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Blyth Spirit – friends disunited?



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This situation might be a lot more complicated than making it Jon Lansman’s fault.

The blame for this does not lie with Dame Margaret Hodge.

I’m not a Corbynista, nor a Blairite. I am though in my mid 1940s, and I have voted for the Labour Party all of my life. I had no sudden urge for voting for Boris Johnson, so not surprisingly my immediate reaction to seeing the ‘exit poll’ for the first time was a sense of impending doom. Not one for hyperbole, but a feeling of cataclysmic disaster, one of the worst days of my life.

We’re left struggling for simple narratives. This election was a referendum on Brexit – or telling the truth – or Jeremy Corbyn – or the NHS.

Paul Mason didn’t hold back:

Brexit will happen, Scotland will become independent within a generation, the political centre in parliament has evaporated. And Corbynism has failed. It failed because, for around a year now, it has been less than the sum of its parts.

The Tories took Blyth Valley which has been Labour since it was created in 1950,in the first shock result of the general election. Ian Levy got 17,440 votes, beating the Labour candidate by more than 700 votes. There was also a win for the Tories in Durham North West, where Labour’s Laura Pidcock lost to Richard Holden.

Laura Pidcock – she was the future once – had only recently on Facebook written the following,

They don’t feel what we feel
Ignore the polls.
Ignore the negativity.
Ignore the lies and the hate.
It’s a waste of your precious energy.”

There have of course been many equally bad days, and plenty more to come. The sense of disbelief at the exit poll from me must have come from a sense of ‘one last heave’ that I had felt after the 2017 election. There were too many ‘twists and turns’ for me to remember as to how we came to be in this horrible mess, ranging from the soap opera with Dominic Cummings to false reports of people being punched.  It was difficult to tell fact from fake news, but somewhere in there was some actual news. Jeremy Corbyn was quite unpopular on the doorstep, or the plans for government were too diverse and unrealistic. Or that the early postal votes were in fact ‘grim’, and people were sick of Brexit.

But the basic question is – if Labour was offering so many good things, why were they so unpopular consistently? It’s possible that Labour defectors were much more worried about Jeremy Corbyn than about Brexit policy. It’s possible that certain Labour voters are now more concerned about Scottish independence. The basic plan for Boris Johnson to lead a greater number to getting Brexit through parliament is, I suppose, one with which ‘Workington man’ or a London black  cab driver could collude with. There are so many possibilities for what we wrong. It could be that Momentum strategists wanting to keep things simple, by being seen to address lots of wrongs, such as WASPI, universal credit, lack of broadband, etc., simply by making pledges. But it might be still that the perception of macroeconomic competence is not strong enough for Labour. Possibly people care less about national debt going through under the Tories than they do about Boris Johnson’s track record in telling the truth.

This appeared to be an election at risk of double standards. I feel the pain of the Chief Rabbi, and yet islamophobia was brushed under the carpet. The Conservatives didn’t want to talk about the details of the Withdrawal Agreement, but they couldn’t be criticised by Labour for this as Labour didn’t wish to discuss the details of Brexit either. The cult of Jeremy Corbyn was criticised, and yet the cult of Boris Johnson was not important. Labour seemed pre-occupied with their social media campaigning, but Boris Johnson found time to put out a ‘Love actually’ type video.

The Tories may appear not like ideal dinner party guests, but Labour still looked like a party at war with itself – with Lisa Nandy, Jess Phillips and Wes Streeting  in one corner, and Jeremy Corbyn, Richard Burgon and John McDonnell in another. Out of everything, I still have no idea what Labour’s plans were for certain things. I don’t know how it intended to progress with the integration of health and social care. All I heard about was privatisation including PFI.  But the Tories did not get into heavyweight arguments of their own, focusing on the numbers of new nurses, or the numbers of new hospitals. I didn’t know, if austerity is such a problem (which it is), how did Labour intend to reverse the cuts in legal aid. If Labour is too obsessed with presenting London élite, how come there was so much exposure of Laura Pidcock and Rebecca Long-Bailey? Maybe the ‘cut through’ had to be more than Ash Sarkar wearing a Marx t-shirt on Newsnight?

It could be that the election of a strong and stable Boris Johnson government is indeed a good thing, in that the European Union is forced to deal with an output decided with some certainty from a UK parliament. I don’t know whether ultimately Britain will benefit or not from Brexit, but it could be that the UK parliament does benefit from getting Brexit ‘out of the way’. Brexit will not finally ‘end’ though – if there is no solution to free trade agreements or freedom of movement which makes sense to all. But likewise we don’t know exactly what Labour intended to negotiate in six months, and whether there was any point in presenting this in front of the UK electorate.

Lancing the boil of Brexit, making the case of independence, is odd given the call for a United Ireland or Independent Scotland. It could be that Boris Johnson’s latest lie is talk about ‘One Nation’, when the majority of MPs in Scotland are SNP – but there could be a genuine repulsion of Labour by voters in certain ‘heartlands’. Voting Conservative might lead to better living standards through reduced immigration, and that might be a price worth paying. Or it could be that the Conservatives have tapped into a sense of national identity and pride, which Labour had no hope of identifying. At worst, both Conservatives and Labour could be accused of ‘divide and rule’, by presenting certain sections of society as ‘the victim’. Or it could be that Ash Sarkar and Grace Blakeney were simply talking to themselves very loudly.

