jamescalumcampbell

March 13^th 2016.  Lord’s Day – as Pepys would say.  To Dunblane Cathedral.  Nothing special about that.  I always go if I’m within coo-wee (Kiwi expression).  Well, something special after all.  It is twenty years, to the day, since the Dunblane massacre.

The town was not taking any official notice of the day.  Yet I can hardly think it coincidental that the cathedral was packed.  The minister did make a short, dignified statement, culminating in a two minute silence.  And the organist, a master musician, played, on the magnificent Flentrop organ, the Passacaglia and Fugue in C minor, by J S Bach.

After the Dunblane massacre, the UK introduced some of the strictest gun control laws in the western world.  Have they worked?  It’s an impossible question.  All one can say is, with the occasional setback, so far, so good.  Today, in Scotland, firearms account for just 2% of all homicides.  In the USA, they account for about 70% .There, there are over 300 million firearms; 8,855 people were shot dead in 2012.  Thanks to The Sunday Herald for these statistics.

Something else caught my eye in the papers this week.  In yesterday’s National, there was a brief report that on Thursday a 77 year old Glasgow pensioner had been arrested for lying down on the road in front of a convoy conveying nuclear warheads through central Scotland.  This is Brian Quail.  Mr Quail is well known to readers of The Herald because he writes letters of the utmost eloquence on the imperative necessity that we get rid of Trident.  I take my hat off to Mr Quail, a man who does not merely express his opinion, but who lives it out.  He reminds me of the man who stood in front of the tank on Tiananmen Square.  I find it ironic that he has been charged with “breach of the peace”.

Mr Obama is tearing his hair out because he cannot persuade the American people that the National Rifle Association has got it all wrong.  Meanwhile here in Scotland the notion of having a population that is essentially disarmed is generally acceptable to all.  Should we not take this further, and not merely ban handguns, but ban the bomb?  Mr Quail thinks so, but for the most part he is a lone voice in the wilderness.  The current government policy (Westminster government, Defence being a reserved matter) is that Trident be renewed for the next 50 years at a cost variously estimated at between 100 billion and 160 billion pounds.  The argument is that nuclear “deterrence” has kept the peace now for over 70 years.  Campaigners for unilateral nuclear disarmament are characterised as being well-meaning but hopelessly naïve, and ultimately dangerous.

Yet little is said about the dangers of having these hellish contraptions on our doorstep.  I have no doubt that people of less noble intent than Mr Quail will have read the report in The National, and thought, well, if a 77 year old Glasgow pensioner can stop a nuclear convoy that easily…

It’s a catastrophe waiting to happen.

 

I picked up a hardback copy, in good nick, of Bernard Levin’s “The Pendulum Years: Britain in the Sixties” (Cape, 1970) in a second hand bookshop in Whangarei, NZ.  I can’t walk past these great, shambling, labyrinthine shops stacked floor to ceiling with fusty old books as if by some sufferer of Diogenes Syndrome.  I’m looking for two items – a hardback Casino Royale and a hardback Moonraker, to complete my Fleming collection.  I didn’t find them.  But you know how it is; you spend so long in the shop that it becomes an embarrassment if you don’t buy something.  Hence, The Pendulum Years.  You know you’ve got a problem if you buy a book you’ve already read.  But I thought it worth the revisit.  How perverse, to cross half the world and then read about a place 12,000 miles and fifty years away.  I was curious to know if Levin’s thesis had stood the test of time, that the sixties in Britain were characterised by a tension between the pull towards the future and the pull towards the past.

It’s an enjoyable read.  I always admired Levin’s outspoken journalism.  Yet I found myself to be more critical on this reread.  The title of the book is misleading.  I doubt if its preoccupations were the preoccupations of most of the inhabitants of these islands at the time.  A more accurate title would be, “The Pendulum Years: Metropolitan London in the Sixties”.  Then I found myself irritated by the tone; everything is described with an air of supercilious above-the-battle ironic detachment.  No wonder somebody threw a punch at Levin, live on air on That was The Week That Was.

