Category Archives: Health

Is Paddington the “big society” in action?

Big society in action is how civil society minister Nick Hurd described the award-winning Paddington Development Trust (PDT) which he chose for his first ministerial visit in May 2010. “Residents have real sense of ownership and power,” he enthused on Twitter about the west London regeneration organisation that supports residents to volunteer a total of 5,000 hours through 350 different volunteering opportunities.

But shortly after Hurd’s praise, the organisation was among the first victims of public spending cuts when £350,000 was axed as the government scrapped its neighbourhood programmes. The trust’s chief executive, Neil Johnston, has spent the last year figuring out how to continue its groundbreaking work. Read the rest of my piece for the Guardian’s Society pages here.

“As a child, I didn’t know what stigma meant – but I certainly knew how it felt”

Guest blogger Lol Butterfield, a mental health campaigner and qualified mental health nurse, explains his involvement with a national drive to tackle the stigma suffered by people with mental health issues. The campaign is driven by service users. Butterfield, who lives in Teeside, has written an autobiographical book which describes his experience of growing up with a mentally ill parent.

Lol Butterfield, Social Issue guest blogger, mental health campaigner
“He must have been insane to have done that!” Sadly, an all too familiar response following reading about a particularly vicious assault or murder, in the newspapers. The reality is usually different though and, statistically, 95% of serious crime is carried out by people who do not have a clinical diagnosis of mental illness, those who are not therefore “insane.” They are “bad not mad”. So why do we discriminate?

People experiencing mental illness are more likely to be the victim, rather than the perpetrator, of a serious crime. This criminalisation, mainly through the media, was one of the reasons I became involved in Time to Change and its Lived Experience Advisory Panel (LEAP).

LEAP is an advisory group of 12 people who shape the Time To Change programme, England’s largest mental health anti-stigma campaign. Time to Change began in 2007 funded through the Big Lottery and Comic Relief with £20 million of investment. Us “Leapsters” have extensive experience and knowledge of mental illness and a passion to put the record straight. We act as campaign ambassadors and spokespeople. With a diverse mix of expertise and good links to service user and carer networks, we work towards ensuring that service user and carers needs are at the heart of the campaign.

Over 30 years I’ve spent time working in mental health services as a qualified nurse. I have seen daily the stigma and discrimination faced by those who experience mental ill health and their families.

I’ve also been on the receiving end of this stigma myself. I experienced mental illness myself when in 2004 I had to take time off work with severe depression. I have worn the shoes of the nurse, and the patient. I can empathise with the one in four of the population who have also found themselves mentally unwell at some point in their lives.

My father also experienced mental illness and as a small child I recall the stigma surrounding this growing up in a small mining village in the north east. As a young boy I did not understand what the word stigma meant but I certainly knew how it felt at that time.

I have spoken to people who have been laughed at on the bus or been called names because people know they have mental health conditions. I know of those who have ever been told to sit in other areas of a pub, who have not applied for jobs because they fear being rejected when they disclose their mental health background. These people are vulnerable to abuse because their mannerisms. Ironically these mannerisms are often caused by their medication rather than the condition itself.

I became involved with LEAP because I saw an opportunity to positively and constructively use my experience, as both a nurse and someone with experience of mental ill-health, to make a difference.

I have presented at conferences telling my story and promoting the campaign message. I’ve taken part in TV and radio interviews, visited schools and colleges to raise awareness. Until recently, I was writing a bimonthly column for the local newspaper where I live in Teesside with the aim of tackling the negative stereotypical coverage we see all too often.

Three years ago, I decided to write Sticks and Stones, my autobiography, as another way of spreading the anti-stigma message. my childhood memories of growing up with a father who experienced mental illness and the stigma my family faced and I myself felt as a child. For me writing the book was also about encouraging others to follow my lead by using myself as a positive role model (ie someone who is trained as a mental health nurse and has experienced mental illness. I am very open about this in order to promote more acceptance from others)

Individually as well as collectively we can and will make a difference no matter how small. With imagination and creativity we can impact in those areas of society that discriminate and stigmatise.

It has not always been easy. The work I do can be stressful because often it is real people with real experiences at the core of what we do as a group, and I do as an individual. I have at times to be mindful of my own limitations and avoid pushing myself into the “dark place” of clinical depression again. That said my work gives me so much satisfaction and pleasure. To know my words and actions have made others think differently around mental health, and act differently in their treatment of those who are unwell, is reward in itself.

