Although it has been really sad to learn of the death from suicide of the actor and comedian Robin Williams, the greater sadness is the thousands of suicides which occur with little or no attention. In a reflection of the modern world which we occupy, it often now takes the death of a celebrity to bring a particular health issue in to sharper focus. The problem is that few people want to dwell for too long on negative health outcomes. For a variety of reasons, that is understandable. People still have their lives to lead and rightly so.
One aspect of the Robin Williams story is inescapable. It is arguably more straightforward to consider his alcohol and drug addiction than it is to consider his depression. Successive studies indicate that alcohol consumption continues to rise in Western populations with the spectre of addiction lurking not far away. Although the numbers taking illicit drugs are lower, the concept is still likely to be more palatable to the many. The stigma attached to all mental health remains as strong as ever.
If the passing of Robin Williams impacts even only slightly on the way people think about not just depression but mental health in general, that will be a great achievement. Only when whole societies start to consider it differently will the potential outcomes of people like him be improved. We will never save everyone from this fate but it is certain that whole societies can make a huge difference just through a change in attitude. The media in particular can make a massive difference by reflecting on the language they choose when reporting. We must all remember that negative language is just as powerful as positive language.
I went to fuel in my car recently and happened to glance down at the pump nozzle as the fuel went in. On the nozzle was a really powerful message and I salute whoever thought to put it there. It simply proclaimed the value of a "can do" message when talking about maths with our children. Clearly, the message is aimed at the parents who will be filling their fuel tanks but this is exactly the sort of subliminal education which is needed to effect meaningful change in our society for the better. That same strategy could be used to great effect to suggest to all of us the benefits of being open, honest and respectful when we talk about mental health.
I listened last night to a wonderful programme on the radio in which Sir Ken Robinson was being interviewed about education. The programme started with him revisiting his first school. As a child, like so many others at that time, he had developed polio. He described the primary school class as looking a bit like the bar in the Star Wars films. He was just being candid. The children at that school had a variety of physical problems but his point was that the children themselves only saw each other as people each with their own humour and so on. He went on to describe how he was taken out of the grammar school for which he had passed the 11 plus exam (to the enormous pride of his family) because the teachers felt that it was too much for him to get up five flights of stairs wearing his calipers. Nobody consulted him and he was indeed moved to another school. Had they consulted him (and there is a growing body of opinion that education should be about the child...), he would have reassured them that he was prefectly happy and loved being at that school. The crime is that nobody even bothered to engage with the lad with polio who would go on to become one of the most sought after speakers and thinkers on education in the world!
The subject of suicide is perhaps without parallel in generating very strong opinions. Some consider it selfish and others look upon it in a wider context. When we are blessed with the gift of life, it is up to each of us how we intend to use that gift. That people choose of their own volition to surrender that gift must rank as one of the most extraordinary acts imaginable. It is not about it being right or wrong because it is entirely a matter for the individual.
During his life, the singer and songwriter Nick Drake could barely sell a record. His songs were wistful, plaintiff and plucked at the very soul of those who dared to listen. Since his suicide in 1974, people can't get enough of his music. Although Robin Williams achieved his recognition, achievements and fame before his death, there are still a great many who never do and that is a real tragedy.
Thursday, 14 August 2014
Wednesday, 2 July 2014
Local community: How would you define it?
Since the new year, I have become increasingly drawn to the concept of community with respect to the town of Denbigh where I live and in the wider sense. Many would stop reading at this point because the subject would be a matter of indifference to them.
I recently read an interesting piece written last year in the Guardian. Written by Rosie Niven, the article contrasts the concept of community of yesteryear with the modern day equivalent. Fifty years ago, the word community almost invariably referred to the place where you lived. Since then, the definition has become a little more flexible often alluding to a common area of interest, values, activities, hopes and fears shared by people irrespective of the place where they live. By implication, it thus follows that people living in Britain today can belong to several different communities be they real or virtual. Communities these days are also less static than their predecessors of fifty years ago.
Local activities are cited as promoting cultural integration. The town of Denbigh where I live has been notably active in this regard in the last couple of years. In a short space of time, my home town has re-introduced a town carnival which for many years had faded away. A variety of local communities have also been responsible for the introduction of a car boot sale, a St. David's Day festival and a midsummer festival to name but a few. All these events point strongly to a town which has decided to get back to basics. Enough local people have got together in a variety of separate communities to generate these projects with the shared intention of regenerating the concept of local people coming together to engage in meaningful community activity.
What has really warmed my heart about this is the obvious intention to do so without involvement of local government. This reaffirms the original modus operandi of the local community - people doing it for themselves. All too often in modern Britain, local government has become a bloated organisation too far detached from the real issues facing the people over whom they exert jurisidction. In truth, history informs us that local government had little to do with community activities such as those referred to. One of the factors which has driven the growth of local government is a greater propensity to depend upon it. Obviously there are those occasions where such dependency is justified if only for the sake of the amount we pay in council tax. Equally, our society has tended to become somewhat lazy expecting local government to provide the solutions in instances where we might have done more for ourselves. It is a rare sight where I live to see someone picking up litter in the vicinity of where they live and yet the majority of us are quite capable. It is also rare to see anyone sweeping the mess off a pavement yet most of us are more than capable.
Citing the examples of litter picking and sweeping up, I am really alluding to the sense of civic pride which was ubiquitous when I was growing up in the early 1970s. It is far less obvious now so I wonder whether my local town is on the verge of rediscovering it. Given that they have voluntarily reignited the sorts of event so much beloved of our forebears, does it follow that they will soon start to assume similar levels of civic pride? I certainly hope so and have every reason to remain optimistic. Rural towns such as this are dependent on a sense of community pride to remain vibrant.
Like many similar former market towns, Denbigh has seen it's high street eroded by a combination of factors which continue to impact so negatively the length and breadth of the land. More people now work outside the locality. More people now have access to a car and the greater access which this affords them. More local councils have sanctioned the introduction of supermarkets on the outskirts of the town which have now lured the consumer generation since the 1960s. All too often, the latter has been devastating for the erstwhile high streets.
