The grinning stupid authoritarian (GSA) phase

bl
…the founder

When privileged-arch-fascist-climate-denier James Delingpole called his 2009 book Welcome to Obamaland: I Have Seen Your Future and It Doesn’t Work , he was onto something.

The UK had unhappily become the template for the next ten years in the polities of the complacent and morally confused West. All thanks to Tony Blair, and I should add, with the benefits of hindsight and his recent return to prominence, the selfish idiocy of John Major. His determination to continue as a dud Tory PM for a couple of years – despite a thriving economy – gave us the horrors that began in 1997.

So, we got Blair, slowly ruining that economy, along with his hated rival Gordon Brown, and visiting quite astonishing amounts of carnage on various foreign countries in the process. He is sort of reviled now, though he obviously finds it hard to take. Brexit has given him the opportunity that he craves to start lecturing us all again***.

In any event, I would say that Britain had begun to recover from his peculiar brand of smoothness, his labelling of opponents as morally bad people, and his oafish certainty. Theresa May’s dismal reign is essentially a hiatus in that recovery, I hope.

That depressing period is becoming a distant memory of course, as we actually got rid of Blair a whole 11 years ago, and whatever his demerits, his successor Brown was not a grinning authoritarian, and nor was Dave, after 2010.

ob
….

Obama, a master of the amiable rictus, came in after a cunningly stage managed meteoric rise, in 2008, and exemplified the essential features of the GSA: a messianic view of his own powers and beliefs; the support of a mostly invertebrate and adulatory media; a hatred of  ‘old’ (and generally successful) norms in economics, morality, societal structure; a tendency to reward untalented cronies for fawning; an unthinking obsession with climate change; complacency about the electorate; a counterintuitive tendency to violence and the use of physical authority.

There are no doubt lots of other themes, but they’ll do for now.

The final common pathway of all this is the same – failure.

This failure though is one that only affects the public good, including the economy. The corollary of it is that the GSA will always end up personally enriched. That said, they rarely end up happy. This blog began in 2010 with exactly that observation.

Obama’s failures are many, although his extended media fan club hate to admit it. His irrefutable achievement was being the first African American president. The rest of it – not so much. Obamacare is tottering, he was the master of the multi-casualty drone strike, he destroyed his own party as for eight years it was all about him (another typical feature), the economy stagnated with absurd claims made to disguise failure, the church was targeted, terrorists were routinely appeased, and so on and on and on. Par for the course.

ma

Macron has turned into an ongoing car crash (even as I write) at a quite incredible speed****. Clearly more intelligent and widely educated than both Blair and Obama, he nevertheless has proven to be amazingly out of touch and stupid. His de haut en bas style is ruining both him and France. It’s as if he’s making their mistakes at triple speed, just to catch up. What is funny is that he clearly didn’t see it coming – he thought the template worked. The inherent lack of principle is deliciously emphasised by him folding on his daft fuel tax – either climate changes exists and the proposed actions matter or it doesn’t (spoiler – it doesn’t).

va
…the new boy

The newest GSA is Leo Varadkar. Poor Ireland, generally badly run by a host of chancers since de Valera threw in the towel, its unique identity has been slowly crushed and subsumed by the secular brutality of the EU superstate. Once it sold its soul by giving in to voting twice on the dreadful Lisbon Treaty, it became a perfect seed bed for a GSA – and Varadkar is an exemplar of the breed. Number one priority was sucking up to EU overlords** – there would be no  prospect of dissent. Number two was going to town on legalising abortion – a far more controversial topic to this day than was ever admitted – which inevitably was joined with lots of church bashing. Number three is kicking Theresa May about, which everyone finds easy these days. It plays to the time honoured anti-English gallery in the Republic, itself a form of ‘toxic nationalism’.

There is no happy ending here. These menaces always cause untold avoidable harm. They bask in the approval of  most of the media and the young, until everyone begins to realise that this maybe isn’t so great after all, by which point lives have been lost, economies ruined, society broken further.

At the moment though, we can always eventually throw the bastards out. Far better would be to spot them in advance and never vote them in, in the first place.

mac
*

 

**This terrific Brendan O’Neill piece on Varadkar’s poison came out a couple of days after this blog post. Essential reading

***and Dominic Lawson rips into Blair’s outrageous solipsistic posturing. He refuses to go away, naturally

****here’s Gavin Mortimer on Macron’s extremely rapid fall from grace

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The unwritten rulebook (part 1001)

I’m lifting this brief post from the very smart and witty Steven Hayward at the peerless Powerline, which apart from anything else, has five regular writers who are absolute role models for concise and pithy blog posting. Here is the essence of Steve’s piece, referring to the work of Michael Uhlmann, about whom I know very little. He is though, a master of the unwritten law:

Like Uhlmann’s law of legislative analysis:

If an Act of Congress has a long title—lock up the children and run for cover.

