Britain has just committed an act of self-harm

The title of an article by the economics editor of The Times caught my eye: “The poorest voted for Brexit, now they will bear the brunt of the cost“. How true, I thought and started reading.

The opening sentence brought me up short. “Britain has just committed an act of self-harm.” I remembered a girl I had admitted when I was a houseman. She had taken an overdose of Paracetamol after a row with her boyfriend. She did not intend to die. It was a protest.

Now you may know that Paracetamol is a particularly nasty drug with which to attempt, or threaten suicide. You do not go quietly to sleep either to wake later, or not wake. It is not particularly sedative, but it destroys your liver and you go jaundiced and die some days or even weeks later.

To my embarrassment I do not remember whether she did in fact die, but I shall never forget the look of terror in her eyes the next morning when she realised that death was the probable outcome.

Many of my fellow Britons have just made a protest vote. I have no doubt that the majority of them will come to regret it: but I know not how soon or how many. The drunken tweet sent in the early hours may have repercussions in hours. The unintended sexual encounter may show its effects in days or weeks. Trusting the Tories with the NHS may not prove fatal for ten or twenty years. I wonder how long it will take the poor downtrodden and exploited British voter to realise that they have simply been taken for a ride by different bunch of public school toffs.


The Poor will not gain from leaving the EU

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The Death of Europe, or just the UK?

I can’t believe that the sun is still shining this morning. The United Kingdom of Great Britain and Northern Ireland has just voted to leave the European Union. 52% of those voting chose to leave.

There will be pundits with more authority to write on why this happened and on what will, or might happen next, but maybe that does not invalidate my shared thoughts as I struggle to come to terms with what feels to me like an apocalyptic decision. After a decade in politics I had thought that the failure of the Liberal Democrats in coalition would be the nadir of my political experience, but what we have just experienced during EU referendum campaign is far worse. The cause, the course and the outcome have all been depressing, each one worse than the previous. I have almost come to despair of democracy.

The Cause.

The roots of the referendum lie in divisions within the Conservative Party and David Cameron’s attempts to keep it united.

As I have written previously with regard to the Liberal Democrats, all political parties are themselves a coalition of differing views, and there have always been tensions within the Conservative Party. It just so happens that they are so focussed on gaining and retaining power that they have developed a certain discipline that enables them to keep those divisions hidden from view for most of the time. The Tories have always been divided on Europe. Some leaders are more ‘pro’ and some more ‘anti’. The phrase that they used to paper over the differences was ‘eurosceptic’. We can all visualise being sceptical without being opposed to something. We even talk of healthy scepticism. The truth is that some Tories hated the EU and always wanted to leave. Their leaders kept the lid on the discontent in two ways: they criticised the EU in public and they talked vaguely of having a referendum. In the run-up to the 2015 General Election David Cameron decided that the best way to keep his own right wing on board and to fend off the increasing threat from UKIP was to make a firm offer to hold an “in/out” referendum if he was the next Prime Minister.

This may well have been a promise that he thought he would not have to deliver. None of the opinion polls predicted a Conservative majority, and if he were in coalition with the Liberal Democrats again he could always blame them for stopping him having a referendum. But, and here comes the first major blow to the democratic process in the saga, he did win an overall majority. Or did he? Was the election ‘stolen’? Or bought? The funding of British political parties and the electoral system is just one of the things that I believe to be wrong with our democracy, but we do have rules on election expenses and there are widespread allegations that the Conservative Party broke these rules. We know that their campaign focussed heavily on a number of marginal seats, and that the wipe-out of the Liberal Democrats was at least in part due to the intensive campaigning in those seats. The story is still unfolding, but it is possible that the Conservatives do not in fact have a legitimate majority.

Tory Battle Bus

“Police launch general election fraud probe” Daily Mail.

“Conservatives admit failure to declare election expenses” Channel 4 News

“What is the Tory election expenses story and why isn’t it bigger news?” Guardian

“Eight police forces investigating potential election expenses breaches

And so, to his surprise, David Cameron found that he was Prime Minister again, this time leading a Conservative government. He decided that he had no choice but to deliver his promised referendum. But first he would go through a charade of having tough negotiations with other European nations and come back with some concessions that would enable him to move from a position of relative euroscepticism to being an outright supporter of the EU.

