Friday, 28 February 2014

'Popular' uprisings are not necessarily popular

We should not make the mistake of assuming that 'popular' uprisings are popular. Or at least we shouldn't assume they represent the overwhelming interests of all the population.

It is instinctive for us to align ourselves with 'velvet' type revolutions - the toppling of oppressive regimes through the shear determination and will of the people expressed through civil disobedience. But the situation in Egypt and now as it develops in Ukraine should tell us that not all outcomes are good. A power vacuum has to be filled and it is often followed by an equally abhorrent regime with equal determination to have its will obeyed.

We now watch the situation as it develops in Ukraine with growing concern. The 2012 election was marred, and with a key opposition leader in prison it was rightly condemned by international observers. But the deposed president was not without popular support. There is a growing unease that Ukraine may split. Prevention of this will require political compromise.  Russia may move to 'protect' the Russian speaking population.

A symbol of this uprising in Western media has been the toppling of statues of Lenin. We should recall that Lenin came to power through a 'popular' uprising. But what is significant in Ukraine is that there isn't a coherent opposition leader around whom the people can rally.

We have learned that all is often not as it seems with 'velvet' revolutions. The 'orange' revolution in Ukraine soon turned sour with political corruption. Most of us have little idea of those who 'lead' the opposition in Ukraine. I doubt we will see a more robust democracy as a result of the events as they have unfolded.

Thursday, 27 February 2014

Did Zoo follow guidelines when it killed Marius?

Remember Marius the giraffe? Copenhagen's scientific director, Bengt Holst, said Marius's genes were too similar to those of other animals in the European breeding programme, and he risked introducing rare and harmful genes to the giraffe population if he had been allowed to breed. This is nonsense. I challenge Mr Holst to tell us what 'harmful' genes Marius had. I doubt if he can. I also challenge him to tell us how he defines these 'harmful' genes.

Nor did Copenhagen's zoo follow fully the guidelines laid down by EAZA, the European Association of Zoos and Aquaria. The guideline specifically states that

a post-mortem examination should be performed and biological material preserved for research and gene conservation. The results of the post-mortem should also be passed to the relevant programme coordinator, and full records of any results and outcomes should be archived. 
Marius was simply cut up and fed to the lions.

Now I must emphasise that I am not against culling animals kept in herds for preservation purposes. This is clearly necessary else the herd will get too big and also it becomes difficult to look after sick and ageing animals.  Inbreeding in a herd could also become a problem. But we need honesty in the reasons for a given cull.

The EAZA guidelines also state that each case must be considered on its merits and alternatives should also be considered. In this case other zoos had offered to take Marius. This alternative was rejected.

Wednesday, 26 February 2014

New English Language Tests for Doctors

Responding to the publication of the General Medical Council’s consultation on introducing English language tests for doctors working in the UK from the European Economic Area, Dr Vivienne Nathanson, BMA Director of Professional Activities, has said:

"The BMA supports the introduction of English language checks for European doctors and new plans from the General Medical Council to set the bar higher for all overseas doctors having to take the tests.

"It is vital for patient safety that all doctors, whether from the European Economic Area or otherwise, have an acceptable command of English to communicate effectively to ensure the safety of their patients.

"Since 2002 the BMA has called for language skills to be made a pre-requisite for any doctors wanting to practice in another EU member state, and while we support freedom of movement it is important that patient safety is paramount at all times."

We all expect our GPs to have good enough English to communicate and understand what we say. A crucial part of a consultation is taking a history, but a history isn't simply a list of symptoms or episodes in a life. It is understanding the patient's narrative. The way people express their emotions or feelings will often be couched in nuances and cliché. Understanding is more than language.

Of course another way of saying this is that language is more than simply words. It is cultural.

Under current legislation, the GMC can assess overseas doctors applying to work in the UK, but not those from other countries within the European Union.

The changes will require doctors from other European countries to provide evidence of their English skills or undergo a language assessment, if the GMC has concerns about his or her ability to communicate effectively with their patients.

