As you get older, you spend more of your time in hospital - not just for your own ailments, but for those of your parents. This accelerates with increasing age. There are visits with your parents to a widening range of specialists followed by ever-longer hospital admissions, and then terminal care. You remember the grim meeting with medical staff leading to consent for ‘Do not resuscitate’, followed by the wait as the defences of a weakening body finally give way. These memories stay with me, but I also remember sitting by bedsides watching life in a hospital ward. What I usually observed was active neglect. Nurses would talk to each other in their ward station while incontinence bags overflowed. Every 10 or 15 minutes a nurse would walk round the ward looking briefly at each at patient but not talking to them. No-one in the hospital saw it as their responsibility to comfort the sick and the dying.
How could this happen? One possible reason is staff burnout. Many people find talking to ill people emotionally taxing. This can wear down the kindest of people, who escape pressure by reducing the emotional content of their interaction with patients or clients, and convert their work to a set of technical procedures. But this raises the question of why organisations do not take steps to avoid burnout or why they continue to tolerate it among their staff. I think the main reason this happens is because the emotional content of professional and personal support work is seen as problematic: the direction of training this group of staff has therefore instead emphasised the acquisition of technical skills. Ethics is still taught as a subject in professional training, but has been reduced to a set of guidelines to follow in obtaining consent for research or for the application of medical, nursing or other procedures.
This loss of the emotional content of health and social care is part of a wider trend towards the excision of passion and feeling from organisational life. It is assumed that no-one works because they have skill and personal commitment, and a passion to apply it to their work. One consequence is the belief-in-practice (written into numerous guidelines and codes of practice and quality assurance manuals) that no-one can be trusted and no-one can perform well unless regulated and inspected or, if they are senior managers, given generous financial bonuses to do their work. This belief becomes self-fulfilling: staff become de-motivated and truculent under the weight of inspection, while senior managers become oriented solely to their bonuses and neglect wider responsibilities.
Of course it is often argued that such mechanisms of control are necessary to manage large organisations and complex centralised states. But this fails to ask whether we need such large organisations or whether our society should be so centralised. It is possible that this trend to centralisation has come about not because it is better at producing goods and services, but because it has generated a new and dehumanised ethos of organisational rationalism. This incorporates the distrust of human emotion and commitment, and hence the negative view of human nature. It proposes instead that humans are properly motivated only by a combination of financial rewards and penalties. This looks rational in the sense that economists speak of rational behaviour, but at its core are the darker emotions of greed, fear, and love of power.
Thursday 28 May 2009
Thursday 14 May 2009
You are not included
Are you socially-excluded? If so, what exactly have you been excluded from? Is it from the basic things of life like a decently-paid job, an active community life, and having a spouse and children? Or is it from life’s pleasures, like eating Marks and Spencers’ ready meals, going on foreign holidays, or even membership of an exclusive London club?
‘Social exclusion’ is a wonderfully vague phrase promoted by governments because it avoids the need to talk about poverty and inequality. It is never made clear precisely which sorts of people are socially-excluded, or what precisely they are excluded from. Nor is evident why they are excluded in the first place. The term ‘socially-excluded’ has at different times been used to include people on low incomes, disabled people, people from ethnic and racial minorities, and even the elderly and the young. When the phrase first became part of political discourse in the 1990s, it was agreed that the problem lay with the excluders - with the lack of opportunities for well-paid work, with poor schools and with discrimination. Now governments increasingly suggest that the problem lies with the excluded, and that ‘social inclusion’ really means coming off welfare benefits. So the unemployed, single parents, the disabled and the chronically sick are to be hectored into taking poorly-paid work, irrespective of the fact that work of any kind is getting hard to find. Of course, if it all gets too much for the socially-excluded, cognitive behaviour therapy will be made available to cheer them up.
But the hectoring received by the ‘socially-excluded’ is only a rather more extreme version of what the rest of us have to put up with. This Government have sent leaflets to our homes telling us that we must all eat more healthily, that we must wash our hands, and use a tissue when we sneeze. Our children are assessed and examined more frequently than in any other country in the world, so that teachers can be harassed into improving their school’s position in national league tables. To supposedly prevent crime, we are watched, scanned and regulated by the largest CCTV network in the world. To supposedly prevent terrorism, basic legal protections are stripped away, with old men arrested as ‘terrorists’ if they heckle the prime minister at a Labour Party conference.
