London's Burning

I've been just as appalled as anyone by what has happened in London, and now seems to be spreading across the UK. What may have started up after the flaring of a peaceful protest against the police has now turned into something in no way related to the initial spark.

People are having their homes burnt to the ground, the shops which are their livelihood ripped apart, and their communities destroyed. It's sickening.

It withstood two World Wars, but House of Reeve's was reduced to a smoldering wreck within minutes.

I'm not from the areas affected so really can't comment on what has caused these outbreaks of violence and criminality, but there are a few things to add to the current debate.

First of all, seeking answers as to why these riots took place is not the same as condoning the violence. If we're to stop riots happening in the future we need to understand why and how they happen, not just put our fingers in our ears and blame the 'bad people'. There has to be some reason why people have come out and destroyed their own communities. If your answer is that they're all thugs, then you have to ask why we have so many thugs in our country?

I was impressed by Dr. Clifford Stott earlier on BBC, an expert in crowd psychology, and one of the most qualified to speak about these riots. He also echoed the frustration in that when trying to analytically look at these riots he was accused of being an apologist. He is no such thing, he simply wants to understand rioting so that we can be better prepared to prevent future outbreaks.

It may seem an easy answer but you cannot attribute these kind of widespread riots simply to 'copycat' attacks, or to an outbreak of mob irrationality, or even as simply criminally predisposed individuals seizing the opportunity to break the law. As Stott says, no research into riots over the last 30 years has supported these views, they are far too simplistic.

People's lives were put in danger last night, people's livelihood's up in flames. Many were left without a home. The kind of damage people do everything in their power to stop outsiders doing to their cities was inflicted upon London by it's own residents. But to simply dehumanise the rioters as is the natural reaction is to miss the point, this will simply happen again if we don't learn lessons.

There are a whole multitude of theories as to what acted as the tinder which was caught by the spark of Mark Duggan's peaceful protest. I think trying to outline them now would be premature. But one of the lessons which does seem to be evident is that police need much closer integration with the communities they serve.

The violence was not a legitimate expression of anger against the police, but it remains high on the list of grievances of many in the communities that have been part of the rioting. If respect for the police breaks down, then the dangers are all too evident. No matter what powers or numbers the police are given, without the respect of the communities they serve they will be powerless to stop this kind of activity.

But before this looks like a criticism of the police, I should say that under great strain last night there were a lot of brave policemen and women on the ground who did everything they could to stem the violence, and they deserve credit for that. Hopefully, with nearly three times as many on the ground tonight, they should be able to regain control of the streets.

One final thing. There have been calls last night and today for either an increase in police powers (perhaps bringing in watercannons) or for the involvement of the army. Whilst I can understand why some people might call for this, I don't think either is a solution to the troubles.

Soldiers are not trained in police tactics, they are trained as soldiers. The best trained people to deal with a situation like this are the police, and their failure last night was not down to them being the police but down to the low numbers they had to deal with such widespread rioting. Bringing in the army against your own citizens should only ever be an absolute last resort, and I don't believe we are there yet. The army is no silver bullet, as Operation Demetrius proved in the 1970's.

The only situations I would like to see the army being used in would be as support for the police operation, such as in assisting fire engines to reach blazes or to provide communications support. Those are legitimate roles for which the army would be well prepared.

As for increasing police powers, I believe they already have the necessary powers to control this violence, providing they have the manpower to implement them. Clearly, an increase by 10,000 in police numbers on the ground is hugely significant and should hopefully be enough to quell the violence without any new emergency powers.

To end on a positive note, whilst last night may have seen the worst of London, today has surely seen the best. Thousands of people have turned out on the streets to clean up the area, and have cheered on the police as they've done so.

And if you're going to listen to only one person from last night's riots, listen to this brave woman, imploring people to stop destroying their own communities. We need more people like her.

Death Penalty Debate

Some people seem to think that even engaging in the debate around the death penalty restarted by the frankly reprehensible Paul Staines is playing into his hands, but I think it's worth reopening from time to time to remind ourselves just why it is so wrong and why its reintroduction has so consistently been voted down.

I'm going to argue this from a slightly different point of view to a lot of others. A lot of people have argued that the death penalty should not be reinstated for practical reasons, because it doesn't reduce crime and because the danger of a wrongful conviction is made to have so much more dire consequences.These are all valid points, and reason enough to not have the death penalty, but I think there's a much more fundamental reason why we shouldn't have capital punishment in our country, it is morally reprehensible.

The traditional argument goes that for some of the most serious crimes, usually including pre-meditated murder, the criminal has taken away the human rights of another and so does not deserve to keep their own right to life. It seems to me that much of the argument in favour of the death penalty is about exacting revenge, rather than justice, and so to me has no place in a civilised society.

The simplest argument against the death penalty for me is that the arguments in its favour make no logical sense. They start with the premise that killing is morally wrong, that it should be punished, and that it should be punished by killing the criminal. The flaw in that argument should be glaringly obvious. Victor Hugo put it well when he said, "What says the law? You will not kill. How does it say it? By killing!"

If you start with the premise that murder can never be justified, then you cannot end with the idea that murder is a suitable punishment.

As for the argument that murderers have forgone their human rights, I disagree entirely. Either human rights are non-negotiable or they mean nothing at all. I might despise what a particular criminal has done, it might make me sick to the pit of my stomach, but I would like to believe that I can be the better person by not stooping to the level of taking another human life.

I'm not religious, and so don't think life is a gift from some higher power, but I do believe it's pretty incredible. The very fact you or I are alive right now and able to do all the things human beings do is spectacular. I don't think the taking of life can ever be seen as a good thing, regardless of my feelings towards another person.

Surely, we are better as a nation than a primitive tit for tat style of justice, than succumbing to the temptation of 'an eye for an eye'. How are we to claim we value life when we so willingly take it from others. And who amongst us would willingly do the job of the executioner?

Who is more humane, the man who demands the death of another, or this man, who is campaigning for the life of Mark Stroman, who shot him in the face.

As he said, "these crimes were hate crimes, and hate crimes come from ignorance. His execution will not eliminate hate crimes from this world, but we'll simply lose a human life."

That's the kind of society I want to live in, one which tries to better itself, rather than equaling the actions of its lowest members. One which sees the right to life as inalienable, not something to be disposed of when convenient. One which sees the taking of a life as reprehensible, not something to be carried out at the will of the state.

