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The Fuhrer of Fuddlement wants to make you forget
I too have read Milan Kundera's great political novel, The Book of Laughter and Forgetting, but, as in the old joke, I have forgotten what it was about. I'm not even sure I've got the title quite right. And that, I vaguely remember, is part of the point of the book.
Memory is essential to integrity, both personally and politically. Forgetting is the enemy of coherence, constant purpose and responsibility. Forgetting is the ally of oppression.
Yet our memories are being constantly overloaded, with information, entertainment, infotainment, scandals, propaganda, pornography, regulations and various other burdens. Our overloaded brains tend more and more to crash.
So then we have constant information-retrieval problems. And because we can barely remember, we hardly know what our politicians have been doing or why or whether we should still be angry with them or newly outraged.
The dodgy dossier is a case in point. We are all vaguely aware that it is very important, but few of us can remember precisely why. It was something to do with the Iraq invasion and it might have been one of the things that swayed public opinion for some reason.
Wasn't it something Alastair Campbell's underlings copied off the internet and tarted up a bit, and was therefore horribly wrong and misleading, but not exactly wrong in itself and therefore not mega dodgy, only dodgy?
But just a minute. We've all forgotten, but in fact there were two dossiers. At least that's what they were saying on the telly all last week.
There was the "dodgy" one but there was also the "sexy" one. What was that one, dear? One of them - or was it both of them? - was "sexed up" by someone in some way so as to make something more important.
Invading Iraq, probably, though it could have been a slightly different point about Syria or Korea or something.
Oh yes, it was the 45 minutes. That's the time it takes to get through on the Baghdad telephone exchange, for the bomb warnings, if memory serves. And someone at the BBC says someone in the intelligence world - isn't that right, dear? - says the dossier shouldn't have been sexed up and lots of the intelligence people are very cross, even though it was quite true up to a point.
It was a question of emphasis - and it's only really the emphasis that's so shocking - more than what it actually said. Someone or other pointed that out.
Plus the fact it wasn't in an earlier draft of whichever dossier it was. It seems to make Alastair Campbell desperately angry that people can't seem to distinguish between the two. He has apologised for one of them, for heaven's sake. Isn't that good enough? Cue table banging and pointy fingers.
Fab, Alastair. But which dossier was it actually? And what was it he said in it? Was that the one that didn't really matter or is he concentrating on the difference between the two to cover up the awfulness of both? Yes, that's what it was, dear, wasn't it? Ah yes, I remember it well.
The problem is not that politicians lie. That is their destiny, for reasons bad and good. William Waldegrave once very truthfully said, at the height of his political career as a Conservative cabinet minister, that politicians cannot always tell the truth. Naturally he was swiftly punished for his honesty - his career was ruined. But the problem is not lying but forgetting.
We need to remember what politicians do and say, so that they cannot so easily bamboozle us. But these days it is very hard to remember anything, because of the constant cognitive overstimulation all around us - did I mention that before?
Alastair Campbell's constant, relentless assault is not so much an assault upon truth (though it is that, too), it is upon our memories. Assaulting our memories is the easiest way - indirect, maybe, but surest - for politicians to gang rape the truth.
In Dorset where I grew up they had a simpler expression. "Bullshit baffles brains". Campbell is not so much Beelzebub, father of lies, any more than he is the Sultan of Spin.
He has tried spinning and playing fast and loose with the truth for years but it hasn't in the end been very successful. On the contrary, it is very largely Campbell's personal achievement (though ably assisted by his master Tony Blair and, more recently, Cherie Booth and her amanuensis Carole Caplin) that the prime minister has lost his halo of honesty and acquired cloven hooves and a forked tongue. It's largely his fault that new Labour is associated not with solid achievement but with insubstantial spin.
Campbell's violent public rage on telly is a delicious spectacle to those of us who enjoy schadenfreude - it is the moral exemplar of the biter bit and in this case almost frothing at the mouth as well, because the dog is rabid. Most people have probably forgotten that as political editor of the Daily Mirror, he hit his opposite number from The Guardian in the House of Commons for making a joke about the late Robert Maxwell.
No. Campbell's outstanding talent is for befuddling our memories, and that is the most powerful weapon of political control, especially for anyone who has any concrete idea of what to do with it, other than more befuddlement. He is the Fuhrer of Fuddlement. The Aga of Airbrushing. The Ozymandias of Obfuscation. The Doge of Distraction.
