Thursday, 30 September 2010

Elections, quitting and crazy headlines.

I tried to keep the political stuff away for a while because it was overpowering everything else, but allow me this small indulgence at the end of the conference just to get me through the cold, hard winter.

There's been two major things happen at the conference which people outside Labour might actually care about. Obviously, the first is that Ed Miliband is the new leader, as I've already talked about. Second, is that a few days later David decided the best thing for him and the party would be to leave front line politics.

For all you Daily Mail readers (not that I think anyone who reads it is capable of logging onto a computer and pressing the right keys to get here) the scandal of the week is that Ed Miliband is living with his partner and their child... out of wedlock! Shock and horror should follow this startling revelation, if you live in the 1800's that is. If that's the best they've got (other than the fact he's not signed the birth certificate yet.. again, shock and horror) then I'd say he's done a decent job so far.

On the whole David issue, clearly I'm disappointed he's leaving seeing as I voted for him as leader, but I think he probably made the right decision out of two bad options. If he'd of stayed we'd have spent the entirety of Ed's leadership with the media scanning every word he and David muttered looking for any sign of a none existent split and it would have become Brown and Blair Mark II. This way he can give his brother the room he needs to take on the government and become the next Prime Minister.

As for Ed himself, whilst my view on who would be the best leader hasn't changed in the last two days, I think he will be more than competent to lead Labour back into power. He's closer to me on policy than David, so if he can get his presentation skills up to the mark then he could be very good indeed. For those who don't think he'll be able to cut it in an election with the others, look at how he overturned the massive gap between him and his brother who was the  clear favourite at the start. He knows how to win people over, and that will come in handy.

I thought I'd take a look at some of the ways the right wing press have tried to define him over the last few days:

  • The Sun decided that whilst it couldn't criticise the contents of his speech, they disliked the order. “But how will putting gender equality before thanking Our Heroes bring him closer to voters?” Its the first time I've ever seen anyone claim the order of a speech shows your true feelings, I'll bear that one in mind.
  • The Telegraph decided they'd completely ignore the results and imagine what they want. “Miliband E and his supporters in the parliamentary party are aware of how exposed he is because of the mark of the unions upon him, and his lack of support in the old shadow cabinet and scarcity of support in the Commons.” I wouldn't say 47% showed a lack of support, especially considering he got most of his brothers second preferences. Would they claim David had a lack of support because he only got 53% of MP's?
  • Again at the Telegraph they decided to stoop to lying in order to make their point more valid. “It’s hard to occupy the moral high ground when you’ve been pushed across the finishing line by trade union bosses.” Of course, anyone with any nous will have checked and realised that the union bosses got one vote each, hardly enough to push him over the line. Seeing as block voting was abolished, the union leaders can't decide who their members voted for, meaning those who voted for Ed were mostly those most communist, left wing of beasts, ordinary working people.
The 'Red Ed' tag is so hilariously wide of the mark it's not even worth going over again. The idea that Ed is much more left wing than any of the other candidates is just plain wrong.

Tuesday, 28 September 2010

Back from the Dead

This is about Horizon from last night, it had some incredible stuff, definitely worth an iPlayer visit if you like what you read.

Humans are very intricate machines, but that means we're also very sensitive to change. In terms of temperature, we vary very little from our standard 37 degrees celsius. If we dropped 1 degree it would be painful, about four or five and you'd feel pretty woozy before passing out. Stay there, and you'd die. Which makes it all the more strange that a woman whose core temperature fell to 14 degrees, a drop of 23, managed to survive for around 2 hours with no heart beat. She had no pumping blood, no breathing, not even any signs of brain activity. By any conventional measure she was dead. But a few months later she was alive, exactly as healthy as she was before.

Now is it just me in my little nerdy medical school bubble that thinks that's pretty cool?

It was precisely because she was so much colder than she should have been that she survived. Without blood the brain would usually starve and die irreversibly, but she was so cold that the brain stopped functioning before it had a chance to starve. It essentially went into hibernation, ready to be warmed back up again. As soon as she started getting heat back, her heart started beating and her brain started again. She wasn't back to normal in a day, or even a week, but the fact she recovered at all is incredible enough.

That might have just been sheer luck, but now hospitals can use the same principle to operate on people who would otherwise have been consigned to death. They can stop the blood flow without starving the organs, something you can't do any other way.