The work of LEAP has made a difference in that dedicated time and effort has ensured that the message is being delivered in many creative, diverse ways that otherwise may not have been. As Leapsters we cover all parts of England to touch as many people in as many regions as possible. Touching hearts and minds, promoting tolerance and understanding of mental ill-health. I believe we are teaching the next generation to act and behave differently, changing attitudes for the better.

Care: money talks but standards should matter more

Freelance journalist and editor Kate Murray
It was when the care home manager started to talk about staff training that the alarm bells sounded for me. Not because I didn’t want the people who would be caring for my mother to be well trained – far from it. It was his reasons for ensuring all his staff had a certificate to their name that I found so worrying. “It’s a competitive business,” he told my brother and me. “Our people have to have those qualifications. That’s what other places have and we can’t afford to fall behind.”

I found his unashamed concern for his bottom line shocking. But I could also see why he was so keen to bring the business in. At some £550 a week for a place in an establishment like his – although he was prepared to haggle to get us to sign on the dotted line – there are serious amounts of cash at play.

Not surprisingly, we didn’t go for the care home in question, plumping instead for an even more expensive option where we felt happier with the atmosphere and the care on offer. But my experience of choosing a care home, which came just before Andrew Dilnot released his recommendations on paying for care, showed me that money talks – even when it should be the standard of care that we should really be concerned about.

When his report was published, Dilnot rightly pointed out that the issue of funding adult social care had been ignored for too long. He proposed that the costs an individual has to pay for his or her care should be capped at £35,000. Many have agreed, arguing that it’s unfair that people who’ve saved all their lives, or worked hard to pay for a home, should be forced to lose most of what they had hoped to pass on to their families.

But for me, it’s not inheritance rights that matter. It’s simply that as things stand, where so many people self-fund their care, we’ve created a market that has spiralled out of control. While the state has stood by, determining that only the worst-off will have their costs made for, care for the elderly has become essentially a private matter.

It’s a world in which staff costs are pushed down so hard that frankly it’s no surprise quality can be so poor. One in which the push for growth can become so all-consuming that, as with Southern Cross, it leads to failure. And one where the prices are so sky high that care home managers seem to believe that relatives will want to haggle over prices rather than talk about how they maintain their elderly residents’ dignity and quality of life.

Establishing a system such as Dilnot recommends, in which people knew how much they would have to pay for their care in later life, would not just allow families to plan for their old age. It would also allow us to concentrate on the things that really matter: good quality care, with respect for the individual.

Care for those who need it should not be about having to worry about the invoice at the end of the month.

The artists redrawing our perceptions of disability

Bengali Welcome, by David Constantine

Photographer David Constantine – he’s the creator of the arresting and uplifting image above, Bengali Welcome, above – has a theory as to why his subjects relax once they’re in front of his lens; his wheelchair breaks the ice.

Constantine’s work is being shown as part of the inaugural Bloomsbury Art Fair that opens today at the Goodenough College, Mecklenburgh Square, London. As well as works by popular artists Banksy and Damien Hirst, there are pieces for sale by new and emerging artists. The three-day charitiable event raises money for spinal injury-related charities.

Constantine, for example, began taking pictures as a teenager and sold his bike to buy his first camera. While on a working holiday in Australia in 1982 he broke his neck in a diving accident and became quadriplegic. Paralysed from the shoulders down, he gave up photography for a year. But while he wasn’t able to pick up his camera, he continued to “see” images. As he writes on his website: “During that year I realised that I was still ‘seeing’ pictures, choosing images in my head even to the point of deciding on film types and composition I would use for a particular shot. The only thing I lacked was the physical ability to use a camera. I realised that this was a ridiculous reason for giving up and all it need take was some adaptations to my camera and wheelchair to enable me to take pictures.”

Exactly a year to the day of his injury he began the process of taking pictures again. He travels with his work for Motivation, the international disability charity he co-founded, and his main subjects are people in their own environments. As he says, “the disadvantages I foresaw with my photography after becoming a wheelchair user have turned into advantages.” He has developed different skills and enhanced others: “I am so conspicuous that it has made me bolder, I am happy to go and ask someone for their picture. If I can’t communicate verbally I make it very obvious that I would like to take their picture, people make it quite clear whether they are happy for me to photograph them or not.”

