Tuesday, December 26, 2017

Why I don't like Nativity Plays...

I hate nativity plays. It’s the sweet little story told by excited small children, that I don’t like. And it’s not in this case because I’m a grumpy old man. It’s because that story is a story for children and the Christmas story really isn’t. Oh rather, there is nothing wrong with the children's play except that when that's all people see. That children's story is not relevant to me, or my life, or anyone I know.
The Christmas story, however, as told by Luke and Matthew tells of a baby born of an unmarried mother (who could have been cast out by society or worse), of poverty, of imperial despotic rule by a foreign power, of dangerous geopolitics, of genocide and of refugees. And at the heart of this mess, the ridiculous notion of God himself arriving.

The Christmas story includes much that is worst of humanity and tells that the God behind the Big Bang – the one who wrote the Standard Equation, who devised the genetic code, looked at our world; looked at the incredible ability of human beings to damage the world, to damage fellow human beings and to damage themselves and decided to become part of that world. A God prepared to reach out to us by first becoming helpless and arriving in the midst of human chaos.

This is not a story for children but it is one of Love. Love is beautiful and often at its most beautiful when it’s not pretty. Love is caring for the relative with Alzheimer’s who doesn’t even recognise you. Love is looking after the sick child who just pukes all over you, love is those who work to keep us safe… so many things: And love is God himself getting involved with our world and our brokenness.
I fully appreciate that in a few short years, I shall probably be in the front row and smiling. But I still don’t like the simplistic story. I do however love the 20-centuries old story of how God became human. And when the news today shows the same chaos, the poverty, the dangerous geopolitics, the refugees, I don’t need a children’s story. But I do want to follow the God who saw all that and rolled-up his sleeves and came to be with us.
Mild, he lays his glory by,
Born that man no-more may die
Born to raise the sons of earth
Born to give them second birth
Hark! The Herald Angels sing,
Glory to the new born King!
 Happy Christmas, everyone; may you know something of God’s awesome love this Christmastime.


Thursday, October 12, 2017


So, the ridiculous referendum occurred

There were ludicrous arguments and out-right lies.

Britain voted to leave the European Union.

Well, a slim majority of those who voted, voted to leave - actually only a third of Britain voted to leave.

And then the government activated Article 50, the legal mechanism laid down in EU law for how a country may leave.

The negotiations are on-going but as far as we can tell, are not fruitful.

The thing is, the Leave Campaign promised the UK a Unicorn. A bright sunny future which was all things to all men. Everyone who knows anything about this said it was impossible. The more time goes on the more it becomes clear that it is indeed impossible.

With this current incompetent government we will be very lucky to get a donkey. If they were serious a pony is achievable - not a thoroughbred but a pony. You see a thoroughbred is easy it simply involves revoking Article 50. However there are some outside the EU options that wouldn't be disastrous. However they would be but a pony compared to the thoroughbred of being one of the 'big-3' members of the EU (as we currently are).

And our government continues to promise us a unicorn.

And I despair.


P.S. I appreciate this is all analogy and assertion without the evidence to back it up. That is deliberate but if you want the evidence, watch this.

Saturday, June 03, 2017

Is this election May's Waterloo?

Well the short answer is, time will tell.

So much has been written over the past 200 years or so about this most-famous of battles mostly by people far smarter and more learned than me. Waterloo has become synonymous with personal defeat but that's not quite the analogy I am looking for. Indeed the odds and the polls still favour a Conservative / May win. However if May does end up losing her majority (if current polling trends are real and continue) there is an interesting parallel that I think is meaningful.

There is one key aspect to the allied victory at Waterloo that I am alluding to here: Napoleon was fully engaged and withdrawing to fight another day was not an option.

On 18th June 1815 Wellington Offered battle at the Mont-Saint-Jean escarpment, expecting the Prussian Army of Blucher to come to join the fight. As with all such things this is controversial but much has been discussed about how the Prussians were late to the battle such that the English-led army was outnumbered and very nearly defeated by Napoleon's army. However when Blucher's army arrived, the French were broken and fully committed such that they could not withdraw and Napoleon was finally defeated.

It is argued by many that if Blucher's forces had arrived before Napoleon had fully committed his forces, then he would have withdrawn and waited another chance to fight the allies. He only fully committed because he believed the English-led army of Wellington would be fully routed. And they would have been if the Prussians had not arrived when they did. Wellington is recorded as saying "night or the Prussians must come."

The history of the battle and the politics that led to all this - why the Prussians arrived when they did is fascinating and well worth reading about. Of course, this is not the only interpretation of events but it does fit with the facts as far as I know. It is always potentially facile to compare anything to war-fighting - especially when the very experienced soldier, Wellington wished to never see another battlefield after the carnage of Waterloo - the battle he is remembered for (although not his greatest achievement in his own view). However, as I alluded to above, it's not uncommon to use war metaphors for all sorts of things and the concept of one's Waterloo is quite common - there's even an Abba song about it.

