Jul 102014
 
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I thought I’d be as formal in my post’s title as possible today.  As of yesterday, I have an official complaint lodged with NHS England about procedure and process at our local pharmacy.  This comes on the back of an error committed last year by the pharmacy I used to use.

I’ve had epilepsy for most of my life, though with a gap of about ten years in my thirties where I didn’t require medication.  Last year, a Chester pharmacy dispensed a number of 300 mg Epilim tablets instead of the normal 500 mg I take.  The size was very similar; the colour identical; the blister pack had only a slight difference in hue on one side.  For a couple of days, I took them without realising – though fortunately no side-effects were felt.  I complained to the pharmacy’s head office, received the corresponding apology and on my following visit for my next prescription it was explained to me how procedures were being changed to avoid a repeat of the issue.

Actually, that next prescription also included a pair of 300 mg tablets.  I was on holiday by then but on my return, I notified both the pharmacy (they didn’t believe me, I’m afraid) and the manufacturer, with the suggestion that, in the future, the two sizes of tablets be differentiated better physically.  The manufacturer took down all kinds of personal details over the phone (all the medication I took; all my conditions; name, address, telephone etc.), and I’ve heard absolutely nothing from them since then.

Meanwhile, as a result of what had happened – and after a long prescription issued by the surgery due to computer problems last summer – I decided to change the pharmacy I went to.

Surprise, surprise – for the first time in my life, I was given a generic sodium valproate, stomach-resistant I think it was called (or maybe gastro-resistant – I can’t remember exactly); clearly, however, not the controlled-release branded Epilim I was accustomed to.  I thought nothing more of this as I assumed it was part of a drive to reduce costs by using generic equivalents.

Last week, a member of my family was issued with a double prescription to cover the summer holidays they were shortly going away on.  Only three of the four bottles were available; the young woman at the pharmacy said she’d order a fourth and it’d be ready at the beginning of this week.  We both went in on Tuesday to pick up our prescriptions, in my case me having phoned first to doublecheck that everything was ready.

Sadly, it wasn’t – and so this is my anecdotal evidence accumulating that not all is right in English pharmacies.  From one big national chain to another, problems with procedures and process have arisen again: this time, only half my prescription was ready, and when I got home, I realised only about ninety percent of that half.  In my relative’s case, the fourth bottle hadn’t been ordered; there was no record of anyone having requested such an order; and neither was there any record of any prescription having being issued since April.

We agreed to return yesterday, which we did – only to find, after phoning once more in the morning to doublecheck everything would be ready (they said it would be), that whilst the second half of my prescription had been readied, the first half’s missing component hadn’t arrived (or hadn’t been ordered) (or had been lost) (and we’re talking only twelve tablets here – twelve damn tablets!).  The manager wasn’t there that day, so in the end to calm the justifiably rising hackles of my relative, I asked for a contact number to complain and then phoned NHS England and registered my dissatisfaction.  (Amongst other things in this complaint, I mentioned the fact that on no occasion had either myself or my relative been given an IOU receipt for part-prescriptions not dispensed.  In our experience, this is what other pharmacies do everywhere.  On reflection, we found it most surprising.  One more procedural issue to add to the weary mix.)

Let it be clear, and just to reiterate: my NHS England complaint was all couched in terms of procedures and process, of course; all the time saying I understood the pressures the people in question were currently working under – especially with the backdrop of a savage cutting behind the scenes by this Coalition government of frontline NHS services.

Anyhow.  Today, Thursday, we went back to the same pharmacy.  I entered alone, and spoke to the congenial young manager.  He was honest, took ownership and explained a dire financial background.  I said I appreciated the situation – and accepted his apologies.  I did query one thing: the previous day, to a person who said he was filling in, I had seen the generic sodium valproate I had been given for my previous prescription, and I’d asked him why I couldn’t just have twelve tablets of generic equivalent to complete what was missing.  He went and had a look, came back shortly and said abruptly: “There are no generic equivalents.”

I mentioned this incident today to the manager, who took the information onboard but was unable to explain anything further at the time.  When we got back home, there was a voicemail waiting for me on the landline.  It asked me to phone him about the “generic sodium valproate”, and so I did immediately.

It then transpired that I’d actually been on the wrong epilepsy medication for two months.  The doses had been correct but the delivery technology was different: ie the generic wasn’t given in a controlled-release way.  The manager was most apologetic and didn’t minimise how serious the consequences could’ve been.  I began to feel sorry for him.  I didn’t want to pile further misery onto the original circumstances – especially as I knew an official complaint was already being processed with NHS England.  But I did suggest that perhaps it wasn’t now just a question of procedures and process: that the person who made the mistake needed urgent feedback and coaching at the very minimum.

I have to say, however, I shall have no compunctions about being more assertive about my medication in the future.  If anything changes, I shall question it most firmly.  And I shall check every blister pack I used to blithely take – but, blithely anyway, will do so no more.

A couple of final thoughts: firstly, to err is human, and errors happen.  But the reason we have national corporate chains is so they can learn from mistakes and transmit organically-acquired knowhow – in a timely, accurate and lifesaving fashion – to all their staff and employees, through appropriate induction training, as well as on-the-job and continuous learning programmes.  (That’s the value they’re supposed to add.  That’s the reason we tolerate such huge profit margins.)

I’m not sure that this has been the case here, though – nor on the previous occasion I experienced either.

Secondly, in times of radical change – and whether you agree with the motives behind a particular change or not – everyone can surely agree to accept that managing such flux is a paramount responsibility, especially when we’re dealing with the lives of people who depend on medication to keep chronic illness at bay and ensure that they remain safe, happy, independent and productive.

And again, the anecdotal evidence I lay before you today doesn’t really convince me that this has necessarily happened.

Finally, my relative didn’t get the fourth bottle they were looking for.  Not the make in question.  They had, instead, to settle for something else.  The reason for the preference?  Once more, a method of delivery: a translucent bottle makes controlling how much is left much easier, as does a dropper which allows for better control of the medication.

So.  Unnecessarily unhappy patients, staff, companies and institutions.  A sad – and potentially dangerous – set of situations all around.

At least in these anecdotal cases I put before you this evening.  At least in my own personal experience.

