Showing posts with label NHS. Show all posts
Showing posts with label NHS. Show all posts

Saturday, July 28, 2012

London's Olympic Opening Ceremony Unwrapped - for the Benefit of the Rest of the World

American sprinter Michael Johnson summarised the issue when asked on the BBC whether the rest of the world would "get" the messages of London's Olympic opening ceremony. Since he worked and travelled here often, Johnson replied, he felt he could appreciate it at a cultural level, but he thought that many of his fellow Americans and the rest of the world would not.

Or, as one contributor put it on Twitter: "This is just plain weird."
 
So, without further ado, here is the opening ceremony unwrapped, for an international audience.

The key to interpreting director Danny Boyle's extravaganza, in my view, is to understand the opening scene. While the crowds filtered into the stadium in the hours before the official start, they were greeted with a stadium filled not with ranked masses of drummers or dancers, but by a green field on which grazed sheep, cattle and goats, tended by farmers and labourers dressed in outfits reminiscent of pre-industrial Britain. Bearded gentlemen played cricket on a village green; white clouds floated gently over the idyllic pastoral scene.





source: gorgeaux


The official opening of the ceremony involved the singing of the traditional English anthem Jerusalem, supplemented by national songs of Wales, Scotland and Northern Ireland. 

Written by nineteenth-century poet, artist and mystic William Blake, the words of his poem And Did Those Feet were put to music by Hubert Parry in 1916. The song - known ever since simply as Jerusalem - has come to be widely adopted as an unofficial national anthem for England, sung regularly at international sports matches, and even at the wedding in 2011 of Prince William and Catherine Middleton.

The poem has been sung at party conferences by several of the main political parties since the second world war. The song Jerusalem has come to be seen as critical of the damaging effects of industrialisation and of the consolidation of economic power by a landed, industrial and ecclesiastical elite. Blake, raised as a Moravian, was a life-long critic of the established Church of England. In place of such a history, Jerusalem articulates an alternative vision of England - one shaped at every level by the mysterious presence of Christ.


And did those feet in ancient time.
Walk upon England's mountains green:
And was the holy Lamb of God,
On England's pleasant pastures seen!


Drawing on mythical themes such as the visitation of Jesus as a youth to the British Isles, accompanied by his supposed-uncle Joseph of Arimathea, the poem combines religious, mystical and political themes and has come to be seen as expressing a longing for a just, political and economic settlement in the British Isles, infused with Christian ideals.


I will not cease from Mental Fight,
Nor shall my Sword sleep in my hand:
Till we have built Jerusalem,
In England's green and pleasant Land


This imagery was not lost on the British audience last night. Phillip Blond, author of the influential book Red Tory: How Left and Right have Broken Britain and How we can Fix It, was tweeting lyrical throughout the ceremony. The political think-tanker, economist and one-time theologian enthusiastically tweeted of the opening scene's imagery representing


"A pre-enclosure and pre-capitalist haven - this is already so political - magnificent - romanticism at our heart."


Daily Telegraph blogger Tim Stanley, meanwhile writes of the opening scene's depiction of


"The brutal uprooting of rural Britain. Was this written by GK Chesterton? It's fantastic."


Blond affirms this interpretation of British history:


"It's essentially a Catholic theory of British history" which sees "enclosure as the original crime." 


The idea that the enclosure of common agricultural lands from the 16th to 19th centuries is a root of much of Britain's current economic problems was explored in the early twentieth century by Roman Catholic social theorists such as Chesterton and Hilaire Belloc. More recently, socialist historian EP Thompson argued in his The Making of the English Working Class that "Enclosure (when all the sophistications are allowed for) was a plain enough case of class robbery."
 
It is perhaps not coincidental to learn that Boyle himself was raised in a Catholic household in the north of England and was at one time considering attending seminary to become a priest.
 
Much else that followed in last night's Olympic extravaganza was a re-telling of this British story. The achievements of the industrial revolution, for instance, were set alongside the fruits of its ugly expression in the efficiency of modern warfare.

