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It’s okay to dislike the NHS: some Frequently Asked Questions

15/08/2009 5 comments

I’ve been enjoying the big online argument over Britain’s NHS. Fox News have thrown around the idea that it lets terrorists into the country. CNN has a pretty good overview of how everyone’s been responding to the US Republicans’ claim that the system is “Orwellian”. And the #welovethenhs tag trundles away on Twitter.

Complaining about the NHS is pretty habitual in practically every British person that I know. “I can’t believe I had to wait thirteen weeks to have my _ looked at!”, “You won’t believe how long I was waiting in Accident and Emergency and then they didn’t even do anything!”, “It’s ridiculous how our hospitals have become home to ‘superbugs’ – why can’t they just keep the places clean?”, and so on.

What most people don’t do is make the outright principled stand – they don’t object philosophically or ideologically to the cost of the NHS, the idea of living in each other’s pockets, or the loss of personal responsibility for health.

(Erm, we also don’t think the NHS lets terrorists in.)

So I’ve always concluded that most Brits want socialised health care, but they want it to be better than it is right now. What’s fascinating about the ongoing debate is that so many people seem to be leaping to the NHS’s defence completely unequivocally.

Well, let’s be measured about all of this. As a Brit by birth, I’ve used the NHS many times. So here is a FAQ:

Does the NHS provide an overall good standard of medical care? Absolutely. It works. People get treated, and it’s absolutely free at the point of use. I usually come away satisfied. Just not always.

Is that standard as high as in a privatised health system? Not at the top, but it’s far better for folks at the bottom of the chain. By the way, in the UK, people who want to can take out private health insurance and seek private aid, so there isn’t a total monopoly.

Is the NHS a massive, creaking bureaucratic behemoth? Oh lord, yes. The NHS is plagued by wastefulness, red tape and is swarming with money- and time-wasting bureaucracy. Hopefully this can be reformed.

Do most people put more money into the system through tax than they’re ever likely to get back through treatment? Of course. If you don’t like that, you don’t want socialised…. well, anything. Apart from maybe education.

Is it OK to be philosophically opposed to nationalised health care? Yes. It does work, it’s about a million miles from being perfect, but if you’re fundamentally opposed to the idea of distributing the personal responsibility for one’s own wellbeing, then you should feel free to hate the NHS.

As the chief legacy of Clement Attlee’s post-war reforming government, the NHS was originally intended to form the cornerstone of a projected ‘Socialist Republic of Great Britain’. Clearly, this never happened. But the idea was so popular and so effective that the NHS is absolutely at the heart of the UK’s version of the ‘post-war settlement.’

It’s an assumed fact of life here: people don’t think to oppose the NHS on any fundamental level any more. The single biggest compromise to universally socialised medicine in the NHS took place months after the service was inaugurated, with the introduction of prescription charges. Since then, not even Maggie Thatcher has found the time to repeal the key parts of our health care system.

Speaking for myself, I find it hard to escape the usefulness and ‘fairness’ of this system (especially when it has treated me well, as it has for the last little while).

But would I institute such an establishment again, today, if I had the choice? Probably not.

The fact of socialised health care legitimises the worst instances of government nannying. We are now nagged and scolded on a daily basis over the latest health fads, based on one or two studies somewhere in some department of medicine, and often quickly withdrawn when competing evidence is produced. We eat too much salt, we don’t eat enough vitamin C, we need certain foods, a certain lifestyle. I don’t think government should get involved with the way people live their lives. But when everyone else pays for your own health problems the responsibility for them becomes impersonal. Your weight, your habits and your choices become everybody’s business.

The NHS is unweildy, but willing; it works in earnest, but doesn’t always deliver perfect healthcare. No system can. So if you’re going to oppose the NHS, do it properly, from the ground up: do it because you think it’s a signpost on the road to decreased freedom. Everything else is just noise.

The New Old Journalism

“The next ten or fifteen years in this country are going to be a halcyon era for state and local political corruption. It is going to be one of the great times to be a corrupt politician.” 

These words were uttered at a hearing in the heart of Political America recently. You can see it, and an interview with Ariana Huffington of the Huffington Post, over on this webcast of a segment from MSNBC’s ‘Morning Joe’.

