Boris, Trump and tripping the lie fantastic

There was a time when voters valued honesty in politicians. Not that they expected ever to find any. There’s an old joke about a man lost in a wood and stumbling into a clearing, in which he sees a blind old woman, a pink elephant and an honest politician. So who does he ask to show him the way?

The answer is, of course, the blind old woman, as the other two are just figments of the imagination.

Boris and the great lie

But even if we didn’t expect honesty from them, we kept up a vaguely optimistic pursuit of the honest politician, or maintained the notion as some kind of ideal towards which we might aspire.

Not any more, it appears. In Donald Trump, we have a US president who, if we really push our generosity, may feel is not an actual liar, in the sense that he may not always be deliberately stating as a truth something he knows not to be true. It may rather be that he suffers from a pathological inability to tell the truth from anything he happens to want to believe. Or, worse still, happens to want his voters to believe.

He may simply be lying, but it may actually be that he thinks that his wanting to believe something is true, makes it true.

North Korea hasn’t actually disarmed at all? So what? The disarmament deal that Trump proclaimed after his first meeting with Kim Jong Il is the best disarmament deal there ever was.

All that nonsense about Trump putting pressure on Ukraine to dig up dirt on his opponent? All made up. The fact that a transcript of the call exists, and it confirms the allegation, is neither here nor there. It never happened.

Isn’t a great achievement that China is paying for the tariffs Trump has put on its exports to the US? The miserable line about tariffs being paid by the population of the importing country, not the exporting one, is just an inconvenient factoid. An unattractive notion, and therefore untrue.

But in Britain too we have our version of Trump. Like Trump in the US, Boris holds the highest elective office in Britain. Unlike Trump, I think he has sufficient knowledge and intellectual horsepower to know when a statement is actually false. So when he utters a falsehood, he is undoubtedly lying.

And he seems to lie as naturally, as casually, as automatically as he breathes.

Perhaps the most embarrassing instance came when he visited Whipps Cross hospital in North London. When the father of a child who had been admitted to the appallingly understaffed and overstretched emergency department accused him of only being there for a photo opportunity, Boris replied that there were no press present. That was despite the fact that, as the father pointed out, the press were clearly visible just a few steps away. 

Omar Salem points out the photographers at Whipps Cross
whose presence Boris had just denied

The father, Omar Salem, is a Labour activist. But that doesn’t alter the fact that he’s a father, his child was seriously ill, and the staff were hopelessly overstretched. It seems that Boris’s first instinct is to lie, even when it’s obvious that he’s going to be caught out almost immediately.

There were so many other instances. Another was the decision of the Daily Telegraph to apologise for an article Boris published in the paper, forecasting that a post-Brexit Britain would overtake Germany as an economy within a few decades. It seems his argument was based on an analysis he’d ready which simply didn’t bear it out.

Perhaps the most notorious deceit ever was the one Boris associated himself with during the Brexit referendum campaign, that leaving the EU would free £350 million a week to invest in the NHS (the National Health Service). It was particularly barefaced, because it deliberately overstated the contributions the UK made to the EU, ignored the subsidies it received back from it, and left out of account the additional costs associated with Brexit and the revenue loss it was likely to entail.

A far wilier campaigner than Theresa May, his immediate predecessor, far being put off by his terrible track record in this field, Boris has boldly taken the battle to his Labour opponents, precisely on the grounds of the NHS. That takes courage for a Conservative, because this is traditionally Labour’s strong ground. But Boris is promising to spend more on the health service, to employ more clinicians, even to build more hospitals.

In other words, Boris is promising to address the very scandals that the distraught father tackled him over at Whipps Cross.

And yet Conservative Central Office has instructed candidates to sign no pledges on the NHS (or indeed on climate policy). So Boris is making the promises but preparing the ground for reneging on them. As he did over Brexit, when he promised to deliver it by 31 October, “do or die” – he didn’t do, but he didn’t die either.

What’s most surprising about this trail of blatant lies and broken promises is, in an election as wide open as any I’ve seen, with four major parties contesting nationally, as well as the SNP massively powerful in Scotland, Boris continues to lead the polls. At nearly 40%, his standing is weak, but way ahead of anyone else’s.

Above all, what that 40% means is that, for two voters out of five, honesty in a politician is simply not an important consideration. They see it as perfectly legitimate to vote for him anyway.

Sadly, 40% is enough to win in a wide-open field.

You can fool some of the people all of the time, or all of the people some of the time, but in Britain, you only need to fool 40% on election day to get to do what you want for the next five years.

Hospitals: the burning question

There was a time – back in the early 1990s – when I used to make frequent visits to Arrowe Park Hospital in the Wirral. 

That’s the peninsula opposite Liverpool.

Arrowe Park Hospital
Scene of many a visit of mine back in the early 1990s

The company I worked for back then had supplied the hospital with a remarkable system to support healthcare staff. To this day, it remains the most powerful Hospital Information Support System or HISS, as we called them then, that I’ve ever come across. Healthcare staff could quickly, reliably and accurately, enter requests for tests or treatments, record test results or the delivery of treatment, or simply consult a patient’s record. It was a great system, and I would take pride showing groups around the hospital to see it in use. Many of the groups came from abroad.

Often, the then Chief Executive, Frank Burns, would meet the group and give a brief, and usually witty, talk. In one remark has always stuck with me, he told a group:

“The problem that keeps me awake at night isn’t a patient falling off an operating table. It isn’t a patient receiving the wrong blood in a transfusion. It’s car parking.”

It’s not hard to see why. There’s only so much car parking space. So who gets priority? Staff without whom no patient would be treated? Patients without whom there’d be no point having the staff? Visitors to patients without whom they’d recover so much more slowly?