With Brexit getting done, and improvements being made to public services, despite a recent track record, might make the next five years attractive, but that is to airbrush out problems with probation, NHS and social care capacity, food banks and poverty. But maybe its condrascending and patronising to say that the ‘working class vote’ can be enticed by talking about poverty, other injustices, and NHS seemingly a lot of the time. Previously, the attack on Labour was lacking ‘aspiration’ – so here the accusation is that Labour by sitting on the fence had no aspiration to get something positive out of Brexit; rather Labour wanted to block Brexit at all costs. When you consider that Swinson wanted to block Corbyn in forming a government of national unity, and that Corbyn might have to block in future a demand for another Scottish referendum, maybe the bottom line was that the advocates of Brexit simply were less disunited. Either way, the end result is that we may have an unfettered Conservative government for another 5-10 years at least, and this could make life very difficult for many in reality.

Johnson is not oven-ready. He’s half-baked at best.



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“Get Brexit done” is, of course, as utterly meaningless as “Brexit means Brexit” or “Strong and stable”.

As Johnson knows from his undergraduate rudimentary study of Ancient Greek,  language in Thucydides and the Peloponnesian War poses a problem. The Athenians, for example, assume a fundamental distinction between erga, “real things,” and logoi, “words,” with the erga constituting reality and logoi a kind of secondary phenomenon.

Occasionally, the mask ‘slips’. The façade of a vivacious charismatic lover of the joie de vivre is suddenly disposed of to reveal a highly unpleasant narcissistic arrogant person who clearly over rates himself. He’s played the system, having been to Eton and Oxford. But that in itself does make him wise or intelligent.

Johnson’s reaction to the news of a boy sleeping on the floor of a hospital was not even faux outrage. It was to stuff a reporter’s smartphone into his pocket. And yet this is a nice parallel to his general approach to evidence. Take for example, the lie exposed about the barriers between Northern Ireland and the rest of the UK, exposed by DExU, the Treasury, an interview with Sophy Ridge, and the leader of the DUP, for a start. Or the lie about the 60 or so hospitals which turned out to be a handful of allocated ‘seed’ funds. This approach to evidence is sympathetic to his contempt of the law, in the alleged abuse of power getting special favours for his technology partner, or riding roughshod of the law such that the Supreme Court had to interview on behalf of decent patriots including HM The Queen.

Johnson does not understand the NHS or social care. Nor does his Secretary of State, Matt Hancock. Johnson’s immediate oven-ready soundbite in reaction to the latest incarnation of the 1992 war over Jennifer’s Ear was to talk about the ‘record investment’ in the NHS. But we know from all the ‘independent’-ish think tanks that this claim is false. We know there’s no green paper on social care. We know there’ve been savage cuts in social care. We know that integrated care under Jeremy Hunt stalled, whereas Andy Burnham’s ‘whole person care’ was oven-ready back in 2015.

Hancock instead sees staff as a costly nuisance in running the service. He is prepared to do something about NHS pensions such that he can’t be blamed for the disgusting performance over the winter crisis to come. He sees data as black gold, so much so he is willing to get into an unconscionable relationship with multinational corporations such as Amazon and Google, to make data breaches from local hospitals to make your eyes water.

The strangest thing about the record of the Conservatives in 2010-5 is that Johnson has managed to deflect criticism of this period onto his LibDem counterparts. He has managed to do this because Jo Swinson is either deeply fraudulent or idiotic in saying that she did not understand the impacts of the austerity policy on disabled citizens, some of whom lost their benefits and later died prematurely. One of the achievements of Jeremy Corbyn and John McDonnell, not McDonald, is that austerity has been exposed as a huge con. A con similar in ridiculousness as Labour causing the global economic crash of 2008. The crash, caused by financial products in the US, allowed a ‘scorched earth’ reaction of austerity. The next scorched earth event to happen is of course Brexit.

Jo Swinson has utter hatred for Jeremy Corbyn, and this has detracted away from the genuine offerings of the Labour Party over the NHS, social justice and tackling inequality. This is not something which ‘tribal’ Labour members will be able to forgive in a hurry. Sure, Swinson’s remarks like the Chief Rabbi or Laura Kuenssberg’s fake report of an altercation on Twitter, get more space than Windrush or islamophobia, but not everyone is deceived.

Jo Swinson has not facilitated any meaningful debate on the economy, climate change, or the NHS.

There will be some people who don’t vote Tory. These include Scots who wish to remain in the EU. Some people will vote for Labour, despite Jeremy Corbyn. This is because it is impossible for the Tories to defend their record. There might be some die-hard Brexiteers who want to ‘get Brexit done’, and, if so, even Dennis Skinner will lose his seat.

But Johnson is a pest, and doesn’t deserve to get a majority. If he does, he will find the country unmanageable.

 

@dr_shibley

 

 

 

I’m voting Labour



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Labour for me has many faults. It has people who are MPs whom I dislike. It has policies which I think are over-the-top.

