Sunday 31 January 2016

Austerity? Not good for your health

In 2008, the Healthcare Commission, the body then charged with monitoring and improving care quality in England, published a report into lamentable failures in Stafford hospital, run at the time by the Mid Staffordshire NHS Foundation Trust. Mid Staffs, as it’s familiarly if not affectionately known.

The scandal that ensued revealed shocking levels of poor care which certainly caused great suffering to many patients, and a certain number of deaths. Just how many deaths is difficult to determine. Headlines at the time of “400 to 1200” excess deaths were deeply misleading, as was the report that established that number, by Dr Foster Intelligence, a healthcare analysis company.

Insofar as the number means anything, it is that there were that many more deaths than would have been expected given the levels of illness recorded among the patients treated. That figure does, therefore, depend on the records kept by the hospital, which weren’t necessarily as comprehensive or accurate as they might have been. Besides, no one has ever established that the “excess” deaths were actually avoidable, which would have been a truly devastating finding.

Indeed, Robert Francis who wrote the report into failings at the Trust, would comment, “…it is in my view misleading and a potential misuse of the figures to extrapolate from them a conclusion that any particular number, or range of numbers of deaths were caused or contributed to by inadequate care.”

Nevertheless, in November 2015 Mid Staffs pleaded guilty to four charges of causing the death of patients, so it’s clear that there were deaths as a result of the poor performance of the Trust, whether or not we can set a reliable figure on the number.

Incidentally, by the time of the guilty plea, Mid Staffs Trust had been dissolved more than a year and the Stafford Hospital, now the County Hospital, was being administered by the University Hospitals of North Midlands NHS Trust.

In his report, Francis identified a number of causes for the failings. Prominent among them was one that had been broadly acknowledged in the general debate: poor levels of staffing, especially among nurses. In its sometimes desperate quests to be granted the status of NHS Foundation Trust that gives hospitals greater autonomy in managing their affairs, Mid Staffs had gone too far in slashing staff numbers to meet financial targets. The Francis report recommended an action on the National Institute for Healthcare Excellence (NICE):

The procedures and metrics produced by NICE should include evidence-based tools for establishing the staffing needs of each service. These measures need to be readily understood and accepted by the public and healthcare professionals.

After the report was published, the government commissioned another, from US Healthcare analyst Don Berwick. It echoed Francis’s views on staffing:

NICE should interrogate the available evidence for establishing what all types of NHS services require in terms of staff numbers and skill mix to assure safe, high quality care for patients.

Admirable idea. What should determine staff numbers is quality and safety of care. Certainly not financial considerations. Nothing could matter more for us: if we’re seriously ill, and admitted to hospital, it would be nice to know that the level of service provided is based on what we need, not on what the hospital can afford.

Or, put another way, if the choice is between an increase in public spending, or the kind of dangerous care that gave Mid Staffs such a bad name, few would choose the dangerous care.

Except, sadly, that too many of us nonetheless vote for people who will make precisely the opposite choice. Those people won’t, themselves, suffer from that choice. The Camerons and Osbornes of this world don’t have to depend on the NHS for healthcare: they can pay for what most of us have to hope will be provided free. So they choose to prioritise money over care.

It was obvious from the beginning, from when Berwick make his recommendations in August 2013. Health Minister Jeremy Hunt rejected the notion that there should nationally backed standards for staffing:

If you start mandating things from the centre you create an artificial target and hospitals and trusts say: well if we meet that national minimum we’ve done our job as far as staffing’s concerned when actually they haven’t – because you’ll find there are places that need a lot more help and a lot more care.

This is a neat argument: it says we’re not accepting a recommendation because we don’t think it goes far enough – but then you don’t do anything at all.

Two and a half years on, few recall the Berwick report. Even the Francis report and Mid Staffs has become a bit of a vague memory: wasn’t that the hospital that did so badly when Labour was in power?”

NHS Nurses: much applauded at the Olympics 2012 opening
But have we now decided we have too many?
So now’s a great time to put the squeeze on, when people aren’t watching that closely any more. And that’s just what’s happening. Faced with a £2.2bn deficit, NHS hospitals are being told to cut staff to get their finances under control. The Guardian quoted Richard Murray, director of policy at the King’s Fund healthcare consultancy, saying:

If trusts do begin to reduce headcount the impact on patients would be swift, through either rising waiting times or reduced quality of care or both. Three years on from Robert Francis’s report into Mid Staffs which emphasises that safe staffing was the key to maintaining quality of care, the financial meltdown in the NHS now means that the policy is being abandoned for hospitals that have run out of money.

The government has long since decided that its overriding aim was reducing the deficit, and ultimately cutting public debt. It’s achieved some reduction in deficit but debt has grown like topsy, making George Osborne Britain’s first ever trillion-pound Chancellor. So austerity has failed.

I don’t know how anyone dependent on the NHS might feel about healthcare being sacrificed for the sake of a failed economic policy. I don’t know how anyone dependent on the NHS might feel about generalising the standards that fuelled the Mid Staffs scandal. I don’t know how anyone dependent on the NHS would want to risk giving that lot another chance in power.

Friday 29 January 2016

A mistake squared, or how getting it wrong about getting it right, gets everything wrong

Isn’t it curious, how an intelligent decision can flip so easily into its opposite and give way to utter dumbness?

In the office, my work laptop links to a docking station, which keeps it fully charged. So I don’t need a charger. Which means I don’t take it with me, and I’m pleased, because I carry the lot on my back: my work computer, my own computer (in case I want to write anything on the way in or on the way back), the charger for my computer (in case I run out of charge), two phones but only one charger (because they can both use the same one, and I’ve trained them to behave better than teenagers and take turns), my lunch, my notebook (A4 size – a bit bigger than letter size, since you ask in the US – and hard backed because that’s the only kind that stands that kind of battering), plus all the various plug adapters and multiple other things which just seem to accumulate in my rucksack and I never seem to remember to take out when I get home (cf women’s handbags).

