If you had a billion US dollars, how would you spend it?

This is such a wide open prompt, that I’m going to set some parameters to it before I start to answer. In the first instance, I’m assuming that this is money that I have responsibility for distributing for the wider good, rather than $1bn that I can simply spend on personal luxuries and setting up my family. Secondly, I’m going to place a geographical restriction on where the money can be spent, and I’m going to assume that it has to be allocated to projects that will directly benefit the people of Wales. And finally, I’m going to assume that it all has to be allocated and spent within 36 months (thus ruling out the prospect of setting up an investment fund and simply allocating the profits annually).

So having set the rules, what would I spend the money on? I’d allocate $100m to match-fund investment by the Football Association of Wales and the Welsh Rugby Union in artificial playing surfaces for football and rugby in communities across all local authority areas in the country. Climate change leading to wetter winters, and financial constraints on local councils reducing funding for maintenance of grass pitches, means that local sports facilities are deteriorating rapidly, reducing participation and enjoyment at all ages, but particularly for young people. The health and wellbeing advantages of regular engagement in team sports (especially for children and young adults) is well documented, and this investment would create facilities that would be self-sustaining (through reasonable usage fees) for generations to come. Alongside the $100m for pitches, I’d allocate a further $100m to allow junior community sports teams to bid for new equipment, kit and the costs of training volunteers as coaches, referees, safeguarding officers and all the other skills necessary to run a safe and successful club to deliver junior sport.

I’d allocate $200m in total to a capital renovations fund for public or community owned arts venues to bid into, to complete repairs and enhancements to venues supporting theatre, cinema, dance and wider performing arts activities. This would recognise the backlog of repairs and maintenance that has developed in so many of the venues that allow local people access to perform in and enjoy arts-based activities. A further $50m would be available to community-arts organisations for capacity building along similar lines to the sports funding outlined in the previous paragraph.

Having targeted sport and the arts, my next priority would be community assets : whether welfare halls, social clubs or abandoned public houses. An allocation of $200m would be available to match-fund capital investment into facilities that have closed or at risk of closing, and that can be transferred or reinstated to community ownership on a co-operative basis (that is, with any profits from operations ploughed back into the asset and its community for the long term). This is really about community cohesion, recognising that places where people can come together socially play an integral role as the glue that binds people together in a sense of place. Often, these facilities are unviable in a strict commercial sense, but their non-financial benefits are immense (and can also indirectly create a sense of local pride and interest that does positively rub-off in terms of other local businesses). Again, $50m would be made available to train volunteers to be part of the teams running and managing the assets; and also to cover the legal and other set-up costs of co-operative societies to act as the owners of the assets.

Which leaves $300m to be allocated (still an awful lot of money!). This would be targeted on education and skills – supporting individuals to engage in formal and vocational education and skills training, as well as providing seed-corn funding for new business development. This would be in addition to existing government funding and would recognise the simple fact that grants and loans to individuals have not kept pace with increases in the costs of living and that inadequate financial support is now a substantial barrier facing those who would otherwise like to train or re-train in the skills and competences demanded by employers.

Sport, culture, community cohesion, skills and education – the key focuses of action that leads to improved health and wellbeing. $1 billion well spent, I think.

‘The principles on which the NHS was founded in 1948 are neither appropriate nor achievable in a 21st century health system’.

In the week where nurses and paramedics have been out on strike and press coverage today suggests that the public is rapidly losing confidence in the ability of local NHS services to deliver, this essay that I wrote as part of my postgraduate course seems relevant. It is deliberately provocative in parts, and I don’t necessarily believe that the NHS is lost, but it is nonetheless the case that if we want to retain a comprehensive, universal service free at the point of delivery, then we need an urgent and grown-up conversation about what that means in terms of how much it costs and how we pay for it. What must now be clear is that we can’t carry on as we are.

Introduction

COVID-19 has acted as a stress test on the National Health Service in England, and the results of that test call into question the extent to which the principles on which the NHS was founded are appropriate or achievable in a post-COVID world. In this essay, I will argue that governments since the launch of the NHS have failed to adequately and robustly review the principles underpinning its operation. Those principles are now an anachronism, inappropriate and unachievable in the context of today’s NHS in England, and – worse – acting as a barrier to discussions about more appropriate and achievable alternatives. In concluding, I argue that what we are seeing in terms of public confidence in NHS England is an example of a “trust thermocline”[1] – a neat label for the phenomenon where stakeholders suddenly lose faith in a product or service.

The founding principles of the NHS

The founding principles of the NHS were contained in the NHS Act 1946 ss.1(1) and 1(2). On the sixtieth anniversary of the NHS, Tony Delamothe[2] condensed the provisions of the Act into a description of the service as “universal, equitable, comprehensive, high quality, free at the point of delivery, [and] centrally funded.” Rudolf Klein[3] acknowledges the work of people like Beatrice Webb, David Lloyd-George, and William Beveridge in paving the way for Aneurin Bevan’s NHS Act. The creation of “the first health system in any Western society to offer free medical care to the entire population”[4] was a radical and audacious act. But it was also very much of its time: “The 1948 model accurately mirrored a society strong on collectivism, reconciled to scarcity and with a firm faith in the technocratic rationality of planning.”[5] In Klein’s Preface to the 2010 edition of his book, he notes that: “The values that inspired the founding fathers, and shaped the NHS in the first place, still drive the service and command support across the political spectrum.” However, Klein’s analysis of the historical development of the NHS makes clear the compromises and concessions that were instrumental in gaining political and professional medical support for the 1946 Act. Those compromises and concessions were the hairline cracks in the underpinning foundations of the NHS that have widened into fatal weaknesses in 2022. In developing this argument, I will consider how services are delivered (universality and comprehensiveness); how well the services are delivered (equity and quality); and how services are funded (free at the point of delivery and central funding).