  Yet some of the chapters are spellbinding.  Vassall, the Profumo affair, Churchill’s funeral.  I’d single out Wives and Servants, Levin’s description of the prosecution of Lady C under The Obscene Publications Act.  Levin sat through all six days of the trial, a feat of endurance in itself.  His account is brilliant, and very funny.  The chapter well exemplifies Levin’s theme of past v future.  It is hard to imagine from our current perspective that Lady Chatterley’s Lover might have continued to be suppressed.  Levin’s notion is that change in the sixties was unstoppable, that a nostalgic longing for Britain past, real or imagined, was futile.

But then there are lacunae.  Science is the obvious one.  It was after all in 1962 that F R Leavis, in his Richmond Lecture launched his vicious attack on C P Snow following Snow’s 1959 Rede Lecture on “The Two Cultures”.  There really was a tension between the roles of science and the arts in the sixties.  Mr Wilson wanted to re-forge Britain’s greatness amid “the white heat of technology”, but little of this gets a mention.  And occasionally Levin is just plain wrong.  He thought the Beatles’ output would be ephemeral!

If Levin never became “establishment”, he mellowed, as perhaps most enfants terribles do.  My favourite of his books is Enthusiasms, in which he ditches his Vanity Fair view of human affairs and exalts his great passions, from music to Shakespeare to friendship even to the life spiritual, with – well – an enthusiasm that is unalloyed.

As for final judgment on The Pendulum Years, I’m not so sure even after all these years that Britain, the country I flew back into on March 1^st, in some respects has changed so very much.  There have been 53 Prime ministers since Robert Walpole.  More than a third of them were educated at Eton, including the present incumbent.  The first duty of the establishment is to perpetuate itself.  At this, for better or for worse, Britain has proved extraordinarily successful.

Auckland has a problem.

Start with the traffic. Wedged as it is in a narrow isthmus between the Waitemata and Manukau Harbours, Auckland cannot be bypassed. If you have the misfortune to have to travel through Auckland in a week day late afternoon, you will join a traffic jam, a crawling nose-to-tail procession stretching from Sunset Road in the north to the Bombay Hills in the south, that is literally 100 kilometres long.

Greater Auckland accounts for over 50% of New Zealand’s population growth in the past decade. Housing and transport have struggled to keep up. Housing prices in central Auckland have sky-rocketed, so that people obliged to work in Auckland cannot afford to live there. Instead, they live in a satellite town like Papakura in the south, and commute. There is no substantial public transport system, so they drive.

Auckland Harbour Bridge has always been a bottleneck. When I lived on Auckland’s North Shore towards the end of last century, and worked in Middlemore Hospital in South Auckland, I would get over the bridge before 7 am, or I’d be sunk. Now, it’s 6 am. Traffic in Auckland has moved from the farcical to the surreal. There has been talk of a second harbour bridge, or a tunnel, but word on the street is there is no money. Personally I would favour greater investment in public transport; cars and cities don’t really mix.

But the traffic problem is merely symptomatic of a deeper malaise. It has been niggling away at me all through February while I’ve been here. I can best characterise it by contrasting a night I spent in NZ’s northland with a night in Auckland. I was in Waipapakauri on Ninety Mile Beach (where, incidentally, Alastair Cameron-Strange lived when he was a child). I came down the west coast and crossed the ferry to Rawene to meet a dear friend. I lost track of time and had an unscheduled stop in Rawene in the Old Postmaster’s House, a B & B of charm and character. My host gave me a door key and the run of the place.

Later, I had a similar unscheduled stop in downtown Auckland. I try to avoid the swanky hotels in the CBD, but I chose a brand new place in Britomart, handy for the occasion. It was the absolute antithesis to the Old Postmaster’s House. Security was tight to the point of paranoia. Yes I could park my car in the catacomb beneath the hotel. My “passport” was 124. I asked, “Is that the number of the parking bay?” The unsmiling man at the desk was implacable. “Your passport is 124.” It turned out to be the number of the parking bay. When I eventually got in, and ascended to the hotel proper, I laughed out loud. The interior resembled a penitentiary, an atrium with tiered galleries of prison cells. I was a bit player in The Shawshank Redemption. It started to rain and I noticed the roof leaked really badly. Not so; there was no roof. I retired to my “apartment”.

