As we pull out of Afghanistan, following American leadership, is it time to ask ourselves whether democracy should evolve, or be imposed? It seems that the Taliban have complete control of Afghanistan, and maybe their influence is their business and not ours. After all, I hear you say, it’s their country and no business of ours.

I guess we could say the same thing about China and the Uighers, or the Christians in Iraq, or the Kurds, or people of colour in America. Now there’s a progression that is very uncomfortable. The good old USA has been a beacon of democracy for the rest of the world. Or has it?

A tragic mass shooting in the UK this weekend was the first fot many years, we are all moved with sorow and horror. Yet in the liberal USA mass shootings are a regular ocurrance, apparently gun control has nothing to do with these awful happenings and the right to bear arms is more valuable than the innocent lives lost. (My assumption)

Mr Xi in China has created hundreds of thousands of middle class chinese, lifted from dreary poverty. He has done this by absolute rule. What he says, goes! He beleives he’s a good guy, and the persecution of the non conformist is OK for the good of the majority. This guy is Karl Marx and Jesus Christ all rolled into one, he is the absolute ruler of China and is, right now, steam rollering the world in China’s favour.

It all boils down, the cynic would say, to shooting folk if it suits or doing what one man says. Stark choices to be sure, the middle road seems obscure, yet it’s what many of us seek to do. Don’t kid yourself, liberism and democracy have their extremes too.

We all love the NHS. We all know that nurses and doctors have worked heroically throughout the pandemic. Yet, we know that the NHS fails to deliver a satisfactory support service in so many ways, not least the failure of a multitude of Governments who have all failed to sort out the intergration of medical and social care.

The consequence of this shortfall is that many people find it difficult to see a doctor, many people are waiting for ambulances for hours, others wait in ambulances outside hospitals, and people wait in A & E sometimes with dire consequences, for hours.

Don’t blame us, they say, the hospital is full, there are no beds. There are no beds because we cannot let chronically unwell people go. It is not our fault. But it is someone’s fault, or something of the system’s fault. The fault exists. Our usual reaction is to pour more money into the NHS.

This is not a question of ‘nobody cares’, of course they do, but nevertheless the whole system, health and social care falls short of what Nye Bevan had in mind. Adequate care that is free at the point of delivery. Even with enormous charitable support, the Hospice movement is buckling under the strain of the demand of the chronically ill, not to mention those who just about manage a declining and misreable old age.

Care workers are undervalued and under paid, many are wonderful a few are not. Why are we surprised? The Local Authorities are charged with providing care packages, whilst the NHS have responsibility for ‘Continuous care plans’. It is clearly a nonsence.

Increasingly, due to the short falls in the system, many are turning to private medicine. Many people even those of a deeply socialist nature are increasingly turning to private medical insurance. Many are re-mortgageing their homes to fund elective surgery. “Elective” it often is not, as the persons concerned are suffering really badly, ruining longevity and what quailiy of life they have left.

A word about carers. The word Carer applies to a huge range of activities that take place in hospitals, hospices and homes. They include assisting in meal preparation,, bathing, dressing, mobility and communication support. The work is intimate and exhausting. Not all of us are physically or mentally equipped for these roles, we must cherish and reward those who are blessed with patience, kindness and generosity of spirit to carry out this important work.

By doctors, (GP’s) not seeing patienst, the strain on A&E and ambulances increases. By not intergrating continuous care and social care we are blocking up valuable beds. So from both ends the NHS is squeezed. The ever increasing take up of private medicine increases strains on the avialbilty of specialists. Walk in to any private consulting room, it will be crowded!

The ageing population is a challenge that is only going to increase, so the pressures on the system in UK is only going one way – up and up! A radical review including the place of insured medical care is not only necessary, it is inevitable. Not only that, the Care sector must be intergrated with that of Health. It will cost, we must pay, and the government must face that. The Government must not rest, and we must sustain a viligence, until we have a sytem that works a good deal better than the one we have now.