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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I can’t follow Marie Kondo's advice – even an empty Wotsits packet “sparks joy” in me

I thought I’d give her loopy, OCD theories a go, but when I held up an empty Wotsits bag I was suffused with so many happy memories of the time we’d spent together that I couldn’t bear to throw it away.

I have been brooding lately on the Japanese tidying freak Marie Kondo. (I forgot her name so I typed “Japanese tidying freak” into Google, and it was a great help.) The “Japanese” bit is excusable in this context, and explains a bit, as I gather Japan is more on the case with the whole “being tidy” thing than Britain, but still.

Apart from telling us that we need to take an enormous amount of care, to the point where we perform origami when we fold our underpants, which is pretty much where she lost me, she advises us to throw away anything that does not, when you hold it, “spark joy”. Perhaps I have too much joy in my life. I thought I’d give her loopy, OCD theories a go, but when I held up an empty Wotsits bag I was suffused with so many happy memories of the time we’d spent together that I couldn’t bear to throw it away.

After a while I gave up on this because I was getting a bit too happy with all the memories, so then I thought to myself, about her: “This is someone who isn’t getting laid enough,” and then I decided that was a crude and ungallant thought, and besides, who am I to wag the finger? At least if she invites someone to her bedroom no one is going to run screaming from it, as they would if I invited anyone to my boudoir. (Etym: from the French “bouder”, to sulk. How very apt in my case.) Marie Kondo – should bizarre circumstance ever conspire to bring her to the threshold – would run screaming from the Hovel before she’d even alighted the stairs from the front door.

I contemplate my bedroom. As I write, the cleaning lady is in it. To say that I have to spend half an hour cleaning out empty Wotsits packets, and indeed wotnot, before I let her in there should give you some idea of how shameful it has got. And even then I have to pay her to do so.

A girlfriend who used to be referred to often in these pages, though I think the term should be a rather less flippant one than “girlfriend”, managed to get round my natural messiness problem by inventing a game called “keep or chuck”.

She even made up a theme song for it, to the tune from the old Spiderman TV show. She would show me some object, which was not really rubbish, but usually a book (it may not surprise you to learn that it is the piles of books that cause most of the clutter here), and say, “Keep or chuck?” in the manner of a high-speed game show host. At one point I vacillated and so she then pointed at herself and said, “Keep or chuck?” I got the message.

These days the chances of a woman getting into the bedroom are remote. For one thing, you can’t just walk down the street and whistle for one much as one would hail a cab, although my daughter is often baffled by my ability to attract females, and suspects I have some kind of “mind ray”. Well, if I ever did it’s on the blink now, and not only that – right now, I’m not even particularly bothered that it’s on the blink. Because, for another thing, I would frankly not care to inflict myself upon anyone else at the moment.

It was all a bit of a giggle eight years ago, when I was wheeled out of the family home and left to my own devices. Of course, when I say “a bit of a giggle”, I mean “terrifying and miserable”, but I had rather fewer miles on the clock than I do now, and a man can, I think, get away with a little bit more scampish behaviour, and entertain a few more illusions about the future and his own plausibility as a character, when he is squarely in his mid-forties than when he is approaching, at speed, his middle fifties.

Death has rather a lot to do with it, I suppose. I had not actually seen, or touched, a dead body until I saw, and touched, my own father’s a few weeks ago. That’s what turns an abstract into a concrete reality. You finally put that to one side and gird up your loins – and then bloody David Bowie snuffs it, and you find yourself watching the videos for “Blackstar” and “Lazarus” over and over again, and reach the inescapable conclusion that death is not only incredibly unpleasant, it is also remorseless and very much nearer than you think.

And would you, dear reader, want to be involved with anyone who kept thinking along those lines? I mean, even if he learned how to fold his undercrackers into an upright cylinder, like a napkin at a fancy restaurant, before putting them in his drawer? When he doesn’t even have a drawer?

Nicholas Lezard is a literary critic for the Guardian and also writes for the Independent. He writes the Down and Out in London column for the New Statesman.

This article first appeared in the 05 February 2015 issue of the New Statesman, Putin's war