And, at a time when hospital budgets are under terrible pressure, do you charge or do you not? And if you do, how much do you charge?

That last point reminds me of another hospital that I’ve visited quite a few times, the Royal Free in Hampstead, north London. I’ve mostly been there for work, but also for personal reasons: it’s where my grandmother died, for instance.

On one work visit, I was shocked by the charge being made for the car park. I couldn’t resist mentioning it to one of the people I saw in the hospital. I didn’t mention it until after we’d dealt with the business, of course; it seemed imprudent to raise the matter until I’d got to know him well enough to be sure he wouldn’t take it badly. Which, as it happens, he didn’t.

“Ah,” he said, “the costs are exactly the same as on Hampstead High Street.”

The High Street is only a few minutes’ walk away.

“The used to be much cheaper,” he went on, “but people kept parking here and then heading up to the High Street to do their shopping. We had to introduce the charge to stop them doing that.”

It’s not that simple a question, you see, hospital car parking charges. There needs to be some way to make sure that limited parking spaces aren’t being abused for purposes other than visiting the hospital or going in to work.

Obviously, a system could be put in place to allow people to pay less, or nothing at all, if they’re patients or visitors to patients. But that costs money and takes staff time. And neither of those are in abundant supply in the British NHS today.

All that becomes particularly relevant today because hospital parking charges are the latest scandal to hit the news. And it seems dead easy: there should be no charge in England as is already the case in Wales and in most of Scotland.

But, as the Royal Free proves, that’s not that simple. After all, we really don’t want to offer Hampstead shoppers an inexpensive parking opportunity so they can do their shopping more cheaply. After all, with some of the most expensive properties in London, Hampstead isn’t a district for the poor or underprivileged.

The Royal Free Hospital
Too close to Hampstead High Street to provide free parking

No wonder Frank Burns was kept awake by hospital car parking. Rather than any of the other issues you’d expect to be troubling a busy Chief Executive.

Just a step, from innovation to obsolescence

My first attempt to get a degree, in the early 1970s, wasn’t an edifying picture of progress through study. But it wasn’t entirely without educational value. It’s just it wasn’t the value that had been planned for the course I was supposed to be following, but wasn’t, as I invested my efforts elsewhere.

The institution kind enough to tolerate my presence for a few years back then was King’s College, London. One of the best ventures I engaged in while there was the publication for a little while of a satirical journal. It gave a slightly radical, highly irreverent and self-consciously humorous take on events in the college.

It was called ‘Something’. As in ‘something is stirring in King’s’. Ingenious, right? Well, amusing to students, at least.

Our best headline ever referred to one of my fellow students as a ‘debutante whore’. She took it well, as it happened – I think there was a certain cachet in appearing in the paper for as long as it lasted – but I certainly would not use such a term for any woman today. To be honest, I wouldn’t have used it then either: it was a typo. I’d been typing the beginning of a sentence, ‘the debutante whose…’, and hit an ‘r’ instead of an ‘s’.

Something’s best writer was a student with a splendidy biting pen. I wish I could remember his name. When he saw what I’d written, he exclaimed, ‘Oh, that’s good! Excellent’. I hadn’t the heart to admit that I’d simply made an error – praise from him was invaluable – so I let it stand.

A typo. An error while typing. For these were the days when we still typed text. On actual typewriters. And the typewriters we used weren’t even the fancy IBM ones with a golfball onto which the letters had been cast, where a mere touch of a key on the electric keyboard drove the letter powerfully onto the page. No, these were the old ones, where the power with which you hit the key determined the firmness of the impression on the paper.

And hitting them hard mattered. Because we weren’t typing onto paper but onto what we called ‘skins’ though the proper term was ‘stencils’. You had to keep the typewriter ribbon – which carried the ink – out of the way so that the keys, unpadded, hit the skin directly and cut the shape of the letter into it. What you ended up with was a foolscap stencil – a bit bigger than A4 which hadn’t yet been introduced in England – with letter-shaped holes cut into it. We’d then load it onto a machine which drove ink through it onto a page. Or rather, several hundred pages.

In other words, it was a duplicator, a quick and cheap way of producing a large number of copies of a single document, before photocopiers were available.

A Gestetner machine with skin in place and ready to duplicate

It was a cheap process but not free. Though it was free to us, only because we impudently helped ourselves to the college’s stencils, ink and paper, and with no authority whatever used their duplicators – one each, from the two great companies that produced them, Roneo and Gestetner. I later discovered that the college principal, Sir John Hackett, scholar and soldier, found Something quite amusing and had told the authorities not to stop us abusing their generosity, as long as we stayed within reasonable limits.

What’s the point of this story?

Well, within a few years, photocopiers appeared in every office and, indeed, college and the idea of typing onto skins and running sheets of paper through a duplicator went completely out of fashion. Roneo was bought by Vickers Engineering and then Alcatel in France; Gestetner was taken over by Ricoh from Japan. Duplicators are now museum pieces.

A few years later, having a little mended my ways and actually got a degree (in a different subject and at a different college), I found myself working in the field which is still mine 35 years later: information services for healthcare. And quite soon I was putting up a business case to my superiors to buy a fax machine. More and more NHS organisations were using them and, rather than wait for us to get documents to them by post, they regularly asked us to fax them through.

It was a battle, but the pressure was growing, measured above all by people using commercial fax services and charging the company for them. Before long we had our first fax machine. It was exciting: we were at the cutting edge of technology, a bit like when I first learned to use a duplicator.