Or Uhlmann’s Razor:

When stupidity seems a sufficient explanation, there is no need for recourse to any more elaborate analysis.

Uhlmann’s Razor also has a corollary known as Uhlmann’s First Law of Historical Causation:

It seemed like a good idea at the time.

And my personal favorite:

When evaluating the soundness of any moral proposition, law, rule, or regulation, however popular, to ascertain its true meaning, read it aloud slowly in a German accent.

…to which Steve adds the rules of historian Robert Conquest:

  1. Everyone is conservative about what he knows best.
  2. Any organization not explicitly right-wing sooner or later becomes left-wing.
  3. The simplest way to explain the behavior of any bureaucratic organization is to assume that it is controlled by a cabal of its enemies.

Timeless advice from both parties, and universal (ie. also broadly applies to the UK)

skynews-brexit-brussels-theresa-may_4177037
Uhlmann’s Razor applies again

 

The paradoxes of #Brexit

Flammarion
A bold and confident Brexiteer…

Paradox is a beautiful tool of language, the master of which was GK Chesterton (1, 2, 3), but in our times Mark Steyn seems to be able to produce them effortlessly and very wittily.

At the heart of the Brexit mess lie a few of these gems, the first being the truth that strikes a cold, paralysing fear into the hearts of the hubristic masters of the EU project:

~ The EU and Remainers are not afraid that (No Deal) Brexit will fail,  they are afraid that it will succeed

~ In the UK the official opposition is not particularly opposed to Brexit (despite some noisy Blairites)

~ Democracy loving (allegedly) Remainers are recklessly trying to overturn the result of the biggest democratic exercise in British history

~In a class ridden society (allegedly), the upper and lower classes are united by being assaulted by an enraged middle class

~ The entire Despite Brexit movement is a living, pulsating mass of new paradoxes and baffled journalists every day. Here are just a few of the recent ones: 1 (from the FT, spiritual home of the Despite Brexit classes) 2 and 3. They’re not hard to find.

No doubt there are quite a few more of  these unexpected results of the Brexit vote, though more specifically, of the failure to accept its result.

Paradox  implies that humility is a good idea. That applies to both sides of the Brexit divide, but Remainers’ continued failure to predict the future suggests that they perhaps need that particular virtue more than most.

As it happens, given the sheer loathing (1, 2, 3, 4, 5, 6, 7) that Remainers have demonstrated for the rest of us – a fault also found in Brexiteers, but to nowhere near the same extent – another Chesterton paradox seems applicable….

It is a great mistake to suppose that love unites and unifies men. Love diversifies them, because love is directed towards individuality. The thing that really unites men and makes them like to each other is hatred.

The 7 ages (so far) of #Brexit

blaue_europe
…happy days
  1. 1st February 2016, the European Union Referendum Act 2015 becomes law. This is based on a Tory manifesto promise, and the referendum was supported by Labour in the debates. The question was to be
Should the United Kingdom remain a member of the European Union or leave the European Union?

with the responses to the question to be marked with a single (X):

Remain a member of the European Union
Leave the European Union

Which seems straightforward. I don’t see any mention of ‘a deal’

2. Dave announces the Brexit referendum. The announcement is on the 20th February  2016. The date of the poll will be 23rd June 2016. Dave says “I do not love  Brussels. I love Britain. I am the first to say there are many ways the EU needs to improve. The task of reforming Europe does not end with yesterday’s agreement. I will never say our country could not survive outside Europe … That is not the question. The question is will we be safer, stronger and better off working together in a reformed Europe or out on our own. You will decide and whatever your decision I will do my best to deliver it” . Well he forgot that last bit.

dpjhbrexit
…not one of Dan’s best

3. There is lots of campaigning. Both sides are working from the same premise. In or out. There is no substantive talk of deals, Hard and Soft Brexits etc. Both sides are spending money like water. There is no mention of Putin. There is lots of absurd Remainer scaremongering. Virtually all of the media are anti-Brexit, though honourable exceptions include a couple of Guardianistas like Larry Elliott, thoughtful    Europhiles like Ambrose Evans-Pritchard, and the Daily Express. The Sun came over eventually. Remainers are serenely confident usually (see right). Oddly, both sides pretty much concede that the EU is a corrupt, dysfunctional, expensive, authoritarian, bureaucratic behemoth (I’m not joking), but weirdly, Remainers still think it can be reformed.

