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Showing posts from 2014

It is a catastrophe

Here we go. It is winter and it is getting cold, freezing cold, shiver your timbers cold. It  is winter. That is what I expect in winter.  But when I read the newspapers or watch television you would not think so. Now is the time for headlines. Winter is no longer sufficient. It has to be 'record low temperatures', 'lowest since records began', 'the big freeze'. It isn't of course. It is winter, and when I look at the story under the headline we find that it is the lowest temperature recorded in some obscure part of the Britain.

Headlines. We live by them. There is that phrase I hear used often 'the headline figure'. Beware of them is what I say.  It is all designed to make us feel that something awful is happening, when it is simply winter.

Now this isn't to say I don't believe it when we are told that environmental change is causing changes in weather patterns - more stormy weather, more floods, more heat waves, more...snow. Winter. Since …

Doctors under stress

A recent survey conducted by Pulse magazine found that four in 10 GPs have taken or expect to take time off from work as a result of increased workloads. 12 per cent had taken time off in the past 12 months, with 29 per cent reporting that they thought they would probably need time off in the next 12 months. 
Today the General Medical Council publishes a report on Doctors who commit suicide while under GMC fitness to practice investigations. 
Responding to today’s [Friday] report from the General Medical Council (GMC), BMA council chair, Dr Mark Porter, said:
“Doctors’ first priority is their patients' care, but we must not forget that they can face the same physical and mental health issues as everyone else, and it is vital that vulnerable doctors undergoing fitness for practice investigations are fully supported."
Previous GMC research revealed doctors’ views of the investigation process and it is clear that more needs to be done to understand the wider implications on doc…

Cameron's democratic conundrum.

I am not at all impressed by the simplicity of 'English votes for English laws'.  Introducing a rule in parliament that says only MPs representing English Constituencies can vote on matters affecting the English doesn't solve the problem of how we move forward with the United Kingdom. On the contrary it hammers yet another nail into its coffin. But my main argument against it is that it denies, yes denies, the same level of democracy that voters in Scotland or Wales etc would have. Far from solving a problem it creates a new anomaly.  If I were then to be a voter in Scotland I would have the opportunity to split my vote - I might for example vote SNP (well I wouldn't but that is a different matter) for the Scotland Parliament but would vote Tory (certainly wouldn't but then this is an example) in the UK wide vote.  If I lived in England I would not have these opportunities. I would have to choose the same party to represent me in England as UK wide.

Now you might …

BMA support banning smoking in cars with children

Responding to the regulations laid before Parliament today that propose banning smoking in cars containing children under 18, Professor Sheila Hollins, BMA board of science chair, said:

“The BMA strongly supports a ban on smoking in cars when children are present, as it is an important step in reducing tobacco harm by restricting the prevalence of second hand smoke in private vehicles.

“Children are still developing physically and biologically and compared to adults they breathe more rapidly, absorb more pollutants and have less developed immune systems. As a result, they are more susceptible to the harmful effects of second hand smoke and are less likely to be able to choose to move away from it.

“Adults who smoke in the presence of children are not acting in the children’s best interest; therefore it is encouraging that the government has brought forward these regulations in order to protect them.”

Brand shows a new brand of politics

I am no great fan of Russell Brand. His brand (no pun intended) of humour doesn't appeal to me. But his appearance on BBC Question Time last night demonstrated one salient lesson. There is everything to be gained by confronting UKIP directly rather then pandering to the fears they stoke up about migration.  The Tory, Labour and Liberal Democrat strategy of trying to outpace UKIP on this key issue simply tells voters that UKIP have got it right. Russell Brand demonstrated how to challenge UKIP on their own turf.  The audience responded. Yes, it was a divided audience but I had the impression of a sense of release that UKIP had finally been challenged and found wanting.

Brand's style cuts through the usual heavily nuanced political debate around a centre ground that is the size of a pin head.  One of the reasons why voters are turned off politics is that there are few people out there who now make a bold statement that might represent their views, and there are precious few who …

NHS Crisis, Crisis, Crisis!

