Do we still want the NHS?

May 25, 2017

Unashamedly political post follows…you have been warned.

As a nation I feel we’ve shot ourselves in both feet voting to leave the EU; I’m sure it will happen and we will be able to repent at leisure. But, for my money, the biggest error is one we are making through neglect, or ignorance: the loss of the NHS.

Think about this: the Tories have been in power for seven years, during which time they have, in a drip-feed manner, made the NHS less effective through constant re-organisation and underfunding, brought in more profit-making private providers, and under-resourced it. There is a constant trickle of stories about clinical errors, longer waiting lists, people ‘wasting’ NHS time and resources: the right-wing press is doing its bit in undermining a national resource.

Over time, the gradual – and, I think deliberate – effect of this is to make more and more people, especially younger people who have never known anything else, or really had to think about healthcare at all, think that the NHS is inefficient, is broken, and cannot cope any more: if this is the case, then – the next stage of the right-wingers’ proposal goes, surely something needs to be done about it… Increasingly the arguments are, well there are more people to treat (especially immigrants and free-loaders from abroad), people are living much longer and therefore need care for much longer, and treatment is increasingly technological and expensive. Of course, a state-provided service can’t possibly deliver all this, it is suggested…

And so, when the Tories decide they can be bold enough to suggest privatising parts or the whole thing – in the interests of giving people better care, of course – enough people may believe them, and allow them to get away with it. And there will be the mantra that the NHS will always be free ‘at the point of delivery’ (whatever that means. Does anyone know?). Perhaps GP visits and A&E will be free, and beyond that, one will have to pay or take out additional insurance.

The great majority of British people have been born and have grown up looked after by the NHS, and have taken it for granted all their lives. We know nothing about how alternative systems work or what they cost – though again we are often told (by whom?) how much better other countries’ health care is than our own – though we may have heard horror stories from the USA, but we’d never end up with that, would we? Hmm. How much time do you want to spend comparing health plans, costs and so on to make sure you have the right deal? But then, since the privatisation of everything else, we have a generation used to doing cost-comparisons on websites for train tickets, energy, broadband: maybe people won’t mind. And if they can get a bargain…

Should you be worried? Well,if you’re inexorably moving towards old age, if the system that’s looked after you throughout your life disappears, what do you do instead? If you don’t have the disposable income to fund private healthcare? Of course, the pill can be sugared: look, we’ll reduce National Insurance payments when we sell-off the NHS, so you can now choose (magic word, there!) your own provider, and how much to spend…

The profit motive is expensive: profit has to be factored into the cost of everything. Of course, allegedly private enterprise is more efficient (it has done wonders for our railways, after all), so will be cheaper. I have to say, if I were seriously ill, in need of major surgery or intensive care, efficiency would not be my first criterion. Skill, care, empathy, things like those would be at the top of my list.

Declaration of interest: my mother was one of the first cohort of nurses to be trained by the infant NHS, and I have a sister who currently works for the NHS. If asked, I’d be hard-pressed to think of any contemporary aspect of our country that I’m prouder of than our health service. And plenty of other countries actually envy us. Give the Tories another five or ten years, and will we still have the NHS? Do enough people actually care?

On war

May 25, 2017

I bought another of Nobel award-winning Svetlana Alexievich‘s books recently: this one is about women’s experience of war. And I’ve found myself thinking: why do I read so much about war – novels, history and so on, why do I visit so many historical sites connected with wars? You have only to look back through the archives of this blog: isn’t there something slightly obsessive, unhealthy about this? I do wonder, sometimes.

We know there have been wars ever since humans have existed on the planet: somewhere I read once that in the last two or three thousand years of history there have only been about a hundred and fifty years where the world has been at peace – whatever that means.

Reading about war has shown me what an utterly vile species we are in terms of how we are prepared to treat each other. And yet, I have also come across countless accounts of astonishing acts of bravery and altruism. One might rather crassly argue that these two extremes cancel each other out; equally I might argue that without war, neither would occur, and that would surely be better for us.

