Man of the People 2

Oh dear, Ed. So short a time after Dave shot himself in the foot trying to be faux poor by jetting off to Spain on RyanAir, you have fallen into the same trap: being interviewed on a train and hoping no-one would notice you are in a first class carriage because the head rest cover had been removed. Stupid! You are the leader of the Opposition, for God's sake! People expect you to have a bit of clout, a bit of heft, a bit of (1st) class! I can think of any number of reasons why you might travel first class -space to work, security issues, hating the smell of the great unwashed - but don't try to pretend you were travelling econoclass: you will be found out and you will look all the smaller for it. Now, get back to kicking Dave'n'Nick's butt.

Man of the people

There can be fewer depressing sights than a politician trying to get down with the 'real' people. Photo opportunities involving pints of beer, cups of tea, fast food or any other perceived preoccupation of the man in the street are legion. In every one of them, the politician looks uncomfortable and desperate to run for the shower to wash away the stench of normality.

Dave and Sam took this to a whole new level of idiocy this week, flying Ryanair from Stansted to Spain. What was this supposed to prove - that we really are all in it together? Travelling alongside us plebs on Ripoffair does not make you real, normal or in tune with the working man. Dave - you are well off. Don't pretend you are not. It is patronising and insulting. Stop pretending that posing as Joe Schmoe will make you sympatico with the people that you are currently screwing. You look unhappy, Sam looks even unhappier and we can see you are proving nothing. Please get back to being the toff we all know you are.

Not our fault, guv!

I was listening to a spokesperson from the Association of Train Operating Companies (ATOC) being interviewed on radio the other day. The interviewer was explaining to him a raft of concerns raised by train-using listeners, from the huge hike in ticket prices that are going to happen over the next three years (30% anyone?) to that lack of seats on trains. The answers that this PR-trained lackey intoned went something like this: "It's the government's fault", "That will be due to government rules", "We would, of course, like to do something about that, but those are the rules imposed by government" and so on. Until he reached the last question. A commuter had questioned the state of affairs that allows the rail company to take £4,000 from him for his season ticket and not once in the year provide him with a seat! That's right - four grand to stand everyday. And Mr ATOC's answer? "Well, it just demonstrates that the rail companies are victims of their own success!"

Leaving aside the notion that "successful" companies tend to invest in some capital items (carriages) rather than short-sightedly pocketing the profits, what a glibly cheap response that is, using the term "victim" to describe the train company rather than the poor sod who has been blatantly robbed. In fact, every one of his responses was the same: it's not our fault - it is all beyond our control. If that is the case and they can influence precisely nothing, what is ATOC for? Seemingly for nothing more than taking the money and running.

Yet another example of things being *so* much better since they were privatised.

Saving the NHS thousands of pounds!

A genuine article from that bible of excellent health advice, the Daily Mail. Why are we spending money on all sorts of mental health therapies?

So there you have it. Simple! Next week, appendectomies with a penknife and liposuction with your Dyson!

Thanks to butireaditinthepaper.co.uk for signposting this gem

Er - come again?

One of the areas that has been put under the spotlight by the popular uprisings (are they revolutions? Not sure....) in north Africa is the British arms trade. Okay, it is not a forensic investigation, admittedly, but it keeps being mentioned.

In the same way that there was a rash of concern a few weeks back that drugs supplied by a pharmaceutical wholesaler in West London might be used to kill Death Row inmates in the US, the role (or non-role) of British-made weapons in the suppression of uprisings is regularly mentioned in news reports on radio and TV. In the case of the drugs, I was more interested in how the US penal system ended up contracting with the owner of a minicab business for such a major slice of business. Did he put forward a great bid when he tendered for the business? Were his rates so competitive that money-conscious public bodies could not say 'no' to his prices? Or were the buyers looking to purchase from a source seemingly far off the radar because they realise the deal is just a little bit grubby?

Likewise, in the past we may have congratulated ourselves that we have a thriving arms industry that exports lots and lots of 'goods'. Fantastic for the UK balance of trade just as long as we don't have to think what they are used for. But then along comes a set of popular uprisings against tyrannical and hated ancien regimes which we find ourselves willing to succeed (whilst worrying a little about future consequences - but that is for another day!) and then someone spoils the party. They mention that the ruling governments might be using the weapons that we supplied to put down the protesters, to kill demonstrators. Ooops! That's not what we wanted at all...

Which brings us to Alistair Burt, Foreign Office minister in the coalition government, going on record last week to say that there was no evidence that British-made tear gas canisters had been used against protesters in Bahrain. How did he know? Did he phone the government there and get them to promise, on their honour, that they would not use the weapons we sold them to do anything nasty? Did he "have in his hand, a piece of paper"? How a government minister can make a claim like this and expect the public to accept it at face value beggars belief. But he did and I suspect a lot of people thought no more about it.

The arms trade has always been a double-edged sword: great for exports, bad for the preservation of human life. Robin Cook, for the most part a fine politician, God rest his soul, rather lost the plot when he talked about the need for our foreign policy to have an ethical dimension. How was that ever to be achieved? Our enemies today will be our friends next week and thus has it ever been so. Mr Orwell was not predicting the future in 1984, he was commenting on what had been going on for ages but was starting to descend into the demonic barn dance of partner changing that characterises world politics today. Similarly, an ethical foreign policy cannot be reconciled with a buoyant arms trade; no-one can guarantee the weapons they sell will only be used against 'bad guys' because, once you've sold 'em, you are no longer in control of 'em.

