Is growth essential? ..... and the impact of the bankers...

Zoe williams in the Guardian has an article arguing for a Plan C that isn't dependent on the fantasy of economic growth. Well done, Zoe. An excellent and ,clearly, provocative article. I have never understood the emphasis on growth. The UK has to be in a phase of decline, having gone from Empire to nation and from the manufacturer for the world to barely a manufacturer at all.

Her comments about the quality , insight and ability (of all) our politicians are well deserved. They all seem to want to strut Europe and the world as global leaders and all talk about 'punching above our weight'. The reason they all love the finance sector is that it makes them feel that they have something big to brag about to their peers. And the existence of that finance sector is what has allowed them to indulge themselves in the fantasy economics of the last 20 years.

It looks as though the finance sector could now fade away and UK politicians will surely then have to grapple with the problems they have avoided for over a generation: making our modest way in the world, living within our means, establishing solid opportunities for our people.

Tony Nicklinson, the right to die and the Liverpool pathway

I have looked after someone with no speech and little movement who needed to be artificially fed so I do know something of what this family is going through.

The thing that always amazes me is that the right to die discussion takes place completely separately from the deaths facilitated by doctors. I saw one GP last week estimate that 130,000 patients a year had their deaths facilitated by doctors in the UK. This normally goes under the cover of pain control. I have seen many circumstances where the morphine dose is increased until death is inevitable. I know that family members are sometimes given responsibility for a morphine driver and can just let their family member drift away.

But there have always been more explicit methods. In Victorian times you would just take your extra laudanum like a good (dying) patient....and if you weren't dying before, you are now. And I remember hospitals having something called a Brompton Cocktail that was designed to see you off in a haze of morphine, cocaine and booze.

And now we have the Liverpool pathway. I know that its origins were well intentioned and it is probably still used really carefully, and caringly, in hospices, but the more widespread use is getting worrying. People who are not terminally ill, people who want to live, people whose prognosis has not been discussed......they can all find their way onto the Liverpool pathway. And unlike morphine drivers or Brompton cocktails, it can be a painful way to go, denied medication and also denied food or water. I said I had looked after someone who needed to be artificially fed. Before their naso-gastric tube was fitted the biggest problem was thirst, a far worse sensation than hunger. And the worry is that the Liverpool pathway inexpertly applied without compassion or sensitivity is just allowing people to die in the agony of thirst. Withdrawal of fluids is apparently a common component of torture. When we have a torture technique masquerading as a medical intervention, then we really are in trouble.

I can never understand how we come to have all of the legal debate about a very few individual cases where people want to have the right to die, and nothing about the apparently thousands of cases where cruel treatment is quite deliberately causing patient deaths. How can these things co-exist?

I think I know the answer. The families who pursue their right to die cases are challenging the classic British fudge that has always been the way things are done. Here's a little dose of morphine, now be a good chap......That's the way it gets done. But if the patient says - I want to know my rights, I want to know how the law will treat this, I want to know how my family will be regarded after my death - then that causes problems.

What is wrong is that this never gets dealt with as the whole system problem that it is. Instead it gets left to families like this one to pursue their individual case and to be forced to let the rest of us engage in the most painful aspects of their lives.

DESTROYING DEMOCRACY THROUGH PROPORTIONAL REPRESENTATION

Next week I am expected to vote in the Scottish elections for local authority councillors. Why should I? It's my public duty. It's my democratic right. It's a social responsibility. Yes, I know all that. But what if my vote can't make any difference? What's the point in voting then?


For years we were told that the first past the post system wasted votes. If you lived in a strongly Labour or strongly Tory constituency then voting against didn't matter. The dominant party would win and other votes wouldn't count. I am fed up being told by pundits at general elections that most constituencies don't count since the winning party there always stays the same. So the choice of government is made by those where there is the possibility of a change. One commentator suggested that it was the floating voters in those areas that determined the outcome, so the choice of UK government was made by around 100,000 floating voters in marginal constituencies. Democracy. 


The solution to this, we have always been told, is PR where our votes will really count. Well in Scotland we have PR. And several varieties of PR. I think the system for the Scottish Parliament, while not perfect, works O.K. You get a constituency MSP and this group is added to by the list MSP's on a regional level to provide more accurate representation based on all votes, not just those for the winning candidate for constituencies. This system has produced Green MSP's and was instrumental in the very small Scottish Socialist Party having great success, until they imploded. 


There are drawbacks to the Scottish Parliament voting system. It favours parties over independents. The list MSP's seem to have less to do than their constituency colleagues. And my particular bug is that if a list MSP gives up their seat, their party just sends the next name on their list to the Parliament. I don't think anyone should be a member of Parliament without being elected. It's just wrong.


