Economics and Politics

So I've been meaning to write a post about economics and where we are as a nation because of the massive gap between the media narrative and the reality. This disconnect has huge policy implications.

Even though over the last 6 years, I have become a firm Keynesian in my thinking, I would not claim to be an economist. I would however claim that reading and accessing the relevant information is an option open to anyone interested.  For reference I would recommend the following 3 books:

End the Depression Now! by Paul Krugman [Nobel Laureate]
The Price of Inequality by Joseph Stiglitz [Nobel Laureate]
Austerity, the History of a Dangerous Idea by Mark Blythe

I had composed a blog entry, trying to encapsulate the argument and I'd got to 2500 words so it wasn't exactly pithy. Then I discovered Simon Wren-Lewis, Oxford Professor and much more qualified than me to comment had put together a nice little series of blog entries that summed this up beautifully. So as well as being more qualified to say it, he'd said it better than me.

So, please read these:
uk-mediamacro-myths-introduction.html
mediamacro-myth-1-2010-britain-faced.html
mediamacro-myth-2-labour-profligacy.html
mediamacro-myth-3-2007-boom.html
mediamacro-myth-4-immediate-necessity.html
mediamacro-myth-5-long-term-plan.html
mediamacro-myth-6-2013-recovery.html

AFZ

P.S. I just want to point out that history will (rightly, IMHO) laud Gordon Brown for his handling of the crisis. History will not be kind to either Cameron or Osborne.

Politics 2015

Very few blog posts recently. The usual excuses of busy-ness etc. This is an election year in the UK - in case you haven't noticed...

For one as geeky-political as me, this is an interesting time. But I've decided not to fill up my blog with political posts. My political thinking is well documented here and elsewhere. However I will not be silent. I intend to produce a series of simple, visually-based statements.

They will appear here: conservatives2015.blogspot.co.uk

As always, agree, disagree, post comments... ;-)

AFZ

'Champagne Socialism' makes me very cross

I have never in my life been accused of being a champagne socialist but it's probably only a matter of time. My father was a salesman and mother was a nurse. When we were small, my mother cut my hair. I was of the first generation of my family to go to university. We never had foreign holidays but we never went hungry either. School represented no real quandary - we went to the nearest.

These days my lifestyle is a bit different. I am a surgical registrar and my income is both a lot more than the average in this country and more than most people I know. I own a second property which is let out and I have an expensive hobby. To be honest, I'm more of a scotch-socialist than the champagne variety. On the other hand, I work more hours than almost everyone I know and a lot more than I'm paid for. I have got here by a combination of very hard work, talent, persistence and yes, opportunity. I do a difficult and often stressful job that has significant (in my view) social value. For example, I took an appendix out of a 9 year old last week. He's fine now; before surgery was invented, appendicitis had a 60-90% mortality. The other night I assisted a consultant operating on a seriously ill newborn baby. This is a very typical week.

The thing is, I really believe higher earners should pay higher taxes. Including me. I really believe we need to get serious about taxing unearned income at a higher (rather than, as currently, lower) rate than earned income. What is so perverse about the argument in my view is the cynicism. One apparently cannot be well-off and left of centre without being a hypocrite. Which is of course ridiculous. In so many areas of life people act out of altruism. Many argue vociferously that taxes should be minimized because 'what I earn is mine and you shouldn't take it away.' This appeal to the moral is deeply misguided in my view because it's grain of truth will not stretch anywhere near that far. Firstly, as I said, unearned income is taxed way below earned income. We live in a rentier society. Moreover 'I earned it' misses out several key steps; any wealth any of us can have depends entirely on living in a secure society to make that possible. It depends on educational opportunites it depends on the infrastructure of the nation that makes wealth generation possible, it depends on national security, it depends on access to healthcare - and also to the general health of those around me (being in a healthy society makes me less at risk of disease). It also, incidentally, depends on access to the earth's resources (such as land and energy and raw materials) which apparently don't somehow belong to all of us. Surely those who benefit most from these things should pay the most towards them. And do so proportionally.

However, this is not the main issue. The main issue is that systematically we have a rent-based economy which is designed for (and very effective at) concentration of wealth. The great lie of my generation is that wealth is achieved on merit. It really isn't. So we have a system that makes the rich richer and the poor poorer and then blames the poor for their own poverty. To be against this and poor is to show class envy. To be comfortable and against it is hypocrisy; as if many don't work very hard and far more than they are paid for and produce social goods and give generously to charity. And yet if you think this, apparently you're not allowed any luxuries. Whereas if you tell yourself and the world that you deserve everything you have then it's ok to sneer at the poor and disadvantaged.