The idea that the common assets of the British working class have been appropriated by their rulers continued through the ceremony's subsequent tableaux. Although framed in terms of children's fairy tales, dreams and nightmares, the lengthy section filled with nurses, pyjama-clad children in hospital beds, and frightening apparitions appeared linked to the story of the enclosures. The message was that Britain's greatest human asset - its National Health Service - is under threat from dark forces.




Source: Julie70



The allusion to the highly controversial NHS reform bill recently passed through Parliament - which gives greater access to the Service to private companies, and which was strongly opposed by all of the main professional medical organisations - will not have been lost on a British public widely dissatisfied with the legislation brought in under the current coalition government. The implication that J.K Rowling's Lord Voldemort could be compared to health secretary Andrew Lansley was both excruciating and exquisite.

That a fictional character - the magical Mary Poppins - was instrumental in driving away the threats to the sick children illustrates an additional strand within Boyle's ceremony, namely that of the British romantic tradition. As blogger Cath Elliott noted:

"So Mary Poppins bravely fought off the tories and saved the NHS. Or something."


Romanticism was a key element in William Blake's creative work, expressed in part in Boyle's opening ceremony through humour. Rowan Atkinson, James Bond and the Queen parachuting into the stadium were all part of this tradition of self-deprecating British humour. Mr Bean also performed the first scripted fart at an Olympic opening ceremony. Blond again:


"And it just gets better - this is the true Britain - romantic, visionary and arcadian - and very very funny." 

 
Comparisons with the opening ceremony in Beijing four years earlier are inevitable and the contrast between creative London's story-telling and formal massed ranks of well-drilled citizens could not have been greater.

The ceremony was visionary in the best sense of the word - even as William Blake saw visions throughout his unconventional life. Here was a view of modern Britain with Christian and egalitarian roots, overcoming the forces that would create a harsher, more oppressive future.


William Blake's etching/watercolour "Anci...
William Blake's etching/watercolour "Ancient of Days" ( Wikipedia)

The young artist George Richmond was at the bedside of his visionary mentor and friend William Blake when he died in 1827 and describes the scene in moving detail:

He died ... in a most glorious manner. He said He was going to that Country he had all His life wished to see and expressed Himself Happy, hoping for Salvation through Jesus Christ.
– Just before he died His Countenance became fair. His eyes Brighten'd and he burst out Singing of the things he saw in Heaven.


Danny Boyle has expressed things slightly differently: "We can build Jerusalem. And it will be for everyone."







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Sunday, March 25, 2012

Lamentable Media Coverage and State Deception: the Scandal of NHS Legislation

Speaking at the NHS Confederation Annual confe...Speaking at the NHS Confederation Annual conference and exhibition in Manchester on 8 July 2011 (Photo credit: Wikipedia)





The Health and Social Care Bill has just passed through Parliament. A huge step towards privatising the NHS has been taken. The most cherished of UK public institutions is being dismantled and large private providers are already signing contracts. All this is against the wishes of a large majority of the public and an even larger majority of health-care professionals.

A big question is why did the national news media fail to cover the issue clearly, honestly and accurately? Their failure to hold David Cameron, Andrew Lansley and their colleagues to account, or to adequately represent the views of professionals and the public was, at times, very frustrating. It demonstrates the weakened state the UK news media. If hacking reveals the deficits of tabloid journalism, this failure represents the deficits of ‘serious’ broadsheet newspapers and national broadcasters.

In many respects, one should look to the actions of the political class first. David Cameron had a seven year career in corporate public relations. The Conservative Party went to extremes to manage its image on the NHS, to obscure its true intentions, and used every trick in the media management playbook to do so. The Conservative-led Government went well beyond spin as it regularly and blatantly misled and now misleads the public about the NHS and the bill.

The very weak opposition from the Labour Party and the leaderships of the BMA and many professional bodies added to the problem. The Department of Health had already been infiltrated by McKinseys consultants under New Labour (see Player and Leys, 2011 ↑ ). For most of the last year, Labour was unclear on its own policy direction ↑ and thus was virtually silent. Equally importantly, the leaderships of the BMA and several Royal Colleges, bypassed their memberships and were in active dialogue with the Government. Few initially were prepared to condemn the bill publicly. So, without authoritative and high-profile opposition, why should journalists have been concerned to investigate and cover the large, highly complex details of the bill?

