Skip to content

Archive for May, 2011

RIP Gil Scott-Heron

Wow, this was surprising news to come home to: Gil Scott-Heron has passed away. He and my friend Rory kept me going through many a retail assistant hour.

Here’s a man who combined speaking a message we need to hear, with music that needed to be heard. Decades it old it may be, but The Revolution Will Not Be Televised is still required listening. Here are his three utterly essential tracks:

  • The Revolution Will Not Be Televised
  • Whitey On The Moon
  • Johannesberg

They might not all sound relevant to the UK until you think about unfair income distributions.

I’ll be spending the weekend listening to his style and trying to hear his message.

Vince Cable on growth at the London Business School

Vince gave an excellent speech today in the UK at the London Business School’s Global Leadership Summit on innovation and entrepreneurship. He fit an impressive amount of substance into just 20 minutes.

I don’t have the time to write a proper post this evening, but here’s three quick thoughts:

  • As a partisan Lib Dem, I’m glad it’s one of ours driving the innovation and growth agenda
  • Based on my non-partisan experience of working for tech firms and start-ups, Vince hit a lot of the right notes
    • In particular the importance of about 10,000 medium size firms to creating jobs
  • There’s a huge opportunity for the Lib Dems to become the Party of Innovation

That last is quite a deep point. Time and again today, stories of how innovations both large and small are nurtured kept reminding me of how the Liberal Democrats are uniquely structured. Different models of ownership, open policy development, built for both globalism and localism – these are the strategies of the innovator and the entrepreneur.

The Conservatives and Labour by comparison share similarities with established firms too married to their comfort zones and back catalogue, fearful of change and therefore restricted in their ability to prepare for the future.

In other words, these Lib Dem differentiators are closely aligned with the UK’s economic needs. Strong relationships between medium size firms and the local parties can only help with pretty much everything the party aspires to achieve.

However, despite all that, the party could also take a hard look at its internal processes and communications. Of course, it already is, before anyone corrects me :)

Tim Farron even tweeted today, requesting suggestions regarding party comms to tim.farron@libdems.org.uk.

After an inspiring day of being reminded just how transferable my background in the tech sector can be to innovation and in particular social enterprise, my letter’s in the virtual mail. Innovation comes from engaging with the outside world; I hope it’s possible for a local member to engage at the national party level. Definitely in a “change the world” mood today!

Why is total cost so rarely discussed in the NHS debate?

As described by Paul Burstow, the changes to the Health and Social Care Bill all sound good. In particular, it is good to see it acknowledged that the driving philosophy was utilities-style regulation, i.e. 80s style privatisation, i.e. US-inspired market-based reforms. Health care is not like a utility. You can’t lag Granny to keep her health bills down, use a lower wattage of bulb to cure your cancer, or use Skype to call your cousin in Australia to relieve your intermittent back pain. Market mechanisms in health care reform are really about flexibility and localism, not lower costs through competition.

I remain concerned, however, that the issue of cost control never seems to feature in articles about the NHS reforms. Cost is a fundamental problem in managing a health service caring for an aging population. It is the biggest driver for the reforms. Yet clear evidence (e.g. comparisons to other nations’ health care) that the proposals will reduce overall costs seems thin on the ground. The debate seems to be between free marketeers and advocates of community politics – neither of which is demonstrably effective at controlling national costs.

The current bill reduces the Secretary of State for Health’s responsibility to “acting with a view to secure the provision of services”. The Secretary effectively steps back and leaves the work to three main bodies: the National Health Service Commissioning Board, commissioning consortia, and local authorities (as respects their public health functions). This is good for the allocation of resources, but not necessarily for negotiating the total amount of resources available in the first place.

Who has direct responsibility for the total cost? In theory, the Commissioning Board. £60bn of their £80bn will be handed over to the consortia, however, so that responsibility is fairly diluted. Diluted responsibility has a tendency to produce higher over all cost.