The BMA has issued its starkest warning yet on the 'crisis' facing the NHS.

Commenting on the publication of NHS England’s 'winter health check' which shows record numbers of patients waiting longer for treatment in emergency departments, and emergency admissions at the highest they've been since records began over a decade ago, Dr Mark Porter, BMA council chair said:

“Patients should be treated on the basis of clinical need rather than an arbitrary target, but these figures point to a system cracking under extreme pressure, leading to unacceptable delays in care.

“While the NHS is used to seeing a spike in demand during winter months, this year it’s experienced a spring, summer and autumn crisis as well, leaving no spare capacity in hospitals as we hit winter.

“This is not just a crisis in emergency care – bed shortages and high numbers of patients inappropriately in hospital beds are now major stress factors on the system, leading to unacceptable delays in treati…

They are all 'cutting the deficit' now — but do they make any sense?

There is nothing more annoying than hearing politicians of all parties telling us 'we must cut the deficit'.  It is annoying because they never explain what they mean by it, let alone how they would do it.  It should come with a health warning, or some kind of caveat that tells you they are talking nonsense. There is no 'must' about cutting he deficit.  It is not in itself a 'must'. It is only a 'must' in the right economic context. Mr Osborne says he has cut the deficit by a third. Mr Cameron often repeats this. What they mean by cutting the deficit varies depending on what message they really want to get across.

Are they talking about the current account deficit, or are they talking about the underlying, or structural deficit? They don't tell you. They simply say 'deficit'. By doing so they give the impression that all kinds of deficit are equally problematic. They are not. You might think the deficit is 'the deficit'. Some politi…

BMA finds creeping privatisation of NHS

Figures released by the BMA today show the extent of creeping privatisation in NHS under Health and Social Care Act

The investigation by the BMJ found that a third of NHS contracts have been awarded to private sector providers since the Health and Social Care Act came into force.

Responding to the findings the BMA council chair, Dr Mark Porter, said:

“These figures show the extent of creeping privatisation in the NHS since the Health and Social Care Act was introduced. The Government flatly denied the Act would lead to more privatisation, but it has done exactly that.

"Enforcing competition in the NHS has not only led to services being fragmented, making the delivery of high-quality, joined-up care more difficult, but it has also diverted vital funding away from front-line services to costly, complicated tendering processes.

"What's worse is that there isn't even a level playing field as private firms often have an unfair advantage over smaller, less well-resourced c…

The politics of poverty

How can we sleep at night when all around us are vulnerable people going hungry? What kind of greedy people are we that would not wish to stop this madness of food shortage amidst food plenty? How can we approach Christmas with 'goodwill to all' whilst we give little goodwill to those who have born the brunt of cuts. Our greed, or at least the bankers greed, brought this about, and yet the government is busy stoking up the same uncontrolled, housing led boom that became unsustainable.

We need a social contract that says that people should not be forced to work for poverty wages. We need a living wage. We need education policies that give realistic opportuities to our children and young people to acquire the skills they need for skilled jobs. We need a housing strategy that provides decent homes for people at affordable rents. We need a decent transport system that enables hard working people to get to work without spending thousand in fares. We need a government that will be b…

Don't believe a word of it - cuts are cuts

Jobs, that is what it comes down to, and wages, and taxes. The reason for the coalition, the coming together of the Liberal Democrats and the Tories was to clear the deficit — so they said. They are failing, and failing miserably. Why? The answer was always there.  The best way to clear the deficit is to get people working for decent wages. The reason the deficit is not shifting is not because of profligate government spending. It is because of falling revenue. The premise that simply cutting spending will cut the deficit is what it is — simple.

Now you could go on cutting and cutting spending in the hope that the deficit will turn around. But the more you cut the more likely it is that you impact on revenue. Surely that is the lesson to be learned. But it isn't a new lesson. It is what several economist warned four years ago.