Because I decided to leave the charger at home, I chose to put it in an intelligent place. The drawer where I keep lots of useful cables and computer-y things which I need from time to time. It’s getting pretty full these days, with the things I actually use near the top, and the bottom rather like the deeper recesses of my rucksack or a woman’s handbag. It seemed the logical place to put the charger, because that’s where it obviously belonged.

So it was distinctly upsetting when, having decided to work from home, I looked for it and couldn’t find it.

“Blast,” I thought, “I could have sworn I left it there. I know I decided to. Where else could I have put it?”

I spent the next twenty minutes checking all the bookshelves, the other drawers, under the coffee table, and in all the helpful little boxes and chests we have which are just so useful to keep things you might need to find some day. When none of those revealed my charger, I tried upstairs in my bedroom (why would I have taken it there? No matter. I had to check. I have a bedside table and it has drawers) and the front bedroom that doubles as an office.

No joy.

So I phoned my wife. Naturally, I didn’t say what I was really thinking, which would have been, “you’ve tidied away my computer charger. Where did you put it?” No. I was much more tactful. “You haven’t seen it, by any chance?” – that kind of thing. Nothing accusatory (to her) or exculpatory (of me).

It turned out to be an inspired phone call. “I don’t know where the charger from the new machine is, but the one from your old machine is upstairs.”

“That won’t work…”

“It worked on my laptop, when I needed a charger, and your machine is basically identical to mine, isn’t it?”

Well, that was all true. I went and got the old charger, with its transformer the size and weight of a brick – the new one is not much larger than a mobile phone and considerably lighter – and tried it on my machine. It worked a dream.

A few hours later, however, frustrated by my failure to find the new charger, I decided to look again. Starting with the drawer where I should, if I were being sensible, have put it.

hands-freeAnd there it was. Where it had been all the time. I hadn’t spotted it because I’d forgotten what it looked like. When Id looked at it, Id assumed it was the device for taking hands-free calls in the car, which looks similar (I wonder where I put that, by the way?) I didn’t recognise it for what it really was, what I really wanted, my work computer charger.


There it was. In the incredibly well-oganised drawer,
where I keep electronic things so I can find them in a hurry
Now my wife, faced with my inability to find something I’m actually looking at, would simply attribute it to testosterone blindness. She may be right. But I think a more fundamental point is being illustrated here.

I’d done the right thing. Acted in an organised and intelligent way. And then behaved with ludicrous stupidity, turning a state of affairs that displayed commendable effectiveness (if I say so myself) into a textbook case of lamentable inefficiency (to which I have to confess).

Or putting it another way, I was mistaken to think I’d been mistaken, which was a pretty exasperating mistake.

Wednesday 27 January 2016

The bulldog spirit: is it a match for a disrupted train?

The British are at their best in adversity, we are constantly assured.

Or, at least, we assure ourselves.

That, we all reckon, was the Dunkirk spirit. When things are as bad as they can be, the dogged British character comes to the surface and sees us through: little boats depart from the Channel ports and bring the troops back from under the mouths of the German guns. Powerful stuff. Even though, as Churchill pointed out, “wars are not won by evacuations.” However well executed.

The doggedness was at its most truly admirable during the Blitz. London and other cities weathered the bombs. The population refused to be panicked or even cowed.

On a much smaller scale, within my own lifetime, Londoners just kept living their lives right through the IRA campaign of the 1980s. Incidentally, the memories of that time always leave me smiling when I hear Americans denouncing terrorism as the most heinous of crimes – the IRA was kept going with funds from the US, and there was plenty of self-righteous resistance from across the Atlantic whenever the British authorities tried to extradite a known terrorist.

Funny how being attacked yourself changes your viewpoint – it somehow relativises everything, even in a country that likes to despise moral relativism.

On a far smaller scale still, I had the opportunity to watch the British soul in adversity the other night when my train home was delayed two hours, on a forty-minute journey. The cause was a suicide on the line ahead.

First of all, it was curious to see how our attitudes – my own included – altered towards the suicide. At first, I felt bad about his death. What drove him to such despair? What a lamentable fate.

That was good for half an hour. The compassion started to wear thin after that, so by the time we reached the hour mark, nerves were being rubbed thin. None of us said it in so many words, but from our comments, more and more of us were beginning to harbour feelings along the lines of “inconsiderate bastard. Why didn’t he choose some other method? Or at least, top himself outside the rush hour?”

The ice had, by then, been broken between us. The reserve that keeps British train travellers firmly locked in their own concerns, focused on their phone or their tablet, had dissolved, and the conversation had become general. Ah, yes, I thought to myself, now we shall see that grand old thing, the British sense of humour, or at least British stoicism, sustaining us in our hour of need.

What a shambles, someone remarked.

“They’re all complete incompetents,” replied another. 

“Look at their Twitter feed!” added a third, pointing at his phone, “it reckons there may be delays on lines out of St Pancras. Might be? What a shower. Why dont they do something about it instead of making fatuous comments?

Right. So that was the shape of things. Patience growing a little threadbare.

I wasn’t quite sure what anyone felt the executives of Thameslink trains should have done. Foreseen the suicide and warned us before we caught the train? Cancelled all the trains? I could imagine how well that would have gone down. Perhaps they should have parked the inconsolable guy on a siding somewhere, and maybe offered to shoot him themselves, in a decent and humane manner, somewhere no services would have been disrupted?

We were in the foremost carriage. One passenger started shouting through the door to the driver’s compartment, demanding information about what was happening.

“Other trains keep shooting past us. Why didn’t you tell us this was going to happen and let us get another train?”

The driver came out and looked at him, completely nonplussed.

“I told you whatever I could, as soon as I got told myself. How could I have known it was going to be this bad?”

“It’s hopeless,” replied the passenger, apparently building up quite a head of anger, “you’ve told us nothing useful. You’ve just left us sitting here without information.”

“You want me to tell you each time I’m at a red light?”

Red light at night. No passenger's delight
But not a lot anyone can do about it
A few minutes later, when we stopped again in the middle of nowhere, he cranked up the public address system again.

“Ladies and gentlemen,” he announced helpfully, “we are stopped at a red signal. I don’t know how long we’ll be here.”