Anyone else – maybe who works on the coalface – who knows whether this is either par for an increasingly depressing course or, alternatively, exceptions which unfairly disprove a rule?


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Jun 302014
 
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Two stories which make me understand why the bad-business sponsors behind the ruling Tory Party believe – and intend – that the NHS must die.

First, this one in Spanish and from Spain (robot English here) – basically saying that since patient payment of medicines was brought in two years ago there, one in four of the unemployed (and remember youth unemployment has touched over fifty percent; overall unemployment around twenty-five percent; and more than half a million people left Spain last year because austerity was getting so grim) has neglected to buy the medicines their doctors prescribed them; medicines these professionals presumably judged their health required.

This second story, meanwhile, is in English and is from England – apparently revealing that London hospitals are now postponing treatments for old-aged pensioners until the very last moment, in order to treat and deal with more rapidly the needs of those able to pay thousands of pounds upfront.

Why, then, must the NHS die?  Firstly, because it provided a safety net which kept the wolf from the door of ordinary people.  And people who no longer fear such a wolf will obviously be more picky about their jobs, agit-prop in their politics and generally more confident about speaking back to the government.

Can’t have that.

Secondly, once it is a given that the poor must not only be poorer but must be made to face the consequences and impact of poverty – the depression, fear, desperation and wider mental ill health, as well as so many other conditions associated with a significant inability to make ends meet – there is an equally humongous downside for the bad-business sponsors of the current Tory-run government: if you change the law to make people cough up the dosh precisely when they’re coughing up the blood, and then they decide not to cough up the dosh even as the blood continues to flow freely, the marketplace of these bad-business sponsors begins to contract severely as a result.  Headline stories of twenty-five percent in two years, however they pan out exactly, represent a helluva fall in company income.

All of which goes to explain the real reason the NHS must die.  The wealthy citizen’s ability to jump a queue by paying eight thousand quid for a straightforward operation more than compensates the inability of the poor to keep up with rising “point-of-sale” payment requirements – requirements which have already manifested themselves in Spain, and which will soon begin to manifest themselves here.  And as unemployment increases and the supply of sensible jobs collapses, in this way the poor can be left to suppurate in their own broader misery, making sensitive employment policy-making ultimately quite unnecessary.  (Something which may be happening in Spain (I don’t know), but is – under this Tory misgovernment – clearly the case in England.)

After all, a living breathing NHS would only give wings to those who saw life as it was unfolding; it’d only serve to give the downtrodden the strength of purpose to continue protesting the injustice of it all; it’d only make the weak see the future with hope; it’d only continue to send out the message that – even now after everything we’ve suffered – everyone has a right to have their pain ameliorated by a society of the kind.

Can’t have that.

The NHS must die so that the poor do not rise up – even as the reasons to do so would multiply a thousandfold.

The NHS must die so that the rich can maintain their company income – even as the poor begin to die, unable to fork out on previously profitable medications.

The NHS must die so that life can march on for the impatient privileged few.

Those who find themselves able, when they’re coughing up the blood, to cough up the dosh as well.


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May 112013
 
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I’ve been tracking the Coalition’s war against the professions for quite a while now.  I guess you must have been too.  In these pieces, written almost a year apart, we can remind ourselves how medieval politicians are; why dequalifying the professions is a bad move; and why Cameron & Co are really no better than 21st century witch doctors.  I’ve also watched, miserable, as the Welfare State has been dismantled pillar by pillar (more here, here and here) out of rank and disagreeable prejudice.

The latest example is complex in its detail (.pdf file) but simple in its impact:

The Criminal Law Solicitors Association (CLSA) has read the consultation on competitive price tendering (CPT) produced by the Government ‘Transforming legal aid: delivering a more credible and efficient system’ and this briefing is our initial response. A formal fuller response will be made shortly.

Here is point 1 of its response, to give you a flavour of what’s going on:

A. Why the proposals are socially divisive, dangerous and against the public interest.

1. It transforms people into mere economic units by denying them the simple human dignity of choice. These Stalinist proposals to require people to abandon their freedom of choice and to force them to be represented by a lawyer allocated by an impersonal call centre are deplorable. Winston Churchill said: “The mood and temper of the public in regard to the treatment of crime and criminals is one of the most unfailing tests of the civilisation of any country’. Clients are people and if they are legally aided when accused of crime they do not cease to be such. The process of arrest and prosecution are demeaning enough without this added humiliation of denial of choice. In contrast, unlike the majority of the community, the political and wealthy elite who will of course retain the economic ability to purchase their choice of legal representation. It is a socially divisive and shameful proposal. We cannot believe that were a politician, MOJ civil servant or wealthy person accused of a crime they did not commit would be content with being represented by a solicitor randomly allocated by a call centre. But the ‘little people’ (Including low paid, the youths, the students and most people who will qualify for means tested legal aid in the Crown court) are to be denied the same choice even when as tax payers citizens will have paid through taxation for the right to be legally aided.

What’s clearly happening here is yet another example of prejudice-based governors ignoring the opinions and sidelining the intelligences of evidence-based professionals.  From teachers to GPs to nurses to lawyers, before and again now, it’s apparent that evidence-based professions pose a serious risk to the incompetent unprofessionalised politicians.  As I tweeted some minutes ago, here, here and here:

@geektrev It’s OK. I managed to get there. :-) I wrote a lot a year or so back on destruction of Legal Aid as pillar of Welfare State.

@geektrev Think it’s part of deliberate wider deprofessionalisation of society (teachers, doctors, nurses etc).

@geektrev Evidence-based professionals present a threat to prejudice-driven politicians and need to be neutralised. That’s what’s happening.

So none of this surprises me, and none of this confuses me.

A century ago, there was nothing more difficult to deal with for the professionals of learning than the self-taught man or woman with a chip on their shoulders.

Today, there is nothing more difficult to deal with for the citizens and subjects of an educated state than a self-made politico or politica with a driven belief in their own prejudices.

And that’s essentially what’s happening as we witness so many generations of structures being destroyed before our very eyes; as we witness aghast the collapse.

Anything we can properly do to halt this careering towards a 21st century Dark Ages?  Perhaps not.  Perhaps we are hardwired quite otherwise.  But, even so, even assuming there is nothing more to be realistically done, I do suggest at the very least you bear witness to what is happening – I do suggest you sign this petition:

Save UK Justice

Responsible department: Ministry of Justice

The MOJ should not proceed with their plans to reduce access to justice by depriving citizens of legal aid or the right to representation by the Solicitor of their choice.