The problem with cuts is that it  begs the question of what to cut and that produces conflict about political priorities. The Tories will say they couldn…

NHS crisis is government created

It is increasingly difficult to see a coherent government strategy for the economy.  Dealing with the deficit has now given way to 'doing whatever is politically expedient to win the next general election'. The NHS is high in list of voters' concerns.

The 'extra' £2 billion for the NHS announced today in the Chancellor's autumn statement is welcome. But it is too little and very late. The government has been warned over the past four years of cuts that the NHS is 'on a precipice' and would have difficulty meeting needs. Mr Cameron promised that the NHS would be 'ring fenced' and protected from the cuts, but so-called efficiency savings have eaten into NHS budgets to the tune of £20 billion.

Responding to the announcement today by the chancellor that NHS services are to receive £2 billion in extra funding, BMA Council Chair, Dr Mark Porter said:

“There is little doubt that the NHS is under unprecedented pressure from a combination of rising pati…

Beware UKIP education policies

Imagine a National Health Service that had selection criteria on the basis  'we will only treat certain people we regard as worth saving'.  Now imagine a state school system based on the premise that only advantaged children will go to the 'good' schools.  Now take a look at this statement:

'Existing schools will be allowed to apply to become grammar schools and select according to ability and aptitude. Selection ages will be flexible and determined by the school in consultation with the local authority.'

The result of such a strategy would be to entrench a two tier system in our state schools. The 'good' schools will select on 'academic ability'. We have of course been here before in the old system of  Grammar and Secondary Modern Schools. Some might argue that it is as good idea because it ensures a good education for the brightest pupils. It will condemn those deemed less academically gifted to second rate schools.

You will note that the polic…

Jake the peg diddle diddle

The Rolf Harris conviction for sexual abuse leads me to ask a question. Does 'evil' or wrong-doing wipe out any 'goodness' we have once seen in an individual? I ask this not to 'forgive' Harris but to address a significant ethical question. Do we like or enjoy Rolf Harris's songs any the less because of his conviction? Are they indeed different when we listen to them.

I have had Jake the Peg buzzing round in my head for days now. It won't go away, and as I conjure up the image of Harris performing it I still smile - perhaps now a kind of guilty smile. We are told there are two sides to Rolf Harris - one being the dark side. But does the dark side really diminish the joy of the light side?

Cilla Black I think summed it all up when asked to comment on the news of Harris's conviction. "I'm disappointed." Yes and I am disappointed too. We have been let down by another 'hero'. We build people up and put them on a pedestal and expect…

Farage doesn't have a mask

No surprise that UKIP did well in the local elections. It was anticipated. It would be wrong to dismiss it as a 'simple' protest vote - something is afoot. Old party loyalties are being broken. What is striking is how easy it has been for Tory voters to switch to UKIP. The worry for Cameron is that, according to a YouGov survey so many of them will not return for the general election next year - well we will see.

Labour should be worried too but their result in the local elections has been better than many had thought in large part because they did well in London where UKIP did badly. On the basis of the local election results, and that should always be treated with caution, the Lib Dems would lose about 20 seats in the general election - hardly the stuff of what Nick Clegg likes to call 'a party of government'.

Nick Clegg has said that Nigel Farage's 'Mask has slipped'. Frankly Farage doesn't have a mask which is why he is appealing to voters who belie…

Lack of funding undermining primary medical care

General practice cannot reached its full potential in the face of continuing under-investment in the profession, the cutting of MPIG funding, the problems recruiting and retaining GPs and the lack of investment in premises, GP leaders have warned.

Backing a motion1 at the annual Local Medical Committee’s conference in York, GPs said that general practice can be the solution to many of the current problems facing the NHS, but was held back by the serious damage being done to the profession.