"Many that live deserve death. And some that die deserve life. Can you give it to them? Then do not be too eager to deal out death in judgement." - JRR Tolkien

Shoddy Mail Journalism

I have used the title of 'shoddy' journalism for the Mail, as I struggled to think of a more apt word, but I hope you agree that their front page today goes beyond shoddy, and in my eyes should be illegal.

The Mail appears not to have heard of the presumption of 'Innocent until proven guilty'

It may or may not turn out to be the case that this nurse was in fact responsible for the deaths of patients at Stepping Hill hospital. If she did indeed tamper with the saline bags then clearly she is a reprehensible individual who should be dealt with by the full force of the law.

However, she should be presumed innocent until proven guilty, and a front page splash like this is no way to treat an innocent individual. If it were to be found that she was in fact innocent, this nurse could well have her career ruined as patients recognise her face as being the one that the Mail claimed was responsible. Social ties that she has made and recently had broken as they peel away in disgust may never be remade.

Whatever the outcome of this, guilty or innocent, this nurse has had her life changed in a major way, and had it changed irreversibly.

It is the exact same kind of disgusting journalism I commented on at the time of the arrest of Chris Jefferies over the murder of Joanna Yeates. He was made to fit the profile of a murderer and so help the tabloids to sell more copies. The exact same thing has happened here, with the Mail releasing information about her personal tastes to give character to the story.

It eventually turned out that Chris Jefferies was innocent, but I suspect his life has never been the same since. Whether this nurse turns out to be guilty or not is irrelevant, it is wholly irresponsible, and if the media won't stop doing it voluntarily, someone should make them.

NHS Debate Re-opens

For now the Hacking scandal is having a relatively quiet time, but an old favourite has popped back into the news again recently, the NHS reforms.

The row over NHS reforms looks set to reopen, and more publicly than ever.

People may remember the recent listening period that the government held when their proposed changes to the NHS were met with fierce opposition from both the medical profession and the public. After intensive lobbying from the BMA, RCN, and RCGP they agreed to substantial changes.

This would all seem positive, but the problem now is that the changed bill is a complete and utter mess. It is a confused bureaucratic nightmare, with no-one being quite sure what its aim is.

The changes even prompted this motion from a  recent BMA Council meeting, "[this council] rejects the idea that the Government's proposed changes to the Bill will significantly reduce the risk of further marketisation and privatisation of the NHS."

That's why the BMA, the association representing 140,000 doctors, has again stated that it is opposed to the bill, despite the changes, and that it would be better for the bill to be withdrawn altogether.

The biggest news from the BMA meeting was that it agreed to start a 'public campaign to call for the withdrawal of the Health and Social Care Bill.' It seems that far from the easy ride through the commons Cameron had hoped for, there will be an almighty battle for public support.

As well as this, the campaigning group 38 degrees, with 850,000 members, have restarted their campaign against the bill, raising £10,000 (in fact, at last check it was over £30,000) within hours which will be used to hire a legal team to look through the bill line by line, looking for any hidden dangers.

With trust in politics in serious decline after Hackgate, and the Medical profession being the most trusted, I hardly think there will be much appetite in the government for a fight with the BMA. It will be interesting to see how much political capital Cameron is prepared to lose in order to pass the bill.

Without a Lib Dem backlash, which seems unlikely, he will probably manage to pass some form of bill, but what it contains, and how much he loses in the process, remains to be seen.

Vigilante Journalism

I seem to have written a lot on both this blog and Twitter recently about the media, but in my defence it has been one of the biggest media scandal's of a generation. I just want to post once more on this, the last day of the News of the World.

A lot has been written about how the News of the World closing will be a loss to journalism, and about how it was apparently the top of its field in investigative journalism. I personally think this is sentimental rubbish. I've looked through the 'famous' front pages that News of the World claims as its successes and see little to write home about. Many of the 'exclusives' are just celebrity tittle tattle, with no real benefit to the public.

On one issue, a great deal of people seem keen to praise News of the World, the naming and shaming of paedophiles and their campaign for Sarah's law. A great deal of people that does not include myself.

Although it may seem bizarre for me to apparently disapprove of their crusade against paedophiles, I hope you'll bear with me and see why. It reminds me of a particularly brilliant episode of Brasseye, paedogeddon. If you haven't seen it you really should, it's hilarious. It's a mockumentary about the whipped up hysteria of the press and the unforeseen circumstances.

No-one is going to condone paedophilia, but when that same whipped up hysteria is responsible for innocent people being attacked by vigilantes then you have to question whether it truly was a 'force for good'. For example,  there was a case in Wales of a paediatrician having her home attacked because someone mistook this job title for 'paedophile'. The stupidity of such people really is beyond my grasp.

Shambolic science in the Daily Express

In a week where certain sections of the media are getting a well deserved bashing, it's important to remember the kind of damage they can do through perfectly legal means. Indeed, there is a front page story in the Daily Express today that will garner very little criticism, but could very easily lead to major health problems for its readership because of its abuse of scientific research.

Their front page, as seen to the right, proudly declares that 'Now salt is safe to eat', claiming that reducing your intake 'does nothing to reduce your risk of heart disease.' (They also call Public Health specialists 'Health fascists' for good measure)

It is very easy to see how they came to this conclusion, but easier still to see how they got it completely and dangerously wrong. This headline is essentially extrapolated from one piece of research, published in the Cochrane Library. As such, it comes from one of the most reliable sources possible, and we can be sure that the research is thorough, but it seems the Daily Express only read what they wanted to believe.

The review of literature covered nearly 7,000 participants, and found that although lowering your salt intake was correlated with a lower BP, they couldn't find a link to a reduction in your chances of developing heart disease.

An Attack on Doctor's Pensions

Public sector pensions have been in the news quite a fair amount recently, and there are plenty of commentators around who can explain better than me why the changes are deeply unfair to workers, and so I shan't talk about pensions as a whole. Instead, I want to write about something that I, as a medical student, have a personal future interest in, the NHS pension scheme.

The BMA remains highly critical of both NHS reforms and of proposed pension reform.

It may seem a pretty dull subject, so I shall try to keep this short and to the point, and in those interests here are a few quick facts about the current scheme.

• It was renegotiated as recently as 2008, with the introduction of tiered contributions to ensure fairness for the lowest paid and an increase in the retirement age for new entrants to 65.
• Employers contributions (i.e. the taxpayers) have been capped.
• The scheme is due to be £10bn in surplus by 2015, providing the Treasury with £2bn a year.