Which minuscule MP and former Hague groupie said rather clunkingly last week that Campbell has an arsenal of weapons of mass distraction? I forget. But all these hogwhimperingly boring dossier details at the Commons foreign affairs select committee, all those impassioned insistences that the comparison between two footling footnotes is the burning moral question of the hour, are superbly designed to sidestep the central questions and bring us all very fast - those of us who are not yet entirely indifferent to public affairs - to confusion.
Campbell should give lessons in it at the third-rate college of journalism in the States to which he will one day soon be exiled, with any luck. To get everyone's eye off the ball at the Wimbledon final of politics, so to speak, was an extraordinary feat.
At the beginning of the week the issue was whether the prime minister and his chief crony bamboozled Britain into war by exaggerating the threat from Saddam Hussein. Within days the headline story was a so-called "row" between No10 and the BBC. Brilliant.
A famous actress once said that her recipe for a happy life was a good digestion and a bad memory. With politics and with people who seek to control us by confusing us, it is quite different. The best recipe for freedom is a good memory.
Second best is a constant, implacable reminder from someone else of what actually happened. It is perhaps quite appropriate that Ganesha, the Hindu elephant god, is god of scribes and hacks; elephants are said to have extremely long memories.
Journalists are not prone to forgetting, either, which is no doubt what Alastair Campbell hates about them.
The Sunday Times | Sunday, June 29, 2003 | Comments (0)
It's tough but not everyone should have a saviour sibling
All rules, even this one, have exceptions. That old philosophical teaser applies particularly to moral rules. Moral rules, and the pursuit of moral absolutes to prop them up, are bedevilled by exceptions. The devil, as ever, is in the individual detail. Last week the case of the so-called saviour sibling proved once again how hard it is to find rules for moral dilemmas.
Jamie Whitaker, a newborn baby boy, was brought into this world by his parents Michelle and Jayson to save the life of his four-year-old brother Charlie, who has the very rare and terrible disease called Diamond Blackfan anaemia. Many of us have seen the haunting pictures of him gravely holding his new baby brother.
What this poor four-year-old has to endure is terrible. Nearly every night he faces extremely painful 12-hour injections of steroids into his belly, and every three weeks he has a blood transfusion. Some tissue of the right type, from a sibling with matching immunity genes, could save his life and spare him all this pain. All that he needs, with any luck - an 85% chance - is a few cells from the umbilical cord of the right sibling.
Unfortunately, his younger sister, conceived in the usual way, was the wrong type of sibling. So his parents took their destiny, or rather their biology, into their own hands and decided to have another baby, by means of IVF and pre implantation genetic diagnosis, with the right genetic match to save their son.
When they found that the British Human Fertilisation and Embryology Authority would not let them do so here, they went to Chicago, where the rules are different. The result is Jamie. Tests are now being carried out to find out whether he is a perfect tissue match. There is a 98% chance he is.
I would certainly have done the same as Charlie's parents, without any hesitation, right or wrong. My heart is with them. However, I feel, perversely enough, that what they did may have been wrong, at least in principle.
I am leaving aside the usual arguments about discarded embryos and their right to life, with which I cannot agree. It is true that eight embryos were wasted, for want of a better word, to produce baby Jamie, and such organisms do have an almost unique moral status. All the same, I see no moral difficulties in throwing away a few minuscule groups of cells in a Petri dish in the process of making a much wanted person any more than I have a problem with early abortion. Much larger bunches of cells are legally thrown away for much less reason.
What concerns me is one of those maddening, confusing, central principles of western morality, which I find I cannot ignore, even though I am convinced that people are much more important than principles, generally speaking. (But every rule, even this one, has an exception.) This principle is that every person is and ought to be an end in himself or herself, and not a means to anyone else's ends. I can't help thinking of the shocking case of an older mother who had a Down's syndrome baby through IVF, happily refusing screening, but then came back later demanding a second, normal baby to look after her disabled first-born.
That is surely the same, in principle, however different in feeling, as the Whitakers' choice. Jamie has been created as a means to Charlie's ends. And that was essentially the principle on which the HFEA would not allow genetic testing in the Whitakers' case. It would not have been done in the interests of the future baby, but purely in someone else's.
This was very unlucky for the Whitakers. If the genetic testing had been requested for the sake of the future baby's own health as well as for someone else's - to select against a genetic syndrome, say - then the HFEA would have permitted it.
As I say, I'd certainly have done the same as Charlie's parents, without hesitation. All that they want from Jamie, medically speaking, is a few cells from his umbilical cord, which is not much to ask, you might think.