The calls come weeks after the British Medical Association launched its ‘Your GP cares’ campaign to support GPs and calls for long term, sustainable investment to be made in GP services across the UK, to:

· Expand the overall number of GPs to attract, retain and expand the number of GPs and ensure patients are given the time, care and services they deserve

· Expand the numbers of other practice staff so each practice has enough nurses and other staff to meet the increasing ne…

GP workload 'crisis' harming patients

Many of us are finding it difficult to get appointments to see a GP and the time a doctor can spend with a patient is ten minutes. GPs are struggling to provide the first line care their patients need. 
Now a new survey by the doctor's representative body, the British Medical Association concludes that overstretched GP practices do not have the time, support or information to explore new ways of collaborative working that could help practices deliver more effective, efficient care to their patients. .
The BMA’s Practice Collaboration Survey asked GPs their views on collaborative working including forming GP federations or networks where practices come together to pool resources and plan local services.

Results from the survey of 1,555 GPs include:

· 7 out of ten (69 per cent) cited workload pressures as a barrier to establishing a network or federation, while close to seven out of ten (66 per cent) also cited a lack of time.

· Almost half (45 per cent) were not clear o…

Peer review gobbledygook

There was more fuss in the media this week about the politics of the science of global warming. A paper by a group of researchers headed by Professor Lennart Bengtsson, a University of Reading research fellow, was turned down for publication by Environmental Research Letters. The Times had a front page headline 'Scientists in cover up of 'damaging' climate view' suggesting that the paper had been rejected for political rather  than scientific reasons. 

Yesterday the publishers of Environmental Research Letters fought back  by publishing the peer reviewers comments in full. What it reveals is more interesting than the story itself - the sloppiness of the peer review process. Consider this bit of nonsense from one of the reviews:

"The comparison between observation based estimates of [warming] … and model-based estimates is comparing apples and pears, as the models are calculating true global means, whereas the observations have limited coverage."  (my emphasis)

W…

Scotland 'no' is too negative.

I am in two minds about Scotland's Independence from the UK. On the one hand I can understand why they would wish to break free from Westminster. The politics of Scotland is a far different landscape than that represented in London - they don't get the governments they vote for. They have been out of sorts with the Tory party for some time. Independence from Westminster is attractive - a fresh start, a new politics shaping their own destiny. There are a lot of good reasons to say 'yes' to  independence. But I would like them to say 'no'. I would like Scotland to stay part of the United Kingdom and my reason is simple. It is because I believe that as part of the United Kingdom Scotland can help us change the geopolitics of the country and of Westminster. It is a somewhat selfish reason - I want Scotland to stay and help prevent continuous Tory-led government from Westminster. Also I am proud of the Scottish contribution to our culture.

The problem with the '…

Fallen idols and lost innocence

We must stop investing so much in celebrities. A person who comes to prominence through some endeavor, be it artistic, sporting or some other regarded action is not endowed ipso facto with other qualities we like to project onto them - kindness, charity, forgiveness, love, goodness. This is true even where the celebrity does 'wonderfully good' charitable acts. These are all part of the 'being' for a celebrity.

It is a media circus - the building up of celebrity status. The subsequent fall from grace where it might occur is also part of the media circus. The once idolized become demonized - gone the smiling, kind photographs substituted now for those that show the 'evil' person. These are media choices. For one fallen idol recently a news program thought it important to show a photograph of them taken when charged - he looked like a criminal was the message.

So many in the media now suggest the 'knew' there was something 'wrong' about Jimmy Savil…

The real cost of alcohol

What is the cost of a bottle of whisky or beer? No I don't mean the price I mean the cost. The real cost has to take account of the effects of alcohol consumption. Alcohol consumption is linked to more than 60 medical conditions. The total cost of alcohol harm has been estimated as £20 billion in England, £680 million in Northern Ireland, £3.6bn in Scotland and £1bn in Wales. These figures include more than £2bn in healthcare costs. That is a big price to pay! The £20 billion in England would be enough to fill the gap in NHS funding. 
The BMA has a campaign to increase the price of alcohol. Now a new study by Cardiff University has highlighted the link between the price of alcohol and the fall in violent crime.