So anyway, I am and suspect, I will always remain a socialist. Proudly believing in democracy, proudly believing in our collective responsibility to each other - and still drinking the occasional single malt.

AFZ

P.S. This is number two on my list of phrases that immediately identify the person using it as an idiot.

Abject Stupidity

So, according to this story, due to an accounting error, nursing staff at the emblematic Great Ormond Street Hospital have been overpaid by 6.5hrs worth and the hospital wants it back. The chief nurse has written to nursing staff, telling them to work additional shifts to make up the time.

The problem with this story is how is doesn't remotely surprise me. Several years ago a hospital trust I worked in sent a similar email to all the ward sisters; which one of them showed to me. A period of very heavy snow resulted in many staff struggling to get in to work. The email told all ward sisters that as a matter of policy any member of staff who arrived late due to the weather would be expected to work through breaks or stay late to make up the time. No 'thank you' for the huge efforts some had to make to get in, just a clear expectation of time 'owing' being paid back.

Just for the record, I want to state that, as anyone who's ever worked in a hospital or seen the inner workings knows, it is very much a normal day when clinical staff work through breaks or stay late because of a caring attitude and/or professional responsibility. Indeed, if I was a union rep in GOSH, my response would be to send the management of the hospital a bill for all the unpaid overtime that is done by virtually all nursing staff. I can assure you that it would be a lot more than 6.5hours/year. For many medical staff I know, 6.5hours of unpaid overtime would constitute a quiet week.

For me though, what makes me very annoyed about these stories, is not the unjust nature of it. That is not to say that doesn't bother me, it really does: it's a big slap in the face to a hardworking and dedicated workforce. It is plain wrong. However the stupidity of the management decisions bothers me even more. Nursing morale is at an all-time low. With significant justification, many public-sector workers feel deeply un-valued by their employers and society at large. It takes something special to do difficult work with enthusiasm and dedication. This kind of nonsense from management only serves to further undermine the wellbeing of not just nursing staff but all staffing groups. I can assure GOSH's managment that a rise in staff turnover which is not remotely unlikely will cost a lot more than £80,000.

AFZ

A little bit of landscape gardening

So for various reasons (partly outside influence) I have been making my garden look more presentable and hopefully come spring it will actually be quite nice.

One part of this can be seen below.

So this so-called 'planter' contains several climbing plants that will hopefully get quite big in the spring, a water feature and a rock speaker that will play music in the garden!

The trellises by the way are made from old pallets that I got for free.

So apart from the plant selection, this is all my work... I have never laid any brick before and it was fun to do. There's plenty of good advice on the web on how to do it. The wall foundation is 150mm deep concrete. Once filled with soil, the planter is completed with an anti-weed fabric covering and then the gravel. The main thing I've learnt is that laying brick is actually quite straight-forward; mixing the mortar to the right consistency, that's the tricky bit.

Anyway, here's a nice little bit of time-lapse of the building work:

AFZ

Crime Statistics

A Long time ago, I wrote about the gap between perception are reality - specifically in connection with crime statistics. I may well expand on this theme some more in the near future concerning welfare, poverty, immigration and healthcare. Issues I care deeply about and in this a (very nearly-) election year, I think them vitally important.

But for now, I just wanted to point towards this neat little Guardian article on Crime Statistics which I think summarises things really well.

Reported rapes leapt 29% in the latest figures, with more than 22,000 reported to police last year. However, according to both the ONS and the minister, Norman Baker, this rise is almost certainly explained by a greater willingness of victims to report incidents, whether recent or historic, helped, perhaps, by some improvements in police practices at the point of report. The detailed analysis of intimate violence is published annually in February. In 2012-13 the proportion of adult women who had experienced any sexual assault in the previous 12 months was at 2%, the lowest since records began.

Paradoxically an increase in reported rape is a very, very good thing. I long to see this figure falling, but only because the actual number of offenses is falling and not because (for lots of reasons) they remain unreported. I think a big step towards making sexual offenses rarer in society is seeing more victims feeling able to report it.