The passenger who’d been complaining cursed under his breath.

Another train went whizzing by on the track next to ours, making that wonderful and inspiring sound we all associate with railway travel at its best.

“Look, look!” cried several passengers, “it’s happening again. Other trains keep going past. Practically empty.”

I’m not quite sure what they wanted the driver to do. Flag the other train down? Hitch our train to it? Or just decide to ignore the red signal?

Eventually we got to my station and I left the train. I paused to wish the remaining passengers good luck. There were a few wry smiles, but mostly just groans.

Alas. Not quite so phlegmatic, these particular Brits, as their reputation suggests. Not quite so undaunted in adversity. Hardy the spirit of the Blitz.

How have the mighty fallen.

Monday 25 January 2016

What has the EU ever done for us?

It was quite an experience, spending a weekend in Cracow – or perhaps I should write Krakow? And pronounce it so the second syllable rhymes with cough and not with bough? Or am I being too political correct?

Well, no, actually. I’m just enthusiastic about the visit and that just makes me a little shamefaced about using an old-fashioned spelling, and German pronunciation. Somehow, I feel that such a vibrant place deserves better from me.

Vibrant it certainly was. Even when the temperature dropped to -16 C, the night was alive with revellers wandering from restaurant to bar to club and back. Even the shops were open, apparently most of the night. The place just breathed vitality.

Krakow: as lively as it’s attractive. And it’s both
You can’t possibly build a serious view of a country from 48 hours spent in one of its cities. But, hey, politicians make ridiculously sweeping generalisations in that way, so why shouldn’t I? After all, out of 330 mass killings in the US last year, one was committed by a pair of lunatics claiming allegiance to ISIS, but that was more than enough for Donald Trump to call for the exclusion of all Muslims from the US, and be applauded for it.

So based on the experience of an entire weekend, I’m happy to proclaim that Poland is young, dynamic, thrusting and going places. Interestingly, 100% of our sample (an old friend – old in terms of time since we first met her, not actually old, I hasten to add – talking to my wfie but, hey, that’s a sample, isn’t it?) pointed to a feeling among Poles that the country is doing remarkably well, and this is due above all to membership of the European Union.

It’s well known, on the other hand, that others have gone off the European project. They resent the loss of national independence it implies, and don’t realise that this is the price they pay for the prosperity. Nothing new there, though. People quickly forget a benefit they’ve already secured, and focus only on what they gave up for it. In Britain we’re seeing the same phenomenon. The Guardian today, for instance, reports on an analysis produced by one Michael Burrage for the British anti-EU campaign. He reckons the country grew much more quickly from trade with the old Common Market than it has from trade with the single market that replaced it.

But isn’t that the way of things? The quickest benefits come in the early days. And the wealth that came from that initial growth has never been lost. We gain less now, but we’re still gaining. As Britain Stronger in Europe replied, for the other side of the debate, membership of the EU was worth about £133bn in 2014, which is no trivial sum. But easy to forget if you only focus on what the country has had to give up to obtain it.

It was fun being Krakow. It was encouraging to see what a lot of good EU membership can do. And that sent me home more than ever determined to resist the trend to take Britain out.

Friday 22 January 2016

The joys of a winter break. Even without the sun

Luton, where we live, boasts an airport.

In fact, many only know the town for that reason. “Oh, the airport, right?” they say.

Some who are better informed, think of it as the home of that enlightened organisation, the English Defence League. It stands for… well, you don’t need me to explain, do you? The word “League” is a bit of a giveaway, isn’t it? To say nothing of “English” and “Defence.”

Another group think of it as “Stab City.” Trainee emergency doctors love our hospital, as there are few places that offer such an exciting variety of knife wounds. They even get quite a respectable number of gun shot victims – I mean, nothing like a US hospital, of course, but still quite substantial by more civilised standards.

The airport is one of those cheerful little ones. The kind you might expect to provide reasonably good regional services – human in scale, unhurried, uncrowded, generally comfortable. Sadly, it has given way to ambitions way beyond its natural limits and become a major international centre. You know the sort of thing: flights to places whose names contain far too many consonants to be real.

Why, it’s even changed its name to London Luton, because if you don’t mind a ten minute bus trip, a forty minute train ride, a twenty-minute tube journey, and probably another ten minutes in a cab at the other end, it’s really quite convenient for London. And the experience won’t set you back anything like the cost of your first night in then hotel.

Well, not a lot like it.

Because it has the aspiration to be a Sylvester Stallone despite having the body of a Woody Allen, it’s always struggling to make better use of its space. Which it means it spends an inordinate amount of time making lousy use of its space, as building workers close huge areas off to transform them into something much more efficient and comfortable. In other words, something delightful which we’ll all enjoy, at some far off day in the future. Like Conservative economic policy, for instance.

They’re doing it right now. I’d been impressed by the way the airport had hugely improved the security check area. After a false start when it took about 45 minutes to get through, they managed to reduce it to under fifteen, which I feel is a reasonable amount to ask for, as the price for not getting blown up at 30,000 feet. Now, sadly, the pursuit of progress has led to massive regression. There has to be a PhD thesis waiting to be written how often that happens, if there haven’t already been several.

The ruthless pursuit of efficiency means that you now wait about twice as long in the queue. When you get to the front of it, you use a huge tray into which to place your things, so big that the number of people who can be dealt with at a time is cut pretty much by half. If you’ve brought a laptop, you need two of them things, one of which looks empty with a MacBook Air in it.

You then shuffle along in a forlorn little line reminiscent of the newsreel film of refugees trying to get into Hungary. Eventually, you get through to the other side to wait in another queue to collect your gear from the oversize trays at a counter far too small for them.

Next one walks through acres of spacious rooms, wide and high-ceilinged and palatial, all screened off for the builders. Eventually, you reach the departures area where the handful of seats have been taken and you’re left standing in front of a board which, for ten minutes, announces cheerfully that the gate for your flight will be displayed in 1 minute.