However, these are now chronic problems in political journalism generally. An over-dependency on Westminster sources, and a general unwillingness to cover detailed policy matters, are two important failings of UK news (see Davis, 2010 ↑ ). Far too often, actual legislation is not considered newsworthy enough to report unless there is internal party conflict or scandal attached. There is also a problematic hierarchy for newsgathering that ensures government sources dominate, with the official opposition trailing behind. Far too often other smaller bodies, groups of professionals and the wider public are excluded altogether from the reporting beat. These problems are common across the UK broadsheet press, whether they be from the left (Guardian ↑ ), centre (Independent ↑ , Times ↑ ) or right (Telegraph ↑ , Mail ↑ , Express ↑ ) of the UK political spectrum. They are also too apparent in national news broadcasters including the BBC ↑ .

This was all too apparent for much of 2011. Professional opposition was widespread. Keep Our NHS Public ↑ , 38 Degrees ↑ , Spinwatch ↑ and others began scrutinising the bill and campaigning at an early stage. New local BMA groups sprang up all over the country in an attempt to force their leadership to engage with its ordinary members about their concerns. Numerous articles and blogs appeared, written by health professionals who had scrutinised the bill in far more detail than politicians or journalists[i]. Public meetings took place regularly - and across the UK, not limited to England. Many demonstrations took place. Marathons were run. Barely any of this was reported or drawn upon in the early stages, or appeared in smaller pieces and letters buried within. Opposition stories focused primarily on disgruntled Liberal Democrats.

Under such circumstances, far too often the Government was given too much space to set the reporting agenda and to define the debates themselves. Serious concerns at all levels were ignored until very late. Perhaps the most concerning of these was the Conservative Leadership’s total disregard for democratic institutions and practices. On Andy Coulson’s advice, Lansley and Cameron’s long-term privatisation agenda was completely obscured in opposition and during the election. The headline pitch was about securing the NHS: ‘cutting the deficit not the NHS’ and ‘no more top-down reorganisations’. The plans were not part of the published Coalition Agreement. Lansley’s long term links and dialogue with private health care lobbyists and providers was barely mentioned (see Spinwatch ↑ ). The same went for the part played by McKinseys. It was also clear to all professionals on the ground that many parts of the bill were already being implemented all through 2011. Civil servants repeatedly blocked the publication of their own risk assessments. Why wasn’t this disdain for democratic process challenged in media reporting?

Similarly, lies and misrepresentation were regularly reported on front pages without challenge. The NHS was portrayed as being inefficient and having comparatively poor health outcomes ↑ in comparison to other countries. But much of the evidence used was certainly debatable (see Roy Lilley ↑ ). Cameron and Lansley regularly stated that the majority of doctors supported them ↑ . But, from an early stage polls showed that two thirds of doctors were very concerned and critical. Towards the end it was over 90%.

That GPs were already forming themselves into Clinical Commissioning Groups (CCGs) was promoted as a sign of positive embrace ↑ . But GPs were given no choice as they watched PCTs being dismantled and new funding structures imposed. News coverage continually reported the line that doctors would be in charge of the budget and that this was about doctor empowerment and patient choice. As doctors in the newly formed CCGs have already found out, their influence over the NHS budget is actually more controlled by Whitehall than ever. CCGs are also having to look to private consultancies to take on key management roles. GP power looks like it will be no stronger than
before.

All along, Lansley, Cameron, Clegg ↑ and then Shirley Williams publicly stated there was no privatisation taking place. The word ‘reform’ is the most common description. But, plain and simple, this is a large step towards privatisation. Bupa, currently flooding the UK with advertising, knows this. So do Virgin, Sainsbury’s, United Healthcare, Circle, and Care UK.
What is happening is ‘reactionary’ and ‘regressive’ and threatens to take the UK public health system back to its pre-1945 state. £20 billion of ‘efficiency savings’ are really £20 billion of ‘cuts’. Again and again Government words and phrases have gone unchallenged - until the last months of the bill. When they were, professional association objections, were all too easily discounted as the calls of ‘self-interested unions’. Labour’s challenge, now led more convincingly by Andy Burnham, was dismissed as ‘opportunistic’. Lansley was chastised for failing to clearly explain the Government’s case to the public ↑ . His real failure was his inability to mislead as convincingly as Cameron.

