means we are fighting more seats and that means we sign more people up, win more seats etc., etc.

The Lib Dem army will be snatching a bit of a break for the next four days as we work together in Brighton to develop the policies and people who can take our Party even further up the slope of success.

We are a united Party. Tim Farron and our other 7 MPs are incredibly popular. Tim, in particular, has caught the spirit of the moment with his very strong expressions and policies for the relationships that the UK must forge post Brexit. There are two lessons here for other Parties. We not only like our Leader but we also like what he is saying. There are no personality splits amongst our membership and no schisms on principles or policies. We are all in the same Party because we have the same beliefs and the same desire to put them into practice.

That does not mean that we agree on everything. I have considerable reservations about the main policy motion and support document that is up for debate. It’s not that I oppose much that is in it but I do not believe that it goes far enough in the radical change that I believe is necessary for the way we are governed and the way in which our policies will reach to those who most need a new approach to things like benefit, poverty and employment.

But when I disagree I will do so with courtesy which I know will be reciprocated. Political argument and discussion should not mean political squabbling and bickering. By listening to others and being prepared to modify your views you jointly arrive at better, more practical and better thought through decisions than you can make yourself.

Liverpool will feature in a number of ways. We have been nominated in 3 out of 6 categories for awards given by our Councillors and campaigning body ALDC. Tim Farron will be launching a leadership booklet that he asked me to write which talks about the longevity of our electoral success in Liverpool and why the sun is shining for us once more in this City. The booklet features Sir Trevor Jones and Tim will reflect on Trevor’s role in the Party both in Liverpool and nationally.

There will be a strong Liverpool contingent present and many of them will speak in debates which we will post on our Liverpool Lib Dems Facebook page. Paul Childs will summate the debate on PReP and the need for the NHS to provide suitable drugs to prevent HIV infection. We will talk about Europe, Health, Devolution and so many things that need to ebb done. Our councillors, MPs and Lords will leave the conference refreshed and ready to do battle with the forces of darkness!

I have been a member of this party for 49 years (boy and boy I like to think!) but I can never recall a time of greater joy in our Party as we face the challenges ahead. A huge influx of bright and committed new members linked to the skills and experiences of us older hands provides a great base for recovery.

We haven’t made the headlines because of leadership elections; squabbles; spats or policy disagreements. We are beginning to achieve a success level that has come to the attention of the media because of our continued membership and vote increase. Let me say it one last time for ‘Jones the Vote, “I love those votes!!!”

Watch this space and our Facebook page for updates of what we are up to.

 

Sir Trevor Jones RIP

                     Sir Trevor Jones with his wife Doreen and (now) Lords Alton and Steel after receiving his knighthood.
Sir Trevor Jones died on 8th September in hospital in Chester. He was an inspiration to a generation (and more) of Liberal and then Liberal Democrat activists after he saved the Party from a near death experience in the 1970 General Election. This Welsh descended scouser linked his deep liberal traditions and principles to the marketing techniques which had led him from being a seaman to owning the biggest and oldest ships chandlers in Liverpool.

He was the second Liberal councillor in Liverpool and worked with Cyril Carr to take control of the Council in 1973. He joined because his business was going to be razed to the ground to build a inner city ring road. Not only would his business be affected Bur scores of others I a city which even in the 60s was desperate for jobs.

Liverpool was the first major council to be Liberal controlled for more than 40 years. He never forgot his antipathy to demolition and as Chair of the Housing Committee produced his “Big Thick Book” a proposal to end the demolition of communities which would have brought the end to all but 5,000 terraced homes in the city by 1995. Instead the BTB produced the biggest housing renewal programme in the Country and subsequently the biggest housing cooperative programme in Western Europe.

He was awarded a Knighthood and the title which he loved most “Jones the Vote” after leading campaigns throughout the Country including by-election wins in Sutton, Berwick, Ripon and Isle of Ely. I well remember him making his presidential address at the Liberal Assembly and telling us how he loved those votes!

His brand of community politics and politics in the community is still successfully followed by Lib Dems and occasionally imitated by the other Parties. As a “Jones boy myself” I have so many stories I could tell of him, his manner in the council and his generosity of spirit. Without a doubt he was the outstanding council leader of his generation. His put downs to opponents were not the vicious nastiness that we see all too often today but a witty quip that totally demolished his opponents. I recall one particularly tedious and raucous lady councillor being stopped in her tracks by Trevor standing up and enquiring sadly, “Have you ever thought of selling Echos?”