Funny word, “apartment”, but apposite. To stay in an hotel like this is truly to be “apart”. You are not going to meet fellow inmates for breakfast, exchange confidences and, as in Rawene, get an invite to Switzerland. Rather, you are in solitary confinement. The “apartment” was brand spanking new, beautiful after the manner of a supermodel’s sullen hauteur, and utterly sterile. If I slept well it was because I was exhausted.

In the morning I had difficulty breaking out. I eschewed the lifts and then got lost in a labyrinth of corridors leading to the hotel laundry, or to a door beyond which the world outside tantalised me, but which I could not open. I might have been in Kolditz.

I think I’ve had it with posh hotels. Miserable places. It is easier for a camel to pass through the eye of a needle than for a rich man to enter the kingdom of heaven. I went out on to Queen Street and sat down on the pavement and played chess with a seven year old Indian kid trying to raise money to play in a chess championship. He beat me hollow.

Twice.

Looks like I’ll be voting in two referenda before 2016 is half over. The first, in March, will ask, “What is your choice for the New Zealand flag?” Then in June, should the United Kingdom remain a member of the European Union?

Yesterday as I was driving over Auckland Harbour Bridge, a New Zealand environmentalist on the radio was talking about the link between global warming and obesity. It had not occurred to me that such a link existed.   His thesis was that both are linked to consumerism. We grow fat, and discharge tonnes of carbon dioxide into the atmosphere, as a result of the driving forces of our economic systems. I fell to wondering if there might be a similar hidden connection between the forthcoming referenda, and if they might share a common theme.

I’m not sure what the driving force was for the “Flag Consideration Project”. It may be that many New Zealanders now consider the inclusion of the British flag in the top left corner (the “canton” or “upper hoist quarter”) to be purely historic and sentimental. But there isn’t a huge appetite for Republicanism currently in New Zealand. A more likely explanation is that New Zealanders wish to be distinguished from Australians. Many people – perhaps most people – cannot tell the flags apart. For the record, the incumbent flag of New Zealand is a blue ensign defaced with four stars of the Crux Australis in red, outlined in white. The Australian… well, it has six stars.

Anyway the process is well underway. From a total of 10,292 designs, the Flag Consideration Panel longlisted 40, then shortlisted 5.   (Vexillologists may be relieved to know that the “Modern Hundertwasser” design was excluded for copyright reasons.) These were put to the public vote in a postal referendum last November-December. The turnout was 48.78%, perhaps indicating a certain voter apathy. In the absence of an overall majority, the flags with the least votes were sequentially disqualified until, on the fourth iteration, a design by Kyle Lockwood was chosen. This will now compete with the current flag in the second, and final, referendum.

You can see both flags flapping lazily on the Auckland Harbour Bridge high above the Waitemata, apparently quite happy in each other’s company. Driving past them, I wondered, no doubt unfairly, whether Kyle Lockwood might be a committee, and his flag a “camel”, that is, a horse designed by a committee. The Southern Cross on its blue background remains, the Union Jack goes, to be replaced by a triangular area in pure black (Kiwi sporting colour), these two being separated by the iconographic New Zealand silver fern.

If I were a betting man I’d wager that the status quo will win the day in March. I just don’t detect any passion for change. Indeed, the only passion in evidence comes from the veterans’ lobby who regard the timing of the referendum, 100 years after Gallipoli, as extremely distasteful.

And what of June? Down in this remote sliver of land in the South Pacific I read in to-day’s New Zealand Herald that the London mayor was still swithering, but it was very nice to get a phone call from Blighty this morning while I was strolling round the delightful Hatea Loop around Whangarei’s Hatea River. I gather that Boris is for Brexit. The next 100 days are going to be interesting.