In the last months, Labour, the BMA and most of the Royal Colleges joined in publicly condemning the bill and demanding its withdrawal. That was widely reported.  General coverage and editorials, even in the Conservative-supporting press (Telegraph, Daily Mail and Mail on Sunday ↑ ), became more critical. Some journalists, such as Polly Toynbee of the Guardian, objected loudly and regularly. But, by then, the bill had progressed too far and too publicly for the Conservative Leadership to be able to pull back.

Commentators have suggested that this might be the current Government’s Poll Tax moment. A far more appropriate parallel is Iraq 2003. Then, and now, the Prime Minister and a small cabal, forced through a momentous policy decision through a mixture of stealth, threats and lies. They did it with utter disregard for democratic processes, Parliament or public opinion. Far too many journalists failed to ask questions or seek alternative opinions over a protracted lead-in period (see account in Davis, 2010 ↑ ). Unfortunately, this is set to continue. We have an under-resourced news media, incapable of critical self-reflection on its out-dated practices and failings. They are little match for a ruthless administration with a media management operation as slick and determined as any peace-time government we have ever witnessed.







Aeron Davis ↑ is Professor of Political Communication at Goldsmiths College. He is the author of Political Communication and Social Theory ↑ (2010). His partner is a London GP.


This article is published by Aeron Davis, and openDemocracy.net under a Creative Commons licence. 


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Thursday, April 21, 2011

NHS: Cameron's Rhetoric is Wearing Thin

NHS logoImage via Wikipedia

Speaking on the Today programme yesterday the Prime Minister claimed to be committed to what he called our ‘precious’ NHS. He said he wanted it to go on succeeding, free at the point of use. But unless he is still not paying attention to what is in Lansley’s Bill (which is possible, as Cameron often seems curiously indifferent to the detail of his government’s policies) he is being completely disingenuous.
The crucial point is this: the Bill relieves the Health Secretary of his existing responsibility for providing a universal and comprehensive health service, and doesn’t allocate it to anyone else. It leaves it up to unaccountable local GPs grouped in Consortia to decide what services their particular patients will be entitled to, and what they will have to pay for, and how much, and this can vary from one consortium to another – goodbye both comprehensiveness and universality. It leaves an unaccountable healthcare market regulator (Monitor) to decide what private companies can offer NHS patients, and whether they can underbid NHS hospitals on price, and it mandates Monitor to promote competition – goodbye free care at the point of delivery.
The whole thrust of the Bill is to create a competitive market with a large expansion of provision by companies focussed on shareholder value. To pretend otherwise is, frankly, to insult the public’s intelligence. And it doesn’t make it any better to declare, as Cameron did, that because the population is ageing, the NHS ‘has to change’. That sort of rhetoric has lost all traction with the growing number of people who have woken up to what is going on. Change is constantly necessary in all services. The question is how handing over the NHS to market forces is supposed to improve it. The evidence points decisively against competition in health care and by now everyone knows it.
In March the BMA came very close to declaring outright opposition to the Bill. The nurses at their Liverpool conference in April repudiated the Bill and Lansley with it – by a majority of 478 to six. Unison and Unite are massively opposed. Cameron now says he would like ‘more full-throated support’ from the NHS workforce. Even his capacity for spin is getting seriously overstretched.
The name of the game for Cameron and Lansley now is to appear to be making ‘substantive changes’ to the Bill which will in fact leave its aims intact. The patently deceptive Future Forum ‘listening’ exercise with its Panel of five, chaired by a notoriously pro-market GP, plus 40 handpicked medics and managers, is designed to give a fig-leaf of legitimacy to what will actually be a behind-the-scenes search for amendments that look major but are not. These will not include the ‘essential amendments’ proposed by the Lib Dem rank and file after the Sheffield conference; those amendments are incompatible with the aims of the Bill and Lansley will not be accepting them. Whether the Lib Dems will tolerate yet another abandonment of their principles remains to be seen.
The task for everyone who is genuinely committed to the principles of the NHS is to ensure that the true aim of the Bill is kept clearly in view, and to insist that the media don’t collude in the lazy sort of misrepresentation that Cameron is hoping to get away with.