And why do I tell that story? Because earlier this week I saw a newspaper article – that is, an article I read on line but on a newpaper’s website, though it wasn’t actually printed on news-paper – announcing that the NHS was phasing out its fax machines. I saw the technology introduced, now I’m watching it go again.

Some years after the campaign for faxes, I was working for another company which was resisting the generalised use of laptop computers. The cost of equipping all the staff was just too high. But, grudgingly and with bad grace,  eventually the pressure was too high and we were all issued with laptops. The same sort of story as with the fax machines a decade earlier.

Today, turn up in a new job and the first thing that happens is that you’re issued with a laptop computer. A phone as well, as it happens – but I don’t have the space here to go into that innovation too.

There was a time, in the middle ages, when children could learn their trade from their parents. Tools had changed so little between generations that the skills were still good. Technology outlived its users. Not today. Within my own career, I've seen a technology appear, be superseded, and vanish again.

Will the same happen to my laptop? Am I already witnessing its decline into the mists of history that have swallowed the Roneo and Gestetner duplicator, and the NHS fax machine? Who knows?

Exciting times. If Something still existed, I could have written a story on the subject.

The NHS at 70. And my mother at nearly 94.

The NHS celebrated its 70th birthday last week. And my mother is due to celebrate her 94th this coming week.

The two aren’t unrelated.

My mother is part of a diminishing band of people born before Britain had its National Health Service. Indeed, she played a peripheral role in its creation. She reached adulthood during the Second World War, and decided to throw her lot in with the Labour Party which, at the time, had never formed a government with a parliamentary majority.

It must have been a challenging time to be with Labour. Under the leadership of its first Prime Minister, Ramsay MacDonald, the party had entered a coalition government with the Conservatives. That action was widely perceived as a betrayal. The punishment had been dramatic, rather as with the Liberal Democrats when they betrayed their voters in the same way nearly 80 years later: Labour had been reduced to a rump in parliament.

By the time my mother became involved, it had increased its number of MPs substantially, but still had only a third the force the Conservatives could muster. And it was back in coalition again. This time, however, that step was widely seen as a proof of statesmanship, since the country was at war. Indeed, the Labour leader Clement Attlee had played a significant role in making sure that the Conservatives would have to select Churchill, and not one of the appeasers of Hitler, to lead any government he would join.

My mother, as I mentioned recently, took a job as secretary to a Labour MP and the reformist Fabian Society. That too was was a challenge: in those pre-#MeToo days, young women were simply warned to be careful with some of their bosses, who were of course almost exclusively men. 

‘Careful, that one has wandering hands,’ they’d be told.

The onus would be on the women to avoid the hands, rather than on the men to withdraw them. It will probably come as no surprise that some of those who couldn’t control their urges had control of significant departments of state.

In her work, my mother wasn’t at the centre of power, but she was on the edges of that centre. She saw how Labour worked with the Conservatives towards victory in the war. And then she was actively involved in the campaign for victory in the peace. At the 1945 election Attlee’s Labour finally won a parliamentary majority, in a landslide victory over Churchill’s Conservatives.

It was that government which launched the NHS in 1948.

Health Minister Aneurin Bevan visiting a patient in Trafford, Manchester
on the first day of the NHS, 5 July 1948

Unfortunately, that’s not the only link between my mother and the health service. She has been occupying a bed in one of the great teaching hospitals of the NHS for two weeks now with no sign of her being discharged. She is unresponsive, spends most of her time asleep and, even when she does open her eyes, seems not to recognise any of us, relatives or friends, who come to visit her.

It was only three weeks ago that I had lunch with her for the last time, in her favourite Oxford restaurant. We both knew she was getting weaker, that she was spending an increasing proportion of her time asleep, that she was losing some of the acuteness of her conversation. But a real exchange was still possible: she and I talked about her favourite subject, history, and also about politics and the fact that Labour is again in a difficult state today.

Yet it was only days later that she started the precipitous decline that led to her present condition. Will she recover? Who knows. At the moment there’s little sign of it. My wife and I took our youngest son and his fiancée over to see her two weeks ago, and then she was alert enough to recognise us all and to wish the engaged couple well with their wedding, even though she was already having trouble finishing some of her sentences. I saw her again with my brother a few days later, and sentences seemed beyond her reach, though at least there was still recognition.

Today, that too has gone. I can’t help feeling that I’ve said goodbye to her already, in those earlier visits. Physically, she survives and continues to eat and drink a little, but my mother, the sharp, sometimes exasperating, but always intellectually bright woman I’ve known for 65 years, is already gone. Or at least away, with no certainty she’ll come back.

So I’m not sure whether she’ll see her 94th birthday. She may survive until it happens, but is it really a birthday if one isn’t conscious of it? All that kind of thing, I fear, is behind us.

The story is not without its more comforting side. She is in no pain. She is being looked after by a group of people, both physicians and nurses, who strike me as highly committed and professional but, above all, humane and focused on helping people. My mother has been in pain for many years; I’m glad to say that she seems now to be out of all pain and at peace.

For that I’m deeply grateful. And all the more so because at no point has anyone asked for any kind of payment for all this. The fundamental principle of the NHS, still one of the best-loved institutions in Britain, remains: as when the Attlee government founded it, the NHS prides itself on being free at the point of care. You need help? They provide it. And no one asks for a credit card first.

The great old NHS that my mother worked to make possible keeps doing what it does best: looking after patients as well and as kindly as it can. And today it’s doing it for her.

My mother in happier times with, I believe, my brother

When Britain turns crappy

Our street’s a bit crappy at the moment.

I don’t mean that’s it’s not particularly aesthetically pleasing, even though it’s not really much to write home about. But then, I’m not sure why I’d write home about it. After all, it is home, so there’d be little point in writing.

