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It’s weird that the government don’t have any, you know, facts and figures about the kinds of reforms it’s trying to introduce now. You know, the sorts there must be loads of, to show how much better it would be. The sort you’d want before undertaking a thorough restructuring of the whole system.

Surely there must be some sort of evidence from the last time an internal market was introduced (in an limited form) in 1991. Surely…

Oh wait! There is! Popper, Burgess & Gossage’s 2003 paper: Competition and Quality: Evidence from the NHS Internal Market 1991-1999.

Brilliant! This should put my mind at ease…

“We find the impact of competition is to reduce quality. Hospitals… in more competitive areas have higher death rates.”

…. Oh. Never mind, sure there’s some good news later…

“Death rates were higher in competitive areas in most years between 1992 and 1999.”

Really? But still, everyone’s living longer anyway, right?

“[T]he negative impact of competition in the more competitive areas more than offsets the positive impact of technological change.”

Oh poo. Please, please, please #savethenhs…

ZST's grandfather

John Rose Battley, MP for Clapham 1945 - 1950

John Rose Battley was never a well man. As a conscientious objector in the First World War, he was sentenced to work in a market garden. On a cold day in February, whilst he was putting 2,000 cauliflowers under cloches, he noticed that his toes were turning black. Despite having never been to the trenches, John Battley was getting trench foot.

With his brother, he started his own printing firm in 1897, working out of a room above their father’s shop. He built the business up, it survived his brother leaving, its proprietor not being able to work at it during the First World War, the Great Depression and at least one extended nervous breakdown, which lasted many months in 1933. That printing firm, although its name has changed, is still around today.

Battley was in his 50s by the time he married in 1933, and that seemed to redouble his activity. He was already an active member of his church and local choir, a leading light of the Temperance Society and the Rotary Club, and in 1938 he was elected to the London County Council, as a Labour member for Clapham.

During the war he worked on the Housing Committee on the LCC, even as his own house was bombed in the V1 attacks. In 1945 he stood for parliament, and became the first ever Labour MP for Clapham. He wasn’t a vocal MP. Although he made notes, he never made a speech in the House of Commons, but he was an ardent worker on behalf of his constituents. He voted with the government most of the time, the only exception being the National Service Act. 30 years after his pacifism had forced him to give up his business, he still believed that no Christian should ever have to (or, indeed, could) perform military service, and so he rebelled against the government once, in 1947.

Whilst he was an MP he also stayed on as a member of the LCC, an active Rotarian, church member, choir member, and managing director of his own business. By 1950 the stresses had got the better of him, and he did not stand for re-election. Indeed, he had another breakdown shortly thereafter, and stayed in a hospital until he died in 1952.

Without knowing it, on 5th July 1948 this quiet, dedicated man saved the life of his grand-daughter and great grand-daughter, neither of whom he was ever to meet.

By voting for the National Health Act, John Battley made sure that when, almost 60 years later, 29 hours into labour, his great grand-daughter – my daughter – Eleanor decided to get into severe distress as she tried to enter the world sideways, her life was saved. Both she and Zoe, Zoe Battley, received the instant care of two paediatricians, two midwives, and at least three nurses (I lost count, I was busy worrying, and wondering if I could sneak out with the gas and air canister).

Over the 34 hours that labour took we had (I say we, Zoe selfishly used most of the drugs herself): heart monitors, midwives, gas and air, an epidural, a room to ourselves, three trips to the maternity ward (three painful trips home), a ventouse (don’t ask), synthetic hormones that accelerate contractions, pethedine for slowing contractions right down. And in between all of the worry about how much pain my wife was in, whether or not I’d packed any of the right things, whether I was going to be a good dad, or, as things got more serious, whether I was going to get to be one at all, the one thing I never had to worry about was how much the whole thing was going to cost. As a self-employed comedian of variable success, I didn’t have to worry whether or not I could afford the things and people that kept my wife an child alive.