If a government which claims to act out of a desire to create more societal freedoms finds it necessary to intervene from a prejudiced standpoint in the workings of society’s fundamentals – from the NHS to Legal Aid to social care to education – then surely we need to draw in the most vigorous terms the rest of our nation’s attention to the contradictions involved.

You cannot create a civilisation of the free based on top-down reorganisations mandated by throwbacks to foolish and primitive times – times which never existed, even as the self-interested rose-tinted spectacles claim to demonstrate they did.

You cannot create a civilisation of the free based on such prejudice – or, indeed, on such back-scratching self-enrichment.

Perhaps it’s time we realised a civilisation of the free isn’t, actually, the goal of these leaders – leaders who, in any meritorious field of endeavour, would be considered to be on the worst side of incompetent.

Puts quite a different slant on everything, once you accept that to be the case.

Don’t you think so?


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May 092013
 
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I love the web, I can’t deny it – but, curiously, I’m not a real fan of all those money-saving websites out there.  There is one, however, even I have heard of – founded by the always excellent Martin Lewis.  So it was that when I got an utterly unsolicited email from what I believed to be his site, I thought perhaps there was more to it than met the eye.

Here’s a screenshot of the email in question – it should be clear enough for you all to be able to read it and fully understand the implications of the content.

Money Expert unsolicited email

So.  What do we conclude?  Under this government, and as is all too apparent (or, at least, as is all too apparent according to this email), numerous areas of the NHS are now officially unable to guarantee either the safety of patients or “their welfare needs”.  Clearly the situation demands drastic action, but instead of focussing on the funding and support which the NHS should be receiving, sites like Martin Lewis’s moneyexpert.com are encouraging us to buy into privatised health.

Or are they?  Because, if you look carefully, Martin Lewis’s site is famously called moneysavingexpert.com – though to a sad soul like myself, only interested in wonky politics, at first glance this information had escaped my less-than-beady eye.  And this is the (admittedly and self-confessedly “out-of-date”) information it currently provides on private health insurance – essentially, stay away from it because the NHS will do us very nicely, thank you:

Private medical insurance is a luxury, not a necessity. There are three main reasons to buy it: to leapfrog the queue for non-urgent treatment; to choose when and who operates; and to get more comfort and convenience during treatment.

Don’t assume private always means better.

The NHS provides comprehensive medical treatment to anyone in the UK who needs it, regardless of their ability to pay – although you may have to wait. Getting fast NHS treatment may be something of a postcode lottery. Yet a good GP is worth his/her weight in gold.

What’s more, the “squeakiest hinge gets the grease”, so by being persistent, you may be bumped up waiting lists, especially if you’re prepared to grab a cancelled appointment at the drop of a hat.

Remember even if you go private, the doctors and specialists aren’t “private” doctors – the vast majority are NHS medics boosting their income. And it’s often the NHS specialists who are at the cutting edge of modern medicine.

Compare and contrast that with my above-mentioned unsolicited email.

So who then is moneyexpert.com?  Well, the limited company which appears to be responsible for it dates from May 2003, some two or three months after Lewis’s site was created.  The former claims to be no more than an intermediary – yet the content of its email hardly gives the impression of a simple hands-off enabler of financial transactions.  Lewis’s approach is much more consumer-focussed: the customer being the user of his web.  In the case of the moneyexpert.com email above, however, it would appear the real customers are the organisations selling the health insurance.  And, potentially and indirectly, perhaps those who are pushing wider government sell-offs in the area of privatised healthcare as well.

I would be interested to know how Martin Lewis feels about such competition.  Both sites are clearly established on the web; both are clearly looking to capture similar markets.  Nothing wrong in that either.  True competition does, after all, tend to guarantee better deals for consumers.  But I do wonder whether moneyexpert.com is as clear as it should be about the chances that its sales approach might be confusing people into believing it is actually Lewis’s site.

Especially when the content of such emails uses the highly-charged and tendentious issue of NHS privatisation to lever new business.

And especially when – in relation to all the obfuscation surrounding the NHS and the Coalition – ordinary people really don’t know who to rely on, or turn to, in order that they might understand the truth.

____________________

Update to this post: someone who appears to be doing a fairly even-handed and evidence-based job of sorting out the obfuscation is Steve.  His latest post has this to say on mortality figures at NHS hospitals:

[...] There is growing consensus among statisticians, academics and, increasingly, among sections of the media (the Straight Statistics and Computer Weekly websites and even, very quietly and cautiously, one BBC News writer) that the claims of ‘excess mortality’ at Stafford hospital are – at best – utterly spurious and inaccurate.

And yet they continue to be recited, rote-fashion, as simple, unchallenged fact by the right-wing press and even by the BBC (just this evening on Look North during a segment on the inspectors’ visit to North Cumbria Hospitals Trust, one of the 9 hospitals targeted in spite of having average or lower SHMI mortality rates).

The weaknesses of HSMRs and of the data entered to create them are not difficult to identify. The articles on these weaknesses are not encrypted or hidden. And yet they continue to be conspicuous by their absence in the mainstream media while false figures are recited as fact.

You really do have to wonder just why that is.


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Apr 062013
 
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In 2011, these questions were being asked of the Tory Party and its relationship with a financial services sector which – at the time – was bankrolling over half its total income:

There is no suggestion that any donor has made personal appeals to introduce policies that would benefit them, or gained from their donation in any way. But the extent of the Square Mile’s bankrolling of the party will raise questions over whether the Conservative-led coalition may be treating its financial supporters favourably.

This very Friday, then, we got this story from the Guardian:

Hundreds of millionaires working in Britain’s banks will save an average of almost £54,000 when the top rate of tax is cut this weekend, according to figures compiled by the Labour party.

The changes mean that 643 bankers, each earning more than £1m, could get a combined tax cut worth at least £34.6m.

