Archive for category Health

The Scottish Greens’ Nordic Future

Patrick Harvie's Swedish opposite number Gustav Fridolin. Notice the dissimilarities from Alex Salmond and Johann Lamont

Patrick Harvie’s Swedish opposite number Gustav Fridolin. Notice the dissimilarities to Alex Salmond and Johann Lamont

The Scottish Greens’ conference in Inverness last weekend was dominated by one theme, and one question. Why is Scotland not like its neighbouring Northern European countries in terms of living standards, life expectancy, wellbeing and sustainability?

Three of the plenary speakers chose variations on the theme and all of them spoke glowingly about the potential for moving away from the Anglo-Saxon obsession with big economics and moving toward a government and financial system more similar to Scotland’s Northern European peers.

The effervescent Lesley Riddoch has made it her mission in recent years to persuade Scotland of the advantages of decentralisation, localism, empowerment and Nordic levels of public service provision. In the Greens she has obviously found a receptive audience. She was joined by Mike Danson  from Heriot Watt University whose time seems to have finally come after years of proposing alternative economic models of Scotland, and Robin McAlpine of the Reid Foundation fronting the work done by a team of academics and researchers to develop a blueprint for an autonomous Scottish parliament.

The Reid Foundation’s Common Weal project is gaining momentum, and Robin McAlpine paid the Greens a compliment in saying that they already have the policies to make it work. The challenge lies in convincing the SNP and Labour of the validity of such an approach or making sure that the Greens gain enough seats at the next Holyrood election to at least begin to implement it in government with another party.

Talk of the Arc of Prosperity may have vanished from the lips of the First Minister, but over in the Green and Independent corner of the chamber the vision is very much alive, and it is hard to argue against Scotland pursuing such a course when all the evidence suggests it would lead to a decidedly better country for everybody.

The list of potential polices is almost endless, but the Greens are committed to increasing investment in strategic public transport infrastructure, re-regulation of bus services to give local authorities more say, increased basic wages to both help people and increase tax yields for investment in services, municipal energy companies and education reforms based on Finland’s proven globally leading example.

The Common Weal project is a welcome addition to the Scottish political scene with its stress on common consensus rather than socialist revolution, and its use of existing similar states to Scotland which clearly illustrate that it is possible to tackle some of Scotland’s endemic problems in an inclusive and democratic way.

The Greens now find themselves in the strange position of having a more cohesive and coherent vision for Scotland’s future than almost any other party in Holyrood, the SNP included. Next time you’re stuck in a traffic jam on the way to pick up your kids from an overpriced nursery and worrying about the 8.2 per cent price rise your energy company have just foisted upon you, take a moment to consider that Scotland has an alternative modern future ready and waiting.

A Niceway To Die

 

The ’Niceway Code’ is not just about appeasing cyclists – it is typical of a government increasingly tokenistic and out touch with the challenges it faces.

The Scottish Government recently launched a campaign to improve Scotland’s road safety record called ‘The Niceway Code’. You may have missed this due to the fact that it only has a budget of 500,000 pounds and it is so appallingly lame that Transport Minister Keith Brown’s department seem faintly embarrassed about the whole thing.

The campaign aims to reduce the number of road deaths by asking road users to be nice to one another, which is surprising in that the law already compels people to be nice to and not kill one another on the roads.

The fact that the campaign does not even remind motorists or their legal obligations (and in some cases directly contradicts what road markings tell cyclists to do as shown in the picture below) has incensed active and sustainable transport groups. One Holyrood insider even talked of how an panel of interest groups were left dumbfounded when Keith Brown’s team revealed their grand strategy for preventing death and injury on the nation’s streets. The Scottish Government’s own statistics show that 1 in 14 road deaths each year are cyclists, and only in a tiny minority of cases have the cyclists committed even minor infringements to the highway code.

Don’t go left, even though that’s where the cycle lane is.

The SNP seem to want to keep everyone happy, which is why they seem to view cyclists and cycling as an interest group and not as a genuine means of tackling some of the endemic transport and urban problems of contemporary Scotland. They will happily commit three BILLION pounds to doubling the A9 from Perth to Inverness but cannot muster the couple of million pounds it would require to radically reshape Scotland’s urban and suburban spaces to make them more liveable.

Cycling is not just about lycra and weekend hobbyists – harnessed properly it can create safer streets for children and families in particular, cut air pollution and help meet Scotland’s climate goals. It can save the government and taxpayers money, cut health bills and reduce the strain on public transport networks without extra subsidies. If even a crumb of that three billion were spent on redesigning towns and cities to make them more people-friendly the SNP would be a world leader, but for the time being they’ve just got everyone sniggering into the back of their hand. And I’m being nice.

