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The doctor who gave up drugs - and why

29/9/2016

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Do you suffer from Walking Deficiency Syndrome, or Hyper Sitting Syndrome? These conditions have been named by Sir Muir Gray, former NHS Chief of Knowledge, as two of the greatest causes of ill health in Britain.

He was on BBC1 last week making his point to Dr Chris van Tulleken, presenter and title character of The Doctor Who Gave Up Drugs. He was dangerously sitting down as he spoke – and so, presumably, were most people watching.

Van Tulleken, who is rapidly becoming one of the most compelling characters on telly, was on a mission. He wants the country’s GPs to provide a real “health service”, not what he calls a “drug-prescription service”. And he wants us all to cut down on the drugs we take – an estimated 100,000 tablets in an average life.

Towards the end of his two-parter he offered a group of chronic pill-poppers a “miracle cure” for just about everything. Well, for obesity, joint pain, heart and stroke risk, type 2 diabetes and depression. Walking. A daily good brisk walk.

Hooray for me. Because I get that already. But most people, it seems, don’t. Most people would rather get a pill from the doctor to tackle their aches and pains.

But here’s the thing Dr Chris and his selected experts found. Painkillers don’t work. Not for long, anyway. Over time they actually make things worse.

In episode one we met Wendy, who had been taking pills for 20 years for shoulder pain. More and more pills – but she still had the pain. Over a two-week trial she took a mix of real and dummy pills. There was no corelation at all between the ups and downs of her reported pain and the fact that after a few days she was taking only placebos. She couldn’t tell the difference. Her drugs were costing the NHS a bomb and doing nothing to help her. After a few weeks off the pills and on a course of exercise she started showing real improvement.

Then there was Sarah, addicted to antidepressants after being on them for eight years from age 16. Still stuck in a grim life of depression. Living, as she put it, “in a chemical fog”. Dr Chris started weaning her off the pills and put her on a course of invigorating wild swimming in cold water. Which is great as long as she can get child care for the delightful toddler who is also a key component of her treatment, as well as a potential impediment to it.

Crystal had a life ruined by unexplained pain. After 20 years of dependency on a 30-a-day pill habit she could hardly walk and had real difficulty with stairs. Dr Chris’s unlikely prescription was a course of kung-fu training – which seemed to be working a treat.

All this miracle-working takes time and attention from the doctor. And when you only have 10 minutes at most for each consultation, that’s not possible. It’s so much quicker and easier just to write out a prescription.

And then there’s the constant advertising pressure from the drug companies, applied both to the GPs and all the rest of us.

Drug research is expensive and it’s done a lot to make our lives longer and more comfortable. But it’s also got us hooked on a massive dose of things we don’t need – at best.

The Doctor Who Gave Up Drugs was first-rate telly, but a tiny prick in the arm against the might of the pharmaceutical industry. It opened such a can of worms that I’ve only scratched the surface in my synopsis here. And I want to know a lot more.

If he’s to do any real good, Van Tulleken needs a series of Bake Off longevity and popularity. Real reality TV. That’d be worth sitting down for.
 
 
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So will Labour now set aside its internal bloodletting and get back to the real job? We can but hope. The need for an effective Opposition has never been greater.

Meanwhile, the view from Scandinavia is interesting. It’s a part of the world renowned for being saner, happier, politically smarter than most others. And much of the Brexit talk has been about whether Britain should follow the Norwegian model.

So here’s Dr Jonas Fossli Gjersø, a historian at the London School of Economics: "From his style to his policies Mr Corbyn would, in Norway, be an unremarkably mainstream, run-of-the-mill social democrat. His policy platform places him squarely in the Norwegian Labour Party from which the last leader is such a widely respected establishment figure that he became the current Secretary General of NATO. Yet in the United Kingdom a politician who makes similar policy proposals is branded an extremist and a danger to society.”

Norway has had 50 years of Labour government in the 71 years since World War II. According to the United Nations it has the highest human development of any country in the world.

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There's no hiding place from the cameras

21/9/2016

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It was in King’s Lynn in 1987 that CCTV first officially hit the streets of Britain. It was, inevitably, an import from America, New York’s Times Square having had its first cameras installed in 1973. Not that they made a fat bit of difference to the Big Apple crime rate.

From the first, I’ve been unsure about the video surveillance of public spaces. Partly through doubts about how effective it really is in preventing crime. Partly because I’m not sure I want Big Brother watching my every move. And we have long overtaken the States to become the most-watched citizenry in the world.

Not that most people, most of the time, seem to mind. Joe Public seems to have accepted meekly the death of privacy. If he hadn’t, he would never have bought a smartphone and clicked to allow Google to track his every movement, his every message, his every photo.

Turns out, though, that as well as being a spy in the pocket the camera-phone can empower its owner. It can turn the tables by turning surveillance on the authorities themselves. And it’s in the States that this is starting to have a major effect.

