Sexist legsit for Brexit...

Women MEPs are concerned about the impact of Donald Trump bringing back the global gag rule.

The Daily Mail - at least for England and Wales - reduced Theresa May and Nicola Sturgeon to their pins yesterday. Accompanying a rather leg-oriented front page picture, the eternally asinine Sarah "Don't you dare accuse me of feminism" Vine felt the need to write a piece about how the legs of the Prime Minister and Scotland's First Minister were their greatest weapons in their ongoing wrangling over Scottish independence and Brexit. A "light-hearted" take on it all, according to the Daily Mail. 

"Never mind Brexit, who won legs-it?" was emblazoned across the front page.

Nothing screams "serious journalism" like a line that is basically the world's creepiest Dad joke. 

It was just like the time the Mail reported on the peace agreement between Yasser Arafat and Ehud Barak back in 2000 and Sarah Vine wrote that hilarious piece about who had the firmest arse in the Middle East. Or her witty ode to Putin and Obama after their awkward handshake in Lima last year in which she declared each man's biceps would be used to forge a bold new relationship between their countries.

Except that never bloody happened. Instead, Sarah Vine wrote a parody-defying load of tripe for yesterday's paper, the journalistic equivalent of taking upskirt photos on a tube station escalator. She came across like a sex pest. Well played, sister!

The Daily Mail issued an explanation. It was just a joke and, anyway, we did loads of serious coverage on Brexit! Bags of it! The crazy feminists clearly need to lighten up! 

Except that every time female politicians are belittled, reduced to their body parts, when their legs or their tits or their clothes or their hair or their faces are the focus, not their policies or ideas, it makes it that little bit harder to encourage smart women to enter politics. And it makes it that little bit harder for women in general to be taken seriously.

The Mail's explanation also pointed out that they're an equal opportunity body snarker - they've also run photos of David Cameron looking a bit portly while on holiday, that sort of thing. Er, yeah. Two things, Dacre. Firstly, it's still gross to reduce male politicians to their body parts too. Secondly, even when the Mail runs such nonsense, it's not usually tied to the biggest political story of the week. The coverage when men do politics is far more respectful.

Of course, plenty of right-wing anti-feminist apologists piped up with their latest lame zinger. "Why are women angry about this when there is FGM and IS is making Yazidi girls and women sex slaves?". Er yeah. Two things, dickheads. Firstly, IT IS POSSIBLE TO CARE ABOUT MORE THAN ONE THING AT A TIME EVEN WITH OUR LITTLE LADY-BRAINS! Secondly, when you are the same people who would deny foreign aid to help stop FGM or to offer shelter, healthcare and employment training to Yazidi girls and women, you are monstrous hypocrites with zero right to tell women how to do feminism.

And when women are belittled out of putting themselves forward as leaders because of the constant sexist noise over which they must shout to be heard, there won't be as many women in positions of real power who are able to stand up for oppressed women everywhere.

In any case, the "Never mind Brexit, who won legs-it?" debacle, it really is a microcosm of the Daily Mail/Daily Express/Sun mentality on the issue of leaving the European Union. The one-liner encapsulates perfectly the simplistic Brexiter mentality, the one where self-serving con artists like Nigel Farage convince people that there is nothing to worry about, that the process of making trade deals and sifting through EU law will be a piece of cake. These people say without irony that it could all be sorted out in a month. These people are irresponsible idiots who make Britain a dumber place. 

Worse, it reflects the mentality of the right-leaning Brexiter of not wanting to take any actual responsibility for the whole shit-show - they do not want to acknowledge the inevitable problems it has caused and will cause and they do not want to do any of the tedious dirty work involved in ensuring leaving the EU doesn't reduce Britain to a joke nation.

Nope, these pathetic dinosaurs are the deluded fools who voted to leave because of some misguided notion that it was better in the good, old days, even though the good, old days were, frankly, a bit shit. But, hey, at least back then, we could all could openly ogle a woman's legs in peace without those feminazis getting upset, am I right...