Anyway, my point is this, Napoleon was finally defeated because he was fully engaged because he believed he was finally going to defeat Wellington's forces that had pushed him out of Portugal and Spain.

It seems to me, that Mrs May decided to go to the country because Labour could be annihilated and she has gone 'all-in' - to switch to a poker metaphor for a moment. If it wasn't for this belief that she could win decisively then surely she would not have called the election now.

But Labour has had a much better election campaign than the Conservative party and defeating the Conservative party (in the sense of there being no overall majority at least) has become a possibility.

When Theresa May is returned with a majority next week, this will all turn out to be idle wondering but, but, if anything else happens then clearly it will be that choice to fully engage that will prove to be Mrs May's undoing. And surely if it were not for the appearance that Labour were going to be heavily defeated, she would never have countenanced starting this battle in the first place.

So, yes, it could indeed be Mrs May's Waterloo. Indeed if she does not secure a majority, then it surely will be and like Napoleon she must step down from power within a few days of the result.

Wednesday, June 15, 2016

Euros and Europe – why saying no-one knows what will happen is misleading.

One of the things I keep hearing in the EU referendum debate is the argument that “No-one knows what will happen in the UK leaves” therefore people who claim that it will bad for the UK are just guessing. This is one of those really annoying things whereby the truth is used to obscure a lie.

It is of course true that no-one knows what the effects might be. It is true in the strict philosophical sense that no-one can know the future. It is however not useful in the real world where we are always making judgements based on evidence and experience without ever knowing for sure. Do I know that this patient will die without this life-saving operation? No, in the strictest sense. But I suspect my philosophical honesty would not be taken as good reasoning by the coroner.

I do like a good analogy. For example, I do not know who will win the European Championship in France at the moment (Euro 2016). I can tell you though that it will not be Scotland. I am reasonably certain that the winner will be one of the countries that is actually taking part.

Back in 1992 Denmark won. This was very surprising as they did not actually qualify. They only got admitted to the tournament 11 days before it started after Yugoslavia had to pull out. This is a really good example of the unexpected. Two weeks before the start it was unforeseeable that Denmark would win but the surprising does sometimes happen.

In terms of the EU referendum, the fact that leaving the EU would be bad for the UK economy and may well be bad for the stability of Europe is fairly clear. The debate is over how bad. The consensus of economists is very strong and based on some decent evidence; The IFS report is a good place to start. No one can tell the future for sure but the outcome is fairly predictable based on what we already know about the UK economy. Spain might win the Euros or Italy, Portugal, Wales, England etc. but Scotland won’t.

To say ‘no-one knows’ what will happen is to bet on Denmark before they were admitted to the tournament or to bet on Scotland now. Except the once-in-fifty years event that led to Denmark being admitted does not look like it is being repeated. It is the same sort of odds as saying I will safely walk across this motorway with a blindfold on. It’s not impossible but it’s also not very wise. What is so striking to me is the idea that in the face of such strong evidence anyone would want to take such a risk with our nation’s future.

Alternatively, invest all your savings on a bet for Scotland to win the Euros. I’ve no doubt the bookie will give you excellent odds.


Friday, April 15, 2016

Thinking Right (And Left)

My politics is well known. Many people approach politics with either apathy or a deep cynicism. I think for the most part, the cynicism is misplaced and most people have the right intentions. (I am increasingly cynical and suspicious of the current government but that is a different post). What I want to talk about here is the philosophy that shapes my thinking. In this sense, politics is a very wide concept, affecting so much of life.

The concept of fairness is often at the centre of this, with both left and right thinking appropriating the word. The problem is they usually mean something subtly but profoundly different by the term. Hence, in my experience often Lefties and Righties end up talking past each other: Lefties declare it's NOT RIGHT that children go to bed hungry and Righties say it's NOT RIGHT that anyone forces me to do something about it, I have what I have, because I earned it. Which is the greater wrong?

I do need to point out at this point that most of my right-leaning friends are at the front of the queue to give freely from what they have. So maybe we have an impasse, should we just agree to differ and know we will always have a different perspective and focus on what works?

But for me, that is not the end of the argument, because I don't think that some having LOTS and LOTS and others having so little is a natural phenomenon or simply the result of some being prepared to work hard and others not at all. Our huge wealth inequalities (in microcosm in our country, and on the full-scale across our world at large) are the result of specific factors. Of course work should be rewarded and people have a right to decide to work for something and enjoy it when they get it. But it is nowhere near that simple.

The bigger factors are things like access to natural resources and who picks up the bigger costs. In the UK in particular, but also in most of the world, if you own land, you are already winning. But who says I own this piece of land? Because I inherited it, or because I bought it off someone else? But why did that person own it...? etc. etc.