AFZ

Pi in the Sky

 

Pi_2

One of the many features available with the Raspberry Pi is the integral Pi Camera. One of the things I was very keen to try out was putting a Pi-Cam on the front of the microlight that I fly. This I have now done. The camera will capture High-resolution images and they look fantastic! Sadly for the purpose of putting the video on this blog I've had to massively reduce the resolution as well as editing the film! Anyway, hopefully you can get the idea with these 2 minutes of footage including take-off and landing. I will put much more interesting aerial footage up when I get it.

So how was this done?

Put simply, I used a Pi_A (for it's lower power consumption) and attached the camera to the front strut of a P&M aviation QuikR. Total cost of components ~£50.

Voltaire

“The art of medicine consists of amusing the patient while nature cures the disease.”


I have always liked this quote. Whilst in modern medicine it isn't strictly true (we hope),  there is deep wisdom within.


AFZ

Flying for Freedom

The British Antartic Mircrolight Expedition are aiming to do something that's never been done before; fly flew-wing microlights to the South Pole. You can follow their exploits at http://flyingforfreedom.org/. A group of ex-servicemen who have suffered significant injuries are striving to do something that has never been done before and demonstrate 'what is possible for often severely disabled people to achieve.'

AFZ

Raspberry Pi

So I have begun my adventure into the world of Pi. I suppose it was inevitable really. In case you are not familiar with the world of Pi here’s a brief history and overview (more details here):

A group of computer scientists – including Eben Upton from Cambridge became aware that students were not getting the opportunity to play with computers – to learn how to program and the huge potential for hardware manipulation there is – in the way that children who grew up in the 80s and 90s did. Whilst home computers had got ever more powerful, they also have become very domesticated. Given the low cost of components they realised that it would be possible to construct a low-cost computer, just the size of a credit card with amazing functionality. And what they came up with was the RaspberryPi. The basic model is priced at $25 and $35 for the more advanced version. So a charitable company makes the devices and a huge community of enthusiasts develop the operating environment(s) and software for the device. It really is impressive.

The Pi has been out for about a year and is loved by educationalists and computer-DIY-enthusiasts like me. The huge array of uses that Pi’s have been put to is really impressive and so it’s about time I joined in (for example...). I suspect I will end up with several Raspberries but this is the story of Pi_1.

Pi_1 – Media Centre Extender

I have had a MediaCentre PC for about 8 years now. It runs the projector which replaced a TV in my lounge. Sometimes, however I want to access media in locations other than my lounge. There are several ways to do this but I wanted the subtly of a Media Centre Extender, rather than having to fire-up a computer every time.  This is unbelievably simple with a Pi. Not least because so much of the work has been done already.

So here it is, powered directly from the TV and networked by mains-ethernet I had a fully functional MediaCentre Extender in less than an hour. The XBMC distribution of Linux is excellent; very functional, user friendly and (of course) freely available.(It will be completely hidden once I've finished playing)

It is important to note that to playback most video file types, the purchasing of codecs is necessary but given that it’s £3.60 for both, I didn’t feel that was too much of a hardship.

The only thing I haven't quite settled on is how I will control it... A lot of modern TV can communicate via the HDMI cable and hence you can control the Pi from the TV remote. I haven't managed to set that up yet but in the meantime there is a neat Android App for my phone... 

Next… well for Pi_2 I have some more advanced ideas.

Pi_1 Specs:

Raspberry Pi Model B 512MB DRAM RASPBRRY-PCBA
7dayshop Professional High-Speed SDHC Memory Card - 8GB - Class 10 CD Card
Raspbmc (XBMC for Raspberry Pi)

Vincent and the Doctor

According to the news, A previously unknown van Gogh has been discovered. Am I the only one secretly hoping it looked something like this?

Surely not?

AFZ

The Gospel According to the Daily Mail

I have written much in the past about my thoughts around the tabloid press and one publication in particular. If you are bored of this then I have good news and bad news. The bad news is I've started a new blog on the theme. The good news is it might just mean I talk about it less here. Maybe.

The Gospel according to the Daily Mail came about from a conversation with a Pagan friend of mine. She was teasing me for being quite conservative in many ways. She suggested that having a faith - as I do - was archetypally conservative (note the small 'c'). I challenged this with the notion of how deeply radical Jesus was. And it occurred to me to suggest that the way the Mail might have reported the occasion when men broke though the roof to lower a friend before Jesus would illustrate this contrast.