How the NHS is delivered : comprehensive and universal?

Klein describes healthcare services in England prior to 1946 as “an inadequate, partial and muddled patchwork.”[6] 70 years after the founding of the NHS, Chand and Pollock characterised services as “fragmented, undermined and decimated.”[7] On the face of it, the NHS is failing in its claims to provide “a comprehensive service, available to all”,[8] and the Secretary of State is in breach of the duty to “continue the promotion in England of a comprehensive health service”.[9] Despite Bevan’s wish for a NHS delivering “a uniform standard for all”[10] and avoiding the risks of “a better service in the richer areas, a worse service in the poorer”,[11] NHS delivery was never comprehensive or universal. Julian Tudor Hart’s work[12] documenting the inverse care law in the 1960s, and recent coverage of public dissatisfaction with access to GP appointments and the fact that more affluent areas have twice as many doctors per as more deprived communities,[13] adds to the sense that comprehensive and universal services has always been aspirational rather than within achievable grasp. This is recognised in the work of Haycox[14] who – as part of his guide to health economics – states: “It is universally acknowledged that the technical ability of healthcare systems to provide care… far exceeds the ability of any healthcare system to afford all such technologies.” Healthcare rationing[15] is present to varying degrees in all forms of healthcare system, and theories such as Accounting for Reasonableness[16] seek to identify the criteria that help secure public acceptance of decisions regarding prioritisation of some treatments over others.

How well are services delivered : equity and quality?

Improving population health is an example of a “wicked problem”[17] – it is complex, multi-causal, and requires inter-sectoral action over an extended time frame. Ilona Kickbusch and Kevin Buckett[18] make the case for a Health in All Policies (HiAP) approach as an essential response to the increasing demands of chronic ill-health on healthcare systems. Drawing on the work of Michael Marmot,[19] HiAP advocates argue that upstream “causes of the causes”[20] of ill-health need to be addressed as part of an integrated approach to maximising the well-being capability[21] of populations. Reflecting on the challenge for UK healthcare following COVID-19, Liz Green et al[22] conclude that the pandemic, climate change and Brexit “act synergistically and cumulatively, creating a huge ‘triple challenge’.” Marmot’s social gradient[23] of health clearly demonstrates that those facing disadvantage linked to upbringing, education, employment, housing conditions, age, or disability are much more likely to experience poor outcomes in terms of both morbidity and mortality. That inequity has been amplified through COVID-19.[24]

Nor is it the case that the NHS in England offers significantly better quality in terms of outcomes than other healthcare systems. Mark Dayan et al[25] note that whilst the NHS attracts a share of GDP comparable to systems in many other countries, it is relatively poorly served in terms of clinical staffing and diagnostic equipment and it “does not have especially good outcomes relative to other wealthy countries.”[26] Nagendran et al[27] compared NHS Trust financial performance and clinical performance between 2011 and 2016 and concluded that “operating margins [£] have progressively worsened… and that this change correlates with poorer… performance on a range of widely benchmarked process measures…” [and] “even the best financially performing Trusts are struggling to manage demand.”[28]

How services are funded (free at the point of delivery and central funding)

Whilst the NHS in England remains “the archetype of a publicly funded health system… predominantly funded from taxation and… available to every resident”[29] it is nevertheless true that some services (dispensing of prescription medication, dental care, and dispensing of spectacles) have been subject to user-charges since as early as 1950. The Health and Social Care Act 2012 s.1(4) qualifies the stipulation that NHS services must be free of charge “except in so far as the making and recovery of charges is expressly provided for” in any other legislation. Chand and Pollock[30] highlight the new charging regimes that now apply to immigrants, asylum-seekers, and refugees; and Dayan et al[31] highlight the difficulties faced by an increasing number of older people in securing funding support for residential care or activities of daily living. It is widely recognised that NHS funding has been significantly reduced in real terms consistently since 2010[32] and it seems clear that this will continue for the foreseeable future.[33]

So what does this mean for the future of the NHS in England?

Chand and Pollock[34] appeal for the restoration of “the founding principles of the NHS” in their 2018 blogpost. It is with some regret that I conclude that this is no longer realistic. Those founding principles were of their time mirroring “a society strong on collectivism, reconciled to scarcity and with a firm faith in the technocratic rationality of planning.”[35] The 2021 British Social Attitudes survey[36] recorded the largest decline in public satisfaction with the NHS since it was first conducted in 1985. Waiting times to see a GP and/or for elective treatment, lack of staff, and insufficient spending on the NHS were cited as the main reasons for dissatisfaction. However, there was only limited support for increasing taxes to spend more on the NHS, and only 54% chose ‘definitely’ when asked if the NHS should primarily be funded through taxation. It is arguably the case that the NHS is past the point of no return on the Trust Thermocline.[37]