The money comes from general taxation. The local authorities will be motivated to spend more on their constituents’ health. The consortia will be motivated to spend more not just for their constituents, but for their privately-run GP practices. The commissioning board will be motivated to spend more money to deliver better overall health outcomes for the nation. Private providers and individual citizens alike will be motivated to ask that more money flows through the system. Collectively, everyone is motivated to demand more money from general taxation.

The only individual with unavoidable pressure to keep costs under control would be the Secretary of State, because only in that position is there genuinely competing interests. Funding from general taxation means the real hard-headed negotiations are with the Treasury, where health care competes for limited resources with every other public service. It is reasonable to assume that at some point the health care bodies will agree that they could do more with more money. Therefore the tough decisions, as politicians are fond of calling them, may only happen when another department – say, education – says that they could make even better use of that same money.

I’m sure Andrew Lansley would say that this part of the plan to devolve power and decision making. On Jan 31st, he said in the House of Commons, “I intend to be the first Secretary of State in the history of the NHS who, rather than grabbing more power or holding on to it, will give it away.” A noble sentiment, but also it means reduced responsibility. The Health Secretary will have a ready made excuse for costs rising faster than expected.

It is entirely possible my concerns are completely unfounded. The substance of reform is re-structuring. Localism, flexibility, patient choice, transparency and democratic accountability are all good mechanisms. It may be that they are sufficient. Perhaps total cost is not much discussed because somewhere it has been demonstrated these mechanisms produce lower cost as an outcome. However, I’ve not seen such an argument being made with any detail. My point is one of managing the risk of reform, not being scared of reform itself.

The Secretary of State for Health will always have final responsibility for negotiating the overall NHS budget. I believe that at least until the reforms have been shown to work, the role should therefore retain direct responsibility to “provide or secure the provision of services” as stated in the NHS Act 2006. Keep responsibility clearly and explicitly at the cabinet level. Let delegation of responsibility be an incremental change when there is a body of evidence supporting it.

An opportunity to tackle attitudes to date rape missed

What you and I are talking about is a man forcefully having sex with a woman when she does not want to. That’s rape, a serious crime, of course it is a serious crime, and I am very glad people do now go to the police and report it, there used to be a taboo against it in a crazy way.

That’s the core sentence at the centre of Ken Clarke being reported as saying that some rape isn’t serious. Except that he said the direct opposite. Twice. And said that people should report it. And that the old taboo against doing so is crazy.

I find it fascinating that when I sat down to read up on the latest media explosion, none of the articles I read included this fact. Nor that the context was distinguishing between rape and consensual sex with a minor. Just the reaction to sensationalist interpretations.

You would hope that the goal of anyone commenting on the story is to improve in some way the way in which the justice system handles rape cases. Society as a whole needs to think about date rape differently, as Jennie Rigg explains extremely well in this post on the classification of rape. Here was an opportunity to talk about it.

Ken Clarke’s comment on date rape was that it “can be as serious as the worst rapes”. This is rather clumsy, it’s too easy to hear it as “date rape usually isn’t as serious as other rapes”. Even so, it’s a given that any and all and absolutely every kind of crime can have variable circumstances, including killing people. Clarke should be more clear on the damage that date rape causes, yes. But pointing out that the same crime can result in varying degrees of punishment shouldn’t be treated as shocking by professional journalists.

The point was made that date rape can also be deserving of the harshest sentence. This is an improvement on times past when it wasn’t even thought possible, let alone punishable. We’ve got further to go – again, see Ms Rigg’s article. The interview provided a basis to do so, if you were inclined to improve attitudes towards rape.

Instead, the media, the blogosphere and the Leader of the Opposition treated it with opportunism, attacking the individual rather than addressing the issue. They have made it clear that it is a political third rail, not to be approached too closely. There’s no reason, as far as I can tell, to believe that Clarke’s use of the word “forcefully” meant physical assault. It was nonetheless taken this way, accompanied by demands for his resignation. This does nothing but make it clear to politicians that rape is not a subject to be discussed lest they get trapped, too.