Yet there are small groups of people who have been exempt from all this monitoring, assessment and harassment - our financial sector and our members of Parliament. Financial leaders have squandered cash on foolhardy investments and driven their institutions to bankruptcy. Once found out, they have retired on very generous pensions while their banks have been funded at immense expense for the taxpayer. Many members of Parliament have used an elastic expenses system to refurbish one or more houses, make large capital gains, clean their moats, employ their spouses on generous salaries, and buy porn videos. When they are defeated at the next general election, they too will retire on a generous superannuation. Both bankers and members of Parliament explain away their behaviour by saying they acted within the rules, and that their activities were subject to audit. But this audit and inspection has been a sham - designed to give the impression of regulation while actually allowing them a free hand.
A sham if this kind exists because the powerful believe in their hearts that those who make the rules need not live by them. This network of beneficiaries constitute the ‘politically-included’, who live from the savings and taxes of the rest of us (the politically-excluded) who must pay for our own mortgages, rents, patio heaters, dogfood, moat-cleaning and so on. Nevertheless, this experience may be character-building, and we have a chance in future elections to improve the characters of our current politicians by enabling them too to experience the delights of political exclusion.
‘Social exclusion’ is a wonderfully vague phrase promoted by governments because it avoids the need to talk about poverty and inequality. It is never made clear precisely which sorts of people are socially-excluded, or what precisely they are excluded from. Nor is evident why they are excluded in the first place. The term ‘socially-excluded’ has at different times been used to include people on low incomes, disabled people, people from ethnic and racial minorities, and even the elderly and the young. When the phrase first became part of political discourse in the 1990s, it was agreed that the problem lay with the excluders - with the lack of opportunities for well-paid work, with poor schools and with discrimination. Now governments increasingly suggest that the problem lies with the excluded, and that ‘social inclusion’ really means coming off welfare benefits. So the unemployed, single parents, the disabled and the chronically sick are to be hectored into taking poorly-paid work, irrespective of the fact that work of any kind is getting hard to find. Of course, if it all gets too much for the socially-excluded, cognitive behaviour therapy will be made available to cheer them up.
But the hectoring received by the ‘socially-excluded’ is only a rather more extreme version of what the rest of us have to put up with. This Government have sent leaflets to our homes telling us that we must all eat more healthily, that we must wash our hands, and use a tissue when we sneeze. Our children are assessed and examined more frequently than in any other country in the world, so that teachers can be harassed into improving their school’s position in national league tables. To supposedly prevent crime, we are watched, scanned and regulated by the largest CCTV network in the world. To supposedly prevent terrorism, basic legal protections are stripped away, with old men arrested as ‘terrorists’ if they heckle the prime minister at a Labour Party conference.
Yet there are small groups of people who have been exempt from all this monitoring, assessment and harassment - our financial sector and our members of Parliament. Financial leaders have squandered cash on foolhardy investments and driven their institutions to bankruptcy. Once found out, they have retired on very generous pensions while their banks have been funded at immense expense for the taxpayer. Many members of Parliament have used an elastic expenses system to refurbish one or more houses, make large capital gains, clean their moats, employ their spouses on generous salaries, and buy porn videos. When they are defeated at the next general election, they too will retire on a generous superannuation. Both bankers and members of Parliament explain away their behaviour by saying they acted within the rules, and that their activities were subject to audit. But this audit and inspection has been a sham - designed to give the impression of regulation while actually allowing them a free hand.
A sham if this kind exists because the powerful believe in their hearts that those who make the rules need not live by them. This network of beneficiaries constitute the ‘politically-included’, who live from the savings and taxes of the rest of us (the politically-excluded) who must pay for our own mortgages, rents, patio heaters, dogfood, moat-cleaning and so on. Nevertheless, this experience may be character-building, and we have a chance in future elections to improve the characters of our current politicians by enabling them too to experience the delights of political exclusion.
Wednesday 6 May 2009
How to be Impatient - Part One
You are standing in a queue at a railway station waiting to buy a ticket. The train will leave soon. The person buying a ticket is fussing with their money, then asks for a timetable, and then asks the staff in the ticket-window which platform the train leaves from. When told ‘Platform 2', they ask ‘Where is Platform 2?’ If you feel mounting irritation at this point, you are, like me, one of the impatient.