The sewage flowing past our doorstep

In any case, in this instance my judgement is meant much more literally. The street’s crappy because it has sewage running down it. Not a torrent or anything, not a flood, but a fairly constant trickle, filling the gutter and spreading a vile, malodorous miasma around.

You’ve got admit that ‘malodorous miasma’ is good, isn’t it? I hope it means what I want because I’m not changing it. I’m pretty certain you know what I mean, anyway.

We’ve spoken to the people in the house from which the sewage is flowing. They’re tenants. They tell me they’ve spoken to the landlord but nothing’s happened yet.

Luton Borough Council kindly provides an out-of-hours number to report such emergencies. After all, it’s a serious public health problem. Think of all the cholera epidemics in cities before proper sanitation was introduced.

Sadly, no one actually answers the number. Nor does it provide a voicemail function so we can leave a message.

I don’t blame the council. They’d do something if they could. But eight years of austerity have pared staffing levels down to the minimum, and then pared more.

Nor is Luton council the only service to have suffered this way. Most recently, such problems have been much discussed in the media in connection with the railways. Trains have been repeatedly cancelled, so there are fears that students won’t be able to get to school in time to take their end-of-school examinations.

The school buildings themselves are increasingly dilapidated, teacher numbers are down, and people are leaving the profession in increasing numbers, leading to a vicious cycle: they leave because understaffing is making the stress unbearable, and by leaving they increase the understaffing.

We have another personal example of this kind of thing just recently. My 93-year-old mother has been admitted to hospital. The care she is receiving is excellent – we were there when she was examined and advised by a consultant (a senior physician) who was admirable in his gentleness, reassuring good humour and kindness. But what struck us most about the place was the tiredness of most of the staff: the faces are drawn as they struggle to cope with a huge workload, never able to devote more than a few minutes to any one patients.

Many of the voices we heard were distinctly foreign. It’s well-known that the National Health Service depends heavily on foreign staff to keep operating. There’s nothing wrong about that. What’s wrong is that since the Brexit vote, there is a feeling that foreigners aren’t welcome in this country. Like the teachers leaving the profession, immigrants essential to the health service, to catering, to hotels, to agriculture and to many other sectors are leaving the country.

That hostility to foreigners is grounded in a sense that Britain is somehow superior to other nations. That pride seems misplaced in a country with failing railways, schools or hospitals. Or, indeed, on sewage running in the streets.

Curiously, our street here contrasts starkly with the street where we’ve recently taken a flat, in Valencia.

In my youth, Spain was a nation made painfully inward-looking, closed to the outside world and, frankly, poor – rather as Brexit is likely to make Britain – by its stultifying dictatorship under the last of the declared fascists, Francisco Franco.

But he died and Spain returned enthusiastically to democracy. It became one of the first European countries to allow same-sex marriage. It has been leading the way in moving towards gender equality – indeed the new government has, for the first time, a majority of women. And now El País, the leading Spanish-language newspaper in the world, is just about to appoint its first woman editor.

When we were last there, I was struck by the level of public service. I got chatting to the woman who cleans the streets around the flat we recently acquired in Valencia. She cleans them – ‘the same streets’, as she assured me, ‘every day’ – since they always need cleaning. That’s principally because a significant proportion of dog owners are highly irresponsible.

Now, I’d like it if dog owners always picked up after their dogs. But failing that, it’s wonderful to know that there is someone who’ll be along within the next twenty-four hours to clear up anyway. That seems particularly desirable when you live in a street made crappy by sewage flowing down it.

What’s more, Spain seems a lot less unfriendly towards immigrants than Britain does right now. That’s not to say that racism is unknown there – it isn’t – but at least xenophobia is less rampant than here. Which is just as well, since we plan on moving there just as soon as we can. Emigrating from a nation hostile to immigrants to become immigrants in a nation that is less unwelcoming to them.

Besides. The weather’s a lot better.

Attlee: a quiet celebration of a quiet man

It’s far from inappropriate that the anniversary on 3 January passed quietly. It was the anniversary of a quiet man. A modest man, a shy man, but the architect of some of the more remarkable achievements Britain has seen.

There are some things about Clement Attlee that are incontrovertible, a matter of historical record. He was born on 3 January 1883. He led the Labour Party into a wartime coalition with the Tories, under Winston Churchill, in 1940. And, five years later, he led Labour to its first spell in government with a parliamentary majority.

Other issues are more open to interpretation.

It was a key factor in Britain’s war effort that the country was led by a national government – in which Labour played a major role. Indeed, Attlee was described as ‘home front Prime Minister’ since Churchill’s key contribution was on the international scene, above all in securing US support. And yet it must have taken extraordinary courage to join a coalition with the Conservatives just nine years after a previous Labour leader, Ramsay MacDonald, had split the party and reduced its parliamentary strength to just 50 by doing the same thing.

What was a betrayal in 1931 was essential in 1940. Labour’s role as the voice of the downtrodden and of workers had to be laid aside for a while, to ensure the very survival of a country in which that voice could be heard at all. The mood was perfectly captured in a cartoon by David Low, showing Labour having to turn away from its appointed task for a while, to focus on something more urgent – but it would be back.

Labour leading 'our democratic institutions' in the shelter
But only for a time

In 1945, triumphantly, it was.

Again, few would dispute that major reforms were achieved by the 1945 government Attlee led. Indeed, many would argue that it was the greatest reforming government Labour has formed. The welfare state was launched, with both universal social security – independent of means, available to wealthy and poor alike – alongside the NHS were key pillars of the post war consensus. They’ve survived to this day, though they’re increasingly battered now.