I have voted Labour all my life. I am now 45.

To be honest, Jeremy Corbyn’s personal style annoys me sometimes; he can appear stubborn and aggressive. There is, no doubt, some frustration on his part, for how the media chooses to interact with him.

I just wish Brexit would go away. With the outcome of Brexit to run into the millions or billions, I think the democratic vote has been exercised enough. I don’t think it was the ‘will of the people’ to impose savage devastating cuts in living allowance on disabled people. I don’t think it was the ‘will of the people’ to introduce NHS reforms in 2013, or to slash legal aid. Or maybe it was the will of some people.

I am not particularly interested in the views of somewhat narcissistic supporters of Jeremy Corbyn pretending to be Nobel Prize winners in economics.

Social care is on its knees. The national debt is now running into the Trillions. David Cameron has set in play a chain of events where we are closer to leaving the European Union, and breaking up the domestic Union.

Taking back control puts international supply chains at risk, international political influence at risk, and lives of people living on essential medications at risk.

I think Boris Johnson loves himself too much, and is not quite as intelligent as he thinks. His Withdrawal Agreement Bill is truly a dogs’ dinner.

We should be prepared to forgive and forget. We all make mistakes – even Tony Blair. But the Liberal Democrats have in their time made some ‘whoppers’ over NHS reforms, legal aid reforms, and austerity in general.

I dislike the outcome of the Referendum of 2016, but this a Tory treaty which has been drafted up by the Tory party for Brexit-leaving voters. It seems far more desirable to try drafting another exit strategy with a fresh pair of hands, and to see whether the UK can approve it. Maybe they can. Maybe they won’t.

The issue is that the Labour Party can work with the SNP and Greens if it wishes to, to see if the EU exit can work. But I think unilaterally pulling the plug on it straight away would be dangerous politically.

I think the consequences of a Tory Brexit, and a further Tory government, are simply not worth thinking about. With my many reservations of the present Shadow Cabinet, I think it is far too risky to do anything other than to vote Labour.

 

@dr_shibley

 

The end of the Conservative Party is nigh. For that reason alone, I’m not bored of Brexit.



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It’s a bad start for the leading finalists in the Conservative leadership election to say that their party will be annihilated unless Brexit is ‘delivered’. Let’s face it – the implementation of Brexit by the Conservative Party, with no involvement of devolved governments or the official opposition, has been a disaster after three years. You only need to look at Jeremy Hunt and Boris Johnson to see that the Conservative Party will soon be totally unelectable for a generation.

 

Boris Johnson exudes incompetence, arrogance, faux intelligence and self-entitlement. Jeremy Hunt fraudulently pretends that his negotiation with junior doctors was a success despite being deeply traumatic unnecessarily for all parties involved.

 

Brexit will do nothing to help with knife crime, or the parlous state of social care. ‘Taking back control’ means reinforcing your borders. So it’s no surprise that Ireland wants to reinforce its border to stop non-EU goods leaking from the UK into the EU single market. Brexit will do nothing to make universal credit run more smoothly.

 

Whatever your views on the economic future of the UK after Brexit, it’s beyond any reasonable doubt that the reputational damage for the UK in terms of an influential world force for good, apart from Trump’s America, has been enormous.

 

If the UK exits the European Union with a successful negotiated settlement, it is pretty likely that the Pound will plummet further. This of course is an opportunity for short-sellers. But the benefit for the City is likely to be shortlived, if the EU denies passporting rights for transactions in London.

 

I don’t understand some voters who might want to ‘get on with it’. I liken this to someone arsoning your flat. Instead of putting out the fire, you are asking the arsonist to pour more petrol on the flames. I don’t understand why some voters have gone all silent on immigration. Maybe they know that Brexit might actually catapult an increase in brown or black faces in their local vicinity. I don’t understand why some voters are still passionate about past glories of England, when their local car plant is being shut down to be relocated to somewhere more sensible for dealing with the international supply chain,.

 

Being socialist meant to me being social. This does not mean turning our backs on, socially, politically, or economically with our EU neighbours. The pretence that Brexit can build a socialist nirvana in one country has never been tested for. It is naïve at best, and profoundly economically illiterate at worst, to think that multinational corporates can be completely obliterated from a post-Brexit UK.

 

It’s too late to honour the referendum result, unless the same parliament, with a different Prime Minister, can ‘seal the deal’ with the negotiated outcomes. This is unlikely if Labour continue to reject the deal, which they should do as it does not fulfil their original stipulated requirements of being at least as good as membership. The EU after their summer recess have no intention of re-opening the negotiation. The whole country apart from the Conservatives and Rory Stewart know that the positions of Jeremy Hunt and Boris Johnson are a pack of lies.

 

The only way forward is for Labour to decide on whether it wants to renegotiate a settlement (to which the EU would have to agree) or whether it simply wishes to end this stressful madness by revoking Article 50.

 

David Cameron’s ‘holding operation’ of an EU referendum has stunningly backfired. If Labour is unable to get a majority in the general election, to work with the Greens, SNP or Liberal Democrats, and to form a coalition of sorts will have to adopt a pro-EU position. These facts need to be stated clearly ahead of any general election it wishes to participate in, unless it is Labour’s intention to scoop up votes to form a coalition with the Brexit Party.