However, nobody can guess how it might affect Jamie psychologically, or Charlie, when they find out that he was "made to order". It's ridiculous to suggest he need never know. Family secrets always come out in the end, not least if they have been broadcast all over the media at some stage, and they are all the more hurtful when hidden, because they destroy trust.
Besides, what people have a legal right to know about their conception is being hotly debated these days and the bias, including that of human rights legislation, is strongly towards full disclosure.
Even so, a reasonable child could understand and sympathise with what their parents did, and even be proud of it. The real difficulty of this case is that there may have been some medical risk to the future baby, however slight.
In the process of genetic screening, one or two cells have to be removed from the tiny embryo. There is every reason to suppose this is harmless and that the embryo can easily spare far more than two of these identical cells without any damage.
However, it must be admitted that nobody knows what the long-term consequences might be.
The same is true of IVF. What's more, if the umbilical cells don't work, Jamie may be expected to donate bone marrow to his brother, which also involves some risk to him.
Finally there is a risk, probably minuscule, that he might have the same terrible inherited disorder as his brother - there is, as yet, no genetic screening for Diamond Blackfan anaemia.
All this adds up to a very painful dilemma. I feel that the HFEA was probably right in principle, but wrong in this case - that is the trouble with principles, of course.
Very few parents could bring themselves to reject a good chance of saving their much-loved son from suffering and death. Very few could turn down a very small risk to an unknown, unborn child to save a known and living child from a known and terrible risk. Lawyers and quangos, no matter how clever or compassionate, can hardly rush in where angels don't know where to put their feet.
This obvious truth has not stopped many people calling, as usual, for legislation.
Ian Gibson, the Labour chairman of the Commons science and technology committee, has said that the 1990 Human Fertility and Embryology Act has been overtaken by medical science and ought to be reviewed. "You can't just handle these cases piecemeal, in the way the HFEA has been doing," he says. I disagree entirely.
Piecemeal is the only way to approach such difficult and delicate questions.
Everything depends on the details of each case. Everything depends on the balance of risk and reward and on the people involved, on the moral feelings of the doctors as well as of the parents. Principles can guide, but they cannot dictate.
It is one of the great glories of English common law, based on piecemeal case law, that it values experience above systematisation. British ethics, unlike European philosophies, have always been pragmatic rather than systematic, in the same spirit. That is the only way to deal with moral problems which are always, somehow, exceptional.
The Sunday Times | Sunday, June 22, 2003 | Comments (0)
Don't cry, angel - it's Labour that says Mummy must work
It is a particularly absurd new Labour irony that on the day when Alan Milburn, the health secretary, announced that he must spend more time with his children, over at the Department of Trade and Industry Patricia Hewitt announced that we women must all spend less time with ours. This does not sound very much like the joined-up government we were so proudly offered by the incoming Labour administration. It is not even joined-up spin.
Milburn has curiously only now discovered that being in charge of a vast and problematic department of state in London is incompatible with being a hands on bath and footie dad a couple of hundred miles away in the northeast. Perhaps he has just read the daft new magazine Dad, recently and wastefully given away by his own National Health Service to teach fathering skills.
Meanwhile, however important time with his children might be to Milburn, his colleague Hewitt tells us that mothers who stay at home giving time to their children are a "real problem".
According to Delivering on Gender Equality, a document just published by the Women and Equality Unit which answers to Hewitt as trade and industry secretary, mothers of young children should go out to work. They ought to dump the kiddies and get out there to help the economy and pay back the cost of their education - in apparatchik speech: "enhancing competitiveness and productivity" and "maximising returns on public and private investment in education and training".
However, it seems that few women do their patriotic duty. There are all too many feckless, unwaged nurturers and cuddlers who are letting the nation down.
According to this document, "real problems persist".
"The employment rates for women with dependent children have remained consistently below those of women without dependent children. Just 48% of women with a child under two are in employment compared to 90% of men with a child under two."
Shocking.
The government intends to do all it can to rectify these "real problems". It also intends to encourage men to work in childcare and in other jobs where they are "under-represented". The paper even sets a new "diversity" target. By next year 6% of nursery workers, nannies and child minders should be men.
It still faintly amazes me that this government can go on putting out such ideological nonsense. It is shamelessly statist and so very much at odds with most people's experience and most people's wishes. One can only hope that new Labour will be as incompetent in "delivering on" these "targets" as it is with most others, or that this is only empty talk, as so often.