I also think that, if you look at the great wealth owners, it's often because they have exploited natural resources, such as oil. Surely, if oil belongs to anyone in a country, it belongs to everyone? But what actually happens is the companies who extract it pay peanuts in access rights and then for the most part, it's the rest of the world who pays the price of the pollution at the end of the day. If you are doubting this, have a look at how Fracking rights are being handed out.

Coupled to that is an economic-political system that means wealth allows access to power that has been used to concentrate wealth and so the cycle goes on.

It is not simply a case of taking MY MONEY off me. It is the case that I benefit from all that a modern society provides: security, legal system, infrastructure etc. etc. and so I should pay towards it. Tax is the means to do so. Moreover, our economic system is concentrating wealth and to argue therefore that it's morally unacceptable to redress that process is a flawed argument in my view. Most of the poor in this country are in-work. For the most part, unemployment is not a personal choice but inflicted on someone by forces beyond their control.

In the race of life, it's a very staggered start.

The concept that success is based on hard work and talent and thus by definition those who do not succeed have mostly themselves to blame underpins this right-leaning view of fairness. The problem is that it is simply not true. For the most part, those who succeed are those who have all the advantages to begin with. So many, who work hard and try to use their talents are by this measure totally unsuccessful.

I have written before about my own story. I am significantly better off than my parents. I came from a secondary school where only a small minority aspired to university. I was the first generation of my family to do so. It would be easy to turn this in to a story of individual striving and reward. Two things need to be said here. Firstly that narrative ignores the fact of all the advantages that did come my way, and secondly it denies the fact that so many equally talented and hard-working people have not had the opportunities I have. Yes, I have worked hard and tried to make the most of the opportunities that have come my way, but I have no illusions about how little I could have done if the opportunities were not provided for me.*

What frustrates me is that rather than try to address the deep ingrained inequalities we would rather lie to ourselves about the systemic bias that exists and pretend that those who are poor are so because it is their own fault.
“So wickedly, devilishly false is that common objection, ‘They are poor, only because they are idle’.” – John Wesley

I have not even touched on the issues of illness and disability which can afflict any of us. Having a disability (or a child with a disability) is one of the biggest predictors of poverty in the UK. All of us can be afflicted and yet we continue to lie to ourselves about this. Where has the idea of a ‘universal insurance scheme for all’ gone? When did we stop believing in a society with a mutual responsibility to each other.

And finally, as a Christian when I think about these issues, I find one other thought inescapable. God’s grace came to me when there was nothing of value in me. I could not earn his love and acceptance. The idea that people do not deserve help is a very dangerous one for a Christian to adopt.

Essentially, in microcosm in our society and across the whole world, where you begin is the biggest predictor of how your life will be – much, much more so than your personal input:  
In the race of life, it is a very staggered start.


*There are also more insidious factors about how able people are to take opportunities but that would need a whole different blog post.

Wednesday, February 03, 2016

Thinking Spiritually

Some idle wondering over the last couple of days...

I always thought that the old saying If you understand the trinity it means you don’t understand the trinity a pretty good starting point. It is enough for me to say that I believe in God who is one God and three persons without being able to begin to understand all that means. But belief in the Trinity is not a meaningless mystery. It has all sorts of implications about how we think about, and more importantly, relate to God. It is, I think, central to understanding the statement God is Love as the apostle John puts it in his letter. Smarter people than me have written very eloquently about how the relational nature of God (i.e. God being three persons in perfect love) is necessary in order for God to be Love.

So, for orthodox Christians (small ‘o’) trinitarian thinking is nothing new. The Bible never uses the word ‘trinity’ but speaks of the different persons of the Godhead in various ways that are summed up by this word. It occurred to me that I have a very poor theology of the Holy Spirit.

What I mean is, that we understand God the father as a concept. We relate to Jesus, the son as the God-man who became one of us but the spirit I think is an afterthought in our theology. I have written elsewhere that I am only interested in what could be termed practical theology. Knowledge and understanding of God that affects us and changes our lives is the only kind worth bothering with. This is one of those situations, in my view, that our (of my) poor theology has important implications. The reason for my obsession with practical theology is that the Christian life is to be lived. It is in discipleship, in the following of our master that we find hope and security and reach out to our dying world in His name. The startling realisation for me was when I was reminded that Jesus only carried out his ministry in the power of the spirit. How much more then do we need God’s spirit?

The writer to the Hebrews describes Jesus as the author and perfector of our faith (some translations may vary). This is a verse I love, for Jesus lived the Christian Life – he showed us how to be followers of Him. Jesus said he only does what he sees his father doing and we are called to do the same. I mention this because the mystery of the incarnation has some interesting points in the gospel accounts. We are told that Jesus is and remains fully God but from the gospel accounts we learn something of the limitations on the second person of the trinity in being incarnate and fully human. I do not, for example think that Jesus was omniscient as he walked the earth. He reacts with anger, astonishment and joy to those around him. He states that he doesn’t know the day or hour when he will return. At other times he clearly knows what will happen. Is that by the Spirit? I think so. Moreover Jesus himself seemed to need the indwelling of the Spirit to live out his calling.