Love, by Sophie Morgan

Among the participating artists is Sophie Morgan, who was runner up to Britain’s Missing Top Models. Morgan had a car accident in 2003 that left her paralysed and in a wheelchair for life. Her beautiful piece, Love, is above.

Morgan’s website declares that she is (in this order) an “Artist, Portraitist, Writer, Arts Psychoth

How the housing safety net is shrinking further

As councils tighten eligibility criteria for housing at the same time as benefit cuts hit, charities warn of an increase in homelessness. With the trend growing for councils to overhaul their allocation policies, there are fresh concerns about people being forced into the unaffordable private rented sector or pushed out into cheaper suburbs. Read my Guardian piece here.

Dilnot: reaction round up

Today the Dilnot commission on social care published its conclusions in its Fairer Care Funding report. Among its findings are that care costs should be capped and the means-tested threshold increased under major changes to the funding of adult social care in England.

The report is a chance to finally fix a shattered system, there will be widespready reaction and analysis later today and beyond to what Dilnot himself calls a once-in-a-lifetime chance to overhaul social care but for now, here’s a selection of today’s responses which I’ll try and update throughout the day.

Sue Brown, Head of Public Policy at the national deafblind charity Sense: “Sense welcomes the Dilnot report, and in particular the key finding that additional public funding for adult social care is urgently required. But we are concerned that the media focus is only on older people which obscures some critical aspects. We believe the report clearly shows that not only can the Government afford to support disabled people of all ages, but crucially as a society we can’t afford not to. It is now up to the Government to fund adult social care so that it gives disabled people of all ages quality of life. For deafblind people social care means communication and mobility support, not just personal care.”

Julia Unwin, the Chief Executive of JRF and the Joseph Rowntree Housing Trust (a non-for-profit provider of housing and care services): “Today marks the most concrete and credible step for years. I believe that the proposed reforms have the potential to bring about a radical step-change in how we value social care, how we think about disability, and how we all – as individuals and as a society – plan and prepare for longer lives.
It is positive to hear commitments from all the main parties to set aside party differences and consider the Dilnot report with the consideration it clearly warrants.
The JRF now urges the Coalition Government to abide by its promises to deliver a White Paper in the next six to nine months. It would be a tragedy for this, one of the most pressing and defining issues of our age, to be kicked, yet again, into the long grass.”

Jeremy Hughes, Chief Executive, Alzheimer’s Society: “Today’s welcome report could bring to an end the scandal of the colossal Dementia Tax where every year tens of thousands of families are left to pay all their care costs whilst other diseases are paid for by the NHS. The government mustn’t miss this opportunity to right a wrong that is destroying lives. In a new system we must end the postcode lottery that gives different support depending on local authority. The Dilnot Commission has given the coalition government the opportunity to show that it is a caring government. Pending implementation they must also show they care, protecting social care spending in the way they are doing for health.”

TUC General Secretary Brendan Barber: “The TUC welcomes the increase in funding for the care of the elderly over the next few years, and the news that social care will be free for those who become disabled before the age of 40.
“The introduction of a national eligibility assessment should avoid a ‘postcode lottery’ and make it possible for those receiving social care to move around the country without losing their care provision.
“The TUC believes that social care should be provided free for those who need it, and funded from general taxation. The Dilnot Commission’s proposals could, however, be transformed into this NHS model by continually reducing the level of the cap on care costs. The government must not set too high a cap – a level above £50,000 per person would mean that families could still face losing their homes to pay for the vital care they need.”

Gordon Morris, managing director of Age UK Enterprises: “The Dilnot commission report delivers a clear call to action to the financial services industry to work with government to develop the innovative products needed to fund long-term care. Existing products, such as equity release and annuities, could present a solution, but far more has to be done to build flexibility into these products to increase access and ensure these products evolve to meet changing financial needs.”

Stephen Burke, founder of social enterprise United for All Ages: “Under the commission’s regressive proposals, the winners would be richer families whose inheritance will be relatively protected, while most families will face a more confusing and potentially costly care system. The proposed cap on care costs will still result in some older people being forced to sell their homes to pay for care and related costs.
“The proposals aim to reform the current inadequate system for funding care. But they would lead to a more complex, fragmented and confusing care system … This could be seen as a care ‘poll tax’ for the so-called squeezed middle.”