Thinking about it afterwards, it occurred to me there could be a rich vein of both comedy and hopefully meaningful comment. The Mail likes to style itself as on the side of Christianity whilst really what they stand for is hypocrisy, hate, bile and some romantic notion of Christendom. There are - sadly - some in our society who think that's what Christianity is. Well, this is my response.

AFZ

GMC guidance....

According to this recent publication by the General Medical Council, I'm not supposed to mention on my blog that I'm a doctor because I am anonymous on here:

If you identify yourself as a doctor in publicly accessible social media, you should also identify yourself by name. Any material written by authors who represent themselves as doctors is likely to be taken on trust and may reasonably be taken to represent the views of the profession more widely.

 Any thoughts?

AFZ

Joblessness

One of my favourite books of the bible is Job. In part because I'm an awkward person and most people see it as challenging and I like to be different. That, however is not the only reason. It is indeed challenging but that is part of its richness.

Job was a man who was very blessed. God then allowed him to lose everything, including his children. But Job refused to curse God. Job was then afflicted with the most appalling body sores such that his friends on seeing him were speechless - for a week. And still he did not curse God.

For the majority of the book we have the conversations between Job and his three friends, before in the end Job is healed and restored. Throughout these conversations we are hit with a big theological problem; how can such a horrible thing happen to a good man? I don't intend to answer that question here, except to say that part of the message of Job is that bad things do happen to good people. And sometimes really bad things happen to really good people.

The problem for Job's friends is they cannot conceive this. They recoil at the implied injustice of it. Also, however, I think their problem is more deep-rooted than that. Firstly it confers on them a responsibility, if Job is not to blame for his inflictions - if the ups and downs of life are not determined by what we deserve then surely our responsibility to each other is so much greater. Secondly they fear for themselves - they sense they are secure in their wealth and health because they are good people and hence have control of that. Job's stubborn denial that his afflictions are his fault mean that this foundation of their self-belief and self-worth is eroding beneath them.

In the UK today, we have a significant problem of poverty. More worrying to me is the attitude to said poverty, like Job's friends we desperately need to believe that the poor deserve to be poor. I came across an excellent report today: The Lies We Tell Ourselves: Ending Comfortable Myths About Poverty. A report from the Baptist Union of Great Britain, the Methodist Church, the Church of Scotland and the United Reformed Church. I would encourage everyone to read the executive summary, if not the entire report - it's not very long. 

The authors take six of the common myths about poverty in the UK: 

1. ‘They’ are lazy and just don’t want to work
2. ‘They’ are addicted to drink and drugs
3. ‘They’ are not really poor - they just don’t manage their money properly
4. ‘They’ are on the fiddle
5. ‘They’ have an easy life on benefits
6. ‘They’ caused the deficit

If you don't believe these are 'common' then they give the survey results of what the British public think. All of these are pervasive received wisdom. And as the report shows; all of them are false. As they put it:

The myths exposed in this report, reinforced by politicians and the media, are convenient because they allow the poor to be blamed for their poverty, and the rest of society to avoid taking any of the responsibility.

Job's friends were wrong. And so are we. The poor are not to blame for their poverty, the factors are far more complex than that.  Our responsibility to each other means seeking justice. Enacting policies that are both just and effective will only be possible when we face up to the reality and stop scape-goating the victims.

Job-lessness is the real problem for our society.

AFZ

Random Showing Off...

My Coffee Table...

Those Pesky Kids...

Today's entry is for a wise and good friend of mine.

AFZ

Devil's Graffiti

One of my favourite authors is, no, my favourite author is, Adrian Plass. His ability to communicate deep truth, often through humour is, I think, unmatched. Some write-off his books as silly humour and miss the true depth (in my view). His ability to entertain is of course worthy in and of itself but most of the time it is a means-to-an-ends. To communicate something more profound about God's love. He is also a good and skilled theologian but perhaps not in the traditional sense. And for me that is the key to his authenticity. Theology is important as it's about the truth of God but it is not what disciples of Jesus are called to - we are called to be disciples. Theology that does not change how we live is worthless. Plass's writing expresses the reality of a relationship and not just dry academic study. What you might call practical theology. Ultimately for a true disciple, no other kind is worthy of any consideration. 