He also ensured that India achieved independence, persuaded as he was that it was time. By doing so, he set in train the process by which the British Empire would be dismantled over the next twenty years.

Other aspects of Attlee’s time in office are more controversial. One was the secret drive to build a British Atom bomb, once it became clear that the US was not going to continue the wartime practice of sharing nuclear secrets with the UK. Another was his determination to preserve British colonial power in certain colonies, even through the use of military force, around Africa, for instance, or in Malaya. What he felt about India he didn’t necessarily feel about every part of the Empire.

Is that inconsistency? Or a willingness to compromise? A readiness sometimes to be pragmatic which led him sometimes to do things we might admire, and sometimes to do things that we might not like so much?

Still more controversial is his attitude towards the left of the Party. Before Attlee formed his government, one of his most outspoken critics was Nai Bevan, clarion voice of the Labour left. It is a tribute to Attlee’s breadth of vision that he invited Bevan to join the government and gave him the opportunity to build the NHS. But the differences remained as powerful as ever and, indeed, Bevan eventually resigned from the government in its dying days, an act for which Attlee may never fully have forgiven him.

The tale of his relations with Bevan give a measure of Attlee. He was a conciliator, and that allowed him to able to lead a government which contained both Bevan to the left and Ernest Bevin to the right. It was all the stronger for it.

As well as the left and right of his own party, Attlee could also work with the Conservatives, as he showed in the wartime coalition. Indeed, he could fight the Tories – though not an outstanding public speaker, his powerful response to the vicious attack launched on him by Churchill during the 1945 campaign was a major factor in giving him the victory – but that didn’t stop him cooperating with them when necessary.

I’m not convinced that someone like that would find it easy to forge a career in the present Labour Party. Given the chance, he became arguably Labour’s most successful leader. But would we give him that chance today?

Ah, well. At least I raised a glass to him on his birthday. A quiet celebration in memory – nostalgic memory – of a quiet man who achieved so much.

Far more than many who are a great deal noisier.

Austerity buried? And the NHS too?

Britain has a new budget.

The Chancellor of the Exchequer, Philip Hammond, for whom the word ‘beleaguered’ might have been specifically invented, has announced the government’s plans for spending and tax over the next year. And though it does little enough, what it does do is more noteworthy than one might have expected.

Hammond with the traditional red box for the budget

He has admitted at last that the prospects for economic growth are a lot worse than the government had previously claimed. What’s more, debt is at twice the level the Tories inherited when they first came to office in 2010, and which at the time they described as intolerably high. 

Indeed, their primary goal was to reduce the debt level massively. To achieve it, they launched a painful programme of austerity, to get government spending in balance within one parliament (five years), later extended to two parliaments, and now to some time in the next decade. Meanwhile, debt climbed inexorably.

This track record ought to be enough to prove to any but the most ideologically blinkered that austerity isn’t working. But the dogmatism of the Tories has prevented them ever accepting as much previously. So it’s interesting to discover that in this budget they have at last made the admission, if only tacitly: the Chancellor has announced plans for actual spending, most notably on housing, as a way of addressing the parlous state of the economy.

Sadly, however, he is doing a lot too little, particularly after the damage of the last seven years. For example, faced with a warning from the Simon Stevens, Chief Executive of the National Health Service in England, that healthcare needs another £4bn a year as a minimum, he has come up with £2.8bn over the next two and a half years. That’s going to mean that the service must still make choices that will be tough to the point of grief: certain treatments will simply not be available or will be denied so long as to lead to suffering or even death among patients.

What makes this even more depressing is that Hammond has also earmarked a further £3bn for Brexit preparations. In other words, we have to stump up more money that is being denied to healthcare, to cover the costs of a step – leaving the European Union – which will itself cause us even worse and longer-lasting economic damage. Not just shooting ourselves in the foot, but paying for the privilege.

There’s a special irony in the fact that we’re having to come up with this money for Brexit at a time that the NHS needs it so badly. A major element of the Leave campaign was the notorious claim that Brexit would free up £350m a week for the NHS. £18bn a year which would certainly sort the underfunding of the service.

Curious that in reality Brexit is costing us money, while the NHS crisis deepens.

Austerity in the GP surgery

Curious.

We – my wife and I together – joined our current GP practice because the service was simply so much better than any other we’d known.

The practice is associated with a walk-in centre, which itself provided great support for patients: anyone needing care immediately but not urgently – in other words, patients who were sick or in pain but not obviously suffering from anything potentially life-threatening – could attend the centre and be seen, seven days a week, from early morning into the evening.

A generous service. But not one it pays to cut

That’s a relatively expensive service to provide. There is at large today, throughout the Western world, a view that such expense should be cut back wherever possible. I wrote the other day that it’s often in the little things that we see austerity economics at work, and our GP practice is no exception.

Today, Saturday, I tried to renew a prescription on-line. That didn’t work. I could log in to the system but the buttons thoughtfully provided to select a medication to renew simply didn’t react if I clicked on them (and, before I’m challenged as a computer illiterate, let me assure you that I tried on two machines, using tree different browsers between them).

I then phoned the surgery but was told that, while the walk-in centre was open, the surgery itself was not. Could I ring in again on Monday?

“Yes,” my wife told me, “we’ve had a couple of letters. Funding’s been reduced so that they can’t stay open at weekends any longer.”

Once more, I felt the glacial fingers of austerity gripping my innards.

If the GP practice is facing cutbacks, the walk-in centre won’t be far behind.