The previous day, meanwhile, we had Mr George Osborne pressing the left’s buttons in the following way:

During a visit to Derby, where Philpott lived on benefits with 11 of his 17 children , Mr Osborne told the BBC: “Philpott is responsible for these absolutely horrendous crimes and these are crimes that have shocked the nation. The courts are responsible for sentencing, but I think there is a question for government and for society about the welfare state and the taxpayers who pay for the welfare state, subsidising lifestyles like that. I think that debate needs to be had.”

Whilst today, as the clock struck twelve (don’t you just love the melodramatic histrionics of that phrase!), thousands of millionaires received tens of thousands in tax cuts.

Even as tomorrow the Observer newspaper explains how NHS hospitals are gearing up to concentrate on creating a two-tier set of services, where private patients will inevitably be given priority.  Evidence of which I reported on as long ago as late 2011:

The point of this post is to underline that this is probably the first in what will become a long line of junk mailshots on the subject of unsolicited health services -  a long line which we shall just have to learn to disregard.  Unaccustomed as we have been to see health as simply one more consumer item, the ability to filter out deliberately scarifying messages in terms of this “product” is something we have yet to properly acquire.

Judge for yourself – forewarned is, after all, forearmed.  For this is just the beginning of the two-tier freemium NHS.

More in a similar vein from early 2012 can be found here.

My conclusion to all of this?

  1. Whilst the NHS ethos of free-at-point-of-use is being surreptitiously driven underground by growing corporate-capitalist markets (oh, if only they really were free-market forces …), since 2011 even I in my relatively humble housing-estate have been the object of rapacious health-service providers, aiming to scare my family into premium lifestyles.
  2. Whilst the “subsidised lifestyles” of the Philpotts of this world are used to abuse the reputation of the 99 percent of benefit recipients who don’t abuse the Welfare State (curious, eh?, how that 99 percent pops up all over again), the very same Welfare State begins to redirect its efforts to “subsidising” the 13,000 millionaires who really do begin to abuse the system.

Essentially, what this is all about is a huge sleight-of-hand shifting of public resources from the subsidising of lowly-paid corporate salaries, as per the New Labour post-Thatcher socioeconomic contract of its tax-credit heydays, directly towards the interests of a) a growing and influential number of private lifestyle service-users who will now take priority over the less well-to-do and lower-tier needs; and b) an increasingly influential 1 percent in society who will soon learn the true advantages of the Welfare State as per Cameron & Co.

By distracting people and cleverly whipping up prejudice about the “subsidised lifestyles” of the 99 percent (the disabled, the pregnant, the working mums, the working poor, the sick, the young and the aged), all this time they’re shifting all that very public resource into the pockets of very private patients, very private bankers and very private millionaires.

And so it is that no one seems to be realising what the aforementioned Coalition is really privatising: it’s not just the NHS, in quite sub-Thatcherite and expected mode, but also – in a particularly novel move, even for the most vicious of a historically vicious English right – the whole bloody Welfare State itself.  Not content with reducing the rights the 99 percent may have to properly claim their part of the action, this Coalition of the Damned goes even further: actually increasing the sleazy access to the public purse the top 1 percent will enjoy in the future!

For the poor and aged, for the disabled and sick, expect to become a band of bottom-tiered citizens.

For the rich and botoxed beautiful people of the top-tiered NHS, meanwhile, expect to become a CCTVed group of wealthily sociopathic Philpotts – secure in the presence of its expensive airs and graces that such madness is only in the eye of the beholder.

And if the beholder is poor, this means nothing at all.

Except the honour of funding – through one’s blood, sweat and tears – the “subsidised lifestyles” … of the rich.


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Mar 192013
 
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I previously suggested we devise a parallel set of institutions to our existing corrupt and corrupting ones, with the aim of encouraging revolution – though of a bloodless kind – to take the place of a clearly failed social and/or neoliberal democracy.

This morning, an NHS consultant tweeted as follows:

Met a colleague in the corridor this morning. He thinks the NHS is doomed and we need to get out and go private. Sad but true.

And so I quickly wondered what permutations the term “private” could possibly – or, even, constructively – lead to in what, at least to date, we have been told is potentially a far more empowering world than the one the NHS originally came out of.

Developing the train of thought, and on the back of my previous Revolution ’13 post linked to above, I tweeted this in response:

Inconceivable we could set up a parallel #NHS for England? Community health services run on mutual, cooperativist & socialist lines. #coop

What do you think?  Would there be enough interested parties for the first stage of my Revolution ’13 thesis to focus on finding a substitute set of health service provisions?  Using tools created for the Third World and other less wealthy parts of the planet (more here), we could revert their revolutionary and necessarily cost-effective approaches to medical cover “in the wild” to the job of supporting poorer people in what to date has been described as the First World.  A First World which is surely – gigantic step by gigantic step – becoming pocked and marked by holes of tremendous poverty and inequality.

No.  I’m not for one minute suggesting we give up the fight for the NHS.  But I am suggesting we put in place measures to save our perishable and finite souls from the medical Armageddon this government may yet manage to visit upon us.

WDYT?  Would it be interpreted as a sign of weakness?  Would we care if it was?

Would we have the right not to contemplate the alternatives, given the seriousness of the situation itself?

____________________

Update to this post: this piece, on GNU Health, has just come my way via the opensource.com newsletter.  It’s really worth a read.  An excerpt below:

In 2006, Luis Falcón founded GNU Health, a free health information system that recently recieved the “Best Project of Social Benefit” award given by the Free Software Foundation.

GNU Solidario is the non-profit NGO behind GNU Health, started as a free software project for Primary Care facilities in rural areas and developing countries. Since then, it has evolved into a full Hospital and Health Information System used by the United Nations, public hospitals and Ministries of Health (such as in Entre Rios, Argentina), and private institutions around the globe.

GNU Health/Solidario and the United Nations International Institute for Global Health—UNU IIGH—signed an agreement in 2011 to train health professionals around the world on the system, as a way of promoting free software in public health, especially in emerging economies. Since then, both organizations have been cooperating and expanding their network of partners to deliver health in a universal way; which, also works towards the UN’s Millenium Development Goals.

The resulting interview is fascinating.  Well worth your time – and perhaps, in the end, your money.