An interesting reaction from by social workerSarah Smith“: “It is local authorities that take the hit from policies devised by central government, and we can only hope that all parties are brave enough to act together for the country’s interests rather than consider of their own chances at the ballot box. We deserve much better than that.”

Labour leader Ed Miliband: “The last thing Britain needs is for Andrew Dilnot’s proposals to be put into the long grass. We three party leaders are of similar age and the same ­generation. This is a once-in-a-generation opportunity which our generation must address.”

Which? executive director Richard Lloyd: “Consumers tell us that long-term care is their top health care priority* so we welcome these recommendations and urge the Government to act sooner rather than later. If private insurance is to play a part in funding long-term care, then we need to learn lessons from the past, where products have either failed to meet people’s needs or have been mis-sold. This will be a new market with a clean slate so it’s important that strong consumer protection is in place from the start.”

Michelle Mitchell, charity director at Age UK, tells the Guardian that the report set out “a clear blueprint” for sustainable reform. Production of a white paper by next spring was ambitious but achievable, Mitchell said. But she warned: “Delay beyond Easter would be indefensible.”

Mark Goldring, chief executive of learning disability charity Mencap, said: “Now is the time for monumental change and it is vital that the government does not bury social care reform.”

John Adams, Voluntary Organisations Disability Group (VODG) general secretary: “Today is about more simply demanding more money – vital though additional funding is – it is about urgent reform of a broken system. The Dilnot commission has taken great pains to build cross-party consensus; ministers now need to match the warm rhetoric with which they greeted today’s report with swift action. The government must find the courage to put its money where its mouth is, succeed where previous administrations have failed and exploit what Dilnot himself describes as a “once-in-a-lifetime opportunity” to create a fair and sustainable system of social care.”

Senior Fellow at The King’s Fund, Richard Humphries: “The budget deficit should not be used as a reason for inaction. This is a long-term issue and questions of affordability go beyond the current economic situation. The additional public expenditure needed to fund these proposals is less than 0.25 per cent of gross domestic product – this should not be too high a price to pay for providing a care system fit for the 21st century….Where they have failed in the past, politicians from all parties must now seize the best opportunity in a generation to ensure that people can access the care and support they deserve in later life.”

Su Sayer, learning disability charity United Response’s chief executive: “The report’s recommendations are the first step towards creating a better system which ensures that people in need of care receive it, funded in a way that is not only fair, but seen to be fair….Whether viewing this economically or morally, we cannot afford to ignore these recommendations, which is why we urge all political parties to work together towards a better social care system for all.”

Guy Parckar, acting director of policy, campaigns and communications at Leonard Cheshire Disability: “The system as it stands is creaking at the seams, with more and more people missing out on the care that they need. This report must be seen as a clear call for action. All of the political parties must come together with one agenda and that is to agree a fairer settlement for social care. We cannot go on with disabled and older people missing out on care because of a system that simply cannot cope with the demands placed upon it…Too often disabled people with significant social care needs can be charged into poverty by our social care system. People are unable to work, unable to save, unable to buy a home as any income or assets will simply be taken to cover the costs of care. This is a critically important recommendation that could make an immense difference, and it is absolutely imperative that the Government acts on it.”

Domini Gunn, Chartered Institute of Housing (CIH) Director of Public Health and Vulnerable Communities: “In reforming the funding of social care, we urge the government to follow Dilnot’s recommendation to review the scope for improving the integration of adult social care with wider care and support system. This must include housing, and housing support, providers and could help drive a more preventative approach, incentivised through funding arrangements.”

Sir Stuart Etherington, Chief Executive of NCVO: “This review makes major strides towards identifying how we can achieve an affordable, sustainable and fair funding system for all adults in the UK. The challenge now falls to all parties to resist turning the review into a political football and to prioritise responding swiftly and decisively. It is the most vulnerable who will suffer if we cannot seize this golden opportunity to improve the funding of adult social care.”

Life stories: freeing the minds of dementia sufferers

It was only a picture of a gurgling baby. But to one elderly woman with dementia, it meant the world. “She had dementia, was in a care home and was past the stage where she could really have a conversation,” says Helen Bate. “But she just fell in love with that photo. She would try and wipe the baby’s dribble off, or feed it chocolate. It’s just an image – but it had the power to really engage her and she’s been able to talk to it.”

