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A sickness at the heart of Westminster

Jun 30

Posted by James in Health, Holyrood, Westminster | 2 Comments

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

When civil partnership was radical

Jun 27

Posted by James in Equality, Holyrood | 6 Comments

My OathJust over ten years ago, the Rainbow Parliament came to town, full of Greens, Socialists and independents. Of the new rainbow intake, just one still remains at Holyrood: Patrick Harvie. His first act, more or less the moment he’d taken the oath, was to propose legislation for civil partnerships – in fact, it was soon enough for the Herald’s cartoonist to draw Patrick with his hand in the air saying “I hereby swear my allegiance to the queens”.

The outrage was widespread, and not just from the usual suspects. Even the less reactionary parts of the media complained that this wasn’t what Greens were elected to do – surely they should just be talking about conservation or climate change? They moaned that Robin wouldn’t have done this, neglecting the fact that it had been a Green manifesto pledge, and that Robin had made the exact same arguments during the previous session.

Just three years prior to that, Scottish Ministers had been the subject of the bad-tempered Keep The Clause campaign, Brian Souter’s hateful effort to try and marginalise LGBT youngsters at school. They’d stuck to their guns, but why would anyone at Holyrood want to kick off another controversy in this area, they asked? It’s too soon. It’s not a big deal. Who cares?

Although Patrick’s Bill wasn’t successful, it did get Holyrood talking about the issue, and it helped ensure that the Scottish Parliament fully debated the issue, and voted in support of the principle, before Westminster passed legislation for the whole UK. Just a year later civil partnerships were approved UK-wide.

Today, as the Scottish Government publishes a bill to deliver equal marriage (with some flaws), supported by the leadership of all five parties at Holyrood, it’s hard to believe how radical it was just ten years ago to propose civil partnerships. This country isn’t free of prejudice or inequality, nor will it be when this bill passes, but on no other issue I care about have I seen such rapid progress. Patrick: you deserve a glass of something fizzy today.

Nigel Farage: time to choose

Jun 20

Posted by James in Democracy, Holyrood | 14 Comments

chooseLast night I happened to be in Holyrood when the Refugee Week reception was on. I spent a year working for the Scottish Refugee Council when the Scottish Parliament was first established, and it’s been an issue I’ve felt strongly about ever since. So I took a glass of wine and listened to Christina McKelvie give the welcome speech.

The section addressed to those visitors to Holyrood who were refugees, asylum seekers or immigrants was basically perfect. Just as I’ve always felt, she told them she was so proud when people choose to make Scotland their home, and proud when we’re able to provide a haven for someone whose own country isn’t safe for them any more.

The theme was heritage, an issue where I often find the tone used by SNP politicians jarring. But not last night. Once you’ve chosen to be here, she said, as time passes you become part of Scotland’s heritage too. You become a strand in our tartan. It’s a splendidly inclusive message for people who’ve arrived here.

But not everyone who comes here gets a warm welcome, she said. Cue puzzled looks. Just a few weeks ago one man got a proper heckling on the High Street. It was made very clear to him that he wasn’t welcome. He claimed it was anti-English sentiment, which came as news to one of the Cambridge-born organisers.

It wasn’t anti-Englishness, she said. It was anti-fascism. And we clapped.

There’s been a lot of pontificating about free speech from Tom Harris and the like after Farage’s visit. Incidentally, Tom thinks #disparagetheFarage was a “mob of nationalists and trots“, but he was unable to say which of these categories he thought covered Labour activist Duncan Hothersall, inventor of the excellent hashtag and one of us who encouraged folk to doorstep Farage. He’s also reluctant in that piece to accept that Patrick Harvie has a proper job title, and he thinks the objections to Farage are because UKIP want us to leave the EU. Not at all: that’s a perfectly respectable aim, even if Farage’s reasons for being anti-European are diametrically opposed to the issues that make me sometimes wonder how I’d vote on the EU. It’s his racism people primarily object to. But “free speech” is how Tom attacks the protest, as others on the right did.

There are many things wrong with that argument. Does Tom think the antifa shouldn’t turn out a counter-protest when the EDL are on the streets? Also, anyone who thinks Farage was “silenced” or doesn’t have freedom of speech clearly hasn’t seen a telly this year, and yes, he’s free to come here just as we’re free to protest his abhorrent views – but the final implication of Christina’s speech is probably the key reason I’m so proud of the people who disparaged him.

