Saturday 19 August 2023

How to give blood in Mexico

 

Early Friday morning our son Chris received a call from a work colleague, Eliseo, a physiotherapist at Pasitos de Luz who specializes in helping blind children (he was born without sight). Eliseo’s son recently had an operation in an IMSS (Instituto Mexicano de Seguro Social) public hospital in Guadalajara. In Puerto Vallarta, where Eliseo lives, the hospitals offer a limited range of procedures, so anything not available there is provided in the state capital, 329 km away.

 

Eliseo explained to Chris that anybody who has an operation in an IMSS hospital is obliged to replace the blood used during the procedure. However, no appointments were available in Puerto Vallarta, so Eliseo asked Chris if he could go to the brand-new hospital just outside San Vicente, where Chris lives, to make an appointment for two blood-donor friends. As in so many cases, although almost all Mexicans carry mobile phones, transactions like making a blood donation appointment are done in person (and therefore in a queue and after a wait). The blood given by Eliseo's friends will be sent to the hospital in Guadalajara where his son had his operation.

 

Chris reports that the new hospital is clean and well equipped, and the staff helpful. The lady behind him in the queue was making appointments for twelve friends to give blood on behalf of her husband who is in his sixties.

 

There is a logic to this system: the state saves the cost of a nationwide blood donation service, such as our NHS Blood Donation service. And friends and family give blood in support of the patient. I wonder where I would find twelve blood donors.

Sunday 6 August 2023

The choice to make in 2024

 

In December 2019 I did something for the first time in my life – I joined a political party, the Labour Party. I had tried to join once before in the 1990s, but nobody answered my requests for a membership form, so I gave up. I have often, but by no means always, voted for the Labour Party in Parliamentary and local elections, and, in the days when we were able to, in elections to the European Parliament. After the Conservative and Unionist Party won a large majority in the 2019 elections, I decided it was time to play a more active part in politics, but after attending a few local party meetings the pandemic intervened, and my brief enthusiasm waned. However, in 2024 a general election will he held and I will once again make my choice at the ballot box, so I have been reflecting on my choice, or rather on one choice – why it is a moral imperative not to vote Conservative. I have never done so, and nothing would persuade to do so next time.

 

The key argument of the Conservative Party in the 2010 election was that the economic crisis of 2007-2008 was the result of excessive spending by the Labour Government of Gordon Brown, and that the consequent increase in national debt risked causing a national financial crisis, similar to that experienced by Greece, if debt, and therefore government spending, was not reduced. I did not believe this argument at the time and do not believe it now. However, the Conservatives managed to form a government in coalition with the Liberal Democratic Party, led by Nick Clegg, a man of poor political judgement, and in 2015 the Conservatives won a small majority in Parliament, bringing an end to the coalition. In 2017 the Conservatives retained control of the government with the support of the Democratic Unionist Party of Northern Ireland, and in 2019, led by Alexander de Pfeffel Johnson, they won a huge majority. Johnson had not just won a majority, he had also engineered a takeover of the party by nationalist, fiercely anti-EU and evangelically pro-Brexit factions.

 

A consistent theme of Conservative administrations since the 1980s has been the imperative to reduce government spending and the size of the state. During the 2010-2015 coalition, a rhetorical favourite of Conservative politicians was that “we’re all in this together,” a claim that was categorically untrue. Budget cuts consistently targeted the poorest and most deprived in our society. The government avoided increasing the financial burden on the well-to-do and wealthy, and, indeed, made them wealthier. The first step was to demonize working age recipients of state support. The Chancellor of the Exchequer, George Osborne liked to talk of being on the side of “strivers not skivers,” and of hardworking people leaving for work early in the morning while their neighbours, who received government support, remained idle in bed, their curtains drawn. Mr Osborne was successful in creating animosity to recipients of government benefits – so much so that some people in wheelchairs who were assumed to be receiving disability benefits (and therefore suspected skivers) were abused, harassed, and even attacked. The rhetoric was used to justify a number of measures designed to reduce state income support for people in need. The result has been an increase in poverty (including child poverty) over the last thirteen years, and a corresponding increase in the use of foodbanks, which are now a substantial part of the non-governmental welfare scene.