 

If Labour were to take a pro-EU stance, if the EU can’t renegotiate the settlement, it’s my genuine belief that the Conservatives will be out of power for a generation.

 

And, if so, good riddance to them.

 

@dr_shibley

Time for the discussion of Brexit to get beyond hashtags and internal bickering



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The fireworks, after Sadiq Khan’s recent display, have certainly been impressive, with the likes of Roger Helmer foaming and frothing at the mouth. I am happy with what the current leadership of Labour has achieved. I have no intention of ‘smearing’ members of Labour. I would dearly love to see a Labour government. But it is an inescapable fact that there is, in fact, no version of Brexit that will satisfy both ardent supporters of Brexit and citizens of the UK who want to remain members of the European Union. If a further referendum is held, the possibility is that whichever side wins won’t win by that much of a margin. If ‘leave’ win, the words ‘be careful what you wish for’ will come back to haunt many. Many of the people who want a People’s Vote want ‘Remain’ to win, and simply wish to hold a referendum to maintain the importance of ‘democracy’. But democracy would possibly mean the UK could bring back capital punishment. Brexit as a solution to all the problems caused by neoliberal capitalism including austerity is a false, fraudulent prospectus. Attacks on ‘Blairites’ are in my view utterly irrelevant now to getting Labour into a position to form the next Government; this does not mean I am a ‘Blairite’, and such a lazy attack would be yet another dead cat.

 

There are some people who are determined to make this all about Jeremy Corbyn. I voted for Jeremy Corbyn twice, as I wanted stability in the Labour Party. I think though the obsession with him has become insufferable, including people who spend all the time flooding my Twitter timeline with plans for “Twitterstorms”. The perception is that Jeremy Corbyn has become more obsessed with getting into Number 10, rather than sorting out other desperate problems within his party, including Brexit. There’s an argument that ‘conference had decided’ that there would be a “people’s vote”, and failing that there would be a general election. However, events have been evolving fast.  The Labour position is deeply unconvincing, and, whilst Jeremy Corbyn’s position ‘has not changed’, the notion that it will be able to negotiate successfully a solution to Brexit, the unicorn approach, is deeply unconvincing. This is nothing to do with my views of Barry Gardiner. The nature of the debate has become extremely toxic, with callers to local radio here in London referring to ‘illegal immigrants’ who can be shown not to be telling the truth with bone marrow aspirates diagnosing to the year their biological age, or “strapping Sadiq Khan” to a Catherine wheel (like yesterday).

The leader of the Conservative Party has had her position consolidated as a result of the failed ambush by the ERG. The only event which is likely to happen is that preparations are being made for the Theresa May negotiated agreement with the European Union to be rejected by parliament. In which case, a central plank of Government’s policy will fall, and it could be then that Labour is saving itself for a ‘no confidence’ vote in the Government, having previously precipitated a no confidence vote in the Prime Minister personally. Brexit has already proven to be a ‘financial opportunity’ for those sympathetic to the views or personnel of this Government, including problematic private companies taking on substantial financial transactions in commercial transactions extracting money from the State to fund their shareholder dividends. This is classic privatisation. The worst is yet to come, of course, with ‘patriotic’ Conservatives short-selling the currency, so betting on its demise, to make millions.

 

This is of course a far cry for why certain might have voted to ‘leave’ the European Union. It is speculation why exactly they believed a position which was impossible to negotiate bilaterally, given the sheer torrent of lies told by Nigel Farage, David Davis, Dominic Raab, Boris Johnson, and their ilk. But the potent ‘taking back control’ did tap into a rump of voters who felt as if the economy had not been working for them, by immigrants under-cutting their wages, and themselves adding to pressures on state-run services, inter alia. Many such voters, many of whom were also Labour voters, do not agree with the nationalism of some members of local clubs. The narrative had emerged that the UK can make a success on its own.

 

It is, however, important to remember that this mess should be owned by the Conservatives. This means that the failure of Brexit must be owned by the Conservatives. It is all very well for Theresa May to ask for no arguments and reconciliation, but she was the one who took her toys home two years ago and produced a deeply divisive partisan strategy for conducting the negotiations on behalf of the country with the European Union. The European Union cannot be blamed for their agreed settlement.  If parliament votes it down, it should not be allowed to allow ‘no deal’ to be shoo-horned through, especially since the country is totally unprepared for it. The only people who are prepared are the ones about to receive privatised contracts from friends in the Government, or people ‘betting’ in the City.  They have no interest in the destruction of the UK, including what happens to the NHS and social care. This is a betrayal of a phenomenal scale, and the Labour Party should keep a safe distance so it is not implicated in causing this disaster. The ‘shock’ of a no deal is of course will be exactly the sort of climate where the ERG or those in the ‘hard left’ can see themselves flourishing. It might even be a tempting climate for ‘Lexit’ to take root, but I don’t believe Lexit provides a solution either economically or socially, definitely not politically, to Brexit.

