David Boyle's Blog, page 95
February 14, 2012
Saving Greece from the euro technocrats
How can we save the Greeks from complete economic shutdown, and keep them in the euro? Answer: give them new kinds of mediums of exchange:
http://www.neweconomics.org/blog/2012/02/13/how-to-save-greece-from-the-technocrats[image error]
http://www.neweconomics.org/blog/2012/02/13/how-to-save-greece-from-the-technocrats[image error]
February 9, 2012
David versus the NHS
I know we revere the NHS, and defend it against all slights and spending cuts. And yes, I revere it. But I have to admit that I spend more time than I should irritated with its little blind spots, by the little humiliations it distributes – but most of all by its boneheaded stupidy about chronic health problems.
These are not marginal. Chronic ill-health – asthma, diabetes, drepression, back pain, you know the kind of thing – takes up 80 per cent of NHS time and a similar proportion of NHS resources.
I feel particularly strongly about this because I suffer from chronic eczema, some times more than others – sometimes very badly. I will do anything if I think it might help, make any journey, go to almost any expense (if I have the money). But the NHS has an instutional blindness about this. They would prefer to carry on quietly treating my symptoms, and maintaining me on my various ointments for the rest of my life. At huge expense.
There may be imaginative and forward-thinking dermatologists out there in the NHS somewhere, but most of those I have met are uncomfortable with anything more challenging than this. That's what they do: treat the skin. The idea that eczema might involve other parts of the body seems to irritate them.
Why should I not go along with this? Well two reasons, apart from the expense that the NHS is put to on my behalf.
First, because if I keep using the powerful steroids for the rest of my life, then I am in serious danger of osteoporosis. For some reason this is never discussed (that is not my department, says Werner von Braun).
Second, if I shift onto the more effective Protopic, then I know there is a greater risk of me contracting cancer. In fact, the tubes carry warnings to this effect in the USA and Australia. Again, for some reason, this is never mentioned in the UK.
So, now the scene is set. Fast forward to this year. I've been asked to be referred, not to another dermatologist, but to the Royal London Hospital for Integrated Health. They have a very successful eczema clinic which uses various different complementary medicines. Not traditional, I know, but they are part of the University College Hospital and therfore part of the NHS, and quite rightly.
But no, Croydon PCT has finally come back and said no. It took me some time to discover the details.
This was a decision by the NHS South West London Regional Exceptions Panel. For some reason, the more we hear about devolving decision-making, the more distant it gets.
Would they give me the details of why? No, I had to get their letter from my GP. This is all it said:
"The Panel's opinion is that this child should first be referred to Croydon Integrated Dermatology Service for their specialist opinion."
Note the care they have taken to ascertain my age (53).
Can I appeal? No, but my GP can - and eventually will - ask them to reconsider on 'clinical' grounds.
Can I be present? No, I can't (though apparently I can write a letter).
So have a glance with me at my rights under the NHS constitution (and I quote from the NHS website):
•The right to choose which hospital to go to if your GP refers you to see a specialist.
•The right to be involved in decisions about your healthcare and to be given the information you need to do this.
Do these guarantees sound as hollow to you as they do to me?
I haven't decided what to do yet. I am reasonably confident that, if I decide to press on, then I will eventually get my way. But I am extremely pushy and articulate. It is a pity you have to be pushy and articulate to be treated with thought, individuality and imagination.
But, more important, how is the NHS ever going to be sustainable for future generations if they don't work with those patients who are determined to tackle their chronic health issues. Because I'm absolutely sure of this: resolutely treating symptoms is the quickest way to backruptcy.
These are not marginal. Chronic ill-health – asthma, diabetes, drepression, back pain, you know the kind of thing – takes up 80 per cent of NHS time and a similar proportion of NHS resources.
I feel particularly strongly about this because I suffer from chronic eczema, some times more than others – sometimes very badly. I will do anything if I think it might help, make any journey, go to almost any expense (if I have the money). But the NHS has an instutional blindness about this. They would prefer to carry on quietly treating my symptoms, and maintaining me on my various ointments for the rest of my life. At huge expense.
There may be imaginative and forward-thinking dermatologists out there in the NHS somewhere, but most of those I have met are uncomfortable with anything more challenging than this. That's what they do: treat the skin. The idea that eczema might involve other parts of the body seems to irritate them.
Why should I not go along with this? Well two reasons, apart from the expense that the NHS is put to on my behalf.
