As the Middle East crisis worsens, the Sudanese civil war continues to be under-reported, as Putin boosts his flagging army with North Korean manpower and the US election is imminent, the world certainly looks a dangerous place. Meanwhile, there’s plenty going on here to occupy us but there’d be much more time and space for international reporting if less resource was allocated to the right wing media’s attempts to undermine this government. From one non-story to another alleging Labour wrongdoing, there was far worse during Tory administrations but somehow this seems to escape the likes of the BBC’s Chris Mason, Sky’s Kay Burley and Beth Rigby and even ITV’s Robert Peston. From the Sue Gray to the Taylor Swift stories and the role of UK politicians in the US election, it’s been non-stop, undermining the government and any pretence to media impartiality. I suspect this campaign is partly due to the media’s irritation that despite their endless speculation and pestering of interviewees, ministers have been discreet about the contents of the forthcoming Budget – a key difference from when the media could rely on Tory leaks.
With the Budget now only days away, more has emerged, and no surprise at the application of VAT to private school fees being misrepresented as a ‘tax on education’ and the rise of employers’ national insurance contributions a ‘tax on jobs’. Needless to say, Conservatives like former Chancellor Jeremy Hunt are doing their best to undermine any policy they hear about but particularly to insist that the ‘black hole’ in the nation’s finances is nothing to do with them. One of the many dangerously misleading aspects of this ‘tax is bad’ narrative is the connection to public services, which we all need and use to a greater or lesser degree. Quite a few have gone on record to say they’d be happy to pay an extra penny or two in income tax in order to raise those crucial revenues. But such decisions are never straightforward, of course: on X Steve pointed out that the media haven’t registered how problematic a rise in employer NI would be for the care industry: ‘…not one of them has picked up that an increase in employers NI contributions will directly hit and hurt anyone having to pay for their own care needs (which ought to be on the NHS). There ought to be tax cuts for people in the care sector’.
Amid the gloom and pre-Budget febrile exchanges, though, lurk a couple of causes for relief, even glee for those on the Left. The Conservatives have shot themselves in the foot by eliminating the centre right Cleverly from their leadership contest, leaving two rabid far right candidates to fight it out and more centrist Tories to become disillusioned. But what’s so noticeable is how seriously the Conservatives still take themselves, aided by media collusion and the constant platforming of resentful has-beens. They still haven’t got over losing the election and won’t be able to progress until they do. As the Guardian’s John Crace put it: ‘…they are locked into their own echo chamber of futility…the Tories have not adjusted well to opposition. Many continue to believe they are the natural party of government and the country has a sacred duty to continue accepting whatever deadbeats it puts in front of voters. They have yet to catch up with reality. They believe that 4 July was a random category error that will in time be righted’.
The most recent example of the media facilitating the rehabilitation of discredited politicians is Michael Gove’s Radio 4 gig, Surviving Politics, in which he purports to engage guests on how they survived their own choppy waters. The first question should be what entitles him to be a judge of these issues? Apart from Margaret Hodge, they mostly didn’t survive: Arlene Foster, Amber Rudd, Humza Yousaf and Peter Mandelson. It’s not the job of the public service broadcaster to platform these efforts to rewrite history, including Gove’s own, but Culture Secretary Lisa Nandy has still not addressed the Tory rot at the core of the BBC, which is clearly aiming to bring Labour down. Sky is even worse and a number of channels have been hosting Kwasi Kwarteng recently. Today BBC News tells us that while Kwarteng concedes that the 2022 Budget ‘wasn’t perfect’ (??) – it was disastrous – Labour measures for this one are ‘pure socialism’. (As if that’s a bad thing). Now a journalist has written about what I’ve been saying all week:
‘No worries if you haven’t felt quite up to it: thanks to BBC Sounds, its recent Michael Gove festival, Surviving Politics, should be available for a year, to prove that no political life, however deeply disenchanting it might look, need now end in failure. Not while the BBC, with its extensive experience in rehabilitating widely detested politicians, is still there to pick up the pieces….. In handing him his own series, the corporation is relaunching yet another failed politician’…. this heavily promoted series reinvents Gove as a twinkling fount of political wisdom, a presenter who should now, if you set aside the countless reasons for his unpopularity, be as acceptable to its audience as any other. Be kind: doesn’t the officially “toxic” Gove, the Brexit hysteric, Cummings-patron, proroguing apologist, blob-detectorist, Murdoch protege, elephant-lamp fancier, expert-denigrator and once-prized contact of Michelle Mone – “Judas” to his friends – deserve another chance?….. the premise seems to be that the Spectator editor, with a reputation principally for Brexit and treachery, is a respected guide to dilemmas often faced in politics…..If these politics programmes tell us anything, it’s that if the BBC does not yet treat politics as a game, it’s still captivated by people who do.’
