Category Archives: current affairs

current affairs

Reductio ad absurdum — but he has a point!

I’m not a natural Guardian reader. I view it as a bit of a rag, like almost all the media. But I can’t help reading George Monbiot’s column in the Guardian every Tuesday. He invariably lifts the lid on something our political masters would rather remained out of sight and mind. Monbiot’s articles are well argued and he always posts a fully referenced version on his weblog.
This week is no exception. In Why stop at Isis when we could bomb the whole Muslim world? Monbiot totally destroys any pretence our masters have for their actions in the Middle East. I give you a few extracts:

Let’s bomb the Muslim world — all of it — to save the lives of its people. Surely this is the only consistent moral course? Why stop at Islamic State (Isis), when the Syrian government has murdered and tortured so many? This, after all, was last year’s moral imperative. What’s changed?
…
The humanitarian arguments aired in parliament last week, if consistently applied, could be used to flatten the entire Middle East and west Asia … Perhaps this is the plan: Barack Obama has now bombed seven largely Muslim countries, in each case citing a moral imperative.
…
Now we have a new target, and a new reason to dispense mercy from the sky, with similar prospects of success. Yes, the agenda and practices of Isis are disgusting. It murders and tortures, terrorises and threatens. As Obama says, it is a “network of death”. But it’s one of many networks of death. Worse still, a western crusade appears to be exactly what Isis wants.
…
More than 6,000 fighters have joined Isis since the bombardment began. They dangled the heads of their victims in front of the cameras as bait for war planes. And our governments were stupid enough to take it.
…
Never mind the question, the answer is bombs. In the name of peace and the preservation of life, our governments wage perpetual war.
…
There are no good solutions that military intervention by the UK or the US can engineer. There are political solutions in which our governments could play a minor role … Whenever our armed forces have bombed or invaded Muslim nations, they have made life worse for those who live there.
…
Yet our politicians affect to learn nothing. Insisting that more killing will magically resolve deep-rooted conflicts, they scatter bombs like fairy dust.

He is pointing the finger at David Cameron and Barak Ombama, but previous governments — specifically Tony Blair and George W Bush — are at least as culpable.
The argument may be reductio ad absurdum, but he does have a very good point.

current affairs, history

Independent or Not?

On the back of Scotland’s decision not to become an independent country, it occurs to me to ask …
How many “countries” (states, provinces, or whatever you want to call them) have ever voted in a free and fair election NOT to take independence from their “imperial masters”?
The only other which comes to mind is Quebec in 1980 and 1995. Are there any others since (say) 1800? One hears of so few that it seems to me that if independent sovereignty is sought, it is almost always attained.

current affairs, medical

Welsh Cannabis

Following on from the previous post about the liberalisation of prostitution, here’s another piece of unexpected sensible news.
The NHS in Wales will be the first in the UK to fund a cannabis-based medicine for people with multiple sclerosis. The drug in question is Sativex which has been on the market for some time.
Bravo for them as this is in line with current medical research, but directly contrary to the the recent draft NICE clinical guideline which rejected the drug for use on the NHS in Wales and England based, apparently, on a flawed assessment of its cost effectiveness.
You see, by chipping away, entrenched attitudes can be changed.
Wales 1, Blinkered Politicians 0

current affairs, sexuality

Internet Prostitution

There was a very interesting article in the Economist on 9 August under the headline “Prostitution: A Personal Choice”.
The first interesting thing is that such an august institution as the Economist does not support the UK government fetish of zero tolerance because the buying and selling of sex is dangerous, immoral etc. etc.
Instead the writer makes a number of points supported by recent research. First and foremost:

The internet is making the buying and selling of sex easier and safer. Governments should stop trying to ban it.

While they agree …

Some prostitutes do indeed suffer from trafficking, exploitation or violence; their abusers ought to end up in jail for their crimes. But for many, both male and female, sex work is just that: work.
This newspaper has never found it plausible that all prostitutes are victims … the commercial-sex trade [looks] more and more like a normal service industry.