Image: European Parliament/Flickr

It's OK to be a bit scared

I'm not scared. This week, some loser in a Hyundai senselessly murdered four innocent people about a mile from where I work but I'm not scared. Sad, yes. Appalled, yes. Sickened, yes. But not scared. I simply don't see the point in being scared, I don't see what being scared will achieve. 

But this does not make me a superior London resident. Some people here are scared and that's OK too. 

Amid the usual bluster about how we won't be cowed, about how we got through the hideous era of IRA terrorism and the Blitz, this week's awful events, and others like it, have spooked some people. Not everyone is walking around London singing jaunty wartime ditties and behaving like a "Keep Calm And Carry On" poster that has come to life.

The people who are scared are not massive racists or inane bigots. They are not idiots who freak out because a mosque has been built in their borough or change tube carriages because a woman in a hijab has got on board.

They are people who are simply scared because none of us know when terrorism will strike again. Will it impact on us? Will we lose friends or family members? What if some twat kills our kids? 

And that is why terrorism is effective - it is all about the grotesque element of surprise. 

The people who died in London this week were not expecting an inadequate dickhead would kill them. Equally, people do not expect to be killed when they go to a concert in Paris, have a boozy holiday in Bali, pop out for a coffee in Sydney's business district, go to work in New York, do their job as an MP in Yorkshire or any number of things for which death should never be the penalty.

It might be true that cancer or heart disease or the pollution of London is more likely to claim our lives than a terrorist but fear is not always rational. Hell, I am scared of entering a public toilet and discovering it is a pull-chain loo. My rational brain tells me the toilet probably won't hurt me but, after one such toilet in Turkey juddered away from the wall when I pulled the chain, my fearful brain tells me I should hold on until I can find a low-level loo with a button or lever.

Within hours of the attack, it was indeed business as usual in London. That is the way it should be. Last night as I was on my way to the tube after work, a Spanish couple asked me for directions to the Houses of Parliament so they could pay their respects. It was a properly moving London moment and I hope my directions made sense to them. 

If anyone is scared, they deserve compassion and reassurance, not scorn. If anyone marks themselves as safe on Facebook, they are simply using a modern form of communication to reassure others who might be worried. Now is not the time to tell people how to react to a tragic event. We all react to tragic events in our own ways. You only need to look at the varied faces of people at any given funeral to work that out.

Predictably, Daesh has claimed responsibility for this week's fuckery even though they probably had no idea who the murderous thug was before the news broke on Wednesday. They don't need to know him personally because anyone with an internet connection can be disgracefully inspired by the acts and warped messages of Daesh. 

I'm not going to name the terrorist. He does not deserve the attention or the posthumous fame. He was last seen by us all as a bloated, middle-aged turd dying on a road. He is not a hero or a martyr. He is nothing. Instead, we should remember PC Keith Palmer, Aysha Frade, Leslie Rhodes and Kurt Cochran. We should honour the paramedics, the police, the doctors and nurses who ran towards the incident from a nearby hospital to help, and, yes, we should honour the journalists who were on the scene reporting responsibly.

And if you're still a bit scared, that's OK. We've got your back, we are with you.

No ifs, no buts, no excuses, there is a global problem with rape

"No punishment for man who raped girl, 12" was the stark headline on the BBC News site on Friday. Never mind that since 2009 under British law, anyone under the 13 is deemed unable to give informed consent to sexual intercourse. This negates the defence of consent in such cases, except the judge Lady Scott decided it was not in the pubic interest to punish Daniel Cieslak, who pleaded guilty to rape, saying it would be "disproportionate given the nature of the criminal culpability here". 

The girl in question said she was 16 and CCTV footage confirmed to Lady Scott that it was reasonable for Cieslak to assume this was the case. He procured alcohol for her even though he knew she was, at the very least, too young to legally consume it.

Well, if that decision isn't a goddamn gift for paedophiles as well as rapists in general, I don't know what is. What is the bloody point of even having age of consent laws when the line in the sand can be easily washed away on the strength of CCTV footage and a tearful defendant?