With the patient on the operating table they cool them down to around 18 degrees by taking out the warm blood, passing it through a freezing heart lung machine, and putting it back in. Then, slightly less high tech, they surround them with ice packs. They can then shut down the heart lung machine, have no pumping blood getting in the way, but rather than the patient dying in a matter of seconds, they have about an hour in which to work. Obviously, they can't push the window much further because no-one is going to risk a patient just to prove a point.

Then there's the even more exciting use for the idea. Most young deaths are caused by trauma, and in trauma cases (hit by a car, stabbings etc.) there's a very short amount of time to help someone before its too late. But what if you could give someone an extra hour, how much more help could you get then?

When you get to A&E for a very serious case and you're heart isn't beating, one of the things they may well do is open up your chest to massage your heart. Some doctors figured, whilst we're in there, why not infuse the blood with freezing cold saline to drop their body temperature rapidly. If they could preserve the brain for long enough, they'd have more chance to repair the damage. In an environment where every second counts, having an extra hour would be worth more than words could say. Millions of people could be saved.

Then just as if we hadn't had enough, there was what for me showed the future of medicine. People always say its genetics and I'm sure that will transform it, but this could be huge. Its just an idea at the moment, but when its fleshed out it could be incredible.

A researcher showed that cells don't automatically die when starved, they die once they start getting oxygen again because they can no longer perform their old job. Once a cell becomes useless it essentially commits suicide. Now this works well in the human body, keeping us refreshed, but obviously if too many cells decide enough's enough at the same time then you're in trouble.

What this guy found is that a certain part of the cell, the mitochondria, controls the cell death, and it might be able to be interfered with. If you could stop the cell committing suicide, you could essentially put someone into limbo, giving you enough time to repair them. The exciting thing would be, if this could be given as some form of injection or infusion, you'd have no need to be in an operating room to be frozen. You could get to a stage where paramedics in the field could hit the pause button on you and whizz you back to the hospital without you dying a little more every second.

If you can stop cells dying, the possibilities for how you could use it in medicine are truly endless. Survival rates for all sorts of things would rocket immediately. Death wouldn't be inevitable in any situation. We're not even close to having it ready right now. But at least we know its a possibility, and one day we might make it.

Sunday, 26 September 2010

Saviour Siblings

I've had far too many political posts recently for a blog that was originally meant to have a lot of health care related posts, so I thought I'd redress the balance.

I saw a piece on the BBC about whether people should be able to use IVF to have children who could then be a bone marrow (or blood stem cell) donor for a sick brother or sister. As you might imagine, the idea of having another child, and 'designing' them to ensure they could save a sibling is pretty controversial.

At first, the idea of having a child to use them for their marrow seems very questionable indeed and possibly the start of a slippery slope towards a society where parents see one child simply as an organ donor for others. Similar to the premise behind the film 'The Island', but maybe without the Hollywood drama of it all. I thought it was a dangerous idea when I first looked at it, but I've come around to it.

To understand, it's probably easier to go through how it might work in an example. Many young children are born with life-threatening and degenerative conditions, where the only hope of cure is a tissue matched donor. The best hope of a match is a close blood relative, so brothers, sisters and parents are your best bets. But what to do if the parents and any older siblings aren't matches?

At the moment doctors can advise that if the parents had another child, there is a chance that they could be a match. There's nothing controversial about just having another child, it may well have been in the couple's plans already. But with many of these blood disorders the chances of any sibling being a close enough match are only 25%. Couple that with the fact there's a 25% chance they will have the same disease as the already ill child and it means that having another child will only solve the problem 19% of the time. Quite a low chance for such a big decision.

Depending on whether the family think they could cope with another child with this illness there are either going to be several pregnancies or several terminations before any hope of saving the elder child is borne out. Either way, it's a horrific mental strain on the mother.

There is another option.

Modern IVF allows for the option of pre-selecting embryos which will be tissue matched for a sibling. You can guarantee that pregnancy will mean both a healthy child, and a child that is able to do something to save the life of their sibling. No-one is talking about producing a 'perfect child', simply one which is going to be able to live a full life.