In purely economic terms, most markets are subject to the whims of cycles in which peaks and troughs are reached with monotonous regularity. While my local high street may well have reached it's nadir in recent times, there are signs afoot to suggest that the ascent to former glories is now on track. Without the involvement of local people in their respective communities with their shared focus, such a change in fortune would have been unimaginable. For a long time, successive generations have looked longingly at the greener grass of the out of town retail centres. Having feasted on that grass now for many years, it seems as though the oldest truism of them all is finally being realised. The grass is becoming more attractive in our own field as indeed it always was.
In our own field, we know more about the local food we eat. We also get to know with forensic detail the people with whom we share that field, warts and all. Ultimately, we exist within a finely balanced ecosystem in which jobs in our local shops are taken by local people often selling the produce of local farmers and artisans. It is difficult to see what can be so unattractive about that particular flavour of grass.
I recently read an interesting piece written last year in the Guardian. Written by Rosie Niven, the article contrasts the concept of community of yesteryear with the modern day equivalent. Fifty years ago, the word community almost invariably referred to the place where you lived. Since then, the definition has become a little more flexible often alluding to a common area of interest, values, activities, hopes and fears shared by people irrespective of the place where they live. By implication, it thus follows that people living in Britain today can belong to several different communities be they real or virtual. Communities these days are also less static than their predecessors of fifty years ago.
Local activities are cited as promoting cultural integration. The town of Denbigh where I live has been notably active in this regard in the last couple of years. In a short space of time, my home town has re-introduced a town carnival which for many years had faded away. A variety of local communities have also been responsible for the introduction of a car boot sale, a St. David's Day festival and a midsummer festival to name but a few. All these events point strongly to a town which has decided to get back to basics. Enough local people have got together in a variety of separate communities to generate these projects with the shared intention of regenerating the concept of local people coming together to engage in meaningful community activity.
What has really warmed my heart about this is the obvious intention to do so without involvement of local government. This reaffirms the original modus operandi of the local community - people doing it for themselves. All too often in modern Britain, local government has become a bloated organisation too far detached from the real issues facing the people over whom they exert jurisidction. In truth, history informs us that local government had little to do with community activities such as those referred to. One of the factors which has driven the growth of local government is a greater propensity to depend upon it. Obviously there are those occasions where such dependency is justified if only for the sake of the amount we pay in council tax. Equally, our society has tended to become somewhat lazy expecting local government to provide the solutions in instances where we might have done more for ourselves. It is a rare sight where I live to see someone picking up litter in the vicinity of where they live and yet the majority of us are quite capable. It is also rare to see anyone sweeping the mess off a pavement yet most of us are more than capable.
Citing the examples of litter picking and sweeping up, I am really alluding to the sense of civic pride which was ubiquitous when I was growing up in the early 1970s. It is far less obvious now so I wonder whether my local town is on the verge of rediscovering it. Given that they have voluntarily reignited the sorts of event so much beloved of our forebears, does it follow that they will soon start to assume similar levels of civic pride? I certainly hope so and have every reason to remain optimistic. Rural towns such as this are dependent on a sense of community pride to remain vibrant.
Like many similar former market towns, Denbigh has seen it's high street eroded by a combination of factors which continue to impact so negatively the length and breadth of the land. More people now work outside the locality. More people now have access to a car and the greater access which this affords them. More local councils have sanctioned the introduction of supermarkets on the outskirts of the town which have now lured the consumer generation since the 1960s. All too often, the latter has been devastating for the erstwhile high streets.
In purely economic terms, most markets are subject to the whims of cycles in which peaks and troughs are reached with monotonous regularity. While my local high street may well have reached it's nadir in recent times, there are signs afoot to suggest that the ascent to former glories is now on track. Without the involvement of local people in their respective communities with their shared focus, such a change in fortune would have been unimaginable. For a long time, successive generations have looked longingly at the greener grass of the out of town retail centres. Having feasted on that grass now for many years, it seems as though the oldest truism of them all is finally being realised. The grass is becoming more attractive in our own field as indeed it always was.
In our own field, we know more about the local food we eat. We also get to know with forensic detail the people with whom we share that field, warts and all. Ultimately, we exist within a finely balanced ecosystem in which jobs in our local shops are taken by local people often selling the produce of local farmers and artisans. It is difficult to see what can be so unattractive about that particular flavour of grass.
Thursday, 26 June 2014
Maybe the last time?
I have just one more day to attend at the medical school in Keele before I can drive away from ten years' study. Although I return on July 14th for my graduation ceremony, it is now that I can begin to reflect on the enormity of the last decade of my life.
It started with the death of my first wife from breast cancer. Having unexpectedly met my second wife later that year, I made the risky decision to pursue the long road to a career in medicine. I embarked on a first degree in Medical Biochemistry before being thwarted after just one semester due to kidney failure. Nine months on dialysis were rewarded with a successful kidney transplant. The birth of my daughter just after my original kidney failure shone a bright light on our lives but then the light went out when she succumbed to meningococcal septicaemia at just 15 months of age.
It was a hard decision to carry on with medicine after that but tomorrow will be the last day of my quest. Barring miracles, I will start the process of giving something back at the Wrexham Maelor hospital in early August. I have nothing but admiration for the students at my medical school all of whom have far more maturity than I ever did at their age. They are also infinitely more intelligent than I could ever hope to be. It is hard to adequately convey the extent of their dedication and focus. It has kept me on my my toes being surrounded by so many bright minds and taught me far more than I could ever teach them. They are an inspiring bunch with the world at their feet - and deservedly so.
When we begin our posts as junior doctors five weeks hence, I'm sure we will often look back on our time at medical school and the friends we made and the lessons we learned. Many of my colleagues are not yet 25 with the biggest hurdle safely negotiated. At the age of 45, I can only say that learning becomes more challenging with the passage of the years. I wish them all luck in their careers and look forward to my own. This has been a long journey which I could not hope to have achieved without the love and support of my amazing wife and family. I wish Dad could have been around to know that I had definitely made it but remain grateful for his enthusiasm and guidance.
When I was working in the coca cola factory in Wakefield in 1994, days like tomorrow seemed to belong to other people. I have stretched myself to the limits of my capacity and have savoured every moment. We really are never too old even though it sometimes might feel like it.