Hopefully by now, I have been convincing on the point that our theology of the Holy Spirit is important. However that leaves the question of why do I think it lacking. I think we have some understanding of God the Father. The one from whom all things proceed and in whom all things hold together. The eternal God who sits in righteous judgment over fallen humanity Yaweh, God. We also know that this is the father who so loved the world he was prepared to send his only Son. This is the father whom Jesus depicts as running down the road to meet the returning prodigal. This is the God of love. Now, whilst the notion of a perfect father is a struggle for many of us whose earthy fathers so completely failed us, I think that we get the idea of an awesome, scary, yet unbelievably loving father. I also think that for the most part our theology of the Son is well worked out. The God-man, the eternal Son, who became one of us and who loves and obeys his father and teaches us to do the same.

It may just be me, but to some extent I feel the spirit is a bit of an afterthought. Not in the nature of God of course, but in our thinking about God. Which is a problem. The Holy Spirit is God with us in a way that Jesus never could be. In all places and all times. And more importantly, indwelling our very selves. It is by the power of the spirit that we are called and able to believe and trust in Jesus. It is by the spirit that we are changed to be more like Jesus.

The point I’m trying to make is that we seem to understand the spirit a bit like The Force in Starwars and thus miss out of the truth of God with us. I think the consequences of this are that we have a theology of partial deism that diminishes who the spirit is and thus makes us less able to respond to His work in our hearts and lives. Moreover I think we might miss out of this great privilege of knowing God in our daily walk. Jesus himself defined eternal life as knowing the Father and this life begins now, in the Spirit of God. The comedian Milton Jones described the Holy Spirit as someone who, when invited into your house, will insist on looking at the mess behind the fridge. But He will also insist on helping you clean it up. By depersonalising the Spirit we make it harder to know God and miss out on blessing I wonder if we sadden him by doing so.

Thank you oh my Father
For giving us your Son
And leaving your Spirit
‘till the work on earth is done.

Anyways, just idle wondering…


Saturday, October 17, 2015

Liar, liar...

(you know the rest).

In general I try to make my blogs about reasoned argument. I try really hard to explain why I think what I do. I am always happy for people to disagree with me but I hope to show why I have come to the conclusions I have.

Today is an exception. It is purely a statement more of how I feel that what I think. It is about attitudes and misleading statements on the NHS and doctors and many other things.

But it is succinct.


Thursday, July 16, 2015

The Rt Honourable Jeremy Hunt MP

I've been asked for my thoughts on the statement today by Jeremy Hunt, reported in the following ways: Jeremy Hunt: 'Doctors must work weekends': Jeremy Hunt Goes to War with Doctors: Jeremy Hunt: Doctors will have to work at weekends.

It's taken a bit of time to order my thoughts but put simply I think this is a deeply cynical attack on doctors and the NHS. Let me explain:

On Radio 4's Today program he talked about the need to forge a "A new contract that brings back a sense of vocation.” And one of his justifications for this is that there are '6000 avoidable deaths' due to care being less good if you're admitted on a weekend.

Medicine is very diverse, and it varies across the specialties. I work in surgery and hence that is very much my perspective and I appreciate that things might be a little bit different in other areas. However, basically he is talking nonsense.

Of course we work weekends. There is always a consultant on duty on Saturdays and Sundays, High Days and Holidays. For the record, doctors who work Christmas Day don't get a premium pay, simply a day off in lieu.

There are apparently lots of consultants who have opted out from working weekends. I'm not quite sure to whom he's referring. Seriously, the numbers overall must be small but let me take one example where that makes sense. Breast surgery is a specialty that mostly deals with cancer. There is some benign disease as well, but most of the work is cancer-related. As such, timing of surgery is urgent but not an emergency. And the pathways (since 2001) work really well with patients being referred by their GP, seen assessed and then treated in 2-4 weeks. Such work requires multi-disciplinary teams and a lot of coordination. However there is no good reason why this needs to take place on a weekend.

If Mr Hunt is arguing that as the hospital buildings are there, they should be used to full capacity 7 days a week, that's fine. But it has very little to do with doctors. It is about making staffing levels at the weekends the same as week days. I am certain that the Honourable Gentleman is not proposing enough funding to pay for that. And how are we going to maintain the same level of staffing on week days if we are sticking to current hours limits? More worryingly for other professionals (nurses, paramedics, physios etc.) the government has muted taking away unsocial hours supplements. Seriously? You want people to work nights and weekends without any extra recompense? How do you think this will help the current recruiting crisis?

So, is there sufficient resources out of hours for emergency care? Well, sort of. As surgeons we provide 7 days a week cover in teams. It can be frustrating when some of the diagnostics (i.e. pathology) is less available out-of-hours but rarely does this actually make a measurable difference to patients. However there is some room for manoeuvre here. But this doesn't seem to be what the Health Secretary is talking about.