Reading about war has made me profoundly grateful that I’ve never been called on to be tested in any of the ways I have read about; even more, I recognise how very fortunate I am to have grown up in a time of peace (at least, in the sense that my country has not been involved in a war which means attacks on our territory putting me and my family at risk… actually, writing a sentence like that one so as to be completely correct and accurate is impossible, but I’m sure you get my drift).

Having grown up during the ‘Cold War‘ (don’t politicians and the military love euphemisms!) made me realise at quite a young age that a war between Britain as a member of NATO and the Warsaw Pact would mean that ‘our’ side would be attacking countries where member of my family lived, and that ‘their’ side would be likewise attempting to kill us… and made me decide that I would never take part in such craziness. As I said above, I’m very grateful never to have been put to the test.

The more I’ve read and thought, the more I have come to think how utterly utopian it is to expect that things will ever be any different. I don’t think that war can be eliminated from our world without some kind of world government, and somehow I don’t see that happening in the near future. Neither can war be eliminated while the capitalist system persists, and I don’t foresee any end to that in short order. And the human ingenuity that has invented all sorts of gruesome weapons will continue, too, and what has been invented cannot be uninvented…

To look at today’s world briefly: many in the West are alarmed at the numbers of refugees flocking to our shores: it seems blindingly obvious to me that one way to address this would be to stop destroying their countries in the first place! We are very good at fighting proxy wars everywhere, and war is really good for business; although ISIS and Al-Qaeda have sprung from the fundamentalist Saudi Arabian variety of Islam, our leaders continue to buy enormous amounts of oil from that country and to sell it phenomenal amounts of weapons. And our leaders and businessmen are much safer from the random acts of terrorism that continue to afflict us, than ordinary people are.

Back to my first thought about being obsessed by war: I think it’s part of my quest to understand why the world is as it is, and to imagine how it might be different – one day, perhaps, long after I’ve left it…

Richard Byrd: Alone

May 23, 2017

I’m more than a little surprised by how many interesting books I come across when reading French newspapers and magazines; on a recent trip I went with a list of four books I wanted and came back with them all plus another must-have… and this was one of them, although originally written in English and available at a high price; the new French edition was nicely produced and sensibly priced.

It’s an astonishing piece of exploration and travel writing from the 1930s: Richard Byrd (a US admiral) was an explorer who (among other things) set up a base on the edge of the Antarctic ice shelf, from which a small station a couple of hundred miles further inland was also set up, in order to make meteorological observations during the polar night; because it was a dangerous task, Byrd, as expedition leader, decided to undertake the task himself, spending several months alone in the polar darkness.

He’s fully aware of the risks he’s taking, and begins with acute and almost disinterested self-observation. He knows he could fall ill, injure himself, get lost whilst outside, suffer from the fumes of his stove, and is several days from possible help or rescue. But it’s the psychological effects of solitude he is initially interested to observe in himself and record; he’s a very intelligent and literate man and so does this well and interestingly.

The horror then starts, and it is truly shocking. He nearly dies from carbon monoxide poisoning because of a malfunctioning generator which drives the wireless transmitter he uses to keep in contact with his base, and as a result of this, realises that certain symptoms he had previously been experiencing show that his heating stove – on which his very life obviously depends – has also very slowly and insidiously been poisoning him. And the depths of polar winter, night, storms and cold – we are talking up to minus 70 Fahrenheit here – are approaching. If he cannot function to keep himself warm, he will die. And if he overuses his stove, it will also kill him…

Recovery from severe carbon monoxide poisoning is truly horrific, from his description: it will take months for his liver and spleen to repair his blood. He can hardly eat, vomiting most things, has appalling headaches, his eyesight is affected and he becomes physically very weak. Nevertheless he attempts to continue his weather recording, rations his use of the stove to a few hours a day because it is not possible to repair or modify it, endures dreadful cold, and will not call in help because it would mean others risking their lives.

I’ve read a number of accounts of men coping with extreme conditions, and this sits alongside voyages like Shackleton’s, or, at the other extreme, journeys through places like the empty quarter of Saudi Arabia; the effects of the poisoning were truly scary and Byrd admits freely that there were times he almost succumbed to the temptation to give up: another of the effects of carbon monoxide poisoning is the inability to sleep; he had strong sleeping tablets with him, which he did not give in to the desire to take… I can see why it took four years and considerable persuasion to get him to commit his account of those months to paper. It’s an astonishing read, an account from a true explorer who was unafraid to take risks and almost paid with his life.