Still, that’s the price you pay if you want a winter break. I’ve often felt their beneficial effects. A great way to recharge the batteries. Of course, most people use such a break to go in search of sun and warmth, but we have more original and unorthodox ways. I’m on my way to rejoin my wife in Cracow, Poland. I’m glad to say that the clouds have cleared from the view I’m enjoying through the window next to me. It’s been replaced by a delightful pattern of snow-logged fields interspersed with snowbound cities. I’m glad to say that the pilot has just announced that the temperature at our destination has risen significantly, and has now reached -four degrees of frost. Nighttime’s going to be fun.

Cracow. Or Krakow.
Not exactly Luton. Not exactly hot, either
Talking about announcements, I did enjoy the safety briefing from our cabin purser. She delivered it in sentences that alternated between English and Polish, but it took me a while to work that out: at first I didn’t realise that every other one was actually in English. Not that it mattered: I think I remember about pulling the mask over my face, fixing it with the elastic band and breathing normally; I also fully intend to deal with my own mask first before helping others with theirs, if the situation ever arises. There didn’t seem to be much talk about lifejackets but, hey, unless we land in the Oder or the Vistula, I don’t see how there’d be much call for one.

Not that I want to be ungracious. I’m happy to admit that she was, at least, making the attempt to speak my language. I certainly couldn’t have replied in hers.

Anyway, I’m on my way to Cracow. Should be fun. A break. A new experience.

I suspect I’m unlikely to regret having forgotten to bring the sun cream. The scarf I left at home, on the other hand? I might need a new one.

Thursday 21 January 2016

Oh, the bikes, the bikes... and the bikers

Our little bit of middle England, South Bedfordshire, is facing a new scourge.

I should relativise that complaint. Like most inhabitants of the wealthy countries, we enjoy levels of comfort and protection far beyond anything we deserve. For us, soldiers are more likely to mean a parade than a terrifying threat of rape, murder and mayhem. The weather turning cold doesn’t mean freezing in a refugee camp or among the rubble of a destroyed city. The sea is a summer pleasure, rather than a menace of terrible suffering and potential death while crossing it in winter.

No, what I’m talking about is a fairly small fly in a relatively large pot of ointment. Even so, we’d like the fly removed. And it’s galling that our government’s commitment to austerity means reducing the amount of ointment and failing lamentably to remove the fly.

The scourge involves young men, some of them little more than boys, performing thrill-rich stunts on well-powered motorbikes, along our narrow streets or in our public parks. The drivers tend to be wearing balaclavas to hide their identities, but no helmets, and the bikes are often unregistered: they have no plates. I can’t confirm that they’re uninsured, but it seems likely, and they may well be stolen.

Nuisance bikers, making the parks – and the streets – a lot less safe
The drivers push their antics to rather beyond their level of skill, often losing control. As well as parks, they like to buzz around schools as the kids come out, for the sheer joy of spreading panic among parents, children and teachers. So far, they’ve neither killed nor injured anyone, though they have killed a cat and one of the riders has managed to injure himself, breaking an arm in a crash. There is, however, a generalised feeling that it could be only a matter of time before they cause serious injury somewhere, especially as the pastime is spreading: all the urban centres of the region, and now increasingly the countryside too.

So we attended a Community Meeting in Luton, where we live, earlier this week. It allowed the audience to express concerns to two police representatives – one a superintendent, so relatively senior – as well as two local councillors and a journalist from a local radio station.

It was a curious experience.

The most striking aspect of the meeting was that the more articulate complainants found it necessary to speak at inordinate length about their grievances, and to do so repeatedly. They were, unsurprisingly, mostly men though one or two women also felt the need to share their thoughts in uncomfortable detail.

Most of these interventions added nothing to the discussion. No one was disagreeing with them. What was going on wasn’t communication, it was venting.

The specific issue that vexed speakers most was that the police do not give chase to unhelmeted motorcyclists when they see them. The superintendent explained several times that pursuing such riders is likely to make a dangerous situation still worse: they will escape by driving faster still, making it more likely that they will lose control of their bikes and cause a serious accident.

It’s also possible that a bike rider pushed to drive too fast, without a helmet, might cause himself serious or even fatal injury. That was when the mood of the meeting turned a little ugly: there was a substantial portion of the audience, though perhaps not a majority, that felt this would be a perfectly satisfactory outcome. “They would have brought it on themselves,” seemed to be the line.

I feel that we should perhaps stop short of making vandalistic bike riding a capital offence. Responding with police behaviour liable to cause death is a tad over the top. I was glad that the police seemed to share that view.

It would make much more sense to catch these lads and take their bikes. That’s the police aim. The problem is that achieving it means being there when they venture out onto the roads, and in a place where space is too constricted, and there are too few exits, for them to get away.

And that’s the central dilemma. Catching these characters would require significant numbers of police, backed by the right equipment: cars, bikes, surveillance systems, and more.

The police superintendent was quick to point out that he had no intention of talking about “resources” – code for the impact of Conservative austerity policies on services, including the police. Even so, throughout the meeting, he had to point out repeatedly that they would invest all they could to deal with the problem, though there were many other calls on their time too.

In other words, they don’t have the resources to deal with the issue. But they’re going to try with what they have.

This bike riding is just the kind of law and order problem the Tories love to denounce as unacceptable. So it’s interesting that it’s made all the more difficult to solve by the Tory government's own austerity policies. Something for which it’s time David Cameron’s government was called to account.

In the meantime, I wish the police well in their endeavours. We’re not, as I say, facing the same hardships as Syrian refugees at risk of drowning in freezing Mediterranean waters. But we are up against an irritation that could turn lethal. I’d like to think that a wealthy nation could afford to resource the police sufficiently to deal with the problem before it turns nastier.

Perhaps we could, if we spent less on prestige projects like nuclear missiles, or pointless ones like ineffective airstrikes in Syria…

Tuesday 19 January 2016

Central heating dialogue

Our central heating system isn’t as young as it was, and is turning a little cranky.