Still, the same judge has form here. In 2013, she sentenced Hamadache Hamza to just six years for weekend-long rape ordeal that took place in the victim's flat, despite the Crown Prosecution Service guidelines suggesting five years as the starting point for a single offence rape sentence, eight years for rape with aggravating factor, and life imprisonment as the maximum sentence. Lady Scott's reasoning was that Hamza had come to the UK from Algeria, overcome a difficult background, and set up a successful hairdressing business and this had to be taken into account.

Never mind that most people who are either immigrants or have come from a difficult background, or both, manage not to rape people. In the world of Lady Scott, these two factors lessen the severity of the crime of depriving a woman of her liberty and her right to personal safety and bodily autonomy for 48 awful hours - and she insults every law-abiding immigrant and every law-abiding person who has come from a disadvantaged background in one fell swoop.

These are just two of the endless cavalcade of examples of rape-related bullshit from all over the world. They are examples are from Britain but Britain is not unique in the ways it fails women and girls.

Rape is not unique to any particular race or religion or social class or profession. That is what makes the problem seem so insurmountable. To single out any one group is to throw the bodies of women under countless other buses. It is a grotesque game of whack-a-mole - while we villify one group based on the example of a few, women are still being raped by other men in other places and in other circumstances, whether it is at the hands of a stranger, as a weapon of war, or in the depressingly likely scenario of being raped by someone she knows.

What is particularly tiresome is the constant minimising of women's anger by men. Just today, a friend of mine from India posted an opinion piece on her Facebook page which advised women not to come to India. It was written by an Indian woman, it was an agonising cry from a woman who does not feel safe in her home country. Pathetically, a man jumped on the page to tell us that there was no use in getting angry.

With all due respect, sir, fuck off. When you are not feeling threatened on a daily basis, it is easy to wonder what all the fuss is about. But it is something women live with every day of their lives in every country in the world. I completely understand why millions of American women choose to take advantage of the second amendment and carry a gun.

The reason why women collectively roll their eyes when they are told to be careful when they leave the house, is not because we are obstinate little flakes. It is because we know already. We bloody know. We make a habit of being careful all the damn time. We carry our keys in a position that is suitable for jabbing an assailant as we walk from the bus stop to the house. We install sensor lights near our front doors so we're not fumbling about in the dark for too long. We tell each other to text as soon as we get home safely. We help each other into taxis. We feed each other water and kebabs and paracetamol when we've had too much to drink. When Judge Kushner said that we are entitled to "drink ourselves into the ground" but our "disinhibited behaviour" could put us in danger, she was not saying anything new.

Still, at least Judge Kushner didn't compare women to cars or houses by using the horrible "You don't leave your car or house unlocked when you go out" rape analogy. Reducing our bodies to a comparison with the contents of a glove compartment or a jewellery box is appalling, reductive nonsense. And if you do get burgled because you forgot to lock a door, you might just get more sympathy than a rape victim who was drunk or wore a short skirt or wore a long skirt or only drank water or left the house or caught a bus or went to work or had the temerity to leave the house in possession of a vagina.

"You silly bugger; leaving the house with the door open!" is hardly on par with the disdainful spite of "Well, you were asking for it, walking around that part of town at that time of day..." when you've just had your body violated in the worst possible way, shy of actually being murdered.

And then if something horrific does happen to us, we'd better hope and pray our assailants aren't wealthy, privileged, or have a great future as an athlete or a city trader because they may just get a sweet deal from a judge.

That is if you report the crime at all. I know plenty of women who have not reported rapes. This is usually because of fear: fear of being disbelieved, fear of ending up on the wrong side of the law in countries where premarital sex is illegal, fear of spending a lot of time being humiliated and reliving a repulsive experience for no justice to be done, fear of bringing shame to the family, fear of the reaction of one's partner, fear of simply making a fuss...

Please do not start with the "But men get raped too!" line. Yes, they do. They do not get raped in quite the same numbers as women but male rape is no myth. And guess what? They are usually raped by other men.

And male rape is, like female rape, drastically under-reported. Oh Lord, I wonder why that might be? When men see what crap women are put through when they attempt to get justice for being raped, where is the incentive for them to report the crime when they are raped?