Such a scheme would seem ideal for a government looking to cut costs, not only are costs not spiralling out of control, they're recieving money from the surplus! In light of this, it seems even more bizarre that the government, fronted on the issue by Danny Alexander, is issuing threats to public sector workers that they must accept new settlements or lose out even further.

News of the World's criminality.

For months people have been wondering whether there could be any more revelations in the phone hacking scandal, whether News of the World and the tabloid press in general could sink any lower. Whether Rebekah Brooks and Andy Coulson could possibly be dragged in more disrepute than they are already in.

Today, we got an answer, yes they can. And the most damaging aspect of today's news, that they hacked the phone of missing schoolgirl Milly Dowler, is that the issue now has a very personal - and very shocking - side to it. This isn't now an issue of idle celebrity tittle-tattle, it's an issue that everyone can relate to, and that no-one can condone.

Why I've returned.

It's been a couple of months since my last post here, I struggled to muster the enthusiasm to start blogging again after I decided to take a break for my last set of exams. (Which I passed, so maybe it paid off!)

Part of the reason why I didn't feel the need to start blogging again was that this site is something of a vent, if I don't write things down I tend to rant, and for the sake of keeping friends it's better to let it all out on the internet than in person.

Recently, however, I've had Twitter available as an outlet, and so felt less need to write out time-consuming blog posts. Twitter does have it's drawbacks though, and the need to fit everything into 140 characters does somewhat stifle the quality of debate sometimes. And that is ultimately the reason behind me starting up this blog, for those occasions when even Twitter isn't enough of an outlet, and I want to write in more detail.

Some people might think it quite egocentric to think that enough people will care about what I say to make this worthwhile, but that misses the point. If people read it, then excellent, but if not this can be more like a personal journal, albeit quite a bizarre journal. Think of it more of a blog/Twitter hybrid, they should hopefully compliment each other.

So, I hope some of my old followers are still around, and long live the blog.

Can death be good?

This could be one of my more controversial posts. Equally, I could be judging the mood wrong and people could find it perfectly reasonable. Either way, it's going to be written. Though of course, I have no idea what it must feel like to be a survivor or relative of one of those in 9/11, and so my opinion counts for little.

It comes after the news broke early this morning that Osama bin Laden has been killed in his hide-out in Pakistan, after an apparent fire-fight with US Navy SEALS. What came next was a day of relentless news coverage showing scenes of jubilation around America, and world leaders congratulating Obama on his success. The question I want to look at now is the question that plagued me during the day. How am I supposed to feel about all this?

It may seem rather an obvious question, the man was responsible for some of the most hideous terrorist attacks the world has seen, and so I should be happy at his demise. But equally, I have never and will never be supportive of the death penalty, or any such form of retributive justice, and so how do I reconcile these two conflicting beliefs?

One article that helped me make up my mind was this by Emma Burnell, who puts his death in the context of a conflict, where casualties occur and can be justified. Like her, I believe that in an ideal world he would have stood trial for his crimes in front of an international court. But we don't live in an ideal world. His captivity would have provoked revenge killings and provoked Al-Qaeda to take hostages in an attempt to secure his release. That is a situation I think no-one could live with.

In the context of a global war perhaps it is justifiable to have killed Osama bin Laden, especially when the cost of his captivity could have been so monumental in human terms.

What I would still disagree with, however, are the scenes of jubilation that his death has sparked.  I do not criticise anyone who feels relief or joy at the death of this man, that he committed heinous crimes is beyond doubt and I cannot begin to imagine how those who suffered losses at his hands might feel. What I simply want to explain is why I would not join the celebrations, and it is summed up rather well by Harry Waizer, a survivor of the 9/11 attacks:

"If this means there is one less death in the future, then I’m glad for that, but I just can't find it in me to be glad one more person is dead, even if it is Osama bin Laden."

If anything, I feel today should be about marking a line in the sand and remembering all those lives that have been tragically lost, not about jubilation. I don't think us reverting to a primitive eye-for-an-eye attitude and dancing in the streets at death is in any way justice for his heinous crimes.

If his death can be justified in the context of a conflict then so be it, but we should be extending our warm feelings to those who lost everything they hold dear rather than expressing joy that we found revenge. I was most struck by the story of one individual who, upon hearing the news, went down to Ground Zero to pay his respect to those who had lost their lives. What he found on arrival was a carnival atmosphere, and had to leave soon after. Again, I can more than understand those individuals sense of joy, but is it possible that in their carnal search for revenge they have lost sight of what is important?

Perhaps that is what I wish for most, in my idealistic mind. That this day marks the turning point. That we can now focus on moving on with our lives, whilst never forgetting the terrible losses that people suffered. From now on let us no longer celebrate death, but let us treasure life.

Lies, half-truths and dodgy statistics: NHS

Part of a series on the many lies and exaggerations used by politicians and the media which are backed up by very questionable statistics.

"There are three kinds of lies: lies, damned lies, and statistics." So goes the quote popularised by Mark Twain, his phrase describing just how easy it is to twist any statistic you can find to suit your given belief. I would add another and qualify two of them, there are actually four types of lies: lies, repeated lies, exaggerated half-truths, and misused statistics.

I bring up this now in light of abuses of supposed 'facts' by Number 10, which have very real consequences for us if they are allowed to go unchallenged.

The misuse of statistics in relation to the NHS is the most dangerous of all, these are the 'facts' which are being used to persuade the public at large of the need for reform. Many of them appear in a new leaflet issued by Number 10 and are reproduced by the Department of Health, entitled 'Working together for a stronger NHS'. The facts it uses are not difficult to debunk, but the issue is that many people will read the leaflet and never be exposed to the arguments as to why it is factually incorrect.

The leaflet starts with a series of statements about the rising age of the population, the rising cost of medicines and so forth which are in fact true, though they do not directly support these particular reforms, merely reform in general. It takes a massive logical leap to go from 1) We need reform, + 2) These are reforms, = 3)We need these reforms. It is a fallacy of necessity.

But on with the leaflet. We soon get away from these truths and into very questionable areas indeed, with a whole page devoted to this devastating fact:

"If the NHS was performing at truly world-class levels we would save an extra 5,000 lives from cancer every year."

