Britain, America and YouGov

It is well worth looking into the details (PDF) of the YouGov poll on British and American attitudes that was written up for the Economist.  Even the more obvious results are quite interesting.  Here are the best headline figures I've found:

The British public are a lot more sensible on environmental policy than the politicians.  There is a majority against increasing taxes on petrol, air flights and increasing taxes to subsidise renewable power.  However, there is a plurality in favour of nuclear power.  If only the public were in charge, if only the demos really ruled Britain!

Britain is a lot less religious than the United States.  Democrats are more religious than Conservatives.  53% of Americans see religion as an important part of their lives against just 21% of Britons.  80% of Americans believe there is a God against 39% of Britons (I didn't know Britain had an atheist/agnostic majority).  We wouldn't care if the Prime Minister were an atheist, Americans would care if the President were one.  Only 30% of Americans think that the theory of evolution is the correct explanation for the origins of life on Earth.  It is clear that religion is pretty much spent as a moral force in Britain but I'm not sure we quite take that seriously enough.  I don't think, as some American conservatives suggest, that you can't be conservative without being religious.  I'm conservative and not religious so clearly it is possible.  However, that doesn't mean the death of God isn't a rather big issue, that it creates a new and extremely open contest of values.  Perhaps we all need to read some Nietzsche?

Republicans are still stronger than the Conservatives in underlying support.  Anyone observing American politics at the moment will have seen that the Republicans are getting completely hammered.  By contrast, the Conservatives are on top of the world with massive poll leads.  However, 29% of Americans identify themselves as 'Republicans' against 27% of Britons who see themselves as 'Conservatives', both Labour and the Democrats enjoy 34%.  This might suggest that, while the Conservative brand has been decontaminated that has yet to feed through into an expansion of the Conservative 'base'.  Perhaps that only ever happens slowly?

Americans want their parties to come together and compromise, we don't.  39% of Britons want the two principal parties to come together and compromise against 69% of Americans.  Clearly all the agreement in the major British parties over things like fiscal policy actually pisses voters off.  By contrast, Americans really are sick of apparent bickering.

We value experience, Americans value character.  In Britain 50% think experience is the most important quality in a Prime Minister against 39% who cite character.  In American the result is reversed with 63% thinking character is most important.  What causes this difference?  Is it the lower number of religious people in Britain?

Britons want TV, rather than the church, to teach kids right and wrong.  We are significantly less likely to think that religious leaders should teach kids right and wrong but more likely to think TV and movie makers should.  People in both countries place the most responsibility on parents.

Britons trust public officials less than Americans do.  Apparently our supposedly neutral Civil Service does not engender more public trust than the more politiscised American system.  53% do not trust public officials (civil servants/administrators) much or at all, though they are somewhat more trusted than politicians.

We trust big business leaders more.  My understanding was that, unfortunately, the Left's 'fat cat' attack of the nineties worked really well.  Business leaders aren't exactly the most popular of people but they're trusted more in Britain than in the States and more than national politicians.  They are also admired by 46% of the population, against just 18% who are clear that they do not admire them.  The exception is a question on 'excess profits' which more Britons think major companies make.

We are a lot more hostile to immigration and multi-culturalism than Americans.  Immigration is the number one issue, with 60% placing it in the top three issues facing Britain today against just 40% of Americans who see it as a top issue.  49% of Britons disagree with the pro-immigration argument that immigration has boosted the economy against just 26% who agree.  I do wonder how long the Conservatives can keep up their relatively quiet position on this issue.  I'm not saying we should return to talking about nothing else but it is dangerous for such public concern to not be reflected in the political discourse.

We take the UN seriously.  26% of Britons think we should only go to war if the UN approves.  Sigh.

We are a lot more pro-free trade.  This isn't particularly a surprise but its always nice to see.  A majority of Britons think it is a good thing, despite concerns about globalisation.

In both countries three quarters of the population support the death penalty for murderers.  This surprised me.  I thought that in Britain there now wasn't a majority in either direction.

Mongol

Genghis Khan is a fascinating character. I first really read his story in the book Genghis Khan by John Man. His impression on history is hard to underestimate. He united a nomadic people and led them to conquer half the world. Despite his empire fragmenting and declining after his death he left behind a Chinese dynasty - no small matter - and a legend for the Mongolian people that lasts to this day.

Thankfully, Mongol doesn't shy away from embracing the legend. It is always tempting for biopics like this to engage in a quixotic attempt to get at the 'real' hero behind the legend. With the passage of centuries having obscured the tracks a historian would need to follow, they can rarely find an adequate replacement for the myth.

In this film the Mongol god provides almost tangible support for Temudjin. Those moments where something truly incredible happens are genuinely ecstatic. If I describe them now I might spoil it but the film conveys a quiet awe that really sucked me in and made miracles seem really miraculous.

The star, a Japanese actor called Tadanobu Asano, handles the challenging role of Genghis Khan with authority, though Temudjin's stern silent act leaves him with only a limited range of visible emotions to play with. The supporting cast are excellent, particularly Honglei Sun, playing Temudjin's blood brother and later adversary, Jamukha. The love story, showing Temudjin's marriage to Borte, has to share the film with Temudjin's rise to become Genghis Khan so never has the space to develop and carry the film as the makers, perhaps, intended it to but it functions well enough to make Temudjin more than just a shouting conqueror.

The photography is spectacular. Behind every scene the steppe is invariably stretching into the distance looking gorgeous and lending a powerful sense of the epic to proceedings. That is fortunate because, except in a limited number of action set pieces, the pace is quite slow. Those action scenes have an incredible kinetic kick but they are too rare for this to really be an action junkie's movie - if you go looking to just cheer on grand battles there won't be enough there.

Instead, sit back and enjoy a luxurious recreation of an incredible legend.

Unity on copayment

Unity has written one of his trademark ‘if you can make it to the end’ posts on the subject of copayment for healthcare. He basically argues that patients choosing to copay place a significant additional burden on the NHS in return for an uncertain and temporary stay of execution and that Doctors for Reform are a biased group whose agendas the Times should have paid more attention to.

I think he is deeply mistaken at nearly every stage. I’ll try to keep my response concise.

Are patients who wish to copay demanding additional resources from the NHS?

“So that’s the deal that Mills and Hirst are demanding here. They want the NHS to put up £6,000 per month in treatments, which they would have [to] have longside the Avastin for it to have any effect, to enable them to pay out a further £4,000 a month for drug that may or may not extend their lives by a bit, although by how much (on average) no one actually knows for sure although the best guess seems to be a few months, as this 2006 article from the New York Times indicates.”

The logic here is stretched. Look at it the other way. If they have Avastin Mills and Hirst will have a better chance of increasing the number of months they will remain alive if the NHS offers them its standard treatments. That means that they demand continuing treatment instead of accepting palliative care and death. This is an additional demand on the NHS.

If someone has a less severe form of cancer then treatment is more likely to be successful. At a certain cut-off point they are either worth treating or they are not worth treating. One patient could demand more treatment because he is more healthy. Non-smokers, on average, may demand more treatment because they are more likely to demand the expensive care associated with long-term conditions like Alzheimers.

What Mills and Hirst have done is, by buying outside drugs, moved themselves into a category where treatments, made generally available within the NHS, offer them the prospect of additional months of life. If the decision is made on clinical grounds alone then clearly using those treatments universally available, free of charge, in the NHS could be seen to be in their interest. It is an option that the NHS, if all concerns for the full implications of copayment – which I’ll discuss later – were left aside, would offer them.

Mills, Hirst and the others who wish to copay aren’t demanding special treatment. They’re just asking for the same heuristic to be applied to them as to everyone else.

Does copayment for drugs like Avastin constitute an irrational choice?

Unity makes a few arguments on this subject. First, he notes that Avastin does not ‘cure’ cancer:

“Neither of these drugs is a ‘cure’ for cancer, indeed neither one of them will even put the cancers they target into remission. Their sole and only purpose is to delay the spread of secondary cancers that will, inevitably, lead to the death of the patient no matter what.”

This isn’t particularly significant. A great many treatments do not prevent but merely delay death. Above the age of seventy-five mortality is not considered ‘amenable to healthcare’, for example. I don’t mean to be trite but, ultimately, everyone dies. All medical science is a stall that can, at best, delay someone’s death by a reasonable amount of time and ideally make it that another condition administers the coup de grace.