It is said that Nigel Lawson once described the NHS as the nearest thing the English have to a religion.[38] The founding principles of the NHS have assumed a status akin to religious texts, but that status has prevented meaningful discussions around other ways of organising (e.g. adjusting the mix of public and private provision[39]), funding (e.g. social insurance[40]), and delivering (e.g. Integrated Clinical Care[41]) healthcare services in England. Even where approaches similar to HiAP are being promoted, it is noticeable that separate guidance has been produced for local authorities[42] and NHS bodies[43], suggesting that the paradigm shift in policy making implicit in HiAP is not fully appreciated. The founding principles of the NHS set out in 1948 are no longer appropriate or achievable because they were never appropriate or achievable. It’s now time to start a new conversation about the governance, organisation and delivery of a new form of health and social care for a post COVID-19 England.

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[1] Initially identified as an emerging theoretical construct around the sudden loss of customer satisfaction in service industries in a Twitter thread and then presented as a blogpost here : The Trust Thermocline : fuseboxgames (reddit.com)

[2] Tony Delamothe – “Founding Principles”, BMJ Volume 336, 31^st May 2008

[3] Rudolf Klein – “The New Politics of the NHS: From Creation to Reinvention”, Radcliffe Publishing, Oxford 2010 p.1

[4] Ibid. p.2

[5] Ibid. Preface

[6] Rudolf Klein – “The New Politics of the NHS: From Creation to Reinvention”, Radcliffe Publishing, Oxford 2010 p.1

[7] Kailash Chand and Allyson Pollock – “The NHS Doesn’t Require Reform – it Needs a Revolution”, The Political Quarterly blogpost The NHS Doesn’t Require Reform – it Needs a Revolution | Political Quarterly

[8] The NHS Constitution Principle 1 https://www.gov.uk/government/publications/the-nhs-constitution-for-england/the-nhs-constitution-for-england

[9] National Health Service Act 2006 s.1

[10] Rudolf Klein – “The New Politics of the NHS: From Creation to Reinvention”, Radcliffe Publishing, Oxford 2010 p.14

[11] Ibid.

[12] Julian Tudor Hart – “The Inverse Care Law”, The Lancet v297 n7696 (1971) pp.405-412

[13] https://inews.co.uk/news/health/gp-surgery-postcode-lottery-england-patients-doctors-figures-worst-areas-1242390

[14] Alan Haycox – “What is health economics?” Hayward Medical Communications 2009

[15] Richard Cookson and Paul Dolan Principles of Justice in Healthcare Rationing : Journal of Medical Ethics 2000:26 pp.323-329

[16] Norman Daniels – Accountability for Reasonableness BMJ Volume 321 November 2000 p.1300

[17] Ilona Kickbusch and Kevin Buckett – Implementing Health In All Policies (Adelaide: Government of South Australia 2010)

[18] Ibid.

[19] Michael Marmot, “Fair society, healthy lives : the Marmot review ; strategic review of health inequalities in England”, London 2010

[20] Sridhar Venkatapuram, ‘Global Justice and the Social Determinants of Health’ 2010 Ethics and International Affairs 24:2 pp.119-130

[21] Amartya Sen, ‘What Do We Want from a Theory of Justice?’ 2006 The Journal of Philosophy 103:5 pp.215-238

[22] Liz Green, Kathryn Ashton, Mark Bellis et al – Health in All Policies – a key driver for health and wellbeing in a post covid-19 pandemic world Int Journal of Environmental Research and Public Health 2021 18 9468

[23] Michael Marmot, “Fair society, healthy lives : the Marmot review ; strategic review of health inequalities in England”, London 2010

[24] Bo Burstrom and WenjingTao : “Social determinants of health and inequalities in Covid-19” – European Journal of Public Health 2020 30:4 pp.617-618

[25] Mark Dayan et al : “How good is the NHS?” The Health Foundation 2018 The NHS at 70: How good is the NHS? (kingsfund.org.uk)

[26] Ibid.

[27] Myura Nagendran, Grace Kiew, Rosalind Raine, Rifat Atun, Mahibon Maruthappu – Financial Performance of English NHS Trusts and variation in clinical outcomes: a longistudinal observational study, BMJ Open 2019:9 doi:10.1136/bmjopen-2018-021854

[28] Ibid. p.9

[29] Robert Blank and Viola Burau – Comparative Health Policy 2013 Palgrave Macmillan ch.3

[30] Kailash Chand and Allyson Pollock – “The NHS Doesn’t Require Reform – it Needs a Revolution”, The Political Quarterly blogpost The NHS Doesn’t Require Reform – it Needs a Revolution | Political Quarterly

[31] Mark Dayan et al : “How good is the NHS?” (published 2018)

[32] Caroline Molloy – “Jeremy Hunt: New chancellor is the man who ruined the NHS – openDemocracy blogpost 8^th July 2022 Jeremy Hunt: How new chancellor ruined the NHS | openDemocracy

[33] Jeremy Hunt: Everyone will have to pay more tax – BBC News

[34] Kailash Chand and Allyson Pollock – “The NHS Doesn’t Require Reform – it Needs a Revolution”, The Political Quarterly blogpost The NHS Doesn’t Require Reform – it Needs a Revolution | Political Quarterly