4.      23rd June 2016 is the date of the referendum. There is a huge turnout. There is no suggestion that this is an electorate that hasn’t thought it through – the opposite is true. Remainers seem relaxed, as like Nigel Farage at 2200hr, they think they’ve won.

5.     The result: 52% leave v 48% Remain. It may sound close, but that is pretty clear cut as these things go. Remainers go absolutely ballistic with rage. That 52% is accurately described by Hero Of Our Times, Brendan O’Neill as the largest bloc of voters in the entire history of this nation.

6.     After more than two tedious years of Remainer and media whingeing about the thick  electorate, we wuz lied to, the thought that they might need to apply for a visa to go ski-ing etc etc, it becomes clear that there has been no substantial preparation by Remainer pols and civil servants for Brexit as both sides understood it pre-referendum (now dishonestly known as Hard, or No Deal Brexit). This was their primary task, not fannying around trying to strike a feeble compromise deal with arrogant Eurocrats who clearly hate them.

To reiterate, there was a necessary role in negotiating over specific (and relatively limited) financial and moral obligations, as well as unique issues such as the status of EU citizens already in the UK. Even popular issues such as visa free travel could wait, as along with many other issues, there is mutual benefit in producing reciprocal arrangements, which would (and will) inevitably come to pass. There was never any sense – until Remain lost – that a complex overarching deal was even an issue.

The pathetic whining by the SNP is a self-centred sideshow – Brexit is irrelevant to Scottish independence, although it highlights their astonishing hypocrisy, mysteriously preferring the EU yoke to that of the evil English. Likewise the utterly cynical invention of an ‘Irish border problem’, intentionally reviving memories of terrorism to serve the twisted cause, could be ‘solved’ at the stroke of a pen. Ask an Irishman.

7.    November 15th 2018: Desperate Theresa May produces a ‘deal’/capitulation that is so comprehensively bad, undemocratic, dishonest and stupid that it unites sworn enemies, and makes Eurothug Michel Barnier smile, albeit temporarily.

The ‘deal’ is well described by many, notably here, by the calm and well informed Pete North, and by Steerpike in The Spectator. I have pinched this from behind their paywall, as it is so important. If anything they go soft on the betrayal element. Apologies for the length, and you can read No 10’s slippery rebuttal here. They must have been stressed:

This week, Theresa May’s government teetered on the point of collapse over her proposed Brexit deal. The withdrawal agreement between the UK and Brussels led to Dominic Raab and Esther McVey resigning in protest. However, May’s remaining ministers have since attempted to rally around her at least in the short term. Speaking on Friday, Liam Fox – the International Trade Secretary – gave a speech in which he declared ‘a deal is better than no deal’. This is rather different to May’s old claim that ‘no deal is better than a bad deal’.

So, is Fox right? Mr S thought it best to let readers decide for themselves. In theory, Britain is leaving the EU on 29 March 2019. But the legal small print, published by Brussels, shows what this means. Parliament will be asked to ratify a deal which clearly admits that ‘all references to ‘Member States’ and competent authorities of Member States…shall be read as including the United Kingdom.’ (Article 7). So the UK will be bound by EU laws, at least during a transition period. But this ‘transition period’ can be be made to last forever (Article 132).  And even if a successor deal is agreed, the UK will have signed away other rights for years to come.

Just in case readers don’t have the time to go through the lengthy document themselves, Steerpike has compiled a list of the top 40 horrors lurking in the small print of Theresa May’s Brexit deal.

In summary: The supposed ‘transition period’ could last indefinitely or, more specifically, to an undefined date sometime this century (“up to 31 December 20XX”, Art. 132). So while this Agreement covers what the government is calling Brexit, what we in fact get is: ‘transition’ + extension indefinitely (by however many years we are willing to pay for) + all of those extra years from the ‘plus 8 years’ articles.

Should it end within two years, as May hopes, the UK will still be signed up to clauses keeping us under certain rules (like VAT and ECJ supervision) for a further eight years. Some clauses have, quite literally, a “lifetime” duration (Art.39). If the UK defaults on transition, we go in to the backstop with the Customs Union and, realistically, the single market. We can only leave the transition positively with a deal. But we sign away the money. So the EU has no need to give us a deal, and certainly no incentive to make the one they offered ‘better’ than the backstop. The European Court of Justice remains sovereign, as repeatedly stipulated. Perhaps most damagingly of all, we agree to sign away the rights we would have, under international law, to unilaterally walk away. Again, what follows relates (in most part) for the “transition” period. But the language is consistent with the E.U. imagining that this will be the final deal.

