CentreRight

A President is born - a visionary dies

As a new President was born on Tuesday, one of my favourite authors passed away. Michael Crichton was a visionary who at 6'9" tall didn't have to stand on the shoulders of giants. Best known for Jurassic Park and ER, it was his medical background and understanding of how new technologies could be perverted that gave his books such authenticity.

Reconstituted dinosaurs might remain fiction, but much of his work should remain in our consciousness to remind us of the dangers of unregulated, unrestricted applications of science. We will face seismic choices, outlined at his best in his last book NEXT. He himself was so disturbed by the potential for perversion of genetic medicine that the books ends with his author's note of five recommendations for legislative change. Various obits can be accessed here, I will miss his brilliance.

Three other changes that must also happen!

Andrew Lansley this morning has announced that he will enable swifter access to new drugs. This will be welcome news for many. However there are three other vital ingredients for speedier access.

Firstly we need to make it compulsory for drugs companies to register all their trials. At the moment NICE only has access to limited information because trials that elicit negative findings only show up if they were disclosed in the first place. This remains a major loophole - published data is currently incomplete.

Secondly there should be parallel development of sensitivity data - more commonly known as personalised medicine. Advances in genetic testing are beginning to reveal why some people respond well to a drug and others not at all. If we can test who will be sensitive to a particular drug, then we will prevent false hope and wasted treatments for people who will not benefit.

And thirdly 2020health's report 'Our health, Our Money, Our Say' highlighted that there is already a huge amount of wasted money in the NHS that could already be being spent on new drugs; some of this money could be equally well spent on ensuring that speedier access is a reality - but also if we all pay a token fee of £1 per prescribed item, we will all take more care not to waste any medication that we are prescribed.

Cultural rejection for in-valids

The world of Gattica came a step nearer this weekend as the Australian Government rejected a residency application from a German doctor, who had answered the Country's desperate plea for foreign GPs to come and solve their medical personnel crisis. Despite being the only doctor in his town, he has been denied permanent residency because he has a son with Downs Syndrome. This translates to: We want your professional skills to assist our Country but we will refuse to support you unless you and your family appear to be perfect.

This is no less than cultural rejection of the disabled; a reductionist, depersonalized, callous appraisal of an individual based purely on their 'economic burden'. That a strong, caring, loving, dedicated family who are contributing immeasurably to the mental, physical and emotional health of a community are being rejected on the basis of a cold, fiscal analysis is nothing less than evil. So while the Camerons, Browns and 17m other Brits with long term conditions know that they need not apply to Oz, what are we going to do in the UK to counteract the creeping culture of 'Perfection', where anything less than gorgeous is becoming less valid and valued?

Balls' chain is off - no new shackles please!

Hip Hip Hooray. Mr Manning is terribly chuffed this morning not to have to waste any more of his time prepping stressed-out adolescents on their key stage 3 SATs which yesterday were binned by Balls. Yet how do you measure achievement while taking account of the context? Getting one of his 'broken' pupils to laugh out loud at a Shakespearian joke ranks very high on Mr Manning's success indicators. Only he and the school know the significance of this. For the same pupil to get a 'D' at GCSE English would also be a major success - in the pupil, teacher and school's eyes - but never in the league tables.

With the challenges of their intake, his inner city comprehensive that takes pupils excluded from other schools is rightfully proud to achieve a 75% A-C grade GCSE pass rate in 5 subjects. Yet this percentage does not do the school justice in that it cannot reflect the context in which these results have been achieved. We surely need a more intelligent and sensitive approach to gauging a school's success, and definitely not one another one that shackles teachers to more paperwork. Mr Manning is off on Friday for an unpaid weekend away with 140 of his pupils - aspirations will grow, confidence flourish and emotional intelligence will soar amongst those 11 year olds in those 2 days. Can any of that be measured?

Is Gordon losing his vision?

According to the Sunday Telegraph on-line, Gordon Brown's eyesight is failing. While the details in this piece seem a bit confused [why send an email in 36 font in order for it to be seen, when Gordon will have his PC set at 36 font anyway if that's the level of magnification he needs?], the fact remains that sight loss is always quoted as the greatest personal fear. And the reality of that loss when it happens is nothing short of full blown bereavement and devastation.