It started with the death of my first wife from breast cancer. Having unexpectedly met my second wife later that year, I made the risky decision to pursue the long road to a career in medicine. I embarked on a first degree in Medical Biochemistry before being thwarted after just one semester due to kidney failure. Nine months on dialysis were rewarded with a successful kidney transplant. The birth of my daughter just after my original kidney failure shone a bright light on our lives but then the light went out when she succumbed to meningococcal septicaemia at just 15 months of age.
It was a hard decision to carry on with medicine after that but tomorrow will be the last day of my quest. Barring miracles, I will start the process of giving something back at the Wrexham Maelor hospital in early August. I have nothing but admiration for the students at my medical school all of whom have far more maturity than I ever did at their age. They are also infinitely more intelligent than I could ever hope to be. It is hard to adequately convey the extent of their dedication and focus. It has kept me on my my toes being surrounded by so many bright minds and taught me far more than I could ever teach them. They are an inspiring bunch with the world at their feet - and deservedly so.
When we begin our posts as junior doctors five weeks hence, I'm sure we will often look back on our time at medical school and the friends we made and the lessons we learned. Many of my colleagues are not yet 25 with the biggest hurdle safely negotiated. At the age of 45, I can only say that learning becomes more challenging with the passage of the years. I wish them all luck in their careers and look forward to my own. This has been a long journey which I could not hope to have achieved without the love and support of my amazing wife and family. I wish Dad could have been around to know that I had definitely made it but remain grateful for his enthusiasm and guidance.
When I was working in the coca cola factory in Wakefield in 1994, days like tomorrow seemed to belong to other people. I have stretched myself to the limits of my capacity and have savoured every moment. We really are never too old even though it sometimes might feel like it.
Tuesday, 10 June 2014
British Values
In recent weeks, a clearer picture has started to emerge of what current British values really are. As the politicians seek to take the moral high ground in their endless quests for power at all costs, I take the opportunity to reflect on what values we have in Britain.
We are obsessed by our relationship with Europe and are about to be dumped by the Scots as the Union begins it's inevitable demise. We have just returned to the economic levels we enjoyed before the financial crash even though the resurgence has largely been achieved by the same route which got us here in the first place. Levels of personal debt are being promoted by another cynical Government more concerned with it's own chances of re-election next May.
We have a worryingly high rate of teenage pregnancy. We have a bigger public sector than France. We have a health time bomb ticking underneath the very foundations of our allegedly beloved NHS in the form of booze, obesity, diabetes, smoking, lack of exercise and diets dripping in the high glycaemic index sugar procured from supermarkets who could scarcely do more to destroy whatever community spirit we might once have had. We obsessed with moaning about the quality of our free health service while the majority seem oblivious of their role in it's downfall.
We bemoan immigrants having their faith having long since discarded our own. As church congregations dwindle, mosques and temples continue their relentless spread. Where we do little to promote the benefits of faith to our young, immigrant families have the good sense to retain their faith. Go to the Law schools and Medical schools and see the students. Every picture tells a story.
British people have new Gods. We have gambled a fortune in recent days on England winning the football world cup. Football and money continue to attract the British although both remain bereft of real value. As I write, the England footballers who are paid morally indefensible sums of money for reasons I will never understand are being urged to try and sing the national anthem at the beginning of their forthcoming matches. Being urged to try?
At the recent European elections, an outcry was heard when it became obvious that the anti-European UKIP had won the day. British values dictate that in the centenary of the beginning of the Great War in which our forebears laid down their lives so that we could enjoy our freedom, only a third of us can even be bothered to exercise our right to vote.
A recent school trip to Barcelona made the headlines because of another set of British values. The teachers were so drunk, they started to fight with each other and thus the example was set for another generation. Where I live, the local council wants to close two of the last remaining faith schools in a cynical attempt to finish the secular job off.
The modern British value is to borrow as much we can in the vain hope we will ever be able to repay it thus guaranteeing a return to the previous recessions for the same reasons.
A British value which has come to the fore in recent times is our ability to eat mountains of food of dubious nutritional content as food banks continue to prosper. We throw away as much food as we eat and the greedy supermarkets are equally culpable. And still the waste goes on less than fifty years after the end of the rationing which guaranteed such a good start in life for our grandparents. We still have the same number of legs as our grandparents but prefer the car even for short journeys.
We pertain to love and cherish our NHS and yet there is little evidence to support that view in the lifestyle choices of the many.
Our prisons are full at a time when our churches have never been so empty.
The British values to which Michael Gove refer are not clear to me but if he intends to teach the values to which I have referred, God help us all.
We are obsessed by our relationship with Europe and are about to be dumped by the Scots as the Union begins it's inevitable demise. We have just returned to the economic levels we enjoyed before the financial crash even though the resurgence has largely been achieved by the same route which got us here in the first place. Levels of personal debt are being promoted by another cynical Government more concerned with it's own chances of re-election next May.
We have a worryingly high rate of teenage pregnancy. We have a bigger public sector than France. We have a health time bomb ticking underneath the very foundations of our allegedly beloved NHS in the form of booze, obesity, diabetes, smoking, lack of exercise and diets dripping in the high glycaemic index sugar procured from supermarkets who could scarcely do more to destroy whatever community spirit we might once have had. We obsessed with moaning about the quality of our free health service while the majority seem oblivious of their role in it's downfall.
We bemoan immigrants having their faith having long since discarded our own. As church congregations dwindle, mosques and temples continue their relentless spread. Where we do little to promote the benefits of faith to our young, immigrant families have the good sense to retain their faith. Go to the Law schools and Medical schools and see the students. Every picture tells a story.
British people have new Gods. We have gambled a fortune in recent days on England winning the football world cup. Football and money continue to attract the British although both remain bereft of real value. As I write, the England footballers who are paid morally indefensible sums of money for reasons I will never understand are being urged to try and sing the national anthem at the beginning of their forthcoming matches. Being urged to try?
At the recent European elections, an outcry was heard when it became obvious that the anti-European UKIP had won the day. British values dictate that in the centenary of the beginning of the Great War in which our forebears laid down their lives so that we could enjoy our freedom, only a third of us can even be bothered to exercise our right to vote.
A recent school trip to Barcelona made the headlines because of another set of British values. The teachers were so drunk, they started to fight with each other and thus the example was set for another generation. Where I live, the local council wants to close two of the last remaining faith schools in a cynical attempt to finish the secular job off.
