Monday, 27 December 2010

A Clean Bill of Health?

Why health Spending and Good Health Care are Not Necessarily the Same Thing.

We are constantly told that the NHS is under-funded and that the more we spend on it the better our health will be. I used to believe it, of course, but nowadays after a lot of experience and reflection I regard the whole issue as being far more complicated.
The best health care does not necessarily take place in the most expensive modern hospitals. Gleaming new buildings, using vast amounts of lighting and heating 24 hours a day and 7 days a week, are expensive for the tax-payer. But I don’t believe that they can make up for long, difficult journeys to hospital from areas where the older, smaller hospitals were shut down. NHS managers earn vast salaries but I don’t believe they can make up for doctors who are depressed and demoralized by the amount of managerial bureaucracy they have to deal with in the course of their work.
State-of-the-art equipment can save lives, but can it make up for the loss of that vocational, dedicated attitude to their work which doctors and nurses used to have? Nowadays hospitals are usually staffed with agency nurses, or hastily-recruited foreign nurses and doctors with dubious qualifications and inadequate understanding of English. All of that has a negative impact on the quality of care. Fourteen highly paid and well-equipped professionals saw baby Peter Conolly before he died yet they failed to save him.
The cost of funding the NHS has mounted astronomically since it was founded. The model for the NHS was the simple system run by the old railway companies, whereby employees paid a few pennies per week for medical insurance. That medical insurance did not include heart-transplants, family planning, fertility treatment, hip replacement operations or gastric bands. Those are modern inventions. Nor did it include vaccination against measles and flu, or treatment for drug-abusers, or HIV sufferers. In 1945 it was widely believed that a dose of antibiotics would cure any disease. So the notion of a simple, national health insurance scheme was not problematical.
Since then, the funding has risen from millions to billions, and the health service is caught up in a seemingly endless spiral of mounting cost. The pharmaceutical companies have invented thousands of new and ever more expensive drugs, and as soon as they are invented, the NHS is expected to buy them. Most of the drugs we buy now did not exist in 1945 and cost from ten to a hundred times as much as their predecessors. This creates moral and evaluative dilemmas. Who is to say whether a particular drug produces results that justify its cost – or justify the loss of spending in other directions to benefit other patients?
The problems are aggravated by the fact that under EU rules we are compelled to sell any drug we produce to the highest bidder anywhere in the EU. So even the prices of previously affordable drugs are being pushed relentlessly upwards.
A friend of mine was suffering from a bunion on her foot, so she went to her local NHS GP. He put her on a waiting-list for specialist advice, but suggested that in the mean time she saw a private chiropodist. The chiropodist spent hours asking her about her entire medical history, cut her toenails for her, looked at the shoes she was wearing and charged her a hundred pounds. She was assured that only the initial visit would be so expensive, and future ones would be only fifty pounds, but she never went back.
When she went to see the NHS specialist, she first of all had to go to have her feet X-rayed. This took an hour, in the waiting-room and afterwards. The specialist saw her in a nice modern office with a computer system, telephone, coffee-machine, pot plants, pictures on the walls and an examination coach surrounded by curtains. He looked at her feet, looked at the X-rays, and read what her GP had written, then talked into a voice-recording-machine instead of making written notes. He thought there was no need for an operation so he did not recommend any treatment at all. His secretary typed up a letter which was sent back to the GP.
Eventually the woman with the bunions looked in a catalogue or internet site and found somebody selling a plastic gadget she could wear at night on her foot to straighten out the bunion. It cost about five pounds. It was made (of course) in China, where people have no NHS and most of them certainly cannot afford to go to chiropodists at a hundred pounds a time. Apparently it is having quite a positive effect. The cheapest treatment has been, in her case, the best and the only effective one.
I don’t know what the future of the NHS will be. If it is taken over – like all our institutions – by the EU, we can safely count on them to mess it up. But we should be very suspicious of any simplistic equation between money-in and results-out.

Tuesday, 21 December 2010

Leak it or Not?