You might say that the Eurosceptic view of Britain’s place in the European Union is that it resembles the incumbent flag of New Zealand, in which the Union Flag has been marginalised to one corner of the frame. It is an issue of sovereignty. Eurosceptics are fearful that, in due course and by stealth, the sovereignty of the UK will be removed from the frame altogether. Campaigners to stay in Europe say that this is nonsense and that, while the EU has its faults, it is a far more democratic institution than it is often purported to be. Economic arguments are deployed to suggest that Britain will be marginalised and her influence diminished, not by staying in, but by leaving.

Well, we’ll just have to wait and see. I think I know how I’m going to vote in March, but as for June, and has for which way it will go, I haven’t a clue.

St Valentine’s Day. To Auckland Town Hall with dear friends to hear Bach Musica NZ play a Valentine’s Concert of Mozart, Faure, Bizet, Tchaikovsky, Rossini, Elgar, Puccini, Mascagni, Lehar, et al. Beautiful music in a beautiful venue of a beautiful evening. Mezzo-soprano Kayla Collingwood and tenor Derek Hill were splendid, and I thought the Bach Musica Chorus were outstanding. There were also some remarkable players in the orchestra and I was greatly struck by the low pitched flute solo in Faure’s Pavane, and the harp cadenza in the Waltz of the Flowers from the Nutcracker.

I confess I had an ulterior motive in attending this concert. I wrote the draft sequel to “Click, Double-Click”, at speed, towards the end of last year, and shortly afterwards disappeared into the southern hemisphere. In this sequel, the troubled Dr Alastair Cameron-Strange flies to New Zealand and, although it wasn’t my principal reason for making the trip, I wanted to visit the venues he visited, to recreate a sense of them. He sat upstairs in Auckland Town Hall to listen to his twin sister play her viola. I might have sat in the same seat as him. I half expected MacKenzie, with her long dark hair and flashing cobalt eyes, to emerge on to the platform in a black and gold gown with her – can it be? – Archinto Stradivari, and render her own transcription of the Stravinsky 3 pieces for clarinet. I told my friends this, and they told me I was living in an alternative universe.

To Lake Gnatu, Cape Reinga, and Te Paki stream in the remote north, half expecting to see ACS’ mirage shimmering in the heat haze on the edge of the huge sand dunes at Ninety Mile Beach. He is everywhere. The only place I can escape him is in the Emergency Department of Middlemore Hospital in South Auckland. He went home to get a job there, but somehow something keeps coming up and frankly I doubt if he is ever going to take up the offer.

Middlemore ED sees between 350 and 400 patients every day, something like 135,000 patients per annum. That’s very busy, and very hard work. Yet, today, everybody was smiling. In England, no one is smiling. I gather that since I departed the UK, the English “junior doctors” (sic) have been on strike again, and Health Secretary Jeremy Hunt has imposed a contract on them that they don’t want. (Incidentally, why are the doctors “junior”? Have you ever heard of a junior policeman? A junior teacher? A junior lawyer? They are, after all, qualified doctors. I think we should dump the “junior” terminology.)

Why are New Zealand doctors happy and British doctors sad? Is it the climate? Is it the fact that Middlemore Emergency Department has 22 consultants, 18 emergency medicine specialist registrars, and 15 more full time equivalent doctors available? (Altogether different ballpark, you see.) Well, all of that helps. But mostly it’s because people here have a sense of personal worth. They feel of value because they know they are valued. Disadvantaged South Auckland has always posed Middlemore huge challenges in health care delivery, yet people rise to the challenge because of a sense of purpose and therefore of commitment.

And yet I have a horrible feeling that ACS, sitting there in a reverie in the Auckland Town Hall listening to the elegiac third movement of the Bax Viola Sonata, is going to go back to the UK.

For pity’s sake, why?

On February 4^th, in Auckland, the representatives of twelve countries signed the Transpacific Partnership Agreement (TPPA) following seven years of negotiation. The countries involved were Singapore, Brunei, New Zealand, Chile, USA, Australia, Peru, Vietnam, Malaysia, Mexico, Canada, and Japan.