It’s equipped with a sophisticated regulatory system, with sensors as well as a timer, so it can work out what the temperature is and compare it with what we reckon it ought to be for the time of day, and the day of the week. Sadly, it often seems to go through that highly intelligent process and then decide, “screw that for a game of soldiers, I feel like heating right now,” or, alternatively, “you think I should be pumping out heat? Hey, give me a break – it’s cold out there – imagine what you’re demanding of me.” So we have to open the windows in summer just to let the central heating out, and freeze in winter when it obstinately pretends that it’s time for the heating to idle a while.

This morning I woke up at a stupid time. I was downstairs making coffee at 4:30, and shivering in the frosty temperature. However, at first I hesitated to turn up the heating – it seemed somehow inappropriate, as though it was discourteous to demand that the heating get going so much earlier than its usual time of 6:00. Just because I couldn’t sleep, did I have a right to interrupting an ageing heating system’s much-needed rest?

Eventually, though, I decided I could stand it no longer. I whipped over to the thermostat and moved the setting up from 14 to 21. I did it as quickly as possible, so I could get away before the system objected. 

And I was clearly right to expect resentment from it. Because nothing happened. I was standing right by the boiler, and it remained quiet. No pleasant roaring sound indicating that it was getting to work to warm me up. It clearly had absolutely no intention of reacting to my unreasonable demands. Eventually, I became so concerned that I decided there must be something the matter.

“It’s got to be set to hot water only. It Wouldn’t take this long otherwise.”

So I opened the flap that gives access to the dial. It was firmly set to both hot water and central heating. There was no excuse for its lack of action.

You're on, aren't you?
So come on
And I’d barely had time to think that before the heating started up.

It was clearly feeling sullen. It had imagined it could get away with not coming on, that I might not notice. But now, caught out, it was saying, “OK, OK, I’m getting to work. But, hey, what the heck are you doing up at this time of day? You expect me to start at 6:00, which is quite bad enough, and now you want heating at 4:30 too? What is the matter with you?”

I slunk away into the bathroom and ran myself a bath. Now, I like my baths hot. I’d barely finished the first two articles in my Guardian before I decided the water was getting too cool. I turned the hot tap on.

Stone cold water flowed out of it. That was OK: it can take a short while before it starts to come through hot. But time went on and on, and all the tap produced was barely liquid ice. Eventually, I turned it off.

A little sheepishly. Because in the background, I could hear the boiler roaring away merrily. It was seemingly telling me, “you asked for heat. I’m giving you heat – you can hear me, can’t you? Now you want hot water as well. Have you no compassion, no empathy? You can bloody well wait. At least, you know you’ll be getting out of the bath into a pleasantly heated bathroom.”

I didn’t say anything in reply. It seemed more judicious just to accept the system’s view, rather than insist on mine. It wasn’t that tough a hardship.

Besides – arguing with my own central heating system? It and I know it might make sense. Anyone else, however, might think I was going round the bend.

Saturday 16 January 2016

Two nations from the axis of evil: contrasting treatment and outcome

It’s interesting to reflect that George Dubya Bush, who has to be in the running for dumbest US president ever – a position only likely to be challenged if Donald Trump is elected – lumped Iran and Iraq together, with North Korea, in what he saw as the “axis of evil.”

Two of those three nations have been the target of intense action by the US.

It was Dubya himself who turned his guns – literally – against Iraq, with the invasion of 2003. Thirteen years on, the nation is a shattered patchwork of regions in conflict with one another. At the centre is a weak government dominated by none other than Iran. To the north, the Kurds form an autonomous region which is independent in all but name. Both the Baghdad government and the Kurds are in a state of continuous war with what has to be the world’s most brutal terrorist group, ISIS, an organisation that grew strongly in the power vacuum Bush’s war created.

There is no reliable estimate of the deaths caused by the war. Those available range from over 100,000 to over a million.

Iran, on the other hand, never enjoyed the privilege of invasion by a US-led coalition. It continued in its evil ways, but as it toyed with developing nuclear weapons, it came in for some tough and highly effective economic sanctions. At the same time, the US and other nations engaged in intense bouts of diplomatic activity with succeeding Iranian governments.

As I write these words, the International Atomic Energy Authority seems poised to publish a report officially recognising that Iran has abandoned its military nuclear programme. As a result, a prisoner exchange is to take place between the US and Iran – a small, symbolic gesture, but symbols matter, especially as there’s bitter opposition to the deal from the backwoodsmen in the States (aka as the Republican Party). A symbolic release will be a significant success for Obama, though his opponents, and in particular Donald Trump, won’t give him credit.

US Secretary of State John Kerry and
Mohammad Zarif, Iranian Foreign Minister
Most significant of all, the deal would allow Iran back into the world economy.

Iran and Iraq may have been lumped together at one stage. But their histories in recent years have diverged starkly. Above all, that’s been due to the different policies adopted towards them by the West.

The problems in South Africa and Iran were approached through a mix of sanctions and diplomacy. In Iraq, Lybia and Afghanistan, on the other hand, the West took military action.

Compare. Contrast. Learn a lesson.

And, friends in America, for heaven’s sake – for all our sakes – keep Trump out of the White House.

Thursday 14 January 2016

It may be Armageddon, but at least it won't be the Tories’ fault

“The worry for the UK,” David Blanchflower told the Guardian, “is that the government failed to fix the roof when the sun was shining over the last five years or so.”

That’s curious. George Osborne constantly assures us that, as Chancellor of the Exchequer, this has been a key priority. He repeated it in June last year: “We must act now to fix the roof while the sun is shining.” Its the kind of homely and simplistic phrase he likes: he used to talk about the (previous, Labour) government having “maxed out the national credit card” until it became clear that his bunch was going to preside over a far higher level of debt still (presumably they got the card limit extended.) Today the debt’s double what it was under Labour, making Osborne Britain’s first trillion pound Chancellor.

So who’s right? Blanchflower’s a former member of the Bank of England Monetary Policy Committee and now a professor of economics at the Ivy League Dartmouth College in the United States. More to the point, he’s one of only a handful of economists who correctly forecast the crash of 2008.

George Osborne, on the other hand, has distinguished himself in his tenure as the British minister of finance by a string of notable achievements that I list, in full, at the end of this post. They have put the economy, he tells us, in a strong position to face the future, for which it appears he deserves great credit. It’s true that he also points out that the economy faces terrible threats and risks for which, on the other hand, he is not even minimally responsible.


