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Huhne’s honest hypocrisy, Leicester’s lost king and Gove’s smear tactics

Peter Wilby's "First Thoughts" column.

Faced with the charge of dodging a speeding penalty, Chris Huhne lied persistently, even, it seems, to some of his oldest friends. He is not the first politician in trouble to have done that. Why are we surprised? Social life would be intolerable if everybody told the truth the whole time; neuropsychiatrists say there is a part of the brain dedicated to lying. And most people give carefully edited versions of their qualities, beliefs and ambitions when they are applying for a job or promotion.

The difference for politicians is that lies and hypocrisies necessarily become part of a public performance and are scrutinised more closely than anyone else’s. Dissembling becomes a round-the-clock business and it is almost impossible to know when to stop. Bill Clinton, Huhne may have reflected, survived a blatant lie to the American public on a technicality about what constituted “sexual relations with that woman”. Why, if the prosecution couldn’t prove, to the required legal standards, that he was driving his car on the night of the speeding offence, should he not be equally fortunate? The AA says roughly 300,000 motorists have at some time “swapped” speeding points. Would it have bothered Lib Dems or their voters if Huhne had escaped conviction? Until he pleaded guilty, he thought he had a chance of becoming party leader. He was probably right.

The artless dodger

In his book Political Hypocrisy (2008), the Cambridge political theorist David Runciman argued that politics doesn’t offer a choice between truth and lies, or between sincerity and hypocrisy, but between “sincere liars” and “honest hypocrites”. The latter have clear goals and firm beliefs but tend, in singleminded pursuit of them, to compromise personal principles and dissemble about their own characters.

Think of Gordon Brown, son of the manse and model of integrity, who behind the scenes could be a ruthless, petulant bully.

The sincere liars make no claim to fixed beliefs and principles. They are conjurors, who take risks and make things happen with, they hope, benign results. They frequently stretch the truth but, in so far as what you see is what you get, they are sincere. These days, voters seem to prefer the sincere liar, as the success of Bill Clinton, Tony Blair, David Cameron and Nick Clegg suggests.

Which is Huhne? I see him as an honest hypocrite with strong beliefs in Keynesian economics, the European Union and environmental protection but a man who hides a dark side beneath a warm manner and sunny smile. My wife rumbled him years ago when we were invited to the annual January party at his home in south London, only to find him absent. He had gone canvassing for the Lib Dem leadership, leaving his then spouse and now-anguished antagonist to preside.

That man, my wife confided, is not what he wants us to think he is.

When the feeling’s gone . . .

Is Huhne’s downfall tragic, as many of his fellow politicians suggest? In tragic drama, according to Aristotle, a great person suffers a reversal of fortune, “not due to any moral defect or flaw, but a mistake of some kind”. Does covering up a speeding offence count as a mere mistake? The crimes of lowlier folk usually attract harsher language.

MPs also describe Huhne’s case as “terribly sad”. For anybody who has read the private text messages exchanged between him and his son and now published widely, there should be no argument. Nothing can be sadder than a parent trying unavailingly to regain a child’s love and respect. But I’m not sure that’s what Westminster – which sees everything in terms of power and preferment –means by “sad”.

Car park king

It is somehow typical of Leicester, my home town, that it has for so long left a king of England rotting beneath a car park.

Leicester has an aversion to anything fancy. J B Priestley found it “busy and cheerful and industrial and built of red brick and nothing else”. Leicester folk traditionally made socks, the least glamorous item of clothing. There is no “Leicester sound”, unless you count Engelbert Humperdinck. Though C P Snow, Joe Orton and Sue Townsend were all born there, none created what you might call a literary tradition.

Leicester did, however, give me a lifelong taste for living quietly and unfashionably, which is why I moved to Loughton, Essex.

Taking the Mickey

I have written at least five lengthy articles and innumerable items in this column which have been critical of the Education Secretary, Michael Gove. I’ve accused him of being stuck in the past, wasting money, using dodgy statistics, grabbing power and much else. So why, unlike colleagues such as Toby Helm (Observer) and Chris Cook (Financial Times), have I not been smeared on @toryeducation?

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 11 February 2013 issue of the New Statesman, Assange Alone

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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