Crisis in Health

It’s difficult to think of a more inappropriate person to be Secretary of State for Health and Social Care[1]. He has all the bedside manner of Dracula. Prime Minister (PM) Rishi Sunak re-installed him in that vital Government post. So far, he’s achieved nothing but distress and mismanagement[2].

I shouldn’t joke. The seriousness of the situation in the National Health Service (NHS) isn’t a joking matter. Winter is testing the service to breaking point. Both the statistics and the experience of patients are not acceptable by any reasonable measure.

What’s intolerable is the general Ministerial response. Hard-line rhetoric about not budging on negotiations is callous. Dismissing every call for support by rattling-off lists of figures about Government spending is no help at all. Trying to redirect attention away from the things that need fixing. The shabby politics of avoidance is not what’s needed.

As a personal note, I find the situation indicative of broader failures too. My one term as a Surrey Country Councillor, between 1993 and 1997 is more history than anything else. The problem is that it’s not. I remember papers coming to full council meetings with a title that is pertinent and recognisable today. The subject being “bed blocking[3]”.

That’s 30-years ago, our institutions struggled with making the transition between hospital care and social care. It was clear that there was going to be a growing problem. The demographics pointed to a rising aging population. There was no ambiguity about the facts.

Ministers have come and gone. Quite rapidly over the last year. Each with the responsibility for NHS service delivery, performance, and social care policy. Some like incoherent gad flies, some who span like windmills in a storm, some like patrician overseers but none with the managerial skills needed to address the challenge that stares them in the face.

Most local authorities are dealing with cuts to their budgets, financial constraints and the cost of living demands we all confront. In some cases, they are tittering on the brink of bankruptcy[4]. Many local authorities have been forced to reduce their funding of social care at a time of rising demand. 

It’s mad that, after all this time, we have still not come up with an integrated health service. Pitching the NHS and local authorities against each other for funding is absolutely ludicrous. It’s costing lives.

Today, we must recover from a crisis. Tomorrow, real change must be implemented to prevent a future crisis. It isn’t as if we don’t know what to do!  


[1] https://www.gov.uk/government/people/stephen-barclay

[2] https://www.independent.co.uk/news/uk/politics/nhs-strikes-barclay-cooper-libdems-b2244466.html

[3] https://fullfact.org/health/bed-blocking-what-it-and-it-paralysing-nhs/

[4] https://www.kentonline.co.uk/kent/news/what-it-means-for-kent-residents-if-kcc-goes-bust-277075/

Where’s the common sense?

It’s two whole years since the end of the UK’s Brexit transitional period. That’s since the day when the UK fully withdrew from the European Union (EU). Have we seen any, I mean any, Brexit benefits from the day of the Brexit referendum? The sad truth is – No. We are worse-off. Investments haven’t happened, political turmoil persists and bureaucratic barriers have grown.

Certainly, it’s right to say that British politicians have been busy. They have found lots of targets to blame for this continuing underperformance. You name it; Remainers, young people, environmentalists, protesters, strikers, human rights, overseas aid, COVID, flu, global economic downturn, energy prices, war in Europe, Biden’s administration, China, France, Germany, hot weather, cold weather, the list goes on and on and on. The Brexiter’s blame list is an exceptionally long one. Add to this the fact that Boris Johnson comes in for caustic blame. Often strongest from the people who trumpeted his ascendancy to power in 2019.

Although we should not dwell too much on the past, it’s as well to not let what has happened in this last year be swept under the carpet. Remember 2022, after 44 days, Conservative Liz Truss resigned as British Prime Minister (PM). She was the first choice of the members of the political party most entrenched in Brexit thinking. This extraordinary farce made the country look it was run by like a bunch of incompetent fools, of ill-disciplined fanatics, of preposterous comics.

The blatant dishonesty behind Brexit can not be denied. A recent example was the Government statement on having not attained a promised boost from new trade agreements. A ridiculous political line about not signing deals until they are right for the country is a brazen smoke screen to cover-up a significant lack of achievement[1].

We need some serious common sense injected into our politics. The UK is not going away. The EU is not going away. Both share an immense common interest. Both are faced with similar challenges and threats. Both share the same values.