Having a cataract bad enough to need removal in your early 50s is unusual - it is usually left untreated for as long as possible when there is only one functioning eye and previous history of trauma as there is an increased risk of operation failure - so it must have been bad. My heart goes out to him - not seeing your children grow up, not being able to read a book or drive a car are a painful daily reminder of loss. There are inspiring precedents of those who overcame visual loss and continued to achieve: John Milton, Catherine Cookson, Handel, JMW Turner, Henry Fawcett and Eric Sykes to name a few. However they were not having to govern their country through times of unprecedented economic meltdown...the combination of emotional pressures must be colossal.

David Cameron's brilliant speech

This was superb; a seminal speech that demonstrated the character and judgement of which he repeatedly spoke. Highlights from a mum who works in the NHS and married to a comprehensive school teacher [and NUT rep!]:

The most important thing to our future PM is his family. We must cherish commitment and that is why marriage is so important.

The Gordon Brown experience: debt, breakdown, dependency, irresponsibility, waste, mistakes, excess.

Sound money - save when the going is good; tax cuts as soon as viable.

The NHS is the institution that DC cares for most. The Mr Woods case was heartbreaking but all too familiar.

Reminding us of the heart of Labour as told by David Milliband - Government or nothing.

Responsibility has to start in Westminster - indefensible perks will go.

Restoration of civil society - background, context, causes of crime have to be dealt with.

Family is the best welfare system there is.

Real freedom for schools and a bonfire of the strangling regulations - bring it on!

Politics of dignity and aspiration - and a rightful commendation for Iain Duncan Smith.

He's a man with a plan, not a miracle, but this country needs that plan turned into action now - I just hope the media - especially the tabloids - do this speech justice so the majority who will hear it through the filter of the press can be as inspired as me.

Rights and wrongs of Ritalin

Prof Colin Blakemore writes a thoughtful piece in today's telegraph on Ritalin - the best line being 'the explosion in diagnosis of ADHD, and in the prescribing of Ritalin, implies an unconscious contract of convenience between over-pressed doctors, frustrated parents and teachers who can't cope'. He thinks that genes are the underestimated component. Incredibly he doesn't mention fragmented families or family breakdown - but you only have to look at the comparison tables for incidence of psychiatric problems in 'looked after' children [46% have at least one diagnosed psychiatric disorder] - to see that the lack of a loving, stable home has to be a, if not THE, significant factor that causes children to be disruptive and unsocialised. [There are exceptions of course.] Oh, and Gordon now wants more of our 2 year olds put into daytime state care. Hmmm.

Obama meets Jed Bartlett

Oh, I know I should have better things to do but this NYTimes peice took me back to those halcyon days and I could just hear Jed speaking as Obama seeks his advice...!

Our money might be safe(r), but are we?

Those of us who have mortgages with HBOS are still hyperventilating with relief as the weekend approaches! But Woman's Hour yesterday featured the thought provoking scientist Professor Donna Dickenson who reminds us that not just our money but our bodies are vulnerable. In her new book Body Shopping: The economy fuelled by flesh and blood she reminds us of the dangers of applying consumerism and commodification to the human body.

It is no longer the domain of fiction, and whereas the common concerns of social intrusion and privacy are well aired here on CR, we ignore at our peril the loss of the ownership of all our public and [not so any more!] private parts. Professor Dickinson is one of several distinguished scientists who has agreed to help 2020health consider policy implications for technologies in health, but where billions have already be staked e.g. on genetic patents, can any Government be strong enough to resist this tempting source of revenue? When Sam Seaborn declared 'privacy' to be the greatest political issue of the future, was he [ok -the script writer] thinking about this?! Is this the ultimate test of libertarianism?

Golden inspiration - weekend watching

It's not making the main headlines, but GB's successes in the paralympics are inspirational. And at one point yesterday, day five, GB was at the TOP of the medal table! We have since returned to second place, but special mention should go to Lee Pearson . Stuck in a broom cupboard by a nurse after he was born as he was expected to die, he has now won 9 gold medals, three at each of the paralympics in which he has competed. Watch a bit of him here - awesome. Shouldn't it be making the main news like the Olympics?