 

The supposed need to reduce public expenditure was used as justification to consistently cut the real value of pay to workers across the public services, either by conceding no pay increases or by granting increases below the rate of inflation. It is worth noting that the real value of pay in the private sector was also reduced (but less so than in the public sector), not directly by government actions, but in response to the economic situation and government policy. For a surprisingly long time workers accepted sacrificing pay increases in order to preserve jobs. However, recent sharply increased inflation concentrated the minds of public sector workers on the sacrifices they had made – hence the numerous strikes of 2023.

 

The government’s treatment of other sectors of the population and the economy on which it relied for votes and funding was quite different. Pensions for example, were increased by the higher of inflation, average earnings, or 2.5% (the so-called triple lock) - the Conservative’s share of the older population’s vote is substantial, its support among the younger less so. The Bank of England’s policy of quantitative easing created large quantities of money seeking assets in which to invest. The result was an asset and stock market boom, which benefited the well-to-do (including the well-to-do pensioners protected by the triple lock). At various times over the last 13 years the government has provided subsidies to buy starter homes, while very little was built for rent to house those who could not afford even a subsidized home. The result has been a boom in house prices – again for the benefit of the well-to-do. Moreover, the Conservatives maintained or introduced a number of measures that benefited the already asset-rich: capital gains tax at a much lower level than income tax; new and generous tax-free allowances for interest and dividend income etc. The Osborne/Cameron slogan that we were “all in it together” was, depending on your taste, an outright lie or a rhetorical sleight of hand.

 

T policy of intentional impoverishment of the majority of workers was accompanied by an expansion of insecure employment. The government boasted (and economists were puzzled) that they had created large numbers of jobs despite cuts in public spending. Many of these jobs are insecure and poorly paid. This has further contributed to the impoverishment of a large proportion of the population. If low-paid workers in insecure employment can afford to rent a home (some struggle to do so) they increasingly have to accept poorly maintained, insanitary housing conditions as an alternative to homelessness. Increasing numbers are homeless and dependent on local government emergency accommodation (often hostels or cheap hotels).

 

Poverty and poor housing are both indicators of poor health. We now live in a country which actively damages the health of the less fortunate, or (if you listen to Conservative rhetoric) people who lack basic budgeting skills (to budget income which they do not have). The life expectancy (which had steadily been increasing until 2010) of the poorer members of our society has decreased. And the lives these people live are increasingly marred by chronic ill health.

 

Conclusion 1: the government has consciously impoverished a substantial proportion of the population, has actively damaged their health and life expectancy, and has, as a matter of policy, increased social inequality.

 

The Conservative party claimed that it was reducing public expenditure while protecting certain aspects of government spending on, for example, the NHS and education. Now, it has been an axiom of British politics since the governments of Mrs Thatcher (1979-1990) that Conservative administrations starve the NHS of resources and weaken the public health service. Since 2010, while the government has increased spending on the NHS by slightly more than the rate of inflation (but not medical inflation, which is much higher), it has ensured (as happened under Mrs Thatcher) that spending on health as a percentage of GDP has ben reduced by comparison to most other developed economies. Consequently, the NHS has fewer hospital beds, less diagnostic equipment and so on, than the health services of other comparable economies. It has also, in particular, consistently reduced the real value of the salaries of workers in the NHS and starved the service of staff.

 

Prime Minister Johnson declared when he was campaigning in the 2019 election that he had an “oven-ready plan” to reform social care, which for decades has been a significant weakness of our health system. As the population has aged, and the number of people requiring domestic or institutional care has increased, government funding of care for those who cannot afford it has declined. One consequence of this is that people who are hospitalized, treated, and are able to return to their home or to a care facility cannot be discharged from hospital because they have not safe place to go. Once elected, Johnson continued to refer to his plan, but did nothing to implement it, or even to define it beyond stating that it was “oven-ready”. When eventually he announced a plan, it consisted of an increase in National Insurance contributions (paid again by those who receive a salary, not by those who possess assets, and not by pensioners) that for the next several years would be used to fund the NHS, not social care. In any case, the plan was scrapped as soon as Johnson was ousted by his own party colleagues for his dishonesty. The social care problem remains unsolved.