It’s this: you have to choose. If you make Nigel Farage welcome in Scotland, then Scotland will inevitably feel a less welcoming place to every refugee, every asylum seeker, every Polish or Romanian expat who’s chosen to live here, just as much of England already does. If a peaceful protest sends him packing with his tail between his legs, it tells all those people that we’re on their side, that we value their role in our communities and in our economy.

The women in glorious West African garb in the Garden Lobby last night who beamed in delight as Christina McKelvie told them they were going to be part of Scotland’s heritage one day: they will indeed be threads in Scotland’s tartan. And that simple fact means we can’t make room in the weave for UKIP’s colours.

Foolishness on e-cigs comes to Holyrood

Jun 19

Posted by James in Health, Holyrood | 3 Comments

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.

Denying prisoners the vote: who benefits?

Jun 10

Posted by James in Crime, Elections, Holyrood, Westminster | 2 Comments

Prison votingWhy would any politician want to deny prisoners the vote? Is it purely because they think it plays well with the less liberal parts of the media (i.e. almost all of it)? Or might there be a better reason? There are all sorts of rationales for the use of prison in the justice system. Are any of them consistent with denying prisoners the franchise as well as their liberty?

1. Public safety. This is the most important one for me. If someone has grievously breached society’s proper moral codes – by which I mean typically premeditated or serious offences against the person – I support using prison to protect society. Why, at the top end of those offences, should the innocent public be exposed to the risk of a repeat offence? I prefer the risk that someone who might actually never offend again still doesn’t get out. You hopefully know the sort of offences I mean here.

So does denying prisoners a vote protect the public? Hardly. What risk is there to the public of further crime from prisoners simply voting? Essentially it’s the same as the threat posed to a mixed-sex married couple by their same-sex neighbours getting married, i.e. none. What’s more, it’s hard to see how they could change anything substantial electorally. There are just over 8,000 prisoners in Scottish jails. A little over 100 per constituency. If they all voted they’d make up 0.4% of the Scottish electorate. A poll I can’t find suggested prisoners would be more likely to vote BNP than the rest of us – and it may not be surprising to turn it on its head and say that BNP voters are more likely to commit crimes – but that’s not a reason to prevent all prisoners voting.

2. Rehabilitation. This is an area where the theory and practice of imprisonment seem miles apart, but can barring prisoners from voting really help them turn their lives around, prepare them for life outside, and reduce reoffending? Actually, the evidence is quite the opposite. It doesn’t seem realistic to say allowing prisoners a vote would have a major impact, but it might have some.

3. Deterrence/retribution. Shall we agree that even the most hardened political hack wouldn’t be put off from committing a crime because of the loss of the franchise? It’s hardly an enormous punishment when you’ve already been deprived of your liberty.

4. Restitution. Nothing here either (cf community services, repayment of stolen money). No victim sees any practical benefit from an offender being denied a ballot.

The best the no-vote side are left with (at Holyrood this means the SNP, Labour and the Tories), as far as I can see, is a reference to some abstract moral principle – that prisoners must forgo any contribution to deciding society’s future, and that when they’ve “paid their debt” they can take part again, irrespective of the absence of any practical benefit to society. It’s precisely the kind of vague and unfalsifiable pseudo-moral hand-waving and hand-wringing certain sections of the media love.

So, conversely, why should we let them vote? First, the minor rehabilitation effects noted above. Many repeat offenders already feel alienated from society, disenfranchised in more ways than one. Do we really want to tell people, especially those who will be released, that society thinks their views are irrelevant? I’d like to believe that allowing prisoners to vote might encourage politicians to consider their views on prison conditions, but the small number of these potential voters (versus the influence of the populist press) makes that unlikely.

Above all, though, we’re meant to be a democracy. If we start going down this road we end up with the approach some American states take, whereby felons are barred from voting forever. We live in a discriminatory society, with a justice system more inclined to prosecute and imprison the poor or protesters than so-called “white collar criminals”, and preventing prisoners from having a say extends this discrimination further for no real benefit. Democracies let their citizens vote, not just the approved subset of the population. It shouldn’t take the European courts to make our governments honour this principle.