St Thomas' Hospital, almost eclipsed by a plump twat

Behind me is the hospital in which my wife was born, picture by Tiernan Douieb

Some people, of course, will argue that this presents a moral hazard. If I am never aware of the costs of treatment, I won’t behave in a way that avoids unnecessary treatments; that health care free at the point of delivery encourages poor decision-making. What that means in this situation I’m not sure I understand. Perhaps I should have impregnated my wife with a more sensible-sperm, which would have seen the birth canal as an opportunity for emerging normally rather than doing somersaults. Perhaps I should have severed the nerves in Zoe’s spinal cord myself as the contractions started, because epidurals don’t grow on trees. Perhaps I should have had to choose which of the two, my wife or my daughter, we could actually afford to treat. Perhaps that would have taught me not to be so feckless. Doesn’t take more than a funeral or two before people start making better life choices, right?

62% of bankruptcies in the USA are down to health care bills. People lose their houses because they get ill. And they aren’t uninsured people. 78% of those people had insurance. Insurance that didn’t, actually, insure them in any meaningful way at all.

It will confuse some people, I know, that someone so vehemently anti-government, a left-libertarian, someone who some days – whisper it – is probably an anarchist should have gone onto a bridge to defend a monopolistic state health provider. Those people are confused as to what Andrew Lansley’s Health & Social Care Bill is. The choice isn’t between a state provider and a free market. The choice is between a state provider of health run for the general welfare of the people it serves, or a state monopoly provider of health that is run to best produce profits for private healthcare companies. It would be bizarre to bemoan politicians plundering the public purse, but to cheer when corporations do it.

I’m not saying Andrew Lansley is a shill for private healthcare companies. That’s his wife’s job. I’m not saying that the £21,000 he received from John Nash, chairman of Care UK and founder of Sovereign Capital which owns several private healthcare companies would have in any way influenced his opinions on the issue of whether private companies should be able to profit at the expense of the NHS. I’m not saying it. But he is. In a speech in 2005, he said: “Demanding uniformity will negate the benefits of competition. How can competition work, whether on prices or quality, if it does not lead to variation and divergent outcomes?” Or, in other words, different people will get different levels of treatment under the NHS, otherwise competition would not work. His vision is an ideological one in which ‘competition’, rather than the needs of patients, is paramount.

And this isn’t a move towards a free market, or towards real competition. It is simply a move that allows private companies to cherry-pick profitable services. Services that are already provided. There is no guarantee that they will provide them better (the responsibility for the Health Service is to be turned over to a quango who are not answerable to Parliament, so out politicans can’t be to blame for however bad it gets in the future), the only guarantee is that money that once would have flowed through the NHS will now flow to shareholders in private health companies. Because ‘competition’ is the aim, not patient welfare.

This is pure kleptocracy. Assets that have been built with the public purse, maintained at the taxpayers’ expense, are to be auctioned off. And what’s worse, private health care companies aren’t even going to have to act like, you know, businesses to get in on the act. They won’t be competing in any meaningful sense, under the umbrella of the NHS, they will simply be pocketing our cash without having to guarantee standards in the way the NHS currently does.

The fact that the local health authority sees no conflict of interest for the practice in Yorkshire that recently started charging for minor skin surgeries highlights the bizarre situations that we must nod through in the name of ‘competition’. The fact that the same GPs at the same surgery will be in charge of deciding if funds are spent on a procedure, and in charge of performing the same procedure privately if they decide it isn’t is outrageous. That’s a moral hazard. You can tell, because it contains a moral element. Eating too many chips is not.

And don’t let them tell you these are cuts. That we need to make these cuts. This plan makes the NHS more expensive. It will cost £1.2 billion more to implement these changes than to not do it, and there are no cost savings at the other end. So we will end up with a service closer to France’s or America’s in that it will cost much more than the one we have at the moment.

And what is so clearly, arse-breakingly frustrating about the whole thing is that it received any Lib Dem support at all in the House of Commons. It’s like they don’t remember the clause in the Coalition Agreement, the line in the sand which, if crossed, would lead to the dissolution of the Coalition, the one about “no more top down reorganisations of the NHS”. Of course, by the time the policy documents for the Coalition emerged a couple of weeks later it was hedged with many qualifiers. The Lib Dems cannot have any serious claim to be a restraining influence on the Tories if they roll over at the disembowelling of one of the nation’s most loved institutions.