Few people seem able to praise impatience; cultural superiority lies with the stolid, the patient, and the inert. Never mind that most innovations have occurred because some impatient person got sick of waiting. This all means that impatient people, like me, are an oppressed cultural minority: we need to use our wits to survive. This obviously requires a lengthy book of hints, of the kind that get sold in airport bookshops. Regard this text as Part One.
The main area in which impatience is experienced, at least in England, is on the roads. I drive a small sports car, and enjoy zipping along the open road. However, a more usual traffic experience is to be at the end of a queue of slower vehicles, tailing along behind a Nissan Micra (the underpowered car for underpowered people). This shows the terrible paradox of driving - that the slower the car, the more likely it is to be in the front of the traffic with an unimpeded view of the road ahead.
So there is not much advice I can give impatient drivers. However, I do have a handy hint regarding another area of impatience: which queue to join in the supermarket check-out. My advice, based on sustained observation and testing, is to choose the queue with the fewest women. There are two main reasons:
1. Women are nicer than men. Women are more prepared than men to regard the staff on the checkout as people, worthy of conversation. This takes time. They will also attempt to help the checkout staff by giving the exact change for their purchases. This involves carefully sorting through their money and counting it out. This also takes time, and contrasts with the male approach of dropping a banknote.
2. Women are more careful with their money than men. Most men keep their cash in their trouser or jacket pockets. Women, on the other hand, keep their cash in a series of containers, each inside the other. The purse (designed to be small and difficult to get fingers into) is kept inside a handbag, which is often inside a shopping bag. Any purchase is therefore preceded by a sequence of money-discovery, and followed by a reverse sequence of money-concealment.
To come later: hints on how to break the buffet queue.
Few people seem able to praise impatience; cultural superiority lies with the stolid, the patient, and the inert. Never mind that most innovations have occurred because some impatient person got sick of waiting. This all means that impatient people, like me, are an oppressed cultural minority: we need to use our wits to survive. This obviously requires a lengthy book of hints, of the kind that get sold in airport bookshops. Regard this text as Part One.
The main area in which impatience is experienced, at least in England, is on the roads. I drive a small sports car, and enjoy zipping along the open road. However, a more usual traffic experience is to be at the end of a queue of slower vehicles, tailing along behind a Nissan Micra (the underpowered car for underpowered people). This shows the terrible paradox of driving - that the slower the car, the more likely it is to be in the front of the traffic with an unimpeded view of the road ahead.
So there is not much advice I can give impatient drivers. However, I do have a handy hint regarding another area of impatience: which queue to join in the supermarket check-out. My advice, based on sustained observation and testing, is to choose the queue with the fewest women. There are two main reasons:
1. Women are nicer than men. Women are more prepared than men to regard the staff on the checkout as people, worthy of conversation. This takes time. They will also attempt to help the checkout staff by giving the exact change for their purchases. This involves carefully sorting through their money and counting it out. This also takes time, and contrasts with the male approach of dropping a banknote.
2. Women are more careful with their money than men. Most men keep their cash in their trouser or jacket pockets. Women, on the other hand, keep their cash in a series of containers, each inside the other. The purse (designed to be small and difficult to get fingers into) is kept inside a handbag, which is often inside a shopping bag. Any purchase is therefore preceded by a sequence of money-discovery, and followed by a reverse sequence of money-concealment.
To come later: hints on how to break the buffet queue.
Monday 4 May 2009
The conspiracy continued...
On the very next day, I read the following letter in my local newspaper, the Worcester News, on 3 may 2009:
Pershore
As I suspected, some people will find a conspiracy everywhere.
SIR – It is highly worrying that on Tuesday morning at Birmingham airport, 400 passengers were allowed to leave a flight from Brazil and go their separate ways – without any checks, records or advice.
Why did nobody go on the plane before embarkation, check the passengers and give advice?
It is now quite obvious that the authorities are not serious about containing the spread of this virus – and for very good reasons. The benefits of a worldwide killer pandemic are huge!
A large global loss of life through ostensibly “natural causes” would lift a huge burden from politicians, by reducing world over-population at a stroke without the enormous cost of any war. It also instantly reduces the demand on our stretched food stocks.
I would go further and say that it might have been surreptitiously and deliberately introduced and Mexico would be the ideal propagation nation. The pieces of the puzzle fit rather too neatly for my liking.
