Wednesday 13 April 2011

NUS distress

Before I start today’s ‘beginner’, ‘ignorant’, ‘right-wing’ etc piece, I would like to make a couple of observations about the way my last article was received. On one side, those who identify as ‘hard left’ said it was right-wing. But my argument, that people rather than political ideas are attacked, shone through. So many of the aggressive and unpleasant comments attacked me personally. Charlie only cares about his own class, middle class bastard, he just asks his parents for money, so on, so forth, so tired. ‘I always assumed he was a Tory’ rather summed it up – because there are two lessons here. Firstly, don’t make unsubstantiated allegations about someone’s person or personal circumstances, because it leads to the charge of ignorance, or worse, arrogance. To those who attacked me personally – get to know my person first. And secondly, if you disagree with someone, at least work out why you do, and have a coherent argument against what they are saying, rather than just spurting a tired ideology. A political argument is interesting and helps shape ideas; a political diatribe, viciously attacking the other side but not understanding or engaging, gains nothing, and is frankly a bit too establishment for young people to be getting involved in. And please, try to be consistent. ‘Doctors are working class’ says one, as they sell their labour; and yet I’m told I am putting my own class priorities first, as a bad thing. I got rather confused – but also rather depressed by the fact that these who attacked me identify as ‘left wing’ and should naturally feel more affinity to people sharing a somewhat common goal than those more to the right. But no, apparently not; and what a shame that truly is. Maybe being sure of yourself gets you far in politics, but if you don’t listen, you might as well give up. Perhaps not listening is part of the ‘hard left’s’ psyche, but it won’t win people over. Still, they probably don’t care.

But anyway. Today sees the start of one of the most derided but potentially most dangerous conferences in the union calendar: the National Union of Students. Aaron Porter, a moderate and deeply committed President, has been somewhat forced out, and there is a real choice for next year’s leader. Slightly right, slightly left, and ‘hard left’.  And the extremists might just win – which would be a disaster for the NUS, and which will lead to distrust from those making and enforcing the law, the public and the majority of ordinary hardworking students. Delegates need to remember that they are representative (note to extremists – representative is when you’re elected for something – like I was – thus I can call myself ‘representative’) of their parishes, and should be voting as such.

The NUS has long been seen as a spring board to power for those centre-lefties who want to make it to the Shadow Cabinet by the time they’re thirty (what an awful thought – how about getting a life and having a life?). And this, together with various pressure groups, has led to a lot of non-student motions being debated. Let’s take one, for example. Israel Palestine, a situation that is as difficult as it is appalling, and one which I wouldn’t believe myself able to comment on, having only a basic grasp of the history and politics of the area. However, there are very strong views on both sides, and it’s something that should be debated in a number of forums. I’m all for debate. But debate and discussion is a very different thing to passing motions and ‘speaking for the student movement’. So a motion condemning Israeli ‘apartheid’ in Palestine, or Palestinian ‘terrorism’ in Israel, goes one step too far. Because it deigns to speak on behalf of ‘students’, not just a couple of politically active and ideologically driven wannabe politicians or activists of the future. It’s not that what is said is necessarily wrong – it’s the forum which shouldn’t be used.

A students’ union must be for students’ issues. The standard argument is that ‘what affects the public as a whole affects students as well’, and this is true – but that doesn’t mean that it is relevant or appropriate for the NUS (or our own beloved CUSU) to pass motions on it. It is perfectly appropriate for a students’ union – a lobby group, if you will – to oppose increases to tuition fees, if that is representing its members. It is also appropriate for the same union to be campaigning to save maintenance bursaries, etc. Because, as a union representing its members in their capacity as STUDENTS, with very specific things that we, as a body, take into consideration uniquely, it should be an effective lobbying force (whether it is or not is debatable – and perhaps it isn’t so effective because of all the peripheral non-student-specific issues that are motioned).