But the basically OK system for the Scottish Parliament is not what we have for Councils. The system for Scottish Council elections was the price forced by the LibDems to form a coalition with Labour in the Scottish Parliament in 1999.


This was a deal done in smoke filled rooms. The public wasn't consulted. It was just an arrangement that suited the politicians. If we had been asked, what would have happened? Judging by the AV referendum, a mixture of mostly apathy and the rest rejection. But, whether we wanted it or not, it's what we've got.


So the historic arrangement of wards in each Council area, with each ward electing its own local councillor, was just thrown away. Now the wards are four times larger, which seems a bit contrary to the LibDem principle of localism, and the voters rank the candidates 1,2,3 etc.The top four represent the enlarged ward/constituency.Together. 


So, this will bring about fair representation? Not if the parties can stop it. When it was the historic wards each party would generally contest each ward. Where I live, that would have meant a Tory candidate, an SNP candidate, a Labour candidate, maybe a LibDem, maybe others.Our MP is Labour and our constituency MSP is Tory. The council has been Tory/SNP,Tory and,before that, Labour. So you would think they all had something to play for. 


But, instead of this giant new ward having four Tory, four SNP, four Labour candidates etc., this is what we have:


2 Tory
2 SNP
1 Labour
1 Lib Dem
1Independent


This is the pattern replicated, with slight variations, across the whole local authority. There are only 44 candidates for 30 seats. In 1995 there were 75 candidates. Voter choice is being squeezed.  So, that means that no party can achieve an overall majority. Good, you might say, we should move towards a more inclusive European model where the parties get together after the election to assess who should form a coalition. Except that, the outcome isn't being determined AFTER the election. It has already been decided by the political parties. Labour and the LibDems aren't even fighting for control in my Council. They don't even have enough CANDIDATES to be the major partner in a coalition. A deal has been done. The Tories and SNP will jointly form the next Council administration. The only question is, who will be the major party? Now that doesn't feel like democracy. It feels like party political manipulation of a system that they put in place without asking the public. The politicians have already determined the outcome. So, back to my original question, why should I vote? 


And one more issue. Given the way that the political parties have have connived to fix the system to their own advantage, I did briefly wonder about what an independent candidate might offer. I had been reading that the independent candidate in the London mayoral elections was having some impact (though we'll see if she gets a place at the table on Question Time). So I contacted the independent candidate and asked where he was speaking and where there was a candidate debate. You will know how this goes. There is nothing. I don't understand how candidates can seek your vote without presenting themselves and their policies to you. So, why should I vote?  

Remploy : U-turn required

We have to hope that enough MPs have the guts to challenge the Government's decision on this. The coalition needs to re-think. Once again this Government demonstrates its deaf ear to public opinion. Do they no longer have sensible civil servants saying  'That would be very brave, Minister',  or are they just ignoring them? 


The argument seems to be that the Government should no longer subsidise Remploy at up to £25k per place. On the same day that the Remploy announcement was made, I heard Government Ministers defending the U.K.'s aid spend of £7,800,000,000. This is a categorically different level of expenditure compared to the £68,000,000 invested in at least 2000 jobs at Remploy. It's not so much the money, it's the priorities that the spending decisions expose that is the real issue. The coalition just doesn't get people with disabilities just as they don't get those communities that were devastated by the de-industrialisation of the 1980's. They have to understand that they will have to take the country with them if we are not to be any further divided,have any further inequality.


The solution to the Remploy position is simple. Treat the existing workforce, the people, as the first priority and put arrangements in place for them. Some of the Remploy factories could be turned around by more innovative management.  Some settings would benefit from a partnership with other companies. Some individuals could be supported in more open employment. The task would be to get every existing member of staff into an appropriate setting. The transition would take a lot longer but everyone would recognise that the Government is putting people first. Just as it puts its overseas aid commitments first.


If the Government doesn't u-turn on this then we have another issue, like the NHS bill, that will lose them the next election.

Mansion Tax

The LibDem idea of a mansion tax is the craziest coalition policy since the NHS bill. There are two main objections.


1. As with the old rates system you can have someone who appears property rich who is income poor who will then struggle to pay. I wouldn't want to see someone who has lived in the same house for 80/90 years being evicted because they can't pay the tax. 


2. The rich will simply avoid paying this tax. They already avoid paying stamp duty when they buy these £1M+ homes. What on earth makes Vince Cable think they are going to fail to find an avoidance mechanism for a mansion tax.


I think I can now be officially categorised as cynical. I think the LibDems know that and it's just cover for agreeing the removal of the 50% tax rate. Or at least flying a kite to see if the public go for it. 