And fuck the Labour Party, too. A supine, spineless, useless thin drizzle of urine that leaks down your face and calls itself champagne. Without the NHS reforms of 2000 and 2008, this Bill would have been impossible. As it is, it is only an extension of the ‘competition’ ethos introduced into the NHS by none other than Tony Blair. You remember, it was when he was telling us that anyone who objected was a ‘force of conservatism’ and that he had ‘no reverse gear’. Vehicles without reverse gears are terrible vehicles, Tony. Most people buy ones which have reverse gears. (Oh, and equally, George Osborne, Plan Bs are a good thing. Doing contingency planning is just sensible, yes? God, I hate them all…)

The ground was prepared for all of this by the Labour Party. They put the ideological argument for it years ago. Some might rail against this now, but what are they doing about it? Sally Bercow accidentally ended up at #blockthebridge because she was having a walk with her children. I saw John McDonnell there, but no other Labour MPs. They are a disgrace, and I’d suggest that they hang their tiny heads in shame, although it’s quite clear they have none.

My agent's office is in that building now. Hello, Corrie!

Me, in front of the LCC building, picture by Sunny Handal

And so I was proud to stand on that bridge. Proud to stand between what used to be the LCC building, and the Houses of Parliament. Proud to stand with a couple of thousand people in front of St Thomas Hospital, where Zoe was born. Proud to speak to, and on behalf of people who believed in a better future.

So, it’s too late to lobby your MP now. It’s too late to have come down on Sunday (you missed Josie Long, Mark Thomas, Nick Revell, Chris Coltrane, Tiernan Douieb, Grace Petrie, Lisa Egan and Nadia Kamil. You are a fool.) It’s too late to adopt a peer, although you could try faxing them something this morning. In a few hours we will know one way or another, whether or not John Battley’s printing business will outlast the greatest achievement of the 1945 Labour government.

The one thing you could do, right now, stop reading and do it, is to sign this petition. 115,000 people did it yesterday, but it’s not enough. Sign it, send it to your friends, tweet about it, talk about it on Facebook, argue with Tories about it (not that I’ve met a single real-life Tory who thinks it’s a good idea). For these last few hours, write and jump up and down and do whatever you can to make a noise about this. The only thing that might sway the crossbench lords (and don’t think I don’t find it utterly galling to have to go grovelling to someone who earned their place in the legislature by popping out of the right mimsy) is if they are left in no doubt that hundreds of thousands, millions of people are angry, worried, dismayed by this.

John Rose Battley was never a well man, but he left behind him something to take care of us all. Let’s do our bit to take care of it for the next couple of hours.

Yesterday, Sir Ian Bowler went to see the rabble on Westminster Bridge who were attempting to ‘save the NHS’. He likes to think he changed a few minds. And sexualities.

BBC Broadcasting House, Portland Place at the ...

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It’s a sad fact that despite having written sketches, plays, online series, and actual half-hour sitcoms that were broadcast on the television and everything, the thing which has most excited my parents was getting credited on The News Quiz. There is no prouder moment for a middle-class parent than when their child is writing additional material for Sandi Toksvig. Providing them with grandchildren pales into insignificance when your name is read out in the 6:30 slot on Radio 4.

And when I say ‘my parents’, I mean ‘me’. It was great fun: a furious whirl of reading papers, trying to squash the news into something vaguely amusing, and saying “Can anyone think of anything that rhymes with Andrew Lansley?”

It was exhausting and pressurised, having to produce joke after joke about occasionally abstruse economic stories, but it was also exhilarating. It was a real thrill to sit in the BBC Radio Theatre and listen to the show be recorded, hearing the instant reactions of the audience to the jokes that made it into the script. And to get to be in a Green Room with Jeremy Hardy.

Topical comedy is difficult and draining because yesterday’s brilliant joke is, today, a reference nobody understands. The fact that it dates so quickly means that there’s a huge appetite for new material, which also tends to mean that there are opportunities for newer writers, some of which I’ll list here.