Naval gazing

Tummy buttons are a source of fascination to many [apart from my friend Richard who hasn't got one -great story] but their precursor the umbilical cord has been neglected! Twenty years after umbilical cord blood was first used to treat a rare type of anaemia, the BBC reports today that the Anthony Nolan Trust is setting up a new cord blood bank programme in south London. Cord blood already has a long history of being used to treat acute leukaemia, but the discovery of embryonic-like stem cells in 2005 meant that the potential use of these cells for research and treatments was enormous.

So why, twelve years after the Conservative Government established the NHS Cord Blood Bank, can blood only be taken at four NHS hospitals in or near London? Why, with this easily accessible, uncontroversial, plentiful supply source of stem cells, have we not invested more immediately in staff who can collect the blood and scientists to research their potential? Why no sense of urgency? Although 'stem cells' and 'alzheimers' are usually metioned in the same breath, the reality is that regenerative cures are still at least 10-20 years away at shown by a recent meta-analysis . An ageing population and degenerative diseases are two of the biggest challenges we face - and when we are presented with a human tissue resource like this, we are nuts not to prioritise it.

Palin would have anticipated the pressure

It's said that grief is the price you pay for love - and it seems to be the price you pay for Public Life too. We don't know how much grief Sarah Palin has experienced in her life, but she obviously has had enough to know that she felt able to handle whatever the American press might throw her way.

If Sarah Palin wasn't already a leader, there would be no disgruntled officials, jealous opponents or ambitious one-horse-town journalists now selling their scoops. So far we find that they have 'revealed' the family scandal [or is that the roller-coaster of any family life?]; the change of stance [or is that political judgement combined with humility?]; the contradictory taxing [or is that redistribution to favour the less well off?]

I suggest that neither McCain or Palin are naive, but when they met he saw character, leadership and competence. Huffington et al only see red but as their vitriol rains down on the electorate I hope that the American public warm to the ordinary woman with exceptional talents who has shown the courage to take the risk of Public Life.

Prepare to be amazed - physics can be entertaining!

You don't have to be in the micro-minority like me with a science degree, as previously discovered on this site, to appreciate the brilliance of this video. Added to which it's global history in the making. Watch, learn and enjoy!

The wrong diagnosis

I don't know about you but I feel healthier just from watching the Olympics! Yet Prof Sir Michael Rawlins the Chairman of NICE seems to be feeling a bit peaky at the moment. It may be called 'NICE', but heading up the body that does the cost-benefit analysis on new medicines and thus determines for what the NHS will pay can be a nasty job. Sir Michael is obviously feeling queasy and this weekend put together a fiery potion in the Observer of accuracy and accusations which I fear will be bad medicine for the whole country.

Where he is right is the fact that the NHS has finite resources and we can't afford everything. He's been saying this for a while. Resource allocation or 'rationing' is a fact of life - we all do it with our pay cheques.

Where he is wrong is to throw the blame for this at the door of the pharmaceutical industry. That's like saying if only BMW would bring down their prices we could all afford one. The obvious point is that the investment that BMW put into developing their products needs to have an adequate return; otherwise they will go out of business. The same applies for the pharma industry. Without their investment in research and development many of us wouldn't even be alive, and the risks they take to bring medicines to market are enormous. Not only does our personal health benefit, but so does that of the country as the contribution to the economy from the pharma industry in the UK is worth billions. My fear is that Sir Michael's comments will cost our economy dear as having been made the scapegoat, the next time a pharma company decides where to build a new plant or commission new clinical trials, it's less likely to be in the UK.

There is no doubt that the NHS can't afford to pay for everything, hence the current consultations on co-payments going on. Yet is that the only solution? If reform is to be successful, doesn't it need to start in the home? How much unused, prescribed medication do you [or more likely, your granny] have in your cupboard?!

It's not work, it's love.

It seems that most of the Sunday papers here and here for example, picked up on last week's report by Prof Jacqueline Scott 'Women and Employment: Changing Lives and New Challenges' which states that ‘fewer men and women believe that family life won't suffer if a woman goes out to work’. Her press release gives the salient points.