The '6000 avoidable deaths' Which is apparently all doctors' fault. (See the Radio 4 interview if you think I'm misrepresenting him): This figure is calculated from  some work published in 2013. It showed that if you look at admissions to hospital, there is 1.3% 30-day mortality. (That is death within 30 days of admission). However this rate varied depending on day-of-admission, with Wednesday being the lowest and Sunday 16% higher. So to put that in context the risk of death rises from ~ 1.2% to 1.4%.  The problem is that no-one is quite sure why this happens. Hunt argues that the lower number of senior doctors on weekends able to make decisions is the culprit. This may be true but you cannot tell from these data whether the patients admitted at weekends are the same as those admitted on week days. Any doctor who works in acute care will tell you that many patients admitted on a week day will be less ill - but in need of some hospital care. It is complicated and we do not have the data. If it was simply a matter of weekend care being less adequate, then why is the death rate lowest for those admitted on a Wednesday and not a Monday/Tuesday as presumably those are the least likely to be still in come the weekend. Basically, what I am saying is that is complicated. If it is due to levels of staffing not being high enough on weekends then the doctors is only one small part of that.

The press has talked about how much consultants are paid - presumably in order to shock the public that they are paid so much and refuse to work on weekends. Well, the consultant's starting salary currently is £75,000. After 5 years at medical school and at least 10 years of post-graduate training and experience. The majority of the post-graduate training self-funded. And taking on significant responsibility for the care of a large number of people. Doctors are far from hard-up, but painting consultants as on the gravy train is deeply offensive as is the argument that we as a profession lack a sense of vocation. In order to earn that, most consultants would be on something like a 1 in 6 on-call rota - hence working part of at least 1 in 6 weekends depending on the work pattern.

So what is this really about? Any analysis of Hunt's comments show they are disorganized and nonsensical at best. Although there are some aspects that he is right about and there are some things to be applauded. However the 'attack on consultants' is, at the very least odd. Here's what I think:

In the 2012 Health and Social Care Bill, one little noticed provision was the removing from the Secretary of State the duty to provide comprehensive care to the whole population that was instituted in the 1948 statute setting up the NHS. This provision is arguably only symbolic. But Symbols can be really important.

The NHS faces significant pressures, from an aging population, a big squeeze on finances (despite what they keep saying) and billions wasted directly and indirectly on a crazy reorganisation that made the NHS significantly less efficient and effective. Not to mention that the real crisis for the NHS is the collapse of social care.

In the face of this, the government is striking out first - I believe today's announcement is a deeply cynical attempt to pin the impending disaster in the NHS on doctors. I am sure other NHS staff will be next. They are playing fast and loose with both the truth and our healthcare system. In order to protect themselves from the fall-out they are trying to make you think it's all the doctors' fault.

I would never claim that my profession is perfect and we do need to improve in many ways but this is nothing short of a slap in the face to so many of my colleagues who are deeply committed and unbelievably hard working.


Tuesday, June 23, 2015

Why me God?

The cry of anguish Why me? must be almost ubiquitous when life goes wrong. When faced with the big challenges, we inevitably find ourselves asking some form of this question. For a believer in God this question is directed as God, for the non-believer perhaps, at the universe. I think we'll all in pretty good company as the psalmists asked this question too. One could even argue that Jesus' words on the cross "My God, my God, why have you forsaken me?" come from the same place.

And I don't think there's anything wrong with that. I think God's big enough to take it and certainly doesn't need me to stand up for him. But I was reminded on Sunday about the value of this question in a totally different context. How about asking Why me? when things are going well.

I would be inaccurate to describe my life thus far as a bed of roses or to try to deny that I have had to make sacrifices and work hard to get where I am. I think it is very easy to turn such truths into a self-made-man myth that so pervades our culture. And a myth it really is.

I have had the following huge advantages. I was born in the UK, the sixth richest country in the world. I have had up until university, free education. I went to university when fees were a lot lower than they are now. All through my life I have had access to free healthcare. As a child, I had a mother who had the simple expectation that we would do our best. Nothing more, nothing less. Failure was always acceptable, not trying was not. At various stages of career and life I have had countless valuable opportunities. I lost my mother relatively young but because she planned well, I've had a big headstart financially.

So I find myself with a home, a career that is challenging and rewarding and interesting. I have true and real friends. I have traveled widely, I have an expensive and interesting hobby. This could end up being a long, long list. It is true that I have made much of what has been given to me, but seriously how much have I been given!!

So inevitably, I have to ask the question: Why me God? Why am I so, so, so blessed?

There are some important ways to think about that question but for now just one thought: Please Lord, let me never, ever take it for granted.


Monday, June 22, 2015

Immoral Hazard?

Whether you've heard the phrase before or not, if you are British you will definitely be familiar with the concept. Moral Hazard dominates arguments about healthcare, welfare, immigration to name just the most obvious three. I've written before about how often the most effective way to sell a lie is with a truth. My argument here is simple; Moral Hazard is being massively overstated. I am not suggesting it doesn't exist but it's over-representation is used to justify some really bad ideas. So let us begin with a theoretical (or not so theoretical) example.