Somebody challenged me to say why I think that some "leaks" of information to the press are justifiable and others, like Wikileaks, are much less so.
It's a good question, and like most such issues we are not always talking about a black and white distinction, it is often a matter of differing shades of grey.
What can justify somebody leaking classified information? What can justify putting into the public domain what was never intended for it? Can anything justify a violation of privacy and confidentiality?

There are many types of "leak". Before we form an opinion, we need to consider two things. Firstly, how did the leaker come by their information and secondly, did they really act in the public interest?
In the case of Mordechai Vannunu, the Israeli nuclear weapons whistle-blower, he came by his information through perfectly legitimate means. He was employed at the Israelis' secret weapons base in a minor capacity and made to sign their official secrets act before he knew what was involved. He believed that the base was merely used for generating nuclear electricity. When he discovered that there were several concealed levels where the weapons research and production took place, he found that he was in the position of being made complicit in a form of illegal conspiracy. He had been tricked into colluding into a secrecy that was in itself illegal and thus conniving in criminal activity.
So he decided to "leak" what he knew. He took photographs and published them in a British Sunday newspaper, thus revealing beyond any doubt that Israel had a secret nuclear arms programme. I regard that as being in the public interest, as I support the world agreements on nuclear non-proliferation and along with that goes an agreement for all governments to make it plain what they are doing. The Israelis deceived international inspectorates, and they acted illegally again when they kidnapped Vannunu and took him back to gaol in Israel. There are good reasons for regarding him as a martyr rather than as a criminal.
Consider also the British cases of "leaks" during the Falklands war. Clive Ponting and Sarah Tisdall got their information by legitimate means. They were employed within the civil service and felt that the government was misleading the public for propaganda reasons. They thought that this justified breaking their professional contracts of secrecy. Not everyone will agree with them, but they felt they were colluding in dishonest behaviour if they did not reveal what they knew. A jury decided that Ponting had acted justifiably because it was in the public interest.
That is of course just the sort of outcome that the EU wants to prevent by destroying our traditional jury system.
A fourth example would be the Climategate E-mails, which were (it is said) hacked from the server computer of East Anglia University and published on the internet in October 2009. Actually, we still do not know who did this, so we do not know how the people who published it came by their information. I think that it is very likely that they were tipped off by somebody inside the university who had legal access. The view that the leak was in the public interest hardly needs stating. The E-mails revealed extensive fraud and falsification of their research by climate scientists whose motives for wanting to prove the existence of AGW were overwhelmingly mercenary. Their jobs and their lucrative grants depended on it.
A fifth example is the leakage of information that lay behind the MPs' expenses scandal of 2009-2010. Somebody within the House of Commons' administrative sector know what was going on and there was no hacking involved. They decided to leak for reasons of conscience. They saw that hundreds of MPs were making outrageous claims for illcit expenses, bending and breaking the rules, lying and cheating right, left and centre. To keep the facts secret was a professional obligation. But it was also collusion in dishonest, immoral behaviour. So the nameless leaker passed on the files to the Daily Telegraph. Did any money ever change hands? That I do not know. It certainly affects my opinion of the leaker. I hope he or she was not paid. But it would be hard to regret the transfer of the information to the public domain even if there were payment involved.
There really is a genuine distinction between insiders who decide to blow the whistle, and mere keyhole journalists who get information by sneaky means and sell it purely for profit.
So, what about the present Wikileaks case? Unlike the
cases above, this is not a matter of information that was legitimately come by. It was all obtained by illegal means by outsiders, people who had no position inside the departments concerned, and could not justify their access to it. Almost none of the information that has been so gleefully and maliciously spilt out onto the internet has involved anybody behaving in an unjust, dishonest or criminal fashion. It has been a matter of diplomats keeping their opinions and a lot of what they know or what they suspect, private for reasons of tact, discretion and security. There is a strong public interest case for keeping it quiet.