I am delighted that before he died he saw the final version of a booklet about Liberal leadership in Liverpool which I will now launch in his honour at our Party Conference later this month. His words and his actions still inspire me and many of my generation.

His spirit lives on in our Party. Our thoughts are with his family and especially his wife, former Lord Mayor Lady Doreen Jones.

Low life expectancy – poor health. The cost of poverty in Liverpool

Yesterday Public Health England produced a report on the health of every local authority area in England. The report for Liverpool is very poor index. This is not the fault of the council or the NHS or housing providers. It is the result of a whole series of things that collectively need attention. Everyone has a role to play in this not least the many people who are ill with problems like obesity which they could do something about.

But we should not underestimate the way that any problems are hugely magnified by poverty. Looks at the difference firstly between Liverpool, the English average and the healthiest parts of England. The more money that you have, the wealthier the area the longer you will live. You can see that on the chart for Liverpool as well. The southern suburbs of Woolton and Allerton, for example, have mortality rates very little moved from the England average.

The links of poverty to poor health have been known for centuries. If you live in a poorly maintained, damp and draughty house of course you will be ill. If you eat poor quality food it will add to your obesity. If you don’t have a job you are far more likely to be depressed and lack fulfilment. If any of these statements surprise you then I, in turn, am surprised! Clearly things are getting better in Liverpool BUT they are not getting better at the same rate as they are in England as a whole.  So in some ways Liverpool is falling even further behind.

So what can be done? Well clearly the most important thing that we must learn from all the facts is that we cannot leave health to the NHS. I am not being disparaging about the magnificent work being done by the staff of the NHS or even the NHS as a whole. But they are not the most important determinant of longevity. If everyone who wanted a job had one; if everyone who needed a decent home had one; if everyone who wanted to live in a clean, safe well managed neighbourhood could do so there would be far fewer calls on the NHS. That would mean that the NHS could concentrate more on those for whom illness is unavoidable, especially those who are elderly who always have massive health problems in the last 18 months of life.

So do we leave it that. Do we say that the is little that we can do because we are poor and because we don’t have enough jobs. Should we just keep our fingers crossed and hope for an upturn in our local economy. Of course not because there is much that can be done to at least reduce the differences.

We can all eat better. Good food is often cheaper than poor food. But we have to know what is good and bad and we have to resist the siren calls of the big company, big budget advertising that encourages us to buy junk food either at the supermarket or takeaways.

We can all drink better. Resist the temptations of fattening, sugary drinks. Keep to the recommended limits of 14 units of alcohol per week.

We can all exercise more. 20 minutes walking a day can do wonders. You don’t need  to have the discipline of an Olympic athlete to do enough exercise to keep fit.

It’s incredible that 20% of people, are still smoking. And don’t be fooled by e-cigs. They are not good for you but they are just not as bad as the real thing..

We should all, young people in particular for obvious reasons be more careful of our sex lives to prevent a whole host of problems including unwanted teenage pregnancy.

This may sound like yet another middle class moralising exercise. Perhaps it is but the science says that the five things above would make huge differences to people’s life spans and the quality of life that they have.

So we we just leave it to the individual then? NO. We all need  help to fulfil these five objectives. This need to come in 3 ways:

INformation. Letting people have the information they need to make informed choices about their lifestyle. This should particularly be available at point of sale so that people know what is in the packets full of goodies.

Support Mechamisms. Giving people a range of educational and practical support activities to help them avoid or come off unhealthy lifestyles.

Legislation. The two things above must be supported by legislation so that manufacturers have to display proper information about contents in ways that ordinary consumers like me can understand. Legislation must also be used, as in the case of tobacco to affect change by looking at advertising, tax and sales regulations.

Everyone knows that all these things must be done yet the Government has cut the Public Health budget by £850,000,000 which means that councils and the NHS will struggle to continue to provide existing services never mind undertake the expansion which is so desperately needed.

People are dying today earlier than they need to. We cannot wait for a vague tomorrow to come to tackle these very clear and very obvious needs.

You can find out the full  4 page note on Liverpool by following this link. Http://fingertipsreports.phe.org.uk/healthProfiles/2016/e08000012.pdf&time_period=2016