It would be easy to presume, reading our media that there is no such thing as a real refugee but I want to begin with the concept of someone who applies for refugee status or political asylum. There are technical differences between 'refugee' and 'asylum seeker' but it doesn't matter here. Let me give you a couple of examples of what we are talking about. The amazing story of Donald Woods is told is the breathtaking film Cry Freedom. Woods being granted asylum in the UK was vital to bringing to the world the story of the state-murder of Steve Biko and this was emblematic of Apartheid South Africa. I want to begin there because I think it important to establish just how vital is the concept of granting asylum. This is completely separate from economic migration: this is the idea that it is necessary to provide a safe haven for people fleeing for their lives.

So let me give you an example of a refugee in modern times, fleeing to Britain:
In a forest pit in the Democratic Republic of Congo, Aimee and her baby son were held captive with 25 others. After seven days, 13 were taken to be shot - with Aimee last in the line. With little Daniel in her arms, she saw the terrified men and women killed one by one.
But when it came to her turn, the soldiers lowered their guns.
Aimee said: "I was crying. I thought I was going to die with my child. Then I heard them argue about what they would do with my child. For some reason they changed their minds. I don't know why, only that I am alive today."
After years of persecution and detention, Aimee Ntabarusha Mungu escaped from the Congo, fled to the UK and settled in Glasgow.
She contacted the local Red Cross branch and used their orientation service to help her adjust to life in Scotland. She also regained contact with her family, who she had left behind in the Congo, through Red Cross international family tracing.
Aimee said: "It was so hard to be here without them. A friend looked after them but they were always in danger as the government was after me. I wanted them here, safe with me."
 This is one of so many stories that can be found on the British Red Cross website.

So let me pose a question in the abstract. Let us say we have 100 people claiming to be refugees. Let us assume for a moment 95% of them are genuine. And let us assume that our vetting process has no means of distinguishing between the genuine and the imposter.

Should we let in all 100 or should we return them to where they came from? These are the choices. If we let them in 95 Aimees have been saved and 5 'bogus asylum seekers' have got in. If we refuse admission 95 Aimees have been sent to be tortured and/or killed but 5 people not entitled to enter the UK have been kept out.

Where the argument really becomes interesting is when we play with the percentages... how about if 20% are genuine? So the number of illegitimate claimants who get away with it is significant but still we prevent 20 innocent people having a horrible fate. How about 1%?

For 2013 there were 23,507 asylum applications to the UK. That's 0.03% of the UK population. So we're not really talking about big numbers here.  64% of applications were refused. (Three quarters of those refused appealed with around a 24% success rate on appeal).

It is impossible to know what human stories lie behind these statistics but let me give you these examples: Hidden stories of failed asylum seekers. In that 64%, how many Simons and Josephines and Gabriels and Joshuas and Isas are there?

There is, of course, no such thing as a perfect system but there is systematic bias. I think it is quite clear that the direction of travel with out system over the past decade has been to an ever 'tougher' system - seeking to deny as many claims as possible. To me, a 1 in 4 successful appeal rate suggests a systematic problem.

So, let us propose for the sake of argument a system that is very lax (dangerous word) let us propose that we allow the majority of applicants to stay, maybe around 20,000. A number that the UK could easily absorb. So, maybe we would be granting asylum to some who don't merit it but Aimee and Simon and Josephine and Gabriel and Joshua and Isa would be safe.

If you accept the responsibilities of the various post world war II refugee treaties, then I think the only reasonable argument to counter this is one of moral hazard. The concept that by allowing a small percentage of the undeserving in, in order to avoid the terrible risk of rejecting the truly needy we provide incentive for people to play the system, we effectively invite illegitimate claims.

I am going to leave immigration there for a moment and move on to the issue of the Welfare state.

Recently I have been supporting a friend through the process of a formal capacity assessment for the Personal Independence Payment that is replacing Disability Living Allowance. I will write a full blog entry on that alone but for now I want to just say, for context, that I have recently had dealing with the DWP (Department for Work and Pensions) and insight in to what our Welfare system currently looks like.

It is worth remembering the concept of a Welfare state is an insurance scheme for everyone - because none of us know when we might be afflicted by unemployment or illness or disability. So as a society we all contribute and we all have the right to basic provision as and when we need it. I just want to add here that the lowest 10% of households pay more in tax (as a proportion of their income) than any other grouping (including the richest 10% of households). This is often overlooked as the poorest pay relatively little in direct taxation.

Anyway, implicitly a system that provides a safety net has in it a moral hazard - if you don't have a job you won't stave, we have a basic income for you. If you are too ill to work, we will provide for you etc. etc.