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Feb 102013
 
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This piece just published by Seema Chandwani on Labour Left describes all too clearly what’s happening to the NHS at the moment:

Across the country, the NHS is being dismantled, downgraded and closed down. These decisions are reckless and defies commonsense considering the  growing population. Regardless of the rhetoric from Cameron, the systematic collapse of the NHS is at the heart of Tory ideology as recently exposed by the release of government documents from the Thatcher era. What we are seeing now is an attack on the NHS to fulfil Thatcher’s once defeated plans.

And whilst the Twittersphere I find myself in appears to be vociferous enough, no hugely physical manifestations in the real world seem to be taking place.  The government is proceeding apace with its plans, it would seem.  Nothing too contrary prevents it.

Seema has this to say on the subject (the bold is mine):

The biggest weapon the Tories (and their Lib Dem friends) have to fulfil their vision is public apathy and naivety. The media’s coverage of what this government is doing to the NHS has been intentionally weak and we are being drip fed myths of desired improvements by a manipulating Tory regime. As I have a diabetic brother and my younger sister is being treated for suspected MS, being apathetic, naive and manipulated cannot be an option for me, I am sure that each one of you have similar reasons or experiences why the NHS is important to you.

Actually, I would wager that the vast majority of English people have very direct reasons or experiences to value the NHS.  If not at a personal level, then almost certainly at a familial.  So this – this personal experience, or lack of it – cannot be the reason the English are not now dramatically out on the streets, defending their future wellbeing and health.

Perhaps, then, the explanation lies elsewhere: are the English, in fact, political cowards?

I don’t mean everyone.  I don’t mean the activists.  I don’t mean those of us who love and hate politics in equal measure.  I mean ordinary people: people living their lives; people the politicians are supposed to serve and represent; people who only have the time to survive, work and occasionally live.

Does a certain level of poverty – or its horizontal threat – make of us all little cowards in some way or another?  When you still have a little to lose, do you prefer not to make waves?  Is the fear of losing everything a matter which leads us to kow-tow to those who are hurting us?  And is that precisely the place where we find ourselves now – as a people, as a community and as a nation?

The Tories don’t really have us by the balls, do they?  They simply have us by our cowardice.


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Nov 252012
 
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Let me explain.

I’ve been away for a couple of days in a hotel room.  The hotel was fine but it wasn’t my home.  I wrote a couple of pieces whilst I was there.  The pieces were more reflective than has been my custom of late.  We need more reflection.

At least, I need more reflection.

I’ve just arrived back home and sitting back in my familiar surroundings, anything but luxurious but – even so – comforting and family-underlining, the rain pitter-pattering on the sitting-room window, the recorded football on the tele, so it is that I am reminded of the great importance of familiarity in general: because for our politicians and rulers, you see, familiarity doesn’t breed contempt but – instead – too much confidence on the part of their subjects.

To feel safe in your castle as all Englishmen and women are supposed to feel is the greatest challenge to all political rulers who aim to desegregate a tapestry of national expectations.  Whilst you fear losing the very soul of your life, you will be cowed into almost any kind of behaviour.  But if you feel your loved ones are protectable behind the four walls of your home, then almost anything may be contemplated.  I can, in this sense, understand those who argue against gun laws – not, I hastily add, because I believe in anyone bearing arms at all but, rather, essentially because I appreciate now more than ever the importance of feeling permanently in control of one’s own destiny.

Which is what I think most profoundly is behind the assertions of such a constituency.

And that sense of control is what Disability Living Allowance aimed to provide; that sense of control is what the NHS which kept the wolf from the door was looking to add; that sense of control is what many of those top-down policies of empowerment we berated New Labour for engineering simply steamed ahead and implemented, day after day, to a wider benefit of us all.

To want to eliminate all those things is, in a sense, the UK equivalent of a rampant US desire for nationwide gun control.  Our “guns” – what allowed the British to protect themselves from the elements – are inventions such as the NHS, Legal Aid and the Welfare State.

As well as a wider network of social-care instincts.

Thus we come to understand that home is a shield which rightly emboldens us all – and DLA, the NHS, Sure Start and all were astonishing extensions of those shields I allude to which allowed us to believe, precisely, in better: better ways of seeing, thinking and living.

I tweeted rather sadly this morning the following sequence of ideas:

Did civilisation get too expensive for those who rule? Is that what this Coalition is all about? Reducing the costs of Western compassion?

And to me, it doesn’t half feel as if this is the case.

They can’t, of course, say that universal education has created a mass of highly intellectualised people which perhaps in many matters knows better than our governors.  They can’t admit this because they are tied hand and foot to the concept of meritorious pyramidal organisation.  Those at the top must be better than those at the bottom, because otherwise those at the top couldn’t be at the top.  It’s a self-fulfilling prophecy which, if questioned, would lead to all kinds of awful potentialities: maybe, for example, an utter and total reworking of that aforementioned – and for me, quite dreaded – pyramid of often dysfunctional relationships.

And the Lord forbid that such eventualities might take place.

*

Chris has a pertinent observation today, when he says:

[...] there’s a belief that the only knowledge that matters is direct experience; Tim seems to think that only the poor can truly understand poverty.This is doubtful. And what’s even more doubtful – in fact plain wrong – is that direct experience of poverty is necessary to know which policies are best to relieve poverty.

Something which I’d be inclined to agree wholeheartedly with.  Being evidence-based is far more important to the justice and fairness one can bring to bear on a matter than whether one was born rich or poor.  Being a person of kindly outlook – with an awareness of others, an empathetic personality and the ability to actively listen – are all far more useful to one’s ability to reach out than whether or not one has suffered personally the disadvantages of deprivation.

Such disadvantages may drive one unremittingly to help others, of course.  On the other hand, they could just as easily encourage us to trample whenever the opportunity presented itself.

It is in the essence of an individual where we must judge people’s integrity – rather than in terms of the origin of the acts themselves.

And so Chris is equally interesting when he concludes with these final biting lines:

It is not the background of Cameron, Freud and Osborne that stops them making effective anti-poverty policy. It is their ignorance and ideology.

Only I wonder if it is truly ignorance and ideology.  To be honest, I think it might be the biggest and most unpleasant practical joke of latterday political times.  A humongous practical joke, in fact.

For them, we are simply buttons to be pressed.  And if you really want my opinion, whilst I admire all that New Labour achieved, I’m going to be blaming Blairism, iPods and technological gadgets equally for this unending robotisation of how a society must function.

Yes.