[35] Rudolf Klein – “The New Politics of the NHS: From Creation to Reinvention”, Radcliffe Publishing, Oxford [2010] Preface

[36] Dan Wellings, Danielle Jefferies, David Maguire et al, Public satisfaction with the NHS and social care in 2021: Results from the British Social Attitudes survey 8^th March 2022 The King’s Fund Public satisfaction with the NHS and social care in 2021 | The King’s Fund (kingsfund.org.uk)

[37] The Trust Thermocline : fuseboxgames (reddit.com)

[38] Attributed to former Conservative Chancellor of the Exchequer Nigel Lawson

[39] Robert Blank and Viola Burau – Comparative Health Policy 2013 Palgrave Macmillan ch.3

[40] Helen McKenna, Phoebe Dunn, Emily Northern and Tom Buckley – How health care is funded, The King’s Fund 2017 How health care is funded | The King’s Fund (kingsfund.org.uk)

[41] Jonathan Erskine, Michele Costelli, David Hunter et al – “The persistent problem of integrated care in English NHS hospitals: Is the Mayo Model the answer? 2018:32:4 Journal of Health Organisation and Management p.532

[42] Local Government Association – Health in All Policies: a Manual for Local Government 2016 Health in all policies: a manual for local government | Local Government Association

[43] NHS England 2022 https://www.england.nhs.uk/get-involved/involvementguidance/

Reflections prompted by the commemoration of VE Day

Today’s blog is something of a long read, but it’s a holiday weekend, so there’s a bit more time to digest it. It comprises a number of extracts from various on-line sources that are pertinent both to the commemoration of VE Day (the end of the war in Europe in 1945), and the challenges that we face currently in seeking to contain and learn to live with the longer-term effects of covid-19. I offer the extracts with no added editorial comment (although their selection is inevitably influenced by my own prejudices and beliefs). I hope that they may give some pause for thought and some hope for a future beyond the current crisis that is more equal, more internationalist, more socially responsible than we have seen over the past decade.

An extract from an article written by Winston Churchill and published in the News of the World in May 1938 (some 16 months BEFORE the outbreak of the Second World War, and at a time when politicians dared hope that the 1914-18 conflict really had been the war to end all wars).

“From all these causes and others that together fill volumes, the conclusion may be drawn with much confidence that the movement towards European solidarity which has now begun will not stop until it has effected tremendous and possibly decisive changes in the whole life, thought and structure of Europe. It does not follow even that this progress will be gradual. It may leap forward in a huge bound of spontaneous conviction. It may even prove to be the surest means of lifting the mind of European nations out of the ruck of old feuds and ghastly revenges. It may afford a rallying ground where socialists and capitalists, where nationalists and pacifists, where idealists and businessmen may stand together. It may be the surest of all the guarantees against the renewal of great wars…

“It is evident that up to a certain point the developments now in actual progress will be wholly beneficial. In so far as the movement European unity expresses itself by the vast increase of wealth which would follow from it, by the ceaseless diminution of armies which would attend it by ever-increasing guarantees against the renewal of war, it bodes no ill to the rest of the world. On the contrary, it can only bring benefits to every nation whose interests are identical with the general interests of mankind.

Conflicts of countries are, we trust, ended. They must not be succeeded by the antagonisms of continents. But surely, after all they have gone through, men will have the wit and virtue to take the good and leave the bad; to the high road which leads to wealth and power, without being drawn down the fatal turning to shame and ruin…

We are bound to further every honest and practical step which the nations of Europe may make to reduce the barriers which divide them and to nourish their common interests and their common welfare. We rejoice at every diminution of the internal tariffs and the martial armaments of Europe. We see nothing but good and hope in a richer, freer, more contented European commonalty. But we have our own dream and our own task.”

The following is an extract from the Guardian’s editorial on this day in 1945 :

“We may not know the answer to the troubles of mankind but at least we know some of the causes. We have learnt, or should have learn, how dangerous is the spirit of nationalism when harnessed to the fact of power. We have seen what can happen to a great nation which surrenders to its leaders the freedom of thought and speech and conscience. We have ourselves felt the terrible power of destruction which man has acquired through science uncontrolled by wisdom. We have learnt… that the brotherhood of man, the unity of nations, and the indivisibility of peace are facts which we can no longer ignore. But knowledge is not enough. Fear, hatred, nationalism and the like are not rational states but emotions which for a long time will continue to govern human behaviour and which will be fed by the chaos and misery in Europe. Hunger and unemployment are not the best schools for reason and tolerance, but they will have many pupils…

“To-day, the people of Europe want above all peace, security, and a decent living. But they also want again that sense of freedom, progress, and enjoyment of life which gave meaning to the nineteenth century… We must prove that just as liberal democracy is a match for dictatorship in war, so in peace it can provide for its people all and more than is offered by Communism and National Socialism. But it will not be easy. If the war has tried our courage and endurance, the peace will test our wisdom and our faith.”

Alan Little’s review of the BBC Archive records of VE Day 1945 includes this reflection :

“Did the public understand, on that day, how profoundly Britain and the wider world had been changed by the war; that there would be no going back to the old normal of the 1930s? This had been total war: the state had assumed sweeping new powers to mobilise the whole country for the war effort. Many of those powers would now survive into peacetime.

“The government took much of the economy into state ownership: the railways, the coal mines, iron and steel. A new welfare state and a National Health Service would bring state provision into every home in the country. For war had created a new public mood that would change the relationship between the state and society for a generation.