The Course

I have seen the rough and tumble of political campaigning, and I have seen rival candidates stretch the truth to its limits, but I have never seen such an ill-tempered, ill-mannered and dishonest campaign. The remain camp engaged in some speculative exaggeration of what might happen if we leave the EU. But the dishonesty exhibited by the Brexit camp was breath-taking. From the claim that we send £350m a week to the EU, and coupled with it the implication that we could spend that money five times over (NHS, Farm subsidy, Regional grants, removing VAT from domestic fuel and Scientific research) to the implication that the whole population of Turkey was likely to flood into the UK we saw an astonishing number of ‘porkies’. Some were challenged by fact-checking web sites or by independent academics, but the Brexit campaigners carried on regardless. The whole situation was exacerbated by the BBC’s famous insistence of ‘balance’. The BBC seemed to think that each time an authoritative statement was made by an independent body, or a letter was published that bore the signature of hundreds of academics, it was necessary for the BBC to bring Farage, Gove, Johnson or Duncan-Smith into the studio to put their case. Their ‘case’ often amounted simply to denying the statement of the experts and repeating one of their sound-bite claims about bringing back sovereignty or faceless bureaucrats. One example of this was when the Michael O’Leary, the outspoken chief executive of Ryan Air, said that because we would lose access to the European open skies agreement air fares would rise. The Brexit response was simply that there is no question of air fares or holidays costing any more.

There were repeated attempts to conflate membership of the EU with the European Court of Human Rights (which was set up by the UK among others long before there even was an EU) and the euro (which is a currency that the UK does not use, and does not give any support to.) But the most inflammatory and dangerous language was used in relation to immigration. Nigel Farage threatened “violence on the streets” if immigration was not curbed. Cameron’s foolish claim that he could lower net migration to “tens of thousands” was thrown back at him, but the Brexit team alternately claimed that they could deliver it themselves and said that they would control migration with a points system that would allow more immigration, not less. It was conveniently ignored that there are already 180,000 immigrants from outside the EU where we already operate a points system, and deceitfully suggested that the UK’s creaky infrastructure was all due to immigrants from the EU. The evidence actually shows that EU migrants contribute more to the treasury than they cost, and as I have repeatedly written here and elsewhere, the problems being experienced by the NHS are the result of UK government policies. Before I leave the subject of immigration I might point out that Jeremy Corbyn proposed financial help for councils who took in significant numbers of immigrants. This statement, like much of what was said by the Labour Leader was conveniently ignored by most of the media, and significantly by the BBC. One might add that the previous Labour government had introduced just such a scheme and it was abolished by the Conservative/Liberal Democrat coalition in 2010.

The xenophobic demagogy we heard from the Brexit camp had the effect of permitting anger and hate to bubble up in individuals. The most extreme example of this hate was the awful murder of Jo Cox, but the aggressive and inflammatory language used by politicians had a more general effect of making acceptable, behaviour and language that would not normally be acceptable . I have a friend who was delivering leaflets when a man came charging out of his house and pursued him down the road shouting obscenities and calling him a traitor. 

One problem of the whole campaign was its asymmetry. There was, if you like an asymmetry of evidence and an asymmetry of truth, but there was an asymmetry of the whole underlying argument as well. The Remain camp seemed to concentrate on the economic benefits of EU membership to the exclusion of all else. I would regard the economic case as unanswerable, but the Brexit camp did not need to answer it. They appealed almost exclusively to emotions: fear, distrust, dislike of governments generally. Only occasionally did the Remain campaign point out that some of us love being part of Europe, some of us love the diversity and some of us love living at peace with our neighbours.

Sheila Hancock on peace and war in Europe.

Sheila Hancock on peace and war in Europe.

Gordon Brown in Coventry Cathedral

Gordon Brown in Coventry Cathedral

The outcome

I shall pause here, and post my thoughts on the outcome later. I do this for two reasons. First, I should acknowledge that my attempts to predict the future may be even more flawed than my attempts to chronicle what has happened and why.

And Second, I need to do something else today apart from thinking about this awful, awful state of affairs. Thank you for staying with me so far, if you have.

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Enough is enough.

Call me naïve if you like, but I still believe that most politicians go into the business because they want to make the world a better place. They may lose their way, become seduced by the sense of their own importance, carried away by the thrill of the chase or corrupted by the influence of big money and lobbyists, but mostly they start off with good intentions. that certainly is why I went into politics. As a GP I was in a position to help individuals, but so often I realised that it was the system that needed changing. I could not prescribe a house for the homeless or a job for the jobless, but as a politician I might, I just might be able to do these things.