While the service it provides seems generous, it’s only those with the narrowest of account-book outlooks, entirely focused on the short term – in other words, Conservatives – who can persuade themselves that such a cutback makes sense. It’s true that shutting down a walk-in centre would save a lot more money than shutting any other kind of practice but, unfortunately, the patients who use it won’t go away. They still feel ill or in pain, so if they can’t find care from a GP, they’ll go to the emergency department of the local hospital instead.

An emergency department is far more expensively equipped than any GP surgery. I’m not just talking about physical equipment, much of which is indeed costly: for instance, devices to provide a view of what’s happening inside a human body, whether by ultrasound, radiology, or some of the more powerful and sophisticated techniques now available such as CT or MRI scanning. However, even that fades into insignificance compared to cost of staff: medical and nursing staff on a wide hierarchical range, professional support such as pharmacists and various types of therapists, and even administrative staff.

The result is that while it may cost £50 to see a GP, it can cost £124 on average to attend an emergency department.

Cutting back on GP care is, therefore, a false economy.

There’s nothing unusual in that consequence of Conservative healthcare policy. All over England, hospitals are spending a fortune on agency or bank staff (“bank” is in effect overtime: existing staff doing additional hours on a far more expensive, hourly-paid basis). Why are they spending so much? Because they’re being denied the funds to take on more permanent staff, though that would be cheaper.

Of course, the false economy of shutting the walk-in centre would turn into a real one, if the patients denied treatment were unable to attend an emergency department instead. But for that to happen, our local hospital would have to close, or be replaced by a private one which only treated patients who could pay the full, economic cost of the care it provided.

I suspect a lot of people at the top of the Conservative Party would be perfectly easy about that happening.

However, I wonder if all their voters, further down the income range, would agree with them…

The lesson of dutifully paying my duty

What a tiresome experience it was!

Phoning a number and being told I needed to speak to someone else. Being kept on hold while trivial music played, only be told after a twenty-minute wait that I was being transferred to another department. Giving a credit card number only to have to repeat it and then being told the card had been declined, though it worked the time before and the next time too. The whole tedious business of trying to settle a bill – or rather three bills – over a telephone: never easy, certainly never pleasant, but in this case, urgently necessary.

Why was the need so great?

My work involves presentations to staff in NHS hospitals. After seven years of austerity policies of Britain’s enlightened government, many of them are close to bankruptcy. It’s good to be able to distribute a few gifts, from time to time, when we turn up: pens, say, or post-it notes, now officially banned for purchase anywhere in the NHS though still much in demand.

We get these things sent to us by our colleagues in the US. Before a series of meetings back in March, we asked them to send out a few batches to several hospitals we were about to visit, which they duly did.

Our visits and presentations went well and the gifts were gratefully received. At first. But then, a small number – for some strange reason not all – received bills from the carrier company. Duty was payable on these (free) gifts and it was up to the recipient to pay it.

A bureaucracy to free ourselves from
If only Britain were

They didn’t, of course. They raised the matter with us. Politely at first.

We were abject. Can you imagine? Clients of ours. To whom we’d made gifts. Which naturally means free of charge. And now they were being charged.

My colleagues set about contacting the carrier service to see what could be done. But these things grind slowly. Long before we’d got to the bottom of the problem, the hospitals had reached the next stage of the exercise: letters that not only demanded that they pay up, but warned of dire legal consequences to come if they didn’t.

One of the hospitals had even gone a stage further. It had reached the point of a letter with a big red banner across the top. “Do not ignore this matter, it will not go away”. You could almost hear the guillotine blade being wound up. As for our embarrassment, well, you can imagine. It was crushing.

There was consternation within the company on both sides of the Atlantic. Nothing we’d tried had worked. We couldn’t get the carrier company to re-bill us instead of our clients. And the wolves were closing in on them. Broke hospitals. Being chased for payment of sums only incurred because we tried to give them something.

Fortunately, they’d sent us their dunning letters. And they had phone numbers on them. Into the breach I stepped: “I’ll ring and make the payments by credit card, over the phone”. Hence the appalling, tiresome experience. The waiting on hold. The explanations of why I was paying, not the client. The card payments that generally worked, if slowly, but sometimes didn’t. The well-meant but time-consuming apologies from the other end of the line. My requests to be sure to provide me with receipts. On and on and on. And all for a sum which, taking three cases together, barely topped £90.

But all bad experiences teach lessons. 

What did I learn from this one? Well, I didn’t need to be taught that NHS organisations were being driven to the wall by a government which regards public service as an inexcusable imposition on its paymasters’ right to make huge sums of money. I knew that already.

No, what I learned was how painful it can be to try to deal with transporting goods across the Atlantic. The petty regulations, sloppily applied: after all, not all our clients were even charged duty. The dead hand of the bureaucracy involved. The impossibility of making anyone listen unless it was to meet their immediate, monetary demands.

And yet Britain is about to throw itself into hugely increased dependency on transatlantic trade as it withdraws from the European Union. And, while it will no doubt keep trading with the EU, it will be under terms that face the same kind of bureaucratic meddling that already affects trade with the States.

Brexit will bring us back control and free us from bureaucracy? Don’t make me laugh. It will allow Britain to become a major world trading power? I wonder who the people who claim that think they’re kidding. It’s going to be a tiresome pain and source of costly inefficiency?

You bet it is.

Stephen Hawking identifies another black hole, called Corbyn

The possessor of one of the most formidable minds of the world today, Stephen Hawking, has joined the growing chorus of Labour supporters calling for the leader, Jeremy Corbyn, to resign.

“I regard Corbyn as a disaster,” he told the The Times newspaper, and “I think he should step down for the sake of the party”.