Look up – if you can bear to watch, if it wouldn’t make you feel complicit – the names Philando Castile, Samuel DuBose, Laquan McDonald, Tamir Rice, Levar Jones, Walter Scott, Eric Garner. Just a few of the 20-odd victims of filmed police violence that has turned up online in the past three years.

Black men – in Tamir’s case, a 12-year-old boy – attacked for little or no reason by white police officers. Caught in the act of such crimes as having a missing number-plate, a broken tail-light, waving a toy gun in an empty playground, selling untaxed cigarettes on the street.

All of them, apart from Jones and Garner, shot dead. Garner was killed by choking.

The case of Jones – the one survivor in the group – is in a way the most revealing.

Having been pulled over for not wearing a seat-belt, he was shot four times when he reached back into his car for his driving licence. But he didn’t die. He was wounded in the hip – and the officer who shot him regained composure enough to summon an ambulance and discuss with him quite calmly what had just happened.

Where but in America would a man reaching into a car be assumed to be going for a gun?

Where but in America would a cop feel so threatened in such a situation as to shoot first and ask questions later?

In none of these videos do the police show any sense of either shock or remorse at what they’ve done. Is it that they don’t feel any – because it’s all too commonplace, perhaps? Or is it that in their macho culture they have appearances, a self-image, to keep up?

And how much does that image come from watching too many movies and TV shows in which casual violence is routine, glamourised – and the cops on the front line always right? Especially those mavericks like Dirty Harry who stray violently beyond the rules.

The unjustified violence in the real-life-and-death videos is anything but glamorous. It’s messy, tacky, built on mistakes and fear. Real violence has always been like that. But the presence of cameras – CCTV, dashboard cams, mobile phones, the officers’ own body-cams – makes it harder for the perpetrators to justify.
 
 
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We live in an era of round-the-clock news, an age when it can seem almost impossible to escape from whatever the media decide to feed us. Which is a common agenda determined, in practice, by a fairly small number of editors and news editors.

Once, you had to make a decision to buy a paper if you wanted the news. These days it’s thrown at you constantly by radio, internet and television.  

In its early days, TV was not considered suitable for news. The BBC feared the temptation to seek interesting pictures would skew editorial judgement. That what was interesting or exciting to look at would prevail over what was important.

And you know what? They were right. These days the BBC’s own news channel is a 24/7 demonstration of the truth of that fear. But it’s not the only one. It’s an industry standard.

Shallow or trivial reporting spoken over a background of telegenic mayhem is always preferred to rational, objective analysis.

As for human interest – well, the words of Elvis Costello’s brilliant 1983 song Pills And Soap come back to me constantly. “The camera noses in to the tears on her face, the tears on her face, the tears on her face…”

Then there’s the wild, the wacky and the downright outrageous.

The brazen craziness of a Donald Trump may induce hysterics, cringeing mixed with disbelieving laughter. But for TV editors it triumphs every time over any clear-eyed relationship with the truth. And we all have cause to fear where that might lead.
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The grammar bee in May's bonnet

15/9/2016

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So grammar schools are back on the agenda. Oh dear. Though I suppose it was only to be expected from the party now governing. So many of its members seem to be stuck in a haze of middle-class nostalgia for a golden age that never really was. And I suppose it does, in a way, mark a subtle rejection of last year’s Tories – the Eton rifles, the Bullingdon boys. 

The previous prime minister got to Oxford via Eton, and before that went to the same prep school as princes Andrew and Edward. Posh. 

Theresa May, famously and proudly, is not so posh. She too went to Oxford, but she got there by a route that was not so smoothed by family cash and privilege.

She went to a state primary followed – strangely, perhaps, for a vicar’s daughter – by a spell at a Catholic convent. But it’s her secondary schooling that’s really interesting.

At 13 she won a scholarship to Holton Park, a girls’ grammar school set in delightful grounds a few miles from Oxford. Just two years later, the school went comprehensive. In came the boys, and all the local kids who’d failed their 11-plus exams.

You can see that this might have been a shock – might even have seemed a disaster – to the nice grammar school girls. Maybe. Maybe not. But it’s surely relevant to May’s attitude now to selective schooling.

It's beside the point, but I rather like the fact that on its Wikipedia page the renamed Wheatley Park School lays claim to model Laura Bailey, actor Dominic Rowan, motorbiker Bradley Smith and the rock band Supergrass before it gets round to mentioning that the Prime Minister also went there.

As it happens, Theresa May and I were in the same school year. Like her, I went from a comprehensive school to a place at Oxbridge, which was rarer then than now. And like her I had some grammar school experience first – five years to her two.  Moving to a comprehensive for the sixth form was an escape.