And, following his blatant book promoting media interviews, it appears that Boris Johnson’s much trumpeted Unleashed has badly underperformed, likely to cause a big loss to its publisher HarperCollins who gave him a £2m advance. I was surprised to see that the cover price is £30….. now available in Morrisons for £16.
The NHS is never far from the news but especially now for so many reasons, including the forthcoming Budget, the 10 year plan that’s been announced and the public consultation now underway, the fact that so many being off sick and waiting for NHS treatment is proving a considerable brake on economic growth, the assisted dying debate putting inadequate palliative further under the spotlight, the decision to spend valuable resources on drugs to tackle obesity, and failing mental health services leading finally to scrutiny of lack of regulation of private counselling and psychotherapy. The number of Blairites advising the new government, including former Health Minister Alan Milburn, has rightly raised fears of further NHS privatization, which Keep our NHS Public and other organizations have long been campaigning against. Many patients won’t know that their GP practice has been sold off to a private company, thanks to the decision of local NHS commissioners and KONP has been robustly challenging these contracts. An even bigger threat is the NHS’s determination to boost the dwindling GP workforce (but also in hospitals) with Physician Associates, who only have two years training and who are, in some cases, passing themselves off as doctors. Numerous doctors are up in arms about this, encountering silence and collusion from the General Medical Council, which has been charged with regulating PAs besides doctors.
The core of the 10 year plan (surely we need immediate action, not solely a long consultation) is based on three long term shifts: hospital to community, analogue to digital and sickness to prevention. Very laudable at first sight but the second has been questioned: not everyone has a mobile phone and not everyone has a smartphone or computer to enable the creation of online accounts, etc. Some patients will still prefer to receive appointment letters through the post and there’s still the knotty issue of personal data being made freely available to US tech firms commissioned to produce the NHS record system. Wasn’t that what the Palantir concern was about? Conservatives still plug their mantra that they ‘invested more’ in the NHS but this is untrue and the amount per capita declined significantly on their watch.
But numbers one and three are also problematic, for example shifting from hospital to community would surely involve enabling more patients to self-refer to secondary services and make much more complex the commissioning of primary care services. ‘Sickness to prevention’ is a no brainer but far-reaching changes would have to be made to enable it, including the boosting of local government public health budgets (stupidly removed from the NHS by the Lansley ‘reforms’) or returning that responsibility to the NHS. It also calls for substantial societal changes, such as properly tackling the junk food industry, easier said than done when those lobbies are so powerful and contribute substantial tax revenue. The Change NHS website states: ‘We want to have the biggest ever conversation about the future of the NHS…. If you are a member of the public or someone who works in health and care in England, go to start here, to tell us how the NHS needs to change’. Where to even start? One fundamental thing hardly mentioned is surely tackling the damaging fragmentation of the NHS, catalysed again by those Lansley reforms. The organogram is shocking, to see how the NHS has been split off into so many parts, reducing accountability and encouraging opacity. And why did NHS England, which seems to be a job creation outfit for former NHS trust staff, ever need a banker to head it up?
Meanwhile, many of the ‘economically inactive’, who concern all politicians although not all will use this stigmatizing term, are unable to work because of chronic pain and long NHS waiting lists. One estimate is that those experiencing chronic pain will rise by 1.9m by 2040.
‘The number of people in England aged 20 and over with chronic pain is set to soar from 5.345 million in 2019 to 7.247 million by 2040, according to projections by the Health Foundation think tank. That 1.9m rise means the proportion of the population whose lives are blighted by the condition will increase from one in eight (12.4%) to one in seven (14.4%). That will add to the strain on NHS GP services and hospitals and also increase their spending on pain-relieving drugs’. This problem was found to disproportionately affect poorer communities, women and older people. Yet another example of the interdependency of socioeconomic issues because health directly affects productivity levels and thereby hinders economic growth.
Of course the state of the NHS is also at the core of the assisted dying debate, because what has led Health Secretary Wes Streeting and others to take an against stance on this legislation is the currently inadequate state of palliative care in this country. One of the leading proponents of this legislation, Dame Esther Rantzen, the Childline founder, who has stage four lung cancer, attracted some flak this week for publicly attacking Streeting when his
decision became known. Some were very annoyed by the well-off Rantzen seeming to think she could determine Streeting’s decision. The Daily Express headline screamed her message to him: ‘Will you force me to fly to Dignitas to die alone?’ Others have defended her on account of the severity of her illness and perception of how much good she’s done in the past.
There’s no doubt the debate is very polarized and whole programmes eg an episode of Any Answers have been devoted to the topic. One doctor said that they could never get involved in the ‘assisted’ bit – they’d ‘have to get technicians to do it’. Some seem to believe (unlike Streeting, obviously) that that the ‘safeguards’ will be sufficient to eliminate potential abuse of the system. It seems to me that although this would not change one’s stance, an important aspect has been overlooked, that of where we locate authority. Many understandably say ‘I should have the right to decide when and how I die’, but for years, due to our traditional location of authority in areas like medicine, the law and the church, those people have effectively decided how things will proceed. It’s only been in the last thirty years or so that these sources of authority have been challenged, effectively shifting the dial towards the individual from the traditional.