The top 40 horrors:

  1. From the offset, we should note that this is an EU text, not a UK or international text. This has one source. The Brexit agreement is written in Brussels.
  2. May says her deal means the UK leaves the EU next March. The Withdrawal Agreement makes a mockery of this. “All references to Member States and competent authorities of Member States…shall be read as including the United Kingdom.” (Art 6). Not quite what most people understand by Brexit. It goes on to spell out that the UK will be in the EU but without any MEPs, a commissioner or ECJ judges. We are effectively a Member State, but we are excused – or, more accurately, excluded – from attending summits. (Article 7)
  3. The European Court of Justice is decreed to be our highest court, governing the entire Agreement – Art. 4. stipulates that both citizens and resident companies can use it. Art 4.2 orders our courts to recognise this. “If the European Commission considers that the United Kingdom has failed to fulfil an obligation under the Treaties or under Part Four of this Agreement before the end of the transition period, the European Commission may, within 4 years after the end of the transition period, bring the matter before the Court of Justice of the European Union”. (Art. 87)
  4. The jurisdiction of the ECJ will last until eight years after the end of the transition period. (Article 158).
  5. The UK will still be bound by any future changes to EU law in which it will have no say, not to mention having to comply with current law. (Article 6(2))
  6. Any disputes under the Agreement will be decided by EU law only – one of the most dangerous provisions. (Article 168). This cuts the UK off from International Law, something we’d never do with any foreign body. Arbitration will be governed by the existing procedural rules of the EU law – this is not arbitration as we would commonly understand it (i.e. between two independent parties). (Article 174)
  7. “UNDERLINING that this Agreement is founded on an overall balance of benefits, rights and obligations for the Union and the United Kingdom” No, it should be based upon the binding legal obligations upon the EU contained within Article 50. It is wrong to suggest otherwise.
  8. The tampon tax clause: We obey EU laws on VAT, with no chance of losing the tampon tax even if we agree a better deal in December 2020 because we hereby agree to obey other EU VAT rules for **five years** after the transition period. Current EU rules prohibit 0-rated VAT on products (like tampons) that did not have such exemptions before the country joined the EU.
  9. Several problems with the EU’s definitions: “Union law” is too widely defined and “United Kingdom national” is defined by the Lisbon Treaty: we should given away our right to define our citizens. The “goods” and the term “services” we are promised the deal are not defined – or, rather, will be defined however the EU wishes them to be. Thus far, this a non-defined term so far. This agreement fails to define it.
  10. The Mandelson Pension Clause: The UK must promise never to tax former EU officials based here – such as Peter Mandelson or Neil Kinnock – on their E.U. pensions, or tax any current Brussels bureaucrats on their salaries. The EU and its employees are to be immune to our tax laws. (Article 104)
  11. Furthermore, the UK agrees not to prosecute EU employees who are, or who might be deemed in future, criminals (Art.101)
  12. The GDPR clause. The General Data Protection Regulation – the EU’s stupidest law ever? – is to be bound into UK law (Articles 71 to 73). There had been an expectation in some quarters that the UK could get out of it.
  13. The UK establishes a ‘Joint Committee’ with EU representatives to guarantee ‘the implementation and application of this Agreement’. This does not sound like a withdrawal agreement – if it was, why would it need to be subject to continued monitoring? (Article 164). This Joint Committee will have subcommittees with jurisdiction over: (a) citizens’ rights; (b) “other separation provisions”; (c) Ireland/Northern Ireland; (d) Sovereign Base Areas in Cyprus; (e) Gibraltar; and (f) financial provisions. (Article 165)
  14. The Lifetime clause: the agreement will last as long as the country’s youngest baby lives. “the persons covered by this Part shall enjoy the rights provided for in the relevant Titles of this Part for their lifetime”. (Article 39).
  15. The UK is shut out of all EU networks and databases for security – yet no such provision exists to shut the EU out of ours. (Article 8)
  16. The UK will tied to EU foreign policy, “bound by the obligations stemming from the international agreements concluded by the Union” but unable to influence such decisions. (Article 124)
  17. All EU citizens must be given permanent right of residence after five years – but what counts as residence? This will be decided by the EU, rather than UK rules. (Articles 15-16)
  18. Britain is granted the power to send a civil servant to Brussels to watch them pass stupid laws which will hurt our economy. (Article 34)
  19. The UK agrees to spend taxpayers’ money telling everyone how wonderful the agreement is. (Article 37)
  20. Art 40 defines Goods. It seems to includes Services and Agriculture. We may come to discover that actually ‘goods’ means everything.
  21. Articles 40-49 practically mandate the UK’s ongoing membership of the Customs Union in all but name.
  22. The UK will be charged to receive the data/information we need in order to comply with EU law. (Article 50)
  23. The EU will continue to set rules for UK intellectual property law (Article 54 to 61)
  24. The UK will effectively be bound by a non-disclosure agreement swearing us to secrecy regarding any EU developments we have paid to be part. This is not mutual. The EU is not bound by such measures. (Article 74)
  25. The UK is bound by EU rules on procurement rules – which effectively forbids us from seeking better deals elsewhere. (Articles 75 to 78)
  26. We give up all rights to any data the EU made with our money (Art. 103)
  27. The EU decide capital projects (too broadly defined) the UK is liable for. (Art. 144)
  28. The UK is bound by EU state aid laws until future agreement – even in the event of an agreement, this must wait four years to be valid. (Article 93)
  29. Similar advantages and immunities are extended to all former MEPs and to former EU official more generally. (Articles 106-116)
  30. The UK is forbidden from revealing anything the EU told us or tells us about the finer points of deal and its operation. (Article 105).
  31. Any powers the UK parliament might have had to mitigate EU law are officially removed. (Article 128)
  32. The UK shall be liable for any “outstanding commitments” after 2022 (Article 142(2) expressly mentions pensions, which gives us an idea as to who probably negotiated this). The amount owed will be calculated by the EU. (Articles 140-142)
  33. The UK will be liable for future EU lending. As anyone familiar with the EU’s financials knows, this is not good. (Article143)
  34. The UK will remain liable for capital projects approved by the European Investment Bank. (Article 150).
  35. The UK will remain a ‘party’ (i.e. cough up money) for the European Development Fund. (Articles 152-154)
  36. And the EU continues to calculate how much money the UK should pay it. So thank goodness Brussels does not have any accountancy issues.
  37. The UK will remain bound (i.e coughing up money) to the European Union Emergency Trust Fund – which deals with irregular migration (i.e. refugees) and displaced persons heading to Europe. (Article 155)
  38. The agreement will be policed by ‘the Authority’ – a new UK-based body with ‘powers equivalent to those of the European Commission’. (Article 159)
  39. The EU admits, in Art. 184, that it is in breach of  Article 50 of the Lisbon Treaty which oblige it to “conclude an agreement” of the terms of UK leaving the EU. We must now, it seems, “negotiate expeditiously the agreements governing their future relationship.” And if the EU does not? We settle down to this Agreement.
  40. And, of course, the UK will agree to pay £40bn to receive all of these ‘privileges’. (Article 138)

