NHS horror stories, my life as a Twitter fogey, and cricket’s robot generation

Peter Wilby's "First Thoughts" column.

Horror stories about the National Health Service come thick and fast, conveniently for a government that wants to hand it over to private capital. One week, it is chaos in A&E; the next, substandard care at 14 hospital trusts and old folk being ushered to an early grave by the Liverpool Care Pathway (LCP). We should treat these stories with scepticism even when they are apparently validated by official inquiries.

With all the talk of “excess deaths”, you would think that our hospitals had become killers. Yet, as the NHS medical director for England, Bruce Keogh, observes in his report on the 14 “failing” trusts, overall mortality in hospitals has fallen by about 30 per cent over the past decade.

Inquiries, however, rarely conclude that the problems they were set up to address don’t exist and they would be dismissed as whitewashes if they did. Given the emotion and fears surrounding serious illness and particularly death, it’s easy to find allegations of medical neglect. Julia Neuberger’s report on the LCP is replete with phrases such as “some people”, “many people” and “all too often”. There are no references to randomised sample surveys. The inquiry invited submissions from the public (it received 483), talked to 113 people at meetings and looked at hospital complaints. Such evidence should not be ignored but it is naturally biased towards those who suffered bad experiences.

No institution is perfect and anything involving medicine, which is as much an art as a science, will be more imperfect than most. What we don’t know is whether a health service run by private providers would be better.

I offer this snippet: in 2010, the US health department’s inspector general reported that 13.5 per cent of Medicare hospital patients suffered “harm” from “adverse events”, nearly half of them because of care failures. British newspapers love to highlight cases of “wrong-site surgeries”, in which ovaries are taken out instead of the appendix, for example. The United States has 40 of those a week; the UK has about 60 a year. The NHS has failings but they seem relatively few and, by international standards, very cheap.

Guilt by association

What’s in a name? The Neuberger report acknowledges that “many relatives” of patients on the LCP felt their loved ones had had “good deaths”. Yet it recommends dropping the term. “Pathway”, it argues, suggests patients being speeded directly to their coffins. I wonder if “Liverpool” isn’t the greater problem. Thanks partly to the Sun and Boris Johnson, the city has acquired negative associations in the past 25 years. Mention Liverpool and people think of poverty, unemployment, riots, too much drink and a declining football team.

Seen but not heard

The BBC’s director general, Tony Hall, says that he intends to stop actors muttering in the corporation’s dramas. If so, he will be performing a service to theatregoers as well as TV viewers. Actors, it seems, are no longer being taught to articulate their lines clearly and “throw” their voices, largely because the big money is now in TV, where authenticity is thought more important than audibility. Being deaf, I nearly always buy front-row seats at the theatre, but in the West End recently, we sat in the grand circle and my wife, whose hearing is perfect, complained that she couldn’t hear, either. Theatregoers should start a campaign and, at an agreed signal, stand in unison and shout: “Speak up!”

Social outcast

We hear much about how social media companies hold extensive databases on us that could be exploited by governments and corporations. We also hear about their inadequate controls over insulting comments. But I have not noticed discussion of their arbitrary power over users. I returned from holiday to find my Twitter account “suspended”, without warning or explanation. After a polite, emailed inquiry, I was told to look at the rules. I replied I couldn’t see how I had broken them. Two weeks later, someone at Twitter emailed me, saying, “It’s been awhile since we’ve heard from you,” and that “hopefully” the matter had been resolved. It certainly hadn’t, I replied. The account was restored a few days later, still without explanation or apology.

Being an old fogey, I use Twitter spasmodically and was not greatly inconvenienced by its loss. To some users, however, it has become an essential working tool. In a telling example of how technology can restrict rather than widen choice, many feel they must use it because their professional peers do so. We should know more about the Californian geeks who run social media and what redress they offer to those arbitrarily blackballed.

Analyse this

How could Ashton Agar, a 19-year-old cricketer playing his first Test and batting at No 11, make 98, the highest score of Australia’s first innings against England at Trent Bridge? The answer is that, since Agar had played only 16 unremarkable first-class innings, the England coaches, lacking videos of him, could offer bowlers no plans for getting him out. International sides now analyse opponents exhaustively. They produce pie charts, spreadsheets, graphs and other statistical paraphernalia, searching for a batsman’s weakness as assiduously as physicists searched for the Higgs boson. Even the best modern bowlers are robots, programmed by back-room boffins. Without the usual input, they malfunction.

What redress does Twitter offer to the arbitrarily blackballed? Photograph: Getty Images

Peter Wilby was editor of the Independent on Sunday from 1995 to 1996 and of the New Statesman from 1998 to 2005. He writes the weekly First Thoughts column for the NS.

This article first appeared in the 22 July 2013 issue of the New Statesman, How to make a saint

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How did I, obsessed with non-places, not know about the Trafford Centre?