To say I was disappointed with the headlines is an understatement. Working women mocked; women who work being set up against those who don't; 'suffering' assumed to be innately bad; no mention of working men.... the simplistic approach is perplexing. Obviously a press-release can't do a whole book justice, but it does seem that a complex issue has been distilled into a stereotypical analysis that creates division. The questions asked seem to have made many assumptions, extrapolated details from generalisations and confused gender-equality with role-equality. Yet the issue there is not that men and women aren't equal, but that the status of paid work is far above that of being a parent. And that is one of the key problems - we have a Government that whether by tax credits or extended schools implies that the State can be a better parent than you can, thus undermining the crucial role of being a mother or father.

But back to the premise which is so damaging: being a working mother does not equal having deprived children. Deprived children are those who aren't loved with the unconditional, self-sacrificing, emotional-intelligence-developing and character-building love that every child needs in order to feel secure and to thrive. You will find them on both the streets of Peckham and the avenues of Dulwich, because it's not about income, not simply about who works - but love. And for those of us who do work and bend over backwards to ensure that our children know that they are loved, this book seems to be an insult.

The challenge for any working parent is protecting the space to give that love. The challenge for Government is twofold; to enable more families to have the choice for one of them to stay at home and look after their children, and secondly to work out all the different types of nudges that some parents need who don't seem to realise that the most important job they can do is to love their kids.

Sensitive yes; sentimental no

The Telegraph online is reporting comments from David Cameron made today about the need to call a spade a spade [my interpretation, I'm sure the PC brigade banned that phrase some while back]. He makes a great case for holding people to account and denounces moral neutrality [which like relativism is a self-negating concept]. Using the example of obesity he references the tendency to talk about people 'at-risk' of obesity as if it is some external event over which they have no control. This is refreshing stuff for this eye specialist who has had patients wring their nicotine-stained fingers in her face as they imply their loss of vision due to a self-inflicted blocked ophthalmic artery is my fault! DC says we have become too sensitive; well 'sensitive' is good I think no matter the cause of the problem, but sentimental is what has got us in this mess.

We have far too often been shoved onto the back foot as we have allowed our humanity and past mistakes to dull our aspirations both for ourselves and others. Sentimental feelings, nourished by the PC brigades campaign to obviate all stigma, have numbed our emotional intelligence and left our children without a moral compass. So is there any wonder when they lash out, desperate for certainties and security? Though of longer duration than the 11 years of hard Labour, this course of moral breakdown has been exacerbated by MPs like my very own Harriet Harman who refuses to hold up any ideal or aspirational model to her hard pressed constituents; in her Peckham base her banalities put the C back into Rap.

It is perfectly possible to stay sensitive to people's problems, but still cast the vision for what should be. DC is straight talking the politics of hope - founded on accountability and fuelled by aspiration - and long may that last.

Democracy at the wax works!

I thought this was a joke when I first saw the email from a friend, but I've checked the website and it seems to be true. Madame Tussauds has decided not to automatically make a wax-work of Gordon Brown as with previous Premiers - it's up to the public to vote as to whether they want one! Should we be melting GB out of GB history even now? Vote here before May 13th! And I wonder who can come up with the wittiest headline if the result is 'non'?

Superb start

We went to see Howard Brenton's fantastic new play about Macmillan's life 'Never So Good' this evening at the Lyttleton while waiting for the result from City Hall. After the gracious and generous victory speech from Boris, the play's title seems very appropriate for tonight!

Brian Who? What is the Times trying to say?!

Candidates for the Mayor of London are Boris Johnson, Ken Livingstone, Brian Caddick and Sian Berry...Thought you'd like to know that Times online is running a subtle campaign on its website today - see the 'London Votes' box.

Give GPs a break!

I remember his words like they were yesterday “I’m quitting the NHS”. Last year, this GP who had given 30 years of his life to caring for patients looked at me with tears in his eyes but a wan smile on his lips. Pain from the resignation and disappointment; relief from the burden and battle. “I’m an effective doctor because I know my patients, their history, their families, their jobs and their neighbourhoods,” he went on. “Up until now I’ve adapted and changed to the Government’s whim, but no more. They behave like we cannot be trusted – I can’t work for a boss that doesn’t trust me”.