The modern British value is to borrow as much we can in the vain hope we will ever be able to repay it thus guaranteeing a return to the previous recessions for the same reasons.
A British value which has come to the fore in recent times is our ability to eat mountains of food of dubious nutritional content as food banks continue to prosper. We throw away as much food as we eat and the greedy supermarkets are equally culpable. And still the waste goes on less than fifty years after the end of the rationing which guaranteed such a good start in life for our grandparents. We still have the same number of legs as our grandparents but prefer the car even for short journeys.
We pertain to love and cherish our NHS and yet there is little evidence to support that view in the lifestyle choices of the many.
Our prisons are full at a time when our churches have never been so empty.
The British values to which Michael Gove refer are not clear to me but if he intends to teach the values to which I have referred, God help us all.
Monday, 31 March 2014
Amazing journey: The 400th and last blog from this series
I started this blog four years ago on the 8th April 2010 as a bit of fun but then it slowly developed in to something more involved. At the time of writing, these little essays have been read over 22,100 times by people from the UK and far beyond. The Americans have been my second biggest readers with Germany and Russia coming third and fourth respectively. I have been read in Papua New Guinea, all bar one of the South American countries, all the European countries and some countries whose location was not immediately obvious to me. I have enjoyed writing these pieces but have enjoyed the feedback far more. Some have been political, some local, some amusing and some reflective. I have enjoyed them all.
During my time as a medical student which is slowly drawing to it's close, I have found writing to be a great release from the endless learning. All work and no play makes Jack a dull boy! With qualification just around the corner, the time has come to bring "betweendenbighandkeele" to an end. It will be a great relief to be moving closer to home and bringing to an end my late flirtation with being a student. I have spent ten years now as a student having previously graduated in medical biochemistry. Aside from the obvious implication of achieving my objective, the most rewarding aspect of this last decade has been the way in which I have retrained my brain to deal with learning. When people suggest that we're never too old to learn, they are quite right.
This is the 400th and final piece in four years. I have learned that readers decide which posts they like. Many is the piece I have written which I felt would be widely read and strike a universal chord only to be sadly disappointed. By contrast, many of my most well read pieces have been written in no time with no great expectations. Last July, I wrote a piece entitled "A twitch upon the thread" which I consider to be my best. It only attracted the attention of 35 readers. By contrast, a rather tongue in cheek piece written about the managerial legacy of Alex Ferguson reached nearly 300 reads. It goes to show that the writer frequently predicts the reading habits of others at their peril.
Of the various communities with which I have become involved, the one which continues to inspire me is the "Health care in the UK" community so ably run by Dr John Cosgrove. It explores aspects of our current healthcare system as viewed by a variety of health care professionals. Although the GMC remains anxious to curb our forays in to social media, I remain in favour of it because it is such a potent vehicle for change because it also promotes healthy discussion and takes in to account views from both sides of the argument. At a time when the future of our health service has seldom come under more scrutiny, communities such as this one are vital for people to express their views. Better to seek their views than to suppress them.
Many of my pieces have focused on medical education and I have offered my own proposals for improvement based on my personal experiences. As a medical student, I have experienced the doctors who I would be proud to emulate and the ones who I would be ashamed to emulate. I am pleased to say that the former outnumber the latter but not by nearly enough.
Next week, I have my final exams after a decade of study and I approach them with a certain fear. Not a fear of the exams because we become normalised to them after such a long time in the system. The fear arises at the thought of passing them and all the responsibility which that will bring. Many of my friends have been reminding me to just think of the money. That is the last thing on my mind.
I have become increasingly concerned at the political direction of our country. In simple terms, there appears to be two distinct factions. Putting aside subjects such as the EU and immigration, the real divide in our country today seems to exist between the realists and the rest. At some stage in the near future, a UK government is going to have to address the size of our public sector and the way in which it is funded. That has to include pension provision which remains as unsustainable in 2014 as it was in 2010 when I started writing these pieces. Put simply, it is no longer a choice to ignore the reality and yet successive UK governments have shirked their responsibilities in this area. It is a sad fact that for many in the UK, a career in the public sector has become the aspiration. If that were more for altruistic reasons then fair enough. The fact is though that the public sector has become bloated and out of touch. It is a shadow of it's predecessor of fifty years ago. The need for a vibrant private sector being propelled by a new generation of skills based apprentices has never been greater and yet too little is being done in this regard.
The power of the UK supermarkets for the first time shows signs of weakening. It is difficult to know whether this is being driven by income or a public weary of yet another retail con. My instincts point me to the latter. Every recession serves to remind us all of what our priorities really are as opposed to what we would like them to be. Even if they are on the downward curve, the presence of these retail giants has had a devastating impact on many of our town centre high streets. This damage is going to take a long time to reverse and can only be helped by a growing private sector. At the heart of any such reversal must be the local communities which have been so badly battered in recent years following some misguided decisions by local government.
If the Scots decide to go their own way later on this year (and I still expect them to do so), the union will be gone after 300 years. This will be a good outcome for the Scots but a bad one for England, Wales and Northern Ireland. It will then only be a matter of time before Wales and Ulster want to follow suit. The writing is on the wall and there will be hard times ahead. That said, if the Scots do vote for independence, it will all but guarantee a Tory victory next year and with that we will be accorded our say on a straightforward in or out EU referendum. For many of my generation, we have waited a long time for this.
A new blog will doubtless emerge in due course but under a different moniker. In the mean time, I would like to thank everyone who has read these pieces and hope they have at the very least been entertaining.
During my time as a medical student which is slowly drawing to it's close, I have found writing to be a great release from the endless learning. All work and no play makes Jack a dull boy! With qualification just around the corner, the time has come to bring "betweendenbighandkeele" to an end. It will be a great relief to be moving closer to home and bringing to an end my late flirtation with being a student. I have spent ten years now as a student having previously graduated in medical biochemistry. Aside from the obvious implication of achieving my objective, the most rewarding aspect of this last decade has been the way in which I have retrained my brain to deal with learning. When people suggest that we're never too old to learn, they are quite right.