Plass wrote some years ago about The Devil's Graffiti, drawing on Jeremiah 31 where God declares that he will write His laws on our hearts. A little bit of theological work is probably needed here to understand what this means. Certainly I think it a mistake to see it legalistically. Good laws increase freedom and I believe what Jeremiah 31 is saying is that God would change cold hearts such that external laws become less and less important. Plass's observation was that sometimes before God can begin to write said laws he first has to scrub away to remove the Devil's Graffiti that's in the way.

The problem, assuming your heart is anything like mine, is that negative graffiti has built up over the years leaving very little space for anything else. The devil gets busy with his infernal aerosol can! Things people have said, failures that have destroyed confidence, traumatic experiences, profound, unforgettable embarrassments – all sorts of things.

Usually each one tells you a lie about yourself:

you will never succeed,

you are not lovable,

God has cast you aside because of that sin,

you’re boring,

happiness is impossible,

your life has no purpose.

The almost invariable untruthfulness of these scrawling should be sufficient indication of their ultimate authorship. The father of lies is anxious that our hearts be covered with a confused mass of misinformation, some of it etched so deeply it comes close to breaking our hearts.

 

I have written elsewhere, in a different context about the poisonousness of lies. I don't think you have to believe in the spiritual interpretation to see the truth of the observation. Most people carry with them deep scars and things that have been burned into them that aren't true. This is of course, most profound in people who suffered in childhood - particularly from abuse but it is also true that some of us accumulate it over the years through constant knock-backs or repeated messages from the world around us. These lies - for that is what they are - are often deeply poisonous, affecting relationships, confidence and hope.

My own personal graffiti - well there's probably a few bits - but the most important one said simply this; "You are unlovable." I can chart particular experiences that are probably the origin of these words but it doesn't really matter. These words, scarred into me, often made liars of good people - for it didn't matter how much people expressed their love, it just wasn't actually possible for people to love me. It's not that I doubted them, I doubted me.

I believe in a God of healing. These words are faded now - God has spent a long time scrubbing away to remove them. In fact they're not visible most of the time; it's only when the rain falls in a certain way that you can see them at all.

I have seen in the lives of many people the poison of such lies. I think recognising them for what they are is the first step to ridding ourselves of them, the first part of the healing the process.

AFZ

Hippos...

Back in the day, when I was growing up, Crusaders produced yearly posters. These posters consisted of a bible verse with an illustrative image. The one I remember most vividly quoted 1 Samuel 16; "Man looks at the outward appearance but God looks at the heart." The image to accompany this verse was a hippopotamus. Presumably because this is an image of ugliness.

For reasons lost in the midst of time (and probably best left there) this became in family-lore "Man looks at the outward appearance but God looks at the hippo..." Now this silliness serves a purpose in that it makes the verse very memorable to me.

Then, when I (kinda) grew up I went to medical school and learnt anatomy. I learnt that there is a part of the brain (well, technically 2 of them) called the hippocampus. Now the hippocampus is part of the limbic system. It is somewhat questionable that the seat of the aphoristic human heart has any anatomical location but if it does, then it is the limbic system for this is the part of the brain responsible for emotions and instincts. So it turns out, worryingly that I was right all along, man does indeed look at the outward appearance and God looks at the hippo...(campus).

All of this extreme silliness is indeed going somewhere. Martin Luther King said that he dreamt of a world in which a child was judged not on the colour of their skin but on the content of their character. And whilst, in many aspects of life, racism itself is not tolerated, different kinds of superficiality still prevail. God however is much more concerned about what goes on in the heart (or limbic system if you prefer). In Matthew 23 Jesus expounds on this inside-out holiness. Get the heart right and the rest of life will follow.

AFZ

Vocation and Calling

I have been thinking a lot about vocation and calling recently.

There is so much to say. But for now I want to concentrate on some words that really touched me a few years ago and the key truth that I think they express beautifully.

In 1928, in St Mary's Hospital in London, Alexander Flemming discovered Penicillin. It is difficult to overstate the significance of this or the effect it has had on the world in the past 84 years. This plaque sits just outside the laboratory where Flemming worked. When I visited the lab I noticed it and asked the guide about it. He told me this was put up in Flemming's lifetime and he approved of the wording.

Very few of us will have as dramatic effect on the world as Flemming did. But whatever we do, I believe if we do it for the glory of God and for the benefit of the people who's lives we touch then we are very much living out a vocation.