The whole experience left me with a very different attitude than the one revealed by May. And though I don’t for a moment doubt her honesty and care on the subject, I think I can fairly claim to know something about it too.
My parents devoted much of their lives to the cause of comprehensive education - Dad as a headteacher, Mum chairing a large county education committee, both as school governors. They would have been dismayed by May's plan to turn back the clock.

May spoke on Friday about “a future in which Britain’s education system shifts decisively to support ordinary working-class families”. 

It’s a worthy ambition. And it’s certainly true that the post-war state grammar school system had some notable successes, including some fine writers, a number of my friends – and a quarter of May’s Cabinet. 

But what about those left behind, the ones rejected at 11 by the selection system? A system which - even if you approve of it in principle - was often little better than arbitrary.

May also said: “Every child should have access to a good school place.” Every child. Not just the bright ones, not just the ones whose parents have books around the house and read them bedtime stories.

The crux is that word “access”. She can’t mean everyone should go to the same good school. That would be comprehensive, not grammar. So she must be talking about opportunity. There’s another word for opportunity. Chance.

And if there are “good schools” to be aimed at, what does that say about all the others?

The school where I took my A-levels had been a secondary modern. Its very first sixth-formers were in the year above me. There were just a handful of them, but they had all got to Advanced Level after being written off at 11 as not grammar-school material. 

The old system had let them down. The school turning comprehensive gave them another chance. Another opportunity. Access to higher things.

None of that year made it to university – I was the first from the school to do that. But when I got to Cambridge I met students who didn’t have the brains or the work ethic some of those 11-plus failures had shown. What they had was family, cash, “good” schools – and, in so many cases, a totally unjustified belief in their own superiority.

One of the weirdest things about May's enthusiasm for grammar schools is that the Tories' own former Education Secretary, Nicky Morgan, thinks it's weird. And there are reports that Justine Greening, who was appointed by May as Morgan's successor, is unhappy with it. Greening herself is comprehensive-educated.

All this, along with the timing of it, suggests the whole thing is little more than a bee in May's personal bonnet. 
I'm sure she's well intentioned, on this issue at least. I'm equally sure she's got it wrong.
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Is the NHS heading in the sad direction of the NCB?

7/9/2016

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Picture
Poring over a box of old family photographs, I came across this evocative shot from my coalmining days. Or, rather, from my day down a mine. A rather shiny, clean and almost glamorous mine, if the photos are to be believed.

It was 1981, there was still a National Coal Board, still jobs to be had at the coalface. Still a PR department whose tasks included luring impressionable young reporters into the bowels of the earth.

Even at the time, as I recall, it seemed a somewhat unlikely assignment. It must have been one of the very last times any British journalist was enlisted in a recruitment drive for miners.

Margaret Thatcher had been in Downing Street for two years. And if she hadn't yet fully embarked on her campaign against the traditional industries, it was already clear that most pits still open had no long-term future.

Rossington Colliery near Doncaster was reckoned to be an exception. Though first sunk in 1912, it was being rebranded as a leader in a new wave of super-pits.

Working there, as I could see for myself, was nothing like the grim endurance I had heard such tales of during my upbringing on the Durham coalfield. One of my teachers had spent his early working years creeping on his back through a seam just 12 inches thick, chipping away the coal with a pick wielded awkwardly behind his head. Re-training for a life at the chalk-face must have seemed an escape from hell. A hell his family and their neighbours had lived through for generations.

What I witnessed at Rossington was a world away from that. I saw (perhaps I was kept away from them) no tunnel you couldn't stand up in comfortably. The actual digging was done not with pick and shovel but by a mechanised toothed wheel the size of a small house.

There might have been fewer jobs than in the old days, but I felt happy recommending them to my readers. I'm afraid any who took up my suggestion were not embarking on long, satisfying careers.

Within three years Rossington would be close to the epicentre of trouble in the infamous miners' strike. In 1993 it was closed. And though it reopened in 1994, in private ownership, it was much reduced in size, its still considerable potential unexploited.

The winding gear turned for the last time in 2007. Construction work began last year on a £100million, 1,200-home housing development on the site. Like others in the area, the landmark spoil-heap is becoming a green hill with no obviously industrial past.

Phasing out coal is undoubtedly a good thing environmentally. But ever since the pits' decline set in, a string of very visible power-stations have continued operating within a few miles of Rossington. They've gone on all these years burning imported coal, much of it dirtier than the variety they were built on. Right under the noses of the unemployed ex-miners.

I remember thinking in 1984 that Arthur Scargill, the miners' union leader, could hardly have done more to seal the pits' doom if he'd been Thatcher's secret agent. It's a matter of history now that Thatcher deliberately goaded the miners to strike. It was part of her successful plan to break their power.

When she became PM, coal was still an important nationally-owned industry. By 1990, at the end of her reign, it was a broken relic heading for private hands.