It makes both moral sense, and economic sense for the NHS to fund it. It may seem insensitive to talk about money when looking at life and death, but like it or not you need to have money to save lives, and the more cost effective the NHS can be, the more lives can ultimately be saved.

The total cost of one cycle of IVF, plus all the other tests and tissue matching etc. costs less than £10,000. Compare that to the cost of refusing to fund this IVF and caring for a child with an incurable illness for the rest of their lives, paying for drugs and constant care and support. It could easily run into the millions.

We should be careful about taking blind leaps into wherever science opens up opportunities. But we shouldn't let that fear stop us saving the lives of people for whom the only hope is the cutting edge. There is no reason why the NHS shouldn't be funding these 'saviour siblings', especially in a country where genetics is so highly regulated.

Creating a 'perfect child' is morally questionable. Creating one free of deadly illness with the ability to save a sibling isn't.

Saturday, 25 September 2010

Tah-dah, here's our new leader.

So, yeah, Labour has Ed Miliband as its brand new leader, in an insanely close election.

It's been a very long campaign, and it's kind of nice for it all to be over. I didn't get who I voted for, as some might have noticed, but I'm more than happy for Ed to be leader. I had David as first choice, and as he walked out with a beaming smile I was sure he'd won it. Never play poker against a Miliband is the lesson for everyone.

Already I hear the cries of 'Red Ed' from ConservativeHome which is frankly hilarious. The fact that he overwhelmingly won the union vote is completely inconsequential. First, the party was founded by unions and exists to support the working man so it's only right they have a third of the vote, are people suggesting union members are all communist monsters?

Second, there is no block voting, which means the unions that voted for Ed are individual members. Teachers, nurses, police, shop workers.. normal people. And let's remember, Tony Blair won a massive union majority in his election, and I don't think there'd be many calling him 'Red Tony'. The idea that Conservative's are happy and we've shot ourselves in the foot by not electing the one they thought was better would be laughable if it wasn't meant to be a serious argument. They were hardly likely to come out and say 'Oh shit, the good one won, now we're screwed!' were they!

The idea that Ed is a far left leader is plain wrong. His ideas are progressive, they are centre-left, but a 'lurch to the left' this is not.

The highest form of flattery - When your opponents feel the need to attack you with nothing but ideological names.
The great thing about this contest is that we haven't completely destroyed ourselves, which was a real possibility if people had resorted to back stabbing and massive ideological arguments which tore the party in two. And the fact that any of the four losers could easily work in the shadow cabinet without any trouble is a testament to how Labour has stopped the back-biting of the past.

Now we have to wait to see who's going to be in the shadow cabinet. I think the key ones to watch will be whether Ed Balls gets his Shadow Chancellor spot and where David slots in. I used to think it was probably wiser to keep Balls away from the chancellorship but have completely changed my mind after the last few weeks where he's impressed so many people with his economic intelligence and different vision for the future. Ed was right in his victory speech, Ed Balls has ripped Michael Gove to shreds in the past months, and will beat Osborne to a bloody pulp.

As for David, he's clearly more than qualified for any of the top jobs. He might want to keep his foreign office mandate, or he may want to go for another top job, maybe Home Secretary?

It's the end of one contest, and the beginning of trying to win an election.

Friday, 17 September 2010

Pipe down Lansley, you're a nuisance.

You'll be glad to know I'm not a raving nutbag. I thought maybe my fears about the privatisation of the NHS by Lansley's reorganisation might just be paranoia, but it looks like the very people he's trying to snuggle up to agree with me on this one.

This is about his plans to put the job of arranging budgets into the hands of GPs (I wrote about why it could mean the privatisation of the NHS here). Now, the Royal College of GPs have released the findings from their consultation with members, and they aren't too promising for Lansley.

Here's a few of their concerns, I'll simplify them to save space, but I'm not twisting anything they said, it's here for all to see if you fancy checking up on me:

- Rather than being efficiency savings, money and manpower will move away from clinical care and be wasted in resource management.

- Health inequality will increase as different areas have different services.

- GPs will be blamed for cuts in services as they're seen as the ones in charge of the purse-strings, which will damage the crucial doctor-patient bond.

- GPs don't have enough time to take on this additional role.

And most importantly of all so I'll quote it word for word -

"The reforms open a door to increased involvement of the for-profit private sector in the NHS, and tax-payer's money will be diverted into private companies and their shareholders. This could be seen as the break up of the NHS with some private companies ready to take over the provision of services."