Unity then discusses various evidence that makes clear that the results of these drugs are highly uncertain. That is probably true. That uncertainty clearly makes the expected increase in longevity that the drugs deliver somewhat less valuable. However, it seems that those patients choosing to put substantial money of their own into copayment see an uncertain chance of living a few extra months as preferable to a near certainty of imminent death.

Debates over the quality of evidence used to support the approval of Cetuximab aren’t particularly relevant to this debate. Companies should be held to account for the veracity of their claims about any product through the courts, the threat of damage to their reputation and through regulation. The point of the specific rule against copayment is not to protect people from dodgy sales pitches.

So, is it rational to spend thousands of pounds to gain some uncertain extension to your life, probably just a few months, or are drug companies exploiting the vulnerable and afraid? A practice we would certainly not want to facilitate.

To answer that question I’m going to need to briefly tell the story of a man I know. I’ll leave all the details I can out, just in case. His wife had been ill for some time but suddenly what had been a chronic condition took a turn for the worse. There was no equivalent of Avastin on which he might spend his money so he did something else. He stopped working and spent a huge amount of time at her beside. This decision undoubtedly cost him tens of thousands of pounds and he wasn’t a rich man. He had to sell a small business that might have provided for his retirement. It can’t have given him with the equivalent of more than a month or so of additional time with his wife. His decision was, in every way, similar to that facing someone who can buy, or not, buy Avastin and he chose to bear an expense of tens of thousands of pounds to see more of his wife. Is that decision irrational?

Colette Mills has a family – she wanted to pay for some extra time with them. Of course, it isn’t going to be a ‘lot’ of time in the grand scheme of things and it is necessarily uncertain but that doesn’t make the decision wrong. It doesn’t seem in any way unreasonable for her to expect that we treat her like any other patient during that time and offer what treatment can give her additional months of life and allow her to make the most of the chance she has bought herself.

The ad hominems

I’m going to focus on one of the doctors that Unity discusses. Professor Karol Sikora. I know Karol as he wrote the foreword to my study Wasting Lives: A statistical analysis of NHS performance in a European context since 1981 (PDF). He struck me as a remarkably decent and deeply intelligent man, for what it’s worth

He is the Medical Director of CancerPartnersUK, former Chief of the World Health Organisation Cancer programme and a member of the steering group of Doctors for Reform. When the Times reported his opinion on the case of Colette Mills they described him as a member of the steering committee for Doctors for Reform. Unity believes they have failed to uphold proper journalistic standards by not mentioning his job at CancerPartnersUK.

Clearly the Times faced a decision over which aspect of Karol’s biography to highlight. They described him as a member of the steering group for Doctors for Reform. That hints at the fact that he has political beliefs; namely that the NHS is in serious need of reform. They could have described him as a Medical Director of CancerPartnersUK which would hint at the fact that he has a financial interest in treating people for cancer. They evidently judged that the political background was more relevant and informative. Are they wrong? I don’t think there is a definitive answer to that question. They don’t have the space the BMJ do and, therefore, can’t put a full bio in. They haven’t even chosen the most positive citation: former head of the World Health Organisation Cancer programme.

Analysis

In the end, the government themselves don’t argue that they need to refuse permission to those who wish to copay on financial grounds. They also don’t make the paternalistic (I’m not using that as a term of abuse) argument that Unity makes: that the Government need to prevent people spending their money on doubtful stalls to inevitable mortality.

Copayment is refused on the grounds it would create a ‘two-tier’ health service. If some people can pay and do better then those treated under the NHS will no longer face equal health prospects. That is the stated and, I believe, genuine reason why copayment is not allowed. I don’t think the government’s decision is right or moral and share DK’s anger.

In the end, people who are better off have all sorts of advantages within the NHS. Civitas have shown that they tend to get seen more by doctors as they are better able to play the system. Equally, there are many ways to copay that are not covered by the rules, as Doctors for Reform showed in an earlier report (PDF). The Government are not defending a genuine principle.

Beyond that, I don’t think that avoiding a ‘two-tier’ system should really be an objective. The objective should, instead, be to provide the best quality of healthcare we can up and down the income scale. The health of the poor needs particular attention but keeping the rich down isn’t the way to help them. My broader view on how we improve the health service is described in Wasting Lives.

In the name of as thin a principle as a one-tier health service, it seems illiberal to the point of brutality to tell people who want to invest extra money in medicines - that we cannot afford to provide them - that we will cut off their treatment if they buy extra treatment on the side.

A new Ministry of Defence

It seems increasingly clear that we are really letting down our Armed Forces. There are good reasons to think that it takes a questionable sense of priorities to have spending on the armed forces going down as a share of public spending and GDP while we are engaged in a major armed conflict in Afghanistan and have smaller, but still significant, engagements in Iraq and other arenas. There is a reasonable case that we are simply trying to do too much with too little.

Still, to a certain extent that puts the cart before the horse. There is no sign that extra money would be well spent. Wasting new money would be both offensive in itself as the taxpayers who ultimately foot the bill are hard-pressed and would undermine the long-term case for Britain maintaining a serious military. New embarassing wastes of resources would give the British public the false impression that, for some reason, we are simply incapable for running a large and effective military.

Hardly a day seems to go by without some new and shocking story coming to light. Some new travesty too dire to be some molehill turned into a mountain by the media. Today, Mike Denham blogged on the Chinooks that have yet to see action after thirteen years and around £500 million spent. The ongoing failure of the Nimrod has cost lives and continues to hoover up money. Accomodation is alarmingly poor. The Defence of the Realm blog is full of examples of lethal procurement failures, in particular the disastrous failure to find an adequate replacement for inadequate Land Rovers. Vital equipment, particularly helicopters, is being cannibalised with only one third of the Army's vital airlift capability functional. Shortages of body armour have definitely proved lethal.

Some of this is down to a lack of resources but that lack of resources isn't purely a matter of failing to place proper importance on supporting the military. There is clearly huge waste going on, particularly in procurement. At the same time as the military falls to pieces for lack of money the Ministry of Defence has been enjoying a spectacularly expensive refurbishment with spectacularly expensive office chairs.

There isn't a simple way of fixing problems fundamentally caused by political leaders who do not understand the military. With the numbers in the services having fallen so low it is unlikely, in the continuing absence of a major war, that ex-service personnel will form a substantial portion of our political elite again. The need for civilian control of the military will necessarily mean that soldiers suffer the suspect command of politicians who don't really know what they're doing. However, the vital institution that should give them support in such debates is the Ministry of Defence. Otherwise, the military's voice is too dispersed, spread around the country and the rest of the world at its various stations. Headquarters in London should be able to do their bit to make the military's case to the politicians.

Tragically, it appears that the contemporary Ministry of Defence is doing quite the opposite. An excellent article in the first issue of Standpoint magazine, by an anonymous military officer working within the Ministry sets out how bad things have gotten:

"I am often asked why the MOD makes so many strange decisions and seems to care so little about the welfare of its personnel. People are surprised to read about expensive computer systems that fail to pay service members their proper salaries — or pay them late. Some are shocked by the apparent dumping of severely wounded personnel from Afghanistan and Iraq into civilian hospital wards, remote from their regiments and families, or the massive contracts for systems that are delivered late and don’t work properly, or the strange failure to publicise genuine successes and minor victories achieved “against the odds” in Afghanistan and Iraq.

None of these scandals — or many others less well known — would surprise anyone who knows the MOD and what it has become."

The problem is clear. The Ministry of Defence's staff aren't really a part of the military. They're just ordinary Civil Servants who would rather be in the Department for Children, Schools and Families. Your average Civil Servant can't really understand the military, let alone really appreciate its needs. Again, Standpoint's anonymous author makes the case eloquently:

"Most people still believe that the MOD is essentially a military organisation. It is not. It is an organisation dominated numerically, culturally and structurally by civil servants and consultants, many of whom are unsympathetic to its underlying purpose or even hostile to the military and its ethos. You just have to spend a few days at the MOD before you realise that the culture there is not just non-military, but anti-military."