Commenting on the findings of study, Professor Sheila Hollins, Chair of the BMA's Board of Science, has said:

"A drop violent crime is positive news, especially if linked to changes in drinking habits.

"With the costs of alcohol related harm estimated at £25bn a…

When we should die?

The craziest proposal from the government on pensions is that everyone will be given 'advice' on their life expectancy. This is an absurd misjudgement about the nature of health science. The idea that data obtained and applicable at a population level can be given for an individual is wide of the mark. Not only is it crazy, it is also from an insurance point of view highly dangerous. It begs also the question of who will give this advice and on what it will be based. Frankly I doubt if the medical profession would touch it with a barge pole.

Unless someone has a particular condition with a particular prognosis a GP would be unable to judge for any of their patients how long they will live. Of course an average life expectancy for the population is available together with relative risks from smoking, poor diet, lack of exercise and so on. But it is all somewhat guesswork for any given individual.

So the government having made the decision to 'allow' people to spend thei…

Maria Miller's lack of ethical compass

The Culture Secretary Maria Miller has resigned. She is yet another self inflicted wound. But how does it happen? Is there something wrong with the way of thinking that gets politicians trapped in this way?  I think the answer is yes. It is an inability to distinguish between what might be 'legal' and what might be ethical.

I didn't do anything wrong is the line taken by the former Culture Secretary. It was also the line taken by Mr Cameron. She didn't do anything 'wrong'. What he meant of course was that she 'followed the rules', and where she may have made a 'mistake' she has apologised. It is all a misunderstanding, and everything really is rosy in the garden, except for the lingering smell of rotting vegetation.

Sadly it indicates that they have no ethical compass. There is nothing in their thinking that asks whether something is ethical rather than simply 'following the rules'. There it is - the problem.

And what are these 'rule…

No sense prevails on badger cull

New plans to eradicate bovine TB in England unveiled by DEFRA today. 
There were many experts who warned that the badger cull would not work. An independent report now confirms the worst fears. That many badgers were killed inhumanely with many badgers taking longer than 5 min to die.  The cull failed to reach its effective target. Yet the Environment Secretary Owen Patterson ploughs on regardless. 
A comprehensive Strategy to "achieve TB free status in England by 2038" has been announced by Environment Secretary Owen Paterson today.

This includes continuing to strengthen cattle movement controls, a grant-funded scheme for badger vaccination projects in the ‘edge area’ at the frontier of the disease, and improvements to the four-year badger cull pilots in Somerset and Gloucestershire.

DEFRA say that following recommendations from the Independent Expert Panel that assessed the badger cull pilots last year, a series of changes will be made to improve the effectiveness, humanenes…

Farage bests Clegg in TV debate

What surprised me about the Nigel Farage - Nick Clegg debate was that Clegg made no real attempt to extol the positives of EU membership. His arguments were defensive not of our EU membership but of his own position. They were also negative rather than positive.

What is odd about the outcome is that Clegg's opening statement was good. In my view better than Farage. Clegg was being positive, but then it all changed.

Clegg attacked Nigel Farage, trying to ridicule his opponent instead of countering Farage's arguments. Clegg missed the opportunity to say why the Liberal Party supports membership of the EU. It was a missed opportunity.

Clegg spent several minutes not arguing about the EU but about Syria! It was a side issue. The debate Mr Clegg was about the EU! A wasted opportunity.

It is therefore no surprise that Nigel Farage came out on top. Even the Liberal spin doctors found it difficult to spin a win for their man. In short, Farage wiped the floor with Mr Clegg and got away…

Cable's idiotic defence on Royal Mail

The Business Secretary Vince Cable has that unfortunate demeanour of somebody who got it right. He would have us believe that he got it right in predicting the financial collapse. He didn't of course but legends are often allowed to grow in politics. Now he insists he got it right over the sale of the Royal Mail despite criticism from the financial watchdog, the National Audit Office, that the Royal Mail was sold off too cheap.