There is no question that anybody in the Wikileaks case acted out of motives of conscience. They were not in a position where they found themselves colluding in immoral behaviour by keeping silent. Far from it.
Julian Assange in particular seems to be a nasty piece of work. My impression is that he is an attention-seeker, a mere anti-social anarchist who hates all government and wants to create disruption. He enjoys publicity and for an anti-establishment protestor, he certainly has an awful lot of rich friends. Enough to put up half a million pounds in bail and enough to invite him to stay at vast country estates for the weekend. No YMCA for him.
I was amazed to hear his lawyer saying on TV that the two Swedish women both accusing him of rape in August (long before there was any other motive for arresting him) could both be dismissed as unimportant. Their combined testimony was, according to his highly-paid and prestigious defence team, worthless againt his denials. Well, it's proverbial that rape charges always depend on the word of the woman against the man. But when there are two women making similar or identical charges against the same man, and corroborating each other in circumstantial evidence about the time, place and details, to dismiss their combined charges as "weak" sounds to me like an insult to women in general.
If two men accused one woman of being a prostitute, would any judge or lawyer dismiss their combined statements? I think not.
I want to know whether these two women can afford a lawyer in the same top league as Mr Assange. If not, why not?
Whatever the outcome of that trial, I have scant sympathy for Mr. Assange and I do not think he is to be put in the same category as the real information-martyrs.

Sunday, 12 December 2010

An Invitation to Join Wiki-Sneaks

Would you like to go snooping into your neighbour's computer? Maybe hack into their bank account or something like that. If they've got an overdraft or any interesting gossip like that, send us the news at Wiki-sneaks and we will put it onto the world-wide-web for you.
Have you accidentally found or even stolen someone's mobile phone lately? Maybe you would like to read through the messages and see if there is something private or even embarrassing that might make people giggle if it got around. Love messages? Nick-names? Secret meetings? Remarks about people they know at work? Health issues? Outbursts of temper? Swear-words?
We could put it all on the web. Just think how funny that would be.
Even a list of the private phone numbers of all their friends would go down well in some circles.
Don't be shy! Go out and pry!

Wikisneaks shock - there is no Father Christmas!

Millions of children around the world were reduced to tears today as the Wikisneaks website revealed classified documents that prove beyond a doubt that there is no such person as Father Christmas a.k.a. Santa Claus, Sinta Klaus etc etc.
Even his team of reindeer has been exposed as a diplomatic fiction, according to Wikileaks. Four people have been named as posing as Father Christmas in London alone, but all deny the charges.

A spokesman for Father Christmas's grotto at the North Pole commented "These documents are a fraud. You cannot accept them as genuine. The people circulating them are sensationalists and attention-seekers. They are anarchists with very dubious motives."

Coming soon:
Wikisneaks hints that it is going to expose the Tooth Fairy as an international conspiracy.

Saturday, 11 December 2010

Want Your Money Back?

The riots in London when the House of Commons was voting on raising tuition fees were a stark contrast from the super-duper celeb receptions universities were laying on for Nick Clegg last April.
My, my, how times change.
Here is a template letter that can be used by anyone who is dissatisfied and wants to claim their money back under consumer legislation:-

Dear Liberal Democrat Party,
I wish to make a complaint under the Supply of Goods & Services Act 1982 (As amended).
On 6th May 2010 I purchased the following goods from you:

Deputy Prime Minister

This was bought for the sum of One Vote Sterling.

I chose the item because it was tall, handsome and well-dressed and came with a glamorous, foreign wife and the assurance that it spoke five languages. The description included the promise that the DPM would oppose government spending cuts and vote against any proposed increase in university tuition fees. However, this item has never functioned as described. Within a few days after the date of purchase it started to malfunction and has never fulfilled the purposes for which it was offered for sale.
I do not think this item was of merchantable quality. It is defective or was wrongly advertised. Therefore I would like to ask for my vote back.
If there is no response to this complaint within fourteen days, I will have to take further legal action,
Yours sincerely,