 

The only solution for me is for Labour to campaign on a platform in any general election to go back to the European Union, and to argue not only for a seat at the table of an influential trading bloc, but to ‘remain and reform’. I understand how tempting it might be for the UK to ‘go it alone’ and get contracts with Russia or China, but it is in reality hard to say that this would be easily possible. Having been a devotee of Tony Benn, and read all his diaries more than once, I am sympathetic to the Bennite view. But that’s where it ends.  I think we can no longer within Labour waste any more time thinking Twitter arguments. There is an economic crisis to avert, but there’s more to Labour than a new radical model of economics even. Brexit will be more of a threat to welfare and social care, and the NHS, than even austerity has been, and there will certainly be no finality to the repercussions for Brexit for many years to come. It’s time for the ‘membership’ of Labour Party to stop thinking about Twitter campaigns, stop speaking to themselves, and put the country first.

 

@dr_shibley

Sticks and stones may break my bones



I had first become interested in the language surrounding dementia in 2014, when I presented a poster on the G8 pitch, at the Alzheimer’s Europe conference in Glasgow.

At that point, I realised that sticks and stones could break my bones, but words could hurt me.

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I have long since not attended any national or international conferences, not simply because I found the same topics being discussed in perpetuity, but because I felt the conferences were for an in-house cliques who were far more into massaging their own egos and putting themselves up in flash hotels than the reality of dementia.

But I later returned to the issue of language, in relation to stigma, in my second book on dementia ‘Living better with dementia’ published in 2015 by Jessica Kingsley Publishers. As my own mother lives with me, and as her dementia advances, I’ve genuinely found my own book to be a source of information and support. For example, only last night I was reading up on my own thoughts of the ‘sweet tooth’ in dementia and the neuroscientific evidence for why it occurs. Latterly, I’ve toyed with the idea of writing a cookbook for unpaid carers, living with limited resources including scarce money and time, of people living with dementia. I would love to work with someone who’s interested in this specialist field, such as a nutritionist or dietician, to help me.

I became physically disabled in 2007 after more than a month unconscious on the intensive care unit of a local hospital, where I was invasively monitored for acute meningitis. Although I subsequently read Goffman on stigma about a decade later, I had the misfortune to experience stigma first-hand. The sense of ‘otherness’ is something you experience if you’re in a wheelchair, and a London cab refuses to stop despite the cab having its yellow light on. Of course, I had direct experiences of ‘otherness’ as other medical professionals disowned and excluded me when I needed help the most – both in my alcoholism and in recovery. I am currently doing professional dilemma questions, and the knowledge that senior clinical people I worked with turned a blind eye, or did not know what to do and did not admit it, to my illness still frightens me.

As a result of this, I have a low threshold to calling out ‘otherness’, that is where you define people as different to you, and, more than than that, try to discredit them. This might include supporters of Brexit or not, Jewish or Muslim citizens or not, or even living with a long term condition. I don’t think the key to destigmatising stigma is by segregating people. At worst, this might include the ghettoization of people with dementia or mild cognitive impairment such that they all safely live in the same ‘dementia village’, to all intents and purposes ‘out of sight’ and ‘out of mind’. Care homes used to be criticised, by some, for potentially warehousing individuals if the prescription of chemical or physical restraints was frequently abused, similarly. This is not real integration and inclusion, in other awards appreciating the diversity of individuals, but actually lumping all people together with the same label.

For example, in ‘dementia friendly communities’, we don’t acknowledge individuals have different qualia of cognitive impairments, in memory, language or whatever, at various degrees of severity. We don’t discuss how the social determinants of health impact on the health and wellbeing of people, such as poverty or the shutting of day centres. We just clump all people together as ‘dementia’. This is not a million miles off of creating vast groups comprising unique individuals, such as ‘learning disabilities’ or ‘the elderly’.

Whilst the counter-argument is that identification of these groups of people means that their needs can be serviced, often the opposite is true. Recently, a paper has been published on identifying the most ‘frail’ people so that we can be aware that they are the most intense in resource allocation. But think about this carefully. This can mean that we use the information to discriminate actively against the most vulnerable – ‘equity’ and ‘justice’ are not necessarily compatible ethically.

Above all, I am scared how language is used to legitimise discrimination, ‘otherness’ and to embolden other people’s vulnerabilities and weaknesses.

I did a brief scan of some ‘offending’ words, and I compiled them into a table.

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I have been much derided for talking about “assets” and “strengths” as well as “deficits”. For example, one person commenting on a piece I wrote in the Guardian remarked similar to, “We don’t need to worry about this patient lying on the operating theatre table with advanced pancreatic cancer. She has great teeth.

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But I strongly believe that it is not difficult to slip into the patronising ‘does he take sugar mentality?’ I don’t wish to turn the medico-legal concept of ‘paternalism’ into a “dirty word”, but, as for our experiences with individuals with special needs, it is a slippery slope to outright dehumanisation and depersonalisation.

I never really understood what it was like to lose your sight until I went blind in one eye last year – but this was surgically operated upon with success. Likewise, I think many of us think we won’t be the ones who get diagnosed with cancer or dementia. But the law of averages means that some of us will be.

And we should think about how “we” would feel if “other people” talked about “us” like that.

