Poll reveals huge potential support for the far right. Why?

What <em>Searchlight</em>’s new survey tells us about race, class and immigration in Britain.

Could half of Britain's population vote for the far right? An alarming story in today's Observer suggests so:

A Populus poll found that 48 per cent of the population would consider supporting a new anti-immigration party committed to challenging Islamist extremism, and would support policies to make it statutory for all public buildings to fly the flag of St George or the Union flag.

The poll, which was commissioned by the anti-racist charity Searchlight Educational Trust, found that voters would be willing to support such a party if it distanced itself from fascist imagery and violence. The results won't be published in full until tomorrow, but here are a few initial thoughts, based on the Observer's story and Searchlight's executive summary:

Britain is no different from the rest of Europe. The past decade has seen a rise in popular anti-immigrant and anti-Muslim sentiment across the continent; if Britain has not seen a rise in support for far right parties comparable to France, Sweden or the Netherlands, it is not because Britons are exceptionally tolerant people. Rather, as the Searchlight report says, it is "simply because their views have not found a political articulation".

There is much to celebrate about what has been achieved in the past 30 years in terms of race relations: but this has been fought for and won largely by the communities at the sharp end of racism, not because of any exceptional aspect of the national character.

Today's prejudices are expressed in terms of culture, not race. Under Nick Griffin, the British National Party has made great efforts to adopt the language of identity politics; it has recently been outstripped in this by the English Defence League, which touts itself as a multiracial coalition of people opposed to Islamic extremism. English nationalism is on the rise, with 39 per cent of poll respondents identifying themselves as English, rather than British.

On the face of it, this can appear more inclusive, compared to the imperialist connotations of the Union Jack. But it's still nationalism, with all the hazards that entails, and the way the EDL has used it to rally large, indimidating demonstrations that target poor Asian communities in Luton, Stoke-on-Trent, Bradford and elsewhere reinforces Gary Younge's claim that we are living in an age where old views have been grafted "on to new scapegoats". Racism by any other name?

– "Tough" talk from mainstream politicians doesn't help. We've seen over a decade of senior politicians, from Blunkett to Hodge to Brown to Cameron, making provocative statements about immigration, culture and national identity. This may draw praise from our country's right-wing press, but it has done nothing to halt the rise of popular prejudice. In fact, it's most likely fuelled it.

– Class still matters. Searchlight identifies "social and economic insecurity" as being a driver for anti-immigration sentiment. It'll be interesting to see how fully this is explored in the full report, but to me this seems to be a euphemism for class. Working-class communities around Britain were left out of the New Labour boom, and they're now the hardest hit by the coalition's cuts. Fears about job security, or housing, may well be expressed in terms of opposition to immigration (which includes a significant minority of black and Asian respondents to the poll), but this doesn't mean it's the cause.

Under Tony Blair, Labour exorcised the spectre of class from mainstream politics. This has inadvertently given racist and anti immigrant propaganda (whether from the BNP, or from more "respectable" sources) greater traction, because people no longer have a progressive framework through which to address their discontent.

– We can't rely solely on anti-racist campaigning. This is not to disparage the vital work done by both Searchlight and Unite Against Fascism, particularly in the run-up to last year's general election. It is crucial that racist and fascist politics remain firmly outside the mainstream, and that people be given the confidence to oppose them within their own communities. However, all this can do is create breathing space for the left to build a popular alternative to the causes of support for the far right.

Searchlight concludes from the poll that people are receptive to "messages of openness, acceptance and pluralism", but politics is also about conflict – about the assertion of one group's interests over another.

Support for the far right was on the rise well before the global financial crisis; in the aftermath, as a programme of cuts is being pushed through by a government that has placed itself unashamedly on the side of the wealthy, we need a political movement that can stand up for the whole of the working class more urgently than ever.

Daniel Trilling is the Editor of New Humanist magazine. He was formerly an Assistant Editor at the New Statesman.

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Want to know how you really behave as a doctor? Watch yourself on video

There is nothing quite like watching oneself at work to spur development – and videos can help us understand patients, too.

One of the most useful tools I have as a GP trainer is my video camera. Periodically, and always with patients’ permission, I place it in the corner of my registrar’s room. We then look through their consultations together during a tutorial.

There is nothing quite like watching oneself at work to spur development. One of my trainees – a lovely guy called Nick – was appalled to find that he wheeled his chair closer and closer to the patient as he narrowed down the diagnosis with a series of questions. It was entirely unconscious, but somewhat intimidating, and he never repeated it once he’d seen the recording. Whether it’s spending half the consultation staring at the computer screen, or slipping into baffling technospeak, or parroting “OK” after every comment a patient makes, we all have unhelpful mannerisms of which we are blithely unaware.

Videos are a great way of understanding how patients communicate, too. Another registrar, Anthony, had spent several years as a rheumatologist before switching to general practice, so when consulted by Yvette he felt on familiar ground. She began by saying she thought she had carpal tunnel syndrome. Anthony confirmed the diagnosis with some clinical tests, then went on to establish the impact it was having on Yvette’s life. Her sleep was disturbed every night, and she was no longer able to pick up and carry her young children. Her desperation for a swift cure came across loud and clear.

The consultation then ran into difficulty. There are three things that can help CTS: wrist splints, steroid injections and surgery to release the nerve. Splints are usually the preferred first option because they carry no risk of complications, and are inexpensive to the NHS. We watched as Anthony tried to explain this. Yvette kept raising objections, and even though Anthony did his best to address her concerns, it was clear she remained unconvinced.

The problem for Anthony, as for many doctors, is that much medical training still reflects an era when patients relied heavily on professionals for health information. Today, most will have consulted with Dr Google before presenting to their GP. Sometimes this will have stoked unfounded fears – pretty much any symptom just might be an indication of cancer – and our task then is to put things in proper context. But frequently, as with Yvette, patients have not only worked out what is wrong, they also have firm ideas what to do about it.

We played the video through again, and I highlighted the numerous subtle cues that Yvette had offered. Like many patients, she was reticent about stating outright what she wanted, but the information was there in what she did and didn’t say, and in how she responded to Anthony’s suggestions. By the time we’d finished analysing their exchanges, Anthony could see that Yvette had already decided against splints as being too cumbersome and taking too long to work. For her, a steroid injection was the quickest and surest way to obtain relief.

Competing considerations must be weighed in any “shared” decision between a doctor and patient. Autonomy – the ability for a patient to determine their own care – is of prime importance, but it isn’t unrestricted. The balance between doing good and doing harm, of which doctors sometimes have a far clearer appreciation, has to be factored in. Then there are questions of equity and fairness: within a finite NHS budget, doctors have a duty to prioritise the most cost-effective treatments. For the NHS and for Yvette, going straight for surgery wouldn’t have been right – nor did she want it – but a steroid injection is both low-cost and low-risk, and Anthony could see he’d missed the chance to maximise her autonomy.

The lessons he learned from the video had a powerful impact on him, and from that day on he became much more adept at achieving truly shared decisions with his patients.

This article first appeared in the 01 October 2015 issue of the New Statesman, The Tory tide