Bedlam, Charity and the NHS

Recently I was unfortunate enough to have to use the emergency services after an accident.  Let me say at the outset, that I am very grateful for the NHS and all that it attempts to achieve.  However, my experience was nothing short of horrific.

Indeed, I am so shocked at how chaotic the hospital system works I am driven to avoid any further contact with my local health board hospitals if at all possible, and this includes life and death situations. ‘Desperate claims’ you might say.  Well, they maybe desperate but believe me that is precisely the way I feel.

There has to be a better way.  Firstly, hospitals must be run more efficiently.  It is apparent that the institution where I was admitted is not.  Why do I say this? Basically because my treatment/diagnosis  from accident to admission took eleven hours when it could and should have taken no more than two hours.  If only a proportion of patients were treated in a timely manner with a view to getting them back on the street it would make an enormous difference.  If however the charitable instinct dominate then there will remain a drive to care even when it is not strictly the need. The consequence will be to add to the overcapacity crisis. In any enterprise there must be some objective definition of corporate goals.  In the NHS it is too broadly set as ‘free care for all’ even the word ‘necessary’ would help, with all the attendant issues of definition that are implied.

The aim must surely be to define the service more clearly. Whilst recognising the ideals of the original concept we have to realise that we cannot exponentially increase care.  There have to be limits.  The NHS cannot succeed trying to be the carer for the whole of British society.  All these lovely employees dashing around doing their best to achieve unachievable goals has to be modified.  Not letting people in to hospital is just as important as getting them out of hospital.

Everyone I’m sure is aware of the issues of the National Health Service; the pressure of exponential demand and of course hapless social care support.  This means that a high percentage of beds are unavoidably blocked unless there is a fundamental change of budget planning at national level.  The prospects of the integration of health and social care is abominably complex especially if the NHS continues as a gargantuan national enterprise. The prospect of it getting even more massive is very challenging and maybe someone at Government or  parliamentary level ought to start thinking more radically and not exclude the idea of regional or even sub regional organisation (s).

Back to our city hospital.  My impression was that the system is not ‘joined up’.  I mean by that there is no discernible system at work. It is as if those who are in charge have surrendered to ‘what is, must be’ system.  An entirely reactionary system which responds without structure or organisation.  One can easily see that this comes about because of idealism rather than practicality. I.e. ‘we must be flexible and ready for anything’ an attitude which lets us become undisciplined and unfocussed.  In turn this leads to counterproductive mini groups who see themselves as the pivotal centre of necessity.

These, so called, teams become more inward looking than collegiate, fighting for their own mini kingdoms rather than looking after the efficient running of the institution as a whole.  Clearly there are issues of life and death, challenges and choices of the gravest nature.  Under these stresses, it is imperative that the institution as a whole runs much more efficiently.

Add to this, the sheer chaos of night time where bedlam is nearer the reality than we would be ready to admit.  The simple idea of peace and quiet has long been lost to the idea that ‘respond at all costs, and ‘what is, must be’ attitudes.  The night staff have an often impossible task of integrating disturbed mental health patients, restraining screaming drunks and drug addicts, as against managing the rest and quiet reqired by those recovering from injury or surgery.   Quiet places and not so quiet places and the management thereof, should not be beyond the wit of man or manager. No one is saying this is easy, buildings are often ancient and inappropriate  but these issues can be managed more effectively.

Despite my cynicism, I know there is much to be cherished about the NHS, but please, please, will someone understand that this is not some charity run by volunteers but a national enterprise run for the benefit of all patients.  Let’s not pass the buck, yes, there are huge problems but at least manage the manageable and give our much vaunted NHS the chance it deserves.

Not so surprising, Saudi Arabia?

I’ve been around a bit, and one of the most vivid memories was of my first visit to Jeddah in the 1970’s.  I was stuck by the strangeness of it all and even had a booking foul up which meant I was marooned over the weekend in Jeddah (Friday).  I wondered about and my curiosity was peaked by the crowd outside the rear of the Red Sea Palace Hotel.  I chanced upon the most revolting dehumanising thing I have ever witnessed, namely a public execution.  I did not tarry but scuttled off, shaken to the core.

Since then the Saudi regimes of the various so called royal rulers have continued to routinely chop off heads  of anyone who they disagree with or those who are deemed to have offended the religious beliefs of the Kingdom’s rulers.

Human rights have been and remain the last thing Saudi royal family consider.  They rule by fear and have no truck with the idea of self determination or even self expression.  The  idea of the noble Arab raising from the desert tribes is truly nonsense, and without oil Saudi Arabia would be nothing.  With oil it could be one of the best educated and progressive countries in the world, alas that has not turned out to be the case.