“‘To a remarkable degree, this includes people who think they’ll be worse off under this new settlement,’ says historian Dan Todman, author of Britain’s War: A New World, 1942-47. ‘Quite a large proportion of middle-class people who weren’t going to benefit necessarily from it said that they still thought it was a good idea; that it was something that ought to be done for other people. So I think that’s part of that wartime mood: the recognition that the nation-state owes something to everybody, especially the least fortunate members of society.'”

Max Hastings writing in The Times today :

“VE Day prompted many people to drink deep, dance high, embrace strangers, because that was what the occasion appeared to demand… There was also, however, huge apprehension. Young people had known only the experience of war — not merely its violence but also rationing, the gloom of the blackout, family separations, dust, rubble and broken glass. They had lived all their adult lives in a straitjacket of enforced discipline, denial of personal choice. They were required to obey orders…

When these constraints were lifted… what would life be like? What jobs would become available to young men who had received higher education only in killing each other? How would thousands of wives explain their babies to returning, long-absent husbands? How would factories, manufacturing tools of war, learn once more to make toys of peace? Would the old social order with its lofty grandees, formal evening wear and deferential servants, once more reassert itself? These and a thousand other questions crowded the minds of everybody free to think beyond immediate survival...

Today, during a new global convulsion mercifully far less deadly and hopefully much less protracted than the war, many people look back and ask whether VE Day has a resonance. In two respects, it may. The first is the saddest: just as the young did most of the war’s dying, so they will suffer most in the ordeal that lies ahead of us, beneath the spectre of mass unemployment. We in Britain shall pay an especially heavy price for being a service economy that… can no longer make much, not even surgical gowns.

Second,… this experience may emulate the earlier era in becoming an engine for change. Winston Churchill, the patrician hero, failed in one big thing. He refused to identify war aims, beyond those of vanquishing the enemy… Talk of glory, victory, duty were not enough to motivate a citizen soldier. “Now he is asking for what sort of victory? For what sort of a post-war country? For ‘my duty’ to what goal in life?”

Churchill’s inability to grasp this was at one with his distaste for the 1942 Beveridge Report, blueprint for a welfare state, and went far to explain his 1945 election defeat. The British people were determined to have their own version of what Franklin Roosevelt, more than a decade earlier, had called the New Deal.

The present crisis seems destined again to change the face of Britain, unleashing demands for social, political and economic reform unprecedented in our memories. It is impossible to guess how the politics, especially, will play out. But it seems certain that the state and its institutions will necessarily play a far larger role in our affairs. People will not quickly forget the tragedy of the care homes, cruelly excluded from the shield of the NHS.

For more than three decades the rich, and even the relatively rich, have had a fabulous run. I find it hard to imagine, however, that a nation with soaring unemployment and a far-worse-than-empty Treasury, which has made a political choice for self-isolation, will continue to tolerate the absurdly low rates of tax today paid by the wealthiest, or the scandal of non-doms who live here untaxed, or the grotesque rewards granted to chief executives, and other excesses of global corporatism.”

Picking the wrong suffragette!

A reader writes : “You picked the wrong Pankhurst; Sylvia is much more interesting that Emmeline!”

Earlier in this coronablogging series, I offered some thoughts on the ten figures from history that I would like to include in my coronavirus ‘bubble’. Amongst my selection was Emmeline Pankhurst, the founder of the UK suffragette movement that was instrumental in securing the vote for women. Barely had the digital ink dried on the digital page (these analogies don’t work so well in a blogging context do they?), than I received a message from a reader suggesting that I’d picked the wrong Pankhurst. The much more interesting choice would have been Emmeline’s second daughter, Estelle Sylvia.

Now – I’ll confess that I had never heard of Sylvia before receiving this message, but having now read up a little bit more about her, I have to admit that the feedback was correct. Sylvia’s was an even more extraordinary life than that of her mother. Born on this day in 1882 in Old Trafford, Manchester in 1882, she attended Manchester High School for Girls and then the Manchester School of Art before relocating to London to attend the Royal College of Art between 1904 and 1906. It was towards the end of her time at the RCA that she began full time work for the Women’s Social and Political Union (WSPU) – the official organisational title of the suffragist movement. Although the WSPU campaigned on a militant agenda in pursuit of female suffrage, it was strictly non-partisan – something that led to an increasingly strained relationship with her mother and elder sister. Sylvia was an active member of the Independent Labour Party (the forerunner of the modern Labour Party in the UK), and supported a range of socialist causes alongside her calls for political reform.

In common with many members of the WSPU, Sylvia was arrested, convicted and imprisoned for her activities in support of votes of women. In just 17 months from February 1913 to July 1914, Sylvia was imprisoned on eight separate occasions, immediately going on hunger strike in prison, and being repeatedly force-fed. In November 1913, Sylvia was one of a number of speakers at a rally in the Albert Hall in support of Dublin workers who had gone on strike seeking the right to join trades unions and in protest generally at the appalling conditions that many Irish labourers were forced to endure at the time. This overtly political stance by Sylvia led to her expulsion from the WSPU. Undaunted, Sylvia was a founder of the Workers’ Socialist Federation (WSF) in East London.