You could argue that the strength of the reaction demonstrates that attitudes to date rape have changed. Not so. The strength of the reaction shows the determination of a political party and the conservative media to attack someone they don’t like. Date rape will remain “not as bad as real rape” as long as it is not discussed openly. I know I instinctively think of the “drag them away and rape them” variety as worse than date rape. Like Ms Rigg says, it’s about having no experience of it and tending to focus on the violent aspect. I can only understand the other damage that rape causes through other people talking about it.

In the Ken Clarke episode, people are not talking about it. They’re talking about the politics and the news cycle. No lessons are being learned here.

So nice job, guys. There were a few column inches to be had – why waste them on an opportunity to discuss why date rape is about more than physical violence?

There are politicians in the world who do genuinely have attitudes like Ken Clarke was being accused of. Republicans in the US tried to redefine rape as only including “forcible rape”. Even if it would mean a victim of (please don’t shoot me if I’ve picked the wrong word) coercive rape is prevented from having an abortion. Yes, not only would the rape not be a rape, the woman could be expected to carry through with any resulting pregnancy. In a world where people think like this, it’s a deep shame that an opportunity to explore the issues was used only as a political opportunity.

Please, media and politicians, when the subject is as serious as rape, explore the subject itself. Take the opportunity to raise public consciousness. There are genuinely and dangerously misogynistic attitudes out there. Exploding over a 70 year old man’s clumsy words will only give them cover.

Ed Miliband also focuses on violence, not date rape

Here’s Ed Miliband’s conclusion on why it was right to call for Ken Clarke’s resignation in today’s Independent:

By reducing the number of police on our streets, by halving sentences for violent offenders, the Government are risking creating more victims. They are failing a very simple test.

In his opinion piece, he barely makes passing reference to date rape being just a serious as stranger or violent rape. The rest of the article is a run-of-the-mill “what about street crime and drugs?” panic attack.

Ask yourself this: if your goal was to make the public realise that date rape is as serious as violent rape, would you make that point by asking for more police on the streets? By talking about drug offences? By insisting that violent criminals are imprisoned for longer?

Of course you wouldn’t. It would only reinforce the idea that date rape isn’t as bad as getting raped by a stranger.

Ed Miliband implies that he is more in touch with the real world. Unfortunately, he seems to be in touch with the bit that follows Richard Littlejohn, who thinks that “rape is rape” is the battle cry of “the self-appointed Boadiceas of feminism”. Miilband’s article treats date rape as a passing issue compared to violent offenders and drug takers. He has all the time in the world to think about what to say about date rape; instead he writes mostly about violence, streets, drugs and the mentally ill. Read more

On becoming a twat

As a techie, I signed up for Twitter when it first came out. Couldn’t be bothered with it, though. It was only after I’d settled into a blogging habit that my ego was sufficiently engaged with the idea, I guess.

Having been using it for just a week, however, my view is transformed. When you’re staring at a computer screen all day, having a ticker tape of comments and links in the corner of the screen is fantastic for tea breaks.

I particularly liked the tweet from BBC Politics that a debate of interest to me (the suspension of David Laws) was being webcast live. I was able to tune in for a few minutes and get a feel for the substance of the debate, and it really is quite different to what gets reported.

Maybe that’s the partisan in me talking. Still, a great way to keep on top of current affairs. It’s less time consuming than my old method of reading multiple columns to get a balanced view – this way I get quickly to the source and arrive at my own, personal unbalanced view much faster.

So there you go. I’m on my way on becoming a Twitter twat.

Long lost conservative ideals

Subtitle: In which ammunition is provided to defenders of the NHS who want to challenge conservatives on their own turf

The truth is that, after a certain measure of tangible material success or reward has been achieved, the question of increasing it becomes of constantly less importance compared to other things that can be done in life.

