The great NHS game of whack-a-mole...

Yesterday was a somewhat astounding day. I'd been interviewed by the Sutton Guardian as part of a campaign I am involved in to keep the services of St Helier Hospital, a hospital which has been serving my community since 1938. A local Liberal Democrat MP, Tom Brake, blocked the Twitter account, @Save_St_Helier, which I manage as part of the campaign. Apparently, this strategy seemed like a more reasonable course of action for Brake in lieu of answering our questions about his online petition and his voting record in the House of Commons.

The media loves a good Twitter spat these days and the Sutton Guardian ran an article with a rather unfortunate headline - a throwaway line I'd uttered in which I likened Brake's behaviour to that of a schoolgirl became the lead. Cue an angry mob who clearly wanted to burn me as a sexist witch. Sigh... Thankfully, there are enough sensible people out there who joined in the comments at the end of the article and were able to steer the discussion back to real issues about Brake's lack of accountability.

I spent a lot of yesterday regretting that I'd put my mouth into gear before engaging my brain but I certainly do not regret calling out Tom Brake on his avoidance of perfectly reasonable questions. And, frankly, if me likening him to a schoolgirl is enough to get open, uncensored conversations happening about the questions he refuses to answer properly and publicly then so be it.

Brake has been running his online save-the-hospital petition for such a long time now that it is addressed to a group that now has a new name but he hasn't updated it. Brake has not answered our questions about exactly who will receive the petition, when this might happen, where it might happen or what he does with the data of people who have signed in good faith.

Likewise, he has not explained why he believes voting for the Health and Social Care Act 2012 or Clause 119, both of which have led to St Helier Hospital's services being under threat as part of the top-down reorganisation of the NHS which represents yet another broken election promise by David Cameron.

If you truly believe that a Conservative-led coalition is a win for smaller government and less bureaucracy, you are deluded - the NHS is now more bureaucratic than ever and, as a result, my tireless but tired band of campaigners in South West London are fighting to make people aware of Clinical Commissioning Groups (CCGs), because they hold the aces here when it comes to closing or downgrading services such as A&E, maternity, renal and children's intensive care.

It is really damn hard to make people concerned about CCGs and the powers they have.

And trying to get straight answers out of CCGs, not to mention hospital trusts, about our services and how they are spending/wasting our money is frequently akin to getting blood from a stone. And then there is the challenge of trying to distill the information they put out into plain English so we can raise awareness as to what is going on.

Then there is the narrative of austerity - that the only way we can afford the NHS is to make cuts - and, in the meantime, hospitals are being run into the ground. Your local hospital may not be cleaned as often or as thoroughly as it was before because cleaning contracts have been outsourced to companies that are more concerned with making a profit than preventing MRSA outbreaks. You may not be served by nurses who work full-time at your local hospital because they may have been supplied by agencies. And, even when staff are working hard and trying their best, they may be overstretched.

And then people complain. They don't necessarily complain via the official channels because these days many people would much rather just whine on social media instead. And in the meantime, it creates a public appetite for closing hospitals. Or merely apathy. And apathy is all that is required for essential services to be slashed without resistance.

You might not notice at first. But the system is being chipped away. The easiest way to do this - and for government to wash their hands of accountability - is to outsource services to the private sector. This has led to the awful G4S - the company whose attempt to run security at the 2012 Olympics was embarrassing and led to thousands of British Army soldiers being drafted - nabbing millions of pounds worth of NHS contracts. After the G4S Olympics debacle, I have no idea why this company would be trusted to run a pub raffle, let alone anything as important as healthcare services. Indeed, G4S is running the non-emergency ambulance service at St Helier Hospital and this has already led to an unnecessary death.

And private companies are exempt from Freedom of Information requests, so this adds another brick wall for anyone trying to find out how our money is being spent.

The CCGs in my end of London used the services 20/20 Delivery, a consultancy firm, when they were involved in the wasteful Better Service, Better Value (BSBV) review of local healthcare provision. BSBV cost taxpayers at least £8m and more than £1m went to 20/20 Delivery but when I tried to find out exactly what 20/20 Delivery did that cost so much public money, I could not get any answers.