Sylvia was opposed to the First World War and the WSF was active in providing safe-houses for conscientious objectors as well running various schemes to support the wives of killed or injured soldiers. She was also instrumental in the creation of advice centres to support women seeking access to decent allowances to support themselves and their families while their husbands were away on military duties.

In the immediate period after the end of the First World War, Sylvia was involved in the formation of various forms of a communist party of Great Britain. At this time, she also began living with Italian anarchist Silvio Corio.

During the 1930s, Sylvia drifted away from communism and became more interested in anti-fascist and anti-colonialist movements on the international stage – in particular seeking to highlight the cause of Ethiopia after that country’s invasion by Italy in 1935. It was at about this time that Sylvia came under surveillance by MI5 (the UK’s internal security service).

Sylvia’s interest in and support for Ethiopian independence and subsequent development continued for the remainder of her life, and she spent the final years of her life living in Addis Ababa at the invitation of the country’s Emperor Haile Selassie. Sylvia died in Ethiopia in 1960 and received a full state funeral.

Her role in the women’s suffrage movement was formally marked through inclusion on the plinth of a statue of Millicent Fawcett that was unveiled in Parliament Square in London in 2018.

As my reader quite rightly points out : “Sylvia understood that no-one is really free until all are free – hence throwing her weight behind working class struggle for both men and women.” Truly, an inspirational woman and one that I am pleased to have learned more about.

Relatively speaking, absolute positions on anything are ill-advised!

I was struck today by the news that in Germany and Austria, the federal governments (supported by local state legislators) have moved to make the wearing of face masks compulsory when travelling on public transport, and in some cases, even when shopping. This is a sensible measure that is evidence-based and follows the precautionary principle that underpins all public health advice : it does no harm to wear a covering of the nose and mouth, and it probably plays a part in reducing the risk of asymptomatic people spreading the covid-19 virus inadvertently when out and about. I have no argument with the policy, and I strongly suspect that something similar will form part of the process that allows the UK to emerge from our current restrictions in due course.

State legislatures in Germany and Austria have legislated to make the wearing of face masks compulsory as part of plans to ease coronavirus restrictions

So what has given me cause to pause by this story? Simply this. That many of these same states have also passed legislation banning the wearing of traditional Muslim full face masks in public.

Now, I’m not an expert in the legal systems of Germany or Austria, but it seems to me that it’s going to be very difficult to reconcile an absolute ban on the niqab alongside an absolute requirement for everybody to be wearing a face mask in defined public settings. In fact, I’d go as far as to say that the two laws will be absolutely in conflict one with the other. And this is the problem with taking an absolute position on almost any particular issue.

European laws seeking to restrict the wearing of traditional Muslim dress in public spaces largely stemmed from fears that a rise in sympathies for far-right and neo-Nazi groups might lead to far greater dangers for Muslim residents. Mainstream politicians of the left, centre and social democratic right sought to reduce the populist appeal of a particular brand of anti-Islamic rhetoric by bringing forward legislation that was itself clothed in words like assimilation, or helping minority communities to ‘fit in’ better. There was even some suggestion that traditional dress was demeaning to women and ran counter to Western values (conveniently overlooking the structural sexual discrimination in those same societies that continues to see women paid significantly less on average than men in almost all large organisations across the public and private sectors).

The problem is that seeking to legislate – to take an absolute, clear legal position – on something as complex as a dress code steeped in a thousand years of cultural and religious symbolism and culture, is fraught with danger. Legislation is not good at nuance – it is usually and necessarily a blunt tool. And seeking to take absolute positions where context and nuance are key to understanding what is going on, is inevitably fraught with danger down the road. Even more so when it now seems that wearing the niqab was actually the socially responsible thing to be doing all along!

November 20th : a red, amber, green and black letter day

Sometimes, I start writing entries on this blog with no real plan for where it might take me. Today is one of those days, but it’s been a fascinating journey, and I hope you’ll enjoy it too…

Traffic lights as we know them are 95 years old today. The patent for three position traffic lights was awarded in the US to Garrett Morgan on this day in 1923. The first traffic light system had been installed in London in 1868, but it was Morgan who came up with the idea of adding the amber light to better control traffic at busy junctions. Morgan sold the rights to his invention to General Electric for £40,000 (equivalent to about £500,000 in today’s money).

Morgan’s is a fascinating life, straight out of the American Dream handbook, made all the more remarkable by the fact that he was the black son of former slaves. Born in Kentucky in the final quarter of the 19th Century, he moved north to Ohio searching for work and took jobs as a handyman and then sewing machine repairman, before opening his own repair shop. Such was his success, that he expanded into clothing stores and then a newspaper – the Cleveland Call and Post, one of the most prominent of the black newspapers in the US.

The Call and Post featured prominently the Scottsboro case in 1931, which led to Supreme Court rulings on the conduct of criminal trials that remain in place to this day. The case was highly racially charged, involving an allegation of rape by two white women against 9 African American teenagers in the state of Alabama. The case is now widely cited as an example of a dreadful miscarriage of justice.