If that doesn't convince you we need change, what will? Well, it might be a devastating argument if it had any real basis in fact. The source they use to make this claim comes from the British Journal of Cancer, and was published in December 2009. So it comes from a reputable source and is recent, what could possibly be wrong then? The issue here is that the government has used research which was never intended to predict current rates and possible future improvements, the data covers the period from 1985 to 1999. The very latest data included was from 12 years ago!

Since that time the NHS has improved massively, with the NHS Cancer Plan in 2000 having massive impacts. It may be frustrating for politicians trying to make a point, but health data simply does not fit into their ideal of being immediately available for analysis and scrutiny. There are complex epidemiological factors at play, to the point that even studies which they use from late 2009 have to analyse data that is massively out of date. This is why changes in the health service, even if they were desirable, should never be implemented at this speed, it allows no time for scrutiny of impact and could well be harmful.

Other such lies have been dealt with by Ben Goldacre in this article and I shan't waste any more space here going over them again.

Needless to say, it seems very dishonest of the government to deceive people in this way, but what can be done to stop it? John Majors abuse of statistics led to the formation of the Office for National Statistics, perhaps it is time the NHS had its own independent statistics, to stop it being used as a political football.

Clegg's fake 'red lines' for the NHS.

What follows is a master class for all hopeful future politicians. A handy trait to master is the art of talking tough, to ease voters worries, whilst simultaneously bending over backwards to please your superiors and assorted vested interests. To demonstrate this beautifully, step forward the nation's darling, Nick Clegg.

He today wrote to all 56 Liberal Democrat MPs, in what the Independent called "the clearest sign yet of a major coalition schism over the reforms", setting out his five 'red lines' that were non-negotiable in relation to the NHS reform. He said that these amounted to 'substantial changes' to the bill and would save the NHS from privatisation. The rhetoric is strong, but the measures set out as his 'red lines' are pitifully weak. Here's a look at his five 'red lines', and what they actually mean:

1. Competition should be driven by quality, not price. -

This has already been amended in response to BMA lobbing in March. Whilst competition is now not to be explicitly based on price, the competition itself is still being implemented, leaving the NHS open to EU competition law and turning health care into a market. The role of Monitor will remain as a competition enforcer as opposed to regulating Foundation Trusts as it does presently. This first 'red line' therefore has not only already happened, but fails to meet any of the demands of the BMA or RCN who have been so damning in their verdicts on the Health and Social Care Bill.

Verdict - Already happened.

2. Family doctors should not commission services alone. -

Whilst the last 'red line' has already been changed, there was no need to amend the bill to comply with this red line. It was never, ever going to happen. Indeed, one of the issues with the reforms would be that not only would doctors be commissioning services, but that they would likely turn to private providers to help with commissioning. Doctors tend to study medicine in order to help people. If they wanted to commission services they would have taken an accountancy course.

Verdict - Was never going to happen.

3. GP consortia must not go ahead in 2013 if they are not ready. -

Again, this has already been agreed, as seen in the Health Service Journal interview with David Nicholson back in February. It also does nothing to address the issues raised by the prospect of certain areas being run by consortia outside of their local area, thus destroying the primary goal of these reforms.

Verdict - Already happened.

4. The principles of the NHS constitution must be protected. -

This is a very woolly 'red line' at the best of times, without specific examples you can essentially interpret the constitution to fit any set of reforms that might be put forward. Even so, this again is a case of Clegg demanding something that has already happened. It is explicitly mentioned on pages 330, 332, 333, 340, 365, 375, 395 and 402 of the revised bill.

Verdict - Already happened.

5. GPs must work ‘hand in glove’ with councils. -

This is already included in the bill through the inclusion of Health and Wellbeing Boards, which states the many ways in which the consortia will be working closely with the local authority, 'like hand in glove' as Mr Clegg may prefer.

Verdict - Already happened.

So, having actually looked at his 'red lines', which will apparently ensure 'substantial reforms' to the Health and Social Care Bill, we see that he has actually included four things that have already been included and one measure that was never included in the first place. Quite an achievement.

That only serves to show just how impressive it is that Clegg has managed to turn this letter, which adds nothing new, into a statement which newspapers are proclaiming as the Liberal Democrat fightback. He has managed to create a fake difference of opinions, which will no doubt help him in local elections, whilst causing Andrew Lansley no problems whatsoever.

There are many people within the Liberal Democrat party who are anxious to see real changes to the NHS reforms, including those with real influence such as Norman Lamb and Evan Harris, but Nick Clegg is once again folding as easily as a house of cards caught in a tornado.

He has shown himself to be a vacuous salesman, a pawn of the Tory hierarchy, and in doing so has provided an excellent example of how to dupe the British public into believing you are listening to their demands. Here's to hoping he doesn't succeed.

Hat-tip to Health Policy Insight for some links and highlighting the vacuity of his letter.

AV vote becoming increasingly partisan

I fear that this Alternative Vote referendum is becoming more and more about party political preference rather than what it should be, a question of how best to represent the wishes of voters. This isn't a sleight aimed at any party, or indeed any individuals, and both sides of the referendum are engaging in it, it's merely an observation which is really quite disappointing.

This vote shouldn't be about what system will help which party, but yet many, many people who's views I respect and agree with on so many other things are basing their support or opposition to the Alternative Vote based on how it will affect their political party. They argue that what is in the interests of their chosen party is in the interests of the country, and so any change to the system which is bad for their party is bad for the country, and vice versa.

Whilst the belief that the interests of your party are in the interests of the nation seems a rather natural belief, it should have no bearing on this referendum. You cannot drag the electorate along with you based on a malfunctioning voting system, you have to earn and keep their trust. When judging electoral systems you should look at it from a completely impartial point of view, and base your decision on whether or not said system reflects the wishes of the nation. If that harms your party, then tough, you should focus more energy into making sure you do represent them.

Too many people in this country don't have a vote that matters. AV is not a cure-all, but it will end the very worst of FPTP in that it takes away the need for tactical voting. I find it outrageous that in a modern democracy people cannot vote for the candidate they prefer simply for the fear of letting in someone worse. If all that happens is AV is the end of this kind of campaigning then I think it will have been worth doing.

I may dislike Tory policy, but is it right that people are denied the chance to vote for them?

I have already made many cases for AV, but this was simply me expressing my exasperation that party politics kept getting dragged into the debate. This is about making sure that MPs truly represent their constituents, not just the ones that are members of their party.