Bate is founder and managing director of Pictures to Share, an innovative social enterprise creating picture books and other resources for people with dementia. She’s a passionate advocate of people with dementia, who she argues shouldn’t be shut off from the world of books and art just because of their condition. “People make too many assumptions about people with dementia,” she says. “There’s often a lack of imagination in their care. If someone liked looking at good painting, they are not going to lose that when they are in a care home. They may not be able to read any more but they can still enjoy looking at the pictures in our books.”

Bate was inspired to start the business after her own mother, a dementia sufferer, enjoyed looking at a scrapbook Bate’s daughter had put together. “There was nothing else out there,” she says. her first three books were published in 2006 and, thanks in part to charitable sponsorship, she has now produced a total of 11, all designed to combat the isolation and depression which can so often be associated with dementia. The organisation has diversified into producing artwork and is now working on dvds.

“If you go into some care homes, it’s almost as if they assume that because people are old and have dementia, all they want to look at on the walls is pictures of the royal family, wartime or old street scenes. It’s pigeonholing everyone into a very narrow category.” The Pictures to Share books cover everything from sport to shopping and from the world of work to travel.

There’s diversity too in the choice of images: colour and black and white photos both old and new are mixed with reproductions of paintings. The key criterion is that all of the images should be powerful and easy to understand to prompt memories, a chat or simply a smile. “Because of their dementia, certain things won’t work if they are too complex,” says Bate. “And we have to be careful about showing pictures people might get worried about. For example, with a picture of children paddling in the sea where you can’t see any adults around, people could get quite distressed because they think the children are in danger.”

I tried out three of the books with my mother, who has multiple dementia. I was unsure how she would react, but I was delighted to find that the pictures inside captured her imagination. She used to be a great traveller, so it was perhaps inevitable that the biggest hit was the travel book. Its shots of the Taj Mahal and train, plane and ship journeys, really got my mum chatting.

The feedback from other users suggests my mum’s response is not unusual. “It opens the channels of communication that are a bit stuck,” she says. “Relatives find them really useful to get a conversation going, which can be tricky for people with dementia.”

For relatives and carers perhaps the most powerful thing about the books is that they remind us all that behind every person with dementia is an individual with their own interests, likes and dislikes and their own life story. They are not all the same, so let’s free our imagination – and theirs – as we care for them.

“Sometimes I get cross with my parents because we don’t have a normal life.”


Above, young carers talk about their role in a Carers Week film.

Next time you feel fed up with doing the household chores, think about Ryan. At 13, he cooks, cleans, does the laundry and helps both his disabled parents get around the house. His father has Crohn’s disease and his mother is disabled.

Aside from the physical requirements of his role as a young carer, Ryan shoulders a huge amount of emotional stress; life is unpredictable because his parents’ health varies from day to day. Getting ready for school in the morning, for example, is hard because he worries about leaving his parents alone and fears his dad will be in hospital when he gets home. The teenager gets frequent headaches, stomach aches and suffers from irritable bowel syndrome, all of which his GP says is stress-related. It is easy to see how being a young carer can adversely affect education, health and wellbeing and lead to isolation and anxiety.

Ryan, who is lucky enough to be supported by a young carers project run by the charity Action for Children, is one of an estimated 700,000 children and young people who have caring responsibilities. Young carers represent over 10% of the UK’s 6m carers, the group of people highlighted in Carers Week this week.

Action for Children is using Carers Week to demand that the government and councils do not ignore the plight of young carers. The charity has released new figures today which show that, in a survey of 23 Action for Children young carers projects, services supporting 1,192 young carers have had their budgets cut by up to 30%. A further 192 young carers are supported by services that have suffered budget cuts of 40% or more.

As Ryan says, he would be lost without support from his young carers project. “I really rely on that time with my support worker to express my worries. It’s amazing to share my experiences with other young carers who understand what it is like to be me. I love my parents but sometimes I get cross with them because we don’t have a normal life and I can’t do the same things as my friends. I used to feel guilty and bad about those feelings but after talking to other young carers I know that we all have feelings like that sometimes and its okay. The young carers project arranges all sorts of activities for us to help us relax and enjoy our time off from looking after our parents. It’s like having a little holiday away from all the worry.”