Are we surprised then when the Saudi regime bumps off in the cruellest way a dissenter. Sadly we are not, which begs the question of why does the West espouse the Saudi regime. The reasons are many, including not allowing China/Russia to have control over an important energy source, the biggest pocket book in the world to buy anything from fighters and bombs, as well as hospitals and luxury goods and property in London and Paris.  Also I believe an honest desire to influence these primeval Saudi rulers towards democracy and the respect of human rights.

Clearly this last objective has failed miserably.  The issues of the pocket book remain.  Who cares if the Saudis kill and maim and starve children in Yemen?  Nobody if they can make a buck from selling the Saudis militaria.  Should we care?

Please, I hope we do, and we should lobby our Parliamentarians to stop this trade no matter what the cost.  A Yemeni child or a Saudi journalist or those Saudi citizens  awaiting a barbarous beheading should be given the chance to live. What price on them?

Imagination vs Fear of the unknown. Brexit is certainly unknown.

There we have it, stay in Europe or strike out on our own.  So far we’ve had umpteen warnings of the catastrophes that will beset the UK if we come out of the EU, so far they haven’t happened.

I wrote two years ago that what has come to pass has indeed happened, quelle surprize! However the lack of leadership from all political parties has added immensely to the conundrum.  “He who tells the future tells lies.” (old Arab proverb) Bare it in mind and accept that we have no idea of what is going to happen.  Absolutely no idea.

There are some out there who feel that launching into the unknown is a crazy thing to do.  They have a point.  There are others who argue that independently the UK will be better off, controlling our trade, taxes, laws and borders.

The worst offenders in irrational arguments are the regional players in Scotland, Wales and Northern Ireland who keep barking on about the financial support they’ve received from the EU ignoring the fact that the UK as a whole is a net contributor.  The aggregate of their argument is that they get a better deal regionally from Brussels than they would from Westminster.  This is a curious argument from those who seek more local power and yet want to bow the knee to an unelected European commission.

The other great argument is about the motives of the Brits to leave the EU.  It is argued, probably authentically, that the great majority of voters voted for Brexit based on their xenophobic attitude toward immigration.  This sad but reflects the oversimplification of a yes/no referendum.  It also reflects poorly on the British sense of values.

We would all do well to go back to the core of the argument, i.e. Do we want to be ruled by an unelected council of ministers whose credo is ever more integration into their idea of a United States of Europe.

Me, no!  That’s it, you may want that, OK if the majority want that, that’s OK with me too.

Just keep in mind that if we leave we have to stride out and do our best to thrive. I hope in so doing we continue to welcome friends of every colour and creed.  I want to see my country thrive as an example of skill and adventure for the good not only of the UK but the world at large.  I just happen to believe that we will do this best as we Brits have done over the centuries.

 

Borrow now, pay back never?

The world is lurching toward another financial meltdown.  Debt is spiralling out of control with all the superpowers going the same way as Japan.  The USA, China and the Eurozone, are piling up debt which is unsustainable.  Add to that the Trump proposition of turning inward  and starting trade wars and the recipe becomes more poisonous.

There seems a disconnect between the macro economic planners and the ordinary citizen, the man in the street who is still blithely encouraged to max out his credit cards and gamble as wildly as he can.  The idea of responsibility and restraint seem to have vanished from our psyche.  Even the memory of the recent bankers crash seems to have faded with astonishing alacrity.

Low interest rates have been seen as the cure to stimulate damaged economies but of course these measures have encouraged more borrowing and less saving thus exacerbating the debt spiral.

Debt equals hardship, if not now, then certainly when the debt is called in.  This is true for  national as well as personal debt.  When are we going to wake up?  Already we see slow or no growth and productivity stuck in a rut.  Going backwards and digging filthy coal is surely not the answer.

Hence the mass return to populism, the easy buck promise is in the ascendancy.  Trump, Farage, Barron et al, shout for the easy way out, namely, screw your neighbour.

Meanwhile the poor get relatively poorer and the rich richer as the manipulative money engineers continue to hedge and make money out of distressed high streets and edgy currency markets.  For example Bitcoins may be an abstract to most of us but it is yet again a method to help those who have the financial muscle to make hideous amounts of money.  At whose expense?  Somebody like you and me.

Left, Right or Centre, it’s a new day.

Many countries including the UK, maybe especially the UK, are running out of money.  From Local Authorities to all the great departments of state.  Whether it is the National Health Service, Education, Justice, even the Ministry of Defence.

The UK exemplifies the mature western democracy where capitalism is approaching the zenith of its life.  The rich are getting richer, the middle classes managing (just) and everyone below struggling in a low growth economy.