For those of us (and there are a lot, although most get so bored and fed up with political posturing at NUS/CUSU that they don’t get involved) that disagree with non-student-specific things being motioned at student unions, what are we supposed to do? The procedural idea of ‘this shouldn’t be debated, move on’ is a good one, but often it doesn’t work.  Instead, we end up having to speak against things that we personally agree with, but which are simply not the domain of the students’ union. I have personally been labelled a fascist this year for moving things to a vote, or voting against things, which are traditional ‘left-wing home-territory’. But if people actually listened to the reasons we have, when we oppose motioning for non-student-specific issues, then perhaps we wouldn’t be so vilified.

I’m all for political discussion, and I’m all for students getting involved and engaged with difficult issues worldwide and in this country (although I think it’s important to remember that students are generally inexperienced and don’t pay income tax), but do NOT use our student-specific lobbying body to launch a general non-student-specific political campaign. Some of the stuff up for debate in the next couple of days will truly affect the student experience. Some of it will be ineffective. And some of it will have nothing, at all, to do with student-specific business, and it should NOT be debated. And if it is, then I will have to vote against, because sometimes accepting your own potential ignorance, and remembering what you are doing – that is, representing a body which has mandated you to do so – is more important than your own political convictions. I am not there as Charlie Bell, member of Labour. I am there as Charlie Bell, delegate of CUSU to the NUS.

I trust and hope that we gain an effective leader, who will hold together the disparate strands of the student body who belong to the NUS. If we don’t, those who elect an extremist will plunge their colleagues – those who elected them to vote on student-specific issues, and get a better deal for future students – into a mire of destruction – and into an NUS that many will no longer feel is their union, and which will not be the representative body it must seek to be.

Thursday 7 April 2011

The ignorance of arrogance

A rather boring and tired complaint in the press is that 'left and right are just too similar nowadays'. Whilst this is blatantly not true, there is perhaps an element of truth in what they are saying. What that is, is that appealing to the centre-ground has never been so important. And what is that centre-ground? Essentially, people who neither have a burning desire for immediate social justice, but are not particularly selfish; people who are somewhat ambivalent about the 'class system' (whatever that means); people who want to see what a government can do for them, whilst giving a toss, to a variety of extents, about what happens to other people.

This is an unashamedly Labour blog, by the way. I am a fair and square social democrat. My argument here is that classic Marxism simply won't work in order to improve the electoral chances of Labour. I smash back the criticism that this means parties are just in it to win - of course they need to win to get power and thus implement their policies - but there must be ideology behind it. Marxism, and all those who are determined to turn the Labour Party into this kind of party, doesn't work - because it is deeply arrogant. It is misplaced arrogance, as well, and alienates the huge number of people who support the Labour aims, but don't identify as 'working class' - and it is deeply patronising to those who do.

It's rather similar to the selfishness of those far to the right (the keep-the-poor-in-their-place mentality) - it's the obsession with class. Blair famously said this is a classless society - this is, sadly, seemingly rubbish. We do have some form of class, in that we have some form of social strata. It's not a nice thing to have, but we have to accept it's there, and try to find a way to break it down. But Marxists love, just love, to go on about it, and about how to 'change' it. Let's be very clear here, if you are not 'working class', then you cannot help with bringing about the 'revolution'. They are not arguing for social change, with improved social mobility, with higher lower wages (or indeed closing the wage gap). No, instead, they say that the 'working class' are the only ones who have the ability and, let us say, 'right' to bring change - that is by bringing down the government and instigating measures such as public ownership etc. This isn't a review of Marxism - just a review of why it doesn't make any sense for the party to adopt it.