The truth is that most mothers with young children do not wish to work, although far more of them actually do so in Britain than anywhere else in Europe. Survey after survey shows that most mothers would prefer not to work at all - or to work part-time - but they feel forced into employment.
Given a real choice mothers would spend much more time with their children, like Milburn. They believe it is better for them to bring up their own children rather than to contract out their development to a succession of semi-qualified strangers. Admittedly this will not do much to "enhance their lifetime incomes" or "maximise personal career development" but these are sacrifices and risks which, in a most unfeminist way, they are prepared to take.
Feminist documents such as Delivering on Gender Equality make all kinds of contentious assumptions about what women really want. They do the same about men: it is highly controversial to state that men are "under-represented in childcare".
Men might not wish to look after children as much as women and they might not be as good at it. There is plenty of respectable evidence about innate differences between the sexes in such areas and anyway people's working preferences, however unliberated, are no business of the government.
The real problem, surely, as most people really know, is that working mothers mean neglected children. A mother's interests are often at odds with her children's interests. She may need and want to work but her child needs and wants her. How often does it need to be said? I admit there are a lucky few, with expensive nannies or wonderful grannies, who go to work knowing that their children are being well brought up. There are some others who find childcare that is at least adequate, affordable and convenient.
For the rest, childcare arrangements are a terrible drain on their income, their time, their work and their emotions and disruptive for their children. And it isn't even very good. No matter what promises Hewitt might make about more childcare and more subsidies, they cannot be kept. There is an absolute shortage of adequate childcare.
The result is everywhere to be seen: child neglect. I hope readers will forgive me for repeating the point. It seems it is not as obvious as I have always assumed.
From middle-class toddlers handed over to neurotic foreign teenagers with broken English to rich school pupils with nobody to ask about physics and acne but the Filipina maid, from respectable children plonked in front of frozen pizzas and television sets to sink estate childen who bunk school and factory-farmed babies in creches, there is child neglect everywhere. And the hidden total neglect of children during the school holidays while their parents both work is an unspoken national scandal.
Children need time, care and attention. They need continuity and mature guidance.
Fewer and fewer are getting it; fewer still would get it if Hewitt's people had their way. It is no accident that our national child neglect has coincided with a national decline in certain standards.
The rise of working mothers has coincided with a collapse in school attendance, literacy, numeracy, educational standards, reading and manners, particularly among boys. It has also coincided with the appearance of so-called feral children and with a very startling increase in television watching, junk food and obesity, street crime, teenage mental illness and suicide (especially among boys), teenage pregnancies and sexually transmitted diseases among the very young.
These social ills are much less common in other European countries, where many fewer mothers work. If this is part of the price of mothers working it might be more cost-effective to encourage them to stay at home.
I don't like thinking this. I wish I were wrong. I have every sympathy both with women who need to work and with women who want to work - and with the frustrations of those who make sacrifices to stay at home.
Painful choices have to be made in every family.
What is so offensive about Hewitt and her team of old-style Stalinists and new Labour generally is that they still appear to believe, after all the socialist horrors of the 20th century, that the state should make these choices for us.
They prattle on about choice and empowerment, but actually they believe they know better than the rest of us what we are like and what we want, what is best for us and best for society. They don't.
The Sunday Times | Sunday, June 15, 2003 | Comments (0)
The NHS is a sacred cow no more and must go to market
Anybody could have told the chancellor of the exchequer, and some people did, that throwing new billions at the National Health Service would be throwing them away.
So it has proved. The independent National Audit Commission published a report on the NHS last week which said that our newly extracted money is being wasted, and will probably go on being wasted.
The money is being used to buy short-term results at the expense of long-term planning. In 2001, for instance, health spending rose by 11%, yet health service output increased by only 3%. The commission's auditors actually say that better management of resources, rather than more resources, is the key to cutting waiting times in hospitals.
The same is true of public services generally. The Office for National Statistics has recently reported that the money - our money - which the government is pouring into public services is not being spent productively. Between 1997 and 2002, spending on public services rose by 40%. Output increased by only 14%.
Much of this money is disappearing into the insatiable gullet of the NHS. The audit commission criticises a long list of quick-fix measures in the NHS and the huge number of targets. And NHS waiting lists have now gone back to more than 1m only a month after the government was crowing about a historic drop below this vast figure.