Watch this space. The deal is doomed. No Deal Brexit, AKA Brexit, is around the corner.

The #Brexit iceberg

It’s getting closer. And the panic levels are rising. Predictably Russia, bogeyman du jour, is getting credit, because all Brexiteers are subliminally (or otherwise) influenced by evil Kremlin masterminds. Whatever.

This is what passes as ‘clever’, in the Remainer echo chamber:

hatweet
*

It’s worth reading a few of the replies to see how easily this ignorant nonsense is debunked, and how switched on Brexiteers are to the rules of the game in a democracy, along with a few honest Remainers.

Then one gets Jo Johnson’s pompous and hypocritical resignation statement, gleefully ripped by Guido. What is it with these people?

It says something that a person as ordinarily lacking in insight as Diane Abbott gets it better than these hysterical twerps:

“I will say this about the second Referendum. You should be careful what you wish for. If we had a second referendum now the same people who voted leave last time, who are not largely speaking in London, would vote leave again saying: ‘Didn’t you hear us the first time?’”

Even if her motives arise from the mad-Leftie end of the Brexit spectrum, she has a point. One which Remainers are enthusiastically ignoring, in their solipsistic misery.

I was idly watching a rerun of James Cameron’s Titanic the other day, when the metaphor became obvious. The ship is the EU, Brexit the iceberg. And boy do those Remainers cling on to the bitter end.

Get off the boat while you can.

The SNP: decline and fall (17)

I haven’t bothered to write on this since January. Not because there hasn’t been stuff, but it’s getting tedious just documenting new episodes in the already massive catalogue of Nat failure. There’s no shortage really, Eck still hoovering up the roubles on Russia Today, despite recent events, Humza’s general hopelessness, the mysteriously poorly photographed Zoomer march on Glasgow with outrageously exaggerated attendance (which the SNP decided not to attend, wonder why?), the pathetic writhing about how Scots love the EU (they don’t). The list goes on. In fact the SNP obsession with banning things that most voters like is producing negative feedback, amusingly.