Stephen Hawking sees politics clearly as well as physics

Hawking is one of the leading experts on black holes. No wonder he sees the black hole into which Corbyn’s taking us. Many voters share his vision but not, unfortunately, most Labour Party members: an Election Data poll of members found that he would be re-elected leader if he had to stand again today.

They’re clearly not reading the evidence of approaching disaster the same way as the rest of us, including Hawking.

As is well known, Hawking is a long-term sufferer from Motor Neurone Disease. This led to a fine transatlantic interchange in 2009, when Republicans opposed to Obama’s healthcare reforms made the bizarre claim that the NHS would have regarded Hawking’s life as “worthless” because of his disabilities and refused to treat him. As Hawking replied, “"I wouldn't be here today if it were not for the NHS.”

That’s particularly relevant today, faced as we are by a new Conservative budget. It continues the seven years of austerity that we have already had and which have had no impact on the scale of the country’s debt, which keeps climbing to peacetime records. Another group of people has now been attacked, this time the self-employed who are being forced to pay higher national insurance contributions.

This explicitly breaches a pledge made by the Conservatives in the run up to the last election under two years ago.

The Chancellor, Philip Hammond, has found some additional funds to back the ‘free school’ initiative, in reality a most expensive form of schooling, for which the results have been at best mixed. Education desperately needs funding but not in this unnecessary way.

Meanwhile, even the police and prison service, generally the parts of the public sector least abhorrent to the Conservatives, are creaking at the seams, unable to act effectively against smaller crime or control the prison population.

What’s most terrifying, though, and must be particularly hurtful to Hawking is that there is no attempt to address the desperate financial crisis facing the NHS. Two thirds of English hospitals are running at a deficit. Accident and Emergency services are struggling, and frequently failing, to cope. Waiting times for operations are on the climb again, having been brought down to acceptable levels – eighteen weeks maximum – by the last Labour government.

Why is this being allowed to happen? The Conservative majority is wafer thin. With a half-way effective opposition, it would have to think carefully about continuing to undermine the NHS. It would have to wonder whether it could get away with breaking its election pledges.

None of that applies if the opposition has an ineffective leader, leaving it incapable of mounting an effective resistance to its rule. Labour is reduced to meaninglessness under Corbyn, seen by too few as an alternative Prime Minister. The Conservatives could even, as has been rumoured, hold an election shortly and trounce him. Why would they do that? They may be bold enough to feel they can count on Corbyn refusing to step down, on the grounds that he’s had too short a tenure, encouraging Conservative hopes that they could thrash him again five years later.

In February, Theresa May, the Prime Minister, held a 17 point positive rating: 53% of respondents to a survey by Ipsos MORI were satisfied with her against 36% who were not. The same poll found Corbyn had a 38 point negative rating: 24% satisfied and 62% dissatisfied.

If you’re tempted to object that polls get figures wrong, it’s worth bearing in mind that in the UK they tend to overstate not understate Labour support.

The Election Data poll of Labour members meanwhile tells us that 51% of Labour members think Corbyn is doing well, against 47% who think he’s doing badly.

It feels to me as though the gulf between voters and Labour Party members is as wide as I’ve ever seen it. No wonder people like Stephen Hawking feel things are heading in a catastrophic direction.

Sometimes I have a nightmarish vision in which backing for Corbyn continues to fall until there are only 300,000 supporters left. Sadly, they are precisely the 300,000 Corbyn supporters who dominate the Party and keep him in office. Giving the Conservatives all the encouragement they need to break their pledges and decimate public services vital to us.

The police. The prison service. Education.

Above all the jewel in the crown, the service that matters so much to Hawking, the National Health Service.

Do you believe the NHS is safe with the Tories? How Thatcher's behaviour exposed that lie

“The NHS is safe with us,” Thatcher told the nation – well, the Tory Party Conference, but we were all listening – in 1982.

It can take some time – in this case, over three decades – but eventually the truth will out, and the lie is exposed. At least, if you have a newspaper as effective as the Guardian to do the exposing.

It was three years ago that we discovered from papers published under the thirty-year rule, that back then Thatcher’s government had considered a proposal to end free Higher Education and to introduce vouchers to pay for school education, freeze benefits and, most toxic of all, to overthrow the founding principle of the NHS that healthcare should be free at the point of care, replacing the service by one based on insurance. As the paper containing the proposal pointed out, “This would of course mean the end of the National Health Service.”

As quoted in the Guardian: the killer phrase in the 1982 proposals

In her memoirs, Thatcher said, “I was horrified when I saw this paper. I pointed out that it would almost certainly be leaked and give a totally false impression … It was all a total nonsense.”

The government dropped the proposals after what her then Energy Secretary, Nigel Lawson, described as “the nearest thing to a cabinet riot in the history of the Thatcher administration.”

What has now emerged, from newly-published Treasury papers of her then Chancellor of the Exchequer, Geoffrey Howe, is that Thatcher didn’t give up on the proposals herself but kept working on them with him. As he noted, “the prime minister has arranged a series of meetings with the main spending ministers to discuss the follow-up to the discussion in cabinet” on the proposals. Among other things, the discussions were to look into replacing some public services by “more efficient alternatives from the private sector.”

If Thatcher was horrified, it was clearly about the fact that the ideas “would almost certainly be leaked” rather than about the ideas themselves.

Now roll on thirty or more years.

There has been constantly extending privatisation of health services in England with little evidence that they provide better quality. In fact, they don’t even seem to be able to generate levels of profit that would persuade the private companies to keep delivering them – several major contracts have already had to be cancelled.