The key, the economists tell us is a lack of real growth and stagnant productivity, we have got to a stage where we find it hard to get even more bang for our bucks. So what to do?

Maybe, just maybe, crashing out of the EU will create such short-term distress that there will be a surge in enterprise to make up for the change of circumstances.  I don’t mean simply selling to non-EU countries, I mean a resurgence of creativity particularly, as seems likely, if the UK is cast adrift from Galileo and other scientific projects of pan European nature.

The future might see the UK, at last, recognizing that it is no longer a world leader either economically or militarily.  Consequently, the powers, at last, abandon wild armament programs such as Trident.  That does not mean shutting up the shop, all these fantastic skills and knowledge can be applied to so many applications from nuclear power to electric cars or hydrogen combustion engines.

Perhaps too, we could see the UK pick up and run with its education system which is currently squeezed so that many educational standards are losing ground and education itself, in all its form, is being devalued.

Most of all The UK could take a leaf out of The Donald’s book, put Britain first, not by protectionism but by creative power. By concentrating on making the UK a better and richer place where the riches are built on a vibrant education system, a competitive industrial base of a highly skilled workforce, and transport and infrastructure at least equal to our European competitors.

In Justice, we need a court that stands for freedom of anyone who makes their home in the UK and respects the rights of all men.  We need to care for all our folk, old and young alike.

To accomplish these things we need a centrist philosophy that balances the meritocracy and the social responsibilities.   Taxation needs to reflect the realities of the British aspiration, a good or bad Brexit, is still a new start for British values to stand and to be built upon.

 

 

 

Capitalism or Socialism or something else? Looking outside the box!

I can’t help thinking that we are going to have another almighty crash.  Things are changing so fast, our systems of communication, markets and public services cannot possibly keep up. The information age is upon us and is outstripping our ability to manage the consequences

At the same time, the financial well being of a whole generation is being squeezed whilst a few of the very wealthy get wealthier by the day. This seems a recipe for disaster. The stock markets are booming, debt is at an all-time high despite the dismal pay packets for the servants of the economy.

Politicians are beginning to wake up to these massive threats, but sadly tend to look back not forward for solutions.  In U.K. the socialists are talking about renationalization whilst the right wing wobbles over the Brexit debate and is in danger of taking its eye off the ball of the impending crash.

In the U.S.A. the POTUS, unpredictable as he is, seems to be turning to protectionism.  However, as I predicted last year, Trump’s unstructured and unpredictable behavior may shed light on new ideas. So far we’ve seen some astonishing moves on the Korean Peninsular scene, who knows if Trump may wittingly or otherwise make moves to improve world trade and to discipline the information giants.

This is particularly important in the management of the information revolution which is changing the world on a daily basis.  These companies mainly of American origin too big to control and too big to fail,  are creating change at an unbelievable rate. From shopping to robotics, information technology is destined to radically change the employment profile of the civilized world and no one it seems can tame these agents of change, or even look honestly into the inevitable chaos that these changes will bring.

Everyone seems concerned about aspects such as personal privacy, just what you would expect.  True, the manipulation of millions of pieces of information is truly dangerous and threatens the old order, even the idea of ‘Truth’.  But this huge threat is only one aspect of the challenges we face.

Whilst the box is ever bigger, looking outside it is more imperative than ever.

Don’t tread too softly.

In an age of political correctness, we are in danger of losing sight of ingenuity and new thinking.  Amongst the revisionists are all sorts of extremes, some trying to rewrite history, some trying to limit new horizons.

We must open our collective consciousness to new ideas and new sentiments even if, at first we find the ideas strange, puzzling or even repugnant.  The idea that any expression that may offend anyone should be avoided is ridiculous.  Consider the following; The Christians defaced Palmyra long before ISIS, Christianity was barbarous and cruel during the reformation and in earlier times, the theory of evolution is denied in many fundamentalist education systems.  The British Empire was largely funded on slave labor. All these statements are fact, many of them difficult to accept.

However, ‘that  Black folk in America get a rotten deal from law enforcement officials,  President Trump is unfit to be the leader of the free world’, are more contentious perhaps, but worthy of balanced debate.

There is reasonable and credible evidence to support these premised arguments but there are also alternative views. For example:

“Black folks in America live in less privileged communities that are more susceptible to criminal behavior, therefore Black Americans are more likely to be on the wrong side of the law.”

“President Trump is a radical thinker who is genuinely creative and essentially an honest man who says it like it is.”

The first is ill-informed, but nonetheless worthy of expanded debate, whilst the second is legitimate especially for those who ‘believe’ in their new President.