So thanks Alistair Burt for trying to make us feel a bit better about ourselves. Great Britain was not in any way helping to stifle the popular uprising in Bahrain and no civilians involved were harmed with British weapons. Nor ever will be. It must be true - our government told us.

I Blame the Renaissance...

A pretty shocking report from the Health Service Ombudsman today exposed the lack of care given to frail, elderly patients in NHS units. There were a number of distressing case studies that highlighted neglect and contempt for dignity bordering on abuse. How can this happen in the new, modern NHS?

When more outright abuse of vulnerable people came to light (there were several high profile nursing home cases in the 80s), it had occurred in smaller units, away from the public gaze and was undertaken by a low paid staff who crossed the boundary between 'efficiency' and 'control'. The low status of the staff was, in effect, taken out on the 'difficult' clients, most of whom were severely confused through dementia. Ok, we can see how this situation might come about in such smaller units. But how does it happen in the public glare of NHS wards?

Some aspects are the same: the patients can be difficult because they are confused; the staff are probably stretched and striving to work 'efficiently' and the public are not on the ward most of the time to see what is happening. But what else has occurred?

I believe a few things have changed, albeit not overnight. The whole relationship between the carer and the cared for has changed through increased medicalisation. In the Middle Ages, treatment was based on a holistic principle: the sick person was just that - a person, first and foremost. They never lost their identity throughout any treatment they were given. The physician's diagnosis and treatment was all based on the needs of the person, the individual. The Renaissance began the revolution in medicine that led to the questioning of Galenic principles that had held sway in the field of medicine for hundreds of years. Certainly, change did not happen overnight and economic and social factors played their part, but over the years from that point, the patient as a person begins to disappear and become replaced with symptoms, a disease, a treatment. The individual is no longer present. Whilst this began with and was carried forward by physicians and surgeons, nurses too have followed the same path as their training becomes more medicalised. As the whole healthcare system has squeezed 'caring' out of the equation in favour of 'curing' (even though there are so many diseases we can do nothing about), so the needs of the elderly frail - who often really need CARE - have been marginalised.

The care and treatment of older people has always been a cinderella service, indeed it has not always been seen as 'health' care, being under local authority control in the past. I am sure there must be examples of excellent practice, but it seems that the whiff of the 'second class service' still hangs around. Perhaps it is the focus on cure (again, thanks you Renaissance pioneers) that is at fault; 'caring' seems so passive, so...unexciting. All the money goes into the sexy end of medicine - trying to find cures for things. Trying to get money to improve end of life care, aiding people in choosing where they die and so forth, is bloody hard! Of course, we all want to live for ever and not think about the other thing...

Maybe it is time to return to a greater degree of holism in the NHS. Perhaps if, from the moment one entered the the hospital system, one was dealt with as an individual and treated (medically and socially) as such, perhaps then it would lead to better care: it is surely hard to treat a person with whom you have a caring relationship with the kind of disregard today's report exposed. If the people on one side of the healthcare equation see only a disease or condition to be treated, beds to be freed-up and targets to be met, then those on the receiving end of 'treatment' may well be terribly let down.

Slightly worrying?

David Cameron, worried that we either don't get the idea of the Big Society or that it has been trampled by the stampede of stories of cuts, redundancies and general gloom, has tried to breath new life back into his pet project in a piece written for today's Observer.

Now, don't get me wrong - I am not opposed to much of what the Big Society proposes: there is nothing intrinsically wrong with encouraging more people to become involved in their communities through volunteering, for example. I do have some problems around the fact that it is too closely allied to the cuts, that we are looking to replace statutory services with charitable provision, something that just won't fly because of the cuts and the reduction if funding to charitable bodies. Dave can argue until he is (Tory) blue in the face that he had the idea if the Big Society long before it was realised that cuts would need to be made, but it still feels like a cover for a fundamental change to welfare systems. If that's what it is, then just say it - don't argue that the two are only coincidentally linked.

Similarly, some of the schemes as outlined seem a bit barking like the volunteer workforce for 16 year olds aimed at fostering ideas of citizenship and community involvement. Which 16 year olds are going to join this? The ones who really need to learn something about being part of a community - the stereotypical tracksuited ASBO kid - or the middle class kids who realises that something like this will look good on their CV when it comes to getting into Uni or that first post-degree job?

But the real kicker in Dave's piece is this:

"And if someone wants to help out with children, we will sweep away the criminal record checks and health and safety laws that stop them."

So those Criminal Records Bureau checks are just useless red tape are they, Dave? You would be quite happy for anyone to walk in off the street and look after your children? I realise that this is an exaggeration, but even so, if these checks are swept away, whose word will we have to take in future that someone wanting to work with children is fit and proper to do so? The previous system was not perfect: a single person working with several agencies might need to have the check repeated for each workplace (a nice moneyspinner for the CRB no doubt) and anyone changing jobs, likewise, needed a new check before starting at their new place of work. This should have been streamlined and could have been quite simply. Similarly, a little more common sense could be applied to who actually needs a check. If you are willing to help out with kids' activities are not left unsupervised with them, do you need a full check for this?

To severely downgrade these checks is dangerous. Whilst there are some aspects of childhood that have become too wrapped up in cotton wool, knowing about those who act in loco parentis with our children is vitally important. Dave's rather blase statement seems to suggest cases such as the one involving Ian Huntly never happened or will ever happen again.