They go on …

Moralisers will lament the shift online because it will cause the sex trade to grow strongly … But everyone else should cheer. Sex arranged online and sold from an apartment or hotel room is less bothersome for third parties than are brothels or red-light districts … the web will do more to make prostitution safer than any law has ever done. Pimps are less likely to be abusive if prostitutes have an alternative route to market. Specialist sites will enable buyers and sellers to assess risks more accurately. Apps and sites are springing up that will let them confirm each other’s identities and swap verified results from sexual-health tests. Schemes such as Britain’s Ugly Mugs allow prostitutes to circulate online details of clients to avoid.
Governments should seize the moment to rethink their policies. Prohibition, whether partial or total, has been a predictable dud. It has singularly failed to stamp out the sex trade.

Moreover …

The “Swedish model” [criminalising the purchase of sex instead of its sale] … is misguided, as a matter of both principle and practice. Banning the purchase of sex is as illiberal as banning its sale. Criminalisation of clients perpetuates the idea of all prostitutes as victims forced into the trade. Some certainly are — by violent partners, people-traffickers or drug addiction. But there are already harsh laws against assault and trafficking. Addicts need treatment, not a jail sentence …
Sweden’s avowed aim is to wipe out prostitution by eliminating demand. But the sex trade will always exist — and the new approach has done nothing to cut the harms associated with it.

And finally …

Prostitution is moving online whether governments like it or not. If they try to get in the way of the shift they will do harm … the unrealistic goal of ending the sex trade distracts the authorities from the genuine horrors of modern-day slavery … and child prostitution (better described as money changing hands to facilitate the rape of a child). Governments should focus on deterring and punishing such crimes — and leave consenting adults who wish to buy and sell sex to do so safely and privately online.

One day governments will start taking real notice of research findings and start understanding.

current affairs, medical

NHS Funding

So. According to all the media reports, and the scaremongering from professional bodies, the NHS is in crisis and falling apart because it is significantly under-funded and a political football. It is barely “muddling by” [1,2,3].
Well maybe.
It cannot be denied that the NHS is in crisis. It is badly organised and badly managed. And yes it is a political football.
I’ve written about this before [4,5] and I make no apology for doing so again.
It cannot be denied that some sectors of the NHS are woefully under-funded. This is especially true of GP services where funding has fallen from a high of 11% of NHS budget in 2006 to around 8.3% today against a background of significant increases in the number of consultations and demands from politicians [6].
However overall I cannot believe that the NHS is under-funded. It seems to me the NHS has shed-loads of money to do everything you and I could reasonably want it to do. But that money is badly used, in large part because of the appalling level of wastage.