Budget cuts to support services for young carers save money now but run the risk of undermining young carers’ futures. As Hugh Thornbery, director of children’s services at Action for Children, says, there is already a huge danger that those who need care start relying on children and young people to support them even more as statutory service provision is decimated. This situation, as the charity stresses, effectively means young carers – many of whom spend up to 50 hours a week looking after a relative – bear the brunt of the country’s deficit and might end up paying for it with their futures.

* To find out more the impact of caring resonsibilities on the young, try also checking out the very good Victoria Cares site, a week-long campaign by children’s charity Spurgeons revealing a week in the life of young carer Victoria.

No voice for the vulnerable

Can you imagine being so desperate for affordable legal advice that you go on an eight-hour, 300-mile bus trip just to get help? I came across such a case seven years ago; a Welsh man facing eviction from his council-owned cottage when the area was being redeveloped found that the only housing legal aid lawyer willing to take on his case was in West London. So desperate was the man to stay in the cottage he had been born in and so great was his fear of homelessness, he made the trip.

Although this tale is from 2004, it highlights the vital safety net legal aid (when the state pays all or part of the legal costs for those who cannot afford them) provides to society’s most vulnerable. The number of solicitors who carry out legal aid work have been falling in recent years (hence the Welsh man’s 300-mile journey) thanks to uncompetitive pay rates, hours of unpaid work and red tape. But now, under government plans to cut the legal aid budget by £350m, the situation could get worse for those wanting to access affordable legal help. It is estimated that around 500,000 people could lose out on legal advice amid the planned cuts as the government wants to remove clinical negligence, family law, education, non-asylum immigration and housing cases from legal aid’s scope.

Today is Justice for All day, with marches and petitions planned by a coalition of 3,000 charities campaigning against the cuts and you can also oppose the cuts at social action campaign site 38 Degrees.

The Law Society, which represents solicitors in England and Wales, has also launched Sound Off For Justice, a campaign for alternative reforms that it says will save more than the government’s own proposals and protect legal aid funding. The campaign encourages the public to demand the government reconsider its plans and look at the alternative measures which it says would save £384m in the next 12 months. You can record a voicemail for Justice Secretary Ken Clarke against the cuts here. The campaign is supported by, amongst others, housing charity Shelter, the Refugee Council, lone parent charity Gingerbread and housing association Eaves.

Here’s the campaign’s latest video:

There’s something rotten going on when an endless glut of super-injunctions protect the privacy, reputations and careers of the super-rich but a lone parent, for example, is denied basic access to his children because he simply can’t get the afford the advice.

What no big society?

Amid the vibrations of doom and whiff of ennui surrounding anything stamped with the politicised big society seal, a new campaign tagged in plain terms as a grassroots effort to improve a neighbourhood is a bit of an attention-grabber.

Shockingly, no one’s claiming it’s part of some shiny new renaissance in volunteering that will allow the state to retreat on the sly, but a tried and tested idea, backed by an organisation that’s been doing similar, citizen-led work for years.

Quick – Dave’s on the line – he wants his big society back!

Today’s launch of Shoreditch Citizens – part of well-established community organisers programme London Citizens – follows an audit of 200 organisations in the east London area, plus 500 meetings to identify local issues that matter and train community leaders.

The Shoreditch arm is the latest chapter for London Citizens, an alliance of 160 groups representing faith institutions universities and schools, trade unions and community groups; the founding member is The East London Communities Organisation (Telco), the UK’s largest independent community alliance launched in 1996.

Shoreditch Citizens has high hopes in aiming to join forces to impact on poverty, poor housing and gang crime – around 75% of the area’s children live below the poverty line and four in 10 adults are unemployed. The campaign, funded by the Mayor’s Fund for London and £270,000 over three years from the community investment arm of Barclays Capital, also wants an alternative to the education maintenance allowance (EMA) to encourage young people to stay in education. There is also a plan to make Shoreditch a “Living Wage” zone, where everyone who works in the area can be sure to earn a decent amount to live on. The Living Wage campaign was first launched by London Citizens in 2001, which says it has won over £40 million of Living Wages, lifting over 6,500 families out of working poverty.

By December 2012, the Shoreditch engagement programme aims to train 300 community leaders from 30 civil institutions and hopes to impact on up to 15,000 families. All this is nothing if not ambitious, but if you don’t have goals…