I also think that if you haven't found your calling yet, working in this way in the meantime means that whatever you actually do, it can be of immense value.

Just some thoughts.

AFZ

Is God... A Doctor?

It has been my great pleasure to spend the last two days at Greenbelt. One thing I particularly enjoyed was a series of short talks under the title "Is God...?" Speakers are strictly limited to 10 minutes to answer their specific question. (They will all be available on Greenbelt TV over the course of this year). I have to admit I was disappointed not to learn the answer to the vital question "Is God Scottish?" but I did learn answers to the following: Is God Time? (Quite philosophical but actually practical; no and yes) Is God Evangelical? (Emphatically No but actually...) Is God offended? (Importantly, no) Is God Jewish? (No.) Is God Anglican? (Well, no. But interestingly Sir Christopher Wren is apparently the founder of Anglicism). Perhaps inevitably this set me thinking as to what question I could attempt to answer in 10 minutes. Perhaps more inevitably I was struck by the question Is God a Doctor? So here goes:

Is God A Doctor?
In my life I have taken a large number of exams. One of the cardinal rules of exams is that you must answer the question asked and not a different one that you want to answer. However when speaking or writing it is often a useful device to answer a different question. So I want to start by asking Is God A Surgeon?

No.

It's easy to tell the difference between God and a surgeon - God has no illusions about being a surgeon.

In his excellent book on medical ethics, John Wyatt presents the analogy of the human person as a masterpiece made by God and the role of the doctor is to restore this masterpiece. For me surgery can be quite humbling. When we repair bowel or a blood vessel, it is the body's own healing processes that does most of the work. When we 'fix' what's wrong with the body, it is evident to me that my restoration work is rarely - if ever - up to the standard of the original. Surgical solutions are certainly very good but surgery is still a relatively crude instrument.

This kind of thinking does beg a question; If God's masterpiece is so wonderful why do we have disease and (particularly) congenital anomalies requiring surgical correction? For me, the answer lies in the answer to the question of why a good God allows suffering. I don't want to duck that question but I don't want to get stuck in it either - simply I want to acknowledge that we live in a fallen world. So God is not a surgeon.

But is God a doctor?

The word 'doctor' has a couple of meanings - the original is 'wise and learned one.' In that sense of course God is emphatically a doctor; omniscience does give him something of an unfair advantage.

More commonly we think of a doctor as a healer. In this sense I also believe that God is a doctor. I believe God is very much about healing. Healing in every sense; physically of course, but moreover and perhaps more importantly emotionally and also most significantly spiritually. And everyone who's a follower of Jesus has a role to play in that.

I have no doubt that God heals miraculously and that annoys me - because he doesn't do it very often. Moreover I think it vital that we do not despise or minimise the non-miraculous. Any healing is a manifestation of God's grace. It is my great privilege to be part of that. The healing miracles of Jesus show that healing is indeed something God values and it is making earth just a little more like heaven and in that sense fullfilling the command to be the Kingdom of God on earth.

But what about when God doesn't heal? There is, I believe a very dangerous heresy around healing - the 'name it, claim it' theology. Your healing is available to you, if you simply have enough faith. I think this kind of thinking very dangerous and often damaging to vulnerable people. In response to it - to the idea that if you do not experience healing, is is because you don't have enough faith - I say this: Paul. Anyone who's read the New Testament would struggle to conclude he lacked faith - anyone who can write "For me to live is Christ, to die is gain" is someone who has deep faith and understanding of his place in this world and the next. And yet God did not heal him of his thorn-in-the-flesh. Despite Paul's repeated prayers. There are two things to say about this. Firstly, God does not promise to always heal in this life - the fact that godly men and women have died over the past 2000 years suggests to me that more often than not God says "no" to those prayers. Secondly God is not only a doctor but also God. He has a bigger agenda about building his kingdom and glorifying his son.

So what about when we see God not healing - what about death? It is always very dangerous to talk to a doctor about death, because we don't like what we can't cure! We cannot cure death - but I do know a man who can! I can offer a pretty good cure for appendicitis but for death... It is important to note that whilst death is inescapably part of God's judgement on a fallen world - the wages of sin is death - it is also paradoxically part of God's grace. For the follower of Jesus, death is release from the suffering of this world and of course so much more - death is the perfect healing!