I particularly enjoyed, in a grim sort of way, the evidence reported by the British Medical Association last week that most hospital accident and emergency departments (85%) met government targets during the week they were being monitored, but only 55% did so in the week before and 65% in the week after.
What's more, one-third of the doctors questioned in the BMA survey did not believe that the figures the government published for their departments were accurate - scepticism about new Labour claims has now reached the levels of a serious epidemic.
Faced with all these inconvenient hordes of expensive patients, the government has come up with a new proposal that is pure Monty Python. Last week it solemnly announced a fourth way for the NHS. Stop treating the fatties - and the smokers.
That would soon bring down the waiting lists and operation costs because these are, of course, the sickest and costliest patients.
The overweight and heavy smokers come predominantly from the most deprived classes, so they would all die much earlier of heart attacks and strokes if denied treatment, saving social services and housing a great deal of money as well. And pensions, too. Brilliant. This must be what new Labour means by joined-up government.
However, there was resistance all round and the selection of the fattest scheme, like so many other new Labour wheezes, has gone back to the drawing board.
One of the main problems with the NHS is its culture of waste. This wastefulness means, among other things, that nurses are underpaid, overworked, demoralised and leaving.
Early this year a distinguished cancer consultant, Maurice Slevin, published a paper for the Centre for Policy Studies attacking over-management in the NHS. He argued (using government figures) that while there are eight managers for every 10 nurses in the NHS, there are just under two for every 10 in a comparable private hospital. Yet private hospitals are indisputably better and more efficient, like for like.
Slevin says that if the proportions of managers and administrators in the NHS could be cut back hard to the proportion in the private sector, the money saved could hire many more nurses and radiographers, and pay them 30%-40% more, without costing the NHS extra.
Other analyses show the same thing. According to figures from the Office for National Statistics, the number of managers and support staff in the NHS has just reached 269,080, as against 266,170 qualified nurses and 100,319 doctors. Since 1995 the number of senior managers has increased by almost 50% with 25% more junior managers. However, the number of qualified nurses has risen by only 7.8%.
Meanwhile, NHS employers go on advertising for nonsense jobs at high salaries.
Readers may remember the astonishing case in February of Nottingham Forest NHS advertising for "three outreach sessional workers for men who have sex with men ... in varied environments" such as "educational and public sex environments".
Now, for example, Oldham NHS Primary Care Trust is offering nearly Pounds 28,000 a year for a "five-a-day co-ordinator" to bully people into eating more vegetables (18A hours a week). Clearly they don't know that fresh fruit and veg are prohibitively expensive for people on low incomes. Calderdale NHS PCT is offering Pounds 30,000 for a "smoking cessation co-ordinator" (36 hours a week). I wonder how the lucky applicants will be able to look a nurse in the eye without blushing.
One almost despairs. Yet it may be that the tide of public opinion is beginning to turn. Blind faith in the NHS is tending towards agnosticism, sometimes even to heresy.
A real reformation may be possible before long. The Conservatives have just issued some simple ideas for NHS reform which not long ago would have been anathema.
Their power lies in their simplicity. Any scientist will tell you that the simplest and most elegant solutions are the most effective.
The Conservatives' new policy, like Slevin's, is to reduce management, slash government red tape and targets and raise medical workers' salaries significantly.
They would also issue patients' passports - a new name for vouchers. Patients will take their passport to get treatment where they choose, either to an NHS hospital or a private one where they might pay a top-up charge.
All the usual angry arguments have been put forward - only the rich will gain, only the pushy will be able to work the system, some hospitals will get worse and there won't be enough treatment available anyway, good or bad. That is the voice of old-fashioned statism, of those who cling to the inadequacies of the NHS because they know nothing better. There are powerful counter-arguments to them all.
For one thing, health insurance would get much cheaper since insurers would no longer pay the full cost of treatments but only the top-up charge. As a result, more people would be able to afford medical insurance and thus many more people would opt for private treatment with top-ups. This would then take a lot of pressure off the NHS. Meanwhile, much better pay would attract more nurses and medical workers into the NHS, providing more capacity.
Sink hospitals that nobody chose would close down, as they should, but more private hospitals would be set up. As for working the system, the internet is the great equaliser; loads of information would appear on the worldwide web about various choices. Elderly patients or those from minorities may not use the internet, but they usually know younger people who do and who will help them to make choices.
Perhaps the time for a decent, universal NHS is at last arriving. The government has created the necessary anger and disillusion to ensure change.
The Sunday Times | Sunday, June 08, 2003 | Comments (0)