Heading for another crash? And will it be Labour's fault again?
Just how bad the threats are it’s hard to tell. The Royal Bank of Scotland has been telling people to sell, sell, sell, as disaster beckons. Albert Edwards of Société Générale, who seems to have become doommonger-in-chief to the banking sector, has proclaimed that Armageddon, in financial terms, is just around the corner. Many other commentators, David Blanchflower among them, are more muted in their predictions: tough times but nothing to panic about yet.

Blanchflower may be right, or he may be wrong. It’s always difficult to know what the future holds. Still, it seems likely that we’re in for torrid conditions. Last time, in 2008 and 2009. Gordon Brown was in office and the Tories have never stopped insisting that the fault for the crash – which was global, just like today’s difficulties – was all down to the Labour government he led.

In all the fog of uncertainty now, at least one thing’s completely guaranteed: however bad things turn out, George Osborne and his Tories colleagues will bear none of the blame.

In fact, they’ll probably still try to pin it on Labour. Who lost power – to them – six years ago.

Monday 11 January 2016

Anniversaries and coincidences

Every year, I’m taken by surprise by the fact that my wedding anniversary coincides with my wife’s.

Don’t worry. I’m perfectly prepared to admit that it isn’t really a coincidence and that I shouldn’t be surprised by it. The feeling is no doubt caused by the fact that it’s the only anniversary of its kind: others are individual, such as birthdays, or public, such as Christmas or, when we’re being French, the 14th of July. It’s therefore a little different when two of us celebrate the same day.

Today, as it happens.

What makes it even stranger, however, is that there’s a real coincidence today. Our granddaughter’s birthday falls on the same day. 

That wasn’t something we planned. In fact, our wedding involved pretty minimal planning of any kind: it was the only day our local registry office could fit us in and still allow us to be sure that it would occur before the likely birth of our first son. And that was important because, had he been born before we were married, he would have had French nationality alone and not British as well. As French law then stood, that would have left him liable to call up at eighteen for several months of completely worthless square-bashing and route marches, as a national serviceman in the French army. .

By the time he actually reached eighteen, French law had changed and he only had to do a single day’s service. I won’t repeat the story here of how it took him several attempts to do that day, because I’ve told it before, but he eventually completed it without much difficulty. That meant we didn’t have to be in such a tearing hurry back in 1983, but hey, there was little point in hanging around and I wasn’t sorry to make sure he’d be at least as much a Limey as a Frog anyway. In any case, we had no idea then we didn’t need to help him avoid the horror of national service (we didn’t know we were going to have a boy, because we preferred to be surprised than to cheat with an ultrasound, but it was always a possibility).
A little coincidence. On top of the large one.
On top of what isn’t a coincidence at all
The other coincidence, this particular year, is that the eleventh day of January happens to be our granddaughter’s eleventh birthday. That’s not something that will ever happen to her again. Come to think of it, it’s our thirty-third wedding anniversary, three times eleven, but I may be straining a bit to establish that as a coincidence particularly worthy of note.

Still, the anniversary and the birthday are worth marking anyway.

So to my granddaughter, happy birthday. To my wife, happy anniversary. And happy anniversary to me too. 

Uncoincidentally.

Saturday 9 January 2016

Betrayal, obscurity, radicalism, disaster: the various models of British government facing Britain today

It’s a hallmark of the political left that its failures often take the form of betrayals.

That’s not surprising. After all, the left is there to speak for the little man against the master class. But, however much we may resent his power, we all tend to admire the master – perhaps Freud would prefer the word father – so we often end up seeking his approbation at least as earnestly as we oppose his authority.

That was Tony Blair through and through. He wanted to oppose the British Conservative Party, but wanted to win their grudging admiration as he beat them. He needed to show, for instance, that he was capable of being at least as patriotic, at least as warlike in his patriotism, as they were. So he’s left a legacy which, despite its many and striking achievements – on child poverty, on healthcare, on human rights – will forever be overshadowed by his catastrophic war in Iraq. A war he waged with overwhelming support from the Conservatives, and against widespread opposition in his own party and across the nation.

That betrayal was only the second worst in Labour history, however. The greatest was carried out by the first Labour Prime Minister, Ramsay MacDonald. A fine radical figure and even a pacifist, he began to show that fatal desire to be approved by the establishment when he agreed to wear pompous (and expensive) court dress in order to be presented to the King. A trivial matter, but an important symbol: he showed his willingness to bow down, for all his radicalism, to the master and his (allegedly) quaint customs.

Ramsay MacDonald, the first Labour Prime Minister
But the smiles would later turn to tears
The truly substantial betrayal came in 1931. 

Facing a crisis as we did in 2009, he decided, as the present Conservative government has, to tackle it through austerity. That meant cutting spending, including unemployment benefit at a time when unemployment was rocketing; that wasn’t a policy Labour could back, so he formed a so-called National government in coalition with the Tories. Only he and two others of his Ministers joined the new government, however, and it was dominated by the Tories. The 1931 general election saw the Labour Party reduced to just fifty seats in parliament.

With the right, in Britain at least, things tend to be different. You get three kinds of Tory government: the ones which do nothing much at all, just widespread meanness without vision; the ones that leave a deplorable mark in history; and the third kind which are even meaner than the first, but with spectacular success.

Maggie Thatcher is the iconic figure for that last kind of Tory. If you were gay, if you were a miner, if you were poor, if you were a trades unionist, you could expect nothing but the cruellest treatment from her. Why, even if you were Nelson Mandela, you only received contempt. But she did it all with style, with ruthless determination, and she achieved a great many of her objectives. 

Far too many.

The first kind of Conservative is represented by figures who have drifted into well-deserved obscurity. Stanley Baldwin, for instance, who joined the so-called National Government under MacDonald, and emerged as the openly Conservative Prime Minister in 1935. No one remembers much about him, but his time in office was marked by such events as the Jarrow hunger march. It protested against a state in which cities in the North of England had unemployment rates of 70%. Britain was the hub of a great Empire, but had citizens dying of starvation.