The Labour Party needs to have this discussion, and they need to have it now - even if it has been had before - because opposition can lead to extremism, if left unchecked. If they go down the Marxist line, it will be a total disaster. On the CULC blog, the argument has been made that we need a Labour party for the working class labour movement. What Labour has come to represent is so much more than that. Atlee, speaking of Labour, summed it up, that Labour legislation was ‘designed not for one class but for all’ (which is not denegrating the poorest, but appealing to the richest). The working class labour movement is, of course, at the heart - the heart which is all about social justice. But that now includes so much more than the outdated and unacceptable idea that firstly, there is something called the 'working class' that will always be the same, and is immobile; and secondly, that people who were, by chance, born into a different background, cannot care about social justice, improving the lot of the poorest, etc. What utter tosh.

Let me say it - the scrapping of the old clause 4 was one of the best things done by New Labour. New Labour got a lot wrong - of course - but that particular (unpopular) move was a triumph. The Labour Party needs to stand for social justice, and mustn't lose its roots - in the trade union movement, supporting the employed (that is, people) against the sometimes uncontrollable excesses of capitalism. But it also needs to keep its wide-church feel. It needs to welcome (in fact, recruit) anyone who cares about social justice in all its forms - rights for the underrepresented, a fresh look at immigration, removal of oppression and discrimination, improved lowest wage, increased education, improved ecosocial mobility, and so on.

The Labour Party needs to be the party of the people - that is, all the people who can get over selfishness, and care about protection of the most vulnerable. It isn't, and shouldn't, become a party for 'class war', because that, in and of itself, is deeply arrogant, and deeply flawed. The fact that the government front bench is full of Etonians (where George Orwell, of course, attended) should not be what is attacked per se - rather, it should be their policies, which may (indeed must) have been influenced by their backgrounds (look at Atlee, Gaitskell, Foot and Blair). The whole idea behind social democracy and its Labour incarnation is that accident of birth shouldn't lead to oppression - and a sharp swing to 'the left' (and I'd argue that calling it left is spurious) is dangerous and pointless, directly contradicting this.

So, Labour, keep attempting to attract the centre, because otherwise the Labour Party will become irrelevant. You don't have to be 'working class' to care - and you shouldn't need to be, to be part of the Labour Party. Class war is damaging, dangerous, and spurious - and an obsession with it, based on political philosophy, rather than an inclusive ideological and pragmatic application of social democracy, cannot be accepted by the public at large (including those who support Labour ideals), nor allow Labour aims to be implemented.

Monday 4 April 2011

Hands off our NHS...and why Ed might be right...

Was today the new beginning? For the first time in SO long, I cheered when I heard a Labour leader's speech. He put forward some decent ideas, argued very well against the government, and made ideological and sensible arguments against a policy. Merci Dieu. 'Red Ed' no longer... for this seemed like a man on a mission, and a man whose mission was to appeal to the country, not just the unions (cf CULC blog today) - a man taking Labour in the right direction.

And what was he arguing against? Possibly one of the most rushed, potentially damaging, and unnecessary changes to one of our public services in living memory (or indeed ever) - and one that this government promised wouldn't be on the cards before the last election. No major top-down shake up of the NHS - what a pile of rubbish. An NHS for the patients? Again, what a pile of old tut.

I had the honour of going to the BMA Medical Students Conference this last weekend, and joined my voice to hundreds, if not thousands, of health professionals and service users by speaking against and condemning the appalling changes envisaged by the government bill (which has now been 'stalled' to allow Andrew Lansley the time to explain it further).

Let me outline the big four problems:

1. GP consortia - yes, of course there should be input from medical professionals in the delivery of care, but that doesn't mean smashing the PCTs or making a bunch of managers redundant simply to make yourself look like an effective government. Of course, a load of the middle managers (the ones the government wants to get rid of) will simply end up working for the consortia rather than the PCTs, hence leading to the removal of high-level managers, the ones with the expertise. Do GPs really have the skills and time to manage health care resources? Do they really want to? Why is there no involvement AT ALL of those working in secondary and tertiary care - those actually employed by the NHS - but rather total monopoly given to those who have a very different contract structure? We should be using all clinicians to inform resource provision, and we should also be using patient groups and government. This is a huge fudge. And another problem - take for example the patient who has a series of severe headaches, and whose GP refuses to grant an MRI scan. That patient has every reason to turn to his doctor and ask her why - and ask her whether it's about saving money. And what could she say to that? I'm all for having input, but there has to be managerial input at least at some level. Chucking out all the managers (and there are indeed arguably far too many at the moment) is simply not the answer, is ideological, gets cheap points, and is dangerous. Patients, our patients, will suffer. Look instead at the managers in hospitals who are employed to order a consultant's materials - which that consultant could do by themselves (and who did a few years ago), and rationalise there, rather than making sweeping and idiotic changes to the provision of the whole of healthcare.