Brexit has added to costs, adding to inflation, labour shortage and under performance. Most people[2] now accept this analysis and want to see serious change[3]. The more both Conservatives and the Labour Party cling on to the mythology of Brexit, the more damage will be done. Keir Starmer has confirmed that the Labour Party will not seek for Britain to re‑join the EU. What a reckless folly from a would be PM.

POST: referendum – latest news, breaking stories and comment – The Independent


[1] https://www.bbc.co.uk/news/uk-politics-63808657

[2] https://www.statista.com/statistics/987347/brexit-opinion-poll/

[3] https://yougov.co.uk/topics/politics/explore/issue/European_Union

Strikes

Impossible to listen to the burbling of UK Minister Stephen Barclay. After a while the listener sinks into an overwhelming feeling of despondency. His words are strung together as if he was on a brain teasing quiz show run by Victoria Coren Mitchell. Barclay exudes a fear of making sense.

For one, please, please, please will he not keep saying the same thing about rigidly adhering to the results of a pay review body. Results which are widely known to be out-of-date. Afterall, if Ministers have any purpose at all, it goes way beyond rubber stamping the work of others.

Given his previous party-political roles it’s astonishing to see him in a serious government job like Health Secretary. A job where playing party-politics can cost lives. I think we all know that the crisis of the moment is not just about pay. However, to pretend that staffing levels and pay are not so important is beyond the understanding of most normal people.

This suited grey-haired man in his early 50s would be better employed on the London stage. I can see him as Marley’s ghost in a Westminster adaptation of A Christmas Carol[1]. Recounting the day when he had the opportunity to fix the problems of Health and Social Care but looked the other way and played for time.

The many strikes that are hitting Britain are avoidable. British politicians are failing to engage with the problem. What’s disheartening about this situation is that everyone knows there will be a settlement at some time. Recognising that fact, it’s about time the groups involved got together and talked long and hard. That is talking with no subject taken off the table.

The Secretary of State for Health and Social Care has a leadership role. It’s time for him, not to excuse the government at every media opportunity, but to engage, roll up his sleeves and meet the unions. Playing party-politics and courting right-wing public opinion was fine as he did in his Brexit job but now Barclay has a real job with real responsibility. It’s winter. This is tragic.

He needs to step up or ship out.

POST: Making a bad situation worse International nurses considering leaving UK if pay does not improve | Nursing Times


[1] https://youtu.be/ReprQS03ZM4

Omnishambles

Ten years ago, the Oxford English Dictionary (OED) Word of the Year was a word that is as usable as ever. It wasn’t brought to the fore by social media. At that time, social media hadn’t bitten such a big chunk out of our attention time. We even had enough time to sit in front of the box on an evening. That said, the box hasn’t faded into the background entirely. The massive screens displayed in electrical stores remain a standard part of a typical living room.

“The Thick of It[1]” ran for four series and captured the insanity of Government spin-doctoring and fanatical incompetence. Unapologetically self-indulgent Ministers and their aides scuttled around reacting to every small vibration coming from the media. This was masterful fiction but it’s closeness to reality is the story of 2022.

In 2012, the media political arena adopted “Omnishambles” as shorthand for chaotic behaviour on a large scale. Although it started life as a way of describing the Labour Party’s muddles and confusions before 2010, it has a universal applicability. Westminster can be a whirlpool of volte-faces, embarrassments and unfathomable twists and turns. 2022 ends with none of this diminished.

So, what have we to look forward to in 2023? This winter of discontent[2] is mostly likely to escalate. The impact of inflation and energy bills are like an erupting volcano. A few minor earthquakes, then an explosive plum and finally the top gets blown off the mountain.

Brexit and the pandemic have left people feeling exhausted. So, to see their standard of living diminish as this Conservative Government shamelessly wobbles on regardless, then this becomes the straw that breaks the camel’s back.

The Prime Minister may try to mine what popularity there is in the public mind, but this is not the time when a new Margaret Thatcher[3] will step forward. This is where simple analogies with the past quickly unravel. In this case the Conservatives own the problems. There’s no denying their responsibility for the last 12-years.

To restore the hope, that things can improve, a new formula is needed. People are not looking for perfection but a convincing vison, some basic honesty, and robust resolve. 