There are many of us who have beliefs that preclude either of these premises, but that should not excuse us from trying to understand where the protagonists are coming from. Cool heads and open minds are what is needed to hear, listen, engage and perhaps change opinion.

Who decides, what is offensive or not?  I think we have to temper our receptors and be brave enough to accept and listen to all shades of opinion, despite the fact, that there are those who are unduly influenced on either side of the moral spectrum.  Perhaps you will listen to preachers of hate and firmly reject them, others may be more susceptible and be influenced by these evil messengers. Likewise, the fundamental zealots of any religion see themselves and their messages as beyond criticism, hence to some of us, the denial of evolutionary theory is nonsense.

Who guards the gates of moral rectitude? We all do but be prepared to tolerate views that are not our own.  Be prepared to think about what these new ideas really mean.  Accept or reject them, but only after considered thought.  Don’t be afraid of the verbal bullies, gaging them won’t help, let them speak everyone deserves a platform of freedom.

 

A new charter for the planet.

Hurricanes, Earthquakes, Monsoon flooding, refugee crisis not to mention the threat of nuclear war.  These are some of the catastrophes that face our planet this September day.  Add to that the deliberate acts of terror and one wonders if the human condition has a future.  Indeed does it deserve a future?

Amongst the most distressing issues are the deliberate acts of ethnic cleansing in Myanmar, sundry acts of terrorism as well as the chaos in Africa and the consequent mass migration.  These are human catastrophes which are the result of human behaviour.  These can be fixed if the human race in aggregate wants to fix them. The U.N. is the evolved institution that is at the centre of world order, and it (the UN) clearly is struggling to maintain any discipline or uniformity of behaviour democratic or otherwise.

Behind the raison d’etre for the UN is the keeping of the peace and the rule of international law and the relief of human disaster.  There is a constant struggle against the differences rather than the similarities of the international community.  Some would say, that nationalism and religious fundamentalism are the key areas of conflict and they may be right,

However, this is an impossibly complex set of issues that harbour the yet more complex matters such as competitive individual and national needs. The management of relative wealth, education, health and welfare all crowd in, an accident of geography seems to mitigate against relative success. In addition, there are the vagueries of leadership and they range from unpredictable populism to totalitarianism.  The rulers ofNorth Korea and Zimbabwe are just two examples where the great mass of the world’s opinion agree that they are just plain wrong.  The former in addition to routine murder and torture of its citizens is threatening nuclear catastrophy whilst the latter is a matter of plain thievery and the wrecking of a prospering economy. There are many other examples of rulers and communities who to the majority of world opinion believe them to be wrong.

Wrong is a big word, and conditioned by the definition of what ‘right’ means.  Sadly, on the one hand, things like women’s’ rights, freethinking, are accepted in some nations they are not in others.  The death penalty is still used in numerous states, dictators seem to be able to rise to power in the vacuum of ignorance.

The U.N. is all we have, it is certainly imperfect.  However, it exists and the institution is the only forum for all these varied and complex conditions to be aired.  Messrs Trump, Mwgabe, Kim Jong Un, and others can have a theatre where their ideas are aired.  The UN has also limited powers of intervention and an inglorious history of failure.

Nevertheless, the UN is the only hope we’ve got, so lets all support it in any way we can, for without it the world would be an even more chaotic planet.

Keeping the faith.

Having started writing a novel, the enormity of the commitment creeps up on you.  What have you done?  An idea is one thing but translating it into a novel is quite another.  The first chapter is hard enough, but in some ways is the easiest.  Your enthusiasm is high your belief in the dominant idea is strong – what can go wrong?

Lots actually. If you let it go wrong.  This is where the creative writer really earns his spurs.  Finding your way from the succinctness of a simple idea to the complexities of a story that fascinates, is a long and arduous journey.  It needs concentration, discipline and most of all courage (guts).

Sometimes the idea is easy to center in a plot that is coherent – if this happens early then ride it, write and write till your hands hurt.  However, more likely, it will be more difficult and you may have many changes of heart along the way. Even to the extent of rejecting the dominant idea.  Kick it out and start again.  Kick it out and give up.  Kick it out and, sod it, I’ll never even try again!  All these are degrees of response when the going gets tough.  Well in most cases it is going to get tough, some call it writers’ block, but I don’t think that’s an accurate description of the crisis that besets every writer no matter what the degree of his/her accomplishment.

It is a crisis of creativity or lack of it.  We all have to be courageous enough to untie the restrictions that tie us down.  This is remarkably hard to do, like walking on the edge of a cliff with a blindfold. Really scary!

Go there.  Go where you’ve never been before and always remember there are no limits to your imagination. There are no frontiers, so step off the edge and see where you land.