Former care minister calls for open-book accounting in care homes

On today’s You and Yours, on BBC Radio 4, Paul Burstow the former care minister called – amongst other things –  for much greater transparency in the finances of care homes.

In particular, he called for open-book accounting so that residents and local authorities can know how their money is being spent and to understand the costs of providing housing with care. 

Care provision is going to be a growing cost for an ageing society and there have already been many abuses of the system. Underpaid and exploited workers have sometimes resorted to inflicting appalling cruelty on vulnerable residents. They have rightly been punished when found, but the problem is the lack of resources and a more serious problem of financial engineering which ultimately led to the collapse of the Southern Cross chain of homes a year or two ago. 

Of course, I’m delighted that any politician should be calling for open-book accounting in any sector, but it shouldn’t just be care homes. 

Politicians’ expenses, perhaps? Election expenses? Everything the government does on our behalf or with our money should be subject to full open-book accounting. 

Economics – what utter cobblers….

I am reading Thomas Piketty’s excellent book, Capital in the 21st Century. It deserves to be as influential as Keynes’ General Theory. 

I have also been following up some other research into the question of inequality, and have found some interesting work going back to the 1950s by influential economists such as Kaldor and Kuznets. The empirical data seems to be that a relatively low level of inequality is fairly well correlated with growth: see, for example, this IMF Staff Discussion Note by Ostry, Berg and Tsangarides, which was recently cited in a speech by Mark Carney. 

Citation-surfing led me to: The Tradeoff Between Inequality and Growth by Jess Benhabib, Professor of Economics at New York University. Benhabib was trying to show that the relationship is non-linear, a result I would expect. But when I read the paper….

That tenured academics are paid good money to produce such rubbish is incredibly depressing. In a social science, there is simply no point in such pages of algebra. So far as I can tell, not one of the variables in the reams of equations can ever be empirically determined. How can these theories ever be tested?  

I’m not great at maths, but I know enough to know that it has incredible beauty in its pure abstract depths, the more remarkable because the same abstract language describes reality so accurately. But this “economic modelling” does nothing of the sort. The “agents” to which it refers have no basis in reality. It’s not wrong, mathematically. It’s just pointless. It’s mathematical self-abuse, an abuse of mathematics – and if it’s the sort of theory that’s been used to inform real, public economic policy it’s hardly surprising we’ve made such a mess of things.

Gaza –

The continuing tragedy of Gaza is that the people most affected by it seem to have the wrong ideas about a solution.  Periodic ceasefires are imposed from outside, accepted at best grudgingly by both sides. Both democratic bodies (Hamas is democratically-elected in Gaza) enjoy popular support for their policies from their electorate. 

But, from here in London, both sides’ tactics seem bizarre, calculated to achieve nothing but perpetuation of the current misery. 

I have more sympathy for Hamas than for Israel, not only because of the one-sided tally of deaths; and I do begin to detect an acknowledgement by Israel that it has badly miscalculated global public opinion. Israel now wants a ceasefire not for its own domestic reasons, but to regain some support from the international public.  The Guardian has today run an obnoxious advertisement, paid for by Israel, to try and blame Hamas for the many child deaths. While Hamas rockets have not killed a single Israeli or Gazan child, it is telling that Israel feels the need to place the ad. It is losing the propaganda war. 

But the Guardian has also run some excellent balanced pieces by Paul Mason, including this one from a few days ago, in which he concludes that, despite everything, Gaza works.  Israeli politicians should read this and try to formulate a different strategy, continuing the logic of the withdrawal that was Ariel Sharon’s last significant act (That he was a war criminal, remembering Sabra and Chatila, does not change the fact that he was also a realist who came at the end of his conscious life to move away from the intransigence of Likud). It will be difficult and hugely expensive, but with the right will, there will be huge international support for it.  Besieged Gaza, isolated and impoverished, will always be a source of trouble for Israel. The inevitable logic of continuing to besiege Gaza is that Israeli public opinion will move closer and closer to calling for a final solution, the tragic irony of which cannot be lost on anyone with any sense of history. On the other hand, a prosperous and independent Gaza, relying first on massive aid and subsequently on tourism and financial services, will fire far fewer rockets and foment far less anti-Zionism.  An independent Gaza is achievable, even with Israel’s twisted internal politics,  because there are none of the intractables of settlements and Jerusalem.  This implies a three, not two-state solution as the end-game, reflecting in any case the divisions between Fatah and Hamas and removes one complication from the equation.  It wouldn’t be my choice (I think that a single, secular state with citizenship decided by birth not blood or faith is the only long-term solution and is the only way to solve the Jerusalem question), but it ought to be Israel’s short- and medium- term strategy. 