Oh yes; journalism (its nature, its state) isn’t just making news at the moment; it’s in the news. The rise of the ‘blogosphere’ has been a perennial issue for some time; as a journalism student I saw many well-known journalists speak and the one topic that they all always came back to was the changing face of their trade in the age of new media.

Alan Rusbridger failed to convince with an almost-powerpoint about how the Guardian’s transition to the ‘Berliner’ format was an attempt to shore up sales while papers do the job of convincing people that their coverage is worth actually paying for (I think I’ve complained about his talk before…). Of the writers, ‘columnist’ Polly Toynbee was particularly derisive of this challenge to her status as arch-opinion-former.

It’s at the movies, too. State of Play (which is excellent) feeds off the in-house tension between a veteran political reporter who types onto a dark screen with two fingers at a time and the young thing behind his paper’s attempt to survive online. When Crowe’s character says “You think I’m over-fed, too expensive and take way too long”, he isn’t simply referring to himself. Newspapers now cost around £1 a day in this country (which almost legitimises my ever-more-frequent splashing out for the International Herald Tribune, at closer to a quid-fifty). Why pay that to read news that was only fresh ten hours ago?

The Independent, under Simon Kelner, tried something new. Objectivity? Who needs it! News is subjective. Importance is relative. Everyone writing this paper is human; let’s not pretend we don’t have opinions. The result was the ‘viewspaper’, a concept which has slipped away somewhat since the start of Roger Alton’s reign (he prefers the more old-fashioned approach of decorating the pages with beautiful women. They “basically make the world a better place”, after all). Today I’m not quite clear whether the ‘viewspaper’ ever made the Indie into anything more than the Express of the left.

The recent outcry over Swine Flu panics on the Internet allowed every traditional-media commentator to point out what they perceive to be the inferiority of blogs, and twitter, and social networking sites. If it’s not edited, it’s not safe. No-one making this claim can have seen some of the front-page headlines I saw a week ago. “Swine Flu to kill 91,000 Londoners” is a personal favourite.

Newspapers are not immune to misjudgments, errors, factual inconsistencies and unqualified opinions. It’s pretty ironic to see the stalwarts of the printed-press attacking new information-distribution systems for inflating problems or being hysterical when the very slump in sales caused by new media is the driving force behind the popularisation, dumbing-down and spectacle-seeking that practically every newspaper I can think of has been moving towards (though I do feel inclined to point out my belief that the USA’s daily printed media are of a sustained quality compared to the papers here in the UK).

The current, excellent issue of Prospect magazine (I know, I keep linking to them) mounts a debate around and defence of ‘serious journalism’. More here.

This seems particularly timely as the Telegraph, mocked and criticised (Private Eye calls it the ‘Maily Telegraph’) for its massive staff cuts and new-found interest in celebrity nonsense, dominates everyone’s news-schedules for the second day running. Its comprehensive investigation into and explanation of Parliament’s flawed expenses system is an absolute must-read, clearly the product of prolonged research, and a genuine scoop. Are there mistakes? Of course. Dozens, I’m sure (it’s still worthwhile).

paperstack

But, crucially, The Huffington Post probably couldn’t get away with this many factual issues or slightly-libellous claims without compromising its standards. I’m simply not convinced that we hold our more established online news-sources to a lower standard than we do our printed media. I’d personally trust a twitter feed more readily than an editorial in the Express.

Warren Ellis advised us in last month’s Wired (another great magazine) not to trust the new media as a source of news. Why? Because online news providers “have no interest in their minimum-wage blogmonkeys thinking about anything bigger than their hitcount”. But how, precisely, does this differ from the editors and writers of the modern-day newspaper, faced with shrinking sales and deflating advertising revenues?

Things move quickly in this new world. Amazon’s Kindle, the most successful of the e-ink reader systems, is moving toward a larger format that can more effectively accommodate the big pages of newspapers and journals. The days of getting ink on our fingers may well be numbered, and this would be no bad thing for an environment that needs its trees.

Are newspapers going to disappear? No. They’ll change, they’ll be forced to adapt. I personally think they’ll become more like magazines. I’m reading more magazines now than I have at any other time in my life; I’ve referred to at least three different magazines right here in this article.

