Have you been in hospital lately, either to stay or as an outpatient? Would you recommend the hospital to others?
This question, now routinely asked, is a daft one. It implies that you have a choice which hospital to go to. Which, in case of dire need, is hardly likely to be the case.
And anyway, I don’t want to have to choose – whether it’s between hospitals, schools, electricity suppliers or brands of toothpaste. I just want the best possible service or product as near and handy as it reasonably can be.
The mania for “choice”, as if it was always a good thing to have, is a cancer eating away at our society.
Nevertheless, nine out of 10 patients at Addenbrooke’s Hospital in Cambridge say they would recommend it to family and friends. Which would sound like a good advertisement if applied to toothpaste or cat food, and is well above average for hospitals.
Whether you’re there for a broken finger or major life-saving surgery, you’ll get better care and less risk at Addenbrooke’s than almost anywhere else. Its survival rates, notably for cancer patients, is among the highest in the country.
The Care Quality Commission found: “Staff were hard-working, passionate and caring … prepared to go the extra mile for patients.”
So why did that same CQC report deem Addenbrooke’s to be “inadequate”. Why was it placed last week under those grim-sounding “special measures” and taken over by an “improvement director”?
Here’s a clue: “Inspectors found a significant shortage of staff in a number of areas, including critical care services.”
And here’s another one about those passionate, caring doctors and nurses. They were, the report says: “Having to swim upstream against the pressures they faced.”
But it’s not just Addenbrooke’s – which, incidentally, was rated “outstanding” the last time the inspectors called. Talk to anyone working in the NHS and you’ll hear about the same pressures, the same staff shortages.
Staff at Addenbrooke’s, the inspectors say, are moved from ward to ward to cover gaps. Often they don’t have the necessary skills.
The same goes for agency workers brought in to cover shortages, who are less familiar with patients or routines than permanent staff on lower pay.
Not good. Now find me a hospital where things are any different.
Last January Addenbrooke’s declared a “major incident” when it struggled to cope with demand for its services. The Norfolk and Norwich was one of 19 other hospitals in the same boat.
One major factor was the number of beds being occupied by mostly elderly folk who should have gone home but couldn’t because of a lack of social care. At Addenbrooke’s that was 200 of its 1,000 beds.
It’s a serious problem throughout the country. My mother is a recent victim of it.
Prof Sir Mike Richards, the CQC’s chief inspector of hospitals, says: “It’s not just the local authority’s problem, it’s the hospital’s problem.” He adds: “It’s about the management of the hospital.”
Well, yes and no, Sir Mike. It’s about the management of the whole NHS. Which is the Government’s responsibility. And so, as it happens, are the cuts in local authority budgets that have caused the dire shortage of social care.
Addenbrooke’s is not alone. It is the 24th NHS trust to be put under special measures in just over 18 months, and the 33rd to be left without a chief executive.
This is not just about failings at Addenbrooke’s – it’s a national scandal.
Despite David Cameron’s famous promises, the NHS is facing the worst funding crisis in its history. That much-touted £8billion is still five years away, and would be too little if delivered now.
An ageing population and the growing cost of medical care (see below) mean the current 0.8 per cent annual rise in the NHS budget is in real terms a hefty cut.
Addenbrooke’s is haemorrhaging £1.2m a week. Faced with a choice between running up debt or offering poorer care, health professionals choose debt.
Then in go the attack dogs of the CQC to lay the blame at their door. Softening up a formerly (and still mostly) outstanding public service for takeover by some profit-driven private business.
 
 
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So why is health care getting more expensive?
Part of it is all the clever things they can do now, keeping people alive – often at high cost – by techniques that were science fiction not so long ago.
Part of it is the cost involved in the research and development of new treatments and new drugs.
And part of it is the thing that drives capitalism. Greed. As brilliantly exemplified by Martin Shkreli, the man who outraged America last week by doing what Americans generally seem to love – finding a way to get rich quick.
The 32-year-old hedge fund manager bought the rights to Daraprim, a drug that treats parasitic infections and is used by some Aids and cancer patients. He promptly raised the price from $13.50 (£8.85) to $750 (£491), a 5,555 per cent hike that took the cost of a year’s supply to $336,000 (£220,000).
He’s since climbed part-way down, under public pressure. But he’s only a symptom of the disease, not the cause.
In fact, he may have done a public service by revealing the rottenness of a system in which companies charge whatever they get away with for things that keep people alive.