If more women are confident to come forward without being accused of "asking for it" when reporting a rape, perhaps it will follow that more men who are raped will come forward too. This is a prime example of how achieving justice for women and girls has the potential to help men and boys.

Indeed, the eternal pit of dick-driven ignorance was fed by the unctuous Philip Davies MP recently when he tried to derail the passing of a bill to recognise the Istanbul Convention in a bid to prevent violence against women and girls.

Predictably, all the douchebros came out of the woodwork to cheer Davies on because men get attacked too. Except clearly none of these intellectual bankrupts bothered to look into the finer points of the Istanbul Convention which quite plainly recognises that men and boys are victims of violence too. But that would require doing some research, becoming informed, not simply believing everything a pig of an MP tells you because it suits your hateful little narrative.

These are the same men who disbelieve the low rates of false accusation and see nothing wrong with someone who admits to grabbing women by the genitals, someone who feels so permanently entitled to access women's bodies, is now the president of the United States. Indeed, yesterday it emerged that Theresa May thought Donald Trump was "a gentleman". Brilliant. Britain's second woman Prime Minister has been gaslit by a self-confessed sex pest.

And so we continue, the women and girls of the world, to constantly take precautions against rape, to be constantly on our guard, because that is our normal. For some, normal means regular rape by a partner. For others, normal means rape at the hands of terrorists. For some, it just means never quite feeling safe.

If you have never felt that fear, you are automatically privileged. It is your duty to stand alongside those who are not so fortunate, the women and girls of the world.

  

"Nightmare of a Gang Rape Victim" image by Syed Ali Wasif/Flickr

George Osborne insults us all

George Osborne's appointment as editor of the London Evening Standard while refusing to stand down as a member of parliament is ridiculous, offensive, corrupt and insulting. It has already been said over the last couple of days that it is impossible to be an effective MP and newspaper editor at the same time. They are both demanding full-time jobs and the people served by both jobs deserve so much more than a part-timer. It has already been said that doing these two jobs represents a massive conflict of interest. His appointment demeans the role of an MP as well as the role of a newspaper editor.

Of course there are inane apologists for this steaming truckload of bullshit.  

"But he'll just be a figurehead editor!"

Great. Super. Wonderful. So he'll be on an inflated salary to waft in and out of the office when he can be arsed, doing the bits of the job that amuse him, while the rest of the Evening Standard staff have to do the real work? Will he be there for boring parts of the editor's job? For the negotiations with the sales team that require decisions about balancing revenue with editorial credibility? For refereeing a dispute over the style guide? For the inevitable staff member who appears at the editor's desk in tears?

As well as propping up the notion that only the privileged get the top British media jobs, Osborne's appointment reinforces the myth that journalism is an easy job that anyone can do. 

"It's all about his great connections!"

When he first aspired to be a journalist many moons ago, his rampant privilege and connections could not get him entry-level positions on The Times or The Economist. He did a freelance stint writing the Peterborough diary for the Telegraph. This means anyone who has done a competent enough job on more than one publication has more experience as a journalist than George Osborne. And in a city the size of London with its large media market, there are plenty of well-connected journalists with genuine runs on the board. 

It should not be beyond the wit of Evgeny Lebedev to find someone who has a full contacts book and the ability to run the daily news conference without having to refer to Journalism For Dummies or surreptitiously Google "what is the splash?" on his phone.

"But Boris Johnson did a great job as a journalist!"

Yeah, that'd be Boris Johnson, the same irresponsible spoiled flake of a journalist who got a bit bored trying to report accurately on the European parliament so he started simply making shit up instead. He is largely responsible for starting the "bonkers Brussels" myths that so many leave voters fell for in the EU referendum. He wrote stories about the EU declaring snails as fish, and EU directives to standardise the smell of manure, ban prawn cocktail crisps and standardise condom sizes. This nonsense was published unchecked and people believed it. Boris Johnson was a purveyor of fake news. 

"But Michael Gove is a Times columnist!"