Meanwhile the NHS is facing an unprecedented level of financial crisis. The 2015/16 year was the second in a row which saw the service in England in deficit – and with three times the level as the year before. The much respected health think tank, the King’s Fund, comments:

The scale of the aggregate deficit makes it clear that overspending is largely not attributable to mismanagement in individual organisations – instead it signifies a health system buckling under the strain of huge financial and operational pressures. The recent strategy of driving efficiencies by cutting the tariff has placed disproportionate strain on providers and is no longer sustainable.

That reference to a “recent strategy” reveals that the problem has been caused by deliberate policy. The government is putting the NHS “under the strain of huge financial and operational pressures”. Unbearable strain, you might say. .

Is this an unfortunate consequence of a misguided policy? Or is it merely the continuation by other means of an approach already launched scouted over three decades ago by Thatcher? An approach that would necessarily lead to “the end of the National Health Service”?

It hardly matters how we answer those questions. What’s clear is that the notion that the “NHS is safe” with the Tories is just sand in the eyes of those too tired or too greedy to resist their propaganda.

Why, you might as reasonably believe that Tories will keep the poor safe.

Labour: getting back to its roots. But which roots?

“The only lesson to learn from history,” to paraphrase the German philosopher Hegel, “is that no one learns any lessons from history.”

In the course of the great debate over the leadership that is currently rocking the UK Labour Party, the supporters of Jeremy Corbyn frequently tell me that we need to get the party back to its roots. It’s because we’ve abandoned them for the last forty years – a precise figure quoted to me on Twitter, though what specifically happened in 1976 I’m not quite sure – that we’re in the mess today.

It never strikes me as a particularly good approach to call for a move “back to” some set of values. John Major, British Prime Minister between 1992 and 1997, Thatcher’s successor, launched a “back to basics” programme that was criticised even within his own party. Generally, it’s best to be moving forward and getting ready to deal with the next set of challenges, for which we’re likely to need different attitudes than worked when we faced the last.

Still, even in a forward-looking process, it’s useful to to see if we can at least learn enough from the past not to make the same mistakes again. Perhaps being aware of our roots might be a more useful approach than getting back to them. However, if we’re to do that well, we need at least to make sure we’re remembering them correctly. A mythical past isn’t going to help us at all in planning our future. It would be a pity to go back to the wrong roots, wouldn’t it?

What, then, were the roots of the Labour Party?

The great historic leader of the early days, and Labour’s first MP, was James Keir Hardie. He died long before Labour had its first chance to form a government, but he had among his advisers a young man, full of fine rhetoric and powerful views, who would lead Labour in government for the first time: Ramsay MacDonald was an early intellectual of the party and one of its most effective voices. He had principles too, and stuck to them: he was a pacifist and nothing could persuade him to back Britain’s involvement in the First World War. So, though he was one of the earliest Labour MPs, elected in 1906, he paid the price for his beliefs, losing his parliamentary seat in the elections at the end of the war.

Ramsay MacDonald: watered the roots of the Labour Party
But it didn’t end well, did it?

MacDonald came back, though, leading the first two Labour governments. Sadly, his second administration took office in 1929 and had to deal with the Great Depression. MacDonald, man of principle, thinker, left-winger, champion of the socialist cause, decided that was needed was a sound-money policy and reduced public spending. So he slashed unemployment benefit, to the fury and dismay of his Labour colleagues. In order to cling on to power, he formed a coalition with the Conservatives and remained Prime Minister, at the head of a government dominated by the party he’d always opposed, until 1935.

Are those the roots we’re supposed to get back to?

To be fair, when people talk about the Labour Party’s roots, they’re much more likely to be thinking of the great, reforming post-World War 2 government led by Clement Attlee. In particular, they’re probably thinking about one member of that government: Aneurin ‘Nai’ Bevan, founder of the NHS. They probably don’t remember that when someone mentioned to Ernest Bevin, Foreign Secretary in the same government, that Nai was his own worst enemy, Bevin growled back “not while I’m alive, he ain’t.”

Nai Bevan, father of the NHS. Much easier to get enthusiastic about.
As long as you’re not too worried abut nuclear disarmament.

Actually, that’s one of those stories that comes up again and again in different contexts, with different speakers. Another version has Bevin saying it about a different fellow Minister, Herbert Morrison. Then again, it was apparently said of Franklin Delano Roosevelt by his fellow Democrat “Cotton” Ed Smith. What all these versions have in common, though, is that they all reflect deeply destructive internal divisions in parties of the centre-left.

Sadly, we’re in exactly the same position today, but surely again this isn’t where we want to be, is it?

Much more significant than any comment of Bevin’s on Bevan, though, is a remark of Bevan’s himself. Jeremy Corbyn has made himself a bit of a name by his resistance to the renewal of the Trident nuclear missile programme. Interestingly, for a man and a member of a movement that swears by the sanctity of party decisions, he took that stance against Labour policy. He nonetheless enjoyed widespread support among his fan base, who tend to be pretty keen on Bevan too. So perhaps they need to ponder the words Nai spoke at the Labour Conference of 1957, during the debate on unilateral nuclear disarmament:

I knew this morning that I was going to make a speech that would offend and even hurt many of my friends. I know that you are deeply convinced that the action you suggest is the most effective way of influencing international affairs. I am deeply convinced that you are wrong. It is therefore not a question of who is in favour of the hydrogen bomb, but a question of what is the most effective way of getting the damn thing destroyed. It is the most difficult of all problems facing mankind. But if you carry this resolution and follow out all its implications and do not run away from it you will send a Foreign Secretary, whoever he may be, naked into the conference chamber… You call that statesmanship? I call it an emotional spasm.

Curious, isn’t it? That a past idol of the left referred to the policies espoused to the policies of today’s idol of the left as an “emotional spasm.”

So – are those the roots we’re supposed to be getting back to?