Congratulations if you've read this far. Are you wondering why I am telling you all this if you don't live anywhere near St Helier Hospital? It is because the same story of CCGs proposing cuts and downgrades is probably happening near you too.

I have been in touch with other campaigning groups across the country and the same stories keep cropping up - unaccountable CCGs, childish Twitter blocking, very real threats to cut A&E and maternity services, cuts that will result in people spending longer in ambulances, cuts that will result in women in labour having to travel further to give birth, services being outsourced to substandard private companies, private companies that make political donations winning contracts, private companies in which either politicians or CCG members have vested interests winning contracts...

Across the country, campaigners are dealing with the same convoluted mountain of nonsense - it is deliberately convoluted because the powers-that-be do not want people to be aware of what is happening. It can be hard to know where to direct your wrath when the Health Secretary is a remote figure in Whitehall, unless the failed marmalade entrepreneur decides to activate Clause 119 and close your local hospital within 40 days.

It is a giant game of whack-a-mole and it is being played with our health services.

Then there is the big distraction of health tourism outrage. It makes for lovely Daily Mail headlines even though it only costs 0.06% of the total NHS budget. Sure, there is a case for ensuring people who are not entitled to NHS care pay for it but some perspective is needed.

And as long as the health tourism drum is beaten on front pages as if there is a queue of illegal immigrants demanding free breast implants at every hospital, that takes the focus off the real financial drain on the NHS - PFI contracts. These Private Finance Initiative contracts were introduced under John Major, their inking went nuclear under Tony Blair and Gordon Brown and the current government is in no rush to stop them being signed. These result in the public footing the bill for one hospital for the price of many, over and over again, across the country. This, in turn, renders PFI hospitals too big to fail and other nearby hospitals end up facing cuts.  A full public inquiry into these rotten contracts is the only way forward here. Do we dare to dream of this appearing in the manifesto of any of the major parties?

But I suspect the powers-that-be know that it is hard to maintain the energy for campaigners to fight for their local services while maintaining the rage about the bigger, wider issues, such as expensive PFI contracts. The little battle going on in my backyard is one of many across the country and those who are still raging that I likened Tom Brake to a schoolgirl need to get a grip. There are bigger fish to fry and if Tom Brake's apologists cannot see that he is trying to stop the fish even making it to the pan in the first place, we are going to lose vital services.






Photography by George Hodan

The BoJo juggernaut rolls on...

Last week's news from the No Shit, Sherlock files concerned Boris Johnson announcing that he plans to run for election as an MP next year. Previously, Boris said had the best job in the world as Mayor of London. Previously, Boris said he had no intention to run as an MP in the 2015 elections. Previously, in his past life as an MP, he was an inconsequential Shadow Minister for the Arts before being sacked from the front bench after lying about an affair with Petronella Wyatt.

Personally, I don't care who Boris sleeps with. None of my damn business. But if Boris intends to complete his term as Mayor of London and be an MP at the same time (presuming he is a shoo-in for a safe Tory seat), it is my business. And it is the business of everyone who lives in London as well as the people who live in his future constituency which, at the time of writing, could be Uxbridge.

Quite simply, he cannot do both jobs properly. He is not doing the job of Mayor of London properly.

If the people of Uxbridge elect him as their MP and only then realise he is a self-serving career politician, they only have themselves to blame. If people in Uxbridge discover this time next year that they cannot get an appointment with him to discuss local issues, why the hell would they be at all surprised? Just as Labour parachutes candidates from elsewhere into safe seats in the north of England, it is equally lazy politics (and lazy voting...) for the Conservatives to drop Boris into Uxbridge or similar.

He is, according to David Cameron, a "star player" and, as such, Boris Johnson MP will no doubt be expecting a cabinet position if the Conservatives win next year. And that should worry everyone in Britain.