There is, of course, one huge problem: Hamas is ideologically committed to the destruction of the Jewish state, and Israel cannot therefore deal with it (and vice-versa). Well, Sinn Fein is ideologically committed to a united Ireland but manages to sit in government in a separate Ulster. It’s not directly comparable, but it shows that with the right turn of phrase and mutual incentives, such intransigent ideological blocks can be overcome. Parties can agree to differ, can acknowledge the other side’s view and disagree with it. Money makes a huge difference, but even so it will cost Israel less in aid than besieging Gaza costs in munitions, and the deal can be done this year. This month, even. Face as well as lives can be saved on all sides if:

- Israel accepts Hamas’ demands to lift the siege of Gaza (so Hamas can claim victory at home);

- Hamas undertakes to disarm (so Netanyahu can claim victory at home);

- Israel offers unlimited reconstruction aid, for which international assistance will be forthcoming;

- Gaza becomes an independent Palestinian city-state, with a secular constitution guaranteed by the international community including Israel and Egypt. 

September to sign the agreement in principle and start allowing some movement of goods and people. December to complete the lifting of the siege and disarmament. This time next year to celebrate Gazan independence and to mourn the martyrs on both sides. 

Buggers’ Clubs And The Right To Die

“If this Bill goes through, so that buggery is no longer a criminal offence provided it is done in private and with no boys concerned, then it will be a charter for these buggers’ clubs. They will be able to spring up all over the place. I can assure your Lordships that it is a very real risk.”

Thus spake Lord Goddard in 1965, when their Lordships were debating the Sexual Offences Bill, which went on to legalise homosexual acts between adult men in private.

Lord Goddard may well have been right. Such clubs certainly went on to spring up all round the Vauxhall Cross roundabout.  It is instructive to read the whole of their Lordships’ debate. In 2014, they would have to  claim a great deal of parliamentary privilege for such homophobic language.

The situation predicted by the most vocal opponents of liberalisation went on to occur. The naysayers were right. Except…

Except it’s nowhere near as bad as they imagined. Yes, there are buggers’ clubs. Apparently. But we also have a Conservative Prime Minister making the case for, and driving enactment of,  equal marriage. Gay sex became legal and the world didn’t end. Instead, it got better, by getting much more like the kind of hell that the naysayers were predicting in 1965.

1967 – Old Sex Rules scrapped

It is the same with assisted dying.  If – when – the law changes, which it will whether by Lord Falconer’s Bill or otherwise, most of the dreadful things that the Bill’s opponents are predicting will probably happen eventually.  Doctors will kill people, deliberately.  Some people will come under pressure to ask for assistance with their suicide.  But it won’t be all bad. We will learn new moral rules to allow for assisted suicide, just as we have done with sex. For most of history, sex outside marriage has been taboo and often illegal.  Then, in the 1960s, we threw the old rules of behaviour on the bonfire. The Permissive Society arrived. Now, we have new rules; anything that consenting adults do is OK. Anything non-consensual or involving children isn’t.  It took us quite a while to sort out the new sex rules, but they’re pretty much the established norm now.  (and while we were going through the change, some pretty sick people did some pretty sick things… but that’s another story).

The “old death rule”

The death rules need changing too. The old rule is an absolute: “don’t kill people”. It’s pretty simple, but its consequence is that we end up keeping people alive when they would rather we didn’t.  But to mess with the absolute “don’t kill people” rule… is a risk…

… We have to take, and it may take us to a place that seems awful.  We need to discover  and learn the new death rules. The safeguards in Lord Falconer’s Bill  or its successor will only be a first draft.  Rules like this come from society; legislators only codify them, usually not very well. The process first of discovering and then of learning the new death rules will be at least as traumatic as learning the new sex rules was. There will be plenty of mistakes made. Probably, some people will die when the didn’t want to. (Quick reminder: this already happens). The new death rules will be much more complicated than the simple, absolute, old death rule, but the process of discovery can only take place once we scrap the old death rule.

Now I am going to get controversial. The main reason we have to change the death rules is to allow a cull of the old people.

No, that is wrong. The main reason old death rule needs changing is because it makes people suffer while they wait to die.

There are two main reasons to change the old death rule. One is compassionate, the other is economic. The arguments for both are compelling. The case can and should be made purely on compassionate grounds, and would stand even if the economic arguments went the other way. If the compassionate argument failed, which it doesn’t, it could not be trumped by the economic argument. But both compassionate and economic arguments go the same way. So, inevitably, something like Lord Falconer’s Bill will be passed, sooner rather than later .