Yeah, that'd be Michael Gove, the man responsible for an embarrassingly sycophantic interview with Donald Trump that was about as hard-hitting as a headbutt from a sea-monkey.

And perhaps most inane of all...

"Oh, it is just delicious that George Osborne can make mischief by trolling Theresa May in the pages of the Evening Standard!"

This is not what a newspaper is for. No newspaper should exist for a self-serving editor, particularly one who already has plenty of opportunities to publicly air his views, to settle scores, to use it for his own personal vendettas. This is not the same as holding the government to account. It is all about George Osborne's ego. It is about him being arrogant enough to assume he can do some newspaper editing in the morning and a spot of parliament in the afternoon and do justice to both jobs.

There is no way George Osborne can do a credible job of editing a newspaper for London. It was bad enough reading the Evening Standard on the commute home when Boris Johnson was mayor. The level of arse-kissing was off the chain. I honestly don't know what Boris would have had to do to be criticised by the Evening Standard in that grim era. Deep-fry a few live kittens outside Buckingham Palace,  perhaps? Then the paper backed Zac Goldsmith even as the wheels fell off his mayoral campaign, Sadiq Khan won the election convincingly and ever since, the coverage of his time in City Hall has been very fair and balanced.

Whether fair and balanced coverage of City Hall will continue when Osborne takes the reins remains to be seen. But it is impossible for him to be an objective editor overseeing the stories that affect Londoners when he has been responsible for votes in parliament that affect Londoners. He is a mess of conflicting ideologies and competing priorities.

He is arrogant enough to think he can remain as MP for Tatton, in England's north-west while editing a London paper. George Osborne has been the mouthpiece for the largely vacuous Tory policy of creating a "Northern powerhouse", of developing the north of England and moving away from a London-centric economy. This is at odds with the unabashedly pro-London stance of the Evening Standard. Can readers expect to be urged to leave the capital for the north? 

He voted for the Health and Social Care Act 2012, an act which led to the creation of Clinical Commissioning Groups, which are putting health services and, in some areas, entire hospitals under threat in London. Will he ensure the government is held to account in the coming months and years if and when London loses essential health services?

Despite being pro-remain, he voted against seeking to protect the residence rights of EU citizens lawfully resident in the UK post-Brexit, despite London being a city that will be seriously depleted in multiple professions if we cannot guarantee the rights of EU citizens to stay on here after the negotiations to leave the EU are complete. Osborne can claim all he likes that he is offering resistance to a hard Brexit but on this issue, he is on the same page as Theresa May. There were two votes on the same issue last year and he was absent for both, hardly the actions of a man committed to wanting the best for London. Yet he is set to edit a paper in a largely pro-remain city where plenty of readers will be uncertain of their own fate or that of friends, lovers, colleagues and neighbours.

He has voted consistently for a reduction in spending on welfare and for a reduction in housing benefit for council tenants with a spare bedroom (the so-called bedroom tax). Unsurprisingly, these laws have done nothing to alleviate poverty in London or address the shortage of affordable housing in the capital, particularly for workers in essential services and low-income earners. 

Will he as editor of the Evening Standard be able to look such tough issues squarely in the eye and ensure they are covered properly? Or will be simply play-act at editing a newspaper, leave the hard work to the rest of the staff and return each night to one of his lovely, warm houses, secure in the knowledge that there will be people on the streets of London using copies of the Evening Standard as bedlinen? 

Photography: duncan c/Flickr

The day after the NHS march...

As most people in the UK are probably aware by now, there was a rather large march for the NHS in London yesterday. Most people know this because it actually was covered by the much-derided mainstream media, including the BBC, ITV, Channel 4, the Mirror, the Daily Mail, the Daily Express, the Evening Standard, the Guardian, the Telegraph, Sky News and Metro.

This did not stop the internet lighting up with people claiming the march was not covered or seeking out conspiracies where none exist.

"It's the mainstream meeja's fault!"

On the Big Up The NHS Facebook page, one person thought it was suspicious that the Evening Standard and the Mail Online used the same photograph, even though it was an agency photo which would be available to any major news outlet with a PA subscription, which is all of them. 