Boris's track record as Mayor of London has been awful - he has presided over increased tube and bus fares, the wasteful Emirates Airline cable car that provides public transport for a handful of people on any given day and involved a seriously dodgy contract that should have been anathema to anyone who supports either free trade or free speech (but it's OK because he apparently didn't know about the finer details of the contract when it was signed), increased homelessness (but it's OK because he thought the anti-homeless person spikes were stupid...), stupid buses that are a fare evader's delight, a failed plan to glue pollution to the roads, the imposition of the Congestion Charge on hybrid cars, the exemption of affluent parts of London from the Congestion Charge, a mindless crusade against all diesel-powered cars that ignores the latest cleaner diesel technology from leading automakers such as BMW and Volkswagen, and the purchase of a secondhand water cannon that Theresa May has not yet let him use...

Still, we really must forget about all that waffle and piffle, as Boris might say when he is being oh-so-hilarious (in the same way that a booming yeast infection is hilarious...).  He does like to trumpet London's continuing economic success as something he has done and of which he is very proud indeed.

Except that London is too big to fail. It will always be here, attracting higher average salaries, higher house prices than the rest of the country, ambitious people, creativity and innovation - and people desperate for a break or even a basic wage. The capital is a giant economic force and not even Boris can bugger that up entirely.

And that is, in a nutshell, why the rest of Britain should fear Boris in the House of Commons. If he is elected and the Conservatives win the next election and Boris ends up, inevitably, in the cabinet, he will not do a damn thing to try and rectify one of the biggest social and economic challenges facing Britain - the obsession with London at the expense of regional development and job creation beyond the M25.

But regional development isn't sexy. The next election will not be won or lost on some random regional development policy from any of the major parties. And, for Boris, the concerns of the people of Uxbridge probably won't be sexy either. If they vote for him and the result is yet another clown in the house, they'll get the MP they deserve - but the rest of the country will have to put up with his ridiculousness too.

On the upside, it might stop people who don't live in London from saying they love Boris because he is "good comedy value", but that's not much consolation for the possible consequences of terminally gullible and lazy giving this wasteful man yet another ill-deserved opportunity.


Photography: Steve Linster 

One state? Two states? ISIS? IS? What's going on in Syria? It's never simple in the Middle East...

Another day, another broken ceasefire, another attempt to get Israeli and Palestinian leaders around the table, another round of futile arguments on social media... And so it goes on and on. It all reminds me of a Facebook argument that broke out on my Facebook page in about 2008 about Israel and Palestine which led to me defriending someone after he started out arguing eloquently for Israel but ended up throwing an ugly racist insult at another friend. Six years on, the same arguments are cropping up on social media and it seems just as pointlessly circular this time around.

But what is interesting is that I have observed with the 2014 round of social media debates is that many people from across the political spectrum are advocating a one-state solution rather than the well-worn "we support a two-state solution" rhetoric that politicians, safely away from the threat of either Israeli or Hamas rockets, like to trot out in a weedy attempt to look fair and balanced.

The obvious problem with a two-state solution is that no matter how borders are drawn, yet again, there will be angry, unhappy people, there will be more displaced people, there will be people left homeless and possibly stateless too. Any attempts to draw boundaries for two states will highlight that this conflict goes beyond religion because everyone will want their land to include the fertile parts, the pretty tourist draw cards, the bits with natural gas reserves and so on...

As the images of death and destruction from Gaza have become part of our living room furniture yet again, it is clear that the constant retaliation from both sides is not doing anything to get the Middle East anywhere near a lasting peace. The hatred is palpable and it not concentrated to the battered shred of land that is the Gaza strip.

Horrible outbreaks of anti-semitic and anti-Islamic sentiments, all of which reduce religions to stereotypes and ignore the diversity that exists within both faiths, are not helping anyone. So many ridiculous and awful things have happened that it is hard to know where to start with calling out the bullshit behaviour - Hamas hiding weapons in supposed places of safety, images of Israelis getting comfortable with a few brewksis to watch attacks on Gaza, George Galloway declaring Bradford an Israeli-free zone, Joan Rivers declaring that Palestinians deserve to die, the banning of a Jewish film festival in London, and the banning of an Edinburgh Fringe Festival show by an Israeli group that promotes Jewish-Arab co-existence, IDF soldiers leaving racist graffiti, urine and bowel movements in Palestinian homes... All these things are terrible and moronic and it just goes on and on and there doesn't appear to be any end in sight.