My early experience of life as a politician was encouraging. In our District Council we Liberal Democrats ran the administration with the support of some independents. We pushed up our recycling rates to one of the highest in the country. We delivered more new affordable homes for our size than any other authority. We attracted inward investment in the arts and developed our sports and leisure services.  IMG_3416Things locally started to go downhill when we moved to Unitary Authority and the Conservatives took over, but by then I had moved on to the national political scene.

Nationally too, the position was optimistic. Party Conferences were a heady blend of idealism and optimism. Liberal Democrats had real influence and if leaders occasionally risked getting ‘too big for their boots’ there were plenty of stalwart members ready to remind them of the pledge enshrined in the Party constitution “to build and safeguard a fair, free and open society… in which no-one shall be enslaved by poverty, ignorance or conformity.”

Then came May 2010: a hung parliament. Like the vast majority of members of the Party I supported the decision to go into coalition. We knew that it would damage the Party, but having sung the praises of coalition government for decades it would be bizarre not to accept the challenge when it was offered. By September 2010 we could see that it was going wrong. The hastily written coalition agreement was already being overtaken by policies that the Conservatives wanted to introduce. The Liberal Democrat Conference warned Nick Clegg that he needed to stand up more for Lib Dem values, that he did not need to agree to everything that his friend Dave wanted. At a private meeting of Local Party Chairs I tackled Nick on that subject. He argued that the most important thing was to give the public a united view. He had to hold the coalition together for the full five years. We disagreed.

The mistakes were many, but for those who know me it will be no surprise that the Health and Social Care Act of 2012 was for me the most catastrophic mistake. I worked closely for months with another doctor who was also chair of his Local Liberal Democrat Party. Graham Winyard had a public health background and had been Deputy Chief Medical Officer and Medical Director to the NHS. Between us we had experience of most parts of the NHS and we had contacts throughout the Service. We were in a position to give the Party Leadership authoritative advice. At no point did Nick Clegg agree to see us. He telephoned us once and spent an hour and a half detailing all the concessions he had wrung out of the Prime Minister after the so-called ‘Listening Pause’. Those apparent concessions started to unravel when the Department published the official response five days later, and within a couple of months it was clear that they did not amount to a can of beans. Graham Winyard resigned from the Party in frustration and disgust. I decided to fight on. I fought on through Liberal Democrat Conferences. Time and again the inner caucus of the Party would block my attempts to allow the Party members to debate the changes being imposed on the Health Service. If I did manage to get to through to the membership, I found great support from the members.

I fought on when the regulatory framework for the Health Act was published. I served on a policy working group that was preparing future policy options for Liberal Democrats with regard to delivering public services. Seven of us in that working group produced policy proposals that included the removal of the wasteful and destructive use of markets in the NHS. Those proposals were never debated. It seemed that Nick Clegg was actually in favour of breaking up the NHS and with the help of junior ministers Paul Burstow and Norman Lamb and with Shirley Williams in the House of Lords he was able to deliver the NHS on a plate to the Tories. Nick Clegg and Shirley Williams Nick Clegg and Shirley Williams voting in the Health debate at Conference

May 2015 saw the Liberal Democrats reap the reward for cozying up to the Tories. The Party was almost wiped out. But every challenge brings an opportunity. Tim Farron had long waxed eloquent on the need to return to the values of Beveridge. If the NHS was conceived by Beveridge and delivered by Bevan there might be hope that Liberal Democrats would rediscover that value of a single nationalised health service. Alas, Tim Farron has made no response to our policy proposals.

And now; and now the final blow. Tim Farron has lead his tiny bunch of MPs through the lobby to support Cameron in his madcap bombing escapade in Syria. Tim Farron Tim Farron in the debate on Syria

I shall not repeat all the arguments against escalating the war in Syria. Many others have put clearly the tactical, strategic, political and diplomatic arguments against escalating the violence there. I must, however, point out that war is a public health disaster. The purpose of bombing is to kill and injure, but over and above that, the damage to the infrastructure of a country leads to homelessness, poverty, starvation and disease. Mass migrations of terrified peoples then exacerbate and spread the suffering. No doctor can look on unmoved while their government or their political party deliberately causes so much illness, suffering and death, and I shall not do so. Enough is enough. I shall resign from the Liberal Democrat Party.


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Paris: Life goes on.


Place de La République: personal witness.

Three days on and Paris is very much ‘open for business’. Place de La République was packed. There were concentric circles round the statue: first flowers then small groups, couples and individuals whom I took to be family, friends and well-wishers. Next were the messages, chalked on the paving or spelt out in candles. Outside that were those of us who claimed no greater connection to this tragedy than the fact we see ourselves as part of  humanity and wanting, wishing and hoping to see a better world.