So, always use a hanky and wash your hands frequently.
STANLEY D PARR,Pershore
As I suspected, some people will find a conspiracy everywhere.
Sunday 3 May 2009
The Great Mexican Swine Flu Conspiracy - Gate
The 20th century saw the creation of a wide range of new art forms: the cinema, television, arranging seats in football stadiums to make words and pictures, and the Internet conspiracy theory. Of course, conspiracy theories are not new. Through much of history European countries have blamed any experience of collective adversity on the Devil or the Jews. But the 20th Century saw many new scapegoats, including international capitalism and international communism, the oil industry, Muslims, and (in the USA) the Federal Government and something called ‘the New World Order’. The Internet has allowed conspiracy theories to multiply and spread in days rather than months or years. The isolated and paranoid can meet their fellows on-line and confirm and reinforce each others’ beliefs.
What makes a good conspiracy theory? There should be a major disaster involving loss of life. Obvious natural events, like earthquakes, floods, and volcanoes must not be involved (although this will not stop enthusiastic religious believers from attributing these causes to the desire of a just and loving God to indiscriminately wipe out large numbers of guilty and innocent people as a sign of man’s fall from grace). There must be some real or imagined discrepancy in the official explanation for the disaster, which can ascribed to a desire by those responsible for the conspiracy to hide their involvement. Further attempts by governments to clarify causes of the disaster, hold commissions of enquiry etc, will be portrayed as a ‘cover-up’, usually involving the suffix ‘gate’. The fact that an effective cover-up would require complicity by the entire government, press and civil service becomes ‘evidence’ that it is a truly immense conspiracy.
What are the conspiracy theories of the future? I propose that Mexican Swine Fever could do the job. This began with predictions of pandemics and millions of fatalities. Then, all of a sudden, we heard of a few non-fatal infections. A conspiracy theorist would argue that the millions of deaths have and actually are taking place, but that governments are covering this up by taking over isolated warehouses and incinerating bodies in secret. Lots of people disappear every year, and this explains what is happening to them. Other bodies are being loaded on to ships and sent to the Gulf of Aden, where Somali pirates, who are part of the conspiracy, capture and sink the ships. We could imagine an even more comprehensive conspiracy theory, in which governments are responsible for the Swine Fever in the first place. This could be a result of using pigs for germ warfare experiments, to be tried out first on the Mexican population. Perhaps governments are in league with the Green Movement, who believe that only a massive reduction in the world’s population can - er - save the world’s population. Of course, the conspiracy theorists could themselves be part of an even wider conspiracy...
What makes a good conspiracy theory? There should be a major disaster involving loss of life. Obvious natural events, like earthquakes, floods, and volcanoes must not be involved (although this will not stop enthusiastic religious believers from attributing these causes to the desire of a just and loving God to indiscriminately wipe out large numbers of guilty and innocent people as a sign of man’s fall from grace). There must be some real or imagined discrepancy in the official explanation for the disaster, which can ascribed to a desire by those responsible for the conspiracy to hide their involvement. Further attempts by governments to clarify causes of the disaster, hold commissions of enquiry etc, will be portrayed as a ‘cover-up’, usually involving the suffix ‘gate’. The fact that an effective cover-up would require complicity by the entire government, press and civil service becomes ‘evidence’ that it is a truly immense conspiracy.
What are the conspiracy theories of the future? I propose that Mexican Swine Fever could do the job. This began with predictions of pandemics and millions of fatalities. Then, all of a sudden, we heard of a few non-fatal infections. A conspiracy theorist would argue that the millions of deaths have and actually are taking place, but that governments are covering this up by taking over isolated warehouses and incinerating bodies in secret. Lots of people disappear every year, and this explains what is happening to them. Other bodies are being loaded on to ships and sent to the Gulf of Aden, where Somali pirates, who are part of the conspiracy, capture and sink the ships. We could imagine an even more comprehensive conspiracy theory, in which governments are responsible for the Swine Fever in the first place. This could be a result of using pigs for germ warfare experiments, to be tried out first on the Mexican population. Perhaps governments are in league with the Green Movement, who believe that only a massive reduction in the world’s population can - er - save the world’s population. Of course, the conspiracy theorists could themselves be part of an even wider conspiracy...
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