@dr_shibley

The morality of dementia ‘awareness’ while imposing swingeing cuts



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The actual reality has been bleak, apart for those for whom ‘dementia awareness’ pays off their mortgages.

In September 2018, the Guardian featured an article on the cuts to social care:

“Nearly all the austerity-era funding cuts to services supporting poor families have fallen in the most economically-deprived areas of England, potentially trapping them in a “downward spiral” of poverty, according to new research. Council areas in the north and Midlands, together with a handful of local authorities in London, have shouldered 97% of the reductions in town hall spending on working age social care, looked-after children and homelessness since 2011, the study says.”

The cost of the ‘Dementia Friends’ programme was always eye watering.

As this press release from 2012 provided,

“Launched the £2.4 million programme, led by Alzheimer’s Society and funded by the Cabinet Office and the Department of Health, to deliver the nation’s biggest ever call to action on dementia to create one million Dementia Friends by 2015.”

I still have deep reservations about ‘cloning’ millions of people to be ‘aware’ of dementia in such a pre-scripted formulaic way.

Take for example this script of how to conduct a ‘Dementia Friends’ information session which can be easily found on the internet. The approach leaves little room for any creativity and innovation by local people to promote awareness of dementia. If there are about 900,000 people in the UK with dementia, you would have thought that they would have had their own personal views of dementia they’d like to share.

But the truth is – this was a massive marketing exercise for the Alzheimer’s Society, with deeply unpleasant political motives. Dementia Friends was never delivered in a genuinely organic way as a social movement. A huge amount of money was put into ‘marketing dementia’ as this press release reveals. There was never any “empathy” as this recent piece from the Harvard Business Review on the topic of change suggested.

In all the intervening years, there has never been an independent report on the return of investment of this programme, despite many many calls for such an analysis of whether the millions of pounds invested ever had any return socially or otherwise.

Take for example the aims of the “marketing programme”:

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What have been the tangible results of this? Do the public think or feel any differently about dementia? Has there been a greater sense of social connectedness between people with dementia, carers and others, despite the drastic cuts imposed through austerity in government policy? Has there been any significant upskilling of the workforce in health and social care in dementia?

What ‘dementia friendly’ means has always remained elusive.

It’s even to me, the full carer of a wonderful person – a mum who happens to live with dementia and who requires now full-time care.

It has never convincingly been presented as anything other than a better ‘customer experience’.

Take for example this claim from quite early on:

“When the dementia friends scheme was still in the planning stages, the aim was announced of signing up 200,000 people who, by doing so, would be making a pledge to become ‘dementia-friendly’ contact points for customers they encounter who are living with the condition. With the number of employees having confirmed their support already surpassing 400,000, however, it is clear that the programme is set to be a big success across the country.”

The five core messages of ‘Dementia Friends’ are not beyond reproach either.

Dementia is not a natural part of ageing.
Dementia is caused by diseases of the brain.
Dementia is not just about losing your memory.
It is possible to live well with dementia.
There is more to the person than the dementia.

As you get older, you have an increased chance of developing dementia. With the drive for dementia diagnoses, there has inevitably been more people who have misdiagnosed with dementia when in fact they did have ‘normal ageing’. We know dementia is caused by diseases of the brain, and it is not just about losing your memory – but it would have been sensible at this point to give a brief explanation of the other types of dementia, particularly for those below the age of 65. It’s simply not good enough to say ‘it’s not just memory’. I would never say, as a complete explanation, a ‘supermarket is not simply a delicatessen counter’. That statement provides no information about what a supermarket actually is. Likewise, the statements are consistently half-truths. It is, I am sure, possible to live well with dementia, but it’s also possible for the person with dementia and carer (and others) to suffer enormously, with the emotional pain of not recognising familiar people, not being able to do simple tasks like writing a cheque and so on.

There is more to the person than the dementia is a hollow campaigning slogan when delivered by advocates and charities who relentlessly do not embrace the issue of other social determinants of health, nor indeed any other comorbidities, but want everything to be viewed through the dementia campaigning focus. For example, a simple irregularity is the issue that dementia-friendly communities or behaviour should be friendly to all, unless you genuinely believe that people with dementia are sufficiently homogenous and do not live with any other diversity in their diagnosis or social determinants of health?

Currently, there are nearly 3 million ‘Dementia Friends’.

And my genuine reaction is “So what?”

 

 

@dr_shibley

 

three amigos

Why I think Labour is wrong over Brexit


December 2, 2018 8:15 pm / Leave a Comment


three amigos

 

 

 

 

 

 

 

 

 

 

 

This has got absolutely nothing to do with the Iraq War or Tony Blair. The background to this for me is personally relevant. I’ve voted Labour all my life – in other words, at every general election since 1992. I voted for Jeremy Corbyn twice as leader of our party, so let me indulge you on why I think Labour has to tread very carefully now.

 

The likelihood is that the main motion on December 11th, the Government and European Union proposal, will not be accepted. This defeat means that Labour will deliver on a promise for a ‘no confidence’ motion. And the likelihood is that even despondent Tory MPs, with no obvious successor in sight, will not want to inflict a defeat in that no confidence motion. We already know that the DUP, despite their reservations over the EU/UK proposal, intend to support the Conservative Government. So, as for Jeremy Corbyn’s challenges, this might end up consolidating and reinforcing Theresa May’s position as the Prime Minister.