Jesus reveals himself to be the ultimate physician in that he provides the cure for death - in every sense. Jesus the self-sacrificing physician who chose not to heal himself so that you and I might be healed.

Is God a doctor? He's the very best.

AFZ

Glibness - a definition

I've had a strong dislike for glibness for a very long time. As with all communication the key is not what is said but what is heard. I think glibness is so dangerous because it is a lie wrapped in a truth.

"Smile, Jesus loves you" definitely contains much truth. Jesus loves you more than you can possible imagine and that truth is the source of much joy, but most often when someone says that what they are saying - or rather what is heard is very different.

Glibness is this: "Your pain makes me feel uncomfortable so please can you pretend to feel better so I don't have to be uncomfortable..."

AFZ

Truth and lies...

I have in the past commented on my strong dislike of using factual statements to mask lies and deceive. Here is another example that is really winding me up at the moment;

"...this is the debate we ought to be having: how do we get resources from the back office on to the front line? How do we do it when right now only 11% of police officers are on the streets at any one time? That is the mess we have inherited; that is the mess we are going to clear up.”

David Cameron, Prime Minister’s Questions, 17 November 2010

“I think we all want more visible policing; it cannot be right that the system we inherited from Labour means that only 11% of police officers are ever seen on our streets at any one time. That is wrong and it must change.”

Nick Clegg, Prime Minister’s Questions, 10 November 2010

This 11% figure has been used quite a lot; it has come up again in the aftermath of last year's riots, with quotes like this: "Only one in ten police officers are on the streets fighting crime at any one time..." And this argument is used to suggest that the police force is very inefficient and can make savings without effecting community policing.

11% is quite impressive - that means 89% of police officers aren't available... Wow! And this is an official figure, it comes from Her Majesty's Chief Inspector of Constabulary.... You can read the Guardian's take on this report here.

The thing is though, that if one looks a bit closer at this figure, a somewhat different picture emerges.... Let's start by saying that as a nation we do want our police officers individually to have time off to sleep and eat and have a life and thus don't want them working 24 hours a day....

As you know I live in Alien Castle in England. Which lies in a small village. Now the local villagers are quite nice and don't cause much trouble but if we wanted to have a police station in the village that was staffed by one officer 24 hours a day, how many police officers would we need?

Three 8-hour shifts a day adds up to 1095 shifts a year. An individual officer working a 40 hour week would fill 260 of these shifts therefore we would need 4.2 officers. If we are going to allow them to have the normal amount of annual leave and allow for the potential of sick leave then just to staff one police station with one officer for this small village we would need 4.7 police officers.

So already we need 5 officers; so by definition only 20% of them are available at any one time (1 in 5!). Never mind the fact that real police officers do have to do a myriad of functions such as go to court from time to time and that many of the police's most effective roles such as CID are much less visible. This leads me to wonder if having 11% of serving officers actually available at any given moment is actually startlingly efficient?

AFZ

For the first time in 40 years, UK doctors are taking industrial action...

I am very torn by this. I didn't vote in the ballot - I couldn't decide what I thought. I certainly would never take strike action personally. In general I think the right to strike is a vital right in helping to redress the massive power imbalance between employers and employees. Of course, for vital services, like medicine, striking can never be an option.

In principal, I do think that taking some form of industrial action that did not harm patients could be justified. I am not convinced however, that such a thing is possible. On the other hand, the last time similar action was taken, apparently mortality went down - same number of staff on duty, only doing emergency work.

I am a paediatric surgeon in training and currently I am working in paediatric intensive care for a short secondment. Therefore this action will not effect me in any way - there's no way I could participate.

For most doctors this dispute is about honesty and fairness. And there is a lot of anger about this. It's also worth noting, that it's the same pension scheme for all NHS staff. So it's not just about high-earning doctors. Doctors only make up 10% of NHS staff, around a third are nurses and another ~15-20% are other professions aligned to medicine.

It is true that the NHS pension scheme is a very good scheme but I object to the term 'generous' for two reasons. Firstly, it is a contributory scheme and so - to a large extent - we pay for it ourselves. And secondly, it is part of the terms and conditions that everyone signed up for.