On the same page as well as on Twitter, multiple people pounced on the inverted commas used by the BBC in an online headline about the march, with "hospital cuts" in inverted commas. If anyone bothered to read the story, they would see that the inverted commas are used to refer to quotes from the protesters rather than any specific cuts and it is, therefore, accurate journalism, but the left-wing media bashers are not interested in accuracy or learning about how journalism works. They'd rather scream about media conspiracies, as if we journalists spend our spare time in a darkened bar, smoking unfiltered cigarettes, drinking whisky neat, and colluding with each other about how to create a Tory dictatorship. 

This is a shame because such paranoid nonsense only serves to distract from the very real issues facing the NHS. And speaking of distractions, one of the biggest and dumbest banners at yesterday's march, bafflingly, said: "SICK OF MEDIA LIES ABOUT JEREMY CORBYN". 

Firstly, Jeremy Corbyn's address to yesterday's march was very well covered, including by the right-leaning Daily Mail, Express and Telegraph. The brutal truth is that marches are usually not that interesting to cover unless violence breaks out. In terms of media coverage, you have images of marching, shouting people with placards and banners, footage or quotes from the speeches and, er, that's about it. From a journalistic point of view, it is pretty limiting as to what can actually be said about a march before it gets repetitive. So for yesterday's march to glean the coverage it did should be seen as a positive. Whining about media conspiracies makes campaigners look certifiable.

Secondly, that banner is absurd at a march specifically about the NHS. Campaigners who want people to seriously focus on the many things that are bringing the NHS to its knees and want to attract people of all political persuasions - as well as the apolitical and apathetic - need to look outside the Corbyn-loving echo chamber in which many of them are stuck. These people (and I hasten to add this is not all NHS campaigners) need to realise that NHS campaigns which come across as Corbyn fan clubs, when he is simply not resonating with people outside the Labour Party and Momentum in particular, will not be effective.  

And then it gets complicated...

On top of all this, the Health and Social Care Act 2012 devolved all responsibility for health services to local Clinical Commissioning Groups (CCGs) and that is where the real lobbying and engagement needs to take place, with elected MPs and local councillors along to ask hard questions about where money will be spent in their regions. In theory, CCGs make sense - the healthcare needs of a seaside retirement town will be vastly different to an inner city borough of young families, for example, so one size does not fit every area. 

That said, the basics such as accessible A&E, cancer treatment, and GP services should be available to people equally across the country - although in the case of GP services, this also varies between different areas. The retirement town won't have the same demand for GP services on evenings or weekends that the inner city area full of time-poor working people will. 

If the message that engagement is required locally at CCG level as well as nationally has not been properly communicated to the wider community as a result of the march, better communication from campaigners is required. This is also needed from Labour at all levels if they are serious about being a proper opposition and forming a government at the next election. 

Yes, the future of the NHS is about adequate funding at the Westminster level, where plenty of MPs have vested interests in private healthcare, just as much as it is about CCGs being financially responsible and lobbying the government if there are local shortfalls, particularly if people cannot be discharged from hospital because of inadequate social care. The financial interests of CCG members are as important in this equation as that of MPs because right now there is nothing to stop members commissioning from businesses or non-profits in which they have an interest.

It is complicated and it is not simply about throwing money at the NHS if it will only end up mismanaged at a local level and the CCGs are not held accountable. 

Do not be naive - we will have a Conservative government in this country until at least 2020 and therefore we will have CCGs at least until then.

So, what next for the NHS?

What happens next for the NHS will depend on what is seen as politically expedient because, like it or not, the NHS is political. 

It is pretty clear that there is an appetite for destruction when it comes to the NHS under Theresa May's government. If she genuinely cared, one of her first orders of business would have been to ditch Jeremy Hunt, the failed marmalade mogul who has been play-acting at the Health Secretary job since September 2012.

The government is smart enough to know that British voters will not stand for a complete replication of the American system. While there are always calls to charge so-called health tourists for NHS services, the free-at-the-point-of-use mantra has been effective. Except it has been effective for the Conservative Party and this is a hurdle for the opposition.