[1] https://en.wikipedia.org/wiki/List_of_The_Thick_of_It_episodes

[2] https://www.bbc.co.uk/programmes/p06yc8k4

[3] https://www.businessinsider.com/thatcher-and-the-winter-of-discontent-2013-4?r=US&IR=T

Voters

It’s one of those things I do, most years. For the greatest part, I can predict what I’ll be doing in March-and April. It started back in the 1980s. At the time we lived in Cheltenham[1] town. Putting leaflets through doors. Knocking on doors. “Hello, I’m calling on behalf of …….” was usually the introductory line. With prepared words not only did I remind the town’s residents that there was a local election in May but let them know the name of the best candidate.

I’m writing this as credentials. Yes, I know a thing or two about the nitty gritty of local elections in the UK. My experience has been accumulated over nearly 40-years. Lots of cold early spring evenings and weekend delivery rounds to get a message out in a short space of time.

One of the biggest changes, in terms of practical organisation, has been a change that has affected all parts of life. In 1985, everything was paper based. If I said: “Shuttleworths[2]” to a 21st century campaigner there’s a good chance they will not have a clue what I’m talking about. These were paper pads used to record names and addresses of supporters.

Local campaigning has undergone a digital transformation. However, in the British electoral system paper is still at the heart of everything that is done. The ballot paper is sacrosanct. Voters put a cross in a box set against a name and a logo. It remains inclusive in that there are few people who cannot manage that basic act.

In all my time campaigning, I can remember no voter fraud or corrupt activities. Yes, over enthusiastic, or idiotic behaviours pop-up now and then, as they do in all walks of life. It’s always an important function but also amusing to check spoilt ballot papers at an election count. A small number of voters can be creative in the insults and images they draw on ballot papers.

So, listening to last night’s Parliamentary debate on new Voter ID Regulations was distressing. The Conservative Government plan is to spend £180 million on solving a problem that doesn’t exist. This law is being pushed forward aggressively at a time when local Councils are cutting services due to lack of funding. The Local Government Association (LGA)[3] is saying that there’s not enough time to make the demanded changes before next May.

Ministers are ignoring such advice. Additionally, these regulations seem nonsensical. They impose new requirements on the operation of polling stations but do nothing in respect of postal voting. The natural suspicion for the forceful timescale is that this act is to suppress votes at a time when Conservative candidates are expected to loose in great numbers next May.

A further reason to be sceptical that Voter ID can prevent instances of electoral fraud is that convictions for voting offences have overwhelmingly related to postal votes, not personation at polling stations. Measure that create a barrier to voting in person will lower local election turnout. That’s a voter turnout that is as low as 29% of registered voters in my Borough.

This is a sad day for British democracy.


[1] https://www.visitcheltenham.com/

[2] https://www.libdemvoice.org/how-did-shuttleworths-get-their-name-40299.html

[3] https://www.local.gov.uk/about/news/lga-statement-parliamentary-vote-plans-introduce-voter-id

Cold Data

It’s cold. The numbers on the energy meter keep clocking up and getting to new highs. Compared with last year my energy bill is going to be horrendous. Add to that inflation on just about everything else and it’s hard work to make it a winter of good cheer. Smart energy meters are useful in that they give real time feedback on household energy use. I’m not sure they have an impact on behaviour, but meters do forewarn of astronomical bills to come. Comparing Christmas past, present and Christmas future gave author Charles Dickens an idea.

Looking at media reports this year’s Christmas looks more Dickensian than ever. That is without the transformation that Mr Scrooge[1] underwent. It’s certain the attitudes of Ministers resemble that of Mr Scrooge. Protect the moneymen in their obsession with money and penalise the ordinary working soul. This story is being played out up and down Britain.

The fact that it’s not seen as strange to be talking of freeing up the City of Lonon from regulation at the same time as restricting and controlling working men and women is a bad indication of these difficult times. The Prime Minister may look like a busy light-hearted mouse, but he has a heart as cold as the winter mists.

As the Government has said it wants to collect data from our smart meters, I wonder what can possibly flow from that intrusion into our privacy. In so far as it might guide national policy and reminds Ministers of the benefits of insulating homes, data collection could be helpful. However, there’s a dangerous precedent set when Governments collect every bit of data homes produce.