The various disability benefits is a good place to start to demonstrate the issues but it is a systematic one. In principal, assessing whether someone is fit to work, providing support to get back to work where appropriate and providing differing levels of support is the right thing to do.

Successful appeal rates against WCA decisions currently run at around 40%. (This rises to nearly 80% when the claimant as access to proper legal support). I don't know about you but I would suggest that a system with a 40% successful appeal rate is a broken system.

Obviously it is fraud for someone to claim this welfare payment when they are not ill or disabled. The official figure on fraud is 0.7%. So in a attempt to stop the less-than-one in a hundred who claim falsely we have constructed a system that penalizes the most vulnerable (by definition). Even if a claimant is successful the process is immensely stressful and demonstrably harmful to them. There are a number of deaths (at least 50) related to the benefit assessments and sanctions that are being investigated by the DWP. It's difficult to find the exact number as the DWP refuses to disclose this even after freedom of information requests.

I want to propose that we should construct a system designed to ensure that we do not deny help to those who most desperately need it - even if by doing so we increase the risk of people taking from the system when there are not entitled to it. Once again the overwhelmingly loud counter argument - constantly in the media - is one of moral hazard.

In healthcare we hear talk of moral hazard too. Thus far it has not, as yet taken hold so much in the narrative but it is often put forward that a free-service will see no end of demand. Charging people a nominal charge for visiting their doctor comes around repeatedly as a way of apparently stopping time-wasting patients from using healthcare inappropriately. I am very wary of this for a number of reasons. Prescription charges began as a nominal charge - before being  massively increased. A nominal charge for one person could easily be prohibitively expensive for another. Patients as well as overestimating the significance of symptoms also often underestimate them too. There are some interesting studies that show how important it is for people to participate in their own healthcare. One famous one, showed that mosquito nets given away were hardly used whereas those sold at a nominal charge were much more widely used leading to a drop in malaria. However, how and where this is translatable to other areas is not straight-forward. Patient-own participation in their healthcare does not need to necessarily be financial and I would argue that people naturally have a stake in their own healthcare anyway. I think the mosquito net example has lots of potential confounders particularly relating to disease perception. Furthermore as the UK experience of dental care shows, the up-front costs deter many people from regular care.

These are complex areas, it will never be possible to construct perfect systems but the debate is important. It is my contention that the argument is far from balanced. What is happening is that rather than weighing the risks of an over-difficult to access system (be it asylum or welfare or healthcare to pick these three examples) against the moral hazard of an 'exploitable system,' all we ever hear about are the moral hazards. As a consequence, systems are made more and more draconian and often Byzantine such that those who are most in need of them struggle to access them.

This is not about raw statistics, it's about real people and real human suffering at the end of the line. It is almost impossible to have a rational discussion about this - the shouting down with moral hazard arguments is immense. I do not deny that the moral hazards exist and need to be addressed but I stipulate that if you look at the evidence they are wildly overstated. Maybe I am guilty of a tactical error here, maybe I should adopt the approach of the other side and ignore their argument and just shout, shout, shout and shout some more about the immorality of the systems we have designed for our selves. Maybe by acknowledging there is a point to their argument, I concede too much. I mean how many fake benefit claimant stories have you read in the newspapers? How many of these stories even mentioned the grave suffering of those wrongfully denied their entitlements?

Ultimately though, the moral hazard arguments are used to an absurd level that they cannot sustain, it is long past time that we cut through them.


Thursday, June 11, 2015


This post is partly a placeholder for reference. Someone else might have done this already but I haven't found this direct comparison anywhere else. What I wanted to show here is the huge gap between George Osborne's economic projections and what has actually happened. If you read many of the economic blogs around this is talked about quite widely but I couldn't find the data put together like this anywhere.

Next month Mr Osborne will lay out his 'emergency budget' because the last budget done this year by - well - George Osborne was so terrible he has to lay out a whole new one again just 3 months later.

In addition he has already changed last year's with the immediate 'savings' demanded from government departments. If the mood music is anything to go by the second budget of 2015 will be very much like the second budget of 2010. I just wanted to point out that whatever economic numbers he puts into that budget should be treated with a significant degree of skepticism given his previous track record with projections. That's what this post is about. And it's not just chance that his numbers were wrong - he is ignoring much of what is known about how economies work to produce these projections and many critics pointed this out in 2010 and have been proven right. Moreover he shows no sign of having changed his approach so this is my prediction: The numbers will be wrong. Very wrong. I would be staggered if he manages to clear the deficit by 2020. Given that he said in 2010 that it was vital to clear it by 2015, it is a remarkable failure in its own terms. The main reason he gets away with this is that it was a complete myth that addressing the deficit was the main priority. But more of that later. Let's look at the numbers (in each case, click on the tables/graphs to enlarge):

I have taken the forecasts from each of Osborne's budget speeches.