The privatisation conundrum

As long as health services remain free at the point of use and people are not filing for bankruptcy because of medical bills, it is really hard to get people to care about whether the services are being provided directly by the NHS or the NHS has farmed it out to a private company.

On top of this, Corbyn's rhetoric about stopping all NHS privatisation is simplistic. For starters, GPs have always been privateers. Any attempt to nationalise GP services, forcing GPs to work certain hours and potentially reducing the flexibility for GPs to work part-time, will result in a shortage, particularly among GPs who are parents - this will disproportionately affect women GPs so hardly a great victory to be had there. 

The big financial pressure here is the cost of administering the tender process, with estimations between £4.5 billion to £10 billion per year. But if we keep farming out services - which can be anything from cleaning the loos to cancer treatment - the government has to run a proper tender process, which is not cheap. Thus the government needs to acknowledge that this will be the case as long as services are open to tender - this is not an expense it can pretend doesn't exist.

Additionally, the NHS is not subjecting private companies involved in bidding for contracts to the same freedom of information rules that government departments are subjected to - so this makes transparency much harder. Indeed, I tried and failed to get solid information from my local hospital trust on whether the rise in MRSA infections had anything to do with farming out the cleaning services to a private company, but I was stonewalled. This government is not going to do anything about this given it already has form in trying to restrict existing FOI access. 

Similarly, there doesn't seem to be any bans on companies being able to bid for or keep contracts after catastrophic events. G4S should have been banned from any government contract after the Olympics security debacle and they continue to run the patient transport services at my local hospital despite killing an amputee in one of their vehicles owing to insufficient staff training. Virgin, meanwhile, has also done an abysmal - and lethal - job of running the Urgent Care Centre at Croydon University Hospital, yet continues to hoover up NHS contracts, including a £700 million contract over 200 hospitals late last year. 

These are fundamental problems with the way things are run at the moment but even if all NHS services were returned to the NHS, the NHS still has to procure stuff it can't make itself. 

It is absurd to expect the NHS to set up its own factories for bedlinen, cutlery, crockery, windows, uniforms and the thousands of other things it needs to purchase in order to function. 

While one idiot once said to me with a straight face that the NHS will indeed make all its own things once the workers control the means of production, that is clearly ridiculous. Instead, the NHS should use its huge purchasing power to get the best possible deals on all it procures. There is no excuse for waste here and the NHS will continue to buy stuff from private companies. Sorry, it will. It's just that the procurers should do a better job of it.

The technology conundrum

Actually, this should not be a conundrum at all. If there is good technology out there that can contribute to saving lives, money and time in the provision of healthcare, the NHS should look into procuring it for the best price possible. 

I have noticed a rejection of technology among elements of NHS campaign groups. There was a placard at yesterday's march that said "TECH IS CHEAP BUT AN APP CAN'T WIPE YOUR BOTTOM". This is very true - there will always be a need for human beings in hospitals to perform such tasks but if there are apps that can improve the way care is provided, this should be looked into.

I've seen NHS campaigners complain about advances such as telemedicine, even though it can be used as a way to improve access to care and relieve pressure on GP surgeries. Again, it cannot always be used as a substitute for an in-person physical examination but it can play a role and this sort of thing should not be dismissed out of hand.

I suspect nostalgia for the good old days of the NHS comes into play here instead of recognising that society has changed since the NHS was established in 1948, the population has increased, amazing advances have been made in medical science, and technological changes have happened and a modern NHS needs to be about making all this work for everyone.

And again, if there is technology that can be used to improve patient care, it will have to be purchased from private companies. Like I said, Corbyn's anti-privatisation rhetoric is simplistic.

The Australian model?

As I said, if services are still free at the point of use, there are millions of people who won't care if the services are provided by a private company.

What I do see happening is a move towards the hybrid Australian system rather than an all-American system, with a mixture of public and private services side by side. I dared to suggest this on a local campaign Facebook page last year and was howled down. I never said the Australian system was perfect in my comments, merely that, as someone who has experienced both the Australian and UK systems, I could see the trends happening over here.