 

Moreover, the government devolved responsibility for Public Health from the national level to local government, while progressively reducing the funding of local government, so that the national infrastructure designed to control, for example, disease outbreaks was steadily degraded – just in time for a pandemic. Now, although local governments have limited tax and revenue raising powers, they depend (or rather used to depend) on grants from central government. These have been consistently and radically reduced. Since local administrations had much more immediate demands on their funding than Public Health (e.g. adult and child social care) the budgets and staff of public health departments were reduced. When the pandemic arrived, experts with local knowledge of populations particularly at risk had been lost.

 

Local government is also, of course, about more than public health. Councils are, for example, responsible for the assessments of the educational support required by children with special needs that are the prerequisite for children to receive support. It has become increasingly difficult to get an assessment, and councils frequently simply avoid their obligation to provide adequate support once an assessment has been made.

 

A Conservative party canvasser during local elections once commented to me that local government is about “emptying the bins.” In fact, it is of course about far more. The borough councillor responsible for the Royal Borough of Windsor and Maidenhead’s budget in 2019-2020 told me that “it is anticipated that this year Councils [in England] that provide Children’s care services will overspend their budgets by more than £2 billion.” As the central government has reduced funding directed to local governments, those governments have relied increasingly on their local tax base and on reserves. Of course, the tax base is weakest in areas of the greatest poverty and social disadvantage in which the need for adult and children’s care and other services is the greatest. In a wealthy area such as ours, the council has chosen to keep the principal local tax (Council Tax) low for the homeowners who are a key Conservative constituency by drawing on reserves – until the reserves finally ran out around 2020. Increases in adult social care costs, combined with low local tax rates, are now responsible for a sizeable budget deficit.

 

Conclusion 2: the Conservative government has neglected and/or actively undermined the health system.

 

One of the results of the borough’s budget crisis was a plan to modernize the public library service, modernization in Conservative parlance meaning closure. I am told that, after libraries had been closed during the pandemic, the then-Conservative leader of the council decided that now would be a good time to close all the borough’s libraries. After all, who needs libraries when one has broadband at home and can access books online or buy them from Amazon? Apart from the councillor’s ignorance (perhaps, more accurately indifference) of the social function of libraries in providing books to those who cannot afford them, internet to those who do not have it at home, and social contact, he was also ignorant of the council’s statutory duty to maintain an adequate public library service. He was apparently, irritated when this was pointed out to him, and staff were warned that they might suffer consequences if they referred to the statutory obligation in his presence. Our library in Sunninghill was one of those selected to be modernised into oblivion, but vigorous local opposition and funding provided by our Parish Council saved the day for the next five years.

 

Schools were, in Conservative rhetoric, protected from budget cuts, but again this was an act of deception. Although teacher pay increases were heavily constrained, they were not always fully funded from central government funds. Moreover, since state welfare benefits have been cut, and local government funding savagely reduced, schools find themselves paying for support for children from economically deprived families: food parcels (sometimes not just for the child, but also the family), uniform items and the like, from a budget never previously intended for these purposes. Sunninghill’s primary school is a short walk from our house in a small community of generally well-to-do households. I had assumed that our school would not have to address these kinds of problem. A conversation with the head teacher proved me wrong. Want exists unseen even in seemingly prosperous Sunninghill and Ascot.