To return to the quote at the top of this blog – is the decline of the traditional media really going to undermine the accountability of the political world? People thought this way when radio hit newspapers, and again when television hit newspapers. The truth is that it has become harder to do wrong, and to get away with it, than ever before. This fact raises ethical issues of its own.

But let us not delude ourselves that ‘serious journalism’ plays some quasi-constitutional role that more democratic systems of reportage cannot match.

Swine Flu: Is Twitter our global immune system?

27/04/2009 6 comments
Perhaps the most interesting and revealing part of the emerging Swine Flu scare has been watching the internet’s reactions to it.
Twitter, which I have only joined very recently, can feel an awful lot like the beating heart of the internet. Keeping an eye on the day’s ‘trending topics’ feels a lot like tapping into the collective thought-processes of the world’s internet-using population.
Thousands of individual thoughts are aggregated – ideas are linked – concepts rebound and react to one another. Particles of information are transmitted and distributed equally and instantaneously. Out of all the chaos, and only partly self-aware, order is generated. It’s completely raw, and somehow delicate: a spiralling spider’s web made up of strands; just statement and link.
It’s all too easy to mock, as the latest (fantastic) XKCD post shows:
Another marvelous image from XKCD

Another marvelous image from XKCD

Evgeny Morozov, who writes an unmissable blog for Foreign Policy, makes a more important criticism of twitter’s current role, suggesting that it’s providing more disinformation than anything else – but also mentions the possibility that the internet could work as a fantastic finder and predictor of emerging biological threats. With the increasing integration of mobile phones and other devices, the internet ceases to be merely our nervous system, and emerges as a component of a global immune system.

Prospect Magazine (for whom I once worked! woo!) have put online a fascinating article: Mark Honigsbaum writes about the means of catching pandemics early. He points out that Swine Flu may well have been abroad in Mexico for a few weeks before the news broke in any meaningful way online. More importantly, his assertion is that the nature of the internet renders it less useful for disease detection – underinformed or worried searchers on google, for example, would distort the information on a given outbreak. Or, to extrapolate from this: the internet is too open, too democratic to operate as an even quasi-scientific virus catcher.

The logical outcome of this – and explicitly suggested by the above – is that the brains behind Twitter and Google and the rest turn their attention to a reserved system of aggregating relevant information for the purposes of planetary self-defence and early warning.

I’m not entirely sure how I feel about this recommendation. The advantage of the internet as it stands is that it is simply the broadest information-exchange ever constructed. I don’t see how a more limited network could articulate the information more quickly.

Swine Flu is surely the most quickly discovered and shared potential-pandemic that we’ve ever seen. If it had started in a western country, it would have broken out on Twitter within moments (though there is weight to the counter-argument that, hey, these things start in poorer countries were internet access is more rare. But that is changing…)

As for informational quality – well, this is a perrenial problem anyway. I’m not sure how comfortable I am with the blind assumption that vetted, ‘establishment’ data is always preferable.

Systems such as Digg and others have an almost marketised hierarchy built-in. The preferences of many translate into the emergence of decent and flawed information: it’s all available, but it’s clearly sorted. Such a system is clearly the next step for micro-blogging as well.

This is the kind of thinking that reminds me of David Brin’s Earth, which posited an emerging planet-wide sentience. In effect, this is a far simpler idea: our ‘intelligent’ superstructure is conscious only as its individual, reporting components are. It’s the beginnings of a hive-mind.

So – I won’t be so quick to sneer at the torrents of little fears, hopes, jokes, and links that pour through twitter on the theme of Swine Flu. It may be our fastest defence against the next big pandemic - whether that’s tomorrow, or twenty years away.

Kettling – More Than Crowd Control

27/04/2009 2 comments

 The morning of Thursday April 1st hinted at the unseasonably warm and sunny weather that was to come.

As the throngs of protesters began their marches and vigils in London, they had no way of knowing just how much of that long, hot day they were going to end up spending outdoors, without food, water, or freedom of movement. Neither did the majority of the thousands of people who had come to make themselves heard as the G20 convened in an anonymous-looking convention centre elsewhere in London.

Much has already been said and written about the crowd-control tactic of ‘Kettling’. It caused a flurry of consternation in 2001 when the police deployed a solid line of men around a group of May Day protesters in Oxford Circus and constricted the mass of people within.