I was invited yesterday to sign an online petition. It said: “We the undersigned believe that the United Kingdom needs a new National Anthem.”

I didn’t sign it.

Not because I have any affection for the dreary, dispiriting dirge that has served in that role since 1745, when the Hanoverian regime of the German-born George II was under glamorous threat from Bonnie Prince Charlie and his Jacobite rebellion.

And not because I feel anything resembling loyalty towards the family whose ageing matriarch we are supposed to desire “long to reign over us”. As if the kingdom, united or otherwise, had not long since become – in theory at least – a democracy.

Who voted the family formerly known as Saxe-Coburg-Gotha into residency in Buckingham Palace? It wasn’t me, guv.

So, on the basis of “no taxation (or compulsory singing) without representation”, I refuse to pledge fealty. Nothing personal, but I feel no more attachment to Mr and Mrs Windsor of London SW1A 1AA than I do to, say, Mr and Mrs Jenkins of Dereham Road.

I sympathise entirely with Jeremy Corbyn over last week’s most contrived controversy. I myself once received dog’s abuse from those around me for failing to stand when the anthem was played before an ice hockey game I was reporting on.

That was decades ago, when I was younger and more foolish. These days I’m more likely to do as Corbyn did – and as many footballers do – stand in dignified silence while others sing, or pretend to.

The Parliamentary petitions website says the Government “will respond” to any petition that attracts 10,000 signatures. And that one with 100,000 signatures “will be considered for debate in Parliament”.

Will be considered. Whoopee.

It all suggests that the whole process is a way of giving citizens the illusion of participation. A way of defusing criticism. A neatly mapped road to political nowhere.

I have signed petitions of this kind. Those organised by pressure groups such as 38 Degrees and Sum Of Us may even occasionally have done some good.

But I fear that the more there are, the less chance each one has of being taken seriously.

And frankly there are more important issues right now than what song people sing (or don’t sing) at sporting occasions (or memorial services).

Like how we should respond to the biggest mass migration Europe has seen since the immediate aftermath of World War II.

Like how best to counter the threat posed by ISIS, in the Middle East and beyond.

Like whether we should countenance the building of more nuclear power stations, submarines and warheads.

Like the potential trashing of green-belt land for “executive housing” while the real need to house those of lesser means goes unmet.

Like whether HS2 is the best way to spend billions updating Britain’s railways.

Like the use of “austerity” as a device for redistributing wealth to the already wealthy.

I could go on. Trust me, I will.

Meantime, there’s one more reason why I didn’t put my name to that petition.

I do quite enjoy the cheery, violence-glamorising French anthem, La Marseillaise. And I don’t mind joining in a rousing singalong of that gorgeous tune Jerusalem, which seems to be most people’s preferred alternative anthem.

But I don’t think we need a new national anthem. I don’t think the UK, or any country, needs a national anthem at all.

Because I think the very idea of nations is a rotten bad idea. One that has arguably caused even more brutality, war and suffering than religion.

I don’t expect to see the day when humankind abandons the idea of dividing itself up into nations. But that day will come. And the sooner it does, the better for all who are around at the time.

I don’t suppose scrapping anthems – or just letting them wither away – will go very far towards advancing that day. But it might be a start, if only a small one.

Meanwhile, the last time I looked that petition had just under 8,000 signatures to go to qualify for a government response. You can just imagine what that response will be.



Shocking violence of the insurgency


“Observers were stunned by the insurgents’ violence. By the time they reached the city, they had already acquired a fearsome reputation, but never anything like this massacre… In horror it was reported that they did not spare the elderly, the women, or the sick.”

Those words are from a book by Christopher Tyerman, out this month. It’s not about ISIS, though you might have thought so.

It suggests “shock and awe” of the sort US Defence Secretary Donald Rumsfeld promised of the invasion which ended up creating the conditions for ISIS to emerge.

Or of the type perpetrated in the same region in ancient times by the Assyrians whose monuments ISIS has set about destroying.

In fact the savage insurgents described called themselves Christians. They were the Crusaders whose conquering of the “Holy Land” set a new low for medieval butchery.

Diarmaid MacCulloch, writing in the latest London Review of Books, draws the parallel between ISIS today and Richard the Lionheart’s 12th-century rampaging. He concludes with reassuring words about the Crusades’ ultimate failure.