 

University education has fared little better. The government determines the fees which students pay for their courses and funds the fees by means of a state-supported student loan. The fee has been frozen for several years. Therefore, the real income of universities has been reduced. Consequently, increasing numbers of teaching staff are employed on short-term, insecure contracts on low salaries. Furthermore, the government has created a supposed market in education: students are customers and universities compete for their custom. Conservative administrations, which frequently advocate abolishing regulation (“a bonfire of red tape” is the favourite phrase), have increasingly regulated universities. The value of a degree is to be determined in purely economic terms: rates of students dropping out, and the percentage of students who find a professional job within 15 months of graduation or who undertake postgraduate study. Students have received the message that the value of a degree is measured entirely by the salary you can expect to earn within a short time of graduating. Moreover, government support for science and technology subjects has been increased, while funding of arts and other “less important” subjects has been reduced. It is no surprise that courses that do not fit the government’s definition of worthwhile are being cut, including some excellent courses, and some fine teachers and scholars are being fired. I am perhaps out of touch and old-fashioned, but a degree is valuable if it trains you to analyze, think for yourself, research and reach sound conclusions, and to express yourself clearly and precisely vocally or in writing. Subsequent employment depends on those abilities at least as much on the content of the degree. My degrees (French, Spanish and a PhD in Mexican history) have been of almost no practical use in my career, but three very good publishing companies were sufficiently impressed with my ability to work things out and make things happen that they employed me for forty years.

 

Conclusion 3: the Conservative government has undermined the education system at both school and university levels.

 

Then, of course, there is Brexit. Now, it is perfectly true that in the 2016 referendum more people voted to leave the EU than to stay. It is equally true that not all Conservatives voted to leave the EU, and that many of those who advocated Brexit did so out of personal conviction. However, there was also an element of political chancers, to whom Brexit offered an opportunity. The most shameless chancer was, of course Boris Johnson, for whom Brexit was the means to achieve his ambition to be Prime Minister. It is also true that for some Conservatives Brexit was the means to redesign the British economy, society and politics, as a low-tax, extra-small state, minimal-regulation, unrestrained free trade country. This faction has not yet won (although they succeeded in briefly holding power under Prime Minister Truss) but the danger remains.

 

Brexit is harmful on a number of levels. It is a strategic political-diplomatic error, which has diminished the UK and reduced its ability to influence international events for the good. We have lost, or severely reduced, our ability to collaborate culturally, academically, scientifically, and on a simply human level with European neighbours with whom we share culture and history. Brexit also threatens the integrity of the UK. Scotland voted to remain in the EU and Brexit has increased nationalist sentiment there. Northern Ireland, which also voted to remain in the EU, was always a problem which the Brexiters never dared to acknowledge. Boris Johnson lied about the Northern Ireland Protocol he agreed with the EU to “Get Brexit done.” The result is a political crisis in Northern Ireland, an increase in support for the nationalist cause, and the likelihood that in the long run Northern Ireland will be united with the Republic of Ireland. It is worth remembering that the full title of the party is the Conservative and Unionist Party. Brexit was such an important objective for the Brexit radicals that the very integrity of the UK is a price worth paying. In the past this would have been unthinkable.

 

Conclusion 4: in the long-run Brexit is the most damaging thing that the Conservatives have done to my country since it is either irreversible or will, at least, not be reversed in what remains of my lifetime. It is simply unforgivable.

 

Theresa May, briefly Conservative Prime Minister 2016-2019, once called the Conservative Party “the nasty party”, and for a time the party attempted to soften its image. However, Brexit changed the Conservative Party radically. A Brexit faction seized control of the party and expelled their most important opponents. A substantial element of the Brexit faction and of the party’s members are a distinctly nasty lot. They harbour a deep loathing and suspicion of those traitors (many millions) who favoured remaining in the EU. My own MP described me, and fellow “remainers” (or “remoaners” as Brexiters like to label their defeated opponents) as anti-democratic, simply because I continue to think that Brexit is an enormous error. This group is, in general, nationalist, anti-immigration (and refugees in particular), deeply opposed to policies designed to prevent or minimize climate change, and authoritarian.

 

They are also authoritarian. Since 2016 the government has taken a number of measures that restrict our human rights. A substantial element of Conservative MPs is keen for the UK to reject the European Convention on Human Rights of 1950, which was in large part drafted by a Conservative UK government. An attempt was made to introduce a UK Bill of Rights, which inter alia would limit “courts’ powers for certain rights, especially Article 8 (right to family life) of the European Convention”; would restrict “UK courts’ power to interpret legislation” so that public authorities would not have to “defend against expensive human rights claims;” and would require a “claimant to demonstrate that they have suffered a significant disadvantage before a human rights claim can be heard in court.” The proposed bill to implement these changes was withdrawn in June 2023, but it remains a hobby horse of a number of MPs.