Instead I draw the attention of anyone who is interested to a nuanced piece by former SNP insider, Alex Bell, who in recent times has painstakingly deconstructed the whole SNP edifice of winging it and make believe.

Here he is on Miss Sturgeon’s situation:

She has led the devolved administration into a showdown with Westminster. Holyrood says No to the post-Brexit divvy up of powers, Downing Street says Yes. All that matters now is what the Supreme Court says, and what Westminster concludes when the deal is put to the Commons.

We can be pretty sure the court will rule this is a matter for the sovereign government – Westminster – and so force the deal on Holyrood. It is impossible at this stage to say what Westminster will do, given so much is still unknown, and what is known is so confused.

Yet the SNP’s grip is slipping. Not least because Sturgeon is staking her reputation in a fight over devolution, which isn’t even her party’s policy.

The Tory government wants Westminster to hold power over matters such as agriculture and food standards because British nationalists think they’ll need to cut deals in these areas in order to strike new trade partnerships across the world when out of the EU.

Sturgeon and Holyrood, except for the Tory MSPs, want powers returning from the EU to go straight to Edinburgh.  So we are not getting a constitutional crisis over independence and not because Scotland rejected Brexit.

Instead it’s a crisis over devolution. This is, then, not her fight. If she wins, all she has done is secure the devolution settlement. If she loses, she looks too weak to fight her big cause, independence.

All of which sounds terribly dull and fairly inconsequential, but it’s really a reflection on how the Nats’ general policy is to pick fights, lose them, and pick some more. There is no vision being built. Poor Andrew Wilson, a nice, normal person, was tasked a long time ago with producing a coherent long term economic strategy for independence, to replace Eck’s failed oil bunkum. It’s yet to appear.

Alex goes on:

Yet the last thing the indy cause needs is another referendum any time soon. Asking the same question and expecting a different answer is the pop definition of stupid. In the years since the last vote, not a single bone has been added to the skeletal case of 2014. Yet Sturgeon is in the odd position of having weaponised her own supporters.

Doh.

It’s a great piece, and has a painful, if truthful punchline for the current First Minister….She’s in a bad place, and it won’t end well.

stursalm
M&S need some new models

1001 things wrong with the #NHS (998): Committees

Print
Pretty simple, and universally applicable

The Knife has done lots of formal hospital management, though on the principle of ‘quit while you’re ahead’, I voluntarily stepped down quite a while ago. I don’t hate it, usually, but I prefer clinical work by far, and if I leave this earth having done any good, it’ll be in the latter sphere, by a long way. If you step too far away from the clinical stuff, you start to act and think differently, ego takes over and your peer credibility dies.

That’s guaranteed.

That said, it’s an interesting milieu, not least because of the subterfuge, inconsistency and indecision that abounds, usually combined with declarations of ‘caring’. The much hated private sector – which happens to constitute most of the healthcare in the developed world – would never tolerate the crap that goes on. (For the record, I do no private work.)

And today, as it happens, was one of the most gruesome** management meetings that I’ve ever attended – I won’t bore anyone with the details, but it was actually depressing. It was an absurdly large group attempting to share a process that neither needed it, nor was amenable to it.

Where to go for solace, some reassurance that my negative feelings are in fact appropriate?

Well…….

committee1

….the author is talking about restructuring the playing season for American football. The key quote is “committees are what insecure people create in order to put off making hard decisions”. It’s nice to be inclusive, if possible, but it’s no surprise that the phrase ‘design by committee’*** is never used in  complimentary way.

Even worse than that is that such large unwieldy groupings always contain people with nothing to lose, no axe to grind, and indeed no expertise worth having. As any endocrinologist will tell you, a negative feedback loop is an essential regulatory part of a well functioning system. You need people with what Black Swan author and polymath, Nassim Nicholas Taleb calls ‘skin in the game’ (1, 2). I don’t want my clinical practice parameters decided by a committee of people without skin in the game. Nor would they, if it was their area, and nor would my patients want it.

What’s the answer to this?

Well, here is the same author. I agree wholeheartedly with it, not least that it’s coming on the back of a riff about the uselessness of management consultants (who should be barred from the NHS)…

committee2

…for money, read clinical practice.

You can guess the author, I would imagine

 

**if you want to know how gruesome the NHS can be, this vivid account (spoiler: bad language), gives a fair appraisal of a bad spell. I did not write it!

 

***As advertising pioneer and author of Confessions of An Advertising Man, David Ogilvy said: ‘Search your parks in all your cities. You’ll find no statues of committees.’