Yeah, like I said, not just me.

So after his reforms have been met by a less than rapturous welcome and been seen as privatising the NHS,  he's been completely shot down over his plans to shut down NHS Direct, and insulted Jamie Oliver's healthy eating campaign based on completely inaccurate data, I'm forced to ask, what the hell can this man actually do right?

I'll say it once more. We like our NHS being public. We like the fact that everyone is treated equal based on need rather than wealth. We like the fact that we have one of the best healthcare systems in the world. Leave it alone you joke of a government!

Big, bad trade unions.

This is one of those opinions of mine that has shifted, quite a fair distance, over a few years. Despite being a lefty I used to think of trade unions as something of a liability at times, and got rather annoyed when they started striking. Now, I've shifted, and I'm much more sympathetic towards them, but I do have some suggestions for them. Here's why and what.

People will often do something similar to trade unions that they do with the 'state', in that they make it out to be a separate entity. When people say 'the state does this' it's often insinuated that the 'state' is some kind of horrible organisation which will eat up aspiration and churn out bureaucracy. The reality is that the state, as are the trade unions, is simply the sum of its parts. The state and the trade unions (when done properly) are both the machines of their ordinary voting members, not some top-down driven corporate machine. Because of that, they can change as quickly as their members attitudes do and its wrong to suggest that they are inherently anything, whether that be inefficient or self-serving. Sometimes they need tweaking, but they are fundamentally good things at their core.

In the '80's the trade union movement suffered a double whammy. Not only did it get beaten to a bloody pulp by Thatcher, but more crucially, it lost the support of the public. People no longer saw them as champions of rights, but as self-serving nuisance makers, particularly after the miners strikes. Union action is far more powerful if the general public are on side, it puts far more pressure on government, and take piles of pressure away from the strikers.

There is a way to make your point, and keep the public on side.

First of all, unions need to make sure they talk to the public as much as they talk to their members. They represent their members interests, but those interests are far better served if the union leaders are out in the media winning the arguments on why rights must be protected. Win the argument, and you'll win the public.

Second, do everything you can to negotiate, to the very bitter end. If the other side is being antagonistic, negotiate anyway, be the bigger man so to speak. It may come to a stage where negotiations fail, but that should be a last resort, not a handy threat to bandy about without thought of consequence.

Finally, be inventive. Don't get sucked into thinking that when workers are threatened the progression is always negotiate, then strike. One of the most successful and inspiring trade unionists was so well respected because he was inventive, thoughtful, and respectful to the public. Jimmy Reid, who recently sadly died, didn't decide to strike when the government threatened to close the ship yard he worked at, but decided to make a much more impressive point by instead carrying on working. It was essentially a sit-in, but they carried on working because there were still contracts to be completed.

This is from a speech he made at the time:

"We are not going to strike. We are not even having a sit-in strike. Nobody and nothing will come in and nothing will go out without our permission. And there will be no hooliganism, there will be no vandalism, there will be no bevvying, because the world is watching us, and it is our responsibility to conduct ourselves with responsibility, and with dignity, and with maturity."

That's the kind of leader trade unions need and deserve. Someone who understands that the best way to help its members is to show them for what they are, decent hard-working folk who are fearful for their livelihoods. No-one could attack the work-in as people wanting to skive, they couldn't say they were making mischief and they couldn't say the shipyard wasn't profitable because clearly there was still work to be done.

He won the argument, he won the public support and because of that, the government backed down. We should learn the lessons. Its going to be a tough time for unions in the near future, as they rightly need to oppose the horrendous and damaging cuts coming down the line from the demolition government. We can only hope that in their number are a few Jimmy Reid's, who realise that losing the respect of the average man means you're losing the argument.

Thursday, 16 September 2010

The Daily Mail: A weekly edition of Mein Kampf.

I'm not sure who it was that gave me the title for this post, but it made me smile so I thought I'd use it. Maybe it's a small exaggeration, but the Mail is certainly no use for anything more than mopping up sick, and even then the sick would be disappointed to be associated with such a rag. In fact, I hate it so much that I'm even going to defend the Pope against what they've written (looking through some previous posts will tell you this definitely is not the norm for me).

