The welfare debate and the end of reason

The way in which the entire debate on benefits seems to be taking place entirely outside the realms of logic seems unprecedented, says Alex Andreou.

I am quite frightened. There have always been some unreasonable people in politics. However, the way in which the entire debate on benefits seems to be taking place entirely outside the realms of logic, seems unprecedented. The way in which evidence is openly sneered at, is nothing short of medieval. The End of Reason.

People going to work early in the morning were stopped outside a London tube station and "vox-popped" by Channel 4 News.

"What do you think about the proposed cap on benefits?", they were asked. "If I have to get up and go to work, I don't see why they shouldn't have to", said one person. "I think it's fair," said another. Challenged by the reporter on whether it's fair on someone who has just been made redundant and has been paying tax and NI for years, she added "well, obviously not them".

The debate earlier in the House of Commons displayed equal levels of Daily Mail common sense. A hissing Kris Hopkins MP suggested that unemployment was "a lifestyle choice". Aidan Burley MP - you know, the one that thinks Nazis are an appropriate theme for a party - read out a letter from an unnamed constituent, relating how she had heard from an unnamed friend, that she was claiming five hundred pounds a week in benefits.

Asked about trial schemes today, Chris Grayling - the dude in charge of Justice, no less - said: “The last Government was obsessed with pilots. Sometimes you just have to believe in something and do it.” That's right. None of your namby-pamby, pinko-leftie evidence rubbish. YEAH. We just think of stuff and do it. And, as the last budget proved, then hastily undo it.

And so it goes, the End of Reason.

A national debate, orchestrated from the top down, which cares not a jot for facts or evidence. Facilitated by the poison pumped daily through our television set, which has seeped so deep into our national muscle memory that we are no longer able to distinguish between Jeremy Kyle guests, chosen because they make for good voyeurism, and ordinary decent people. Our reaction as considered as that of a patellar ligament to a doctor's reflex hammer.

So, how do we fight it? Anger may well provide the energy, but it is not the whole answer. Reason, logic, truth are - and have always been - the precision instruments for dissecting hysterical phobias.

The Conservatives will continue to speak the language of fear. It suits them; it is all they know. They released this image yesterday.

Look at that little arrow. You're only getting that now. Look at that BIG ARROW. Someone else is getting that. Look at what all that scrounger waste can win you. Iain, show the contestants what is behind door number 1. Doctors! And behind door number 2? Teachers! And let's open door number 3. A tax cut of ONE HUNDRED AND FIFTY POUNDS!

How exciting. So, what are we getting for sentencing two million innocent children to hunger? Well,  in fact, none of the above. NHS frontline staff numbers are declining, education is being hung, drawn and privatised and the tax burden on the majority of the electorate is higher than when the coalition took over.

But at least my arrow will get bigger, right?

Guess again. Quite contrary to the rhetoric of "making work pay" this measure does absolutely nothing to improve what work pays. As a matter of fact, making the 9 unemployed people chasing every 1 vacancy that much more desperate, is likely to have a deflationary effect on your wages. Your arrow is shrinking.

But at least this will get people back to work - the government keeps saying that. That's true, isn't it?

Wrong again. This bill does not create a single job. Indeed, the IMF recently admitted that cutting of precisely this sort has a disproportionately negative effect on growth. Essentially, by reducing the spending power of people who spend all their income on necessary goods and services (rather than those who squirrel it away in tropical island tax havens), local businesses sell less and the economy contracts.

What's that, Channel-4-News-lady-outside-the-tube-station? You work in a shop? Not for long. Soon, you will get your wish fulfilment. In a way. You won't have to resent those who don't get up to go to work. You will join them; with the added bonus of having the government that made you unemployed call you vermin. It may not be economic growth, but it is an opportunity for personal growth, don't you think?

So, what does it actually do, this bill? The short version: it attempts to plug a hole in the Government's forecasts, which keep getting revised down and down and further down, as if calculated by an over-enthusiastic limbo dancer. Only the savings are small, the hole is massive and their policies (including this one) are making it bigger. So, it's more like throwing a single shrimp into a shark's gaping mouth. Bad news for the shrimp, little effect on your chances of survival.

The added bonus is that nobody seems to be talking about huge multinationals paying no tax in this country, about which everybody seemed to be talking a month ago.

The End of Reason.