Norman Davies: Trail of Hope

May 17, 2017

Norman Davies is probably the leading expert on Polish history in Britain; he has written the best and most detailed academic history of Poland, as well as several books on specific episodes in the nation’s history such as the Warsaw uprising or the war with the Soviet Union in 1920. Here he attempts to trace the Polish diaspora which resulted from the Nazi-Soviet pact of August 1939 that led to tens of thousands of Poles from the eastern half of the country being deported to and imprisoned in the Soviet Union, thousands of them being deliberately murdered and thousands more dying of starvation and ill-treatment.

It’s clearly a labour of love, and not one in the style of earlier academic works. It reflects Davies’ travels through many lands, and his friendships and contacts with many Poles in many countries; it’s copiously illustrated with photos, maps, drawings and detailed extracts from memoirs, and manages to give a voice to the generations which have now largely died.

When the Soviet Union was attacked by Nazi Germany in 1941, Stalin agreed (after a fashion) to allow the Polish prisoners of war to leave the country and join the Allied war effort in the West. Of course, the many thousands of officers whose deaths Stalin had sanctioned and the NKVD carried out at Katyn were not available to join them. A Polish Army was established on Soviet soil and gradually made its painful way, with many thousands of civilians in its wake, first to Persia (as it then was) and subsequently by many diverse routes, and over a lengthy period of time, came to take part in various campaigns in the war, notably at Monte Cassino in Italy, and Arnhem in Holland. For some reason which I have yet to fathom, Davies concentrates almost entirely on the Monte Cassino trail, and the Arnhem battle merits less than a page. This I found particularly disappointing, as it’s my father’s story…

Davies spares no-one in his criticism and condemnation of the Allies’ betrayal of the Poles all down the line, and he’s right, I think: men who had lost everything gave all they had left in the hope of freeing their country and eventually returning home. This was not possible, as their part of Poland was ceded to the Soviet Union, which automatically regarded them as Soviet citizens, not Poles. Few did return, and of those who did, a good number disappeared. The rest remained, exiles, refugees, and not very welcome in post-war Britain. It’s a shameful story which is not widely known.

Trail of Hope is a weighty tome and a very welcome addition to the existing works on the subject. At the same time, it has its flaws, which I will charitably put down to poor proof-reading and checking at the production stage – careless typesetting, spellings and transliterations of names and place-names in many countries lack any consistency, with variations even on the same page (!). And I shall be attempting to discover why the Arnhem story is sidelined. But if you want to know about a little-known aspect of the Second World War, this is a book to read.

Erika Mann: When the Lights Go Out

May 16, 2017

This novel – a collection of linked stories really – is very grim and depressing, made more so by the fact that we know what came after. It was first published just after the start of the Second World War (though its publishing history is incredibly complicated, as the critical apparatus with this edition made clear), and the author is the daughter of Thomas Mann, the perhaps better-known German writer. She sets her stories in a small town in southern Germany in the years between Hitler’s seizure of power and the start of the war, and bases them on actual events and people she knew.

Although we know about the history of the war, and the debate about how much the average German knew about or participated in various atrocities of the Nazi era, understanding the lives of ordinary people, the choices they made, the silences they kept and the difficulties they faced, is rather harder, partly because of unwillingness to speak or to own up to their own past, and also increasingly because those who lived through those times are dying off. Much has been researched and written in recent years about how the Nazi regime extended its grip throughout society and sustained it for so long, but somehow fiction is able to bring the details and the effects to life and to our understanding in different ways.

Mann uses a small number of characters – perhaps a dozen or so – in the years leading up to the start of the war. Already, then, hindsight suggests how much worse it must have been later on. There are the shortages of food, before the war starts, the gradual prioritisation of re-armament and planning for aggression and its effect on the job market and what consumers could buy; there is the growing craziness of the effects of a tightly planned economy. Smaller shopkeepers are closed down because they are inefficient, workers are increasingly detailed to particular jobs, there are expectations that everyone will take part in extra work at weekends: all of this increasing inefficiency, and the production of inferior goods, may well remind us of what we know about the various problems and eventual failure of the Soviet Union. All of these details, no doubt available in textbooks and history books, (and Mann gives us her sources), are woven into the lives of ordinary people – her characters.