 

Recent legislation has restricted the right to protest. A protest can be declared unlawful if the police decide that it is too noisy (a term not defined in law), or may cause serious disruption. Individuals can be arrested if they are carrying items that can be used in a protest that the police has deemed to be illegal, especially if they can be used by protesters to “lock on” or glue themselves to a building, road surface etc. The arbitrary nature of these measures was clearly demonstrated on the day of the Coronation of King Charles. Republican demonstrators were arrested because they had placards held together in their van by straps, which police decided they intended to use to fix themselves to something. Workers employed by the local council to ensure the welfare of homeless people sleeping on the streets were arrested the night before the Coronation (and therefore several hours before the event had started) because they were carrying rape alarms (which they distribute to at risk women for their protection). The workers were accused of planning to startle horses in the parade the next day. Finally, an unlucky monarchist tourist was arrested because anti-monarchist demonstrators were standing next to her.

 

In 2016, shortly before I retired, I was asked by my employer to produce a copy of my passport. When I asked why I was required to do this, I was told that it was a government requirement to confirm my right to work in my own country, where I had worked, unchecked, for decades. When I asked why I should comply, I was told that not to do so might cause problems for colleagues working with visas immigration. I complied reluctantly. In May 2023, I was required to produce a photo ID again, on this occasion, for the first time in my life, to be able to vote. This requirement had been introduced by the Conservative government despite the lack of any evidence of voter fraud or irregularities. The new regulation was justified by claiming that it would prevent any future fraud that might be attempted. After the May elections produced poor results for the governing party, one of its MPs who had been an advocate of voter ID described the ID requirement as voter suppression that had misfired by depressing the Conservative vote rather than that of opposing parties.

 

The government has particularly targeted refugees and asylum seekers as a group whose rights the government has restricted in contravention of international law. Those who arrive in the United Kingdom by a means other than one deemed acceptable to the government can now be declared “illegal migrants,” detained, and their right to claim asylum in the UK automatically denied. They may also be deported to “a third country” (Rwanda is proposed), and denied the right to enter the UK in future. Steps have been taken to ensure that the places where people are detained are as unwelcoming as possible, including, painting over murals of Mickey Mouse and other cartoon characters in a child detention centre. Rhetorically, refugees are painted as people who exploit British generosity, a threat, a burden on the taxpayer etc.

 

These elements of the party have also created exaggerated or false stories to create alarm. One Conservative MP claimed, with no evidence other than a contentious “thinktank” report, that schoolchildren are taught to strangle their sexual partners when having sex. I have asked schoolteacher friends about this: they are extremely sceptical that any school would ever have done this, or even considered doing so. The government Business Minister (NB not an education minister) recently alleged, based on a brief, partial, video clip of a class discussion, that a school was allowing a student to self-identity as a cat. She demanded an enquiry. The Office for Standards in Education did so and found nothing untoward, other than that the teacher of the class in question was found not to have handled the discussion well. My guess is that a child in the class was either joking or making an exaggerated point for argument’s sake.

 