This article is published by Colin Leys, and openDemocracy.net under a Creative Commons licence.





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Tuesday, November 30, 2010

Market Forces: Coming to a Prison or Hospital Near You

The steady erosion of the public service arena continues apace with two developments this week either side of the Atlantic.

In Arizona, a state commission is recommending the privatisation of the state's parks and prisons, in an attempt to reduce a $1 billion budget deficit in the state.

In the UK, meanwhile, a private firm has been selected to take over the running of an NHS general hospital (Hinchingbrooke Hospital in Huntingdon) for the first time in the history of the health service in Britain. Circle, the new "franchise holders" are a co-operative company.










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Thursday, October 07, 2010

Dismantling the NHS?

NHS logoImage via Wikipedia
In-depth analysis on the nature, processes and people involved in the Government's NHS reform agenda.

The claim that the long-term outcome of these reforms is a two-tier health service, with only a limited range of treatments available for all, is hard to avoid.

Worth a read.





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Friday, August 14, 2009

Responding to Jerry Bowyer on Healthcare

The current debate, if it can be called that, about health care in the United States is one that I have generally avoided taking part in on this blog. The following video, however, has proven too strong a provocation for me to resist.

In it, radio broadcaster Jerry Bowyer misuses our beloved British National Health Service in order to give support to his own position on healthcare and in doing so expresses disrespect for an institution which is held in high regard here in the UK. More significantly, Bowyer makes a number of statements that are simply untrue or which appear designed to mislead and sow fear among his listeners.

Specifically:

1) He states that UK doctors are low paid. However, recent figures compiled by the British government's Department of Health and reported in the British Medical Journal here reveal that the average pre-tax salary of a British General Practicioner (equivalent to a local family doctor in the US) was £106,000 per year ($175,000) in 2007. Commenting on this figure, the British Medical Journal suggests that "there is a groundswell of opinion [in Britain] that GPs are being too generously rewarded."

The same article from the BMA compares average salaries among doctors internationally and reveals that British doctors are higher paid than their peers across Europe and trail behind only American doctors on an international comparison of medical salaries.

2) He states that physicians in the UK are "civil servants" comparable to post masters, without the same level of prestige as doctors in the US and that this fact makes the profession less attractive to British citizens as a career choice, opening the door to foreign-born doctors from Muslim majority countries.

As a British resident, I can assure Mr Bowyer that his view of British doctors is way off the mark. It is a highly respected profession and doctors are routinely among the most trusted individuals in their community. A recent poll rated them as significantly more trusted by members of the public than teachers, academics, judges or church leaders.

Furthermore, applications by British students for medical degree courses at British universities are hugely oversubscribed every year. Over 1000 applicants applied recently, for instance, for the 40 available medical training places available at Bart's Teaching Hospital in London.

It may be difficult for Mr Bowyer to appreciate - and this may reveal a cultural difference between the two countries - that "prestige" in a British context cannot be equated solely with salary in the way that he might assume to be the case in the United States. Medicine is very much seen as a vocation rather than a business in Britain - as it happens, a well paid and well respected vocation.


3) He states - ably assisted by the un-professionalism of anchorman Neil Cavuto - that the number of foreign Muslim doctors in Britain increases the probability of terrorist attacks taking place in the UK.

Fox News illustrates Mr Bowyer's thesis with images of Dr Bilal Abdullah who drove a car loaded with gas canisters into the front of Glasgow Airport in 2007, causing 5 injuries.

The message is that, since Dr Abdullah worked in the National Health Service and was a muslim, Americans can expect to be attacked by foreign Muslim terrorists with increased frequency if the current health care reform bill is passed.

That an educated man such as Jerry Bowyer could publicly make so stupid a statement almost defies belief.