An NHS in peril.

Readers will doubtless have heard many of these arguments on this blog in the past, but as this post was written for OpTank, I have tried to write the most complete summary of the reforms that I have done to date.

From 'Moral Leadership' to privatisation

In 1944, with the country emerging from a devastating war and crippling debts, Aneurin Bevan was tasked with introducing a health care system fit for a new era of Britain's history, which would treat patients based on need rather than wealth. In July 1948 he unveiled the National Health Service at Park Hospital in Manchester. The institution, he said, gave us 'the moral leadership of the world.'

Aneurin Bevan: Architect of the NHS

62 years later and the National Health Service faces the greatest threat to its existence in its history. Andrew Lansley's reforms may not remove the NHS from our lexicon, but it threatens to take its very soul, leading us on an increasingly rapid path towards a time when the NHS will be nothing but a brand name.

This all seems very melodramatic, but looking closely at the reforms shows that they are not merely a reshuffle of management, nor about cutting bureaucracy, but about a fundamental shift in what the NHS stands for and how it works to achieve those ends.

Forcing Competition into the NHS

For reform which is intended to give much more power to doctors in guiding patient care it is notable that nearly the entirety of the medical profession is united in its opposition to much of this bill. The reason being that whilst GP-led commissioning is welcomed, there is a widely held belief that this portion of the bill is merely a fig leaf to mask its more sinister elements, the elements relating to competition.

Monitor, which currently has the role of regulating foundation trusts, will now regulate competition in the NHS, ensuring that any willing provider is able to tender a bid for NHS services. No longer will Monitor focus on patient care, but will instead focus on enforcing competition, fragmenting well established partnerships at a local level when they are deemed 'anti-competitive', and leaving the patients with a poorer service as a result. NHS services will be at substantial risk of closure as the most profitable parts are cherry picked by private providers.

For those reasons, a recently convened Special Representative Meeting of the British Medical Association passed the following motion:

"That this Meeting believes price competition is a hugely retrograde step and:- i) that price competition in healthcare is damaging; ii) that with scarce resources the prime focus will be on cost and not quality;"

Indeed, that very same meeting passed a range of motions providing a devastating critique of the health reforms. People who watched the meeting will know that the Health Secretary was only spared a vote of no confidence because of the plea of the chairman not to hinder negotiations and lobbying. The motion may not have passed, but be under no illusions, few at that meeting had any confidence in Andrew Lansley whatsoever.

Furthermore, even if the detail of the reforms wasn't hugely dangerous, the pace and scale are mystifying. To enforce a £3 billion top-down reorganisation on the NHS at a time when the organisation is being asked to find further savings of £20 billion to protect services for the future is outrageous and wholly unnecessary.

Lies, damn lies, and Cameron's statistics

The government is of course keen to stress that reform is necessary, that the NHS simply doesn't perform well enough as it stands. Facts, however, would seem to dispute those claims.

Firstly, despite the attempts by the secretary of state to hide the research, it is now known that patient satisfaction with the NHS is at an all-time high. Hardly a sign of an organisation in peril.

Secondly, it seems a new favourite claim of David Cameron that we are performing very badly in preventing and treating both heart disease and cancer. He may be better served by first seeking to understand the meanings and trends behind research before diving into the argument with his own ill-judged opinions.

Whilst we may have higher mortality rates from heart attacks than nations such as France (which is the lowest in Europe) we have seen the greatest reduction in those rates during the past 30 years, and on current trends will have lower rates than France as soon as 2012. All this despite seeing a lower increase in health spending.

Again, with the claims on cancer, the independent King's Fund showed that our survival rates were improving. And comparisons to nations such as Bulgaria neglect to mention the fact that the two nations have very different levels of cancer registry coverage, making comparisons naive at best, and deceitful at worst. Perhaps it is for these reasons that the BMA also passed the motion:

"That this Meeting deplores the government’s use of misleading and inaccurate information to denigrate the NHS, and to justify the Health and Social Care Bill reforms, and believes that:- i) the Health Bill is likely to worsen health outcomes as a result of fragmentation and competition;"

In summary

There are positive elements to this bill, but they are few and far between. GP-led commissioning could be implemented without the need for legislation. It is only now being used as the government hopes to pass through damaging reforms in the name of greater power for patients and doctors. And when those reforms are widely rejected by the BMA, the Royal College of GPs, the Royal College of Nursing, the Kings Fund, UNISON, and even ex-GP, now Conservative MP Sarah Wollaston, it is time for a rethink.

In 1951 Aneurin Bevan resigned from the cabinet over the introduction of a 1 shilling prescription charge introduced to boost the Treasury coffers. Lord knows how he would react were he alive to witness the destruction being rained down on the nation's crown jewel by the lunacy of Andrew Lansley.

In his now oft-used quote, Bevan said that the NHS 'will last as long as there are folk left with the faith to fight for it.' With petitions gathering pace, and demonstrations planned, it is time for the public of England to stand up and show that they still have the faith, and that they will fight for their NHS.

The smearing of UKUncut

It's taken a little time for all the details of events at Fortnum & Mason to be clear, and in that time it seems UKUncut has been getting a very bad press indeed. For an organisation that enjoyed a range of support from the Guardian to the Daily Mail, this is a very new experience.

People from all shades of the political spectrum have been, including the left who claim they ruined the message of such a well organised and executed march. Several MPs who supported their cause in the past have withdrawn that support, and those that insist on continuing to support them like John McDonnell are labelled radicals.

I'm not going to write another long post about why I think they're such a breath of fresh air in protest, or why their message needs to be heard. Instead, I thought I'd leave a selection of the most important links to help people understand what went on. Hopefully, they will provide the proof that far from changing tack and becoming more radical, UKUncut are just as peaceful as they ever were, and that they were badly let down by both police, and by other more violent protesters.

- Video proof that shows police first promising that UKUncut would be free to go before then breaking said promise and arresting them individually once outside, as well as police officers inside the building appreciating the peaceful nature of the protest. Video found here.

- Personal story from one of the protesters detailing conditions which the protesters were kept in, and the bemusement of the police who 'regretted having to charge the protesters on orders from Scotland Yard.' Story here.