 

“Cull the old people”

Prediction: A “cull of old people” will be the “bugger’s clubs” of assisted dying.  A terrible thing that turns out not to be half as bad as we thought. We are very lucky to live in a time when people live longer and longer; and most of those longer lives are longer, fulfilled and active lives. Because we no longer drop dead (much) from heart attacks in our sixties, or from infectious diseases, or childhood infections, or in childbirth, or by killing each other in industrial wars,  we are living to a ripe old age, and then…  the body stops working properly. The interventions needed to keep it working become more invasive, less dignified and much, much much more expensive. Eventually they fail; eventually, we all die.We now beginning to realise that there may be a point in these final stages of life where it is better to stop giving the interventions that prolong life and change to ones that curtail it.  Recognising that point is going to be much harder than learning the vital signs. It’s going to require evaluation not just of biological and medical criteria, but social, compassionate and ethical ones.  It means we, humans, are going to have to take on more responsibility.  We may need a whole new class of professional to make such judgements; we will certainly need a whole new form of professional language in the caring professions.  Lord Falconer’s Bill skips the most difficult question by requiring “sound mind”; but the brain is a very important part of the body and it too starts to fail. For many people, the brain starts to fail before the rest of the body; for the fortunate, it is the other way round.  If I suffer dementia as I age,  I want the treatment that most mitigates my distress even if I cannot communicate it to those treating me.  If that means putting me out of my misery, please do so.

People with disabilities

The most cogent arguments against assisted dying have come from people with disabilities.  There is, naturally, a fear that their disability will be weighed in the balance when the time come to judge the time to make the switch from prolonging to curtailing an individual’s life.  It is, I think, a specious argument. People with disabilities must be treated equally, and we as a society are getting much better at doing so. We’re not perfect. But the answer to their concerns must be that a compassionate society will extend that equality to the new death rules which we need but have not yet discovered.

Living funerals

In a bit of futurology from the Tomorrow’s World annual of about 1970, it was suggested that people would check in to boutique hotels, enjoy a last meal and then go to eternal sleep.

I’d like to think that it won’t be so lonely. I’d like to share my last meal with my friends and family. I’d like it to be  matter-of-fact: yes, I’ve had a good life, you’ll manage to sort out the mess I’ve left for you,  it’s been lovely knowing you, thank you for coming, adieu. No tears. No shock, it’s in the plan.

 

A brief note about that airliner over the Ukraine.

Most likely story. which we may never find out.

A bunch of rebel casuals gets their hands on the SAM kit their Russian friends had supplied them, for the purposes of shooting down Ukrainian government helicopters and troop planes.

Training was a little rushed, especially that bit about really checking the identity of the plane you were firing at.

But it wasn’t on an official flight path. Usually only troop planes here.

Airliner diverted to avoid turbulence/heavy weather.

Oh fuck.

Rebel commanders seriously pissed off with muppet who was only trying to score another troop plane.

Massive panic.

We can blame the Ukrainian Government.

Hide everything.

 

 

Scotland: just say no!

I would be excited by independence, lived I in Scotland. But I hope that I would not vote for it.

Keep the power to influence your own future -

If you vote for independence, it will be the last time you have the power to influence your future at all. As a small nation, you will be bound by the same international trade rules as the large ones, but you won’t be able to afford the lawyers to bend them.

Or cede it to multinational corporations

Instead of Westminster as your colonial master, you’ll have powerful global corporations deciding your laws in backroom deals with your local politicians.
You’ll still have to borrow money from the vampire squid of international finance, but they’ll have even fewer qualms about screwing you than they do about screwing us.
If you keep the pound, Threadneedle Street will still run your monetary system. If you’re not allowed Sterling, you’ll have to keep the Scots Pound at parity with it and the vampire squid will have a ball.
Scotland’s a great country with a great future if it realises that it doesn’t need to be a nation state or to assume the tiresome responsibilities that go with nationhood. If you vote for independence, you’re just giving a bigger trough to your local politicos.

British Values

Mr Gove’s declaration that schools will, henceforth, be required to teach British Values shows just how far he has lost the plot. He has always been a libertarian ideologue, and he has removed lots of the citizenship things that Labour put in to the curriculum.

Pundits have been having a lot of fun trying to work out what British Values are; of course, they are whatever you want them to be. If the conservative Muslims of Birmingham succeed, British Values will become Muslim values; and there is nothing wrong with that – if that is how society develops. I hope it doesn’t, because I don’t hold with conservative Muslim values although there are parts of Islamic morality that I like (as well as lot I really dislike).

As it happens, it’s much easier to make a case for French values or American values – because they’re encoded in their history. Freedom, equality and brotherhood – French values in a national motto. But British values? Not so very long ago, the answer would have been simple – British Values are Protestant values. Christian, but certainly not Catholic. Mr Gove is probably thinking a bit along those lines, but he can’t say it. The Protestant enlightenment allowed the free-thinking in which our society and economy developed.