I arrived in New Zealand on February 3^rd.  The following day there was a heavy police presence in downtown Auckland and all the media were out in front of a posh hotel as I walked by. Then a massive anti-TPPA demonstration wended its way down Auckland’s main drag, Queen Street. The most interesting thing about Queen St is that it follows the route the lava took coming off Albert Park volcano when it erupted. Queen Street has the atmosphere of a gully. I stood at the corner of Queen Street and Customs Street and watched this impressive procession, boisterous but peaceful, go by. It was headed by the Maori. They paused exactly where I stood and performed a haka that made the All Blacks version seem a bit wimpy. It stirred some deep emotion within me and made me realise that New Zealand really belongs to the Maori. The predominant culture of Eotearoa is Maori. All the place names, all the street names, are Maori. In that respect, New Zealand rather resembles Scotland and its association with Gaeldom.

The arguments against TPPA are complex but I think most people who are against TPPA think of it as a corporate scam construed to entrench the power of multinational companies and to take that power away from sovereign states. Therefore it is thought to be antidemocratic. Part of the agreement is the Investor-State Dispute Settlement (ISDS). Global corporations could sue governments in tribunals organised by the World Bank or the UN to obtain compensation from them for loss of expected future profits due to government actions. For example, the economist Joseph Stiglitz has suggested, TPPA could give oil companies the right to sue governments for loss of profits due to efforts to reduce carbon emissions and global warming.

February 6^th is Waitangi Day. On this day New Zealand celebrates the Treaty of Waitangi between the British Government and the Maori people in 1840. Then, a lot of the Maori wondered if they weren’t being taken for a ride. Many people feel the same with respect to TPPA. They wonder if the real issues are not being buried in a mound of obfuscation. The New Zealand Prime Minister usually attends the February 6^th celebrations in Waitangi. The last time I was in New Zealand I actually attended myself. All these Maori war canoes tied up on the isthmus between Paihia and Waitangi create an awesome impression. I seem to recall somebody threw a punch at the PM but nobody was much bothered. This year the PM elected not to go. Prudent.

There are some parallels between anti-TPPA sentiments in New Zealand, and “Brexit” in the UK – a suspicion that huge multinational conglomerates will inevitably erode national sovereignty. The difference is that while Brexit threatens to tear the Tories apart, anti-TPPA sentiments come largely from the disadvantaged and dispossessed.

I wonder if any of this got reported on the BBC? I would guess not. They say “all news is local”. You might say all news is parochial.

But New Zealand is as beautiful as ever and, I think, unchanged in essentials. I went to an outdoor performance of Shakespeare’s The Tempest last night at the Pump House by Lake Pupuke and a beautiful young thespian sat beside me before the start and chattered away. I said to her, “Lovely to talk, but don’t your need to psyche yourself up?” Apparently not. She was happy to blether away. Then the lights on stage came up and suddenly she was “on”.

What is the defining characteristic of being Kiwi? Straightforwardness. There is no guile. Maybe that’s why they have this misgiving that, behind all the acres of wordage, TPPA is not quite what it seems.         

Off to New Zealand on Monday February 1^st, Storm Henry permitting.  Glasgow – Dubai – Sydney – Auckland.  No stopovers.  I once swore I’d never do that again, but this time I bit the bullet.  28 hours in a hermetically sealed cigar tube.  I am anxious to board, and emerge into Eliot’s “unimaginable, Zero summer”.  It is better to arrive than to travel hopefully.

Auckland International Airport is certainly the friendliest airport I know.  Even the customs officers smile at you.  In no time at all you emerge into Arrivals and then walk out into the sweet New Zealand air.  There is a moment of déjà vu; it is as if everything has been in freeze frame.  And then, as if cued by your coming, the huge New Zealand flag above the carpark begins to flap lazily, and the traffic starts to move, and the people start to bustle.

It’s a fallacy.  It doesn’t take you long to realise that these people have not been in suspended animation at all.  They have moved on. Things are not quite as they were during your last visit.  In fact, you realise, it is you who have been in a deep hibernation and who now need to wake up and rediscover what it is you are doing down here.  I once toyed with the idea of spending six months in each hemisphere.  A life without winters might be attractive if you aren’t into winter sports.  Yet I’ve gone off the idea.  It’s not that I would feel guilty about dodging the rigours of the cold. After all, the birds do it.  They fly vast distances and come back six months later and land in the same pond.  No, it’s the sense of continuous displacement that puts me off.  Where do you live?  Where have you put down roots?  Answer – in an airport departures lounge.  I lived and worked in Auckland for 13 years and I do go back from time to time but I’m conscious of a sense of dislocation.  Despite the fact that you can text and telephone and skype and email and so on, there is a sense that there is no real point of connection between life here and life down under.  They are entirely separate entities, like parallel universes.  You have slipped through a worm hole and the other place has disappeared.