Vince Cable defends his decision saying that the sale achieved its objective of selling the company and 'reducing the risk to taxpayer'. It is a bizarre defence. Selling the company for 1p would also have achieved that objective. What he failed to do was to get the best deal for the British taxpayer. But Vince Cable knows best. It is an idiotic defence.

Older Women want babies too!

Don't you love it when the media uses words such 'soars'! The best one is 'more than doubles'. It sets the heart beating faster. two multiplied by 2 is 4. Now depending on context four is not a big number and nor is five, but 'more than doubles' is 'massive'! And so we have the headline for the numbers of women over 50 having babies.

It has 'soared' according to a headline in the Guardian - and they know what soaring is. It has indeed 'more than doubled' from 69 in 2008 to 159 in 2012. Then of course we get the speculation. It will continue to rise at the same rate. And then we get the doom and gloom. It will all be very bad and put pressure on scarce resources. Older women have more complications in child birth. Indeed they do - but not all older women. In truth there are more younger women having children than older women and some of them have complications too!

It is all part of this scare tactic about pregnancy. We are led to bel…

Politicians are failing the NHS

Remember how the NHS was supposed to be 'safe' in Cameron's hands. Remember how the NHS was supposed to be 'ring-fenced' from the effects of austerity? Yes we remember. But we see an NHS starved of funds. But do the politicians care sufficiently to act?
The NHS Confederation’s survey of politicians has highlighted  that seven out of 10 MPs believe there is insufficient political will to meet the challenges facing the NHS.
Responding to the report, Dr Ian Wilson, Chairman of the BMA’s Representative Body, has said:

"The government must not risk the NHS' core value of being based on need, not ability to pay, purely because they are unwilling to take action and make the changes they admit are desperately needed.

"It is unbelievable that while eight out of 10 politicians agree change is essential, almost seven out of 10 say there is insufficient political will to allow this to happen.

"The reality is that the NHS is under intense pressure from a combin…

It is not 'insulting' to be concerned about pensioner finances

As the analysis of Osborne's budget unfolds there is concern that the changes to pension funds will leave pensioners vulnerable in relation to financial decisions. This has been dismissed by government spokepersons as being 'insulting' to the ability of pensioners to make decisions. This must be one of the most absurd statements of the week. I would not call it insulting. In the light of so much recent legal action on mis-selling of financial products and inappropriate marketing I would call it sensible concern.

Unless the market is regulated and appropriate safeguards put in place the I think we will all be vulnerable. It is clear that this has not been thought through. There will be a host of new and difficult to understand financial products flooding the market. It will be a mess.

Osborne has taken a bold decision but he appears to have taken it without proper regard for the consequences.

Osborne's budget headline unravels ?

As with a lot of budgets from Osborne the day after the night before looks less good. The rabbit he pulled out of his hat on pension pots is beginning to look less like a good deal in the cold light of analysis.

It is a good idea in principle to allow those retiring to invest or spend their pension savings how they wish. Certainly annuities are a bad deal with interest rates so low. Pensioners have suffered with their incomes falling.  It has a good ring about. It fits the 'being in control' on ones own finances. But how will these complex decisions be made and how do we avoid unscrupulous exploitation of pensioners?

I can see headlines in 30 years time about mis-sold investment schemes. There will be a mad scramble of financial companies creating difficult to interpret 'products' with difficult to read small print. It will be a mess.

BMA: 'Shameful' Budget does nothing for NHS shortfall

Calling today's budget presented by the Chancellor 'shameful' the BMA has condemned it for doing nothing to address the NHS funding shortfall. 
Responding to the Budget today Dr Mark Porter, Chair of BMA Council says

“Despite claiming the economy is on the up, today's budget does nothing to address the crippling funding shortfall in the NHS.

"While the Government claims the NHS budget is protected, in reality it's suffered £20bn of cuts, billions of which have come from a sustained attack on staff pay.