Topical comedy was my way into writing comedy, it allowed me to develop my skills, hone characters, learn a lot about how to craft a joke, and get paid (a little bit) whilst doing it. If you write a good topical joke or sketch there are lots of places you could try to sell it, and you’ve a better chance as a newcomer than in almost any other field.

Stage Shows – Both The Treason Show and News Revue have open submissions policies and pay for anything they use. They won’t pay a lot and it will take a while for the money to arrive, but if it is funny and you send it to them, they are very likely to use it. Then: congratulations, you’re a professional comedy writer!

The Treason Show also holds meetings for its writers where (if you are Brighton-based) the director will tell you what they are looking for. It is well-worth going along to one or the other show to see what sorts of things work and don’t work, if you can make it.

These two shows provide a great apprenticeship in topical comedy. The first sketch I was ever paid for I sold to News Revue, and if one of the two shows doesn’t like your sketch you can always send it to the other. If the worst comes to the worst you can do what I did and become a writer-performer, get cast in the shows, and then refuse to go on unless they use your work*. This is blackmail. It is also very effective if you do it once the audience are seated.

Youtube – If you’ve written a sketch or a topical song that isn’t suitable for the other shows, or that you want to perform yourself, Youtube is a great way of doing it. Nowadays, if there is a certain amount of interest in your video (I’ve found that about 1,000 views over a couple of days seems to be the trigger), Youtube invites you to join its affiliate programme. You can then stick an annoying advert over the top of your sketch in return for money. Again, the financial rewards are fairly minimal, but it is at least a way of making something from your writing. Here’s what a video looks like when it has been whored out:

However, if your video contains any profanity, then they will not approve you for the affiliate programme. Instead you will be hunted down by a pack of slavering obscenity-hounds and have your remains fed to the crows. As happened with this video, which I forgot I had sworn in the middle of.

RadioNewsjack has open submissions, and you should be sending them stuff. A series is running right now. Go away. Write a good joke, work out which of their segments it could be useful for and send it in now. Better still, write lots of good jokes and send those in.

Recorded For Training Purposes also has an open submission policy (or has had in the past), so keep an eye open on Writers’ Room for when that opens to submissions. Submitting to these shows is an excellent way to get your work in front of the eyes of joke-hungry producers. Following Jason Arnopp would be a good way to learn more about RFTP.

Comedians – If you are good at writing jokes, topical or not, you may well find that there are comedians who are willing to buy them from you. Keep an eye on the forums on Chortle, or advertise yourself there.

Online – BBC Comedy Online currently produce topical sketches, although their turnaround times for submissions tend to mean that if your jokes are bleeding-edge in their topicality this might not be the way to go. However, you can always make it yourself, and then see if they want to buy it. Other sites have, unfortunately stopped commissioning, and, with the demise of Comedybox and Funny Or Die UK, you may be better off making things yourself and putting them on Youtube for a while.

TV – There aren’t really many ‘open opportunities’ here, as such, but there will be occasional sweeps for ‘new talent’, and I got my first proper TV work (not that my appearances in Smile as The Queen weren’t proper, but you know…) from doing topical jokes.

If writing gags for TV floats your boat, why not follow Aiden Spackman, who is something of a god at that sort of thing…

Twitter – Twitter is a great place to practise gag-writing. 140 characters is a little limiting, but it encourages brevity and can give you an instant barometer of how funny people found something with the ‘Your Tweets, Retweeted’ tab. Note: clicking this can also be a tremendously dispiriting experience.

So, whilst topical comedy is hugely ephemeral and can require an enormous amount of thought and concentration for something that won’t be funny in a week’s time, it is still an area in which new writers can get their work performed, and can even make a little money out of. It’s tough, brain-scrunching work, but there are real rewards in terms of credits for getting it right. And a crushing sense of defeat and humiliation for getting it wrong.

Go forth and satirise…

* There are slightly different opportunities for writer-performers, and I’ll do a separate post on those next week.

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