Several coalition MPs even suggested a link between rises in tax credits and the financial crisis. "Is there a direct correlation between the time that tax credits started," asked Marcus Jones MP, and "the start of the financial crisis"?

I would love to tell you that Hansard recorded the response: "Which crisis? The global one? The one that started in Iceland in financial institutions, spread to US  financial institutions and eventually reached the financial institutions of the UK? Of course there is no correlation, direct or indirect, you fucking numpty."

Sadly, the response by Alun Cairns MP was: "My Hon. Friend makes an excellent point". Pretty much any point is an excellent point, when you are witnessing the End of Reason.

An estate in Rochdale, named the most deprived area in the UK. Photo: Getty

Greek-born, Alex Andreou has a background in law and economics. He runs the Sturdy Beggars Theatre Company and blogs here You can find him on twitter @sturdyalex

Getty
Show Hide image

All doctors kill people – and the threat of prosecution is bad for everyone

We must recognise the reality of medical practice: just because a doctor makes a mistake, that doesn’t mean they’ve all broken the law. 

On 15 November the Court of Appeal quashed the 2013 conviction for gross negligence manslaughter (GNM) of a senior consultant surgeon in London, David Sellu. Sellu, who had completed his prison term by the time the appeal was heard, will never get back the 15 months of his life that he spent in jail. Nor will the personal and family trauma, or the damage to his reputation and livelihood, ever properly heal. After decades of exemplary practice – in the course of the investigation numerous colleagues testified to his unflappable expertise – Sellu has said that he has lost the heart ever to operate again.

All doctors kill people. Say we make 40 important decisions about patients in a working day: that’s roughly 10,000 per annum. No one is perfect, and medical dilemmas are frequently complex, but even if we are proved right 99 per cent of the time, that still leaves 100 choices every year where, with the benefit of hindsight, we were wrong.

Suppose 99 per cent of those have no negative consequences. That’s still one disaster every 12 months. And even if most of those don’t result in a fatal outcome, over the course of a career a few patients are – very regrettably – going to die as a result of our practice. Almost invariably, these fatalities occur under the care of highly skilled and experienced professionals, working in good faith to the very best of their abilities.

If one of these cases should come before a crown court, the jury needs meticulous direction from the trial judge on the legal threshold for a criminal act: in essence, if a doctor was clearly aware of, and recklessly indifferent to, the risk of death. Sellu’s conviction was quashed because the appeal court found that the judge in his trial had singularly failed to give the jury these directions. The judiciary make mistakes, too.

Prosecutions of health-care professionals for alleged GNM are increasing markedly. The Royal College of Surgeons of England identified ten cases in 2015 alone. This must reflect social trends – the so-called “blame culture”, in which we have come to believe that when a tragedy occurs, someone must be held responsible. In every one of these cases, of course, an individual’s life has been lost and a family left distraught; but there is a deepening sense in which society at large, and the police and Crown Prosecution Service (CPS), in particular, appear to be disconnected from the realities of medical practice.

Malpractice investigation and prosecution are horrendous ordeals for any individual. The cumulative impact on the wider health-care environment is equally serious. In a recent survey of doctors, 85 per cent of respondents admitted that they were less likely to be candid about mistakes, given the increasing involvement of the criminal law.

This is worrying, because the best way to avoid errors in future is by open discussion with the aim of learning from what has gone wrong. And all too often, severely adverse events point less to deficiencies on the part of individuals, and more to problems with systems. At Sellu’s hospital, emergency anaesthetic cover had to be arranged ad hoc, and this contributed to delays in potentially life-saving surgery. The tragic death of his patient highlighted this; management reacted by putting a formal rota system in place.

Doctors have long accepted the burden of civil litigation, and so insure themselves to cover claims for compensation. We are regulated by the General Medical Council, which has powers to protect patients from substandard practice, including striking off poorly performing doctors. The criminal law should remain an exceptional recourse.

We urgently need a thorough review of the legal grounds for a charge of GNM, with unambiguous directions to the police, CPS and judges, before the spectre of imprisonment becomes entrenched for those whose only concern is to provide good care for their patients. As Ken Woodburn, a consultant vascular surgeon in Cornwall who was accused and acquitted of GNM in 2001, has said: “You’re only ever one error away from a manslaughter prosecution.”

This article first appeared in the 01 December 2016 issue of the New Statesman, Age of outrage