I'm not sure the normal starting points for reforming a public service - accountability, contestability and autonomy - will work here. I don't think that the strength of hierarchy in the world's militaries is an accident or irrational. It seems quite plausible that when you want people to get into a gunfight with others out to kill them a very visible hand is an important source of confidence and trust.

The vital step would seem to be, to me, making sure that the Ministry of Defence is returned to its proper role as a military organisation. There are two ways we might do that:

1. Set a fixed ratio for military officers to civilian personnel and dictate that the balance is swung back to the military in the Ministry of Defence. The policy would look like a kind of hawk's cap and trade with an enforced shift in the ratio that the Department could get to however it wanted.
2. Change the career structure for all staff at the Ministry of Defence. Stop using generalist recruits and end the practice of maintaining the Ministry of Defence organisation as one more department of the Civil Service. If you do need to recruit civilians then use a separate recruiting process. By a process of attrition, we can move towards a Ministry of Defence that is a military organisation as staff leave for other departments or retirement.

Once the staff at the Ministry and the Army, Navy and Air Force are all really part of one team the headquarters might become rather better at supporting the troops at the sharp end. Military procurement will start to become a military matter rather than a new industrial policy. Even if the politicians are hopeless at least the military will have a powerful ally in Westminster again.

Private companies to take over hospitals

"Poor managers are to be sacked without receiving large payouts and replaced by staff from profit-making companies who would be paid with public money.

The NHS will retain ownership of hospital buildings and services but the private firm will "take over" the day to day running of the hospital.

Ministers believe the proposals will drive up standards within the health service."

This is good news and provides genuine accountability for hospital managers delivering poor quality services. Ironically, the problem with this new initiative was well summed up by Alan Johnson when he set out the scheme:

"[He] admitted that too often, poor performance had been dealt with only after a serious problem had emerged, as happened with Britain's biggest superbug scandal at Maidstone."

That's the issue. It isn't good enough if the private sector can only come in once things have fallen to pieces so badly that it becomes a live scandal. Thousands of patients will have been subjected to sub-standard treatment before the 'story' breaks. The private sector will be asked to take over the most demoralised of hospitals and turn them around, which is a lot harder than building an effective organisation from the start.

Instead, private companies - and other organisations such as charities and co-operatives - should be offered a level playing field to compete with the current hospitals. That pressure will either drive improvement in current hospitals or lead to them, slowly, being replaced. Competition can improve standards before serious problems emerge.

Cross-posted from the TaxPayers' Alliance blog.

Wikio rankings

Sinclair's Musings is ranked an astonishing 23rd in the politics category of the Wikio rankings, 82nd in the overall rankings, for June. The JeunesEuropeensFrance may have helped.

I haven't had as much time to devote to Sinclair's Musings as I used to before two other blogs and the small matter of a more than full-time job intervened but I still want to maintain a space that is my own for posts not right for CentreRight or the TPA blog. The Wikio ranking is a nice vote of confidence. Thanks.

A new laptop

I'm blogging on a new laptop. The old one was a huge and incredibly heavy Toshiba Qosmio. It was great when I first got it and needed a desktop replacement for gaming and didn't want to move the thing (it actually hurt me if I carried it too long). And, when it still worked. Now, the old Toshiba's optical drive has been broken for a year, it has started overheating and dying on me and the power cable has to be jiggled about just right, and I want a laptop that is actually portable.

So huzzah for the HP DV2799 special edition. Performance seems good so far, though I haven't tried anything terribly demanding (beyond running Vista). Features are rock solid with everything from fingerprint scanning to a little camera and microphone at the top and an HDMI out. The design avoids the plain, minimalist box or 'boy racer chic' dichotomy that usually limits computer design. The computer came recommended and it appears TrustedReviews have steered me right again. So far, I like it.

In the news today...

...there are two stories in the news today. First, the Home Secretary is an alien out to destroy Britain:

And, the Home Secretary announces a new plan for therapy for extremists:

"Controversially, the new plan makes clear that people who fall under the influence of violent organisations will not automatically face prosecution."

No connection at all.

Just kidding! Before I get accussed of something, clearly there is a space for those who have gotten somewhat involved in terrorism to receive some treatment other than the swift, sharp deployment of the criminal justice system.

1. Huge chunks of supposedly anti-extremism spending is actually spent either trying to promote the benefits of Islam to non-Muslims or funding Muslim community activities. A classic example is the response by Whitemoor's authorities to discovering that their prison is run by Islamist gangs. The Pathfinder fund (PDF) for preventing violent extremism is another example. Nothing wrong with promoting the benefits of Islam or funding Muslim community groups but both the first is a dubious use of taxpayers' money and it would be better if community groups (I think there's a basketball programme in there somewhere) funded were ones where different communities interacted. The authorities current attempts to combat extremism the touchy-feely way are a bit suspect and that raises questions about whether this therapy will be run effectively.

2. Violent extremists respond (PDF) to political signals. Jacqui Smith hardly has something of the night about her. To send the proper signal that terrorists should, on no account, mess us about we need her to behave like a border line psychotic. There is every reason for the British Home Secretary's first, second and third thoughts when the word 'terrorist' comes up to involve 'getting 'em'. That, instead, we regard terrorism, along with sadness, as yet another pathology we want to 'treat' is worrying. By all means offer those with only a fleeting encounter with Islamist extremism treatment instead of prison but it doesn't need to be a grand plan that sends all the wrong signals.

Sinclair Road

My full name is Matthew John Hayes Sinclair. The Hayes is not without meaning, it is the surname of my great, great grandfather.

Before he died my paternal grandfather wrote a book setting down his life story. My uncle had it printed and very generously gave all of my grandfather's, rather numerous, descendants a copy.

It contains the following:

"I now believe that John Samuel Sinclair never existed and was simply a fictitious person of that surname concocted by my grandmother at the time she decided to adopt the name of Sinclair, and only necessary in order to complete my father's birth certificate. In my own lifetime no one in the family has ever mentioned meeting or knowing a John Samuel Sinclair and no photograph or picture of him has ever been found. I can submit two further facts that, although circumstantial, clearly indicate that the fictitious figure of a John Samuel Sinclair was merely a subterfuge to hide the real name of my paternal grandfather.

Why did my paternal grandmother decide upon the use of the name of 'Sinclair'? A clue lies in a Burial Grant issues in consideration of a fee of Five Pounds and Five Shillings to Mrs Annie Sinclair granting exclusive rights of burial in a grave No: 4669 at Hanwell Cemetery in the county of Middlesex. This document is dated November 19th 1902; only some four years after the birth of my father and it records my grandmother Anne Darby's address at that time as being 67, Bolingbroke Road, West Kensington, London.

One has only to look at a street map of the Kensington area of London to see that Bolingbroke Road is only a stone's throw from 'Sinclair Gardens' and 'Sinclair Road'. It is easy to imagine that if that area of the city held some affection for Anne Darby she could well have decided to adopt the name as her own and passed it on to her son and his consequential heirs by falsifying the birth certificate."

He goes on to discuss how his records show that a John Samuel Hayes is likely the real father and the new name was probably designed to cover up the child's illegitimacy.

I've known about this for a while. I'm the only one of my generation to carry Hayes and the link to events more than a century ago is fascinating. It took until a few weeks ago, though, for me to have the idea of trying to find the two roads (Sinclair Gardens isn't actually a park) my family are named for.

Today myself and a friend made the trek over to West Kensington and found it:


It is an unremarkable but quite pleasant road near Kensington Olympia station most obviously notable for the cast iron shelters over some of the mini-balconies. I now have a fierce ambition to eventually own one of those houses! The only down side might be that if I ordered something delivered to Matthew Sinclair, 76 Sinclair Road it would sound like a hoax.

Further wandering yielded this. Who would have thought it. The Parish Church of St. Matthew, Sinclair Road. What are the odds!

Apologies for the break from normal service. I'm afraid a near dead laptop has made blogging a bit difficult. I'll return to politics soon enough.

Opening up the NHS?

"Death rates of patients undergoing major surgery at NHS hospitals are to be published on the internet.

[...]

Death rates are expected to be at a disproportionately high level in hospitals where fewer operations are performed and surgeons have less opportunity to improve.