- A few photos from the occupation at Fortnum & Mason's showing the 'damage' and peaceful nature of the protesters. Photo album here. (Hat-tip to @MissEllieMae)

- A slideshow on the frontpage of UKUncut's home page showing the range of people attending their entirely peaceful protests, from very young children to the elderly. Page here.

- Finally, a video from inside Fortnum & Mason's during the occupation. Bagpipes? Yes. Vandalism? No. Video and article here.

Grey Haired Manky Codger

I'm sure many of my readers may well have already seen this, but I needed to share it. My disgust at Andrew Lansley and his privatisation plans are no secret, so obviously a rap about him and how bad his plans are was always going to be a favourite of mine. No doubt it will be sung many times at the march on the 26th in London.

The Libyan Conundrum

Libya is something of a conundrum for many in the West, and indeed those in the region itself. How best to support democratic revolutions without imposing regime change, which was so disastrous in Iraq? And when that revolution falters, and the regime in power threatens genocide, what measures are acceptable to take without being seen to once again be meddling in the Middle East?

It's important to note that this is less polarising than Iraq, the UN resolution and circumstances on the ground see to that. There are people who care about the rights and cultures of other people on both sides of the argument, we just disagree on whether on not this No-Fly Zone is the right way to protect the Libyan people. I'm of the view that it is.

I think for all the arguments that will inevitably come to light about our hypocrisy in intervening in Libya but not in places like Bahrain, about our interventions invariably being linked to oil, and about the other hypocrisy of now attacking the very weaponry we once sold to Colonel Gaddafi, those questions are of no importance or interest to the people of Benghazi who were seemingly on the brink of a brutal massacre just as the UN resolution was passed.

We can rightly ask questions about our general policy in the Middle East at another time, or even alongside Libya, but I don't think we can use our past mistakes as the sole reason to stay out of Libya. We should treat each case individually as it comes along.

It was clear to the world that many Libyans would never be safe under Col. Gaddafi's rule, we had the support of others in the region, and crucially waited for multilateral involvement before intervening. Those facts make it compare favourably to other western interventions of the past.

I understand the arguments against our intervention, but simply could not see an alternative which did not involve the slaughter of innocent civilians. Yes, other places are in a similar situation, but our inability to help everyone shouldn't stop us helping anyone. And I am not accusing those who oppose intervention of being heartless towards the Libyan people, far from it, it is just that I just could not personally have accepted us standing on the sidelines on this occasion.

What we must now focus on is not whether or not the NFZ was the right way to go, but where we go from here. There are still massive questions that need answering. What constitutes mission accomplished? What happens if we're left with stalemate, Gaddafi in the West and the rebels in the East, how long can we maintain the NFZ? Will this only finish when Gaddafi is killed, and if not then how can you ensure peace with him still in power?

Big and important questions, the answers to which will determine whether Libya is the turning point for western interventionism, or just another grubby black mark on our relations with  the Middle East.

For a good post that disagrees with me and is against our intervention, visit this blog.

Tuition Fees plan in meltdown.

We're now beginning to see the fruits of the ill thought out and ideological increase of tuition fees, as universities line up one by one to ignore the governments plea and charge the full £9000. 

Charging the full amount was supposed to be the exception, but it's fast becoming the rule as we discover that the Office for Fair Access which was set up to monitor the new levels is completely impotent to stop universities charging what they wish so long as they make a courtesy gesture towards the very worst off students.

All of this comes on top of the news that some graduates will end up paying back twice the amount that they borrowed for tuition fees, with many never being able to pay them back fully.

No university wants to be seen as the 'cheap and tacky' option, and so charging £9000 s a way for them to appear to be good quality. And with their funding being slashed, who can blame them?

Here's the article from the Independent.

Doctors harden their stance.

I couldn't make a return to blogging without first talking about the BMA meeting that took place two days ago, where doctors came out against just about every single major part of the Tory Health Bill. I call it the 'Tory' bill because it's now also clear that their partners in coalition object to it as well as everyone in health care.

Here's a selection of the motions that were approved by the meeting:

- That this Meeting believes that the current plans for reform are too extreme and too rushed and will negatively impact on patient care. We call upon the Health Secretary to:- i) call a halt to the proposed top down reorganisation of the NHS; ii) withdraw the Health and Social Care Bill; iii) consider and act on the criticisms and advice from the medical profession that were collected during the White Paper consultation; iv) adopt an approach of evolution not revolution regarding any changes to the NHS in England.

- That this Meeting believes that the proposals in the Health and Social Care Bill were not part of the election manifesto of either of the coalition parties, and calls on the government to accept that:- i) there is no electoral mandate for the introduction of such changes.

- That this Meeting deplores the government’s use of misleading and inaccurate information to denigrate the NHS, and to justify the Health and Social Care Bill reforms, and believes that:- i) the Health Bill is likely to worsen health outcomes as a result of fragmentation and competition.

As well as these more general points, each individual part of the bill was itself dissected and rejected. And whilst the BMA called for the withdrawal to the bill, it stopped short of opposing it in its entireity. However, people watching the meeting online will have noticed this was more of a result of the Chairman's plea to not tie the negotiators hands rather than any particularly good parts of the bill, the proposer of the motion to oppose the entire motion got the loudest standing ovation of the entire day.

Equally, Andrew Lansley was only spared a No Confidence vote because Hamish Meldrum appealed to the meeting and because the Special Representatives would have no more confidence in whomever replaced Andrew Lansley.

Whilst at the time I was disappointed the tone wasn't more strident from the BMA, I now see it has its benefits. The claim from David Cameron that the BMA is 'just another trade union' is frankly laughable in light of this meeting. The debates held were a million miles from the Punch and Judy politics of the House of Commons and despite being baited by politicians who insisted they would ignore the insights of doctors the BMA insisted on continuing to engage.

Frankly, Parliament could learn a lot from the democracy of the BMA. And they should certainly listen when the people who know the NHS the best say that this will destroy it.

P.s. I noticed that a favourite way to claim doctors were onside was to point to the number of GPs who were already involved in pathfinder schemes. I should make it clear to Lansley, these GPs didn't take part because they like the scheme (at least the majority didn't), most did so because PCT's are in meltdown because of these changes and someone needed to step in to fill the gap or patients would suffer. Unlike Lansley, GPs were simply putting patients before ideology.

Hello again!

People may have noticed that I took an impromptu break from blogging. call it burn-out or just plain boredom, but I didn't feel like writing for quite some time. Now however, I want to get back into it, so expect a flurry of posts coming up soon to make up for my absence.