This is the 400th and final piece in four years. I have learned that readers decide which posts they like. Many is the piece I have written which I felt would be widely read and strike a universal chord only to be sadly disappointed. By contrast, many of my most well read pieces have been written in no time with no great expectations. Last July, I wrote a piece entitled "A twitch upon the thread" which I consider to be my best. It only attracted the attention of 35 readers. By contrast, a rather tongue in cheek piece written about the managerial legacy of Alex Ferguson reached nearly 300 reads. It goes to show that the writer frequently predicts the reading habits of others at their peril.
Of the various communities with which I have become involved, the one which continues to inspire me is the "Health care in the UK" community so ably run by Dr John Cosgrove. It explores aspects of our current healthcare system as viewed by a variety of health care professionals. Although the GMC remains anxious to curb our forays in to social media, I remain in favour of it because it is such a potent vehicle for change because it also promotes healthy discussion and takes in to account views from both sides of the argument. At a time when the future of our health service has seldom come under more scrutiny, communities such as this one are vital for people to express their views. Better to seek their views than to suppress them.
Many of my pieces have focused on medical education and I have offered my own proposals for improvement based on my personal experiences. As a medical student, I have experienced the doctors who I would be proud to emulate and the ones who I would be ashamed to emulate. I am pleased to say that the former outnumber the latter but not by nearly enough.
Next week, I have my final exams after a decade of study and I approach them with a certain fear. Not a fear of the exams because we become normalised to them after such a long time in the system. The fear arises at the thought of passing them and all the responsibility which that will bring. Many of my friends have been reminding me to just think of the money. That is the last thing on my mind.
I have become increasingly concerned at the political direction of our country. In simple terms, there appears to be two distinct factions. Putting aside subjects such as the EU and immigration, the real divide in our country today seems to exist between the realists and the rest. At some stage in the near future, a UK government is going to have to address the size of our public sector and the way in which it is funded. That has to include pension provision which remains as unsustainable in 2014 as it was in 2010 when I started writing these pieces. Put simply, it is no longer a choice to ignore the reality and yet successive UK governments have shirked their responsibilities in this area. It is a sad fact that for many in the UK, a career in the public sector has become the aspiration. If that were more for altruistic reasons then fair enough. The fact is though that the public sector has become bloated and out of touch. It is a shadow of it's predecessor of fifty years ago. The need for a vibrant private sector being propelled by a new generation of skills based apprentices has never been greater and yet too little is being done in this regard.
The power of the UK supermarkets for the first time shows signs of weakening. It is difficult to know whether this is being driven by income or a public weary of yet another retail con. My instincts point me to the latter. Every recession serves to remind us all of what our priorities really are as opposed to what we would like them to be. Even if they are on the downward curve, the presence of these retail giants has had a devastating impact on many of our town centre high streets. This damage is going to take a long time to reverse and can only be helped by a growing private sector. At the heart of any such reversal must be the local communities which have been so badly battered in recent years following some misguided decisions by local government.
If the Scots decide to go their own way later on this year (and I still expect them to do so), the union will be gone after 300 years. This will be a good outcome for the Scots but a bad one for England, Wales and Northern Ireland. It will then only be a matter of time before Wales and Ulster want to follow suit. The writing is on the wall and there will be hard times ahead. That said, if the Scots do vote for independence, it will all but guarantee a Tory victory next year and with that we will be accorded our say on a straightforward in or out EU referendum. For many of my generation, we have waited a long time for this.
A new blog will doubtless emerge in due course but under a different moniker. In the mean time, I would like to thank everyone who has read these pieces and hope they have at the very least been entertaining.
Thursday, 27 March 2014
Substance and Style
The pursuit of power seems to be dominating our headlines as never before as various factions of British society vie with each other for their taste of this precious commodity. I always thought tobacco, alcohol, sugar and drugs were addictive but it seems as though power is the most addictive of them all.
Last night saw the first of the televised debates between UKIP and the Liberal Party over our continued membership of the EU. I listened yesterday to a programme looking back at the first of these televised debates way back in 1960 during the US presidential campaign. That debate took place between the rising star of John F Kennedy and the establishment conservative Richard Nixon. In due course both would meet their fates in rather different ways. When the US public was asked for their opinion of the debates though, the results were rather surprising. For the few who watched them on the television, Kennedy came out on top. For the majority who listened to the debates on the radio, the rather less photogenic Nixon won the day. But that debate set the precedent for the X Factor formula now embraced by the marketing men to choose our next Government.
The clash between Farage and Clegg last night was little more than a side show in many ways but it did have huge relevance in other areas. The issue of Europe will not go away so it was refreshing to see a debate between the two opposite poles of the argument. Although neither has a hope in hell of securing a majority at the next election, this debate does need to happen. After the politicians have finished with their carefully choreographed posturing, it would be nice to think that after 39 years the rest of us might have a say but it appears that the power still rests firmly with the political classes.
In 1989, I was living in student accomodation in the Anfield area of Liverpool on the day of the Hillsborough tragedy. It is nothing short of a disgrace that as we approach the 25th anniversary of that appalling tragedy, we are still seeking the truth from the police. As I write, the parents of Stephen Lawrence are still seeking the whole truth in the matter of the murder of their late son. In both instances, the police have been shown to be culpable of hiding evidence which would not flatter them if it was in the public domain. The erstwhile Tory Chief Whip Andrew Mitchell is still trying to get to the whole truth in respect of allegations made against him which have effectively cost him his career. Once again, the police have been found wanting in the truth department. It is instructive to consider the role of the police and the people to whom they are ultimately accountable. Theirs is to serve the public trust with integrity and impartiality. It seems that power is preventing them from doing so unless there is another less obvious explanation.
The headlines have once more been dominated by revelations that the British are increasingly viewing obesity as the cultural norm. It would be difficult to contend with that assertion. The strains on our hospitals are also well documented which is not entirely surprising given the current lifestyle crisis. As if the hospitals didn't have enough of a challenge in trying to meet the extra demands being placed upon them, it is today revealed that the body charged with the allocation of the NHS budget has been found guilty of diverting funds for their own use. The hospital where you live receives it's funding from your local council.