Trouble is, that’s a historian’s perspective. From first massacre to last, the Kingdom of Jerusalem endured almost 200 years.

So now the real fun starts. Having elected the leader no one – himself included – could have imagined in the job a few months ago, the Labour Party must now figure out what to do next.

To let Jeremy Corbyn lead and do what he really should do and wants to do, which is oppose the Tories. Or to form up behind him in a disorderly rabble, opposing only those who are supposed to be friends.

There are two different narratives at large as to why Labour lost the General Election. One says it was too left-wing, the other that it wasn’t left-wing enough. Party history suggests it’s really when it’s divided against itself that it loses.

The party has always defined itself as a “broad church”. This has often been a cover for a deep divide between the socialists and the soft capitalists. Each likes to claim to be the “real” Labour Party.

For the last 21 years the capitalist wing has had the upper hand. Now the party has experienced a revolution. At the “grass roots”, not in the Parliamentary party.

Labour’s split has never been deeper or more apparent. And it’s never been clearer where it lies.

While just under half of all long-standing party members – and almost 60 per cent of all those who voted in the leadership election – support Corbyn, only about 15 of the 232 Labour MPs voted for him.

That gives him – and them – a potentially huge problem. How huge will depend on how some of those other 217 perceive their principles and responsibilities – and how others among them see their career paths.

How the mass of Labour MPs came to be so out of step with the party they supposedly represent is an interesting question.

The simplest answer is to blame Tony Blair and the cosy coterie he built around himself.

There has been much talk of the “entryism” that has supposedly led to the swing of popular support behind Corbyn. But it was entryism of a kind that enabled Blair to force out of senior positions almost all who stood for traditional Labour values.

Most of the (non-Parliamentary) Labour Party now has a visceral loathing of Blair. It is commonplace to blame it on the Iraq war.

But though it is true that many have never forgiven him for the 2003 invasion, there is much more to it than that.

The NHS private finance initiative, the failure to reverse Margaret Thatcher’s catastrophic policies on housing and energy, the establishment of “free” faith schools, the disastrous loosing of regulation in the City… the list of Tory policies perpetrated by Blair’s scandalous government goes on.

Most of those Labour MPs now agonising over whether to back or oppose Corbyn first took their seats under the anti-socialist Blair regime. Many of the rest have done so since.

No wonder the party in Westminster is so out of step with the party beyond.

Is a Corbyn-led Labour Party unelectable, as we keep being told? Until a few weeks ago no one thought he was electable as party leader. No one thought Barack Obama was electable until a few months before he was elected US President. The momentum, for now, seems similar.

The Conservatives hardly have a popular mandate. Only 24 per cent of the electorate voted for them – a long way short of the 40pc they say should be the minimum for a trade union vote to stand. By their own logic they should not be allowed to govern.

It’s common to assume – the Blairites and the Tory press want you to believe it – that a Corbyn-led Labour Party can never win power. I can’t help feeling that had the popular surge that put him where he is today had come six months earlier he might now be resident in Downing Street.

Many of those who voted against the Tories – and many who didn’t vote at all – did so in protest at the general state of politics. One of the unexpected things Corbyn has already achieved is to make Labour again something it has not been for far too long – a party of protest.

Unelectable? I wouldn’t bet on it.

What may make them so is not the allegedly hard-left policies which poll after poll has shown are the policies people actually want.

It’s the rabble of left-over Blairite MPs who are so far out of step with the majority of the party they claim to represent.


War-mongers in Dockland


“War, huh, what is it good for? Absolutely nothin’.” So goes the song lyric, demanding the response: “Business. It’s good for business.”

And, to bring that down to the level of the common people, jobs. War is good for jobs, which is the way the arms trade has always been sold to those who don’t hold shares in it.

The world’s biggest annual arms fair begins in London’s Docklands today, showcasing the deadly products of British manufacturers to a worldwide gathering of potential buyers.

Among countries that have official invitations are Angola, Azerbaijan, Egypt, Kazakhstan and Thailand. All of them considered by the United Nations to be guilty of gross infringement of civil liberties. Any weapons they buy at the ExCeL are apt to be used against their own people.

Delegations from Saudi Arabia, Pakistan and Colombia are also invited. All three are on the Foreign Office list of “countries of concern”.