- Theodore Roosevelt, “Citizenship in a Republic”, April 23 1910

Teddy Roosevelt was one of the great Presidents of the United States of America. A Republican, he was the physical embodiment of what some might call the conservative ideal: hard working, physically courageous, outspoken advocate of family, fiercely self-sufficient – almost a force of nature. Yet when you read the quote above, you realise that one of the great tragedies of the 20th century was America losing its way as a torch-bearer for conservative philosophy.

The quote is taken from a speech delivered to the Sorbonne, the University of Paris. It is often refered to as The Man in the Arena, because it argues strongly in favour of blood-and-guts self-sufficiency. As he puts it, “It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face in marred by dust and sweat and blood”.

Roosevelt was a statesman and a soldier, and there is a deep truth in his words. For my own part, not being a fighter, the lesson is easily translated to the arts: the credit belongs to the musician who gets on stage and performs, or the painter who puts their art on display. It’s a business lesson, too. I first heard of it from an American entrepreneur.

The failure of conservatism is to have taken this truth and perverted it. The man in the arena is a popular image amongst free marketeers, but they tend to forget that in the same passage, that man is one “who spends himself in a worthy cause”. As with most lessons, it is not a simple ode to competition but a balanced lesson in values. Later in the speech comes the other side of equation:

Nevertheless, while laying all stress on this point, while not merely acknowledging but insisting upon the fact that there must be a basis of material well-being for the individual as for the nation, let us with equal emphasis insist that this material well-being represents nothing but the foundation, and that the foundation, though indispensable, is worthless unless upon it is raised the superstructure of a higher life.

That is why I decline to recognize the mere multimillionaire, the man of mere wealth, as an asset of value to any country; and especially as not an asset to my own country. If he has earned or uses his wealth in a way that makes him of real benefit, of real use—and such is often the case—why, then he does become an asset of worth. But it is the way in which it has been earned or used, and not the mere fact of wealth, that entitles him to the credit.

There is need in business, as in most other forms of human activity, of the great guiding intelligences. Their places can not be supplied by any number of lesser intelligences. It is a good thing that they should have ample recognition, ample reward. But we must not transfer our admiration to the reward instead of to the deed rewarded; and if what should be the reward exists without the service having been rendered, then admiration will come only from those who are mean of soul.

The truth is that, after a certain measure of tangible material success or reward has been achieved, the question of increasing it becomes of constantly less importance compared to other things that can be done in life. It is a bad thing for a nation to raise and to admire a false standard of success; and there can be no falser standard than that set by the deification of material well-being in and for itself.

There may be equal, but there are no better, descriptions of the failure of modern day conservatism than its appeal to those who are “mean of soul”, with a “false standard of success”. This is the great risk of the Health and Social Care Bill 2011. Yes, the NHS requires a more flexible structure. Experience has taught us, however, that reliance on markets is to give too much power to those who choose to deify material well-being in and for itself. Even the hardy frontiersman recognises such limits:

I am a strong individualist by personal habit, inheritance, and conviction; but it is a mere matter of common sense to recognize that the State, the community, the citizens acting together, can do a number of things better than if they were left to individual action.

Along with national defence, health care is one of those things that must be managed by the State and the community. The common theme of Lib Dem criticism of Andrew Lansley’s Bill is not the re-structuring but the abdication of government responsibility. When asked why we should be concerned about this, the conservative wisdom of a hundred and one years ago isn’t a bad place to start.