The Call and Post was facing bankruptcy and dissolution in 1998, but was saved from the brink by boxing promoter Don King. King is one of the most flamboyant and controversial characters in world boxing. He promoted the Rumble in the Jungle and the Thrilla in Manila – two of the three bouts contested by Mohammed Ali and Joe Frazier; and more recently, he was responsible for charting the meteoric rise of Mike Tyson, before an equally dramatic decline in his protogees fortunes. King himself has twice been charged with manslaughter – on the first occasion he was acquitted when the court accepted that he was seeking to prevent the victim from robbing him. The second case was much less justifiable, and King spent nearly four years in prison as a result.

More recently, King landed himself in hot water when he used the n word while introducing Donald Trump at a presidential campaign event at a Black church in Cleveland in 2016. It’s perhaps unfortunate that there isn’t a system of warning lights for Republican speakers at political rallies. It would save them all a lot of unnecessary trouble!

 

 

It’s not all equally bad news

It’s been too easy recently to assume that we are all going to hell in a hand-basket. Austerity and its impact on the poorest members of our society; Brexit and the feral, anti-immigrant sentiment that it stirred up; abuses of position and sexual harassment in the corridors of political power – all suggest that we are becoming less tolerant, less social, less equal as a society.

Its good to be able to reflect on two pieces of very positive news today. The first details a change in maternity and paternity leave policy by the UK’s largest insurance company, Aviva. In future, both parents will be able to claim up to 26 weeks leave at standard basic pay in the first year following the arrival of a new child or completion of an adoption. Where both parents work for Aviva, this could allow a full year of child care to be provided by the parents without any reduction in basic pay. This is not only great for the child, but has the potential to significantly reduce the negative impact on the woman’s career of taking time out of the workplace after childbirth. What’s particularly encouraging about the Aviva initiative is the recognition that changing the policy alone won’t achieve the sort of cultural shift that they are seeking to achieve. “Aviva [will] use male role models to show it is acceptable to take up the offer of parental leave, to encourage a change in perceptions and foster a cultural change. Otherwise, male employees may still be reticent about taking time off, even if paid.” I genuinely hope that this is the start of a wider review of maternity and paternity leave policies across the private and public sectors. It’s in everybody’s best interests to support women and men equally as parents and employees.

The second ‘good news’ story this Friday comes from an unusual source. Swansea City FC and AFC Bournemouth have become the first Premier League football clubs in the country to formally recognize transgender and non-binary supporters in the way that they are addressed. In future, supporters will have the option to choose to be addressed as “Mx” as an alternative to the more ususal Mr, Miss, Mrs etc.. Explaining the change in policy, Swansea City’s equality and diversity manager said : “We’re continually looking at ways to make our services more inclusive. Language plays a really important part in delivering this and ensuring that everyone feels welcome – regardless of age, gender or gender identity, sexuality or ethnicity.” Too often, football and football clubs are associated with a laddish culture in which minorities and ‘difference’ are seen as fair game for ridicule or humiliation rather than celebration. It’s great to see some clubs now taking a much more enlightened attitude to these issues. This weekend also sees the launch of the Rainbow Laces campaign, promoted by Stonewall, and designed to tackle homophobic, biphobic and transphobic attitudes in sport more generally. Of course, as with the challenges of cultural change at Aviva, adding Mx to a list of prefixes won’t suddenly lead to premiership football becoming a safe space for transgender and non-binary fans, but it may encourage those have been reluctant to attend football matches for fear of how they would be received, to go along. And that’s good for the fans and the clubs.

Have a good, equality-filled weekend!

Check your privilege

Some facts. There are 650 members of the UK parliament. 442 of them (68%) are men. According to the 2011 Census, approximately 51% of the population of the UK is female. There was a 21% increase in police recorded sexual offences between 2015 and 2016.

These facts are important because to listen to some of the (mainly white male) responses to the allegations of discrimination against and bullying of women at the heart of the UK legislature, one could be forgiven for thinking that men are somehow under siege.

A particularly extreme version of the siege mentality was described by Charles Moore in yesterday’s Daily Telepgraph. Under a ridiculous headline and a picture of the Russian anarchist group Pussy Riot, Moore launches into a bizarre tirade which includes the following, astonishing, assertion : “It would now be highly unwise in many work situations for a man – especially an employer – ever to share a room with a woman without the presence of a witness. It makes men more reluctant to give women jobs.” This astonishing statement is presented with no supporting evidence whatsoever.

It appeared in the press at the same time as another one about a school in New Zealand where girls have been instructed to lower the hemline on skirts to “keep our girls safe, stop boys from getting ideas and create a good work environment for male staff”. This prompted the only response possible from one Twitter commentator, who wondered : “At what point, when protecting your male staff from the seduction of children’s knees, do you think you might have hired the wrong staff?”

The simple truth is that, for far too long, women in the workplace, and women and girls of all ages and at all stages of life, have been subjected to unfairness, discrimination, and oppression at the hands of men and as part of a society that is stacked inexorably in men’s favour. The lack of women in the boardrooms of major companies, the absence of women at the top of Universities and public bodies, the under-representation of women in legislatures and law-making bodies across the globe – all points to a system that is structurally unfair. Worse than that though – it points to a system that is necessarily under-performing. If 50% of the candidates are at a structural disadvantage in reaching their full potential in the workplace, politics, and wider public life, then we all lose out as a result.

That’s why the current furore at Westminster and in Hollywood is so welcome. Shining a light on an area of discrimination and abuse that we have all known about for far too long, must now lead to positive, decisive action to end the casual oppression of women in all walks of life, and at all stages of their lives.