Yet that other world stays in the memory with extraordinary high definition.  Sometimes in the heart of Glasgow of a cold wet and blustery day I’ve closed my eyes and imagined myself on Narrow Neck Beach on Auckland’s North Shore, looking across to Auckland’s 48^th volcano, Rangitoto.  And for one crazy moment I’ve believed that when I would open my eyes again, the characteristic twin peaked silhouette of Rangitoto’s caldera, in the Hauraki Gulf beyond the Waitemata Harbour, would be there before me.  Didn’t Yeats feel this way?  While I stand on the roadway, or on the pavements grey…  It’s my Innisfree moment.

Perhaps next Wednesday, if I’m standing on Narrow Neck Beach, I will think fondly, perversely, of Buchanan Street.  I’ll let you know!  It is the blessed dilemma of dual citizenship.  Am I a Scot in New Zealand or a New Zealander in Scotland?

He iwi kotahi tatau.

Sunday night.  Just returned from a Burns Supper – haggis without the mawkish sentimentality.  I was called upon to render the Selkirk Grace.  I looked to the ceiling and intoned “Some hae meat” and left it at that.  The purveyor of the offal intoned “Fair fa’ your honest, sonsie face” and left it at that.  We tucked in.

I like peasant food.  I think of the Address to a Haggis as the antidote to all these foodie programmes on the TV.  Cookery shows are very fin de siècle.  Imperial Rome was obsessed with matters culinary just before the fall of the Empire.  Surely the ultimate in decadence is captured in the recurrent reportage of money men, masters of the universe, going out to dinner at £5000 a head.  Fillet of bruised spatchcock phoenix drizzled in a cabriolated coulis of emblazoned pitchblended mud, drowned in a nuclear-wintered farce.  (£3000 surcharge).  Chateau Rubbische Swipes throughout.

They don’t even know how to boil a Brussels sprout.  To capture the charisma of a sprout, you must leave it for longer than you think, until it’s quite soft.  Then the flavour comes out.  This has got nothing to do with money.  Boiled cabbage is the same.  Add pepper.

In this context, I’m particularly fond of the fifth stanza of the Address to a Haggis:

  Is there that owre his French ragout,

  Or olio that wad staw a sow,

  Or fricassee wad mak her spew

  Wi perfect scunner,

  Looks down wi sneering, scornful view

  On sic a dinner?  

Notice that curious construction of the first line.  Burns is fond of this.  He means: “Is there (anybody) who, over his French ragout…”

He does the same thing in A Man’s a Man for A’ That:

Is there for honest Poverty

  That hings his head, an a’ that;

  The coward slave – we pass him by,

  We dare be poor for a’ that!  

That is to say, is there anybody that hangs his head for honest poverty?  Unthinkable.

En route, I caught “Words and Music” on Radio 3.  Just a snippet.  I was able to figure that the programme’s theme was “dreams”.   I heard the opening to Rebecca –

Last night I dreamt I went to Manderley again…

Then, some of Ravel’s Daphnis and Chloe.

Then, Winston.  The close of the first volume of his history of the Second World War.  “I felt as if I were walking with destiny….  Facts are better than dreams.”

And then Yeats.  “Tread softly…”

I’m not sure that Words and Music is a successful programme.  What I have noticed is that the music transcends the literature, at least in terms of performance.   Somehow the translucence of the music makes the thespian luvvies sound completely over the top.   The secret of acting (Michael Caine has said as much) is not to act.  “Speak the speech trippingly…”  I found myself wondering what I would have included if I’d had to compile a programme about dreams.  I would certainly have included Martin Luther King.