First, because if I keep using the powerful steroids for the rest of my life, then I am in serious danger of osteoporosis. For some reason this is never discussed (that is not my department, says Werner von Braun).
Second, if I shift onto the more effective Protopic, then I know there is a greater risk of me contracting cancer. In fact, the tubes carry warnings to this effect in the USA and Australia. Again, for some reason, this is never mentioned in the UK.
So, now the scene is set. Fast forward to this year. I've been asked to be referred, not to another dermatologist, but to the Royal London Hospital for Integrated Health. They have a very successful eczema clinic which uses various different complementary medicines. Not traditional, I know, but they are part of the University College Hospital and therfore part of the NHS, and quite rightly.
But no, Croydon PCT has finally come back and said no. It took me some time to discover the details.
This was a decision by the NHS South West London Regional Exceptions Panel. For some reason, the more we hear about devolving decision-making, the more distant it gets.
Would they give me the details of why? No, I had to get their letter from my GP. This is all it said:
"The Panel's opinion is that this child should first be referred to Croydon Integrated Dermatology Service for their specialist opinion."
Note the care they have taken to ascertain my age (53).
Can I appeal? No, but my GP can - and eventually will - ask them to reconsider on 'clinical' grounds.
Can I be present? No, I can't (though apparently I can write a letter).
So have a glance with me at my rights under the NHS constitution (and I quote from the NHS website):
•The right to choose which hospital to go to if your GP refers you to see a specialist.
•The right to be involved in decisions about your healthcare and to be given the information you need to do this.
Do these guarantees sound as hollow to you as they do to me?
I haven't decided what to do yet. I am reasonably confident that, if I decide to press on, then I will eventually get my way. But I am extremely pushy and articulate. It is a pity you have to be pushy and articulate to be treated with thought, individuality and imagination.
But, more important, how is the NHS ever going to be sustainable for future generations if they don't work with those patients who are determined to tackle their chronic health issues. Because I'm absolutely sure of this: resolutely treating symptoms is the quickest way to backruptcy.
Don't let them tell you that high streets are dead
A slightly insidious campaign is going on, largely in the pages of the Financial Times, to persuade us that high streets must be allowed to die. This is dangerous nonsense:
http://www.neweconomics.org/blog/2012/02/08/our-high-streets-have-life-in-them-yet
http://www.neweconomics.org/blog/2012/02/08/our-high-streets-have-life-in-them-yet
February 7, 2012
Saving the Sustainable Communities Act
Only five years ago, the New Economics Foundation commissioned Ron Bailey to draft a bill to tackle Ghost Town Britain. Now that ghost towns are seriously on the march, it is really no time to water down the Sustainable Communities Act:
http://www.neweconomics.org/blog/2012/02/07/time-to-save-the-sustainable-communities-act
http://www.neweconomics.org/blog/2012/02/07/time-to-save-the-sustainable-communities-act
February 6, 2012
McKinsey still don't get it
Here I was blaming most of the corrosion of public services on management consultants McKinsey, and their fatal assembly line – and impoverished data-driven approach to human systems – what what should I find but this.
Well, actually, of course, I didn't find it. Simon Titley sent it to me (thank you, Simon). "Many companies lose sight of what makes human beings tick," says the article – 'The human factor in service design' – by three McKinsey apparachiks.
It is all a strange reflection of my book The Human Element which says that they do indeed lose sight of the human aspects, and so do public services, which is why they are so expensive to run.
The article is by John DeVine, Shyam Lal and Michael Zea and they encourage managers to ask exactly the right question: How human is our service?
But read further on and you discover the battle is not yet won.
For one thing, the authors are not really interested in understanding people. They seem far more interested in using behavioural science to avoid human traits, for example "by surprising customers with a coupon for a free product".
Yes, big surprise. How many times has that happened to me, even today. Not enough, I can tell you. It leaves the basic power balances in place. It still leaves the managers chained to data for how customers 'rate' them – which, as we all know, means not very much.
Second, they fall prey to the most vacuous management jargon. "Some companies are investing in advanced analytics to understand customer interactions and channel preferences at a much more granular level". Quite so. But does this mean they have human conversations with customers? I don't think so.
Third, the solutions are still horribly twentieth century – analysing data and standardising the way agents 'handle' situations.
Precisely the opposite of what they should be doing, which is providing authentic human interactions with well-trained staff, capable of dealing with complicated requirements.