One law for the rich…

It’s funny how sometimes a pattern emerges from a whole series of different stories and events that in many respects would appear to be unrelated. That’s been the case for me this past week.

It started with news coverage of the decision of the Financial Conduct Authority to order the end of an enquiry into UK banking culture that had originally been proposed as one of a number of measures to determine whether the lessons for the world financial crisis had been learned. Apparently, the FCA thinks they have, and that we should all stop giving the bankers such a hard time (http://www.theguardian.com/business/2015/dec/31/banking-culture-review-john-mcdonnell-urges-george-osborne). Others are less sure, and see the dead hand of the Chancellor behind the move which will go some way to appeasing the likes of HSBC who had been threatening to pull out of London and take their HQ elsewhere.

This was followed by the confirmation from the Crown Prosecution Service that the posthumous ‘trial of the facts’ to examine allegations of historic child sexual abuse involving former MP Lord Janner, had been shelved (http://www.bbc.co.uk/news/uk-35304528). This on the same day that it emerged that an establishment cover-up in the 1990s may have prevented a more detailed inquiry at a time when Janner was well enough to have been properly questioned in relation to complaints against him (http://www.theguardian.com/commentisfree/2015/apr/19/establishment-stopped-me-exposing-greville-janner-25-years-ago).

At the same time, and without any public fanfare or opinion pieces in the national newspapers, a family in South Wales is facing the double heartache of fighting health and social services to secure appropriate treatment and care for their daughter who is suffering constant fits and debilitating paralysis, whilst at the same time needing to find a new home following the decision of their landlord to sell their rented property out from underneath them.

There is little doubt that lawyers have been working tirelessly and at great expense to lobby both the FCA and the CPS that any further enquiry into the actions of their respective clients would not be in anyone’s best interests. They’ve done a good job and doubtless been paid handsomely for their expert services. I don’t begrudge them a penny.

Unfortunately, the same access to legal support is not available to the family fighting to make public services discharge their health and care duties, nor to support them in securing suitable alternative rental accommodation. Both parents have jobs and work hard to support their kids, but their disposable income after living costs won’t stretch to the fees of a housing or community care lawyer.

What seems like a lifetime ago now, I worked for the Legal Services Commission at a time when its prime concern was securing access to justice for those who desperately needed it, but lacked the means to pay for it in full or at all. Unfortunately, since then, successive governments of all colours have seen legal aid as a cost rather than an investment, and have sought to reduce both the scope of things covered by the scheme, and the rates of pay of those lawyers foolish enough to continue to operate it.

The theme that runs through all this, of course, is the old adage that there’s one law for the rich (and powerful) and one for the rest of us. It’s this that is highlighted so perfectly in this Tom Robinson song for the Justice Alliance.

Is justice being turned on its head for celebrity defendants?

So, a jury has listened to all of the evidence and reached the conclusion that Bill Roache is not guilty of rape and indecent assault having faced charges relating to events that were alleged to have taken place over 40 years’ ago (http://www.bbc.co.uk/news/uk-england-26068034). Subsequent press coverage of the case has questioned whether it was right that the case was ever brought to trial, given the inconsistencies that emerged in the prosecution evidence presented, and the inherent challenges faced in seeking to prove ‘ beyond all reasonable doubt’ that the alleged events happened at specific times, in specific places, over four decades before. There have already been calls for a review of pre-trial review procedures to ensure that there is adequate prima facie evidence to support a prosecution before the matter is put to a full trial, and the reintroduction of some form of grand jury process, still in place in the US but phased out in the UK in the early 1800s. These are interesting suggestions and deserve to be considered in detail. It might also be time to think about the introduction of a statute of limitation for criminal offences. This could establish a presumption against bringing prosecutions in cases where there was no complaint made at the time without the prior permission of a High Court judge who could be asked to review the reasons why there was a delay between the alleged events and the subsequent complaint, and whether the time period between the two is such that the prospects of a successful prosecution have been fatally damaged

The case also raises some interesting questions about the nature of police investigations into alleged criminal conduct by celebrities (and those in the public eye more generally). Paradoxically – and despite the English legal maxim that defendants are innocent until proven guilty – the media attention given to investigations of allegations against ‘famous’ people, means that a trial is often the only way that their innocence can be established. From a PR perspective, it is almost inevitably most damaging to the reputation of an individual to have been taken in for questioning or arrested in a blaze of publicity, and then to have the investigation dropped at a later stage with barely a mention. The fact of the arrest and the implication that ‘there is no smoke without fire’ leaves an almost indelible stain on the individual’s character. At least a ‘celebrity trial’ creates the opportunity for a ‘dramatic’ not guilty verdict and a press conference on the court steps at the end of the process

This could be addressed, at least in part, if the same rights to anonymity were extended to defendants as they are to complainants in these cases. I have previously blogged that I am not convinced that the benefits of anonymity in criminal cases outweigh the disadvantages (https://andrewpearce16.wordpress.com/2013/09/11/anonymity-no-but-accelerated-justice-is-essential/) but there may be a case for introducing greater restrictions on the reporting of investigations and arrests until such time as a decision has been made to formally charge somebody with an offence

What is clear is that the Roache case raises a number of issues that need to be looked at as part of the on-going review of the criminal justice system. As Roache himself said outside court yesterday, the current system produces “no winners”