Libya polls show that British public is divided

YouGov poll shows 45 per cent of people supporting action in Libya, while ComRes finds 43 per cent o

The first polls gauging British public support for military action have come out – and they show contradictory results.

A YouGov poll for the Sun shows 45 per cent of people supporting action by Britain, the US and France, and 36 per cent stating that it is wrong.

However, a ComRes/ITN poll shows almost exactly the opposite, with 35 per cent in favour of action and 43 per cent opposed to it.

Clearly, this shows that we mustn't be too hasty about declaring that the public is opposed to or in favour of the war, as many news outlets have been doing this morning.

Discussing the ComRes poll, John Rentoul declares that "it is not even as well supported by the British public as the Iraq invasion", citing a Guardian/ICM poll which showed 54 per cent support for Britain's role in the invasion of Iraq in the days after it started.

While it is true that all pollsters showed a boost in support for the 2003 Iraq war after it actually began, the comparison is slightly disingenuous, given the unique circumstances. Drilling down into the figures from Ipsos MORI (taken before the war started) shows that this support was highly conditional – while 74 per cent would support war with proof of WMDs and a UN resolution, just 26 per cent would support it without either of these two things.

It's also relevant that support for the Iraq war (and for Afghanistan) dropped substantially as they dragged on. Over at the Washington Post, Chris Cillizza suggests that the first Gulf war might be a better comparison, as public support started and stayed high:

The secret to that political success? The war was short – military actions lasted less than a month – and the US was widely perceived to be at the head of a broad international coalition that soundly defeated Iraqi dictator Saddam Hussein . . .

Given that history, it's no surprise that President Obama is focusing almost entirely on the planned brevity of the US's military involvement and the near-unanimity of the international community in support of the actions taken against Libya.

This would certainly be a better model for this action – though it's worth noting that neither of today's polls shows public support even approaching the levels seen in 1991, when 80 per cent of the British public thought military action was right.

All today's polls tell us is that the public is still unsure: there is no widespread opposition to it, but nor is there a swell of support.

Samira Shackle is a freelance journalist, who tweets @samirashackle. She was formerly a staff writer for 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