So, what can a tabloid newspaper possibly have done to make me despise it so intently?

It's the intentional manipulation of facts they use to back up their views which are often racist, homophobic or just plain evil. No respectable journalist could work there without severely marring their reputation.

Here's a few examples. I'll start with there main headline from today's website:

'Pope likens the rise of atheism in Britain to the Nazis as he admits his 'shock and sadness' over abuse scandal' and the first line which says 'Benedict XVI, a former member of the Hitler Youth, warned Britain it must retain its respect for traditional values as he attacked the 'atheist extremism' seen in Nazi Germany.'

Now, two posts again I argued the Pope should be arrested and tried for his pivotal role in years of sex abuse, so evidently I'm no fan of Benedict XVI. But when there are so many good reasons to attack him, why would they choose to take his remarks completely out of context and smear him?

He did not liken Britain to Nazi Germany, or atheists for that matter, although he did attack 'militant atheists', a group I'd imagine I'd be included in despite having no militant tendencies whatsoever. The Mail seems to enjoy wheeling out the word Nazi whenever it wants to plump up a story. But then even worse is the mention of him being a member of the Hitler Youth, they don't say it directly, but I can only imagine it was intended as a smear. Yes, he was in the Hitler Youth, but like so many children of his generation it was not out of choice, he was forced into joining. For all his sins, being in the Hitler Youth was not one of his immoral actions.

So let's look at the front page, and the Mail seems to want it both ways as it says there is an 'athiest hate campaign led by Stephen Fry' and names the 'Left-wing chorus' who are 'spitting venom'. So in one breath it essentially labels the Pope a nazi, and then swiftly attacks those who were simply questioning whether we should be paying the bills for the visit of a man who in any real sense is not the head of any real state and is at the centre of a massive controversy? They had no problem with him coming to visit, just the fact that we were paying for his nice holiday.

Anyone who can attack Stephen Fry and label him a self-involved quiz master is clearly an idiot.

Now let's rifle through some other disgusting Mail examples (links are to the brilliant Left Foot Forward site which has kindly shown where and why the Mail is wrong):

In the words of Stephen Fry:

'It is the final proof, if proof were needed, that the Daily Mail is not just actually wicked (intentionally, knowingly lying) but actually now quite, quite mad. In the name (it must suppose) of morality, spirituality, goodness, kindness, sweetness and honesty, it intentionally, knowingly twists, distorts, misrepresents, smears and calumniates.'

It's very sad that so many people choose to read a paper that will eventually poison there mind with lies and smears.

We'll know we live in a better society when papers like the Daily Mail disappear because no-one is longer willing to read their drivel.

An Impromptu Break

I'd hope that at least someone out there has noticed my break from writing recently. It was because I've now moved into my house in Manchester and have only just now got internet.

I don't have the energy to write a full-blooded post today, not even about the Popey visit, after the first night out since my return with all the other mentor medics last night. I really can't wait now for fresher's week take tso and meeting all my new kiddies (some of whom are likely to be older than me, but never mind).

We've got curry night first up on the Tuesday, which is likely to be even messier than last nights, and then pyjama pub crawl on the Thursday. We're gonna need to find the most horrendous pyjamas ever made to break them into the fancy dress spirit of things.

Anyway, this is just to announce my rearrival, I'm sure I'll find some inspiration for a post soon.

Friday, 3 September 2010

Do the right thing, arrest the Pope.

I was going to save this up for his visit, but now that this major player in the church has called the UK a 'moral wasteland' because we dare to have equal rights for women and gays, I couldn't contain it any longer.

The only good thing that could come of the Pope's visit to Britain is if we overturned his immunity and arrested him as he arrived at Edinburgh.

Only religion would be able to shield its leader to the point that we give a state visit to a man complicit in 20 years of paedophilia, who did nothing to stop it and actively hushed it up from the authorities. This is from a letter he sent out to the world's bishop's, talking about the issue of child molestation:

He told bishop's they should investigate within the church, not involving the police, "in the most secretive way... restrained by a perpetual silence... and everyone... is to observe the strictest secret which is commonly regarded as a secret of the Holy Office... under the penalty of excommunication"

The only reason we've seen the document is because of a leak from a decent bishop, the letter actually came with instructions to 'keep it locked in a safe at all times'.