Read more in The Human Element. It's all there! But this is perhaps part of a bigger problem, which is the unworldly nature of so many management consultants and think-tanks, partly because they employ extremely young ideologues to carry out their work.
This is a vital new debate: see the New Think Tank blog.
Well, actually, of course, I didn't find it. Simon Titley sent it to me (thank you, Simon). "Many companies lose sight of what makes human beings tick," says the article – 'The human factor in service design' – by three McKinsey apparachiks.
It is all a strange reflection of my book The Human Element which says that they do indeed lose sight of the human aspects, and so do public services, which is why they are so expensive to run.
The article is by John DeVine, Shyam Lal and Michael Zea and they encourage managers to ask exactly the right question: How human is our service?
But read further on and you discover the battle is not yet won.
For one thing, the authors are not really interested in understanding people. They seem far more interested in using behavioural science to avoid human traits, for example "by surprising customers with a coupon for a free product".
Yes, big surprise. How many times has that happened to me, even today. Not enough, I can tell you. It leaves the basic power balances in place. It still leaves the managers chained to data for how customers 'rate' them – which, as we all know, means not very much.
Second, they fall prey to the most vacuous management jargon. "Some companies are investing in advanced analytics to understand customer interactions and channel preferences at a much more granular level". Quite so. But does this mean they have human conversations with customers? I don't think so.
Third, the solutions are still horribly twentieth century – analysing data and standardising the way agents 'handle' situations.
Precisely the opposite of what they should be doing, which is providing authentic human interactions with well-trained staff, capable of dealing with complicated requirements.
Read more in The Human Element. It's all there! But this is perhaps part of a bigger problem, which is the unworldly nature of so many management consultants and think-tanks, partly because they employ extremely young ideologues to carry out their work.
This is a vital new debate: see the New Think Tank blog.
February 4, 2012
Time to move our money
In one month last year, as many of 650,000 Americans moved their money out of the dysfunctional big banks and into small local banks. That is a huge amount and potentially the beginning of some kind of self-help solution to tyranny by big finance.
I'm glad to say that a similar Move Your Money campaign has been launched in the UK, though there is rather a problem about it of course. Half of all the money in the USA is in small banks. In this country – almost uniquely in the western world – we don't have any.
Yes, there are a handful of possibilities – the Co-op, Triodos, Nationwide and a handful of surviving building societies. There is Metro of course.
Virgin Money promises a great deal but experience with Virgin Trains does not make one hopeful, especially since Virgin is a strange network of leased brand names based offshore in the Virgin Islands. That kind of thing isn't the solution to unrooted banking, it's the problem.
One major reason why the nation remains locked into recession is that we don't have a range of small, regional banks able to take decisions about loans, but that is another story.
In the meantime, it makes sense to move your money where your mouth is. If you are complaining about having to pay a slither of Bob Diamond's humungous bonus or the £500 million on bonuses earmarked for RBS staff, then there really is only one answer. Don't.
I moved my bank account away from HSBC to the Co-op last year and it felt good. To celebrate the launch of the UK Move Your Money campaign, I've moved my credit card account too. Next move: extract my business account from Barclays – why should I contribute to Bob Diamond's retirement?
I'm glad to say that a similar Move Your Money campaign has been launched in the UK, though there is rather a problem about it of course. Half of all the money in the USA is in small banks. In this country – almost uniquely in the western world – we don't have any.
Yes, there are a handful of possibilities – the Co-op, Triodos, Nationwide and a handful of surviving building societies. There is Metro of course.
Virgin Money promises a great deal but experience with Virgin Trains does not make one hopeful, especially since Virgin is a strange network of leased brand names based offshore in the Virgin Islands. That kind of thing isn't the solution to unrooted banking, it's the problem.
One major reason why the nation remains locked into recession is that we don't have a range of small, regional banks able to take decisions about loans, but that is another story.
In the meantime, it makes sense to move your money where your mouth is. If you are complaining about having to pay a slither of Bob Diamond's humungous bonus or the £500 million on bonuses earmarked for RBS staff, then there really is only one answer. Don't.
I moved my bank account away from HSBC to the Co-op last year and it felt good. To celebrate the launch of the UK Move Your Money campaign, I've moved my credit card account too. Next move: extract my business account from Barclays – why should I contribute to Bob Diamond's retirement?