The cordon in action

The cordon in action

The debate which followed culminated in a legal ruling, just this year – that the use of the kettling tactic had been legitimate. Clearly the London police forces have taken this precedent to heart: if it was fair in one case, then it is fair game in every other.

 

So perhaps it should have been no surprise when mounted police first charged the ranks of protesters, and then a line of batons and riot shields enveloped the crowd entirely. Until that moment, the police had behaved calmly and professionally.

 

Some people spend the whole day in the kettle; eight hours and more. An elderly couple, completely unassociated with the protesters, had become trapped with the rest: they were simply in the wrong place at the wrong time.

 

The police did not countenance letting that couple out; neither did they allow a journalist to leave, despite his obviously possessing the relevant credentials. Families, including small children, were treated no differently. No excuse would do: one person urgently needed to meet an ill relative in order to care for her, but the line remained closed. A man with a broken arm was allowed medical attention – but his friend was not allowed to go with him.

 

Right now we are all appalled by the tragic death of Ian Tomlinson, and at the footage of his being struck by a police officer moments beforehand. The investigation into this matter must proceed. But we must not lose sight of the broader actions that the police undertook the very same day. ‘Kettling’ should come under similar review.

 

The police seem to believe that a protest has become unlawful, and therefore suppressible, if it starts to block roads and obstruct thoroughfares.

 

The majority of the actual violence and vandalism that took place can be traced back to the confrontational atmosphere which settled upon the demonstrators as a result of their incarceration. Where before the miscreants and troublemakers had been a tiny minority, the thousands of people alienated by a seemingly uncaring police force were liable to become angry and even aggressive – and that’s exactly what happened.

 

The police have forgotten that one legal ruling cannot constitute a permanent bending of civil rights law. There are serious implications to what happened that day, from the insensitive group-think of the police to the simple restriction on freedom of movement, which is regarded everywhere as a fundamental human right.

 

Boris Johnson is wrong. This police tactic was disproportionate and unfair to the vast majority of protesters, who had legitimate concerns and sought only to voice them, quite legally.

 

Is there anybody left who seriously questions whether ‘kettling’ should be banned from the Police toolkit of crowd control tactics?

 

Scary / Awesome Science

(Click headings for links)

The sun is getting colder.

Only a bit colder. This sort of news tends to get the climate-change deniers very excited indeed. This is because they are idiots (a worrying trend, which I want to write about some other time, is how stupid science-denying and edgy-internet-libertarianism seem to go hand-in-hand a lot of the time. Just what kind of a super-culture are we breeding here?).

The sun has cooled from its modern-day heat peak of 1985. UK scientists suggest the sun is on an 11-year cycle; others that the sun follows a centuries-long pattern. Either way it’s unnerving that there is now no sun-spot or flare activity. One is put in mind of the excellent Sunshine. Or of Alastair Reynolds, who points out in his Revelation Space trilogy that messing with a star would be the best way for an advanced intelligence to totally obliterate planet-bound species. The sooner we’re operating in more than one solar system, the better. Also, someone should write about human civilization trying to cling on post-mysterious-sun-extinction.

The sun without its spots.

The sun without its spots.

Alternatively, what if the intelligence is within the sun? Better yet,what if the intelligence is the sun? Watching us roast or throwing us a helping hand?
 

Scientists are reverse-engineering the mammalian brain.

This follows news a while back that half a rat’s brain was successfully reconstructed within a computer model and run for 60 seconds, non-real-time (the rat brain’s subjective time was operating at a fraction of real time for processing reasons). In just those moments of subjective time, the brain generated patterns recognisable from brain-scans of living rats. Now the Blue-Brain people have rebuilt a part of the human brain, with similar results. THE SINGULARITY APPROACHES. 

“It starts to learn things and starts to remember things. We can actually see when it retrieves a memory, and where they retrieved it from because we can trace back every activity of every molecule, every cell, every connection and see how the memory was formed.”  – BBC News reporting on the ‘Science Beyond Fiction’ conference
 

The cow has now joined the ranks of the fully gene-mapped.