"If growth forecasts are rising it’s even more shameful that the Government won’t even agree to a 1 per cent uplift, as recommended by an independent pay review body, for all front-line NHS staff.

"Doctors and other staff face increasingly challenging, high pressured and stressful work environments. Cuts to budgets and rising workloads are leading to a recruitment and retention crisis in many parts of the NHS, and we're already seeing the effect of thi…

Expect the unexpected

Today is budget day - expect the unexpected! Much of what will be in the budget has already been trailed in the media, but there will most likely be a rabbit of some sort that the Chancellor of the Exchequer will pull out of the hat. There is an election next year - indeed there are elections this year too. There will be the waving of order papers and cheering from the coalition back benches.

I will not and cannot speculate on what the rabbit will be. It will be some kind of give-away that will please the bulk of middle Britain and appease disgruntled Tory backbenchers.

There will be lots of talking about how solid the recovery is and what kind of recovery. Unemployment is tumbling and growth is strong - and there are more clear skies. Spring is bursting out all over. People will begin to feel better, and the Scots are more likely than not to vote to stay as part of the United Kingdom. That will make people feel better - won't it?

The coalition - or at least Cameron, Clegg and Osb…

A diplomatic solution must take account of the wishes of the people of Crimea

The resolve of the US and EU to ignore the wishes of the Crimean people is arrogant and inconsistent. I am no fan of Mr Putin or Mr Putin's Russia. Far from it. But my view of the Russian regime does not blind me to the clear expression of the overwhelmingly Russian-speaking people of Crimea to be part of Russia. To ignore that is to have a very one-sided view of what William Hague and others call 'legitimacy'. If it is legitimate for an uprising in Kiev to overthrow the regime in Ukraine then it must surely be so for the crowds of people who are now celebrating the outcome of their referendum in the Crimea. 
President Obama says he wants a diplomatic solution to the Ukraine crisis. But a diplomatic solution will have to take account of the genuine concerns of Russia about the instability on its doorstep where it has major strategic interests. 
There is something unfortunately vague about the British foreign secretary's stance on the events in Crimea. He knows that a d…

Crowd power, referendums and legitimacy in Ukraine

It is odd this talk by the EU and the US of 'legitimacy' or its absence in relation to the referendum in Crimea. As I write the result of the poll is being announced. An overwhelming majority in favour of the proposition that the Crimea be once again part of Russia. William Hague says the referendum is illegitimate. But is it any the less legitimate than crowds of protesters in Ukraine leading to the overthrow of a democratically elected President?

What it demonstrates more than an argument about legitimacy is an interest. The Russian interest in the Crimea and the outcome of the changes in Ukraine are palpable. The interests of the USA and the EU are opportunistic and full of bluster.

They talk of 'consequences' and 'costs' that will flow if the referendum goes ahead. The referendum has gone ahead. The one thing Putin knows is that the 'consequences' and 'costs' are a lot of hot air - minor restrictions aimed at certain individuals in Russia.

Tony Benn, Thatcher and New Labour

One aspect of left-wing politics that irritates me is the propensity for those on the left to assume that theirs is the only moral position on the big issues of the day and in particular war and peace - everyone else is a war criminal or traitor to the cause. The same of course applies to right-wing politicians. There is an implied and often explicit distaste for those of the middle ground. What the left and right cannot accept is compromise. They talk about standing on principle - and we tend to admire more those who 'stand by their beliefs'.

Yet practical politics is the art of compromise. I have little doubt that Bevan was right in the compromises he made with the birth of the National Health Service - and compromises he made in dealing with the then opposition of the medial professions. Now, nobody believes that Bevan was not a man of great passion and principle. Indeed, when he could no longer compromise, as over the imposition of prescription charges, he resigned from th…

Ukraine crisis trapped in history?