“I have a dream…”

There is no greater orator than Martin Luther King.  He is a greater orator than Churchill and that is saying something.   He shares something with Churchill: substance.

  I have a dream that one day, down in Alabama, with its vicious racists, with its governor having his lips dripping with the words of interposition and nullification…

It’s Biblical.  He makes the governor sound like Herod.  What on earth are the words of interposition and nullification?  I’m not exactly sure, but I think in the broadest sense they refer to what we would now term, in a technical sense, “bullshit”.  Despite the fact that Burns contemplated more than once going to the Caribbean to run a plantation, I have a sense Burns and Martin Luther King might have got on quite well.  After all, Burns never actually went.  God bless him.

 

There’s a lovely story on the front page of this week’s West Highland Free Press.  A Gaelic singer performing at a ceilidh stopped mid-song and indicated he was feeling unwell.  He then suffered a cardiac arrest.  A member of the ambulance service, a firefighter, and a nurse who all happened to be in the audience commenced CPR.  They successfully used a defibrillator which had been installed at the venue.  An ambulance arrived minutes later, and the patient was transferred to Raigmore Hospital in Inverness where at the time of the report, he remained an in-patient.

The extraordinary thing is, this event took place at 11.30 on a Friday night in Poolewe.

Hold this thought.

This week I’ve been watching from north of the border, believe me without a trace of schadenfreude, the progress of the spat ongoing between Jeremy Hunt the Health Minister and the British Medical Association.  Mr Hunt wants to create a “24/7 NHS” in which high standards are maintained at all times, irrespective of the hour of the day or the day of the week.  “At the moment,” said Mr Hunt, “we have an NHS where if you have a stroke at the weekends, you’re 20% more likely to die.”  The doctors are worried that the contract on offer is going to leave them exhausted and burnt out; bad for doctors and bad for patients.  Talks have reached an impasse.  The doctors have gone on strike for the first time in over forty years.  That is a disaster.

Irrespective of the virtues or shortcomings of the proposed new contract I have to say I don’t think well of my medical colleagues.  In my opinion, doctors should not go on strike.  Strikes are designed to cause disruption.  Disruption in turn causes harm.  You might try to make a distinction between causing “inconvenience” and causing actual physical damage to patients, but you’d be hard pushed.  Even when the medical profession is firing on all cylinders, things can and do go wrong.  It is impossible to practise medicine in a half-hearted way.  It’s an all-or-nothing pursuit.  Hippocrates is said to have counselled us, “First, do no harm.”  The man who heckled the doctors’ demo and said, “This is against the Hippocratic Oath” – he was right.

I also find it reprehensible that the medical profession has failed to come together in order to tell Mr Hunt how to run a Health Service.  But the fact is that the medical profession has no clear leadership.  Medicine remains profoundly tribal.  All the specialties and subspecialties are preoccupied in claiming their slice of the budgetary cake and looking after it.

There is no meeting of minds between Government and the BMA.  It is not merely that they are not singing off the same hymn sheet; neither side appreciates what this argument is really about.  It appears to be about money and rosters and on-call commitments and pensions and all the nitty-gritty of a contract but deep down it’s about none of these things.  Deep down, it’s all about clinical medicine.  It’s about the delivery of health care.  It’s interesting that doctors talk about “managing” patients’ conditions; there’s no clear distinction to be made between clinical medical practice and the organisation of health care delivery.

What Mr Hunt is looking for (though I don’t suppose he knows it) and what the medical profession needs (they certainly don’t know it) is a Specialty of Emergency Medicine.  Think about it.  Medical specialties might be defined by age (paediatrics and geriatrics), gender (gynaecology), physiological system (chest physicians, cardiologists), pathological processes (oncology) and so on.  Emergency Medicine is defined by time.  Emergency physicians are interested in patients whose condition is time critical.  They know they can make the biggest difference within “The Golden Hour”.  That hour might be on a Monday afternoon or on a Sunday night.  Emergency Physicians are reconciled to the fact that they are liable to be busiest between Friday night and Monday morning.  They know that the most miserable day of the year for many of their patients is Christmas Day.  They are attuned to Mr Hunt’s idea of providing a round-the-clock service.  They also know about the huge and positive impact that early intervention and stabilisation (of the sort that occurred in Poolewe) can have on patient outcomes; and also the way that high quality prehospital and front-of-hospital care can take the pressure off intensivists, surgeons, interventional radiologists, endoscopy services and catheter labs by presenting them with stabilised patients and to some extent making emergency procedures semi-elective.