The government believes publishing the figures will mean badly performing trusts will have to improve standards or halt areas of surgery where they are lagging behind."

This, from a report in the Telegraph, is great news. If patients can make an informed choice then that should put pressure on the acute trusts to up their standards. In fact, this is long overdue:

An inquiry into the deaths of children at Bristol Royal Infirmary a decade ago showed how poor practice persisted because mortality rates were not disclosed.

The effect will be limited though as - within the NHS - patients only have a limited amount of choice. While the trusts could compete with each other to a certain extent they are protected from new entrants to the market, a restriction that will severely limit the ability of patients to take advantage of this new information.

Beyond that, the structure of the NHS will restrict the ability of the trusts to respond to quasi-market pressures introduced by this new source of information. The NHS is essentially a quango of quangos. It is made up of a combination of the primary and acute trusts, strategic health authorities and a maze of central quangos. In our report, Wasting Lives: a statistical analysis of NHS performance in European context since 1981 (PDF), we set out how the central quangos control many of the most important NHS decisions:

"The NHS has a large number of local bodies, the Primary Care Trusts, NHS Trusts and Regional Strategic Health Authorities. However, these are all both legally non-departmental bodies answering to the Department of Health and effectively part of one organisation. Most have only a very limited ability to act independently:

• Their decisions over which drugs to buy are expected to conform to guidance from the National Institute for Health and Clinical Excellence.



• IT expenditure is mostly handled by Connecting for Health which runs the National Programme for IT , the largest single information technology project in the world.



• Staff pay, the largest item of expenditure, is determined nationally by the NHS Pay Review Body.



• Amounts of funding are also set nationally according to a weighted capitation formula. This became very controversial in 2006 when the Government were accused of manipulating the funding decision for political advantage."

This information will be a valuable resource for NHS patients. It would be so much more valuable if our healthcare system were liberalised more broadly.

Cross-posted from the TaxPayers' Alliance blog.

"Democracy, freedom, subsidiarity - federalism, the solution we've got!"

They're young, lyrically imaginative and enthusiastic for the European Project!

Lipdub Europe United par les Jeunes Européens - France
Uploaded by JeunesEuropeensFrance

This gave me rage blackouts.  I defy any Briton of good sense to watch it and not want to quote Nelson's advice to a midshipman aboard the Agamemnon.

P.S. If this has been posted by someone else already, and I missed it, then apologies.

Glorious Isolation

Zoe Williams, at Comment is Free, is confused by our lack of friends that might support a bid for Eurovision victory:

"But still, two questions: first and most obviously, why have we got nobody to vote for us? Everybody goes on about eastern Europe and their bloc voting, but this is not some ex-communist curiosity that we in the hyper-individualised west will never understand. Everyone has chums: the Scandinavians vote for one another; Cyprus votes for Greece; and Andorra, Portugal and Spain stick together."

Well, the answer's obvious, isn't it? Humans are angry, tribal killer chimps.

Europe's other nation states aren't very stable. Most have them have had their borders redrawn endlessly and have even ceased to exist several times pretty recently. All sorts of people aren't in the nation they started out in and have tribal loyalties elsewhere. Even when no one is being conquered a land border is far more porous than a watery one. All this means that most European countries have human ties to others in their proximity.

We're just as tribal. In fact, Anglos of one kind or another have been - for some centuries - the biggest, baddest tribe on the planet. Not only do we keep our own borders steady (the last battle on our mainland was in 1746) but we also conquer the others and take their stuff. However, we generally haven't taken territory in Europe (too high maintenance) but in the rest of the world.

If it wasn't Eurovision but Worldvision (World Vision might be peeved if it were set up) then our Anglo cousins and Commonwealth buddies would be in play. We'd do fine. The best evidence available suggests that we would do extremely well, that we are the world's favourite nation.

Our relationship with continental Europe has defined our history and frog-bashing has become a dull cliche best left behind. However, there is no reason to get wound up in a fit of teenage self-consciousness just because the continentals won't vote for us at Eurovision.

Cross-posted from CentreRight.com.

The decline of the traditional family - the sixties or Thatcher?

I've written a response to a post by Unity addressing that subject. Unfortunately it is a bit too heavy on the graphics to easily copy over here so you should go to CentreRight.com to read my argument.

Taking responsibility

Great post by Pub Philosopher:

"But there is another similarity between both these tragic stories. Khyra's and Victoria's fathers were not living with their daughters and were out of the UK when they died, yet they displayed their grief for all to see and launched tirades of criticism at the British state for its failure to look after their children.

[...]

Much of this disproportionate response resulted from a mind-set which assumed that the state must take all the blame for Victoria Climbie's death. Anyone who suggested that, perhaps, her father should bear even a little of the responsibility for entrusting his daughter to inappropriate carers was drowned out in the chorus of "something must be done".

[...]

I'm not saying Birmingham's social workers are blame free. They should have asked questions when the child had been away from school for so long. If they were unaware of this, then that is a system failure too.

But Mr Zaire has some cheek to blame just about everyone else when, it appears, he had very little involvement with his children. "

Re: Overclass values created the underclass

Tim links to a blog by Melanie Phillips who attacks the Guardianista crowd. She accuses them of being responsible for many of today's social problems through an attack on the social institutions that are often called "traditional values".

If you haven't read it before, Theodore Dalrymple's The Frivolity of Evil, a piece for City Journal, is a superb introduction to this subject and one of the best articles I've ever read. The effects on the 'underclass' of the dangerous combination of the welfare state and the moral equivalence that pervades our culture and institutions is a subject Dalrymple has spent a huge amount of time discussing and if you want to read more his archive at City Journal is well worth a browse.

I think Phillips is wrong on one point. She suggests that "the supercilious overclass" has "the money to get itself out of trouble". It does have the money, education and other advantages to largely avoid the kinds of problems that afflict the underclass. That doesn't mean that it has got out of trouble. Allan Bloom's landmark book The Closing of the American Mind sets out the harm that relativism - emerging out of a frivolous nihilism - has done to the Western elite. It is a hard book to sum up within a single post but here's what I wrote when I first discussed it on my own blog:

"Bloom's masterpiece is hard to precis. It begins discussing his students and how relativism has closed their minds; how a doctrine of 'openness' has perversely undermined serious dialogue between different opinions and cultures. It then goes on a tour of Western philosophical thought illustrating the struggles that brought us to where we are now. My understanding of his critique is that we have lapsed into nihilism without taking the condition seriously. We cannot take seriously old visions of the good life and have broken the processes and destroyed the environments in which new visions might flourish. He sees this as a broad problem for Western civilisation but sees the crucial centre of the problem in the decline of liberal education within the Universities.

[...]

Dalrymple's work is excellent but if you only read Dalrymple and look at the problems of the poor it is as if you are studying an oceanic earthquake by measuring coastal waves and understanding the misery of those they make homeless. You need to understand the problem at its source. The source of the awful problems Dalrymple describes is in the elite and their intellectual decline. A philosophical decline in the West. Hopefully Bloom can provide a valuable first step in understanding that source of our problems."

That's pretty inadequate but this is a hard subject to get your head around. It is worth the time though as it is the thread that connects so many problems the modern Right should aim to confront. A relativist distaste for morals, nations and individual free will can be found at the root of a host of less esoteric problems.

The class card

This article by Nick Cohen has an interesting explanation of why Labour's attempt to play the class card backfired so badly in Crewe & Nantwich.

Of course, in some sense it is easy to explain why the "toff bashing" went poorly. It was done badly. They didn't have enough else to say, Edward Timpson isn't a "toff" in any meaningful sense and Tamsin Dunwoody is part of a political dynasty. However, it does seem to have been particularly ineffective and it might be worth thinking about whether there is a broader weakness in appeals to class.

My normal thesis is that the British people never respond the way class warriors expect them to and just don't think in classes. Ever since the First World War nationalism has proved itself just one group loyalty among many more potent than class. When Prescott said that Labour are "always better fighting class" he was clearly wrong. They got hammered by Thatcher when it was socialists versus capitalists in the eighties, the supposedly post-class Blair did far better. Marx was just wrong, at least in Britain and probably elsewhere, and class really isn't a good way of understanding political struggle.