I've done a little bit of reading around this. As a back-of-the-envelope calculation, a lot of consultants will be on ~£100,000 / year. If they have 40 years of service to the NHS they would then be entitled to 50% of that as a pension (forty 80ths). A quick look on one of the many private pension sites tells me that such a pension would require a pot of ~£1.1m. I worked out that my pension contributions of around 8% on current pensionable pay for the years as a junior plus years as a consultant, roughly (without any interest or investment) comes to £500,000.

Notionally, the way the NHS pension scheme works is that the employer puts in a contribution of up to 11%. If you put these two contributions together over 40 years, then this pays for the pension. Over the past 30 years (or longer) the NHS pension has had a significant surplus. Governments of all flavours have decided, rather than investing the notional pension funds to keep the money in the exchequer and act as an underwriter to the fund. That is not necessarily unreasonable - for a nation-state. The excess returned to the exchequer is money the government would otherwise have to borrow. Currently the NHS pension fund is running at a £2Bn/year surplus.

In 2008, the NHS pension scheme was reformed significantly in such a way as to make it sustainable for the long term. Nothing has changed since then, the scheme is still sustainable in the long term. So this is simply a money-grab by the government.

The dishonesty and unfairness of it has angered many.

On the other hand, I daily thank God for the chance to do a job I love. And be paid well for. My income is very substantial and even if they do gut my pension I'll find other ways to save money.

It is worth noting that at my level (6-7 years experience - after 5 years at university) my basic pay is around £33k. I earn a lot more because of the out of hours work we do. I have to pay around £4000 / year in student loan repayments, £1000 / year in professional subscriptions so I can do my job and I have to pay for all my post graduate exams and most of the courses that I need to go on.

I am not pretending that I'm hard up. I'm really not. It's just that when you work a 90 hour week, you do tend to feel that you've earned the money you get. And that includes the pension scheme.

Having said that, I remain uncomfortable with the notion of taking action which runs a risk for patients. However, it is difficult to argue when people say the government has not given us any other option. They have completely and totally refused to negotiate. They have said, this is what is happening. No debate.

One final thought. When I read the various newspaper stories - all united in condemning doctors - I noted that in the comments sections, most of the comments were critical of the reporting and supporting doctors in taking action.

I remain torn. This is grossly unjust. There is no need for this change and the government is consistently lying about it (as they did about NHS reforms). On the other hand, I am a very well paid professional and the abuse and the indignity inflicted on the poor and particularly the disabled is a far greater injustice. So what is right? To stand up to this injustice or to accept that as well-off as I am, it is a minor indignity really? On the other hand, most NHS employees are not well paid doctors who will seriously suffer as a result of this assault on their pensions.

AFZ

snoitcelfer - 7 years on...

Recently I was preparing for a humongous, horrible and highly significant medical-interview. At stake, was my entire career - well future prospects anyway. One of the things one does in this situation is to review one's professional portfolio. In it I have a section - beyond all the publications and professional qualifications on Reflective Practice. 

This is there, because it is a requirement. Please don't misunderstand me, I think that reflecting on one's practice is vital, continuous and at the core of what we do. It's just that when someone gives me a piece of paper and tells me to "Reflect" I don't find it very helpful. Over my seven years of being a doctor there are a few interesting things I've put in there, often when things have not gone as well as we'd hoped. Learning how to deal with the unavoidable problems in medicine is - well - unavoidable... What really caught my eye though was something, again that was forced, which was a piece of reflective writing we had to do before qualifying.

My medical school - as do many - arranged for us to spend two weeks shadowing the doctor we would replace when we started work. This is a vital part of the process; learning where the blood bottles are kept, meeting the ward sister and learning how that particular job works. At the end of this time, we had to write something; this is what I wrote. 7 years on, I'm wondering what I would write now as a 'middle-grade' doctor.

Thoughts from a railway platform.

Some days, you being gone doesn’t matter as much

On those days, there isn’t a strange hole in my world

On those days, I don’t think about you constantly

On those days, I can remember certain things:

I can remember that we were trapped;

I remember that life goes on

I remember that truth is always better than a lie

I remember there is so much hope for many futures.

Some days, you being gone doesn’t matter so much

On those days, my world makes as much sense as it ever did

On those days, I think about all the parts of life I love

On those days I can be so much more free;

I can be free to live

I am free to enjoy what I enjoy

I am free from the hurt and the sadness

I am free from the fears of what won’t be.

The trouble is, today isn’t one of those days

It’s one of the other kind of days.

AFZ