Enjoy.

Brazen lies and sick campaigning from No to AV.

I'm getting sick to the back teeth of brazen lies that are perpetually coming from the No to AV campaign, and so thought I'd write this to show exactly why they are completely wrong in their claims,.

They claim that a switch to AV would cost £250m, and then proceed to ask people what better uses that could be put to. First off, I don't think money should be an issue, a dictatorship would be much cheaper than a parliamentary set-up, but somehow that's never wheeled out as an argument for change to having a dictator. Second, the idea that it will cost £250m is a lie, not a misconception but a lie, and a lie upon which No2AV seem to be basing their entire campaign.

To make the massively inflated figure the No2AV campaign had to include the cost of two things, the cost of the referendum itself, and the cost of supposed 'necessary' voting machines.  Point one. How can you claim the cost of AV will include the referendum? The referendum will cost money regardless of whether you vote Yes or No. Are they now campaigning against the referendum itself? Because if so, they could forfeit and save the country a whole lot of money it might otherwise have wasted.

Point two. They claim we will have to spend vast amounts of money on counting machines. The only problem with this claim? An expert from Australia, where AV has been used for a considerable time, has stated that there is absolutely no need for counting machines under AV. And even if we did switch to machines, it was a switch we were looking at making under FPTP anyway! It is not an AV cost, it is a cost of any election.

That leaves a grand total of £26m for the switch to AV on voter education, and even that is a wild exaggeration based on the cost of educating Scottish voters about the STV, an entirely more complex form of voting that required far more information than simply putting numbers from 1 to 5 in order, I imagine the cost of that is covered almost entirely by the teaching given in Reception of Primary School.

If we're going to have a serious debate leading up to this referendum, and there is a debate to be had, then the No campaign needs to stop playing dirty and stop taking voters for mugs. Tell the truth, make your argument, and hope that people side with you. That's how this should be conducted. Or perhaps they're running scared?

Edit: I was linked to this yesterday, turns out not only are they lying to people, but they're resorting to the most sickening campaigning tactics.

NOT how a debate should be held.

The author of protest.

Found this pretty interesting on the BBC today, an article about Gene Sharp, an author whose book 'From Dictatorship to Democracy' seems to kindle for the fires of revolution that we are seeing in the Middle East at the moment, as well as in previous revolutions in Serbia and Ukraine.

It's a pretty interesting read, stressing that by protest turning violent it plays into the strongest hand of the oppressors, and has several key factors for revolutions.

• Develop a strategy for winning freedom and a vision of the society you want 
• Overcome fear by small acts of resistance 
• Use colours and symbols to demonstrate unity of resistance 
• Learn from historical examples of the successes of non-violent movements 
• Use non-violent "weapons" 
• Identify the dictatorship's pillars of support and develop a strategy for undermining each 
• Use oppressive or brutal acts by the regime as a recruiting tool for your movement 
• Isolate or remove from the movement people who use or advocate violence

But, of course, it would be wrong to attribute all or even most credit to this one man for successful protests. The major strength of what is happening at the moment is the strength of belief and character of those on the streets, and that is something no book can teach you.

Barclays 'Bail-In'

I know I've had quite a few posts about UKUncut, but they really are a brilliant example of spontaneous and fun protest that can really get a story into the public eye. Their latest day of action aimed at Barclays, who were recently revealed to have effectively paid 1% tax on their UK profits, was a great success, with branches up and down the country turned into comedy clubs, libraries and all manner of other things.

The reasons they've taken to targetting banks were outlined in a brilliant blog post. And the anger is only fuelled further by the news that big companies, banks included, are soon to be handed a massive tax reduction as the government changes the rules on corporation tax. It's fairly obscure tax law, but it means that rather than the situation at present where a companies with profits overseas has to pay the difference between the tax rate of the other nation and ours, they soon won't have to pay anything at all. It's explained more here.

It just seems that no-one in government has the balls to make the banks pay for the mess they created, perhaps because as David Cameron told bankers, 'My father was a stockbroker, my grandfather was a stockbroker, my great-grandfather was a stockbroker. The city is in my blood'.

Massacre in Libya

Since the revolutions in Tunisia and Egypt a new wave of protest has kicked off in the Middle East, but the protests in Libya in particular seem to have taken a dark turn, with snipers, artillery, and helicopter gunships being used against protesters, it's horrifying.

Here's the article from the Telegraph, and an article about the differences between protests in Bahrain and Libya.

Lansley promotes sham treatments.

As if destroying the NHS wasn't quite enough to be getting along with, Andrew Lansley has decided to put his neck on the line by defying the EU to help protect the market for Chinese Herbal Remedies. He's getting around the new ruling by the EU by reclassifying 'Herbalists' as authorised healthcare professionals.

I'd suggest that while he's at it he also suggests a name change, from Herbalist to 'Crackpot sellers of magic leaves'. Yes, some traditional medicines do have health benefits, and the ones that do are now 'Medicine'. Anything that falls into 'Alternative Medicine' is there for a reason. It doesn't work.

I suppose that when you're buggering up the NHS it can't do too much more harm to encourage the sale of medicine that doesn't work.

The next ruler to fall?

After the fall of Ben Ali in Tunisia, and of Mubarrak in Egypt, could it be the turn of Bahrain to jump on the bandwagon of revolution that is gaining pace? Live rounds have apparently been fired at anti-government protesters in the streets, a sure sign that the regime is fearful.

Just like in Egypt, new media has given the world a glimpse of what is happening. Some of the stories coming out of the country are quite disturbing and frightening. One person from Bahrain was Tweeting from a protest at a roundabout, where her updates included, "I see them [riot police] on the bridge, hundreds of them", "They're shooting at us", "They're attacking from everywhere", and "There are women and children inside the roundabout when the attack started, people were sleeping when the attack started."

Here's hoping that the protesters get the reform they long for without any more tragic deaths.

The Good Society

It would seem David Cameron's big centrepiece to the election, the 'Big Society', is in serious trouble, with him having to relaunch it just a few months into parliament. Already councils that had signed up to the idea are pulling out because they have realised that you can't build a big society at the same time as making swinging cuts. So, with polls showing most people have no idea what the big society even is, I thought I'd provide some reading material.

Courtesy of Dave Brown

From the BBC.

From Cameron himself.

And the reply from Ed Miliband.