The damned statistical lies of the NHS (hip replacement edition)

A quick observation. The ‘top nurse’ in NHS England, Jane Cummings, is quoted in today’s Times as follows:

A million more cataract operations or 250,000 hip replacements could be funded if the NHS did not have to pay for appointments that people failed to attend

Of course this is only the latest in many claims about the NHS which appear shocking, eye catching and as one might expect, either unprovable or simply untrue.

A few facts, assuming that Ms Cummings is primarily referring to missed outpatient appointments. Depending on your specialty, very few operative patients fail to attend:

a. Patients who fail to attend are very often patients who shouldn’t even have had an appointment. Many have got better. Many were given appointments ‘just to check’. There is lots of evidence that the clinical yield from an arbitrarily timed clinic appointment is minimal. Who is benefiting here? Do not assume that these appointments were necessary. The fault may lie with the hospital.
b. It depends if your outpatient clinic template already factors in DNA (Did Not Attend) patients. Mine used to. If your clinic is very busy then these absent patients are actually a great relief. If there is a factored in DNA factor and they all do attend, then it creates a real problem. In other words, it’s not always an administrative disaster, just as it’s not always (or ever) a clinical disaster – see point a.
c.  The claim that these DNA’s mysteriously add up to a quarter of a million hip replacements is a classic piece of pseudo-statistical rubbish. It probably emanates from an NHS head office algorithm built on crazy assumptions, or on the specious views of overrated NHS parasites like the oft-quoted ‘charity’ The Kings Fund. The Times article states:
At an average cost of £120 per slot, this indicates that doctors’ time worth about £950 million was wasted last year.

In the real world, in the unlikely event that your clinic finishes early, then you probably do one of the following valuable things: speak to colleagues (including non-medical ones), have lunch, conduct a ward round, review investigations, write to GP’s, make necessary phone calls, answer emails, complete training dashboards online, speak to management and much much more. All necessary parts of the job. What this unexpected ‘spare’ time does not, and cannot equate to is knocking off a quick hip replacement.

Oddly enough it might, if in a parallel universe the NHS had spent a bit more of its already colossal budget on meaningful infrastructure, like operating theatres. There is no shortage of patients who can come in at short notice, and NHS admin staff are now often superbly responsive at  getting hold of patients in a hurry. That is the sort of NHS of which Nye Bevan and William Beveridge would approve. The NHS desperately needs to factor in some free space in both its physical and administrative infrastructures, if it wants that kind of flexibility. I think it should.

Ms Cummings is describing a made up situation that is misleading at best. It appears to be part of a national drive. Some Scottish health boards, for example, are claiming that these DNA’s cost an unlikely £4 million a year, based on back of an envelope calculations.

If, however, you want to save millions of actual cash payouts for work not done, generally speaking, try rescinding the increasingly absurd and profligate New Deal contract.

There’s a suggestion for 2018.

surgery day
….it’s actually a bit more complex than this

The SNP: decline and fall (16)

As 2017 ends, this long running saga is drawing to a close. It’s been 3 months since the last episode, and in truth, not much has happened. Not much in Scotland, that is, although events elsewhere have conspired to put a further dampener on the whole SNP raison d’etre (unless you cynically believe that such a thing is in fact the mere fact of clinging to power and the associated trappings, with independence merely a Scottish avatar). So….

51. Ozymandias Salmond

Although Shelley’s paean to fallen grandeur and the passage of time had a certain romantic majesty, it’s difficult to claim as much for the fate of Alex Salmond. Not only does he seem to think that a gruesome chat show on the amusingly barefaced bias of Russia Today is some sort of positive career move, he’s in trouble for blatantly lying in his opening episode, so short was he of ‘material’.  In keeping with no. 49 in this series, there’s a bit of unhappiness between Eck and Ms Sturgeon on this one, which is strange given they’re one big happy family. Talking of which, the ubiquitous Tas has been both getting exposed to Eck’s undoubted sartorial flair (see pic), and being punted (by Eck) as a fashion guru herself to deal with the…um…shortcomings of middle class legend SNP MP Mhairi Black. To quote Ms Black:

He then said that the last time he’d had this conversation it was with a young woman called Nicola Sturgeon.

“I thought, ‘oh, very good’ and I just left the awkward silence hanging when he asked me if I wanted him to arrange it with Taz. I’m like, ‘I am never going to be told how to dress, especially by a man.’

Still, the good news is that Eck’s flagging TV career may only last as long as his overpaid yet now apparently defunct journalistic one.

Look on my works, ye Mighty, and despair!