A Hereford cow named Dominette is deemed the archetypical bovine for the purposes of mapping their genetic profile. Perhaps we can take away their pain receptors for guilt-free meat-eating. That is all.
 

A vast ‘Lyman-Alpha’ blob – a bundle of gas and energy several times the size of a galaxy – has been spotted by powerful telescopes a long, long time before it should have had time to form in the early universe.

What exactly are we seeing here? Lyman-Alphas (not a term for the CoS of a fictional White House) are essentially structures that give birth to millions of stars. Clouds of interstellar material are ballooned by the energy output of their contents.  We’re starting to look so far back in time that pretty soon we’ll have to see some of the oldest emitted light in the universe. If this thing existed before it was supposed to, then what was it? A remaining cloud from whatever existed before the big bang?
 

Pig flu is more dangerous and more likely to go pandemic than bird flu.

Oh god, the Jews and Muslims were right.

Seriously, though, I’m starting to seriously think that pig-meat should be off-limits. We’re talking about the fourth-smartest animals on the planet here. The fact that their evil diseases could kill us all is just gravy for the potatoes.

 

And finally, we could send emails through the planet.

I had to include this, as it’s a Queen Mary scientist making noises about it. Perhaps a more intriguing use for this technology would be the ability to transmit signals through other planets – say, to our base on the far side of the moon without an intermediary satellite?

The Darling Manoeuvre

30/08/2008 2 comments

There’s plenty of speculation about over just what has gotten into the Chancellor of the Exchequer, Mr Alistair Darling. He’s been delivering pithy, bullish statements – not something one expects after his immensely dull Budget day – to the effect that Labour are dead in the water and the Economy’s in much the same state.

Clearly this isn’t news to anybody. But if anything, Darling seems to be overstating the problem, over-exaggerating the peril (at least in terms of the economy). Anyone with a cursory knowledge of the ructions of the 1970s Oil Shock will be forgiven for raising their eyebrows at claims like “arguably the worst slump for 60 years”.

A certain brand of economist has been arguing for a little while now that we are witnessing the self-correction of the Market, a natural and belated adaptation to the real price of key resources. However we stand on that debate, confusion has to reign over Alistair Darling’s change of tack. There are a few theories floating around, but as I haven’t really encountered them set out properly anywhere else- here’s MY take.

1. This is a planned move. Ignore the Times when it says that the government wasn’t expecting Darling’s interviews to cut the way they did. If there’s an iota of journalistic integrity behind such stories, then the explanation probably lies in an usually well rehearsed bit of story-management. There’s been silence from Labour throughout the summer recess – the relatively slow news days where someone looking to cause a stink might have had the agenda to themselves, or given Gordon Brown the last nudge needed to topple him after his electoral setbacks. But instead everyone waited, took a breath while the smoke cleared, and planned.

2. This is what the American media might call Expectations Management. Scare people senseless about the economy, and they might just be pleased when we manage to keep our collective chins above water after all. Especially if it looks even slightly attributable to the inevitable raft of economic measures the government is set to deliver over the coming weeks.

3. By the same token, tell Labour that things aren’t merely as awful as they seemed after Glasgow East. They are, in fact, uniformly terrible. The Chancellor, Brown’s political glove-puppet, is even breaking free. And then – a little while later – a wee bounce in the polls. A decent conference season. Some well-received new policies (see above). Labour’s grassroots expect the worst – and they’re happy to be merely disappointed.

4. Best of all, let’s emphasise just how bad things can get. Let’s blow it up. Because while Labour might not benefit in the ways suggested above, the Tories may not butter any parsnips as a result either. The gamble here is that with truly, genuinely difficult times on the horizon, the public is far more likely to invest in the party that delivered them ten years of solid growth and stability than the young and cock-sure Conservatives. When things get tough, the tough get conservative – that’s with a small ‘c’ – and a change of government might be the last thing on people’s minds if they’re properly convinced that the apocalypse is coming.

5. Of course, for all this wonderful street theatre to work (and it has to be theatre to pull me away from the US elections just now), like any decent tragedy-play, we must have a death. Be it murder most foul or the honourable fall upon the sword, most commentators smell a reshuffle, and with his unguarded comments, it’s hard not to come to the conclusion that Mr Darling is the one to have drawn the short straw, and go out in a blaze of doom-mongering glory. 