I thought an important development in this area (but not acknowledged) was Martha’s Law – the regulation which is supposed to entitle friends and families of severely ill patients to obtain a second opinion. Merope Mills, the mother of the little girl who died of sepsis due to inadequate hospital care over one weekend, wanted notices to be put up in numerous hospital areas to inform people of this right. I wonder how this is going, because it’s a direct challenge to the ‘doctor is always right’ philosophy. How well it works also depends on the appropriate resources being available and, as we well know, the strained NHS will often fall short of expectations despite the best efforts of the staff.
Another indication of how far and wide the NHS tentacles reach are the calls, finally (as a former therapist I and others have been pressing for this for years) for statutory regulation of private counselling and therapy. Why now, you may ask. In recent years NHS mental health services have been so misdirected in my view (and those of many) towards the shorter term and biomedically oriented Cognitive Behaviour Therapy, when what most people experiencing mental health difficulties want and need is relational work, which gets to the root causes rather than just dealing with symptoms. Add to this workforce shortages and the result over years has been a massive increase in people seeking help privately. It’s a real lottery because anyone, whether trained or not (and some trainings are just not adequate) can call themselves a counsellor or psychotherapist and in my experience people are invariably taken aback to learn this. Numerous trainings also require very little or no personal therapy for the practitioner, the engine of this work: it’s crucial that we understand and have worked through our own issues before we try to help others, so that we can recognize our own projections and introjections and not erroneously attribute them to the client. In my own MSc we were required to be in therapy for the entire three years and many therapists do much more than this. This muddled situation means that people often don’t know where to start seeking help and there have been numerous accounts of serious harm being done by the inadequately trained.
“The public needs more understanding that psychotherapy can do good but it also can do harm, and anything that’s powerful enough to change your life for the better is powerful enough to do some damage if it’s in the wrong hands and done wrongly, or recklessly,” said Glenys Parry, an emeritus professor at the University of Sheffield and an accredited psychotherapist’. Ms Parry also pointed out the under-recognised syndrome of unconscious ignorance and people working beyond their level of competence without referring on. Regulation would help ensure that all therapists have an agreed minimum level of training and experience, and would be expected to keep up with new research and professional updates’. Extraordinarily, it could be argued, when I took this up with my MP during the coalition years, she received a response from the then Health Secretary, Jeremy Hunt, who said that regulation of counselling and psychotherapy was not in the public interest. What ignorance, but then it’s well known that regulation of any kind is contrary to the Conservative mind set.
The professional bodies and others will trot out the existing system of ‘accredited registers’, which they pretend is a form of regulation. ‘A robust system of regulating therapists has been in place since 2012. It is the Accredited Registers programme run by the Professional Standards Authority (PSA). Therapy organisations can apply to have their own registers accredited by the PSA, which involves meeting and maintaining rigorous governance standards in which public protection is prioritised. Any therapist on such a register has been properly trained, is subject to professional and ethical codes of practice and a robust complaints procedure is available to their clients. Registrants of a PSA-accredited register will display the PSA logo in their publicity’. I take issue with this: it is not consistently robust, it’s a way of professional bodies maintaining their business model and member income and, primarily, it is not statutory and does not protect titles. It will be interesting to see if anything comes of this important issue coming to the fore. Perhaps it’s now time for more letters to our MPs.
Finally, I was really struck by the news of the theft of 22 tonnes of premium quality cheddar cheese from the warehouse of the prestigious Neal’s Yard Dairy in London, thought to be worth around £300,000. ‘Fraudsters posing as legitimate wholesalers received the 950 clothbound cheeses from the Southwark-based company before it was realised they were a fake firm… Neal’s Yard Dairy sells Hafod Welsh for £12.90 for a 300g piece, while Westcombe costs £7.15 for 250g and Pitchfork is priced at £11 for 250g’. It seems this theft is even more upsetting than another would be because ‘the artisan cheese world is a place where trust is deeply embedded in all transactions. It’s a world where one’s word is one’s bond. It might have caused the company a setback, but the degree of trust that exists within our small industry as a whole is due in no small part to the ethos of Neal’s Yard Dairy’s founders’.
I wondered about the logistics: how was it transported, where and how would it be offloaded without detection and where would it be stored in the meantime? It’s a reminder of how food is increasingly expensive now, especially premium brands, giving rise to a substantial black market. Let’s hope the Met Police are better at detecting this crime than they’ve been with so many others. Celebrity chef Jamie Oliver has described the theft involving more than 950 wheels of cheddar as a ‘brazen heist of shocking proportions’ and urged members of the public to help the police catch the scammers.