2. The lie about competition -  at the BMA, I heard the argument go like this: we are all medical students competing for jobs. Therefore, competition is good for patients, so stop moaning about competition between the NHS and private companies for provision of services. Simplistic? Just a little. What a load of rubbish. The difference is that competition between people for jobs, meaning the best and most qualified is likely to get the job, is good for patients. But once price becomes an issue, then quality will suffer. Fact. The government has announced that value for money will be considered by Monitor (the new watchdog) rather than simply cost, as a carrot to those appalled by the plans. Sorry? That wasn't the original intention? How can competition be anything other than dangerous if quality is not the first criterion? Put it like this: would you like a hip replacement with cheap material and labour that will last for 5 years but have quarter of the cost of one that will last for 15 years? It's value for money, it's just you'll need three in the time. If you believe that healthcare is one of the things that should be equally given to all (like education, for example), then competition is not a good thing. Why not spend the time looking at how to provide NHS treatment better, or rolling out limited competition for specific purposes? We are primarily a caring profession - caring for patients. Giving them worse options to save money simply isn't ethical. That's not to say that we can continue spending what we do (or increasing spending) on healthcare - indeed, it is thought that if we continue to increase spending like we have for the last 10 years, then we will be at 100% of GDP spent on healthcare in the not too distant future. So what we need is a rationalisation, a bottom-up decided, and then top-down implemented system, to determine what we should, can and will pay for, and how best to achieve that within the NHS.

3. Cherrypicking - arguments abound on this - suffice to say that private companies taking the cheap and profitable operations, leaving the costly and complicated ones to the NHS, will lead to the destruction of the fabric of the NHS, making it even less sustainable. Which isn't what the Tories want to do, of course...

4. The national NHS - postcode lotteries are despicable. Utterly so, and it is a failure of the last government not to have destroyed them. Devolution aside (and I'm not a huge fan of it), if we believe in a national service which provides free health care at the point of use, that is what we should provide. We don't. We provide localised health-care, so 'local people can have a voice on what their priorities are'. This is NOT a NATIONAL health service, and devolving power from national to local government in this area does two things. Firstly, it removes the blame from the Dept of Health - so when the inevitable goes wrong, they can sit back and say 'not us gov'nor'. And secondly, it further cements localism which is damaging to a national health service. In this area, like in education, we need nationwide priorities, and nationwide services that are available. If someone in Surrey can get IVF on the NHS (or any number of other treatment), then someone in West Yorkshire should be able to as well. It's not fair, it's not popular, and it's not something we should countenance any longer. Taking it to extreme - if loads of people have heart attacks in Hampshire, but few in Cambridgeshire, should you be prevented from life-saving treatment simply because you live in the latter? Of course not. So anything provided by the NHS should be exactly the same.

These reforms (if that's really what they are) are a disaster, and in the words of the BMA, we should be going for evolution, not revolution. Ed Miliband struck the nail on the head today, and I hope this is characteristic of what is to come from the Labour opposition. He suggested a cross-party think on the NHS - one badly needed and well overdue - and I just hope he is taken up on it. These reforms are a disaster, they are not popular with the public or the health service, and we need to stop them. Otherwise patients will suffer, and then why bother having an NHS at all?