The NHS employs way more managers and administrators than it needs. That in itself is a huge waste of resources. Just take a look next time you visit a hospital at how many staff are wandering about apparently aimlessly. What do they do? Is it useful? How many are doing nothing but moving pieces of paper from A to B? In this day and age moving pieces of paper around by hand is an inexcusable waste. Do it electronically! Use email, or on-line documents, or database systems.
Yes, to get the NHS using pervasive electronic communication is going to take time, and will need an up-front investment. It will also need the Civil Service and government not to cut corners on cost by being constrained to choose the cheapest bidder, to understand how to manage a big IT project (like don’t keep changing the project scope) and to listen to advice from their trusted suppliers.
The NHS also has far too many managers. Their lives seem to be predicated on bullying staff and chasing meaningless government targets. If we could get rid of the pointless targets and teach the managers how to manage people the NHS would need far fewer of them. In doing this it will take the NHS quite a long way towards trusting and empowering its employees. Trust them to do their job. Trust them with the empowerment to do it efficiently. Empower them to change things sensibly if they can see a better way. In other words, act like a good private company.
Somewhere else the NHS wastes money is in the sheer waste of supplies. One hears stories of hospitals where Ward A needs supply Y but can’t buy it because there’s no money; yet Ward B has a cupboard full of the same supply but has to throw it away because it has gone out of date. In one instance I know of where this happened, and it was pointed out to the top brass by a junior nurse, just changing the procurement policy saved the hospital several million pounds in the first year. Practices like this are not uncommon.
And let’s not talk about hospital food. If patients were fed properly, not only would there be a lot less food waste but the patients might actually get better quicker so they could be discharged sooner.
This is all well and good but I fear it will never happen. For a start politicians, almost by definition, have to keep meddling. Not only is it ideological but it is the only thing they can do to try to show they are doing something.
The other reason it will never happen is that there is no-one at the top of the NHS who has the ability to grasp the whole organisation and energise it. That is not the Civil Service way. But without this there will be no change. The NHS needs someone highly skilled, robust, no-nonsense and bloody-minded to head it up. Someone who will energise the employees, from top to bottom. Who will empower from the top and support empowerment from below. Who will give his or her henchmen a job to do and expect them to get it done — or get out. And most importantly someone who will tell the politicians to butt-out and stay out.
Names like Richard Branson, Alan Sugar and Digby Jones come to mind. You may not like them, but they are the type of people who are needed. Badly needed.
Without someone like this, and without government getting a proper, business-like grip, the NHS is indeed going to go nowhere except, as predicted, down the tubes. And that is something the country cannot afford!
——————————
References:
[1] Observer; 28 June 2014
[2] Daily Telegraph; 18 June 2014
[3] Independent; 29 June 2014
[4] https://zenmischief.com/2014/02/transforming-the-nhs/
[5] https://zenmischief.com/2012/08/reforming-the-nhs/
[6] Royal College of General Practitioners; 27 June 2014

amusements, current affairs, ramblings

Oddity of the Week: Legal Tender

Now here’s an oddity which I found out by chance the other day …
Bank of England sterling banknotes are the only paper money which is legal tender in England and Wales. No banknotes are legal tender in Scotland or Northern Ireland! (Bank of England coinage is legal tender throughout the UK.)


The following quotes come from the Wikipedia article on Banknotes of the Pound Sterling which, for those in doubt, is well referenced.

The Bank of England [acts] as a central bank in that it has a monopoly on issuing banknotes in England and Wales, and regulates the issues of banks in Scotland and Northern Ireland …
… some of the monopoly provisions of the Bank Charter Act [of 1844] only applied to England and Wales. The Bank Notes (Scotland) Act was passed [in 1845], and to this day, three retail banks retain the right to issue their own sterling banknotes in Scotland, and four in Northern Ireland …
English banknotes … The majority of sterling notes are printed by the Bank of England. These are legal tender in England and Wales, and are always accepted by traders throughout the UK …
Scottish banknotes … are the recognised currency in Scotland, but are not legal tender. They are always accepted by traders in Scotland, and are usually accepted in other parts of the United Kingdom. However, some outside Scotland are unfamiliar with the notes and they are sometimes refused. Institutions such as clearing banks, building societies and the Post Office will readily accept Scottish bank notes.

The situation in Northern Ireland is exactly as in Scotland except that Northern Ireland banknotes are seldom seen outside the province.


And here now is the interesting part …

The concept of “legal tender” is a narrow technical definition that refers to the settlement of debt, and it has little practical meaning in everyday transactions such as buying goods in shops (but does apply, for example, to the settling of a restaurant bill, where the food has been eaten prior to demand for payment and so a debt exists). Essentially, any two parties can agree to any item of value as a medium for exchange when making a purchase (in that sense, all money is ultimately an extended form of barter). If a debt exists that is legally enforceable and the debtor party offers to pay with some item that is not “legal tender,” the creditor may refuse such payment and declare that the debtor is in default of payment; if the debtor offers payment in legal tender, the creditor is required to accept it or else the creditor is in breach of contract. Thus, if in England party A owes party B 1,000 pounds sterling and offers to pay in Northern Ireland banknotes, party B may refuse and sue party A for non-payment; if party A provides Bank of England notes, party B must acknowledge the debt as legally paid even if party B would prefer some other form of payment.
Banknotes do not have to be classed as legal tender to be acceptable for trade; millions of retail transactions are carried out each day in the UK using cheques, bitcoin, or debit or credit cards, none of which is a payment using legal tender … Acceptability as a means of payment is essentially a matter for agreement between the parties involved.
Bank of England notes are the only banknotes that are legal tender in England and Wales. Scottish and Northern Ireland banknotes are not legal tender anywhere … The fact that these banknotes are not legal tender in the UK does not however mean that they are illegal under English law, and creditors and traders may accept them if they so choose …
In Scotland and Northern Ireland, no banknotes, not even ones issued in those countries, are legal tender. They have a similar legal standing to cheques or debit cards, in that their acceptability as a means of payment is essentially a matter for agreement between the parties involved, although Scots law requires any reasonable offer for settlement of a debt to be accepted.
Until 1988, the Bank of England issued one pound notes, and these notes did have legal tender status in Scotland and Northern Ireland while they existed. The Currency and Bank Notes Act 1954 defined Bank of England notes of less than £5 in value as legal tender in Scotland. Since the English £1 note was removed from circulation in 1988, this leaves a legal curiosity in Scots law whereby there is no paper legal tender in Scotland.

