Ed Miliband: tough on parasites

In an interview with the Daily Telegraph, the Labour leader talks about reforming capitalism - and practises a little pest control.

Today's Daily Telegraph carries an interview with Ed Miliband, written by former editor Charles Moore. In it, the Labour leader expands on one of the themes he explored in the New Statesman last week: his plan to "remake capitalism".

He tells Moore:

'I am now much clearer than I was two years ago about the depth of change we need. . . Tony and Gordon were products of their historical circumstances.’ They had to break with the past, but in the process, New Labour became too credulous about business: 'The consensus around regulation ['light touch’] turned out to be really problematic.’ The project became 'too easy and accepting’ about globalisation: 'It’s just not true that all the top CEOs will leave the country unless we pay them whatever they demand’.

The interview picks up on some concrete policy proposals: there is a "strong case" for making takeovers more difficult, and ordinary employees should be represented on the committees which decide executive pay. Miliband also believes that there are too few banks and that the "big six" energy companies have a stranglehold on supply. He adds that wealth is created by "the private sector working with the government. We shouldn't be ashamed of wanting an industrial policy".

Miliband is careful to reassure Telegraph readers that a top 50% tax rate is the limit for him and that it's fine to be rich "if you make it the hard way".

He also manages to swat a mosquito which has settled on Charles Moore's shoulder:

With a commanding show of decision, Mr Miliband squashes it, spattering its remarkably copious blood over my light grey suit. So that’s how he deals with capitalist parasites.

Perhaps he's been taking tips from Barack Obama:

 

Ed Miliband: "It's just not true that CEOs will leave unless we pay them whatever they demand". Photo: Getty

Helen Lewis is deputy editor of the New Statesman. She has presented BBC Radio 4’s Week in Westminster and is a regular panellist on BBC1’s Sunday Politics.

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