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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The Brexiteers who hope Article 50 will spark a bonfire of workers' rights

The desire to slash "employment red tape" is not supported by evidence. 

The Daily Telegraph has launched a campaign to cut EU red tape. Its editorial they decried the "vexatious regulations" that "hinder business and depress growth", demanding that we ‘throw regulations on the Brexit bonfire’.

Such demands are not new. Beyond immigration, regulation in general and employment protection in particular has long been one of the key drivers of frustration and fury among eurosceptics. Three years ago, Boris Johnson, decried the "back breaking" weight of EU employment regulation that is helping to "fur the arteries to the point of sclerosis". While the prospect of slashing employment rights was played down during the campaign, it has started to raise its head again. Michael Gove and John Whittingdale have called on the CBI to draw up a list of regulations that should be abolished after leaving the EU. Ian Duncan Smith has backed the Daily Telegraph’s campaign, calling for a ‘root and branch review’ of the costs of regulatory burdens.

The Prime Minister has pledged to protect employment rights after Brexit by transposing them into UK law with the Great Repeal Bill. Yet we know that in the past Theresa May has described the social chapter as a sop to the unions and a threat to jobs.

So what are these back-breaking, artery-clogging regulations which are holding us back? One often cited by Brexiteers is the Working Time Directive. This bit of EU bureaucracy includes such outrageous burdens as the right to paid holiday and breaks, and protection from dangerous and excessive working hours.

Aside from this, many other workplace rights we now take for granted originated from or were strengthened by the EU. From protection from discrimination and the right to equal treatment for agency workers and part time workers; to rights for women and for working parents; and rights to the right to a voice at work and protection from redundancy.

The desire to slash EU-derived employment rights is not driven by evidence. The UK has one of the least regulated labour markets among advanced economies. The OECD index of employment protection shows that the UK comes in the bottom 25 per cent on each of their four measures.

Even if the UK was significantly more regulated than similar countries – which it is not – there is no reason to expect that slashing rights will boost growth. There is no correlation between the strictness of employment protection – as measured by OECD – and economic success. France and Germany both have far more restrictive employment protection than the UK, yet their productivity is far higher than ours. The Netherlands and Sweden have higher employment rates than the UK, yet both have greater protections for those workers. And if EU red-tape was so burdensome, so constraining on businesses, then why has the employment rate continued to increase, standing as it does at a record high?

While the UK certainly doesn’t suffer from excessive employment regulation, too many employees do suffer from insecurity, precarity and exploitation at work. We’ve seen the exponential growth of zero-hours contracts, as well as the steady rise of agency work and self-employment. We’ve seen growing evidence of endemic exploitation and sharp practices at the bottom end of the labour market.

Instead of evidence, it seems the desire to slash employment rates is driven by ideology. Some clearly see Brexit as an opportunity to finish what Margaret Thatcher started, as Lord Lawson, who served as her Chancellor admits. He claims the deregulation of the 1980s transformed the economy, and that leaving the EU provided "the opportunity to do this on an even larger scale with the massive corpus of EU regulation. We must lose not time in seizing this opportunity".

The battle that is to come over employment regulation is just part of a wider struggle over what future Britain should have as we leave the EU. At the start of the year, the Chancellor warned our EU neighbours that if the UK did not get a good deal, we would be forced to abandon the European-style taxation and regulation and "become something different". In a thinly veiled threat, he said that the UK would ‘do whatever we have to’ to compete with the EU. To be fair, the Chancellor said this was not his preferred option. But we know that many see this as the future for the UK economy. Emboldened by both their triumph in Brexit and by an enfeebled and divided opposition, many Brexit-ultras want to build a low-tax, low-regulation, offshore economy that would seek aggressively to undercut the EU. This turbo-charged, Brexit-boosted Thatcherism would not just be bad for our continental neighbours, it would be bad for UK workers too.

Britain faces a choice on leaving the EU. We can either seek to compete in what the last Chancellor called the "global race" by driving up productivity, boosting public and private investment, and improving skills. Or we can engage in a race to the bottom, by slashing rights at work, and making Britain in the words of Frances O’Grady the "bargain basement capital of Europe".

Joe Dromey is a senior research fellow at IPPR, the progressive policy think tank.