There’s a creeping tendance to always ask for more data. Mr Scrooge can then compile a leger on the comings and goings of every citizen. Don’t believe for one moment that GDPR will protect our data. Personal information such as names, addresses and bank details are not stored on a smart energy meter. However, computing capability being as powerful as it is, relating energy data to its point of collection and thus bill payer isn’t so difficult to do.

To me, this recalls the saying about knowing the cost of everything but the value of nothing[2].


[1] Ebenezer Scrooge, character in the story A Christmas Carol (1843) by Charles Dickens

[2] Oscar Wilde’s famous definition — someone who “knows the price of everything and the value of nothing”

Reform

The UK’s recent political calamities make it look like we have a long-run soap opera rather than an example of effective governance. There are examples of good governance. Look at the role played by select committees in holding decision makers to account. That’s a rare example. One reason for the last six years of turmoil is that stultifying lack of innovation and blockheaded belief in MPs superiority. Gradually, Parliament has become disconnected from everyday life. It mimics a theatre of the absurd in its form and manners. 

Parliament will be relevant to people if it’s seen to work for people. Today, any claim that it works raises laughter and sullen looks.

So, I welcome Labour’s former Prime Minister proposing a rewiring of the UK Parliament. The House of Lords (HoLs) in its current form is “indefensible”. Naturally, the tabloid media uses the word “abolish” for its dramatic impact. Better to say that there’s a transformation to be undertaken to bring our democracy into the 21st century.

This is not as new as detractors might suggest. Here I sit not far from a rotten Borough[1] that returned two Members of Parliament at a time when cities like Manchester returned none. Gatton’s disfranchisement was agreed on 20 Feb. 1832. Yes, that’s 192 years ago but in terms of the evolution of the British constitution that isn’t that long ago.

The arguments against the current HoL should not be based on an attack against all its members. There are many who take their role extremely seriously and perform the scrutiny of Government bills with care and diligence. However, out of the large number of members many do little.

It’s the legitimacy and structure of the institution that are highly questionable in the 2020s. The form of the HoLs does not represent the country. It’s manner of working is stuck in pre-history. It’s a sign of reward for a tiny minority.

Both Canada and Australia have a Parliamentary system. Their second chambers are based on a more rational, democratic and effective structure. They provide regional representation as well as scrutiny.  A Senate of the UK makes sense to me.

It’s well overdue that the “Mother of Parliaments” stepped into the world we all inhabit.


[1] https://historyofparliamentonline.org/volume/1820-1832/constituencies/gatton

Tramline

The time for change is now. It’s not much more than a year before a UK General Election. Sadly, we are seeing only reactive thinking from the two largest British political parties. Both bounce off each other like a game of ping pong. There’s a conversation going on across the country about the need for change, but the Conservatives and Labour Party are stuck on a tram line.

“It’s the economy, stupid.[1]” I remember reading James Carville’s book about Bill Clinton’s 1992 presidential campaign. It’s about the great political motivator of how people feel about the amount of money they have in their pockets. Probably shouldn’t put it like that anymore since we tap every purchase with a card and local bank branches are closing. Cash is no longer king.

As an example of the terrible economic damage that Brexit is doing, we need only look at trade figures between the UK and Germany[2]. There’s been a huge fall in trade between the UK and Germany during the first period of the post-Brexit trading relationship. So far, the impact of the EU-UK Trade and Cooperation Agreement (TCA) has been negative.

Knowing the facts, the Conservatives and Labour Party still parrot the nonsense that they know how to make Brexit work. It’s a peculiar dance around an economic corpse. Where both political parties point fingers at each other for ruining the dance.

Except for trade specialists, the British media are being inarticulate about the failings of Brexit. It’s as if there’s a distinct fear of being called out and ostracised. Many of those who should be speaking out are sitting on their hands. Maybe this is the dull precursor to change since we don’t know what the public mood will be in a year’s time.

Brexit does not negate the facts of geographic proximity, globalisation and decades of close economic partnership. Close European links will continue and need to be nurtured. Politicians who have wilfully attempted to destroy the bridges built between the UK and the EU belong to the past.

A Government that continues to endanger more than just back pockets and living standards shouldn’t win another term of office – should they? Will people vote for candidates who plan to improve our dismal economic outlook? Those who will tell the truth about Brexit. Today, neither the Conservatives nor Labour Party are telling the truth.