Baldwin was followed by the man who is the prime example of the disastrous Tory, Neville Chamberlain. He signed the agreement with Hitler which he claimed would guarantee “peace in our time.” World War 2 broke out a year later. When he presented the agreement to parliament and Arthur Greenwood, deputising for the absent Labour leader Clement Attlee, rose to reply in a House of Commons silent with shame at the government’s cravenness, Leo Amery cried out from the Conservative benches, “speak for England, Arthur.” Such was the depth of the humiliation that even Tory supporters of a Tory government had to call on Labour to reassert some pride.

Why is any of this interesting today?

We have a radical leading the Labour Party. But many among his parliamentary colleagues are mired in the belief that we still need to win the approval of their masters. So who will win? Will he stand firm against the failures of the Tory representatives of that master class and continue to reject what they stand for? Or will he be brought down and replaced by another Ramsay MacDonald?

On the other side, the question is more about what type of Tory government we’re looking at. It certainly won’t be the Thatcher kind. After five years in a coalition administration, and nearly a year on their own, there’s no sign of any great radical act to mark its tenure. Today these Tories look like Baldwins: nasty, but without either courage or conviction. They have, on the other hand, put themselves in a position where they have to hold a referendum on British membership of the European Union, probably later this year. That could well lead to the disastrous outcome of Britain leaving.

In the Middle East, they’re to be pursuing the same Blair approach of reliance on military muscle – and we know where that got us in Iraq.

Baldwins, so far, then. But it looks as though they may be setting out on a different course. Could they be about to turn into Chamberlains after all?

Wednesday 6 January 2016

War, peace and halcyon days

1975. What a year. The longest, hottest summer I remember in England. I was between two phases of my existence and living at my grandparents’ house – rather overstaying my welcome, I’m ashamed to admit – but finding the time extraordinarily comforting and restful.

The BBC was running an adaptation of War and Peace on television and, in a time before DVDs or catchup, you just had to tune in each week if you wanted to know what was happening. I couldn’t wait in suspense a whole week at a time, so I borrowed my grandmother’s copy of the novel, an Everyman edition in battered red cloth covers which I’ve since inherited. I lay in the back garden surrounded by the vivid green of a lawn I did everything I could to avoid mowing, soaking in the sun while immersed in an extraordinary novel.

Last weekend, the BBC started a new serialisation. I had to watch it, if only out of nostalgia for that time four decades ago. But it left me less than fully satisfied. So I got hold of the Audible version and started listening to it, on the way to and from work, and during my lunch hour, on my phone.

On Audible, the book lasts some 61 hours. The BBC series covers six one-hour episodes. To say that it fails to do the novel justice would be to fall far short of the truth of the travesty if makes of the Tolstoy. It just hasn’t given itself the space to do otherwise. The worst aspect of it? The book presents us with a panoply of characters which is bewildering enough even when they appear to us over a number of chapters. In the telescoped timescale of the series, they’re just dumped on us in a great rush of confusion. It put me in mind of the rather cruel words of the Mossad spy genius Kurtz, in John le Carré’s The Little Drummer Girl. Talking about how two young women could switch identities in an airport, he explains:

“… they go to the ladies’ room, they switch tickets … they switch passports too. With girls, that’s no problem. Make up – wigs – … when you dig down, all pretty girls are the same.”

Without giving way to quite that degree of misogyny, I have to admit that the TV series did have something of that effect on me. The BBC provided a large number of pretty young women actors, but that just left me wondering who they all were. Was that one Julie Kuragin? Lise Meinen? Hélène Kuragin? Or even, I’m ashamed to admit, the key figure Natasha Rostova herself? I had only a hazy idea. And, to be honest, that did make following a complex plot a trifle difficult.


The 2016 BBC version of War and Peace.
Lots of lovely people. But which one is which?
Still, who cares? It’s splendid spectacle. And it’s spurred me to re-read the book, and I really mean read as well as listen: so that I can keep on going at home, I’ve downloaded the Kindle version too, for the princely sum of £0.00. 

Besides, series has reminded me of an idyllic time in my youth. How much more can I reasonably demand of the BBC?

Monday 4 January 2016

Beheadings and beheadings, and how the West has no idea how to react to any of them.

Curious times we live in.

We’re rightly shocked and sickened by the appalling behaviour of ISIS. It has released yet another video of a gruesome beheading of people the group disapproves of. We’re particularly upset in Britain because the main figure has a British accent. It wasn’t that long ago that a drone took out a similar British-accented assassin, so-called Jihadi John. This was presented at the time as a major success for the Western cause, which was to be further reinforced by the Royal Air Force joining in US-led airstrikes against ISIS positions in Syria.

Well, a few weeks on, it seems that those airstrikes haven’t achieved much. Jihadi John’s heir is in place and, apparently, plying his bloody trade just as fiercely as his predecessor. Indeed, those airstrikes aren’t even finding much to do. Planes have had to come back with their weapons unfired for lack of targets. Instead, if they take any useful action, it’s in Iraq supporting the advance of the Iraqi army back into the city of Ramadi.


Iraqi troops retaking Ramadi from ISIS
with support from Western airstrikes that actually served a purpose
Oddly, the government has yet to admit that critics said all along that a campaign of airstrikes in Syria would be useless, until there were forces we could back against ISIS on the ground – as in Iraq. No doubt that’s an oversight by Cameron which he’ll correct as soon as he can, when he admits he got that call wrong.

He’ll no doubt be as keen to admit his error as Blair was to admit his own, and far greater one, of invading Iraq in the first place.

Meanwhile, Saudi Arabia has decided to do some of its own beheading. Like ISIS, it carries them out in public, to make the process as ghoulish as possible. On the other hand, it doesn’t film them or post the videos on-line for the edification of the West – indeed, it goes out of its way to hide what it’s up to, suggesting that it’s rightly ashamed. It also works at quite a scale: fully 47 killed in the latest outrage.