However, Cohen might have a better explanation. He essentially posits a subtler understanding of class - i.e. class can have a significant effect on politics but it isn't just some lever a left-wing party can pull at will. The contemporary Labour party has no credibility attacking the ex-Bullingdon Club types as they are themselves just another tribe within the same elite:

"You will find part of the explanation the next time you read one of the 'when I was at Oxford I hated the Bullingdon Club' articles, which have taken permanent residence in the pages of the liberal press. You can guarantee that the outraged journalist or Labour politician was not at Oxford because they were working on the assembly line at Cowley. When they say 'I was at Oxford', they mean they were living in the same colleges and listening to the same tutors as Boris Johnson and David Cameron. They just moved in different social circles.

Freud's narcissism of small differences can power great hatreds and I have no doubt that the rage at the return of the Etonians is sincere. I feel it myself, while realising that these are tensions within a tiny and privileged part of British society.

[...]

Indeed not. Labour has been marching through the institutions for 11 years. With the exception of the armed forces, it has not allowed one state body to stay in the hands of natural conservatives. The Church of England, the BBC, the judiciary, the senior Civil Service, the trusts, agencies and quangos all have a pinkish hue. Even chief constables sound like Harriet Harman.

You can't run as an anti-elitist when you are part of the elite. You can only argue that you and your kind are best qualified to govern the country. Labour could make their case when Mrs Blair was gloating and Britain was booming. When hard times come, voters blame the people in power for their troubles, not 'the people on the grouse moor'. The old ruling class has been out for so long it no longer frightens voters, while Labour's jeers strike them as a cynical distraction from the enveloping economic crisis."

His casting of Thatcherism and the right-wingers who reacted with fury at attacks on grammar schools as representing a middle class, meritocratic (for better and for worse) anti-elitism within Britain's conservatives suggests that class distinctions are complex on both sides of the partisan divide. The most obvious expression of anti-elitism within the contemporary Conservative Party is, perhaps, Direct Democracy. That movement could be understood as an attempt to make elites more accountable to the popular will.

It seems plausible that the fate of the 'pink hued' elite, with values that might best be described as 'tranzi', that Cohen describes could come to dominate our politics in the coming decades.

Cross-posted from CentreRight.Com.

Emissions trading continues to dissapoint

From the European Commission Spokesman's briefing yesterday:

"Overall emissions of CO2 from businesses in the EU Emissions Trading System (EU ETS) increased by 0.68% in 2007 when adjusted for changes in the number of
installations covered, according to the information provided by Member State registries. While well below the 2.8% growth in the EU's Gross Domestic Product recorded last year, the slight increase in emissions underlines the need for the tighter emission caps that have been set for the 2008-2012 trading period."

Ignore the spin that this is well below GDP growth. It is no achievement of the ETS that emissions intensity (emissions/GDP) is falling - that has been happening across the developed world for some time.

In fact, the real picture is even worse than this suggests as the EU is, in part due to schemes like the ETS, exporting huge amounts of manufacturing activity, and therefore emissions, to the developing world. If green taxes and regulations result in a very efficient plant in Sunderland being replaced by a very dirty plant in China that is no green achievement at all.

Kissinger and Metternich

There is a fascinating article over at The Atlantic discussing the lessons Kissinger took from his own experience and history; the foundations of his realism. In particular, the Austrian Prince Clemens von Metternich's construction of a peaceful order following the Napoleonic Wars and the hideous consequences of appeasement at Munich.

It's worth reading it in full but this is a choice paragraph:

"The "most fundamental problem of politics ... is not the control of wickedness but the limitation of righteousness." The Nazis, the Jacobins, the ayatollahs, and the others who have made revolutions have all been self-righteous. Kissinger suggested that nothing is more dangerous than people convinced of their moral superiority, since they deny their political opponents that very attribute. Tyranny, a form of disorder posing as order, is the result. This was one of Edward Gibbon's arguments against early Christianity. Gibbon represented the Enlightenment in full flower, just as Metternich, Kissinger reminded us, represented its dying breath before the onset of modernism, with its righteous causes. In any event, Kissinger observed wryly, punishing the wicked is "a relatively easy matter, because it is a simple expression" of public decency, and thus not a crucial task of statesmanship."

The logic of collective action taken to a bizarre extreme

Recently I wrote, for ConservativeHome's Platform, about Mancur Olson's The Logic of Collective Action. That landmark political text set out how minorities could impose their will on a majority in a democracy. People have an incentive to free ride on the political efforts of others and minorities find it easier to organise and motivate their members. This is one important reason why the work of the TaxPayers' Alliance is so vital. It also explains why some truly ludicrous trade deals can get through - the small number of people in industries that benefit from the tariff can organise while the broad swathes of society who benefit will struggle to.

Still, this case from the Aplia blog, via Marginal Revolution, is exceptional:

"Advocates of trade restrictions often argue that protection will save jobs. Since we can observe price and cost increases associated with trade restrictions, we can estimate how much it costs to save each job in a protected industry. According to the NPR story, there are roughly 30,000 dry cleaners in the U.S., and on average, each pays an additional $4,000 per year due to the hanger tariff. This indicates an average annual cost of 30,000 firms x $4,000 per firm = $120 million. According to the U.S. International Trade Commission's report, U.S. employment in wire hanger manufacturing was 564 workers in 2004 and fell to 236 workers by 2006. Let's assume that employment in this sector would have fallen to zero in the absence of the tariff, and that with the tariff, employment will recover to 2004 levels. In other words, assume the tariff "saves" 564 jobs. Dividing the cost of the tariff to U.S. dry cleaners ($120 million year) by the number of jobs saved (564 jobs) indicates that each job saved costs about $212,765 per year. Keep in mind that the typical full-time worker in this sector earns about $30,000 per year. Even if we assume that industry employment doubles, the cost of the tariff is still roughly $120,000 per job."

$4,000 per dry cleaner is well above the £100 per household that I figured it would take to get people to sit up and take notice of a decision that hurt their economic position. I can see a few possible explanations for why it happened:

1) The dry cleaners pass the cost on to their customers - that means the $4,000 is spread across hundreds of customers few of whom even know they're paying let alone care enough to change their vote.

2) Enough dry cleaners benefit from this measure which prevents new entrants to the market and puts some existing firms out of business - regulatory capture.

3) This measure won't last and is just an exceptional moment of madness.

Regardless, this highlights how divorced from basic common sense political decisions can become. It isn't just in America. European trade policy is full of similar lunacies, the Common Agricultural Policy is the biggest example, and there is little accountability for most public spending. We need to decentralise and hand decisions back to individuals so that powerful special interests cannot take advantage of us.

Failed asylum seekers and the NHS

Here is an interview I gave this morning, with BBC Radio Wales, debating plans to offer NHS care to failed asylum seekers with the head of the Immigration Advisory Service.

This is one of those plans that, at first, sounds entirely humane but cannot be economically and politically sustained. It is far too vulnerable to be swamped by those who seek to abuse the system and make Britain cover their, often very expensive, treatment. That would either create huge problems for the NHS and British taxpayers or result in the asylum system itself being curbed, to the detriment of those fleeing real persecution. When the courts don't take proper account of these sorts of concerns we wind up in the kind of absurd situation we're in now with regard to Somalian pirates who the Royal Navy can't detain for fear they'll gain a legal right to live in the United Kingdom.

Big Brother is watching

Government plans for a single, massive database containing records of all public internet activity, e-mails and phone calls, reported in the Times, are alarming. This system will be massively vulnerable to abuse and would allow Government officials to snoop, far too easily, on ordinary people. It is also likely to prove exceptionally expensive.

Holding the information in place will always make it easier for a system to be abused. Anyone looking to gain access to people's very personal phonecalls, e-mail or internet records will only need to gain access to, and then search, one system instead of many. The increased convenience to the unscrupulous will be of a greater magnitude than the improvement for those meant to be in the system, who don't need to crack into each database. Government claims that it will be secure are hardly credible after endless lapses in recent years.

Beyond that, government agencies have a track record of creating powers supposedly needed to tackle serious crime and then allowing them to be used to snoop on ordinary people, for extended periods, for inadequate reasons. Tim Aker, our grassroots co-ordinator, provided one example:

"The Regulation of Investigative Powers Act 2000 was introduced on the grounds that it would boost national security. Poole Council, being a creative sort, went well over their remit by using the powers to snoop on families. They monitored this unnamed family for three weeks, with intentions to stop them sending their children to a good school if they lived outside the catchment area."