In an article published in the British Medical Journal, a Freedom of Information request has revealed that 45 councils have been guilty of diverting local NHS funds for public services such as smoking cessation, substance misuse, sexual health and obesity. It was thought that the councils had a duty to ensure that the allocated health budget for their local area went to the local health service as intended. Instead, they have defended their actions citing housing and planning as being just as important as the public health services mentioned. Be that as it may, theirs is not to decide. They are taking it upon themselves to decide how to spend you local health budget. So the next time you hear a horror story pertaining to your local health service, remember that your local NHS is dependent upon the local council to allocate their funds as intended. That they are not choosing to do so is about as glaring an illustration of the power of local government as I have yet seen - and that really is saying something.
In Wales where I live, our local councils have paid out £32 million in "Gagging orders" over the last 10 years. It seems a bit rich then to consider that the local health services are helping to pay that price at a time when they have seldom been more stretched. If your local health budget was properly ring fenced as we are constantly promised, such deviation would not be possible. Only power makes it possible.
But back to Clegg and Farage. Neither will achieve power in their own right but both would do a deal to gain a share of the big prize. Clegg has already intimated his openness to form a future coalition with either Cameron or Miliband. Clegg's principles appear to be in retreat. Farage by contrast appears to be more realistic and pragmatic. Give him a vote on our membership of the EU and he will probably fade away in to the sunset. He could scarcely be more clear. The announcement by Miliband that he has no intention to offer such a vote will make a vote for Farage compelling for a lot of people at the next election in 2015.
The concept of democracy has been questioned many times in recent weeks. The 100% vote with which North Korea re-elected their leader was about as farcical as is humanly possible. That said, President Putin came a close second when he secured an impressive 97.5% of the vote in the Crimea recently. Clearly both elections were an utter nonsense and made a nonsense of democracy. To complete the rout of the dictator over the people, the Egyptian general Abdul Fattah al-Sissi has announced his intention to stand for the presidency. Having seen so many lives lost to dispense with the military man Mubarak, the Egyptians had a free vote and elected the Muslim Brotherhood. Had the latter complied with the requirements of the Egyptian army, they might have survived as puppets. The mad cycle of events is therefore about to enter it's latest chapter by appointing another version of Mubarak - and all in the name of power.
With Russia having taken the Crimea, the issue of power has once more come to the fore. Not power in the political sense (although that is now beyond question) but domestic power in terms of how we heat and light our homes. Although the UK is only marginally dependent on Russia for it's power, it has certainly sent shock waves through our energy markets. One of our Big Six energy companies yesterday pledged to freeze it's prices for 18 months. Theirs was the biggest price rise in the autumn and the wholesale price of energy has actually come down quite a lot over the same time period. Quite how impressive this "freeze" really is I don't know but I feel copious amounts of wool being pulled over our eyes as the powerful Big Six seek to continue their grip on power - quite literally.
So 12 months hence, you and I will have the opportunity to see Cameron, Miliband et al performing for the cameras in a last gasp attempt to secure our vote. For my part I will be concentrating on the facts. In the golden era of Yorkshire cricket when the county side was expected to win the championship every year, their choice of captain was as relevant to politics as it was to cricket. "Tha' picks a captain to laike (play) cricket - not make pretty speeches". My vote won't go to the prettiest speech either. Give me substance over style every time.
Last night saw the first of the televised debates between UKIP and the Liberal Party over our continued membership of the EU. I listened yesterday to a programme looking back at the first of these televised debates way back in 1960 during the US presidential campaign. That debate took place between the rising star of John F Kennedy and the establishment conservative Richard Nixon. In due course both would meet their fates in rather different ways. When the US public was asked for their opinion of the debates though, the results were rather surprising. For the few who watched them on the television, Kennedy came out on top. For the majority who listened to the debates on the radio, the rather less photogenic Nixon won the day. But that debate set the precedent for the X Factor formula now embraced by the marketing men to choose our next Government.
The clash between Farage and Clegg last night was little more than a side show in many ways but it did have huge relevance in other areas. The issue of Europe will not go away so it was refreshing to see a debate between the two opposite poles of the argument. Although neither has a hope in hell of securing a majority at the next election, this debate does need to happen. After the politicians have finished with their carefully choreographed posturing, it would be nice to think that after 39 years the rest of us might have a say but it appears that the power still rests firmly with the political classes.
In 1989, I was living in student accomodation in the Anfield area of Liverpool on the day of the Hillsborough tragedy. It is nothing short of a disgrace that as we approach the 25th anniversary of that appalling tragedy, we are still seeking the truth from the police. As I write, the parents of Stephen Lawrence are still seeking the whole truth in the matter of the murder of their late son. In both instances, the police have been shown to be culpable of hiding evidence which would not flatter them if it was in the public domain. The erstwhile Tory Chief Whip Andrew Mitchell is still trying to get to the whole truth in respect of allegations made against him which have effectively cost him his career. Once again, the police have been found wanting in the truth department. It is instructive to consider the role of the police and the people to whom they are ultimately accountable. Theirs is to serve the public trust with integrity and impartiality. It seems that power is preventing them from doing so unless there is another less obvious explanation.
The headlines have once more been dominated by revelations that the British are increasingly viewing obesity as the cultural norm. It would be difficult to contend with that assertion. The strains on our hospitals are also well documented which is not entirely surprising given the current lifestyle crisis. As if the hospitals didn't have enough of a challenge in trying to meet the extra demands being placed upon them, it is today revealed that the body charged with the allocation of the NHS budget has been found guilty of diverting funds for their own use. The hospital where you live receives it's funding from your local council.
In an article published in the British Medical Journal, a Freedom of Information request has revealed that 45 councils have been guilty of diverting local NHS funds for public services such as smoking cessation, substance misuse, sexual health and obesity. It was thought that the councils had a duty to ensure that the allocated health budget for their local area went to the local health service as intended. Instead, they have defended their actions citing housing and planning as being just as important as the public health services mentioned. Be that as it may, theirs is not to decide. They are taking it upon themselves to decide how to spend you local health budget. So the next time you hear a horror story pertaining to your local health service, remember that your local NHS is dependent upon the local council to allocate their funds as intended. That they are not choosing to do so is about as glaring an illustration of the power of local government as I have yet seen - and that really is saying something.
In Wales where I live, our local councils have paid out £32 million in "Gagging orders" over the last 10 years. It seems a bit rich then to consider that the local health services are helping to pay that price at a time when they have seldom been more stretched. If your local health budget was properly ring fenced as we are constantly promised, such deviation would not be possible. Only power makes it possible.