This has to be a good move. As Niall Dickson, GMC chief executive says 'these new measures to ensure doctors from other European countries can communicate in English, combined with the higher test score requirements, will help us strengthen protection for patients."






Sunday, 23 February 2014

It Wasn't Always Late Summer

My novel, It wasn't Always Late Summer, is a powerful story of Mary, a single teenage mother living on a housing estate plagued with predatory abuse and prostitution, and Annie, an innocent girl whose ghostly presence links the central characters over two generations, bringing the events that led to her death, the loss of innocence and the unfolding story to a dramatic, thrilling conclusion.

It is a long held view that child abuse is rooted in the cultural heritage of denigrating children  and that most abusers are repeating child rearing patterns they themselves experienced as children.  It wasn't Always Late Summer, explores this thesis in the context of predatory sexual abuse. But it isn't intended to be an academic thesis.



It is a mystery-suspense thriller. It explores through the characters the psycho-social dynamics of the culture of sexual abuse and grooming. Some readers have said they find it compulsive and engaging but they do find it difficult. They put it aside several times. There is a vulnerability in all the characters that creates a sense of trepidation. It is a deeply disturbing story. I can understand the readers difficulty. I cried several times in writing it.

It is a ghost story too. But I didn't set out to write a ghost story as such. In many ways Annie represents the lost innocence that runs through the narrative. It is a story with an interesting twist. 



Friday, 21 February 2014

Rural GP practices under threat


Changes to the way GP practices are funded in England could threaten the future of at least 98 GP practices, including some that provide vital services to thousands of rural patients, GP leaders have warned today.

Last year the Government decided to begin phasing out the minimum practice income guarantee (MPIG) from April 2014. MPIG provides an important financial lifeline to many smaller GP practices by guaranteeing a minimum level of funding that is not dependent on the number of patients a GP practice has on its practice list.

NHS England have idenitified 98 GP practices that will lose substantial levels of funding that could place their long term survival in question. In addition to the 98, there are a significant number of other practices that will be severely affected. This is compounded by the Government's failure to put in place a national plan to help support the practices affected.

Dr Chaand Nagpaul, Chair of the BMA’s GP committee said:

“The government has seriously misjudged the potential impact of its funding changes, especially on rural GP services. It is likely that a few hundred practices will lose noticeable levels of funding, with 98 practices identified by NHS England as being at serious risk from severe cuts in their financial support that could threaten their ability to remain open. This comes at a time when GP practices are already under pressure from rising workload and declines in overall levels of funding.

“The government has not confirmed where these practices are or the extent of their financial difficulty, however some will be smaller GP practices in rural communities with comparatively small number of patients registered with them. These GPs provide vital services to patients in areas where accessing healthcare is already not easy because of the large distances patients have to travel to get to their local NHS services. If these practices were to close it could leave large geographical areas without a nearby GP practice.

“The situation has not been helped by NHS England’s decision to devolve responsibility for this issue to local NHS managers without a framework on how these GP practices should be supported. We are without a national plan of how to tackle this problem and safeguard GP services.

“Ministers have to get a grip on this problem urgently given these funding reductions are just weeks away from being implemented. We need to ensure no practice closes and that there is a coordinated approach to deal with this issue.”

One of the GP practices that is concerned about these changes is a Cumbrian practice run by Dr Katharina Frey.

Dr Frey said:

“My practice is a very small one that cares for just under 1,000 patients in a rural South Cumbrian area. We have for many years provided a real family orientated service for patients and I believe we are a really vital service for our local community.

“We are under real financial pressure already and cant, because of the current funding climate, afford to employ a practice nurse. We are also having to think very carefully about how we replace senior staff. This situation will become even more pressurised when we lose the MPIG support that currently accounts for our around a third of our current core funding. We are already working at full capacity with declining resources: I just don’t know how we will cope with this additional financial blow.”

 

Read Ray'a Novel: It wasn't always late summer 

Wednesday, 19 February 2014

Is food packaging a threat to health?

Something doesn't taste right. Our food comes in so much packaging. It is even hard to get into. Scissors, knives, fingers pulling and tugging to get excessively hard packaging open. But is that all we have to worry about? Not according to the latest commentary by environmental scientists in the current issue of the Journal of Epidemiology and Community Health.