Alex-Salmond RT kilt
“Is anything worn under the kilt, Alex?” (I’ll stop there)

 

52. Catalonia is still part of Spain

No need to reprise the whole Catalonia secession thing. Suffice to say that despite the ignorant and rather pathetic urgings of various SNP lackeys, neither the glorified opinion poll of  October 2017, nor the actual national elections of last month, lead to anything like independence, nor is there any hard evidence that it would be popular.

In fact the Spanish have lead the way on this by issuing various arrest warrants, such that the floppy haired Salmond manqué (and talk show guest) Puigdemont, ran away from the heat and is now in exile.

Oh, and the SNP’s beloved EU backed Spain to the hilt on this. As any sane observer would expect them to.

53. Tax the ‘rich’

The SNP, having avoided using their tax raising powers for a long time (with good reason), have now caved in, and courtesy of the ‘limited’ Delboy Mackay, their Finance Minister, have decided to punish the middle classes.

It may please the zoomer base, but as a general observation, these things never end well. Interestingly, it coincides with Trump’s bold application of Laffer Curve principles in the USA. We’ll see how that works out as the year unfolds.

54. Reflections on the Revolution in Scotland

(misquoting Edmund Burke).

The Knife has continued to be impressed by the resemblance (1, 2) of the intolerant zealots of the SNP to their French predecessors, the Jacobins of the French Revolution. In keeping with their bizarre attempts to take over the rearing of the nation’s children, and to impose a monoculture on debate within their masses, I was struck by the similar mood music of the Law of Suspects, which the National Convention of 1793 passed in France:

“1. Immediately after the publication of the present decree, all suspects within the territory of the Republic and still at large, shall be placed in custody.

2. The following are deemed suspects:

i. those who, by their conduct, associations, comments, or writings have shown themselves partisans of tyranny or federalism and enemies of liberty;

ii. those who are unable to justify, in the manner prescribed by the decree of March 21st, their means of existence and the performance of their civic duties;

iii. those to whom certificates of patriotism have been refused

…and there’s more. I’m not saying it’s going to happen, although a stroll round SNP Twitter might persuade you otherwise, it’s just that there’s a certain doctrinaire flavour that keeps cropping up…

eck2
…wishing the voting age was even lower

 

To close, over to a better and more measured writer than me, Euan McColm, with his New Year observations:

Nationalists now growing impatient with the First Minister over her hesitancy will, I think, be further disappointed in the year ahead.

Sturgeon is understandably keen to maintain the myth that she is in control of when another referendum takes place but the power to make this decision lies with Westminster and, after the general election showed a majority of votes for unionist parties, the UK government would have no hesitation in rejecting the First Minister’s proposal. This, I suppose, might play into the SNP narrative about a Scotland forced to bend the knee by the Westminsters (which is what we must now call the English) but no matter the grievance dividend, it will not get Sturgeon the referendum she says she wants.

The challenge for the First Minister in the months ahead is to keep her hardcore supporters happy with just enough constitutional meat while winning back the trust of unionist Scots who were previously happy to back the SNP in Holyrood elections but who are now weary of and frustrated by the nationalists’ obsession with another referendum.

Quite.

 

 

The new semantics of the public square

From Sky News, who are slowly drifting into sloppy PC reporting, on the tragic murder by stabbing in an Aldi store, the details of which remain obscure:

North Yorkshire Police said it was neither terror-related nor a hate crime.

Terrorism I get (see below), but is ‘hate crime’ a thing in the public mind these days to be placed on a par with terrorism when considering each violent death? If so, it has a pretty warped definition. Murder is a crime, and it seems inevitable that hatred was involved in some way. Yet this wasn’t ‘hate crime’. What a relief.

On the other topic, it’s hard to beat the weaselly syntax of the Australian police, no doubt under a certain amount of pressure:

Acting Chief Commissioner Shane Patton said police had found no evidence Noori planned his horrific actions or that they were terror-related.

Which as the numerous news reports (1, 2. 3) indicate, is not really true.  There are lots of ethical and practical problems with this intentional deception, not least is that it’s an appalling slur on people with mental health problems to clearly suggest that this kind of rampage is the sort of thing we can expect from them.

Frederick William, The Great Elector of Brandenburg-Prussia who dealt with the devastating aftermath of the Thirty Years War,  wrote eloquently about this in his Political Testament, exactly 350 years ago – some things never change:

“One thing is sure. If you stand still and think that the fire is still far from your borders, then your lands will become the stage upon which the tragedy is performed”

Non-politicians will draw their own conclusions.

melb
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