Concerning climate change, Conservative members of the Net Zero Scrutiny Group have devised a number of specious arguments to undermine the government’s net zero plans. One of the group’s founders, Craig McKinlay, describes climate change policies as “a net-zero electoral disaster based upon uncosted fairytales”. Another member, Lord Frost, has argued recently that, since more people have died from extreme cold than from extreme heat, warmer temperatures would be a good thing. He failed to mention that his party has done little or nothing to enable those who have died from cold to keep their homes warm, or to address the threat of desertification in countries from which we source our food imports, mitigate sea rise and flooding etc. McKinlay has applied these arguments to the recent extreme heat in much of Europe. He tells us that we in the UK need not worry because, while Europe was hot, we were cool. He has argued that the devastating fires in Greece were caused by arson and were therefore nothing to do with climate change. Assuming arson to be the immediate cause (it may not be) his argument ignores the role of extreme heat and high winds in spreading the fires rapidly. He has also argued that, since the Treasury and the Bank of England have failed to forecast economic trends accurately, we can’t trust scientists to predict the climate (which is much more complex than the economy) correctly. The comparison ignores the enormous accumulated historical evidence of climate change, and speciously depicts climate change as a forecasting error. Now, after narrowly winning a bye-election in Boris Johnson’s former seat by opposing on a single issue, against the expansion of London’s ultra-low emission zone, a measure intended to improve air quality, the government has decided that its best chance of surviving the 2014 election is to pander to the climate deniers, and to depict the Labour Party as “anti-car”, a destroyer of jobs in the fossil fuel industry, and opposed to national energy security.

 

Conclusion 5: Conservative administrations since 2010, and especially since 2016, have been increasingly authoritarian and damaging to the essential interests of the people they govern.

 

Finally, since 2010 we have had five Conservative Prime Ministers in 13 years (an average of 2 years and 7 months each). Between 1940 and 2010 the UK had 13 Prime Ministers, an average of 5.5 years each. In those same seven years, there have been 13 Foreign Secretaries, seven Secretaries of State for Health (including one who served two separate terms), ten Secretaries of State for Education, six Chancellors of the Exchequer, six Home Secretaries.

 

Prime Minister Theresa May was chosen to lead her party, which promptly refused to support her approach to Brexit negotiations and voted against her on all important issues related to Brexit. Mrs May was earnest, unimaginative and uninspiring, but worse was to come. Her successor Boris Johnson was a known liar, and in office he confirmed his reputation for lying and was spectacularly incompetent. He was expelled from office by his own party. His successor, Liz Truss, survived for 50 days before, once again, her party ejected its leader from office.

 

Conclusion 6: the factionalism, incompetence, ineptitude and dishonesty of the Conservative Party have undermined and destabilized the governance of the UK.

 

I recently read a splendid history of London written by Stephen Inwood. In the final chapter Inwood writes:

“social services, schools, libraries and other borough services … were under severe and increasing pressure in the 1980s and 1990s.

            The problem … was … a shortage of cash. The growing inadequacy of council income was a direct result of government policy, which drove down revenues at a time of great social need … It was a notable achievement of central government in these decades to diminish the willingness of … taxpayers to contribute towards costly public services, and to foster the growing belief that taxation was a form of theft and that social problems could be solved without ‘throwing money’ at them. … A city with the capacity to generate wealth on such a scale does not need to endure overfilled railway carriages, understocked classrooms, decaying social services, underfunded libraries, neglected housing estates or families living in fire-trap bed-and-breakfast accommodation. These things are a matter of choice, not necessity.”

 

This gloomy description of 1980s and 1990s London under Conservative national government is a pretty convincing depiction of Conservative-governed Britain three decades later.

 

The Conservatives have damaged our public services and our economy for decades. In the last thirteen years they have added to these achievements assaults on our human rights, and undermining our prospects for managing climate change. It is my social duty to vote for another party in 2024. As a member of the Labour Party, I should, according to the party’s rules, vote for a Labour candidate. But in the 2019 general election the Conservative candidate received 59% of the vote on a 72% turnout. The Liberal Democrat’s candidate received 22% and Labour 15%. The Green Party’s share was 3%. If all those opposition votes were given to a single party, say the Liberal Democrats, the Conservative candidate may be defeated, but that is not a realistic scenario. The important thing in Windsor is not to defeat the Conservative candidate, who cannot lose, but to contribute to a loud national voice that calls for an equitable, tolerant society in which solidarity replaces a bogus hyper-individualism and division, for the restoration of our relationship with the EU, a positive and consistent contribution to international climate change action, and a positive role in international affairs. Given the state of our nation, this is quite a challenge, and I worry that we lack a political party whose leadership is capable of the task.

 

I am still pondering where to put my X when the election comes. I would welcome advice from friends.