You should fear the invasions of privacy this measure will facilitate even if you haven't done anything wrong and don't think that the Ed Balls is going to develop a penchant for the goose step any time soon. After all, it's all in the database:

Finally, this is almost certain to be wildly expensive. If you look through the projects listed in our report (PDF) on big government project overruns you'll see that many of the most troublesome, like the NHS National Programme for IT, are those that try to stitch together a lot of incompatible IT schemes. It tends to become a very complex and lengthy process as so many different organisations need to contribute. The Internet Service Providers and other companies involved have not created these systems with combining them in mind. There is every possibility this will become a wildly expensive project.

This new database will be vulnerable to abuse, encourage and enable snooping by officials and is quite likely to cost us a fortune. It should be abandoned.

Cross-posted from the TaxPayers' Alliance blog.

One year at the TPA

This article was first posted on ConservativeHome's Platform.

I’ve been at the TaxPayers’ Alliance a year; I’m a year into my first serious job. It seems a good time to take stock and think about what that work is for. What is the role and function of the TPA?

Of course, there is a simple answer to that question: to campaign for lower taxes and public sector reform. However, I think that such a simple answer misses the deeper problem that the TPA addresses. The case for low taxes, and for the government to do less, isn’t just one more conflicting priority that must be lobbied and advocated for. Campaigning for low taxes requires us to confront the fundamental logic of how a democracy operates.

Mancur Olson, in a landmark work of political theory, set out the Logic of Collective Action in the mid-sixties. An understanding of his thinking is vital to understanding how the modern British state functions. He explained how a minority could effectively dominate a majority.

Any individual has a powerful incentive to free-ride on the efforts of the rest of any group providing public goods. While someone may want lower taxes they have every incentive to leave the political effort required to get tax cuts to others. The results of their effort, or slacking, will be diluted across all those with an interest in low taxes. It will not be in their interests to put the socially optimum amount of effort into securing tax cuts.

Successful societies evolve ways of encouraging people to act in the common good. However, it is harder for large groups to do so. It is easy to encourage six people to act in their common interest by personally appealing to their sense of duty, tradition, loyalty or shame. It is far harder to do the same for a group of sixty million.

Beyond that, in a large group each individual person will usually have less of a stake in a given decision than the members of a small group will. Suppose the British government were to decide to give £3 million a year from general taxation to the 125 residents of the isle of Iona, off the Western edge of Scotland. The islanders would each receive £24,000 a year. That would make a pretty substantial difference to their standard of living. People will definitely turn out to vote in droves to be given £24,000. By contrast, each taxpaying household would face a bill of about 12p a year. Who is going to change their vote for the sake of 12p?

I actually think that it takes about £2.5 billion – if it is paid for from general taxation - for a fiscal decision to become a real live political issue. At £100 a year, £2 a week or half of one percent of median gross income, people start to care. Anything smaller than that and you are no longer appealing to peoples’ concern at how their money is being used and can only really get them interested by finding some lunacy, perversity or corruption that is important or interesting despite the amount at issue being relatively minor. What so many people describe as apathy in the face of significant fiscal decisions is actually rooted in a rational decision to accord little importance to decisions that, in each case, have such a small impact on the well-being of each taxpayer.

£2.5 billion is a lot of money. It is more than the budget for the Foreign and Commonwealth Office. It is a real problem if a numerically tiny group can so easily extract, say, £1 billion as they have every reason to invest huge effort in presenting the benefits of their billion pound scheme and no one really cares about the cost.

Politicians are faced with hundreds of groups each claiming a vital need for a billion here, a billion there and it all adds up to a colossal, and increasing, tax burden far larger than the socially optimal amount. The political logic becomes simple: Group X won’t vote for us if we don’t give them taxpayers’ money. Taxpayers won’t change their votes for a few pennies each a week. Give X the money. This is repeated for group after group demanding taxpayer cash until people have little income of their own left, the economy is crippled and we are all less free.

Popular outrage at each overly eager use of their pocketbook is further weakened by a lack of transparency that means it is next to impossible to fully understand where taxpayers’ money actually goes – Group X gets their cash and no one but the politicians, civil servants and those directly involved ever hears about it. That’s the main purpose of the quangos that disperse so much taxpayer money with pretty much zero accountability.

There is no single ‘answer’ to the problem posed by Olson’s Logic of Collective Action. Olson himself came pretty close to claiming that only totalitarian revolution and then losing a war could clear the cobwebs of special interests out. I wouldn’t be as fatalistic as Olson though. It clearly is possible for political entrepreneurs to change things. He didn’t predict Thatcher’s successful challenging of union power, for example.

A vital, long-term, reform which would improve matters would be to decentralise and, thereby, decrease the scale of government decisions. If we make decisions on a smaller scale then the majority who need to be mobilised will be smaller and each member of that majority will be more interested in the outcome. If the difference in size between a minority who benefits from a fiscal decision and the majority who pay the bill falls then all of the problems discussed above become less severe. That is why the TaxPayers’ Alliance should always have a respect for localism in its bones.

However, localism cannot ‘solve’ the issue. Most local politics takes place with constituencies of tens or hundreds of thousands. The difference in size between a minority and majority can clearly still be very significant. The disparities that create the Logic of Collective Action can still exist in small democracies, even though they will be less marked than in large ones. Beyond that, few localists plan on abolishing central government and the Logic of Collective Action could easily lead a shrunken central government to grow again.

One thing we’re told a lot by groups who feel slighted by our research attacking their claim to public support for themselves or their cause is “well, I’m a taxpayer”. Indeed, most people are both taxpayers and, in some way, recipients of taxpayer funds. When I get my pay packet or buy something I’m a taxpayer. When I enjoy a painting at the National Gallery I’m a happy beneficiary of public generosity. The TaxPayers’ Alliance speaks not for a clearly identifiable group of ‘taxpayers’ but for the taxpayer in all of us. We speak for the cause of leaving as many pounds in peoples pockets as possible.

Our work is essential as we can help better mobilise the majority, on each individual issue, that has to pay for each government scheme. By making it easier, more rewarding and more obviously necessary for people to look at and take account of the cost to taxpayers of spending on each item we will make it less likely that the Logic of Collective Action will lead to the wrong decision being made. We make wasting each £1 billion a politically bigger deal.

It requires a thick skin. When people are told that their, often quite reasonable, particular pet use for taxpayers’ money – whether higher doctor’s salaries, more wind turbines, increased museum subsidies or anything else – may not represent good value it is understandable that they sometimes take it poorly. It also requires willpower as trying to fight against the very logic of collective action is quite a challenge.

However, the work is essential to our future prosperity and the defence of the basic freedom of ordinary people to spend a good portion of their money as they see fit. The TaxPayers’ Alliance needs to be eternally vigilant if economic liberty is to survive.

The Japanese Mob

This article, via Marginal Revolution, is fascinating.

DonaldS and abortion politics

There is a deep irony to the comment DonaldS left on my last post. His major contribution, before that, to the debate has been to attack politicians for failing to engage with the issue. He argues that politicians avoid it because the issue is to complex to "tabloidize". That isn't it at all. Politicians sound off on energy policy, for example, all the time despite the fact that it is ludicrously complex. Complexity may cause politicians to get an issue wrong but it won't stop them talking about it.

The reason most people whose minds aren't made up about the issue avoid talking about it is that no one who does care about abortion seems capable of having a reasonable conversation about it. Nadine Dorries may be guilty of all manner of sins. That doesn't mean that there is any real point to Liberal Conspiracy's group hate. They are free to do as they will with their blog but if they seriously think it will achieve much, beyond putting a few moderates off the debate entirely, they are mistaken. Donald's snipey response to my post is an example of how this debate is had in a manner that guarantees most ordinary people and politicians will avoid it.

So, to his arguments:

"So, by chopping the date back on the basis of no new medical evidence [his emphasis]"

He's missing the point: As I set out, I don't think that viability is relevant to whether a fetus is deserving of rights or not so neither the old nor the new medical evidence is particularly relevant to my position.