Pathetic!

Unemployment heads for 3 million.

It's not exactly a surprise that things have got this bad. In fact, it's completely predictable. From the start the coalition has talked strongly about public sector cuts and the mantra of austerity. (Interesting to note, though, that austerity doesn't extend to their own public spending with £400,000 wasted on renting fig trees for Portcullis House.) But the public sector cuts were to be offset by private sector growth. The trouble has always been that there has never been a strategy for creating those jobs. What kinds of jobs? In what sectors? In what locations? How supported? If the public sector redundancies really are about cutting out waste, then those jobs won't be replaced in the private sector. And there are many functions carried out at present by the public sector that just couldn't generate a profit. at least not without dropping down wages and conditions, or increasing public purchasing budgets. Probably both.


The absence of any kind of growth strategy is really disturbing. It's fantasy economics and fantasy politics. I wrote in this blog back in October 2010 that government 'will also have to deal with the unfinished business from the 1980's of how to restore exporting industry, and what to do about  all those communities that have lost the reason for their existence'. In contrast, their policy seems to be to cross their fingers and hope for the best.


This is a little PS. This morning I saw three young men emerge from the building that houses the local probation service and NHS addiction service. I don't know which they had been visiting, possibly both. All three were pasty, emaciated  figures stumbling along in their matching Burberry baseball caps. (How Burberry must hate that : its a sort of anti-marketing to have your stuff adopted by your least welcome demographic.) One had crutches. Quite a common site around this building. It's because they damage their ability to walk by injecting in their groin. 


Anyway, it got me thinking on what it would take to get that three into work. They have probably never worked. They are drug users. They probably have a criminal record. Who will ever employ them? The most worrying thing is that, if not already then soon they will have kids. Kids they will ignore but kids who will, in 20 years time, also look like these three : permanently unemployable. And what is the strategy for breaking that cycle? I suspect that, once again, it's cross your fingers and hope for the best.

NHS REFORM

I'm so glad to be living in Scotland and out the way of these unnecessary and wrong NHS reforms. It has, incidentally, been a very long time since there was, as Labour likes to say, one NATIONAL health service. Things have been very different in Scotland and England for a long time. In fact some of the resentment that fuelled the rise of the SNP derives from the last time the Conservatives were in power when unacceptable policies were imposed : poll tax, de-industrialisation, introduction of markets into the NHS. That's why the Tories still have only one seat in Scotland.


The current NHS reforms are hard to understand. Why are they doing it? David Cameron said that the NHS would be safe in their hands and that there would be no 'top-down re-organisation'.  While we are used to politicians telling lies, this is a breathtaking example of promising one thing to electors and then, once elected, of doing the opposite. Whatever else it is a gift to Labour. You can be sure that much will be made of it in the next general election campaign. And its the most important issue for many voters. I saw the NHS described as the closest we have in the UK to a state religion. For a PR professional the Prime Minister has a very uncertain touch.


So, why are they doing it? I think its in their DNA and its unfinished business. When the Thatcher government came to power in 1979, they did have a mandate to privatise and got busy on coal, steel, rail etc. They were then keen to extend this approach to the NHS but found that it was such a shambolic organisation in business information that there was no basis for either separating out elements of service (because everything was so integrated - generally regarded as a good thing) and because nothing was properly costed. No one, famously, could tell Ministers how much a hip replacement cost.


All of the re-organisations that have taken place in the intervening years have been attempts to resolve these structural  problems. The NHS is now divided up into business units. And everything is costed. But these changes have largely been to the detriment of the NHS. The rot set in early. When they found that they couldn't privatise in 1979 the then government started to prepare the NHS for a future privatisation. They commissioned Roy Griffiths, then the Chairman of Sainsburys, to report. He found an organisation without adequate information and cost systems and recommended the introduction on general management.  


I think Griffiths was probably correct and I don't agree with those who think his approach was to turn the NHS into a supermarket. The NHS in those days did need to modernise systems and management but the scale of the changes has gone far beyond anything Griffiths could have imagined. Part of the problem is that so many NHS managers are not really managers, they are at best administrators,  and the sub-divisions of NHS business units are so unwieldy that integration, once in the bloodflow of the NHS, is now a full-time demand on those administrators. Another problem is that anytime anything becomes an issue civil servants advise Ministers to introduce another role to determine policy, monitor implementation and interpret results i.e. someone just like them. That's why there are so many civil servant type roles in the modern NHS.


So, Conservatives always want to privatise. It's the Conservative way. And they are completing the work they were frustrated in back in 1979. They are completing Keith Joseph's dream.


Whatever you think of it, it will lose them the next General Election.