Social mobility means you walk the streets with your frozen hands clasping firmly a PAYG phone.

Social mobility means you can never know if your parents will ever see their grandchildren.

Social mobility means you will never live in a face-to-face community again.

Social mobility – of this kind, I mean – leads us to a desperate scrabbling for a smidgen of human warmth.

And without that warmth, we have no hearth.  And without a hearth, we have no home.  And without a home, we have no shield.  And without a shield, above all we are as defenceless as the men and women who once occupied the caves.

Oh yes.  We have running-water and central-heating, but without the wherewithal to properly purchase it, it all becomes a mirage.

Hold on to that home.

Hold on to that shield.

Embolden yourself before it’s just – infamously – too late.


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Sep 152012
 
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This story from the Telegraph this morning provokes an understandably immediate and cheesed-off reaction: “Who knew?”  As a newly-appointed junior minister admits the government screwed up over the NHS reforms, it’s hardly surprising that the reactions prior to the bill’s passing should already, back in February, have been thus.

http://youtu.be/aoFZx3SeMwg

But the big story for me today is not that the government finally admits it screwed up.  The big story for me today is that the government is bad before it’s mad.

Any intelligent and sentient beings, understanding that things were getting as grave as they have been with a subject as impactful as the nation’s health service, would surely have found it within themselves to seek support and help across party lines in order to resolve the encroaching mess.  Now I’m not arguing that Cameron & Co are anything but intelligent and sentient beings.  What I am saying is that, despite this fact, they are sufficiently lacking in self-confidence – even now, two and a half years after half-winning/half-losing a general election – for them to feel incapable of such acts of sensible politics.

They’re not primarily mad ideologues out to destroy the entire fabric of English society – though this may yet be the case – but, rather, simply awfully insecure politicians who don’t really know what they’re doing to our country and, actually, in the light of these recent declarations, know they don’t know.

The world suffers often from the securities of the single-minded.  But there is a moment in the political cycle when the insecure and inept are far more dangerous than the pig-headedly decisive.  And that moment has now arrived.  That moment is when the insecure and inept realise they may not be up to the job they are responsible for; that their previous decisions have made things far worse; and that history will almost certainly judge them poorly.

When the insecure and inept realise – with security – how inept they are, and even so do not want to give up on the responsibilities which make their lives so astonishingly attractive and powerful, is when the rest of us do need to begin to watch our steps.  Nothing more dangerous than a wounded animal, after all.

Nothing more dangerous than ineptness in charge.


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Aug 212012
 
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It’s pretty clear now, isn’t it?  After yesterday’s news that the NHS brand is to be “developed” for overseas consumption, and as waiting-lists at home begin to grow dramatically, the real face of Tory strategy is revealed for all to see.

Like the commonest and cheapest asset-strippers of all, we’re not even really looking to take care of the core business.  Rather, it’s a buying-up of the name, a moving of the customer focus and manufacturing base abroad – and an ultimate maximisation of shareholder interests to the expense of other so-called stakeholders (in other words, patients, doctors, nurses and local communities).

So who and what did we vote for when we elected David Cameron?  If the reality behind the rebranded face of New Toryism has anything in common with the current US Presidential contest, I wouldn’t be surprised if it were the banks and other financial institutions which make so much of their money out of mergers, change processes and other massive modulations of wealth various.

Via opensecrets.org

After all, as many have already observed, fifty percent of all Tory Party income comes from those who will benefit directly from the commercialisation abroad of the NHS.

Gut the brand at home and lay waste to its integrity – even as abroad you build up its power?  What else could you expect a PR politician such as Cameron to come up with?  This is absolutely the world as seen through the prism of marketing.

This is the marketing of policy-making taken to its final and unrecognisable degree.

And this was a man who claimed our health services were safe in his hands.

He’d cut the deficit and not the NHS, right?  Lord only knows what negligences might have happened if Cameron had become a surgeon instead of a politician.

Jack the Ripper was nothing compared to Dave the Asset-Stripper …


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Jul 312012
 
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Matt tweets sentiments today I’m sure we all can sympathise with:

People still miss the point about the NHS. The point is: should people make a profit from healthcare? Should life and health be a market? No

But whilst sympathy is easy, agreement is not so simple.

Since its creation, and via their hierarchically differentiated salaries, GPs, consultants, surgeons, nurses, cleaners, ambulance drivers, managers and receptionists have all made a profit from the NHS.  Many have chosen their roles as vocations: none could have worked for nothing.

And do we really think those who have supplied blood plasma, oxygen, sterile products of all sorts, medicines, bandages, syringes, hospital furniture, light bulbs, signs, telephone and communications infrastructures, sandwiches, food in general and a whole host of other products and services were not, in reality, motivated by the incentive of the market in order to make as fast a buck as possible for their shareholders?

Back to Matt’s tweet, then: “Should people make a profit from healthcare?” he asks.  The answer is: “Of course.”  And before this awful Coalition government, and maybe before New Labour, we didn’t mind when they did.

So what’s changed?

I think it has something to do with what I alluded to the other day.  It has become all too self-evident that government is no longer the caped crusader and protector between naked capitalism and the rest of society.  Whilst we trusted that the game between governors and corporate capitalists involved some kind of give and take on both sides, we were prepared to contemplate situations and structures that perhaps were a little unwise and risk-ridden on our part.  But that silent social contract between a society which created infrastructures on the one hand and a large corporate base which generated employment on the other has been splintering for more or less a decade now.  And when that corporate base showed that – despite all the favours society had paid it – it was manifestly unable any more to fulfil its unwritten social responsibilities, we began to suspect – and understand far more clearly – that we had been much more than a little unwise in our even-handedness; much more than a little risk-ridden in the way we had chosen to keep our eyes wide shut.

As long as key public services remain free at point-of-use, we should not mind that private companies tender competitively for public provision.  But when corporations accustomed to engendering and working inside monopolistic markets want to do the same to our public sector, we not only gain nothing from the changeover in terms of efficiency, we also lose a tremendous amount in democratic accountability.

We could easily argue, with the evidence on the table, that the private sector is named thus precisely because it generally attempts to keep its sometimes horrific failings to itself.  After all, the light of public day is not generally cast on the boardrooms which take their cold decisions – protected as they are by their legions of lawyerly advice.