And the relevance of all this sad history to today's political scene? It's a potentially even sadder scenario.

The Tories may have a harder time painting doctors as "the enemy within" than they did with the miners. The latest poll I saw suggested 57 per cent of the public are still on the junior doctors' side in their dispute with Jeremy Hunt.

But there can be little doubt that Hunt keeps deliberately goading them into what is curiously known as "industrial action". And in so doing he is following a classic right-wing formula.

Provoke the workers to the point where you can blame them for a failing service. Then claim public ownership doesn't work and hand control over to private enterprise. People who put profit before service.

With minor variations, that's what Thatcher and Hunt's party did to coal, steel, gas, water, electricity, telecoms, the railways, the Post Office and - perhaps most scandalously and disastrously of all - council housing.

And if you think it's a good prescription for the NHS, you haven't had the experience of being presented with a bill before you get into an ambulance. Or being pressured to shell out for unnecessary therapy. Or having to sell your home to pay for life-saving treatment. Yet.

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Powerful predators threaten the forest

4/9/2016

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Power vacuums. Power generation. Power to the people – or against the people, or over the people. When you look at it from a few different angles, it begins to seem power is at the heart of most of humanity’s problems. As well as being crucial to any hope of resolving them.

Has a reliable way of selecting a good government ever been devised? And, in the rare case of good government being achieved, is there any way of keeping it on the right course?

A quick look round the corridors of power across the world right now might make you doubt it. Then again, I don’t think right now is anything special. Pick any time and place in history and your chance of landing on an unequivocally sound government is pretty slim.

It’s not just that there may be something dodgy about those who seek power. There are decent and honourable reasons for wanting to call the shots, but there are also plenty of less worthy motivations. The worthy may or may not be outnumbered, but they are sadly likely to be outplayed by the less scrupulous.

And then, as they say, power corrupts. A saying which is true of more kinds of power than the purely political sort.
Financial power may be the greatest corrupter – or lure to the already corrupt – of all. And as for the kind of power you hook up to when you turn your key in the ignition or insert your three-pin plug in the wall-socket…

The Amazon rainforest is under threat. We all know this by now, and we probably all know several good reasons why it’s a bad thing. But what power do we have to save it?

The forest may be the lungs of the Earth, but there are powerful predators wanting to take chunks out of it.

The Brazilian government is planning right now to grant permission for 42 massive dams to be built right through the heart of the forest. What for? Well, power of course.

Power to drive an increasingly electricity-dependent society. And, inevitably, the power of big global business cash.
Never mind that flooding the forest will drown vast numbers of already endangered animals and plantlife. And deprive the survivors of livable habitat.

With each dam submerging vast areas of rainforest under deep water, hundreds if not thousands of monkeys, tapirs, anteaters and birds could perish, pushing precious species closer to the brink of extinction. 

Never mind that the flooding will displace thousands of people who won’t benefit in any way from all that generated power. Though it may well force them into dependency, the newest and poorest members of a modern society they’d be better off not knowing or understanding.

That’s progress for you. That’s power.

The building of just one dam means the destruction of hundreds of square miles of rainforest. The recently-completed Belo Monte dam wiped out huge areas of forest, then failed to produce anywhere near its power targets. Once built, it wasn’t fit for purpose. But the damage done cannot be reversed.

Another 42 dams adds up to a catastrophic level of devastation. A catastrophe not just for the indigenous people and the native wildlife, but for the world.

And in a way it’s not fair to blame the Brazilian government too much. They, after all, like governments everywhere, are in the power of global corporations.

Which is to say, governed by market forces. Except that the term “market forces” is a weaselly way of making it sound like something natural, something inevitable.

Taking the spotlight off the powerful people who call the shots. The faceless men (they’re mostly men) in international boardrooms who care a lot about their own money – their own power – and not at all about the jaguar, the toucan, the tapir, the princess flower or the forest people.
 
 
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A spirit-crushing prospect for the environment 

Brexit, we keep being told, means Brexit. Which means what, exactly?

I’m fairly sure nobody voted for a concerted attack on the environment. But among many things we stand to lose by leaving the EU are decades of hard-won progress on clean water, clean air and wildlife habitat.

One pro-Brexit Tory, George Eustice, called European nature protections “spirit-crushing”. Which is itself a pretty spirit-crushing thought.

From the day of the vote, all kinds of undesirables have taken it as a licence to emerge from the cupboard. We’ve heard about the racists, we’ve heard about those who want to rid us of human rights and decent working conditions. Now it seems there’s even a climate sceptic group called “Clexit” that wants to abandon last year’s Paris agreement on greenhouse gas emissions.

You’d have thought by now that the climate-change denier would have gone the same way as the flat-earther. Except for one thing. There’s no money in claiming the world’s flat.
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