A young couple, planning to marry, overworked and undernourished, are driven to suicide by what a court eventually describes as a ‘regrettable error’ – a careless Nazi doctor accuses the woman of having had an illegal abortion and the concentration camp beckons. A leading doctor who has kept his head down and his nose clean for several years in the vain quest for a quiet life, is appalled by the increasingly poor training and ineptitude of medical staff because of the way the regime has organised their training, prioritising their employability not by their skills but by party loyalty, the number of children they have and their sporting prowess. A factory owner is horrified to discover that his secretary, to whom he has been making advances, is half-Jewish. A local Gestapo leader, unable to stomach the orders for the Kristallnacht pogrom, disobeys orders, enables some Jews to escape, then flees to Switzerland and is returned to his fate in Germany by the Swiss authorities…

I can imagine that in 1940 this book may have shocked many readers; it will probably shock less now, or else in different ways. We often wonder, why did nobody say or do anything, or resist in those early years? The answer is that some did, but it was not enough, the regime’s tentacles spread control very quickly and thoroughly, creating an atmosphere of fear through surveillance and spying. And initially, many did well enough out of the new regime…

At some level, the book remains a warning, to everyone, to be vigilant, and perhaps in our current uncertain times of increasing xenophobia and nationalism, we should heed such warnings.

Note: an English translation of the book exists, but I read the newly-published French paperback.

Antony and Cleopatra at the RSC

May 15, 2017

I’ve also been lucky enough to have taught this play to sixth formers a good number of times; again, a play I’d never seen on stage till now, although I admire the Trevor Nunn film version which we used to use in the classroom. But I’m utterly convinced now that Antony and Cleopatra is my favourite Shakespeare play, and also that this performance is probably the best Shakespeare performance I’ve ever seen on stage. I was utterly gripped throughout apart from a brief moment during the sea battle scene: I was able once to remind myself that I was ‘only’ watching a performance on a stage, but from my seat in the centre, towards the front of the stalls, I was there, and it was riveting.

Given that it’s quite a bitty play in a lot of ways, flitting from Rome to Egypt and back again so many times in a large number of very short scenes at certain points, what made it work here? Simplicity of the set and a clear visual definition of Rome and Egypt certainly helped, as did the pace of the performance – not rushed, but not disjointed either, which helped convince me of the inevitability of Antony‘s disintegration, as Rome slips through his fingers. The sense of tragedy develops surely and certainly from the coincidence, as we see Antony realising as he loses Rome, that Cleopatra is more important to him, the most important thing in his world: I was totally convinced of their love for each other, although this is perhaps harder to detect in Cleopatra, who is empress of Egypt and used to having everything just as she wants it, her every whim satisfied on the instant. For me it worked. Cleopatra is inevitably selfish, never having had reason to be anything else, but I felt she came to realise her love for the man who has lost all, given all for his love of her.

Cleopatra was superbly cast and played, exuding luxury and sensuality and Egypt, Antony and Octavius were very convincing and Enobarbus, whom it’s impossible not to love, was outstanding. Even his death, which must be one of the hardest to carry off effectively onstage nowadays (he dies of a broken heart) convinced. And I came to understand much more about Cleopatra’s women too, their love, loyalty and devotion to their queen shown through the adoration in their eyes fixed on her and ready to respond to her slightest look, word, gesture or whim.

For me, the sense of tragic waste with the death of Antony, and then of his lover, was full and complete. It was marvellous to hear the gorgeous language that Shakespeare poured into this play delivered so effectively and powerfully; the stagecraft was astonishing and it was, for me, an amazing production.

Julius Caesar at the RSC

May 15, 2017

I’ve just got back from my annual Shakespeare week, having seen productions of both Julius Caesar and Antony and Cleopatra.