Let us, then, understand one point: the truly free market could help our healthcare a thousandfold.  But the market proposed by Cameron & Co is not the free market in question.

And the market proposed is not a problem because it allows people to profit from healthcare.  We understand that a nurse or GP should want to build a life around their career.

No.  In truth, the market proposed is actually a problem because it allows non-human corporations to profit to the ever-increasing exclusion of flesh-and-blood people.

That’s what’s changed.

And that’s why we now find it easy to sympathise with tweets like Matt’s.

The problem isn’t the profit motive, per se.

But, rather, what’s invading our social and emotional landscapes – and taking us over.

It’s not that we shouldn’t make a profit out of our wellbeing but, rather, that – in the future and at our expense -  only others will be able to.


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May 182012
 
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Imagine the situation, if you will.

Marketing-geek 1: Looks like the PM’s losing it.  Rebellions left, right and centre.

Marketing-geek 2: Time for a wizard wheeze perhaps?

Marketing-geek 3: How about a leveraged buyout of the NHS?  Cripple it with overwhelming debt and then sell it to the private equity firms?  Do for NHS hospitals what KKR did for biscuits.

(Hands out photocopy of Wikipedia article.  Short pause whilst other two skim-read.)

Marketing-geek 2: That would be a wizard wheeze!  We could start with introducing NHS vouchers!

Marketing-geek 3: Excellent idea, my man.

Marketing-geek 1: But wait!  How could you convince anyone to go for an NHS voucher scheme at a time like this?  They’d all say it was privatisation by the back door.

Marketing-geek 3: Not necessarily, my dear Marketing-geek 1.  We could, for example, choose something as British as fish and chips to launch it.

Marketing-geek 2: Like, say Boots.

Marketing-geek 1: Uhhhh …

Marketing-geek 3: Exactly!  Remember that scene from “Brief Encounter”?


http://youtu.be/Il8B6E9FzSE

(Everyone then remembers the Boots Lending Library reference.)

Marketing-geek 3: So even if the rebelling left, right and centre do remember what’s behind a wizard marketing wheeze like this one, who’s going to be able to convince the public that something as British as Celia Johnson’s favourite library is anything like as wicked as a leveraged buyout of the entire British state?

Marketing-geek 2: What a wizard wheeze!

Marketing-geek 1: Hats off to you mate!

(Both scrape and bow before their colleague as befits the moment.)

Marketing-geek 3: Of course, the only problem we now have is to convince the PM to go on breakfast tele and – in the midst of total global economic meltdown – explain a silly plan to get practising parents, who he’s currently taking tax credits away from, to go to Boots in their droves in order to pick up hundred-quid parenting vouchers.

Marketing-geek 1: But if we can convince him, it’ll only be a matter of time before we will be able …

Marketing-geek 3: (cough) … he’ll be able …

Marketing-geek 1: (nods vigorously) … he’ll be able to extend the idea of vouchers to practically everything else the state does.

(Big smiles all round as the big realisation dawns.)

(The rest, as they say, was history.)

____________________

Footnote to this post: uncertain as I am to the true dynamics of the matter I allude to in this piece, it does occur to me to wonder whether some of this hadn’t already happened under Tony Blair’s reign.

What say you?


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Apr 292012
 
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Jonathan Freedland has an interesting piece in the Guardian at the moment on whether Miliband & Co should treat and characterise Cameron & Co as useless or evil.  It’s an important point, for getting the message right in traditional megaphone pyramidal politics is just about the most important thing that you can do.  He does conclude that:

Put another way, should the opposition say this government is hopeless or heartless? The funny thing is, Labour may not even have to choose – for the government is doing its level best to be both.

And here I think we get to the nub of the issue: this Coalition government is driven by a consummate PR man – a man who believes whole worlds can be shaped through the use of well-chosen words for the broader benefit of paying company clients.  When transferred to our body politic, it’s about as conditional a view of the matter as you can get.  Cameron really should not be underestimated though, for he has never underestimated the facility cunning advertising has for turning a situation upside down.

Freedland argues that the choice is twofold: between useless or evil.  I think this government can actually be characterised with a third description: deliberately destructive.  The process used has developed thus: early on in its time, the Coalition has employed to its advantage our uncertainty as to whether it was incompetent or horrible to deconstruct our ability to focus properly on which megaphone would best be shouted through.  Our resulting uncertainty of tone has allowed them to continue being horrible whilst cloaked in apparent ineffectiveness.  Yes.  We have all been very clever on the data and content of our detailed rebuttals to almost every single policy idea the government has put forward over the past two years – but this is really not enough: the government is still firmly in place; we, meanwhile, are still occupying the role of moaning – and perhaps moderately anal – minnies.

Through the cloak of incompetence, then, the government has managed to continue with its evil intentions, the final goal being the total destruction of those sensible English socialist instincts which the NHS and Legal Aid at their best represented.  By cutting away the safety nets of both, and releasing huge private sector activities and impulses from their control, Cameron has managed to be useless, evil and – as I suggest in the title – deliberately destructive too.

For Cameron’s long-term aim is to rid this country of anything which might stand in the way of the Tory Party’s sponsors.  This is One Nation Conservatism brought firmly up to date: the Nation in question is a capitalism built around large companies; the Conservatism in question depends entirely on making it impossible for a government of a different hue to reverse any of the changes – even if it were possible to find and vote for such a government.

Not just useless.  Not just evil.

Deliberately detonating just about anything and everything that once served to counter the unimaginative, soul-destroying and – ultimately – fossilising “one best way” of corporate mindsets everywhere.

But politics – at least my vision of politics – shouldn’t be about finding ways of slotting people into a system; rather, it should be about fashioning a system around the needs of the realities of individuals.  The difference is subtle; the implications and consequences for the wellbeing of the individuals concerned immense.

We love the way that Barça plays – but the goals themselves only ever really get scored when people like Messi or Iniesta flash brilliance.

And Messi has never achieved the kind of brilliance at national level which he clearly has achieved at club level.

Systems are needed – but they need to respond to the characteristics of real people.

New Labour attempted and failed to grapple with this challenge.

Cameron & Co have simply unashamedly gone down the “one best way” road: pork-barrel politics and shock-and-awe tactics leading to a napalming of all and any other ways of seeing or doing.