POST: What can we know about the cost of Brexit so far? | Centre for European Reform (cer.eu)


[1] https://en.wikipedia.org/wiki/It%27s_the_economy,_stupid

[2] https://www.bbc.co.uk/news/56347096

To see

It’s the most difficult of challenges. Trying to see things as they are rather than how you would wish them to be. I came to that conclusion much because of my work on aviation safety management. Collecting data, doing analysis, and trying to distil what’s important and what’s not.

Data speaks. It tells you things about what has happened in the past. That gives a clue to what might happen in the future. Although, estimates and forecasts are derided by some people they are essential in a technocratic society like ours. Results can be inconvenient and embarrassing. Not paying heed to them can compound any difficulties a thousand-fold.

It’s not sane to use complex technology without doing some projections into the future as to its possible implications. I know there’s a contradiction in that we have adopted digital interconnections without a great deal of thought as to what can happen. That proved to be a very bad move in at least one fictional depiction of the future[1]. The possibility that Artificial Intelligence (AI) could move against our general interests is real.

That aside, my general point was on the more unemotional and objective view that can be taken of evidence gathered for a purpose. Taking that and then imposing dogma and prejudice on what has been learnt can be down right dangerous.

I found a backup for this view coming from British philosopher Bertrand Russell. He provided advice when he was interviewed in 1959 by John Freeman for the BBC’s Face to Face programme[2]. The great man came up with this message to future generations a year before I was born. Russell having been born in 1872 had seen so much change in his life he was well placed to conclude as he did.

Good advice “ask yourself only what are the facts” and what they show. He’s not saying we must be automatons. Judgements must still be made in relation to the facts. There will always be an ethical dimension to those judgments. There are most often multiple choices.

Russell foresaw more societal interconnection and interdependency but left us before the world wide web took-off. In social media venues like Facebook and Twitter tolerance and care for the facts are often found to be lacking. This does have a profound impact on political thinking. It gives legitimacy to complete folly. Dare I bring up the subject of Brexit?

My advice – Try to see things as they are rather than how you would wish them to be.


[1] https://www.imdb.com/title/tt0407362/

[2] https://youtu.be/ihaB8AFOhZo

House of the past

Legacy. So, many of our problems are because we carry the millstone of the worst of the past. It would be nice if the best of the past guided us forward but that’s not the English way.

In 1990, we were treated to a television feast. A wonderful political thriller that echoes down the years. House of Cards[1] reflected and exaggerated the twists and turns of life in a fictional Westminster. It was the post Thatcher era. Surrounding succession, intrigue, and dastardly goings on filled the corridors of power and Parliament.

One of those sayings that keeps bouncing back in respect of politics is: “under a tall tree nothing grows” and variations on that theme. In essence it can mean that the aftereffects of having had a powerful leader, or a period of unchallenged power is inevitably a desert of ideas and imagination.

Ian Richardson’s portrayal of Francis Urquhart is masterful. House of Cards depicts the scrabbling for power, for the sake of power that consumes British politics from time to time. It shows how the greedy, incompetent, and foolish can be manipulated by a clever person with devilish intent.

32 years on it is surprising, although it shouldn’t be, how much of the series resonates with the political turbulence of 2022. The 1990s were different times. No social media. An infant digital world as mobile phones were just starting to impact daily life. That said, untrammelled ambition adapts to whatever technology is available.

What’s missing this year is any British politician that can be said to be charismatic. We are blighted by a cohort of dreary managers, automatons, and greasy pole climbing jobs worths. This adds to the reason that we need a General Election. Not for more turbulence and squabbling but for a clear out and to bring in new thinking.

What might happen on the other hand is that those who still have the potential to thrive outside Westminster will jump ship rather than suffer defeat. That means the good and the bad. Case in point being the former pensions secretary Chloe Smith Conservative MP for Norwich North, who will be standing down.

The shadow of the Thatcher era haunts the Parliament. It’s about time to open the curtains and let in the light in. There’s a stale mist hanging over the House of Commons. The remaining Eurosceptic vampires need to be consigned to the vaults.


[1] https://www.bbc.co.uk/programmes/b0082dzs