The authors of this commentary warn that the synthetic chemicals used in the packaging, storage, and processing of foodstuffs might be harmful to human health over the long term.

This is because most of these substances are not inert and can leach into the foods we eat.

Despite the fact that some of these chemicals are regulated, people who eat packaged or processed foods are likely to be chronically exposed to low levels of these substances throughout their lives.

The authors of the report suggest that far too little is known about their long term impact, including at crucial stages of human development, such as in the womb, which is “surely not justified on scientific grounds.”

They point out that lifelong exposure to food contact materials or FCMs - substances used in packaging, storage, processing, or preparation equipment - “is a cause for concern for several reasons.”

Known toxic substances, such as formaldehyde, a cancer causing substance, are legally used in processed food packaging. Formaldehyde is widely present, albeit at low levels, in plastic bottles used for fizzy drinks and melamine tableware.

Secondly, other chemicals known to disrupt hormone production also crop up in FCMs, including bisphenol A, tributyltin, triclosan, and phthalates.

“Whereas the science for some of these substances is being debated and policy makers struggle to satisfy the needs of stakeholders, consumers remain exposed to these chemicals daily, mostly unknowingly,” the authors point out.

The total number of known chemical substances used intentionally in FCMs exceeds 4000. The major point here is that we do not yet know the accumulative effect of these potentially harmful substances.

Furthermore, potential cellular changes caused by FCMs, and in particular, those with the capacity to disrupt hormones, are not even being considered in routine toxicology analysis, which prompts the authors to suggest that this “casts serious doubts on the adequacy of chemical regulatory procedures.”

They admit that establishing potential cause and effect as a result of lifelong and largely invisible exposure to FCMs will be no easy task, largely because there are no unexposed populations to compare with, and there are likely to be wide differences in exposure levels among individuals and across certain population groups.

But some sort of population-based assessment and biomonitoring are urgently needed to tease out any potential links between food contact chemicals and chronic conditions like cancer, obesity, diabetes, neurological and inflammatory disorders, particularly given the known role of environmental pollutants, they argue.

But is this scary-mongering pure and simple? Like the fear of the dark, is it what we don't know that is of concern and can we shed light where there is currently darkness, a paucity of information. This is the real problem. We just do not know. We have no way of properly assessing the potential harmful consequences of long term exposure. What the authors of this commentary are advising is that we need to start addressing this issue.

“Since most foods are packaged, and the entire population is likely to be exposed, it is of utmost importance that gaps in knowledge are reliably and rapidly filled,” they urge. It will probably take several decades before we have the answers. Meanwhile we just have to hope they are wrong. 

Sunday, 16 February 2014

No joy from taxing the rich

According to a report in today's Sunday Times many Labour candidates are worried the party will lose the support of business. They are right to be worried but Miliband and Balls will find it difficult to win back the business vote. Blair and Brown worked hard on it when in opposition. It wasn't something that came together in a few months.

Labour is instinctively correct in looking to top earners to contribute or share some of the pain. The problem is that too many of them are immune.  The Tory mantra that taxing the rich is counter productive has not only a ring of truth but a considerable grain of truth. They argue that the rich are paying more in taxes with the top rate reduced than when the top rate was higher and the top 1% of earners pay almost one third of tax revenue.

It is not difficult to see that bashing the poor is easy compared to bashing the rich.

Saving the world from itself

It is reported that US Secretary of State John Kerry is to issue a clarion call for more 'global action' on climate change. This is all well and good but there isn't a 'global body' that can take 'global action'. There are economies competing in a 'global market'. How that translates into 'global action' against climate change I cannot see. Persuading individual countries that they are the ones that need to make a sacrifice for the sake of saving the world is very difficult. For the most part the West has already contributed its share of global emissions. Their damage is done. Now developing countries will have to be persuaded that there are better ways to economic growth and prosperity.

Up to ankles in water does PM no good.

It appears from the opinion polls that the prime minister has misjudged the handling of the floods. All that donning of Wellington boots wading around and looking serious has done little to assuage the mood that too little has been done too late.