But back to Clegg and Farage. Neither will achieve power in their own right but both would do a deal to gain a share of the big prize. Clegg has already intimated his openness to form a future coalition with either Cameron or Miliband. Clegg's principles appear to be in retreat. Farage by contrast appears to be more realistic and pragmatic. Give him a vote on our membership of the EU and he will probably fade away in to the sunset. He could scarcely be more clear. The announcement by Miliband that he has no intention to offer such a vote will make a vote for Farage compelling for a lot of people at the next election in 2015.
The concept of democracy has been questioned many times in recent weeks. The 100% vote with which North Korea re-elected their leader was about as farcical as is humanly possible. That said, President Putin came a close second when he secured an impressive 97.5% of the vote in the Crimea recently. Clearly both elections were an utter nonsense and made a nonsense of democracy. To complete the rout of the dictator over the people, the Egyptian general Abdul Fattah al-Sissi has announced his intention to stand for the presidency. Having seen so many lives lost to dispense with the military man Mubarak, the Egyptians had a free vote and elected the Muslim Brotherhood. Had the latter complied with the requirements of the Egyptian army, they might have survived as puppets. The mad cycle of events is therefore about to enter it's latest chapter by appointing another version of Mubarak - and all in the name of power.
With Russia having taken the Crimea, the issue of power has once more come to the fore. Not power in the political sense (although that is now beyond question) but domestic power in terms of how we heat and light our homes. Although the UK is only marginally dependent on Russia for it's power, it has certainly sent shock waves through our energy markets. One of our Big Six energy companies yesterday pledged to freeze it's prices for 18 months. Theirs was the biggest price rise in the autumn and the wholesale price of energy has actually come down quite a lot over the same time period. Quite how impressive this "freeze" really is I don't know but I feel copious amounts of wool being pulled over our eyes as the powerful Big Six seek to continue their grip on power - quite literally.
So 12 months hence, you and I will have the opportunity to see Cameron, Miliband et al performing for the cameras in a last gasp attempt to secure our vote. For my part I will be concentrating on the facts. In the golden era of Yorkshire cricket when the county side was expected to win the championship every year, their choice of captain was as relevant to politics as it was to cricket. "Tha' picks a captain to laike (play) cricket - not make pretty speeches". My vote won't go to the prettiest speech either. Give me substance over style every time.
Friday, 21 March 2014
Shut up and go! The mantra of local government?
In many of my recent posts, I have repeatedly questioned the accountability and worth of my local council. Not the locally elected councillors but rather the employees charged with running it. As with many other councils in the UK, my local council has undoubtedly been subjected to the same cuts as the rest of us as the Coalition seeks to balance the books which they inherited in 2010. The way in which they have approached this challenge has been cynical and underhand which does them little credit.
Just yesterday, new information came to my attention. Under normal circumstances, I would have been flabbergasted but there is now little they could do to surprise me. Following a link on a social media site, I learned of a Freedom of Information request which eventually revealed details of the "Gagging orders" paid out by my local council over the last four years. It's fair to say that this information has been released not because they wanted the public to know but because they have been legally forced to do so.
In 2009/10, 3 gagging orders were paid out by my local council at a cost of £131,962.12. In 2010/11, 2 orders were paid at a cost of £37,500. In 2011/12, 4 were paid out at a cost of £91,963.92 and in 2012/13, 8 were paid out at a total cost of £182,032.24. This means that my local council has paid out a whopping £443,188.28 in the last four years (obviously not including the current financial year!). During the last year, that same council has closed down Rhyl Sun Centre, Prestatyn Nova Centre, the North Wales Bowls Centre and Llanbedr primary school to name but a few. They also tried their very best to close St. Brigid's faith school in Denbigh and have stated their intention to do so by 2018.
A gagging order is issued when the council wants to terminate the employment of an employee and shut them up. To do so, they have to pay a price such that both parties are happy. Thus, rather than go through normal employment tribunals and grievance procedures, they can simply pay off any employee whose face doesn't fit. This is 2014 and this is our council. If this was 1934 in Stalinist Russia, it would be difficult to tell the difference. Put simply, the power has got out of control. It will continue to do so until such time as they are held to account. The £443,188.28 so profligately spent in the last four years was done at a time when Clwyd Leisure (the not-for-profit company charged with running Rhyl Sun Centre) were having their annual budget slashed by £50,000 per annum. You don't need to be a mathematician to see that Rhyl Sun Centre, the Nova Centre and the North Wales Bowls Centre should all still be open. Meanwhile, the current Chief Executive continues to earn more than the Prime Minister!
I feel genuine sympathy for the ordinary council employees who are just trying to do their jobs to the best of their ability with the resources they have. I do take issue though with the spending decisions being made by the more senior personnel. Any outsider looking in at Denbighshire would surely question this track record? It does not reflect well on the people making these poor decisions and it insults the thousands of council tax payers in the county who frankly deserve a lot better. If you pay for a service in your life, you normally expect to get what you pay for. For the people of Denbighshire, such an expectation has for too long been an aspiration instead of a reality. Shame!
In his 1864 novella Notes from Underground, Dostoyevsky referred to the "farce in Schleswig-Holstein". The Schleswig-Holstein question concerned the relationships of the Duchies of Schleswig and Holstein with the Danish crown and the German confederation. It was not an easy concept to try and understand and few people did. Famously, the British Statesman Lord Palmerston admitted that "only three people have ever really understood the Schleswig-Holstein business - the Prince Consort who is dead - a German Professor who has gone mad - and I who have forgotten all about it".
In Notes from Underground, Dostoyevsky rejects the concept of Utopian Socialism which would ironically come to dominate Russian life throughout much of the twentieth century. The novella portrays humans as they are which caused great upset among his contemporaries. He portrays humans as irrational, uncooperative and uncontrollable. It is perhaps easy to see why such assertions would cause discomfort. He also claims that human needs can never be satisfied. Many critics consider this novella to be the first example of existentialism in literature and no less a judge than Nietzsche called Dostoyevsky "the only philosopher from whom I had anything to learn".