You may have noticed, barely a day goes by when GPs are not being criticised and maligned, or pushed and shoved. No matter how much the Government messed up the GP contract resulting in a few doctors being paid a six figure salary, is this the way our health ambassadors should be treated? Our confidant in sickness?  The professional who we trust with our most intimate care?

Appreciation on a Friday

I've just come home from seeing my last housebound patient for the day. I only work as an optometrist now with the 'unseen' - those who can't get out alone because of disability or mental illness or being indisposed at her Majesty's displeasure - or all three. For 14 years I've lived and worked in da hood that Harriet now wears a stab vest to visit - because of course she doesn't live in her constituency. And I sat in my car and wept. It's been a day of emotion. This morning a disabled 70 year old man described, with tears running down his cheeks, how an accusation of pushing his 93 year old mother over had made him too scared to ask for help with her care. But he was now on his knees and not knowing who to turn to.

The lady I saw at the end of the day was so grateful, so positive, so accepting. Losing her sight to diabetes - which is what I try to prevent - wasn't the trigger for my weeping, nor was the way she sat so dignified in her wheelchair describing the sciatic nerve operation that had gone wrong. It wasn't the daughter I was introduced to, the same age as me and already blind and with organ failure from sickle cell aneamia. What moved me was the struggle. It was the way this lady accepted the battle to get Care. The forms they had been sent to fill in that they couldn't even see. The anxiety of being told hard fought-for help was being withdrawn because the criteria had changed. The relentless daily challenge of making it through - and the grace with which she faced it. She appreciated life in the way that JFK would have recognised 'the highest appreciation'- living by words not just uttering them. I felt ashamed of how little I appreciate - and that was why I wept. But that is also why I write here - and why I hope to live out my words of wanting to make life easier for people like her - in the world outside hers.

Living Zimbabwe

While we wait to hear whether the old political regime in Zimbabwe has died, the conservation of the Zambezi basin ecosystems and wildnernesses is a living and ongoing concern. The Zambezi Society run by my cousins in Bulawayo, south western Zimbabwe, aims to spread the practice of good conservation techniques. Through this Society we can give this beautiful country our practical support.

McCain's plan to solve the health economy

The best explanation yet of what McCain's plans are for health in the USA from Fortune Magazine.

He needs to demonstrate how he'll provide for those with long-term conditions, but in the words of Shawn Tully, "on economic merits, McCain wins. For all its problems, at least it puts the consumer in charge...It will create a world where health care is treated as the precious resource that it is."

Health Visitors inspire confidence

A Universal health visiting service was the Tories big announcement at their spring conference. The Department of Health's comprehensive Health Visitor's report 'Facing the Future' last summer talked about 'Progressive Universalism' - where those with the greatest need got the most help - which was the ethos of the Sure Start programme. That's fine, but what was tragic about the Government's response to this report was their shameless admission that whilst Health Visitor figures have dropped by 3% from 1997-2006, this was ok as 'children's services' ie children's centres had increased.

The whole aim of the Health Visitor is support for mother and baby in the home to build up the mother's confidence and independence, whereas the result of Children's Centres is state care for children and family dependence. In the deprived areas of south east London where I work, there is a permanent shortage of health visitors - up to 75% vacancy rates have been known. Yet money is pouring into the Centres which are perceived by many locals as free childcare, thus typifying the hand-out not hand-up mentality of the Left. 'Facing the Future' was an excellent report; the Government responded with warm words and sent Health Visitors away empty handed. The Conservative's announcement is to be welcomed!   

Known for integrity

For those of you who missed last nights installment of 10 days to war it featured Tom Conti as the Mexican Ambassador to the UN Adolfo Aguilar Zinser, known for his pithy quotes and integrity. It was his speech in November 2003 saying America saw Mexico as it's 'back yard' that got him fired, not simply his oposition to the War.

Having studied international law at Harvard and taught at Berkeley, he could see how much the 2nd resolution departed from the law. He developed a real passion for the role of the UN and the importance of women in diplomacy as can be seen from this coverage of an event at Berkeley in 2004 where my brother taught Latin American History. He died in a car accident at 55; his obit in the Economist is best but the NYTimes gives a good overview of the man. 

I wonder how many other UN Security Council members of 2003 were known for their integrity? Do any CR readers know?