It is important to bear in mind that just as we have postcode lotteries with care in the UK because of differences in how CCGs spend their money, the American system is actually multiple systems on a state-by-state basis - so to simply say: "We're going all American!" is also simplistic. We will see more involvement by American companies in the NHS, particularly if we are left wide open to this in a post-Brexit trade deal with the US. It is important to remember here that American companies are very nimble and thus good at adapting to trading in diverse markets. 

From McDonalds varying its menus across cultures to big oil companies making money in countries with a wide range of tax and regulatory systems, it's what American companies do. Healthcare is seen as no different by American companies.

Like America, Australia has differences in health systems between states but with public-private hybridisation across them all. I can see this Australianisation happening in microcosm form at my local hospital, St Helier.

St Helier could well lose its A&E department in the near future, which will be disastrous, forcing people to spend longer in ambulances or in traffic or on public transport seeking medical attention. 

But I predict it will keep its maternity unit, bolstered by its expanding assisted conception unit. Currently, IVF patients undergo pre-IVF testing and appointments as well as egg extraction at St Helier but the eggs are fertilised at Kings Hospital. The transfer of fertilised eggs also takes place at Kings. When St Helier's assisted conception unit expands to include its own embryology department, it will become a one-stop shop for IVF patients. Under local CCG rules, one round of IVF per patient is funded on the NHS but there is nothing to stop St Helier from receiving paying private patients - this should prove a handy source of income for the hospital and I suspect we will be seeing more and more of this across NHS hospitals all over the country. This sort of thing is not unusual in Australia and the funds raised from the private business helps keep the public services afloat.

The IVF example is an interesting one because, like privatisation but services being free at the point of use, it is also an example of what the public will tolerate here in the UK. In Australia, there are some Medicare rebates on fertility services but, by and large, it is an expensive undertaking with plenty of couples spending thousands in their quest to have a family.

It would not surprise me if, in the coming years, IVF on the NHS becomes virtually unheard of. I believe this is something the public will tolerate overall. Breast implants, unless they're for mastectomy patients, is another service I can see being chipped away, along with transgender procedures. Prochoice activists will also need to be vigilant about any attempts to limit abortion access - Jeremy Hunt has publicly said he'd like to see the time limit reduced to 12 weeks and if the government thinks it can save a few more pennies this way, or give the impression of being fiscally sensible, without taking too much of a hit on election day, I wouldn't put it past the May regime. Hunt was shot down in flames by people across the political parties last time but that was 2012. Britain has become a more conservative place in just five short years. 

I am not saying any of this is right - especially as such cuts would target women disproportionately - but it is the kind of thing this government can get away with if it doesn't anticipate harm at the ballot box. Hell, you've only got to look at Labour's catastrophic humiliation in the Copeland by-election, losing a safe seat to the Tories at a time when local maternity services are under threat to see what resilience this government has right now in terms of withstanding removing NHS services. 

The other Australian trend that has already gained plenty of traction here in the UK is increased take-up of private insurance. The advertising is ubiquitous, the deals often sound affordable, there is an increase in employers offering private cover as part of the package for staff. Around 50% of Australians have private health insurance, compared to an estimation of around 8.7% of people in the UK. Figures up to the end of 2015 show a surge in uptake of private health insurance in the UK. Again, plenty of people will not see this as a bad thing, especially if they find they can be treated faster if they go private.

Apologies for the long blog post

I have ranted for longer than usual this time but it is a complex subject. Just as there needs to be follow-up after the women's marches in the wake of Trump's election, there is a long road ahead if the NHS is to be preserved. I do not expect the NHS to survive in its current form and, despite yesterday's impressive march turnout, there is plenty that voters will tolerate in terms of cuts particularly if it doesn't affect them directly. Too old for an abortion? Not a woman? Intolerant to transgender people? These are the people who probably will turn out to vote in 2020 and they might not seek to punish the Tories over the NHS. 

It's a massive issue and none of it fits nicely on a placard.

Photography: Loco Steve/Flickr