I usually find it silly that politicians have to be 'seen to be doing something'. This is why they end up paddling in water and 'coming to see' for themselves the enormity of it all when in truth it provides little they couldn't already understand. Being 'seen' in a crisis is all important. Being 'seen' to be indifferent to people's suffering is highly damaging.

Curiously Miliband's paddling and being 'seen' has been more effective than Cameron's. Voter's minds tend to be made rather early and Cameron was fighting a losing battle with public perception. He just looked like a man out of his depth.

All this is probably distinctly unfair. But it is the nature of politics. I  am sure the Prime Minister handles things with skill when he chairs Cobra meetings.

Chairing cobra meetings has also become a feature of being 'seen' to do something. Taking charge. Politicians have to be  'seen to take charge' or as it is so often said 'get a grip'. It is a euphemism that is most often used when politicians have little 'grip' to grip with. Events take more control than any politician could do.

Politicians are slaves to events, and the biggest 'event' is environmental change and certainly the weather. I would put my money on the weather winning. Politicians cannot control the rain and wind - at least not yet. Maybe some bright spark in a Cobra meeting is suggesting this be done.

Saturday, 15 February 2014

Sterling scuppers the SNP?

I can understand the arguments for Scotland's independence. They are a proud nation and for too long the politics of Westminster has polarized opinion. I agree with Salmond that if Scotland vote for independence then we will have  to work with it. But whether they can be part of a single currency union if they vote for independence shouldn't be a matter for voters in Scotland alone. Such a union would affect all people in the United Kingdom. It is reasonable therefore for the British government to state now that it would not be possible, or at least it would not be possible without some kind of political union.

It seems that the SNP want to have their independence cake without true economic independence. They want the benefits of being part of the UK economic community without the political responsibility. That is not true independence. It would hand more of their sovereignty to Westminster whilst removing any influence on policies. It is crazy, and it is clear this has not been thought through by the SNP.

Postscript

News that José Manuel Barroso, president of the European Commission, has said that an independent Scotland would have to apply for membership of the EU is a further blow to the position taken by the SNP. Once again the SNP dismiss it as 'preposterous' saying that Scotland has been a member of the EU for 40 years. Yes but not as an independent country. It is the UK that holds membership.

The SNP should concentrate on the arguments for independence. Their assessment of monetary union and EU membership are at best questionable and at worst clearly wrong. They should be arguing that the undoubted costs of independence would be outweighed by the advantages of being independent. This they are not doing. They are trying to argue that little if anything would change. They cannot have it both ways. Independence without pain isn't an option. They would be better arguing that the pain would be worth it for the freedom to control their own destiny.

Thursday, 6 February 2014

Ban smoking with children in car?

I am not much impressed by the 'libertarian' arguments against a ban on smoking in a car with children. The only argument of value is whether and how it could be enforced.

People should be aware of the real potential damage to children's health particularly when they are trapped in a small space and the air is polluted with toxic chemicals. Secondhand smoke contains more than 7,000 chemicals. Hundreds are toxic and about 70 can cause cancer. Put that in your libertarian pipe and smoke it!







Sunday, 2 February 2014

Hand wringing on Syria

One of the more absurd accusations levelled at former Prime Minister Tony Blair this last week was to blame him for the lack of intervention in Syria. The argument runs that the reason for the West holding back from intervention is the legacy of Iraq. What is somewhat hypocritical is that many of those now adopting this position would have been against intervention at any cost. It is as if the lessons of intervention in Iraq should not be learned: regime change rarely works and it leaves a bloody mess.

But this isn't a criticism of Tony Blair. It is a lesson learned. So we sit back unable to act when hundreds of thousands of Syrians suffer. We wring our hands and cry foul, yet we have no idea what to do. I can't help feeling that Blair and Bush would more likely than not have intervened long before now. I was against intervention. What I no longer know is what is best. Perhaps I should rephrase that: I no longer know which is worse, the bloody cost of not intervening, or the bloody consequences of military intervention and regime change. The truth is we don't know.