And here’s a further curiosity …

Bank notes are no longer redeemable in gold and the Bank of England will only redeem sterling banknotes for more sterling banknotes or coins. The contemporary sterling is a fiat currency which is backed only by securities; in essence IOUs from the Treasury … Some economists term this “currency by trust”, as sterling relies on the faith of the user rather than any physical specie.

In other words all money is worthless; it is all either physical tokens (banknotes, coins) or electronic bits in a computer system and it is all government IOUs. But it was the definition of “legal tender” and the lack of banknotes as legal tender in Scotland and Northern Ireland which piqued my interest.

current affairs, medical

"Another NHS cock up"

This is an absolutely classic example of why NHS — no actually not just NHS, but all government — IT projects fail so spectacularly.
There are a couple of telling comments in the report on the NHS decision to quietly close the “Choose and Book” outpatient appointments system.

During a recent investigation … MPs were told by NHS staff that while some GPs liked Choose and Book, many did not, and that not all outpatient appointment slots were available on it, limiting its usefulness.

Whether GPs like it or not, that’s the process they have to use; so get on with it and then get it improved. But not having all the appointments there is inexcusable. And the appointments aren’t there; I’ve recently had the run-around getting an audiology appointment because Choose & Book can’t get their act together. (And to be fair my GP went ballistic because of the inefficiency.)
But then it gets worse …

NHS England said … the new e-referral system would use different technology, but it was unable to say how much the scheme would cost.
(Emphasis mine.)

drThis is the crux of the matter. If you don’t know how much a project is going to cost, then you do not have a project because you cannot commit funding. There are three prerequisites to running ANY project: a sponsor (ultimate responsibility), a coherent defined and documented set of requirements (the job) and committed funding (ability to pay). Without all three there is no project. Ever.
And government never provide any of the three. They are totally unable to define, specify, cost and manage projects (and they will not take sensible advise from their suppliers). The right level of funding is therefore never committed. And no-one takes overall responsibility.
So things either never happen (because suppliers won’t accept rubbish contracts) or they go tits up (because what is specified either can’t be delivered at the agreed price or isn’t fit for purpose).
So it seems likely that this new project will either be stillborn or will fail within three years. And that is our money — our taxes — down the drain. Again!
Why is there no-one in government, the civil service or parliament with any teeth?

current affairs, freedom of speech

Sports Disgust

First of all the retailer Sports Direct bans a mother from breastfeeding her child in their Nottingham store.
Then when a group of mothers protest outside their Ealing store (as mothers apparently have been around the country) the staff gratuitously photograph them and call the police.
Now I admit I do not know all the ins and outs of this case, just what has been reported by Ealing Today, but this seems like a disgraceful over-reaction by Sports Direct.

current affairs, medical

£50m? That Goes Nowhere!

In a widely reported impending announcement David Cameron is allegedly to pledge £50m to fund 1000 GP surgeries (roughly 1 in 8) to open 0800-2000, 7 days a week. See for instance here.