 

These events won’t make the problem of the European Union exit disappear. The clock is still ticking on the UK’s exit. The position that would be, however, that the UK parliament will have rejected the mutually agreed terms for departure. The departure of the UK was always presented by Brextremists as being entirely on the UK’s terms, well Little England’s terms actually. The reality is that the agreement legally will need to show consideration, and will need to be bilateral with an intention to produce a meaningful arrangement.

 

The absence of a deal, or ‘crashing out’ of the European Union, would be disastrous on a number of fronts, ranging from medicines to airports. But with a lack of instant agreement on WTO processes, we would not be able to sell our products with agreed standards abroad. That is one of the biggest problems, aside from other major problems such as the lack of radionuclides for urgent cancer treatment.

 

It cannot be forgotten also that the EU has been incredibly patient and accommodating with the UK government, and themselves have earned a ‘good deal’ by all reasonable measures. So, they’ve run of patient a long time ago, but they want this all settled now. This means that they have already stated categorically that they don’t want a renegotiation, and this is unlikely to change with a change of government. It would, however, be useful if the EU could state their position on this now.

 

One of the former heads of the civil service of the UK government has said it would take at least 7 months to sort out the logistics of a people’s vote. We’d have to agree the question too.

 

I think socially, economically and politically, now that we know on what terms the UK would depart from the EU, different from when the original ‘will of the people’ was measured, it would be a disaster to exit the European Union.

 

People make mistakes, and, as a surrogate phenotype, UKIP won’t care as they are changing in public into their BNP clothes. The Conservatives are admired for their control of their economy (which I disagree with). Labour is not. Lexit is also a deeply deceptive construct, as it is always possible that exceptions can be carved out for public services for the UK. The EU didn’t make us legislate for competitive tendering in NHS services in section 75 in the Health and Social Care Act 2012. The guff about state aid and greater public investment as a result of Lexit are so false it belongs on the side of a bus.

 

A lot of the problems in our country have been entirely self-inflicted by the domestic governments, such as welfare reforms including universal credit and the ‘Bedroom Tax’. These have been nothing to do with Brussels. At the risk of re-running the refererendum campaign, Jeremy Corbyn can legislate for his socialist nirvana for all, promoting equality, fairness and social justice, even if the UK remains part of the EU.

 

The Conservatives are also admired for their decisiveness. Whilst Barry Gardiner will deny he has vassilated from warning against a ‘vassal state’ to embracing the ‘will of the people’, it all is beginning to look a bit false and hollow from Labour. I agree they need to win an election to get anything done, but, if they willingly want to give a vote to people knowing that the UK could tank in the process, I don’t believe they can be supported.

 

@dr_shibley

 

bg

The GMC needs to get its house in order, before it starts lecturing others


August 16, 2018 9:23 pm / Leave a Comment


bg

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I still personally find the death of Jack Adcock devastating.  The reason for this is that I know how stressful it can be to be a carer experiencing the NHS, and my own cousin lives with Down’s syndrome.

 

Anyway – we can all agree that the BBC and GMC are both “national treasures”.

 

No – that didn’t quite sound right.

 

Both the BBC and GMC are funded from members of the public and all Doctors akin to taxation. They both misuse public funds to go on witch-hunts, and court popularity in doing so. And they both act as if they are above the law.

 

We live in a democracy, where freedom of expression is cherished, even though under no interpretation can GMC cases be seen as ‘entertainment’ from the BBC.

 

Patient campaigners have long warned about ‘cover ups’.  But they indeed strangely disappointed when the Court of Appeal judged in favour of Dr Hadiza Bawa-Garba. To rule in the GMC’s failure, erasing her from the GMC medical register, would have led to the most enormous of cover-ups.

 

“Nothing to see here”.

 

It is easy to underestimate how truly appalling the monitoring of Dr Hadiza Bawa-Garba was, with numerous postgraduate qualifications in the difficult discipline of paediatrics. The differential diagnosis of a child who is clearly not himself is huge. The full power of the media were able to whip up the narrative of a Nigerian doctor committed an offence ‘against one of us’. That is the most alarming aspect of the whole business, along with how racially biased fitness-to-practise cases are in front of the GMC.

 

This was never about #BawaGarba in a way, but as they say in the latest Mission Impossible film, ‘everybody was expected to play their part’. #TeamHadiza surprisingly paid a big part by crowdfunding a massive cover-up by the GMC into discussing system factors in healthcare.

 

This week, I revisited a postgraduate medical course which I had last done in 2002, before a monumental cover-up into how sick I was was effected. I nearly lost my life in 2006, but I live to tell the tale (just, despite the cardiac arrest.)

 

In that course, many Doctors had told me about very sick patients they’ve had to face, obviously without breaking any confidentiality, and how medicine is not always entirely predictable or an exact science. You could give a therapy that could worsen the actual diagnosis, because the details of the actual diagnosis have not revealed themselves yet. Learning not blaming is critical for this.