Mr Bowyer is aware, I presume, that Dr Bilal Abdullah was born in Aylesbury, Buckinghamshire - a more traditional English town would be difficult to imagine. His father was a doctor and Abdullah trained for medicine in Baghdad.

More informed sources than Jerry Bowyer have conducted factual research into the nature and extent of Islamic terrorism in recent years. An extensive investigation into the number of terrorist attacks by Islamists worldwide between 2001 and 2006 was carried out by Peter Bergen and Paul Cruickshank of the New York University School of Law and published in 2007.

The facts reveal that, whereas there were no attacks on European soil between 2001 and 2003, the number of fatal attacks rocketed after 2003 - the year that British and American forces invaded Iraq - and that 297 civilians died in these attacks.

What do Bergen and Cruickshank conclude about the reasons for this upsurge in terrorist violence? More Muslim doctors, perhaps? Surprisingly not. The report's authors state that,

"We are not making the argument that without the Iraq War, jihadist terrorism would not exist, but our study shows that the Iraq conflict has greatly increased the spread of the Al Qaeda ideological virus"

and that

"the Iraq War has generated a stunning sevenfold increase in the yearly rate of fatal jihadist attacks,
amounting to literally hundreds of additional terrorist attacks and thousands of civilian lives lost"

and

"our survey shows that the Iraq conflict has motivated jihadists around the world to see their particular struggle as part of a wider global jihad fought on behalf of the Islamic ummah."


Mr Bowyer also fails to mention that in the United Kingdom, national health doctors are required to treat the entire population, not only those who can afford health insurance. 100% of British citizens have a legal right to healthcare, free at the point of delivery. It really would be an excellent thing if our American neighbours caught up with us.

In the meantime, we must put up with this nonsense. Watch if you can bear it.












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Sunday, July 19, 2009

A Sick Proposal on the Health Service

The Social Market Foundation, a British political think tank, is proposing that a £20 charge should be payable for members of the public to see an NHS doctor. The proposal, it is claimed, is a response to the "financial crisis" facing the NHS in the coming years.

The proposal, which is of course not government policy at present, illustrates the huge gap that exists in Britain between those who make such proposals and those who would suffer their consequences should they be implemented.

Report author David Furness (pictured) is clearly immune from the pressure that such an outrageous move would have on low and middle income families. The report's recommendation that the charge should not be levied on "anyone receiving tax credits" is a typical piece of nonsense driven by people whose life experience of poverty appears to be acquired from studying statistics and calculating averages rather than from struggling to make a living in the world of low-paid work.

The report's statement that "A charge of £20 for GP appointments should be introduced to encourage healthier, wealthier people to avoid using the NHS except when absolutely necessary, with anyone receiving tax credits totally exempt" represents an incredibly naive perspective - dividing British society up as it does into the wealthy and those on tax credits.

As noted on Left Luggage in May, many poor parents register as self-employed rather than accepting what is described as "poverty pay" in clerical or manual jobs and, in doing so, make themselves illegible for tax credits or other forms of social security. Such low income families would, of course, still be required to pay the proposed £20 charge to see a GP.

Under the report's proposal, furthermore, middle-income families with children would find themselves hundreds of pounds out of pocket every year just for making an appointment with their GP, despite assurances that such charges would be capped at "around £100 per year" per patient. This is before the cost of any prescriptions and other charges and before the hidden cost of illness such as work time lost, travel costs to hospital or the "choice" of going private for major surgery.

When faced with the option of making such payments or risking their children's health, parents will do whatever they feel they need to in order to get the service they are being taxed to provide and will, if they cannot afford the £20 levy, will turn up at A & E centres in large numbers demanding to be seen by a doctor. Hardly an efficient use of public money.

Perhaps we should not be too surprised by the report's lack of rootedness in the real world. The Social Market Foundation is chaired by Lord (David) Lipsey whose statement in the House of Lords in 2001 on the crisis of capitalism seems rather apt under the circumstances:

"However, that does not mean that there will not be a crisis of capitalism. A different kind of crisis can come over an economic system: it is not so much an economic crisis as a moral crisis. It can occur when a system becomes so far divorced from the moral sense of the people who make it work as to become inoperable."
Hansard Feb 2001












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