Yes, these extended GP hours are something we, the patients, are asking for. And there is a need because currently there are people (just how many is really debatable) who can’t (for lots of reasons) go a GP appointment but unnecessarily clog up A&E.
But yet again the UK government has proved it doesn’t have a clue about how to actually run the NHS. Cameron doesn’t stand a hope in hell of achieving what he’s pledging, because $50m by my reckoning will pay for a quarter of that for just one year.
Here’s why …
Opening 8-20, 7 days will mean around an extra 34-40 hours a week to be covered. (It’s 34 hours if the practice is currently open 0800-1800, 5 days a week; and many aren’t.)
This means every GP practice which is going to extend their hours, as demanded will need to employ at least one extra full time equivalent GP.
And to cover the extra hours they will also need at least one full time extra member of reception/office staff.
Leaving aside where they are going to find all the suitable, spare GPs, let’s look at the cost. Here’s a very broad brush, back-of-envelope, estimate:
Assume that a GP costs the NHS £150K pa (that’s salary plus pension contributions, plus employers NI contributions, plus other benefits like holiday etc.).
Assume similarly that a full time trained receptionist costs £30K pa (again salary plus benefits package). (Yes you do need trained receptionists; medical work is not something anyone off the street can do, and certainly not safely.)
And then remember that the extra hours will also incur costs for heat, light, hot water and other services — let’s assume that’s £25 per week per practice.
Which means each practice would need funding of around £181K a year.
Dividing that into £50M would provide enough funding for around 275 practices, or about a quarter of what is proposed. And 275 practices is little more than 1 for each NHS area (CCG) in the country (by my count there are 211 of them in England).
So even if the “reorganisation” also provides 100% efficiency savings (which would be a world first!) that still means we’ll achieve only 50% of Cameron’s pledge.
So not only will Joe/Josette Public not realise that this may mean his/her GP isn’t open (and they have to go several miles across the borough to find the practice which is open — on a Sunday when there are no buses), but it is going to go nowhere near meeting Cameron’s pledge.
And that’s without all the fancy gizmos, like Skype video consultations, which are being promised. They have to be paid for too!
Oh and if you read the articles don’t be deceived by all the twaddle about the over 75s. That’s been in the plan for a long time; it isn’t new. Just as I suspect the £50m isn’t new money either.
How do we get these people to understand that healthcare is expensive, that the available funds are being misallocated and mismanaged, and that GP services are hugely underfunded compared with 10 years ago? Because they really don’t have a clue how to fix things.

current affairs, ramblings

Coming up in March

Interesting events an anniversaries in the month ahead.
4 March
Shrove Tuesday, and therefore Pancake Day. Traditionally this was the feast to eat remaining winter food stocks on the last day before the fasting of Lent. It was also the day when the penitent went to confession (hence “shrove” from “shriven”) in preparation for Lent.


Pieter Bruegel the Elder; The Fight between Carnival and Lent (detail)

5 March
The day after Shrove Tuesday is therefore Ash Wednesday, the first day of Lent.
8 March
International Women’s Day. Find out more at www.internationalwomensday.com
11 March
This day in 1984 saw the beginning of the National Miner’s Strike in which Prime Minister Margaret Thatcher defeated the Miners’ Unions and effectively killed the British coal industry.
14-23 March
National Science & Engineering Week is a ten-day national programme of science, technology, engineering and maths events and activities across the UK aimed at people of all ages. Find more at www.britishscienceassociation.org/national-science-engineering-week.
21 March
Spring (Vernal) Equinox and the pagan festival of Ēostre (which the Christian church subsumed into Easter and made a moveable feast).
21 March
Composer Modest Mussorgsky was born this day in 1839.
25 March
Lady Day or the Feast of the Annunciation of the Blessed Virgin. It is the first of the four traditional English quarter days when servants were hired and rents were due.
26 March
The UK Driving Test was introduced on this day in 1934.
30 March
Mothers’ Day in the UK, which is always celebrated on the fourth Sunday in Lent.
31 March
Paris’s Eiffel Tower was opened this day in 1889.