My wife had booked us all in to a showing of the latest Bond film at the IMAX Cinema at the Trafford Centre. “Why the Trafford Centre?” I taxed her. She looked at me as if I were a complete ass, but refused to enlighten me. 

Last year I bought a copy of J G Ballard’s last novel, Kingdom Come, a dystopic tale of the near future in which bored suburbanites descend into anomic violence as they retreat inside a giant shopping mall. Predictably, I bought my copy at the Bluewater shopping mall in north Kent, on the outskirts of London. Bluewater held the title of Britain’s biggest shopping mall for a number of years and it is surpassing large: a huge circular corridor that has become a destination. I asked a police officer where the Waterstones was and discovered she was a good old-fashioned bobby-on-the-beat – her beat having been, for seven years, to walk slowly around and around . . . Bluewater.

But I wasn’t fettered by Bluewater’s surly gravity, any more than I was galvanised by rampant consumerism. Novel purchased, I took a cab over the soaring Queen Elizabeth II Bridge to Essex, where I alighted at Bluewater’s twin establishment: the Lakeside shopping mall in West Thurrock. I headed for the Lakeside branch of Waterstones, where I . . . well, you guessed it: I returned my copy of Kingdom Come. This surreal little exercise was undertaken for the BBC Radio 4 documentary Malled: Sixty Years of Undercover Shopping, and I’ve detailed it here purely in order to illustrate this point: I have more than a passing interest in shopping malls.

This is why the events of a fortnight ago, when Family Self went up to Manchester for what is termed, I believe, a “city break”, seemed quite so bizarre. My wife had booked us all in to a showing of the latest Bond film at the IMAX Cinema at the Trafford Centre. “Why the Trafford Centre?” I taxed her. “It’s in Trafford, which is five miles from the city centre.” She looked at me as if I were a complete ass, but refused to enlighten me. My revelation came later, when we were wandering the rococo halls of the Trafford Centre, marvelling at the lashings of gold leaf applied to the serried columns as our soles slapped on the Italian marble flooring. My wife couldn’t believe that one such as I, obsessed by what the French philosopher Marc Augé has named “non-places”, didn’t know about the Trafford Centre.

But I didn’t – it was a 207,000-square-metre hole in my map of the world. I knew nothing of the bitter and protracted wrangling that attended its inception, as successive planning applications were rejected by ever higher authorities, until our Noble Lords had to step in to ensure future generations will be able to buy their schmutter at TK Maxx and then sip their lattes at Starbucks without having to brave the harsh Lancashire elements. Did I feel small as my savvier spouse led me through these storied halls? You bet your waddling, wobbling, standing-still-on-the-travelator bum I did. How could I not have known about the great central dome of the Trafford mall, which is bigger – and statelier – than that of St Paul’s? How could I have been unaware of the Orient, Europe’s largest food court, with its seating for 1,800 diners, served by a plethora of exciting outlets including Harry Ramsden’s, Carluccio’s and those piquant bun-pushers, McDonald’s?

Actually, the Orient completely bowled me over. The Trafford Centre’s imagineers point to the nearby Manchester Ship Canal as influencing this wholly novel and utterly weird space, which is formed by a sort of Möbius strip of 1930s ocean-liner design, being at once superstructure – railings, funnels, tables arranged to simulate the deckchairs on a sun deck – and interior. However, nothing like this ever cruised by Runcorn. Not that I object to this, any more than I objected to the cluttered corridor full of orientalism – noodle bars, sushi joints, all-you-can-eat Chinese barbecues – that debouched from it and led us back into the weirdly glistering main retail areas, with their ornamental griffins and neoclassical columns bodged up out of medium-density fibreboard.

The Trafford Centre’s imagineers also make great play of design features – such as the aforementioned griffins – that are meant to tie the humongous mall to its hinterland (these are the heraldic symbols of the de Traffords, who used to own hereabouts), and to the north-east’s proud industrial heritage. But this is all ornamental balls; the truth is that the Trafford Centre’s ambience is so sumptuously wacky, it could quite reasonably be twinned with Las Vegas.

While the rest of the family went in search of retail opportunities, I watched the Mancunians process. It occurred to me that if there were any influences at work here – besides the Baudrillardian ones of hyperreality and simulation that underpin so much of the contemporary built environment – it was the presence of a large British Asian community. The only people who didn’t look out of both place and time, wandering about among all the gilded pomp and crystalline circumstance, were women wearing saris, shalwar kameez and burqas. Tracksuit bottoms and hoodies just didn’t cut it – although, I concede, come the breakdown in civil society anticipated in Kingdom Come, this pseudo-sportswear will come into its own as the perfect pillaging outfit.

Next week: Lives of Others

Will Self is an author and journalist. His books include Umbrella, Shark, The Book of Dave and The Butt. He writes the Madness of Crowds and Real Meals columns for the New Statesman.

This article first appeared in the 26 November 2015 issue of the New Statesman, Terror vs the State