In the final, outermost circle were the media: cameras on tripods, floodlights and long fluffy microphones all tied by cables to vans with satellite dishes on their rooves.

Press and the media

Paris: the World bears witness


All was sombre and respectful, but Paris is not afraid. Paris lives on. Good luck Paris.


Daylight reveals the flowers and cards in the rain.

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Saxophone Sundae

We  had the pleasure last weekend of taking our saxophone quartet to a Christmas Fayre in Bridgnorth. Over six hundred people visited the event which was focussed on recycling, and we certainly saw some imaginative examples: bags made of folded newspaper and jewellery made of enamelled dominoes. Perhaps the prize should have gone to the large snowman who welcomed us; he was (mostly) made of old plastic drinking cups.

Our Saxophone Quartet in action

Saxophone Sundae

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We can show those French a thing or two

We got off the ferry at Dover with a crowd of Belgians, French and Germans. The lorries were from further East, Poland, Czech republic or Latvia, but the cars and motorcycles were mostly from Western Europe. We had driven two thousand miles in France and had occasionally suffered from congestion; in total we had been delayed by perhaps twenty minutes. We set off on what should have been a four hour drive. By the time we had been driving for an hour, the predicted journey time had increased to five and a half hours.

We decided to stop at one of the UK’s motorway service areas. French travellers should note that service areas are not as frequent in the UK as they are in France, and in order to ensure that drivers get back into their cars and join the traffic jam on the motorway as quickly as possible you will be fined £60 if you stay for more than two hours. It is perhaps better not to order a three course meal and then hope to enjoy a leisurely cup of coffee afterwards.

Motorway Services

Quality dining at a British Motorway Services

This particular service area consisted of a tin warehouse with no less than five fast food outlets. There was no-one serving what one could describe as a meal. You could have sandwiches, burgers or bits of chicken in batter. There were no fresh salads or Boeuf Bourguignon and no drinking-water fountains. I opted for a jacket potato as the healthiest option I could find and had it served in a cardboard tray. I didn’t have to eat it with my fingers, I was supplied with a plastic knife and fork which broke.

Before long I was back on the crowded motorway. By now it was apparent that the M6 was closed and there were traffic jams on the M1, M25 and M40. Our journey took six and a half hours. Still, that was better than a previous visit when there were four motorways closed and the journey took seven hours.

We Brits certainly know how to live. No wonder these all these foreigners are trying to get into the UK.

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Lib Dems to be offered radical new Health Policy

I shall go to Glasgow this weekend with a group of others to promote our new policy on the NHS.

After a year of deliberations, a policy working group set up by Liberal Democrats failed to reach agreement. Two policy documents were produced. One favours the status quo, continuing to outsource public services and subject the NHS to all the rigours of market competition with the complexity and costs that that entails. This is the policy that fragments healthcare and offers parts of the service to private providers in what amounts to a one-way route to privatisation. The other promotes a view of a public service NHS: a service for all regardless of where they live or what their medical need.Hosp_corridor

One document will be promoted with the full vigour of the central party machine, the other will be promoted by a group of individual party members and experts.

We have seen the Conservatives protesting their love of the NHS, while starving it of cash and at the same time breaking it up and offering it up for sale. We have seen Labour protesting at Lansley’s disastrous Health and Social Care Act (HASCA), but leaving open the door to privatisation by continuing the cumbersome, dangerous and damaging market in healthcare. Andy Burnham says that he will repeal the HASCA but he is not committed to removing the market. Labour under Blair and Brown did more privatising of the NHS than did Margaret Thatcher. Simply repealing the HASCA leaves more questions unanswered than answered. What happens to all the Clinical commissioning Groups or to NHS England, which Labour themselves have described as the biggest quango in the land.

Our proposed policy draws on the evidence of experts and the experience of international healthcare systems. We have consulted with doctors from all fields, and our view is that the NHS does not need a market: not the internal market, not the external market. The NHS does not need to sell itself. We believe that a directly provided, publicly funded NHS is the best way to deliver a joined-up service that is efficient, effective and equitable.

We look forward to welcoming Professor Allyson Pollock, a renowned expert in public health research and policy to our meeting in Glasgow. Allyson spoke out for years against the iniquitous and wasteful Private Finance Initiative and the damage that it was doing to the NHS. For years the establishment tried to ‘rubbish’ her. Now politicians of all parties accept that she was right. We look forward to hearing what she has to say.

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