Friday 1 April 2011

Manacles, morons, money-making and morality

Internet here is about as good as Alex Salmond's policies, so if you're looking for BMA stuff check  my twitter (@charliebelllive), which will have up to the minute updates on conference. I am currently in a bar with Hamish Meldrum, Chairman of the BMA Council... so here is a blog on current affairs that I wrote on the plane...

One thing which can’t go unnoticed is the absolutely unbelievable change to the prison system in the UK. No longer are we guaranteed that the hand of justice will be fair, even and community-based – no, instead we are diving head first (well, North first, needless to say) into a world of privatised prisons.
It doesn’t sound too outrageous to start with: especially in this time of cost-cutting, moving some public services out to the private sector is the ‘austerity compassionate conservatism’ that we’re being asked to support, or at least understand. However, is this not just a step too far? Take HMP Doncaster, for example – close to home for me, and indeed for the Labour leader Ed Miliband. The idea propounded by Ken Clarke QC, is that this will be a results based prison! And how will this be measured – simply, he suggests: the fewer repeat offenders, the more cash.
Maybe I’m over-complicating things, but I thought there were a few very simple concepts that British justice ran on: innocent until proven guilty, and all equal under the law. Well the first isn’t being challenged here (although it might well be under potential new rules governing child sex offence cases), but the second seems to be.
There is just such an incredible level of stupidity involved in the new plans. Once again, much like in the fee issue, money talks, sense is put to bed, and the philosophical – ideological indeed – reasoning behind the changes is totally ignored. Clarke, a natural liberal, surely cannot be very happy with the changes – and Labour, used to being seen as too ‘soft on crime’, will be unwilling to make too much noise: but they should. Another Blair (or actually Brown) phrase comes to mind – tough on crime, tough on the causes of crime. The latter, in particular, is philosophical – and something the government doesn’t seem to be considering in their ‘targets’ for prisons (indeed, I thought this was the government with new politics, moving away from the target culture…).
Let’s take the money for a second. How much is this saving – according to Mr Clarke, £265 million, over the lifetime of the contracts. Is it worth it? The current government mantra that cuts need to be deep, fast and now is already being somewhat eroded by their spending serious amounts on Ireland’s bailout, Libya and the World Cup bid. I’m not suggesting these are not worthy causes (maybe more on that anon), but the fact is, if there really is NO money, and the cuts were absolutely necessary to keep us on an even keel in May 2010, how much more now needs to be cut after those ventures? Nothing? If so, then something is awry. But anyway, is the relatively small saving worth it?
I would say absolutely not. What this means is that there is likely to be a disparity in provision at different prisons – look at the arguments over NHS contract outsourcing: are we looking for quality, or price? Surely the latter is important – even if it’s dressed up as ‘value-for-money’ – and if the former suffers, then we’re in trouble. The government’s answer – challenge private prison companies on their re-offending statistics, as though that’s an accurate way to determine quality.
The whole issue is another mess for the coalition – or the government, as I was reminded it is yesterday. Unless we can tackle the causes of crime, which will arguably be exacerbated with some of the badly-targeted cuts taking place, harping on about results from private prison companies is extraordinary. It’s an odd country where taxpayers are willing for companies to make profit, and shareholders to make money from prisons. I’m not one for public ownership of all utilities – thank goodness clause 4 was removed – but I am fully in support of public ownership of the things which are the cornerstone of our democracy.
It’s like the student fees issue – the questions which need to be asked aren’t being asked. ‘Prison works’ said Michael Howard. Does it? Do we have too many people in prison? Are community orders effective? What is prison for – punishment, preventing public danger, reformation? If the latter, why the low levels of education in prison? Why is there such a high level of crime in our inner cities? Why are so many petty criminals so poorly educated – and once again, cutting education budgets is inherently stupid! Why is there a huge increase in the level of antisocial behaviour? Look at knife and gun crime. Let’s get the causes of crime and effective methods to prevent offending first, and worry about cash once there is actually a plan.