What’s worse is that one of those murdered – executed is far too anodyne a term – is a leading Shia cleric in this Sunni state. Now, he wasn’t a particularly savoury character, by Western standards. He favoured the establishment of a theocratic state, with religious leaders running the state, rather like Iran at its worst. But by killing him, Saudi Arabia made him a martyr. Specifically, a martyr for Iran with its 90% Shia population.

So there have been ugly protests in Tehran, including an invasion of the Saudi embassy. Now Bahrain, the United Arab Emirates and Sudan, models of democracy all, have joined the Saudis in severing or reducing their diplomatic ties with Iran. On the other side, Iraq, tipped into being another Shia-dominated nation under the tutelage of Iran, following Blair and Dubya’s ingenious invasion of 2003, has come out on the side of its mentor.

Few developments could be more worrying for the whole world, let alone the Middle East, than increasing tensions between the two regional superpowers, Saudi Arabia and Iran. And that’s what now’s happening, as a result of the barbaric behaviour of the former. Barbaric behaviour not unlike that of ISIS.

The West doesn’t confuse these two series of killings. So it will do no more than express token regret over the Saudi beheadings. Saudi, of course, has oil and huge financial influence in the West. ISIS has neither, at least for the moment. In addition, the West has a track record of entirely miscalculating the reality of tensions in the Middle East. One can’t help wondering whether distinguishing between the two types of assassination isn’t just a measure of its underlying confusion.

So here are the key questions: was it actually sensible to let governments with that level of incomprehension of the situation in the region, take further military action out there? Or might it have been more judicious to take a little longer to think about alternatives? And if none came to mind, perhaps hold back from ill-judged gestures unlikely to improve matters?

Sunday 3 January 2016

Americans and their words

The reason I find the occasional eccentricities of their English baffling is that Americans often make excellent use of the language. 

Here’s the opening of John Grisham’s The Litigators:

The law firm of Finley & Figg referred to itself as a “boutique firm.” This misnomer was inserted as often as possible into routine conversations, and it even appeared in print in some of the various schemes hatched by the partners to solicit business. When used properly, it implied that Finley & Figg was something above your average two-bit operation. Boutique, as in small, gifted and expert in one specialized area. Boutique, as in pretty cool and chic, right down to the Frenchness of the word itself. Boutique, as in thoroughly happy to be small, selective and prosperous.

Except for its size, it was none of these things.


Better written than one might expect
Why do I like this writing?

Firstly, I find it refreshing that Grisham breaks a couple of my own taboos. Repetition, for instance, as in using the word “firm” twice in quick succession. I go out of my way to avoid such repetition. He’s also relaxed about the passive (“was inserted”) which I try to avoid, on the grounds that active verbs are more dynamic. Or so I’ve been taught.

Secondly, the simplicity of the style is engaging. “Two-bit”, “pretty cool” – the language is everyday and familiar. The last three sentences don’t even have a main verb. And Grisham avoids pompous words. Indeed, the only moderately recherché word is “boutique”, but its Frenchness and slightly high-flown tone make his point. You might perhaps quibble about “misnomer”, not perhaps a common term, but it’s hard to imagine anything to replace it without a long and clumsy periphrase.

This understated style is an ideal I pursue. It feels like no style at all, letting the reader apparently straight through to the meaning underneath.

It’s only simple in appearance, however. Those last three sentences represent a classic trick of rhetoric, the rule of three ending in a cadence. Compare it with the Churchill speech:

Never in the field of human conflict
was so much
owed by so many
to so few.


It’s a powerful device of the best orators. And Grisham even closes by including a second set of three within the first: “small, selective and prosperous.”

Then he opens a paragraph with a short, punchy sentence that undermines everything he has said before. It all adds up to an effective hook to draw the reader into the rest of the book. Which, incidentally, I enjoyed.

If your taste is for something more elevated, you could do worse than turn to Carl Sandburg. He was a poet but also the author of a fine biography of Lincoln. He describes a young Civil War soldier discovering the body of another that had been left for a year sitting apparently at ease against a tree, and tells us:

He had interrupted a silence where the slants of silver moons and the music of varying rains kept company with the one against the tree who sat so speechless, though having so much to say.


The use of the word “slants” is a poet’s touch: it’s unclear that there’s such a thing as a “slant”, but perfectly clear what he means. In addition, the sentence has a single comma, dividing the long flow of description of the physical scene from the last few words – another cadence – that add a new dimension to the scene and make it representative of far more than itself.

Americans make use of the language as well as any English speaker. That’s why I find it difficult to understand the bizarre turns of phrase they sometimes adopt.

Why do they visit with, or meet with, people? You can hardly meet or visit anyone without them, can you? So what’s wrong with simply visiting or meeting them?

They can be clever about filling gaps in the language. British English has no expression corresponding to French “bon appétit.” The Americans have turned to “enjoy”, a generally transitive word used intransitively, to make up for this deplorable lack. I’ve adopted it with enthusiasm.

I wish they’d come up with some way of expressing the distinction between “connaître” and “savoir” in French, or “kennen” and “wissen” in German: it’s the difference between knowing a person and knowing a fact. The absence of a distinction in English allows us to play on words, as in “I know about him, but I don’t know him”, but the language is still poorer for not marking this real distinction.

Similarly, it’s an irritating gap in English that we have no single word for the opposite of “behind”. The French have “devant” to go with “derrière”, the Germans have “vor” as they have “hinter”. All we have is the laborious circumlocution “in front of.” With their creative approach to language, I’d have expected the Americans to come up with a bright translation for “vor” or “devant”. But they’ve done the opposite. They’ve used “in front of” as a template, to give us the equally ugly and unwieldy “in back of”, as an alternative to “behind.”

A disappointing lack of imagination, if I may be allowed the criticism.

Still, it’s nothing like as awful as the expression I came across the other day. I was informed that something had been “based off of” something else.

Now, with an expression that is essentially an image – “based” is being used metaphorically – there ought to be some link to the reality behind it (or in back of it?) If you’re off it, you’re certainly not using it as a base.

As for off of, whatever is the point of the second preposition? If something’s off its base, what more need be said? Surely it’s off your head to add that “of”? Or off of it.