 

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Soylent Green is… not real.

As has been covered by the UK-wide Green blog Bright Green, there has been a bit of a stooshie amongst  some unreformed environmentalists after the leader of the Green Party of England and Wales, Natalie Bennett, made a speech unashamedly embracing immigration.

The population control lobby are a stick which people use to beat Green movements the world over, accusing them of authoritarianism or, at worst, eugenics.

A simple-minded approach to environmental problems says that there are too many people, and that we should just have fewer of them to solve all problems. This is less noticeable in Scotland but to the casual observer might appear true in England where issues of sprawl consuming green space is far more prevalent.  England’s problem is more that it has an addiction to suburban housing estates instead of building high density sustainable urban housing and social space – one of the great ironies of the modern suburb is that they often have lower levels of access to the things they were designed to facilitate – namely a higher quality of life outside of urban centres. Such spread is what led to the expansion of the slip road and the motorway and much else besides, along with an associated decline in point to point urban travel such as buses and railways.

Even if Britain were overcrowded, keeping people out would not save the planet anyway. As science hurriedly maps the global ecosystem it is becoming increasingly apparent just how interdependent we all are in areas other than the global economy. Stopping people from entering the UK would do nothing to stop population growth and the associated environmental burdens whatsoever.

If the far right or the population lobby were serious about stopping immigration they would plough as much money as possible into the developing world to encourage the transition to the relatively gender-equal societies of Europe and North America, give countries help in moving on from the economic or social pressure to have large families, and push to reform international trade so that it did not put economic and population growth as the primary means by which countries advance.

The population lobby should direct its ire at half a century of misplaced architecture and planning or the bizarre injustices of the global economy, as contemporary Greens are, and lose the Soylent Green dystopian scaremongering.

A sickness at the heart of Westminster

nhs-cameronThe Tories’ latest wheeze to head the racists in blazers off at the pass is this: to make Johnny or Joanna Foreigner have to pay for his or her treatment on the NHS, unless it’s an A&E visit.

Well, it’s not that new, but it’s back in the papers, and it sounds like Mr Hunt has spent another ten minutes thinking how it’d work. Time for a crass press release!

As the Guardian points out, the cost of the problem they’re trying to solve is £33m out of £109,000m – less than a thirtieth of one percent of the English NHS budget.

Actually, is it even right to call the English system “the NHS” any more? It feels like spin, or perhaps nostalgia: like the sad wee British Rail logo you still get on your tickets even through the system has been smashed into pseudo-competing franchises to be run by anyone’s national rail company except our own. But I digress.

This may be a gross over-simplification, but imagine NHS services as a line that stretches from the poor souls stretchered into A&E after a motorway pile-up at one end through to the most elective of treatments at the other. If the Tories erect a wall just beyond A&E, they ensure non-British nationals go untreated for infectious diseases they currently can see a GP for. Sure, if Johnny in this case is Mohammed Al-Fayed they’ll go to Harley Street or BUPA. But most foreign residents are working, studying, looking for work.

And deciding not to treat those people when they’re sick means they’ll spread disease to others, leading to more unhappiness and taking folk away from their jobs. And costing the NHS more. They may get sicker and sicker until they do eventually get rolled into A&E: now they’re much more difficult to treat. Again, costing the NHS more. This stupid idea isn’t even likely to save taxpayers money. In fact, immigrants are taxpayers too: VAT in every case, often income tax, stamp duty or VED, all sorts.

Part of the reason the NHS has been so totemic for voters is that it treats everyone. It’s one of the few bits of actual socialism to have put down proper roots across much of the political spectrum. But the Orange Book Lib Dems and the ideological and racist austerity-addicts of the modern Tory party want to undermine that universality. The mid-market press and Nigel Farage have laid the groundwork for them to start this assault by not treating foreigners. How long before “shirkers” get treated after “strivers”?

Not long, perhaps. There’s already a campaign going on the right (with all sorts of misleading and emotive propaganda in it) to start charging for GP visits. It’s to reduce pressure on them, honest! Nonsense. It’s to ration healthcare away from the poor. Would the worried well middle classes be put off by a fiver charge? Unlikely. Would the seriously ill poor be deterred? Sometimes. And so the pressure on GP’s surgeries would fall, perhaps, but offset again by extra pressure on A&E. And at the price of a fair system that treats people according to need, not income.