But just how accurate were the assertions of Dostoyevsky? Are we irrational? Are we uncooperative? Are we uncontrollable? I've not yet met anyone who doesn't tick all three boxes. So why did he cause so much upset? Is it because we would rather not face the realities of our shortcomings or do we genuinely believe these claims don't apply to us?
Lord Browne resigned as Chief Executive of BP in 2007. Since his peerage, he has become active in Government and today highlights a culture which exemplifies the observations made in Notes from Underground. Referring to the civil servants in Whitehall, he expresses his exasperation at their culture. His background in the Private Sector meant that any mistake made was identified and dealt with such that chances of its repetition were negligible. I have worked in such a culture and can concur with him. Things get done. This is the culture of progress. Lord Browne highlights a culture in which mistakes are never admitted and where accountability is non-existent. It must be intensely frustrating for him to be faced with such a culture when he has spent his whole life in a proactive environment. He points to a prevailing culture of blame and denial which renders progress nigh on impossible. Several cases have emerged whereby ministers have recently found themselves having to micro manage a project for fear it won't get done if left to the Civil Servants. If this is true, it begs the worth of bureaucracy. This surely confirms what many have suspected for a long time. Bureaucracy stifles people and stifles progress. While it is intended to promote the most efficient way of completing a task, it all too often acts as a barrier. In short, they are complex, inefficient and inflexible - all the things against which Dostoyevsky warned. Trying to find out who is responsible is like trying to understand the Schleswig-Holstein question. Even Lord Palmerston struggled with that one!
Just yesterday, new information came to my attention. Under normal circumstances, I would have been flabbergasted but there is now little they could do to surprise me. Following a link on a social media site, I learned of a Freedom of Information request which eventually revealed details of the "Gagging orders" paid out by my local council over the last four years. It's fair to say that this information has been released not because they wanted the public to know but because they have been legally forced to do so.
In 2009/10, 3 gagging orders were paid out by my local council at a cost of £131,962.12. In 2010/11, 2 orders were paid at a cost of £37,500. In 2011/12, 4 were paid out at a cost of £91,963.92 and in 2012/13, 8 were paid out at a total cost of £182,032.24. This means that my local council has paid out a whopping £443,188.28 in the last four years (obviously not including the current financial year!). During the last year, that same council has closed down Rhyl Sun Centre, Prestatyn Nova Centre, the North Wales Bowls Centre and Llanbedr primary school to name but a few. They also tried their very best to close St. Brigid's faith school in Denbigh and have stated their intention to do so by 2018.
A gagging order is issued when the council wants to terminate the employment of an employee and shut them up. To do so, they have to pay a price such that both parties are happy. Thus, rather than go through normal employment tribunals and grievance procedures, they can simply pay off any employee whose face doesn't fit. This is 2014 and this is our council. If this was 1934 in Stalinist Russia, it would be difficult to tell the difference. Put simply, the power has got out of control. It will continue to do so until such time as they are held to account. The £443,188.28 so profligately spent in the last four years was done at a time when Clwyd Leisure (the not-for-profit company charged with running Rhyl Sun Centre) were having their annual budget slashed by £50,000 per annum. You don't need to be a mathematician to see that Rhyl Sun Centre, the Nova Centre and the North Wales Bowls Centre should all still be open. Meanwhile, the current Chief Executive continues to earn more than the Prime Minister!
I feel genuine sympathy for the ordinary council employees who are just trying to do their jobs to the best of their ability with the resources they have. I do take issue though with the spending decisions being made by the more senior personnel. Any outsider looking in at Denbighshire would surely question this track record? It does not reflect well on the people making these poor decisions and it insults the thousands of council tax payers in the county who frankly deserve a lot better. If you pay for a service in your life, you normally expect to get what you pay for. For the people of Denbighshire, such an expectation has for too long been an aspiration instead of a reality. Shame!
In his 1864 novella Notes from Underground, Dostoyevsky referred to the "farce in Schleswig-Holstein". The Schleswig-Holstein question concerned the relationships of the Duchies of Schleswig and Holstein with the Danish crown and the German confederation. It was not an easy concept to try and understand and few people did. Famously, the British Statesman Lord Palmerston admitted that "only three people have ever really understood the Schleswig-Holstein business - the Prince Consort who is dead - a German Professor who has gone mad - and I who have forgotten all about it".
In Notes from Underground, Dostoyevsky rejects the concept of Utopian Socialism which would ironically come to dominate Russian life throughout much of the twentieth century. The novella portrays humans as they are which caused great upset among his contemporaries. He portrays humans as irrational, uncooperative and uncontrollable. It is perhaps easy to see why such assertions would cause discomfort. He also claims that human needs can never be satisfied. Many critics consider this novella to be the first example of existentialism in literature and no less a judge than Nietzsche called Dostoyevsky "the only philosopher from whom I had anything to learn".
But just how accurate were the assertions of Dostoyevsky? Are we irrational? Are we uncooperative? Are we uncontrollable? I've not yet met anyone who doesn't tick all three boxes. So why did he cause so much upset? Is it because we would rather not face the realities of our shortcomings or do we genuinely believe these claims don't apply to us?
Lord Browne resigned as Chief Executive of BP in 2007. Since his peerage, he has become active in Government and today highlights a culture which exemplifies the observations made in Notes from Underground. Referring to the civil servants in Whitehall, he expresses his exasperation at their culture. His background in the Private Sector meant that any mistake made was identified and dealt with such that chances of its repetition were negligible. I have worked in such a culture and can concur with him. Things get done. This is the culture of progress. Lord Browne highlights a culture in which mistakes are never admitted and where accountability is non-existent. It must be intensely frustrating for him to be faced with such a culture when he has spent his whole life in a proactive environment. He points to a prevailing culture of blame and denial which renders progress nigh on impossible. Several cases have emerged whereby ministers have recently found themselves having to micro manage a project for fear it won't get done if left to the Civil Servants. If this is true, it begs the worth of bureaucracy. This surely confirms what many have suspected for a long time. Bureaucracy stifles people and stifles progress. While it is intended to promote the most efficient way of completing a task, it all too often acts as a barrier. In short, they are complex, inefficient and inflexible - all the things against which Dostoyevsky warned. Trying to find out who is responsible is like trying to understand the Schleswig-Holstein question. Even Lord Palmerston struggled with that one!
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