 

On Twitter only today, I was told by a member of the general public that dementia is a normal part of ageing. That is, however, fake news, and it is hard to deny that there exists an information asymmetry between doctors and patients.

 

Suddenly, many patients became experts on how easy it was to diagnose sepsis.

 

Think to yourself about a thought experiment. Imagine if the details of the Bawa Garba case had been anonymised, so that you knew nothing about her identity. Pretend it’s like judging a paper for peer-review. Now imagine that it could never have been reported upon in the media, identifying the person.

 

Would this have altered the balance of ‘public interest’ or ‘interesting to the public’? I believe so certainly.

 

“Public confidence” cannot be measured accurately if the regulator depends on the Daily Mail’s readership for support, I feel.

 

Bawa Garba was given the same degree of knee-jerk hostility as Cliff Richard, with both parties knowing very little about the facts mostly.

 

And they’ve both had to pick up the pieces, with a few people conveniently forgetting that they would require rehabilitation.

 

One could argue that they are both indispensable, after all, depending on how much you ‘like’ them.

 

We need to have a debate about “human factors”, or whether ‘medical manslaughter’ needs to be better defined where the dividing line between risk and uncertainty is sometimes blurred.

 

We need to have that debate urgently on ‘learn not blame’. The GMC admits it ‘got it wrong’. A concession is that it does not intend to appeal the Court of Appeal judgment at the Supreme Court. The GMC could perhaps use the money, and its statutory duty in medical education, to improve yet further the clinical skills of this Consultant to be.

 

I strongly feel the regulator misused its power, and, if you’re talking about accountability, I think Charlie Massey ought to resign as he hasn’t ‘raised a difficult issue’ in a helpful way, but actually has done a considerable amount to decrease confidence in the medical profession. But everyone makes mistakes, even the GMC, even if ‘sorry’ is the hardest word for it.

voices

Ticking boxes and snazzy campaigns won’t be sufficient to improve ‘dementia rights’


May 31, 2018 5:50 pm / Leave a Comment


voices

 

 

 

 

 

 

 

 

 

 

 

 

Cited in a OECD report, it is reported that half of all people with dementia may have experienced verbal, physical or psychological abuse or neglect at some point.

 

We feel strongly that the discussion of ‘dementia rights’ is very serious, and far too important to be left to marketing leaflets.

 

Dementia rights affect many people, such as carers or care home managers, but not least people living with dementia themselves.

 

And yet it sometimes feels as if ‘dementia rights’ have primarily been interpreted according to the needs of the people other than those living themselves with dementia.  And, disturbingly, there is no distinction between ‘consumer rights’ and other rights.

 

A wider of range of people should be involved in the future discussions of rights. There are burning issues to discuss, such as glaring inconsistencies in current law. What about those who have agreed to hospital admission, or at least show no signs of objecting to it, but who may still be deprived of their liberty in various ways – for example residing in a locked ward?

 

We know in theory that every effort should be made to prevent the need to deprive someone of their liberty. It must be used for the minimum time possible. The legislation is supposed to protect vulnerable people. But why the perpetual schism between rhetoric and reality?

 

The English Law Commission’s own recent report“372 Mental capacity and deprivation of liberty” noted that:

 

It is concerning that people often do not feel safe, treated with dignity or that their human rights are respected whilst detained.”

 

Dignity is an essential intrinsic part of human rights law. It is not merely an ‘adjunct’.

 

In response to the war’s atrocities, the UN’s universal declaration of rights in 1948 provided that “all human beings are born free and equal in dignity and rights” under its article 1.

 

But Catherine Dupré comments:

 

Protecting and defining dignity through human rights law is not always a straightforward business, especially because it often raises, in the words of the European court of human rights, a question of civilisation.”

 

It is critical now that we have an inclusive, wide-ranging debate, about how to progress. For example, an independent reviewhas set up for England and Wales, led by Professor Sir Simon Wessely, to look not just at our mental health laws, but also how they interact with services, good practice and the wider care system.

 

We must concede that changing legislation alone will not be enough to improve the lives of people affected by dementia, but, still arguably, a wider range of people with dementia and care partners should still have a seat at the table while this legislation is being changed.

 

In the “competence model”, a patient with dementia might be deemed incompetent to make a particular treatment decision, the decision must be based on an advance directive or made by a substitute decision-maker on behalf of the patient.

 

But this does not appear consistent with article 12 of the UN Convention on the Rights of Persons with Disabilities (CRPD).

 

It seems that CRPD article 12 makes it impermissible to deny persons with mental disabilities the right to make treatment decisions on the basis of impaired mental decision-making capacity and requires the replacement of all regimes of substitute decision-making by “supported decision-making”.

 

The crucial difference is, therefore, that the “UNCRPD states that everyone with a disability should enjoy legal capacity on an equal basis with others in all aspects of life.”

 

Whatever local focus groups and tick-box “engagement meetings” take place, it is essential we have a thorough discussionof ‘dementia rights’ including specialists in law and dementia care, especially when so much is at stake. This is especially important as there are so many valid voices and actors in the ‘civil society’.

 

As the experience of Dementia Alliance Internationalshows, “nothing about us without all of usneeds to be more than a slogan.

 

@dr_shibley

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