The tragedy of the NHS throughout the UK is that, although of course there are some wonderful emergency physicians and a few wonderful individual emergency departments, the Specialty of Emergency Medicine doesn’t really exist.  Emergency Medicine in the UK is about thirty years behind the times.  It’s reflected in the archaic language used to describe it.  “Cas”, “casualty”, “A & E”… If you talk to an Emergency Physician from Australia, New Zealand, or the United States, and you refer to your injured patient as a “casualty”, you will see him, or her, visibly shudder.

Doctors in training prop up acute care throughout the NHS.  They are demoralised and miserable, they are walking out, they are leaving for Australasia in droves, not because they are being asked to cover more weekends, but because they know in the deep heart’s core that they are propping up a ramshackle NHS.  Thirty years ago in Australasia a small group of doctors took on the combined might of the Royal Colleges and established the Australasian College for Emergency Medicine.  The college has never looked back.  This is a battle that has never been fought on these shores, let alone won.

On Tuesday January 5^th, Jackie Brock, who is Chief Executive of Children in Scotland, wrote The Herald Agenda article “Food Poverty and its effect on our children can no longer be tolerated”.  I learned that 3.7 million children are living in poverty in the UK.  Locally, free school meals are taken up at Ibrox Primary in Glasgow by 71% of the pupils.  At Irvine Royal Academy in North Ayrshire almost half of pupils receive clothing grants.   I knew all this, and more besides, as my cousin is head teacher of a primary school in North Ayrshire.   She has told me that it’s virtually impossible to teach children who are constantly hungry.  This is a problem the world over.  Dunblane Cathedral currently has an outreach project in Likhubula Malawi which tries to ensure each school pupil there has one square meal every day.

By bitterly ironic coincidence, The Herald also published on January 5^th a glossy magazine insert, “Independent Schools”, being an advertisement for in this instance nine Scottish private schools.

These two worlds, the world of the Agenda article, and the world of the glossy ad, could hardly be further apart.

If I say I found the glossy, frankly, repellent, I hope I will not be misunderstood.  The gulf between the privileged and the disadvantaged is as old as time itself.  Perhaps the best way to ensure that the world become a better place is to give our children the best possible start in life so that they in turn are in a better position to help those who are less fortunate.  All well and good.

No, it’s the mode of expression in the glossy that repels.  Contrast these.  First from Jackie Brock in Agenda…

“Initially focusing on Ibrox and Irvine, our Food, Families, Futures programme will ensure the provision of meals in schools at weekends and during holidays.”

…cf Ken Mann’s feature article in the magazine:

“Maximum attainment is far more easily assured through accurate fit with individual pupil need and robust methods of imparting knowledge.”

And again, from Jackie Brock:

“We want to take action now to ensure our young people have an education that isn’t undermined by food poverty.”

…cf Ken Mann:

“Responsible jobs requiring knowledgeable people can bring the type of salary capable of setting desirable lifestyle levels for a lifetime.”

What a private education gives you is “polish”.

But is “polish” a desirable attribute?  Nicola Sturgeon, Scotland’s First Minister, went to state schools in Irvine, North Ayrshire (Dreghorn Primary and Greenwood Academy).  Putting party politics to one side, one of the reasons why she is so popular on a personal level both north and south of the border is that she is “normal”.  She doesn’t have a veneer.  She is entirely lacking in smarm.  She was able to visit the flooded-out folk in Aberdeenshire last week and talk to them in a sympathetic and entirely unaffected way.

I went to a state school in the west end of Glasgow.  It amuses me that there are more MSPs at Holyrood from my old school than there are old Etonians (3 to 2 when I last counted).  Maybe in the modern world “polish” is beginning to lose its lustre.