Talks between the US Secretary of State, John Kerry, and the Russian Foreign Secretary, Sergei Lavrov, have failed to 'break the deadlock' on the Ukraine crisis. This is no surprise. Once again the main players are trapped by historical precedent. 
Russia has a genuine interest in the Ukraine, but to say that all sounds like Hitler's claims to the Sudetenland. Yet, if there is to be a diplomatic resolution to the crises there is not doubt that Russia's concerns will have to be - dare I say it? Appeased. 
It serves little purpose declaring the referendum in the Crimea unconstitutional. It begs the question of which constitution has legitimacy, and in the end the US and the EU will have to accept it. The Russians are not going to give way on it no matter what 'the costs', to use the phrase of the US and the EU. 'The costs' are rarely spelled out. It is a vague threat and has little substance to it. 
And so the tension increases with the possibility that R…

BMA Condemn Government pay cut for NHS staff

David Cameron once promised that the NHS was safe in Tory hands. But then he also said there would be no top down reorganisation. On both counts his lips say one thing, the government's deeds say another. The one thing we can do without in the NHS is a demoralised staff, yet this is what we have. We have an NHS struggling to make ends meet with cuts of billions of pounds from budgets taking their toll. Now we have an insulting pay increase to NHS workers.

Thursday's announcement from the Government that doctors will be subject to another real terms pay cut highlights its abject failure to find a fair and sustainable solution to the funding crisis imposed on the health service the doctors union, the BMA says.

The decision to yet again penalise doctors devalues and disrespects the vital role of frontline staff in the NHS.

Jeremy Hunt has said that the continued erosion of staff pay is ‘not sustainable’ yet he has chosen to ignore his own advice. Despite the Government announcing…

Low saturated fat diets don’t curb heart disease risk says expert

I gave up on diets a long time ago - or at least I gave up on the formulated ones. There is nothing wrong with 'eating healthily' and taking exercise. But diet fads can be a menace.  At my local book shop I can sit and have a cup of coffee and a Danish pastry surrounded by the shelves of books. One shelf always strikes me as being full of contradictory dietary advice. There is a lot of money in publishing diet books it seems. 
For dietary advice from health care professionals we might expect a great deal more evidence base. The British Heart Foundation emphasise the importance of the type of fat we eat. Essentially the mantra is that saturated fats are bad. 
But in a new article in the journal Open Heart Dr James DiNicolantonio suggests that the dietary advice to switch saturated fats to carbohydrates or omega 6 fats is based on flawed and incomplete data from the 1950s.

DiNicolantonio points out that the demonisation of saturated fats dates back to 1952, when research suggested…

Accountability of town and parish councils

I discovered something disturbing about our local governance arrangements. I should have known, but I didn't and it surprised me. We can complain to the Local Government Ombudsman about the behaviour of a whole range of public authorities including fire and rescue authorities, national park authorities and a host of other public bodies whose decisions affect our lives.

You would think that you could complain to the local government ombudsman about the behaviour of all local councils. But you would be wrong. The ombudsman does not consider complaints about town or parish councils. So, should we be concerned? I think we should.

Town and Parish councils will soon be able to take a range of decisions that affect our lives - arguably they can already take such decisions. But they are soon to get a larger role in planning. It is all part of the governments 'localism' agenda. But woe betide you if you think decisions of your town or parish council have been taken inappropriately.…

The press should stop speculating on Michael Schumacher

It is inevitable that the Media should speculate on Michael Schumacher's condition. But it would be better I think if neurologists not directly involved in the care of Michael Schumacher were not asked to speculate on the possible outcome. It was made clear at the outset that health care workers and family would make announcements if there was significant change in his condition and that they didn't want to deal with speculation. Quite right, and this should be respected. It serves little purpose to speculate, and Neurologists should say so if they are approached for their opinion.

It is natural for fans of the former Formula 1 champion (including me) to want to know how he is progressing. But clearly day by day commentary would serve little purpose on a process that can take months. Only when that process is completed will we know the extent of any functional damage. Let's wish him and his family well and be patient for news.

'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 politica…

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 aga…

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 …

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…

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 m…