I don't think anyone across the political spectrum has a problem with the basic principle of voluntary groups being able to take control of projects if they so wish, and as such most agree with the underlying theme of the big society. But, the issue is that you cannot encourage this whilst at the same time removing state support. Cameron's assumption that removing the state leads to more public initiatives is wrong. These groups need the support of the state, they are often not strong enough to 'go it alone.'

It seems to be a cover for the cuts, instead of saying 'we're going to close down this library', he can say 'we're giving you the power to take over the running'. Knowing full well that the public don't have the expertise and know how to run it, and it will inevitably shut down, whilst keeping his hands sparkly clean. Ditto for the forests.

So, whilst we mostly agree on the premise, in actuality, Cameron is killing the big society more than he is nurturing it.

We won't forget.

I thought this post from UKUncut about why they're now also going to target banks as well as tax avoiders was really good, so thought I'd share it here.

It starts with the quote, "The struggle of man against power is the struggle of memory against forgetting" and goes on to talk about as time has gone by the banks have hoped we would forget that it was they who caused the crisis which meant we are now in such a financial mess. With my favourite part of the post being this:

"They are praying that we don't remember what caused the economic collapse. They want us to believe that the public sector is to blame - that our welfare state became bloated. They hope that we buy the lie that we've lost our jobs because our nurses cured too many sick people, our libraries had too many books, we cared too much for older people, and invested too much in the young."

It's true, and by targetting the banks hopefully we can make sure they pay back their fair share of the burden, rather than the pathetic bank levy or the new arrangement under Merlin which means they can essentially do as they please with all it's various get out clauses.

It's not banker bashing, it's about asking them to pay for the mess they have caused, and I don't think they've even started yet. Every time a sure start closes, or a young student can't afford to go to university because of fees, or a young child can't get access to books because their library is closed, or a patient can't get treated because their illness isn't 'cost-effective' in the newly privatised NHS, we'll remember the bonuses that the men who caused the pain paid themselves.

They privatised their profits whilst nationalising their losses. And now we're all paying the price.

Universities head for maximum fees.

And so it has begun, first Cambridge and Oxford have set about the necessary motions for them to be able to charge the full £9000 maximum fees to their students. Whilst this might not be a surprise, they are the two most prestigious universities in the country, what is more worrying is just how many others are planning the exact same thing, in complete contradiction to the promise that £9000 fees would only be charged in 'exceptional' circumstances.

£21,000 will be relatively low for final debt when the new fees come in.

Rather than being the exception to the rule, it seems that at least a third of universities are ready to charge the full amount, which is understandable following their budget being cut by 80%. Which all means that students will pay three times as much, for no better education than they have had previously. Seems like a pretty raw deal to me.

Of course, those in support of the fees will claim it's all fine, after all we're not paying up front. As if students were all mindless peons who couldn't quite grasp this basic fact. People are aware this is not paid up front, but somehow the spectre of more than £30,000 worth of debt is more than enough to make them question if university is really worth it, and we will lose many brilliant minds simply because they cannot afford to learn.

Sexism rife in Russia.

This is a quite unbelievable story I found out today from @stavvers, about a woman who lost her sexual harassment case in Russia. Whilst that might not seem like a major headline, the verdict given by the judge is shocking. He didn't throw it out because of lack of evidence, but rather because he admired the man, adding 'If we had no sexual harassment we would have no children.'

It's like a window to the past, where the men were in charge and women had to do as they were told to live a quiet life. A survey quoted in the Telegraph (I can't vouch for its accuracy) suggests that 100% of women in the workplace had suffered sexual harassment from their bosses, 32% had had sex with their boss at least once, and another 7% claimed they had been raped. 80% said they felt it was impossible to get a promotion without having sexual relations with male superiors.

For a nation like Russia, such a major power in the world, this is disgraceful. I honestly could never have imagined this still happened in such a developed nation in the 21st century, how naive I was.

A vision of true multiculturalism.

Speaking in Berlin yesterday David Cameron launched his most scathing attack yet on multiculturalism in Britain, saying that we should use 'muscular liberalism' to enforce equality, law, and freedom across society. Whilst the message about enforcing equality and freedom is one I think we can all sign up to, I do question the manner, the tone, and indeed the timing of this speech, and wonder if it wasn't a little reckless.

Multiculuralism isn't an experiment, it's a way of life.

The reason I question the speech is that whilst the aims are noble, he has targeted the rhetoric towards a minority in an unfair and lazy way, which could fuel ignorance and hatred of other cultures. When an EDL leader welcomes your speech, you should pause for thought.

An example of this is his insistence that no Muslim group should recieve state funding unless they endorse women's rights and promote integration. Now, neither of these are bad things, but again the targetting is the part I have an issue with. Why Muslim groups in particular? Will he put the same onus on the Catholic church as it refuses to acknowledge women priests, or as it condemns homosexuals? If you're going to enforce equality, then do it across all groups, you cannot single out one bad apple from a rotten orchard.

I fear that all this speech will do, rather than setting out any new solutions to the problem of integration, will fuel the ignorance of far-right groups who like to pretend that Islam is the problem, the sole problem, and being rid of it will solve all our nations problems. Assigning blame to Muslims for not integrating whilst completely ignoring those factions within British society who are generally far more violent (such as the EDL, who had a major rally on the day of the speech) is reckless, and will do nothing to benefit anyone.

Multiculturalism is not something that can fail or succeed, it is not an experiment, it is simply a description of the current state of affairs of our nation, where we have a range of cultures living side by side. Cameron himself said in 2007 that, 'We wouldn't be half the country we are without immigration.' The answer is not to bully people into adopting one culture and one culture only, it is to allow a state of affairs where we have different cultures, but not distinct social identities, where cultures overlap and you are free to move between them.

Paul Vallely in the Independent gives a simple example of this from a school in Moss Side, Manchester. Children there are encouraged to embrace other cultures as well as their own with the result that 37 nationalities can learn harmoniously, and you have 'black children there doing irish dancing, and white kids play in a jamaican steel band'.

This is the kind of multiculturalism I'd like to see, where you have the best of all cultures, living not only side by side but interspersed with one another. Where you break down barriers and stereotypes at the very youngest age. And I don't think David Cameron's ill-judged attempt to appease the right wing of his party, by suggesting we churn out clones who all share the same culture, is the right way to build a society, or indeed to solve any problems currently present.