Neither can Mr Gove say secular values, although he almost certainly does mean that. France is proud of laïcité; but secularism this side of the Channel is still seen as a little cranky. It shouldn’t; religious people in particular should embrace secularism as the best guarantee of religious freedom. The opposite of secularism is state-sponsored religion, which isn’t that far from theocracy. I don’t think we can directly compare today’s Church of England to Massachusetts Puritans or the Taleban; but the Church of England under Queen Elizabeth the First wasn’t a nice organisation if you were a Catholic.  The difference is one of degree, not of nature, and it was the bad experiences of the sixteenth and seventeenth centuries that led America’s founding fathers to write the First Amendment. A secular state gives no faith any special privileges, and thus it guarantees all faiths the same treatment.

In a secular society, a woman may wear the hijab, should she choose to do so; but she may not be forced to do so – either by the State or by any other player. That’s a pretty good example of a modern British Value, which most of us would endorse (I’m very uneasy with secular France’s outlawing of the hijab – it strikes me as populist, Islamophobic and illiberal).

But from the punditry and the vox pops of the last few days, another British value has emerged: the idea of good manners. It’s been renamed “respect”, but that’s a horrid weasel word. Good manners matter; as William of Wykeham said, “manners makyth man”.

Piketty

I will confess that I haven’t read Thomas Piketty’s notorious new book. It is on my long list of things to do. So my comments are based on what I have heard others say about it, rather than a direct read. Nevertheless, I do have things to say.

Certainly, I share with him a general concern about inequality; as I have said, I think too much inequality is bad because of its social effects and because it tends to restrict growth.

However, I disagree with Piketty’s diagnosis of the cause and hence his prescription (a global wealth tax).  I don’t think it’s nearly as simple as he makes out and in particular I don’t agree that it’s about a difference between the rates of return on capital and labour.  One of the features of twenty-first century capitalism is  low capital rents as a result of very high asset prices. Capital assets generate returns for their owners not through income but through capital gains. For ordinary people, savings give a poor return.

My other quibble with Piketty as summarised by the pundits (which may not be borne out following a full reading) is that he hasn’t considered demographics.  Globally, rather than regionally, we are coming to the end of a baby boom.  Labour costs on a global scale are low because of the bulge in China’s working-age population which will start to contract rapidly over the coming decades as the little princes of the one-child generation leave the workforce. This will shift the balance of power towards labour.  We will see a similar process in the West, sooner: our ageing population needs lots of local labour to care for it.  We didn’t need local labour to supply our needs in a consumer society – cheap Chinese labour made the stuff we bought – but we will need local labour to empty our bed-pans.

Ukraine and Crimea

A long way off-topic.

I am astounded at the self-evident incompetence of Western diplomacy here. Since the start of the Kiev protests, the West has not put a foot right.

It was far too loud a cheerleader for the protests to begin with. It has failed to condemn the nationalist ultras who led them. Like Russia, it has put all the West-Ukrainian people under the same heading; Russia describes them as Nazis, the West as democrats. They are probably mostly democratic, but many of the people on the front line were right-wing vigilantes. There is no place in the EU for a nation run by such people.

As soon as the old regime collapsed, the West should have started vocally to agitate for minorities, Russophones and Tartars especially. Self-determination is an important democratic principle, which trumps “territorial integrity”, so the West should have been vocal in pushing for a plebiscite in Crimea. That’s a “yes, but later”, rather than a “no, never” to Putin.

We know Putin was sore at losing his puppet in Kiev. He may well have encouraged the shooting; after all, it worked for him in Grozny. The West’s reaction to this wounded bear? Poke it with a stick!

Kerry, Hague and Ashton feebly echo the paranoia of the former Soviet satellite states who are now their allies. The West can tame the Russian bear, but we will only do so by championing our values rather than taking sides. Putin’s charge of hypocrisy is not without its validity.

PIE, lies and liberty

Obviously, the present row between Ms Harman and the Mail is all politics.

Predictably, Ms Harman has failed to make the case she should be making about her past; political cowardice is rife.

So let me do it for her.

The Paedophile Information Exchange stood for repugnant views. But I will defend to the death its right to to express them, and that is what NCCL should have done and been doing.   People like Hanson, Hose and O’Carroll were far more honest than, say, Stuart Hall or Jimmy Savile. 

Paedophilia is now considered the most heinous of crimes. PIE may well, unwittingly, have helped us come to that position. It sought publicity, it made its case as in a free society it had every right to do. And it lost the argument on the merits of the argument.  Paedophilia is a perversion and acting on it is criminal.

NCCL was right to support PIE’s right to make its case, and no apology is needed.

 

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