"A tiny fraction of abortions are carried out between 20 and 24 weeks, almost always for reasons of late-discovered abnormality, where the woman doesn't understand what's happening (very young, so doesn't understand she's pregnant; mentally impaired, so ditto; etc.), where a partner has become abusive, and so on."

Okay, so the provision for abortions up to 24 weeks is for exceptional circumstances?

From the Department of Health's abortion statistics it appears there were 2,948 abortions after 20 weeks gestation in 2006. That's pretty high for exceptional circumstances. However, I see no reason we shouldn't make an exception when exceptional circumstances do come up.

It would seem sensible that we can take account of these circumstances with the kind of compromise I discussed in my last post. If we were to move towards a significantly tighter limit, possibly well below twenty weeks but remove obstructions like the two doctor rule below that limit and create a rule to allow abortions in exceptional circumstances above the new limit we would move to a system like the one they have in the rest of Europe. We would have a system where only early or exceptional abortions would take place which might reassure the large number of people (probably a majority) who find abortions above twenty weeks distasteful but would also allow for people in exceptional circumstances.

Abortion uncertainties

I'm really grateful to Chris for writing about the subject of abortion. I've generally steered clear of it due to the strong emotions the subject provokes (even compared to this blog's normal topics). It's nice to know that I'm not the only confused moderate in the debate.

There are a few themes I'd like to cover:

Chris's points

I'm not sure either of these are capable of settling the issue:

"One is simple empiricism. Many women who miscarry feel something like bereavement, which suggests they regard a foetus as something like a living being - not as much so as an actual child, perhaps, but certainly more than just a bundle of cells."

Two points here:

1. I have no desire at all to, in any way, play down the trauma of a miscarriage. I entirely believe it is about as tragic a thing as can happen to a person. However, I would think that people find it incredibly upsetting to lose their ability to have a child as well. Without entering into the ugly process of comparing grief it seems plausible that those who suffer a miscarriage mourn the loss of an expected child rather than the death of the fetus itself.
2. If we are to decide the value of a foetus based on some people's subjective upset at losing one then we have to accept that the argument cuts both ways. Those fetuses that are not valued (those that the mother wishes to abort) have no value.

"The other is that a foetus can be regarded as a call option upon a human being. If human beings are valuable, an option on them must also have value - though again, less than that of a full human."

I'm not quite sure on this one. After all, every sperm has some potential to become a human. Valuing such potentials seems so complex that I'm not sure it can translate to abortion policy. Does the "value" of a fetus translate to the 'on'/'off' quality of inalienable human rights? If not, how do we translate such values to policy?

I have a friend who thinks abortion should be taxed. Is that the logical conclusion of Chris's position? It's an interesting moderate stance.

The campaigns

The extremism with which both sides express themselves, their mutual loathing for each other, is offputting. However, I'm always loathe to condemn those who feel certain about the issue. After all, one group believe that their opponents are endorsing rape, the other that their opponents are legitimising murder. If you hold either belief it seems understandable to get pretty angry about it.

However, what does surprise me is that the pro-choice camp, in particular, don't seem to be trying very hard to appeal to the median voter. The one thing I want to know is this: what use do people have for a post-20 weeks abortion?

I mean, it seems quite plausible that people will make the decision at a pace such that they're pretty much evenly likely to get in trouble and miss the deadline whenever it is set. They'll respond rationally to the deadline.

This seems like such a basic question but I've yet to find an answer. When I click for 'More Information' on the Coalition for Choice website all it gives me is a list of things they want. Nothing about why.

On the other side, I guess the pictures of fetuses that the pro-life movement use are effective but I find them distasteful. They're too similar to the pictures of animals that the animal rights movement uses. Trying to play on simple visual cues that have no deeper meaning. It strikes me as crass.

I'm the median voter on this issue but, of all the countless articles I've read, not more than a handful seem to be appealing to people like me who are uncertain - the vast majority seem to be out to get their own side angrier instead.

The crux of the issue

I really don't think this debate can effectively be settled without answering two simple, but also impossible, questions: What quality makes a human worth the unique protection of basic rights? When does a fetus develop that quality?

I can't believe that a woman has a right to choose to kill a baby. However, I think they absolutely have the right to choose whether or not to keep a fetus. That's the divide. Plain and so far from simple.

I don't believe anyone really has an answer to the first or second questions. The first must, I'm sure, have something to do with the mind; with our status as thinking beings. The second cannot be answered with so fuzzy an answer to the first. All I'm really confident of is that it happens at some point between conception and birth.

Until recently I was of the opinion that with so little certainty the best solution was simply to defend the status quo. Not because I think viability is even particularly important but just for stability's sake. On simple conservative grounds that poorly thought out change tends to make things worse.

Where I am right now

You know the argument that most convinced me?

This one. While I don't know when a fetus becomes a baby, I'd rather err on the side of caution and not have the most liberal limit in Europe. As such, I'd support tightening the limit, I think.

Here's a balance though; what if we tightened the limit and also removed the two doctor rule? That way we'd remove the unpleasantly arbitrary quality of the current system. That would seem like a decent way for both sides to take something from the present process.

The persistence of American power

Will Hutton's article today is excellent (another one on Comment is Free, I'm not sure what's happening today). He explains why the US will remain an economic leader. Traditions of argument and institutions of learning make it a natural leader in "a world where the deployment of knowledge, brain power and problem-solving are the sources of wealth generation."

There are two reasons, that come to mind, why non-Western countries have such a hard time keeping up:

1) Cultural differences

There is something about the Western individualist, adversarial tradition that is particularly productive. Frank and competitive exchanges of views produce the goods. From what I've seen such exchanges are a particularly important part of public, and indeed private, life in the West. To the extent they become a part of other countries' public life it is often associated with Westernisation.

2) Network effects

Good academics like to study with other good academics. Being around others makes it easier for them to establish a reputation (important if you want to advance your career) and bounce ideas of colleagues. That means that an established academic centre can attract new staff far more easily than a new one.

Jay Rayner on Gordon Ramsay

Brilliant attack on Gordon Ramsay's food fascism from Jay Rayner on Comment is Free:

"Indeed, let me confess. I love strawberries in season. I really do think they are better. But I have also eaten mediocre strawberries in winter and enjoyed them. And doing so didn't make me feel like a terribly bad person. So shoot me."

My speech on British environmental policy

The Heartland Institute have posted up an audio file (MP3, 20.4MB) of my speech in New York on British environmental policy. At times it gets a little hurried but we'll put that down to fitting a twenty minute speech into fifteen minutes rather than nervousness!

Otherwise I'm pretty pleased that I got the right balance between hitting important points and having a bit of fun at the expense of Britain's crazy green politics.

Scottish Independence

I'm currently trying to work out if this article is a satire that I don't 'get' or a breathtaking inane waste of space in the Telegraph's Comment section that could have been better used. Still, the fate of the Union is a topic worth returning to.

I'll go over the politics and then the issues - the money and the intangible benefits Scotland takes from the Union.

The politics

The SNP are playing an absolute blinder. Some promises such as subsidising first time buyers and paying off student debt have been abandoned but between freezing council tax and boosting police numbers they've got two tangible and very popular measures in place. Not bad for a minority administration in relatively tough times.

The Scottish Tories are doing alright as well, they handled the budget effectively, but they're a bit player in a fight between the SNP and Scottish Labour in a country with little appetite for Conservative leadership. The Labourites are losing that fight so badly it is embarassing.

In that context, Wendy Alexander's call for a Scottish independence referendum now makes some sense. She shifts the question from "would you rather have the SNP or Labour governing Scotland" to "do you want Scotland to become independent. The Union is currently a lot more popular than Labour so shifting the question in that way could improve her position. While it is always possible that Scottish Labour could screw up a Unionist campaign so badly the Nats win it might well be a risk worth taking to fight an independence referendum now rather than a few years down the line with a Tory government at Westminster and the SNP even more popular.

The money

I don't think the money is as big a deal as people make out.

From the English perspective, the pattern of regional fiscal transfers wouldn't change much if Scotland dissapeared. At the moment the Greater South East sends about 8 per cent of its regional GVA to the rest of the country. Everyone else, to a greater or lesser extent, comes out better off.