Of course, none of the above is anything like certain. It might be that Darling, friends as he is with Gordon, will not be moved so easily; though if I’m wrong and his was and is a genuine gaffe, it’s hard to imagine him holding on past Christmas.

But if a change of tactics was ever called for, then it was called for just prior to the summer break. Perhaps we’re seeing the start of that right now.

“Au revoir, auf wiedersehen, and arrivederci…”

27/06/2007 8 comments

Thus spake our erstwhile Prime Minister of ten years, the Right Honourable Tony Blair (QC) MP, retorting a classic Conservative backbench attack on how rubbish the EU is with his customary style. And about five minutes later, he stood and exited the commons for the last time as Prime Minister; indeed, for the last time as any kind of minister at all. The applause continued long after he left the chamber, parliamentary protocol collapsing, all sides rising to see the man out.

Then……and now

I have been aware for some time now that I will really quite miss Blair. He got enough wrong, sure enough: extending and over-complicating the powers of the State, fighting to introduce prohibitively strong anti-terror legislation (incitement to religious hatred Bill, the 90-days detention fiasco) and, in similar terms, dangerously illibertarian ideas like biometric ID cards.

But he also got a great deal right. Constitutional reform has been slow and messy, but at least it’s happening; the devolution of Wales and Scotland and the granting of greater powers to local councils; the end in no uncertain terms to the concept of Britain as an uninvolved, isolationist nation; his commitment to internationalism and intervention abroad on a humanitarian basis… the list runs on. The cornerstone domestic issues of health and education have never looked more… erm… healthy, either, as the former Prime Minister never grew tired of reminding us.

I am not a natural Labour voter. I believe far more in Liberal Democracy than I do in its Social counterpart. But Blair’s economic and political globalism shall, in time, be recognised as his proudest legacy; moreover, it is part of the reason why I can imagine myself supporting Labour in the future. The other reason comes in the form of a gruffly intellectual boulder of a Scotsman, a man with only one working eye and, seemingly, only half a working jaw.

The rise of the economist.

Blair’s successor, the former Chancellor Gordon Brown, has already said lots of things that I personally am quite liable to find exciting. He keep uses the phrase “government of all the talents”, cementing the implications of the cabinet position offered last week to Liberal Democrat peer and political powerhouse Paddy Ashdown. This is what I would call a Very Good Thing: a careful undermining of stubborn current LibDem leader Sir Menzies Campbell, a willingness to escape the partisan absolutes which can tie the wings of smaller governments (particularly in a system, such as our own, designed for nothing so much as a house of independents), and laying the foundations for the overtures that would be required should the bookies be proven right and the next general election (whenever it is) results in a hung parliament.

Brown could do far worse than call such an election straight away. There is no historical precedent for seeking to renew a party’s mandate upon the appointment of a new Prime Minister, but then again, there has never been a stronger case for it, either. Brown has by-passed both a general election to office and a Labour party election; he has arrived in office, effectively, with no personal democratic mandate whatsoever. This would be easy enough to remedy; Brown has, for the time being, a lead in the polls over Cameron and a great deal of national goodwill behind him. He must capitalize upon this brief period of being the face of the new before everyone wakes up and realises that he was, and is, the second greatest architect of the New Labour project. A snap election would generate a good turn-out, almost certainly result in a strong Labour victory (particularly dominating the Liberal Democrats in battleground seats) and then give the new cabinet a fair amount of time to set some new policy in motion.

About that cabinet: Alastair Darling appears to be a shoe-in for the Chancellorship, which probably relegates Brown’s secondary economics guru Ed Balls (whose constituency has just been Gerrymandered out of existence but who shall surely be parachuted into a safe seat soon- perhaps even Sedgefield in County Durham?) into Trade and Industry. The rest is really up for grabs: latest news has it that both Patricia Hewitt and Margaret Beckett shall be leaving their current roles when the cabinet is recalled. Tipped to rise: one (if not both) of the Miliband brothers; Jack Straw; and I should personally be very surprised if Alan Johnson, pipped-at-the-post for Deputy Labour Leader, wouldn’t get a strong brief: perhaps a return to Education.

All change in Westminster. The economists are coming.

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