Community campaigner and Ham&High columnist Janet Shapiro has died, aged 84.

Not only did she merit a wonderful obituary in this paper, but the Guardian also carried a tribute.

Tireless is much overused to describe anyone who cares, is passionate and campaigns. But, in Janet’s case, it was completely appropriate.

Her final Ham&High column was published on July 8 and, referring to a frailty conference she had attended, she wrote about the complexity of service integration and how clinical and care partnerships must include patients and carers if they are to succeed.

Her final point was well made and I’m sure that Janet would have been deeply concerned at England-wide initiatives that are profoundly changing our ability to access and receive care. They seem to have crept up on us with no discussion.

Physician Associates continue to be in the news as the Government tries to backfill gaps in primary care GP provision and compensate for a proper workforce strategy.

But where is the patient and carer engagement about training, registration, protocols and how they should be deployed? Instead, there is a rush to give PAs a white coat and a stethoscope, bung ‘em in doctors’ surgeries and hope nobody notices.

Ham & High: David Winskill remembers Janet Shapiro as 'tireless'David Winskill remembers Janet Shapiro as 'tireless' (Image: Archant)

Virtual Wards are a fine idea (who likes hospital food?) but the NHS planners and providers have arrogantly and complacently assumed the availability and willingness of an army of unpaid carers to make them work.

As far as I can tell, carers have never been invited to the conversation.

Digital access to services is the way forward. Fast, cheaper and convenient - if you have the kit and know what you’re doing.

However, for many (like the frail that Janet championed) it can be confusing and a brake on getting treatment - an effective form of service rationing, marginalising those most in need of care.

Each of these initiatives can be made to work, but not without active input from patient and carers’ groups.

Everyone - of whatever age - reading this column will be affected by these changes. Perhaps not directly, but we all have parents, friends and neighbours who will need help.

Hornsey Pensioners Action Group ( has a large, Janet shaped vacancy waiting to be filled.

They need support - why not drop them a line?

  • David Winskill is a Crouch End resident and campaigner.