Even Father Doyle, a Vatican lawyer at the time, said that there "is an explicit written policy to cover up cases of child sexual abuse and to punish those who would call attention to these crimes... Nowhere in any of these documents does it say anything about helping the victims. The only thing it does say is they can impose fear on the victims, and punish [them], for disclosing what happened."

Joseph Ratzinger (The pope's name for those unaware) was head of the Congregation of the Doctrine of the Faith. All issues of the type involving accusations of child molestation went through his desk, at his explicit demand. He was made aware of cases where priests had abused young children, and rather than hand them to the police or even excommunicate them, he simply shuffled them around to different parishes, free to abuse once more.

Not only did he know about this abuse, he covered it up, ordered that the victims be frightened into silence, moved the priest to another parish and repeated the whole thing over when that priest inevitably abused more children.

Again, a Vatican lawyer tells us, "When abusive priests are discovered, the response has been not to investigate and prosecute but to move them from one place to another." Backed up by the finding of memo's and testimonies of other priests which shows that the now Pope was aware, and did nothing, about the return to duty of a priest convicted of molestation, without even having received any form of treatment.

Now, in any other sphere of life, these accusations would at least warrant debate and a trial to determine whether the Pope was complicit in this abuse. Innocent until proven guilty stands, but his innocence or guilt should be proved by a jury, not the word of God.

The most the Vatican has had to say on the matter is that the accusations coming to the Pope are like the 'collective violence suffered by the Jews.' Yeah, sure, let's forget the fact you were complicit in paedophilia. You're just a poor victim, this is much tougher than the holocaust for you.

I suggest that before the Church labels us a 'moral waste ground', it gets its own affairs in order. Never has an organisation which preaches that we should do good been responsible for such evil.

And before we start fawning over this religious leader, let's remember what kind of horrors he allowed to happen under, and aided by, his watch.

Thursday, 2 September 2010

Defending the NHS

A while ago, I talked about the government's new reshuffle of the NHS, and that whilst I had some small fears at the time I'd see how things went. You'll be glad to know, I've now made up my mind and am 100% against this 'white paper' because for me, it signals the start of a stealth privatisation of the NHS, and that can't be allowed to happen.

That's not just my view, but the view of the biggest health care union, UNISON, and the independent NHS Support Federation. Not to mention the private sector itself who described it as the 'start of the privatisation of the NHS'.

I'll forget for the moment that this signals the latest of David Cameron's broken promises, back in 2006 he categorically promised "no more pointless and disruptive reorganisations." It seems what you say in opposition means nothing once you get to the hallowed ground of power. I'll even ignore the fact that at a time when the poor are being hit hardest by Osborne's regressive budget and they have a belt-tightening mantra they are still able to squander away up to £3bn on this needless reshuffle. What I find worse than both of these is the fact that they're putting us onto a path where the NHS will be nothing more than a brand name, stripped of all that was once good.

They plan to hand over £80bn to GP consortia to use as they will within their area. Now, I have nothing against GP's, but I'd suggest they have better things to be getting on with than being accountants. Many already argue that the amount they do now in ordering services for patients through PBC is too much. You will immediately have a postcode lottery of health care. On top of that, you will have GP's, unable to be accountant's whilst caring for their patients, who have to buy in help from the likes of United Health. Then you have a case where private commissioners will be able to send patients to their privately run hospitals. That conflict of interest is the start of a very slippery slope indeed.

Then you have the quiet scandal that they are also pushing through competition laws into the NHS which will allow private providers a massive foothold. No longer will GPs and hospital doctors be allowed to discuss patient care without letting a private provider put in their twopence worth lest they be judged to be 'monopolising'. Care will stop being about the patient and start being about profits. You want to see where this road leads, look across the pond to America.

I'm not sure what it is about the Conservatives and the NHS. It's the jewel in the crown of British society, perhaps that's what they find so disconcerting. Whilst they have this belief that the private sector will turn everything to gold, the thing we love most isn't the CEO of Barclay's or the Taxpayers' Alliance, but a publicly funded, universal health care system. That's far too close to socialism for their liking, so they attack, and try to sneak in privatisation by the back door.