So Freedland, in the piece I link to at the top of today’s post, is kind of right about useless and evil: what he gets wrong, though, is that both are actually tactics chosen intentionally, not characteristics exhibited unavoidably.

And as they lay waste to our nation in order to make it impossible for Labour to undo their evil, so a “one best way” will inevitably become a “one only possible way”.


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Apr 112012
 
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http://youtu.be/radTKsTJPNE

This is a strange video.  It washes over the viewer in pale dystopian greys.  Towards the end, the NHS it wants to rebuild is white and industrial-looking – just like the padlocked ballot box we are told will serve as a tool to its recovery.  We are missing only the white coats and padded cells to complete the image of Bedlam.

The Labour Party exists only as a logo and is represented by extraordinarily managerialist-looking figureheads (always excepting, perhaps, the nurse).  This is the final nail in someone’s political coffin.  Maybe mine for making such observations.  A corporate NHS, defended by the kind of corporate Labour which cannot itself quite step up to the barricades, populated by corporate bodies who tell professionally-couched corporate tales in the kind of carefully trained corporate tones of practised presentation-givers.

In this video, we also see what I would judge to be a mistaken appeal being made to the voters: here, we see the NHS belongs to a single political identity; it does not belong to everyone.

Yes.  I know.  There are good historical reasons to suggest that without the Labour Party, the NHS would never have existed.

But the people who are taking advantage of this badge of identity are using it quite desperately to capture as many floating voters as they can in a moment in our body politic when Labour should really be ripping apart the Tory-led Coalition in the polls.

This isn’t happening.

Labour is not polling beyond the combined strengths of a curiously resilient Tory Party and even a highly weakened Lib Dems.

This is the reason why I hate elections of most kinds – and dystopian elections in particular.  These are the dynamics of easy “us and them” – the dynamics I might venture of a kind of civil war – where what we are in favour of is made up mostly of what we are against.

I didn’t join the Labour Party to turn fellow Englander against fellow Englander.

You may disagree, of course; you may feel this video does nothing of the sort.

Convince me otherwise, then.

And, whilst you do, please explain why there are so many dystopian greys.

Is this really the kind of colourless future you want the public to see you voting for?


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Mar 282012
 
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Whilst unions announce today the serious possibility that our education system will, by 2015, follow the NHS and Legal Aid down the financialisation and commercialisation routes of private self-enrichment on the part of our professional politicos and their business sponsors, it surely becomes evermore clearer – without a shadow of a doubt in fact – what the government is really up to.

They care not a jot about winning the next election; not a jot about currying favour with all the voters; not a jot about creating a society and set of nation states fit for all our peoples.  Only one thing motivates them: the establishment of an unshakeable regime whose reversal will become so unappealingly expensive that – no matter who gets into power at the next general election – the legacy of five long years of anti-socialist ambush will be maintained and sustained for several generations to come.

Perhaps forever.

Labour is falling into a trap, I have to say.  It is fighting a losing but honourable battle on so many simultaneous fronts of political shock and awe that it’s hardly surprising it is allowing itself to be ambushed in this way.  But it needs to come to its senses: the government has done enough for even the least politically scientific amongst us to be able to realise its true trajectory and destination.  British socialism has a long and efficient tradition – the NHS and Legal Aid being two of its major achievements.  Where efficiency is ignored and discarded outright by supposedly businesslike politicos, it’s clear they are not caring to be evidence-based professionals but, rather, aim to act out of prejudice.  And by acting out of prejudice we can conclude they are acting out of personal self-interest.

What’s so bad about all of this is not that these Tories at the top under Cameron’s rule have managed to hijack their own party – which they clearly have; nor that they have hijacked the democratic system as whole – which they did back in 2010 and will do so until 2015; nor, even, that they betray their business roots by doing what they want rather than what is empirically accurate – something which all of us can now surely see.  What’s so really bad about all of this is that we’re all falling into their trap: focussing on discrete policy battles instead of being brave enough to fashion and forge a counter-narrative.

The government say they are looking to reduce the inefficient state.  We should say they are looking to enrich and expand the inefficient private sector of bad business cronyism.  The government say they are looking to reduce the deficit.  We should say they are looking to transfer its impact from a strong nation to helpless individuals.  The government say they are looking to create an environment of opportunity and empowerment.  We should say they are looking to restrict opportunity and empowerment to the already wealthy.

As I said some months ago now, the bad capitalist blame game works as follows:

  1. When large corporations and the people who own them set themselves up in business, they limit their responsibility if everything goes belly-up to the very minimum they can manage to get away with;
  2. When everything goes belly-up, which it almost always does at least once in the history of such companies, the ones at the very top manage to hide behind Chinese walls that reduce their legal responsibility to a very minimum;
  3. When companies’ profits do not achieve expectations, the fault is first and foremost due to the costs of labour – the term “labour” being understood to mean those at the most humble levels in a company and not the (mainly) ever-so-red-blooded gentlemen at the top;
  4. If companies suffer excessively from declining profit margins, people at the top get paid enormous amounts of money to take immediate decisions to fire massive percentages of their workforces – even where such decisions show absolutely no degree of imagination or added value;
  5. If the wider economy falls completely apart, the taxpayer will be obliged to bail out the failing private sector but compelled to destroy the public;
  6. When the wider economy stops functioning in any meaningful way, the workers who lose their jobs will carry both the moral and economic can for not wanting to find new jobs – even where these new jobs don’t exist;
  7. When the economy finally recovers, the workers will have to continue to accept wage cuts for two reasons: firstly, automation might price them out of the market if they don’t watch their demands; secondly, only the rich work harder for more money – the poor, on the other hand, tend to slacken off their labour when not sufficiently terrified;

These are the things we need to be underlining; these are the things we need for our counter-narrative.

In fact, if truth be told, we need – also – to point out to our nation states and our peoples the degree to which a good socialism ruled our waves.  Only when we can shrug off the instincts to be stealthy about our achievements can we begin to generate a different way of opposition: socialism was always a heartfelt instinct of the British.  In the past we called it fair play.

Perhaps, then, we need to resurrect that idea and begin to call ourselves the Fair Play Party.  A Fair Play Party for a fair play society.

As British as you ever could get.

Whatever your nation.


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