(the full text of the speech is in my previous post)

Citizen in a Republic: full text

My next post is based on this powerful speech by Theodore Roosevelt, delivered at the Sorbonne, Paris, on April 23 1910. Here’s the full text for reference. The source is The Works of Theodore Roosevelt, Vol XIII, pp. 506-529. I found the text here, and have re-formatted with headings for clarity and emphasis. The American spelling has been retained as it seems the right thing to do :)

This is without doubt a speech from a conservative. But the left leaning reader should enjoy it, as long as they bearing in mind one of the snippers buried within: “Much of the discussion about socialism and individualism is entirely pointless, because of failure to agree on terminology. It is not good to be the slave of names.” Speaking as a liberal, I’m a great admirer of this speech, but would note that liberalism is an ever evolving philosophy. With another hundred years of change and learning, a long-lived Roosevelt might have become a modern day liberal, whose philosophy lies on a different axis to right vs. left. As he himself puts it:

The man who, if born to wealth and power, exploits and ruins his less fortunate brethren is at heart the same as the greedy and violent demagogue who excites those who have not property to plunder those who have .. In either case, when once loyalty to a class had been substituted for loyalty to the republic, the end of the republic was at hand. There is no greater need today than the need to keep ever in mind the fact that the cleavage between right and wrong, between good citizenship and bad citizenship, runs at right angles to, and not parallel with, the lines of cleavage between class and class, between occupation and occupation. Ruin looks us in the face if we judge a man by his position instead of judging him by his conduct in that position.

Enough of my thoughts. Here’s the speech. Read more

New British phrases for 2011

I miss the April weather.

Baroness Murphy, the NHS reforms deserve sober analysis

It’s not often I get a reply from a Baroness, so I was initially pleased it popped up in my inbox. Well, strictly speaking, a robot somewhere forwarded on Baroness Murphy’s reply on Lords of the Blog. The content was disappointing however; it is a cliché of lazy right wing thinking to imply that those who object are socialists. The House of Lords should be a place for serious reflection, not knee jerk characterisation, so my response (below) was fairly blunt. But it’s true: legislators should avoid getting caught up in us-vs-them debates, and take their duty seriously. Details matter.

Note: really, I’m not in the habit of waving around qualifications and suchlike. But it seemed appropriate to point out just how wide of the mark she had been. It’s important that objections about the NHS reforms are seen to be coming not just from the vested interests or members of the Utopian Resistance Force. They also come  from people on the side of reform.

My response, with a couple of typos corrected:

Baroness Murphy,

Thank you for your response.

I have no fixation with the vested interests and socialists. As a private sector, corporate, Ivy League MBA professional with good experience of commercial realities, I have no instinctive aversion to private sector involvement. For the same reasons, however, I prefer a more hard headed analysis than you appear to have performed.

According to the Office of National Statistics, NHS productivity has been flat for a decade. The introduction to date of private commissioning and higher quality standards have, it would seem, not contributed to improved cost containment. Rising demand combined with level productivity is an expensive combination.

As a point of comparison, Canada also provides free at point of care, privately provisioned health care. They face the same demographic trends, and Quebec recently considered introducing fees for GP visits. They settled on an additional tax, with exemptions for low incomes. That is the first step to a health insurance model rather than giving commissioners direct access to general funds.

Free at point of care encourages demand, private commissioning and provisioning provide incentives to encourage demand, and the inevitability of ageing and health care guarantees demand. Conversely, high standards limit supply. Health care markets have high barriers to entry, limited substitutes, and wide asymmetries of information. Regulatory bodies have a natural tendency to focus on abuse, not prevent incremental increases over time.

There is little reason to believe the NHS Commissioning Board will prove capable of controlling the aggregate costs of such a system.

To correct you on its substance, the current bill not only maintains but also amends the NHS Act 2006. Government would no longer be responsible for providing or directly securing the provision of care. I believe this introduces a risk of weak cost controls, based on the personal experience of working for a corporation with a budget comparable to that of the NHS. When executives’ control over their P&L is weak, cost controls are weak.

In my view, it is irresponsible for a Cabinet Secretary to pre-emptively wash his hands of responsibility for the cost outcomes of a major reform of a large, complex service.

Perhaps in the future, there will be evidence of the success of these reforms. I would be delighted to be proven wrong. In the meantime, I ask that you take your duty to consider the nation’s best interests more seriously.