Thank goodness this vicious and counterproductive idea would only apply to the English health service, although I’m starting to have the first twinges of anxiety when I visit England: what will happen if I get ill? A taste of the same concern people get when they visit America: will my travel insurance cover me? Will I come back a million in debt for having broken my leg?

It baffles me that English voters appear to be swallowing this stuff: competition in the NHS, patchworks of privatised services, bureaucratic chaos. Shouldn’t this lead to protests and a collapse in the polls? Perhaps it’s because Labour aren’t opposing it with the kind of fierce clarity that led their much more admirable predecessors to set the NHS up in the first place. In fact, they were making the same sort of argument before they got chucked out in 2010.

Health is one of those areas where the SNP have got it broadly right, for my money, and one where devolution is saving Scotland from horrors no-one foresaw during the 1997 referendum campaign. Westminster may have a sickness at its heart, but whenever English voters turn against market control of health, hopefully Scotland will have a system that they can point to and say – that! That’s what we want back!

pic from Liam

Foolishness on e-cigs comes to Holyrood

E-cigAlex Massie’s right: attempts to clamp down on electronic cigarettes are entirely misguided, and will, if successful, lead directly to more preventable deaths. The opponents are doing Big Tobacco’s work for them – there has never been a bigger threat to tobacco consumption than e-cigarettes, vaporisers, call them what you will, at least in the West. If you’ve got the time, here’s an extraordinarily long list of scientists and others quoted on the subject. To give one example from there, here’s Professor John Britton, chair of the Royal College of Physicians’ Tobacco Advisory Group:

If all the smokers in Britain stopped smoking cigarettes and started smoking e-cigarettes we would save 5 million deaths in people who are alive today. It’s a massive potential public health prize.

So why not regulate them? Here, from the same source, are ten good reasons. And perhaps this is the clearest summary, from Professor Jean-François Etter, head of the tobacco group at the University of Geneva’s Institute of Social and Preventative Medicine:

It would be a mistake I think to regulate these products as medications, and if they were regulated as medications this would limit access to the product too much and cause many deaths. … Astonishingly, the most vocal opponents of e-cigarettes are people from the public health community, who perhaps don’t understand what is at stake, and just don’t like the product because it looks too much like a cigarette.

And now the foolishness of the “treat them as medicines” lobby has arrived at Holyrood via this motion from Stewart Maxwell MSP. He led the campaign for a ban on smoking in public places from 2003, so seeing him trying to restrict something which reduces the incidence of smoking is like watching a road safety campaigner suddenly argue against speed limits, seatbelts or airbags. His motion says the “potential health risks are unknown”, and advises people to stick to the patches and gum which have left us with almost a quarter of Scots still smoking.

Sure. We don’t know everything yet, but research is coming in, and we can also be absolutely certain about the alternative: continuing to smoke tobacco. To quote ASH, this country’s most implacable opponents of smoking (who do support regulation but also oppose a ban on the use of e-cigs in public places):

Certainly, in the absence of thorough clinical evaluation and long term population level surveillance absolute safety of such products cannot be guaranteed. By comparison, the harm from tobacco smoking – the leading cause of preventable death in the UK – is well established.

One study concludes that e-cigarettes have a low toxicity profile, are well tolerated, and are associated with only mild adverse effects.

I don’t even think they should be unavailable to children, despite the concerns about young people starting straight on e-cigs. Currently 13% of Scottish 15 year-olds smoke cigarettes: I’d rather they weren’t inhaling any tar, any particulates, any carbon monoxide, or any of the remainder of the toxic cocktail a cigarette generates. Maxwell’s motion calls for a ban on promotion to non-smokers, and that’s probably as far as I would go with him, although I’m not quite sure what that looks like.

With proper support, this could be the last generation that sees mass smoking of tobacco in this country. With a decent alternative for those already hooked, you could even make the case for pre-announcing a 2020 ban on smoking altogether (not that the Massie family would be likely to support that). One more quote, this time from Robert West, Professor of health psychology and director of tobacco studies at UCL’s Department of Epidemiology and Public Health:

We could see the end of tobacco use in the UK within five to ten years if e-cigarettes are allowed to flourish. Why would smokers continue to kill themselves if they could use e-cigarettes? Smoking tobacco is so last century.

The prize is that big. I see my friends switching from something that will very likely kill them to something which almost certainly won’t. And I wish Stewart Maxwell was on board with that.