It started, unfortunately, under New Labour with it's PFI's, but this is a far more drastic step towards giving private providers control of public money. The Tory's conveniently forget that the NHS is rated as the most efficient health care system in the commonwealth, and forget the drastic cuts to waiting times. Instead, they focus on introducing market forces where they aren't wanted.

Market force's have their place. They are good at their job, namely making money. They are successful because above all else they place profit, all other outcomes are secondary to that main objective. In some place's, that lack of heart for anything other than money just isn't appropriate. In our schools, in our police, and most definitely, in our health care.

It may sound like I'm being a little dramatic, but I've been looking forward to qualifying and being a doctor in one of the best health care systems in the world. One that I can be proud to work in because I know it treats all patients as equal, no matter who they are or what they can afford.

I don't want that future ruined by the lunacy of Andrew Lansley and David Cameron.

Wednesday, 1 September 2010

Tough on crime, or just plain stupid?

There are some things in the world which you challenge at your peril, for doing so makes you a 'soft lefty liberal' who will bring the country to destruction. Two spring to mind, drugs and prisons. The policies in both those areas can only be described as stupid, yet they're immune to attack because anyone who would dare suggest an alternative would automatically be seen as somewhere beneath rapists in the eyes of Daily Mail readers.

With drugs the problem is that prohibition doesn't work, with prison's the problem is that they often harden offenders rather than rehabilitate them.

Behind bars means out of trouble, but what about when released?

If someone was creating a health service from scratch based on our current prison set-up it would look a little like this.

+ve - Takes people off the streets in order to protect the public.

-ve - Huddles all the sick together in one place to catch each other's disease. Based on the fact that at the moment we are sending offenders with minor offences into the prison system where they quickly learn the tricks of the trade from 'harder' inmates and often end up in prison gangs.

-ve - Rather than treating the illness they are instead left to fester, whilst their frustration at being locked up makes their illness far worse than it was. Rehabilitation in the prison system is shoddy at best, despite the fact that 82% of prisoners can't read and write to the standard of an 11-year old. Many of our prisoners are illiterate, addicted or insane, yet they receive a pitiful amount of support. This isn't about their 'human rights', its about the fact that you can't expect these people to stop committing crime when they're released if they can't read and write, how would they fit back into society?

-ve - After an arbitrary period of time, throw the patients back onto the streets, free to spread their infection around the community once again as they haven't been cured from the previous illness. A year after release 47% of prisoners re-offended, rising to 73% in young men. We aren't helping solve crime, we're just hardening criminals who might have been able to change their ways previously. In Denmark, the figure is 27%, we'll get round to how later.

So, clearly, prison doesn't work. We're pumping money into a system which is fundamentally broken. Labour may have lowered crime rates, but to hark back to what Tony Blair said in 1997, we tackled crime, but we completely forgot to solve the causes of crime.

So what's the alternative?

Simply put, tackle the problems that make the offenders turn to crime, rather than mindlessly locking them up for it. Now I can hear the cries of outrage already, 'Why should we help these criminals, these rapists and drug dealers, why should they be helped at all?'. Because, if you don't want them reverting to old tricks when they get out, you have to. About 70% of prisoners have 2 or more diagnosable mental illnesses, and 10% are severely mentally ill. Locking them up will do nothing to help them, and will do far more damage to people who really need help.

Of course there is still a place in society for jail for violent offenders and people who pose a serious risk to the public, but they don't make up the bulk of our prison population. For the vast majority the alternative is far cheaper and far more effective. Give them a long community service sentence at the same time as attending education classes or drug/mental health treatment as necessary. Fight the real causes of their criminality, rather than just hiding it behind bars.

There will be those yelling at the computer that I'm just a namby pamby liberal who would let paedophile's (they're always the criminal chosen for shock and awe tactics) roam the streets. I'm too soft you may say. Call it soft, call it liberal, whatever you call it, there's no denying it works better than what we do at the moment.

You might get some kind of pleasure from knowing that a criminal is behind bars, but I bet that sense of pleasure soon disappears when you're the one who is attacked by a reoffender.

I'd rather have a prison system that works, not one that just makes people think its working. Given community service and treatment people are 50% less likely to re-offend than those who go to prison, that's a system that works.

Who was the last person to halve prison numbers? A young, namby-pamby, soft liberal type no doubt? Actually, his name was Winston Churchill, and crime fell as a result.