If Scotland were removed from the picture then there would be a bit more money to either leave with the South or slosh around the other regions but, in the grand scheme of things, not much would change. Things could even get worse if the Scottish subsidy was simply reallocated to the North of England and increased the extent of all the problems that an excessively large state already creates for the Northern private sector. There are only two ways of significantly reducing harmful (PDF, pages 9-25) regional dependency:

1) The wrong way - start winning seats as the Southern League (you would do ten times as well as the UKIP et. al.).

2) The right way - shrink and decentralise the state.

From the Scottish perspective the money is rather more important fiscally. Even if Scotland takes 90 per cent of North Sea oil revenues (as they probably would) they'll lose around 2.4 per cent of their GVA with independence. That's a lot of money and, combined with transition costs building a new state, will mean the Scots are seriously worse off in the years following independence.

However, that isn't the end of the story. When the Scots try to recover their economic position it seems entirely probable that the first country they'll look to learn from is Ireland. It is the obvious parallel as a former component of the United Kingdom and has been astonishingly successful. As Matthew Elliott, TPA Chief Executive, noted in his opinion piece for City Am yesterday:

"In 1993 Ireland was significantly poorer than the United Kingdom, with income per capita 28% higher in the UK. Its economy then took off, with average real terms economic growth between 1994 and 2006 of 7.4%. In contrast, the UK managed just 2.9% real terms growth in the same period. Today the Irish enjoy income per capita 20% higher than we do in the UK."

If the Scots can replicate that they won't be shedding too many tears over their lost Southern subsidy. In the end, the best way for a region to get rich isn't, thankfully, to try and extract a subsidy from wealthier regions. As an article by Benjamin Powell for the Cato Institute establishes, EU subsidies did little for Irish economic growth. As a result, I don't think the Scots should want to stay a part of the UK just so that they can hold onto subsidies from the South.

It is unfortunate and innapropriate that a debate that should be about national destiny is, so often, fought over the fools gold of state subsidy.

The intangibles

As I've set out before, I think that conservatives should be sad at the passing of a state with the history of the United Kingdom and sceptical that we can do better replacing it with something new.

However, I think it is the Scots, in particular, who would lose out from the United Kingdom being broken up. They would lose a grand stage. At the moment an ambitious Scot (and they're not all dismal Scottish Labour politicians) in business, politics or the arts has a domestic "market" that includes a population of 60 million and an international centre in London. Scottish Independence would make all that "abroad". The intangible, psychological effect would, I think, do damage to the ambition and prospects for greatness of all Scots.

Would Adam Smith have left the same legacy to history if he had not lived in the same country as the government of a great empire that could promote or enforce free trade, in particular, around the world?

So many talented Scots head South to make their mark. Any list of Scottish people who have gone on to great things would, I think, find few of them living in Scotland. That process isn't an accident. It is, I think, pretty common for small communities that their best and brightest must go elsewhere to explore their full potential. The same is true of small towns in the South East - people move to London to make it big. It only becomes a 'loss' to the Scottish nation with independence - when someone moving to London is moving abroad.

Sod off Ramsay

I don't like coffee. The bitterness just doesn't appeal and I've never enjoyed it. Normally, coffee has to be flown in from abroad. I think coffee should be banned.

"Not only [do other drinks] taste better, but it also helps to cut carbon emissions by reducing the number of miles needed to transport [it]."

I walk in to work. If there were no cars around it would be quieter for me. Walking to work might cut carbon emissions. Ban cars.

"Not only [is walking more pleasant], but it also helps to cut carbon emissions by reducing the number of miles [we drive]."

It's quite simple really. Combine an arrogant willingness to impose the choices you prefer, or find convenient, on everyone else for no good reason with an appeal to the global warming omni-justification and you can justify banning anything you vaguely dislike. Gordon Ramsay's call to ban out-of-season produce is illiberal nonsense.

...without a paddle

This, from the Sun, illustrates an important PR lesson:

I'm pretty certain the message most people will take from this isn't "the planet is in trouble, it's warming!" They'll think "these greens are completely batty!"

If you're going to try and communicate with a broad audience don't rely on implicit cues that are obvious to you but won't be to them. You might wind up sending a very different message to the one you meant to.

Drinking on the tube

Really bad reason to oppose Boris's ban on drinking on the tube

From Dave:

"Mayor Johnson, as we know, opposed the smoking ban. His voting history on the issue can be found on TheyWorkForYou.com. The noxious fumes produced by the evil weed were not, it would seem, enough in Mr Johnson’s opinion to warrant an
intrusion on people’s liberty and bar and pub workers would have to lump it; they could, of course, choose to be out of a job at any time if their health was such a big issue.

At Old Street station, there is a sign up announcing that alcohol will be banned from the first of June on public transport. The occasional drunken idiot is now more of a threat than smoking, which the World Health Organisation considers to be behind 26% of male deaths and 9% of female deaths in the developed world."

There is no hypocrisy here. The justification for Boris' ban on alcohol is that it leads to drunks on the tube threatening other people. When that happens the Millian sphere has been violated.


Therefore, the proper comparison isn't deaths from smoking but deaths from passive smoking. Those World Health Organisation figures are entirely irrelevant to this debate. The evidence for the dangers of passive smoking is very weak - see Richard North & Christopher Booker's impeccably sourced book for the full story of how weak.

Really good reason to oppose Boris's ban on drinking on the tube

From DK:

"I gave the example of consuming one beer on the way home; it was very pleasant, since from Southfields to Earl's Court is, like 55% of the Tube, not actually underground. The sun was streaming through the windows, the carriage was about only about half full, my Private Eye was interesting, and the gentle rocking of the train was complemented by my lovely bottle of cool ale.

The ale was all the more welcome since my colleague, who gives me a lift from Ockham to Southfields, needed to drop into the supermarket (where I had bought my beer) to buy his week's supplies and I didn't even get onto the Tube until nearly seven in the evening. With an hour on the Tube ahead of me, the beer really appealed."

I fail to see how banning drinking is easier than banning drunk and disorderly behaviour. Stick to banning drunk and disorderly behaviour. If you do so you'll allow a lot of people a little pleasure having a quiet drink on their way home. Those are the small happinesses that we lose to illiberalism.

Less fuel, less noise

This is the kind of innovation that can really solve problems like noise over the West of London and other urban centres and the huge amount of fuel aviation burns:

It is a creation of universities and private industry. No need for a tax as the rising price of fuel, the private market's response to scarcity, ensures innovation in response. Ordinary jets are becoming more efficient and this concept illustrates just how much more efficient planes can become.

Monbiot's approach to air travel is thoroughly silly:

"While a large commercial airliner cruises at about 900 kilometres per hour, the maximum speed of an airship is roughly 150kph. At an average speed of 130kph, the journey from London to New York would take 43 hours. Airships are more sensitive to wind than aeroplanes, which means that flights are more likely to be delayed."

Utterly unrealistic and not remotely justified by the harms identified by, for example, the IPCC. The only redeeming thing about the article is its brilliant self-parody of a headline:

If there is a God, he's not green. Otherwise airships would take off

...and there I was worshipping the Jolly Green Giant. Perhaps Monbiot is right, his failure to provide suitable blimps does make all the tasty sweetcorn a bit of a hollow pleasure.

The "there will be more scrutiny" conventional wisdom

Andrew Rawnsley repeats the argument put forward by several Labour ministers, that the silver lining for Labour with their dismal election results will be that Tory policy will now face more scrutiny. That's lunacy. One of the biggest problems that the Conservatives have faced for a number of years is that they can't get the public to listen to their policies. That policies become unpopular as soon as they are identified as those of the Conservative Party. If their policies are now taken seriously and subjected to scrutiny that offers them the opportunity to set out a platform for government.

Beyond that, there is good evidence that the more the Tories are in the news the better they do (this is discussed frequently by Mike Smithson). Of course, there are risks for the Tories. If they screw up, as they clearly did with the Quality of Life Policy Group report, then they'll have more to lose and are more likely to be found out. However, unless they never want to form a government this is an upping of the ante that the Conservatives have to be happy about. While things clearly could go wrong and Labour could be offered a way out of their current predicatement, this isn't much of a silver lining for them.