In graphic form it looks like this:

Two points to note; firstly how wrong the projections from 2010 and 2011 were. And secondly how the prediction for the financial year 2010-11 was wrong in the opposite direction to subsequent years. That is the deficit in 2010-11 was less than predicted and higher than predicted in each of the other years. This is true for the projections made in 2010, 2011 and 2012. The 2013 and 2014 projections were much closer to reality.

Of note, the revenue reductions that Osborne planned were essentially achieved. The much bigger than predicted deficits were due to much lower tax receipts than expected as the economy failed to grow as planned. This is seen in these data below:

UK GDP Growth (%)

Once again, the projections are taken from each of the chancellor's budget speeches. Graphically it looks like this:

The chancellor hugely over-estimated growth in 2011 and 2012. 2013 was still below his initial projections with 2014 being basically in line. It's quite useful to look at these numbers summatively - i.e. where in 2010 the chancellor predicted the economy would be compared to where it actually is.

Again in 2012 the projections were much more accurate than 2010 and 2011. This is no coincidence, for it's in 2012 that he relaxed austerity as the economy floundered.

I think at this point it's worth just covering some basics. GDP (Gross Domestic Product) is an estimate of the total economic activity of a country - all the shops and schools and factories and hospitals and building sites and hotels and bars and car mechanics and farms - summed together. As technology progresses and efficiencies improve - leading to greater productivity - the natural trend is for GDP to grow - this has been the pattern since the industrial revolution. This is why growth is always being talked about in any discussion of national economies. A recession is defined as two consecutive quarters when the economy shrinks (sometimes termed negative growth).

So because the Chancellor's growth projections were so wrong, the tax revenue projections were wrong and hence despite cutting spending as planned, the deficit has been much higher than he said. Tax revenues are estimated simply as a proportion of the entire economy. If the economy is smaller, than the tax take is correspondingly smaller

To me, this speaks volumes as I think it indicates that the claims Osborne makes about how the economy works are completely wrong. The 'Confidence Fairy' as Krugman calls it is a myth, the private sector doesn't somehow explode because the public sector is retrenching. It is interesting that if you look at the first two quarters of the financial year 2010-11 when the policies of his predecessor when in place before the measures taken in June 2010 worked through to the economy at large, the economy continued to grow before going into a major slump until 2013 following a relaxation of the austerity measures. It is noteworthy I think that in 2009 Alastair Darling predicted a deficit for 2009-10 of £175Bn and it was actually £22Bn less. This is because he was very cautious in the assumptions he made about the effects of the fiscal stimulus. Osborne underestimated growth in 2010 and then overestimated it for all the subsequent years.

You could, potentially write this all off as bad luck or the effects of other factors. I don't intend to discuss here in full why the other factors are probably irrelevant. But I will say this: according to Paul Krugman (and others) mainstream economic theory predicted that growth would be much lower than Osborne's projections. They made these calculations in 2010 and were scarily accurate. So who do you believe the chancellor who consistently over-estimates his own competence whilst ignoring academic economists. Or the academics whose predictions have been much more accurate and who have working models that tell you why their predictions will work? One of the reasons I like Paul Krugman so much is that he shows the data that supports his position - as opposed to the unsupported assertions by certain others.

All this matters as the next budget is very likely to be similar to 2010. We may not suffer a recession as a consequence but look out for the growth projections made in the budget. I, for one, suspect they will be true-to-form and consistently over optimistic with the inevitable knock-on effect that the deficit projections will once again be completely wrong. If clearing the deficit really was as critical as Osborne claimed then we really would be facing massive interest rates. Conversely, the effects of austerity on the wider economy and thus well being of us all are somehow airbrushed out. A very conservative estimate of this is that the economy is £100Bn smaller than it would otherwise be. That is we are all £1500/year worse off. Every year.

All this is avoidable. Counter-cyclical spending as advocated by anyone with just a basic understanding of Keynes' insights would promote growth and thus support tax revenues and manage the deficit easily. As long as Britain has spare capacity in the economy (and there's lots) and the ability for the government to borrow cheaply (record low borrowing costs) there is all the freedom in the world for Keynesian policies and thus the deficit would improve.

Three big advantages of this approach. Firstly we might actually meet borrowing targets. Secondly the economy would be healthier overall and thus we would all be better off and thirdly the most damaging of cuts which have hit the poorest really hard could have been avoided.

This is an economic argument but it is also a moral one.

The question for me is that given the last 5 years, as Simon Wren-Lewis (Oxford Professor of economics) points out, to repeat the same mistakes as Osborne seems to intend is unforgivable. Either he is stupid or something else. I am really not sure whether his economic illiteracy is ignorance or malice. Either way he is probably the worst chancellor this country has ever had. Certainly the worst in my lifetime. I am sure, however much the Tories have managed to convince the contemporary public, history will not be kind at all. Sadly for those that suffer the most now, by then it will be too late.

Anyway in the meantime look out for the economic projections in next's month's budget and then don't believe them and if we do go into recession in the next 18 months look out for some very creative excuses from the Rt Hon Mr Osborne.