Today, we have a lack of enthusiasm for Egypt-mediated peace talks which, given they are about as neutral as Liberace's living room, is entirely understandable from all sides. But if a one-state solution emerges from this mess as a more realistic prospect, it is interesting to speculate on what this might look like. It'd be amazing if everyone around the negotiating table could even agree on a name for this new state, and even if they did, its citizens would probably refer to themselves as hyphenated nationalities, like Italian-Americans, but I digress. We are not even close to that level of nitty-gritty detail today.

Do we dare to dream of a secular state where everyone is free to practice their religion in safety, where churches, mosques and synagogues can exist in the same street without violence erupting, where atheists are allowed to get on with their lives without interference from any religion, where your sexuality is not a criminal offence, where tourists can visit and roam the whole country in total safety, where children are not raised to hate anyone, where my friends with Palestinian passports but have never set foot in Palestine can finally return home, where everyone has equal access to education and opportunity, where women can dress as they please, where there is no need to conscript young people in an army and imprison them if they conscientiously object?

But who should try and negotiate such a solution? For starters, probably not any of the nearby Arabian Gulf nations. The combined economic might of the Arabian Gulf nations could pay for a Palestinian Iron Dome and then some, but these states instead pay lip service to supporting Palestine and send aid such as blankets and medical supplies. The leaders of the UAE, as well as Saudi Arabia, choose their words very carefully when it comes to speaking out on behalf of Palestine. After all, there are alliances with the US that they do not want to jeopardise. And if their leaders were seen to be calling for a new secular state with democratic elections and freedom of religion, that would reignite the pro-democracy campaigners who stuck their heads over the parapet during the Arab Spring only to find themselves silenced or imprisoned or lashed. It has been suggested by many analysts that Qatar, among others in the region, supports Hamas (and the US sells billions of bucks worth of weaponry to Qatar so, once again, the moral high ground turns to quicksand...).

I could muse on who the hell can fix this this all day long but it would only be a matter of time before someone chimes in with: "OK, Gaza is a bad situation but what about ISIS?". ISIS, or IS as they are now being called in today's new bulletins, is completely appalling. Horrific. Beyond vile. A tragedy for Iraq and beyond. They are all about a ruthless land grab achieved through the mass killing of Muslims who don't strictly adhere to their narrow interpretation of a faith that has 72 sects, and of Christians, of children, babies, anyone who gets in their way, basically.

IS is such a revolting organisation that it doesn't actually matter that the stories of forced, mass FGM were never proven - their heinousness is such that there is no shortage of appetite for airstrikes to blast them off the face of the Earth. Of course, nobody is saying the the Kurds, who as I write this, have, with the help of the US, managed a victory over IS fighters in two Iraqi towns, have one of the biggest problems with FGM in the region. But nothing is ever simple, nothing is ever black and white in the Middle East. Equally, the situation in Syria has created unholy alliances as intervening nations try to decide what group is the least dreadful.

And while all this is going on, while my Twitter and Facebook feeds continue to fill up with more and more arguments that will never be seen by Benjamin Netanyahu, Khaled Mashal, Mousa Abu Marzouq, Mahmoud Abbas, Tzipi Livni, Moshe Ya'alon, Abu Bakr al-Baghdadi, Bashar al-Assad, Zahran Alloush, or anyone else who can actually do something about any of this crap, innocents continue to be killed, families separated, people displaced, and, hey presto, we have another refugee crisis on our hands.

Perhaps a one-state solution could honour the original spirit of the creation of the state of Israel and be a safe haven for refugees displaced by these latest Middle Eastern conflicts, regardless of religion. There is a long way to go before that idea is even remotely feasible but, as far as aims go, it sure beats the aim of obliteration in anyone's name.