February 3, 2012
Why my library needs saving
Because I'm made that way, I suppose, I do kind of collect new kinds of organisations, especially if they seem to pre-figure the future. One such is the Upper Norwood Library.
It is red brick and 111 years old (I believe Bilbo Baggins was also eleventy-one at the beginning of The Hobbit). There are computers, but it hasn't been taken over by the boneheaded technocrats and cleared out of books altogether. It is always lively. But what is really interesting about it is that it is independent, run by a local board and funded jointly by the two London boroughs on either side of the building, Lambeth and Croydon.
Partly as a result of this independence, it is much loved, much used and considerably cheaper to run than the libraries surrounding it. It is also an innovative structure of the kind that the Cabinet Office is keen on for the future of public services.
You would think then that the surrounding boroughs would be proud of their creation. In fact, Croydon is now considering closing it down.
I ask myself sometimes, as I stare out of my bedroom window across the soulless and largely unoccupied towers that Croydon Council have given permission to, what is the matter with local government here. Croydon has embraced the most old-fashioned, least effective means of regeneration - high rise property, surrounded by empty offices, which cast a blight on the area. It is the Clone Town connoisseurs' clone town, the very opposite of the distinctive and thriving place it could be.
So perhaps it isn't surprising that they are considering vandalising my library. I hope before they do that the Cabinet Office studies it, because it may provide some clues about providing library services in an era of austerity - everywhere else apart from Croydon.
I'm drawing the attention to my friends in the Cabinet Office now, before it is too late. But, hey, let's look on the bright side. It is possible that Croydon may decide after all to be on the side of the future.
It is red brick and 111 years old (I believe Bilbo Baggins was also eleventy-one at the beginning of The Hobbit). There are computers, but it hasn't been taken over by the boneheaded technocrats and cleared out of books altogether. It is always lively. But what is really interesting about it is that it is independent, run by a local board and funded jointly by the two London boroughs on either side of the building, Lambeth and Croydon.
Partly as a result of this independence, it is much loved, much used and considerably cheaper to run than the libraries surrounding it. It is also an innovative structure of the kind that the Cabinet Office is keen on for the future of public services.
You would think then that the surrounding boroughs would be proud of their creation. In fact, Croydon is now considering closing it down.
I ask myself sometimes, as I stare out of my bedroom window across the soulless and largely unoccupied towers that Croydon Council have given permission to, what is the matter with local government here. Croydon has embraced the most old-fashioned, least effective means of regeneration - high rise property, surrounded by empty offices, which cast a blight on the area. It is the Clone Town connoisseurs' clone town, the very opposite of the distinctive and thriving place it could be.
So perhaps it isn't surprising that they are considering vandalising my library. I hope before they do that the Cabinet Office studies it, because it may provide some clues about providing library services in an era of austerity - everywhere else apart from Croydon.
I'm drawing the attention to my friends in the Cabinet Office now, before it is too late. But, hey, let's look on the bright side. It is possible that Croydon may decide after all to be on the side of the future.
February 2, 2012
How politics prefers symbolic gestures to action
What is it about the UK political establishment that they believe taking away Sir Fred Goodwin's kinighthood is doing anything to fix our staggeringly dysfunctional and corrosive banking system?
http://www.neweconomics.org/blog/2012/01/31/stripping-sir-fred-a-monumental-irrelevance
http://www.neweconomics.org/blog/2012/01/31/stripping-sir-fred-a-monumental-irrelevance
January 11, 2012
Why competition is the key issue
The Office of Fair Trading has nodded through the takeover by Amazon of the Book Depository, the only UK competitor capable of taking them on. We are in danger of becoming miserable supplicants to the new monopolies. Do we want to be cooked Tesco-style, Amazon-style or Virgin-style? And what can we do about it before it is too late?
http://www.libdemvoice.org/opinion-why-competition-is-the-key-issue-26522.html
http://www.libdemvoice.org/opinion-why-competition-is-the-key-issue-26522.html
January 4, 2012
The future of the high street - its another squeezed middle
Yes, the high street is in trouble. But something else is going on there which is important for the future - a new division between would-be monopolies trying to sell us everything, and local enterprises with a personality behind them. If you're not one of those, you;re in trouble:
http://www.guardian.co.uk/commentisfree/2012/jan/04/retail-squeezed-middle-high-street?newsfeed=true
http://www.guardian.co.uk/commentisfree/2012/jan/04/retail-squeezed-middle-high-street?newsfeed=true
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