The UN has a list of countries where child soldiers are used or which are guilty of “grave violations against children”. Of the 23 countries on that list, the UK has sold military equipment to 19 in the past five years.

The Government continues to ignore UN requests that it ban such sales.

Want to put guns and rocket-launchers in the hands of children? Here, have a few.

Makes you proud to be British, doesn’t it? And gives you an idea of what the new Leader of the Opposition actually has to oppose.

Gun law – thank goodness – seems to be an exception, but British governments have a long history of following bad American example. The real and present threat facing the NHS is only one recent obvious example.

And now there’s fracking, which the Tories seem particularly gung-ho about. So much so that they plan to give companies the right to force shale gas out of the ground beneath your feet whether you – or your local authority – like it or not.

And, as the residents of Oklahoma have been finding out, there are good reasons not to like it.

A sixth of all jobs in Oklahoma are now in the oil and gas industry, most of them connected with fracking. Which sounds like good news. But there’s a “but”.

Earthquakes were very rare in the state – until the fracking started. Over the past 10 years they have become a more than daily occurrence, with 580 quakes last year.

Not big quakes, admittedly, not big enough to bring down buildings. Not in one go, anyway. But the constant shaking is taking a toll, with many homes throughout Oklahoma showing severe signs of cracking and crumbling.

Meanwhile, a case settled in a Dutch court may have caught the eyes of a few eager Okie lawyers. And maybe a few round Blackpool way too.

Oil giants Shell and Exxon have been ordered to pay compensation to homeowners. It’s on account of their joint venture in the Groeningen gas field, where earth tremors have caused house prices to plummet.

The two companies have set aside £920million to compensate 900 homeowners and 12 housing associations. Which may be enough to give even the world’s two biggest oil firms pause for thought.

“One death is a tragedy, one million deaths is a statistic.” Joe Stalin may have been showing his cynical, brutal side when he uttered those words, but there was something in what he said.

A truth horrifyingly shown again in the reaction to those gut-wrenching photos of little Aylan al-Kurdi’s body washed up on a Turkish beach.

No one with a heart could fail to have been moved by the sight of the three-year-old lying face-down at the waves’ edge. No one could feel anything but deep sorrow for the anguished father who had lost both his young sons and his wife.

But what was it about Aylan’s death that moved so many where previous images of other refugee tragedies had apparently left them cold?

It’s been suggested that it was because he looked so much like one of our own children – well fed and clothed, the image of a white, middle-class European.

That doesn’t mean we’re all closet racists. Simply that humans of all kinds inevitably empathise more quickly and easily with others who seem like them. Whose lives are readily imaginable.

There is something a trifle spurious in the distinction some papers, and some politicians, are now making between “migrants” (bad) and “refugees” (good). But if it leads to an outbreak of long overdue humanity, perhaps we shouldn’t knock it.

It should be obvious that no one would send their own children to sea in an overcrowded, unseaworthy vessel unless they were truly desperate. And if people are that desperate, it should be the natural human reaction to offer them help. Whatever they look like.

The British government has been shamefully late in catching up with most of Europe – and its own people – on that.

The same applies to some national newspapers. The same ones, in some cases, that have been pulling the heartstrings with words and pictures of little Aylan.

The paper that railed against the “flood” of Jewish refugees from Nazi Germany was still at it until last week on the “tide” of migrants supposedly threatening Britain’s shores. Unfortunate metaphors, you might think.

That paper has now switched to a line summed up in a bygone headline: “For pity’s sake let them come”. Though pity, it seems, is still constrained by numbers.

Shamed at last into a response to what is rightly being called Europe’s biggest humanitarian crisis since the Second World War, David Cameron talks of offering refuge to “thousands” of Syrians.Which, when clarified, comes down to 4,000 a year for five years.

Or one per thousand of the four million Syrians who have fled the civil war in their homeland, mostly to neighbouring countries. In Lebanon, hardly a rich or untroubled country itself, Syrian refugees now make up a quarter of the population.

But to talk of numbers and quotas is to deny, or avoid, the individual humanity of those involved.

By comparison with the horrors that have been unfolding all year in the Mediterranean region, events in Calais are a minor sideshow. Not for those who are there, though. Many have made harrowing journeys to exchange one type of hell for another.

So I applaud those who have begun collecting and delivering food, clothing and other supplies for their relief. They at least are showing that this country is not as heartless as some of its media and some of its politicians.

They at least know that people are people, not numbers.