They’re doing a Roman season at the RSC, so there’s a certain coherence to the staging and set design, which I really liked, and I think one of the things that struck me most about this production was its coherence: all the characters worked well together and the set enhanced the overall effect. And I was fortunate enough to have a seat in the middle of the third row, so the view was stunning.

Brutus and Cassius made a really good pairing, and I got a strong, clear picture of the closeness of their friendship, and their centrality to the play which I did not have from previous readings of the play and filmed performances. We see the strength of the bond between them, the stresses and tensions it endures, and its survival to the bitter end: the scene of their quarrel in the Roman camp was very moving, particularly when it came to the news of Portia‘s death; despite his stoicism, Brutus’ humanity shone through as well. And the moment of their final farewells to each other on the morning of the battle, which I’ve always found effective even in a reading, was very touching.

The nature of the stage set made the moments after the murder of Caesar astonishingly effective: you really had the impression that not only had the conspirators not thought things through beyond the actual killing, but also that they somehow had not fully realised that they were going to kill someone, and what that meant…

There were strong performances from other characters, too: Caesar’s physical weaknesses and frailties were well portrayed; Antony was clearly a chancer and a gambler, and the callow youth that Octavius was seemed very real, like an arrogant sixth-former who has just been chosen as deputy head-boy, polite and well-behaved but with a power-hunger just below the surface. It’s not a play with strong female roles; Portia worked for me, but Calpurnia didn’t: I just couldn’t see her as Caesar’s wife.

I’m really glad to have finally seen a performance after having taught it so many times in the past; the BBC Shakespeare film version never really cut the mustard for me, so this really was a special treat.

On a certain lack of understanding

May 4, 2017

I wouldn’t say I’m obsessed by war, but I do find myself thinking about it a lot, and I suppose given my family’s history, it’s not that surprising: my father was born and spent his early years in a village pretty much on the Eastern front line in the Great War, and ended up in England as a result of the Second World War, during which my mother was a child. I’ve recently been on my annual walking holiday in the Ardennes, and each time I’ve learned a little more about the Battle of the Ardennes in winter 1944-45, the enormous casualties and the horrors civilians endured during this last gasp of the Nazi war machine.

The European project emerged from the ashes. It was idealistic: the twice-repeated horrors of the first half of the twentieth century should never happen again. Initially it was mainly an economic project, binding countries together with links and ties that eventually began to grow into a more political union. Britain was outside for a long time, a nation that had become great, building an empire on conquest and commerce and trade, and gradually losing it again. Britain had stood alone for two years, unconquered; some people felt we had ‘won’ the war. But we wanted the trade advantages of the ‘Common Market’ and strove to gain admittance; we wanted the chance to trade with a huge and growing market and make more money. I don’t think that, as a nation, we ever really understood the real thinking behind the project. We hadn’t been conquered and devastated twice in thirty years.

1973: we joined. The EEC became the European Community and then the European Union. We seem to have done well commercially and financially, but we never really wanted the rest of the project, which we seemed to see as interference in our affairs, faceless bureaucrats in Brussels wasting ‘our’ money; we never really understood what was behind it, and preferred to hang on to the US coat-tails instead. We could have been in there in partnership with the French and the Germans developing and shaping a great project. Who knows, if we had played our part, we might now have a better and more democratic Europe, more to our liking.

2016: we decided to leave. We will leave, and lose many, if not most of those trade advantages that attracted us in the first place. Talk about cutting off the nose to spite the face…

I am deeply saddened by the turn of events, and have come to feel that as a nation we don’t understand Europe, we probably don’t belong in Europe, and that it may well be better for Europe that we are outside again. I don’t believe our politicians have a clue about what they are doing. I wish more of my fellow-citizens did understand, and shared the wish to build something worthwhile. I don’t have any illusions about the EU being perfect – far from it – but that doesn’t make it any less a noble idea.

Ibn Tufayl: L’Éveillé

May 3, 2017

In some ways this is an astonishing little book: an Arab writer in the twelfth century prefigures Defoe’s Robinson Crusoe. It’s a little more complicated than that, however.

We are told the story of a child who grows up from birth entirely alone on an island; either he was spontaneously generated, or else washed up onshore having been set adrift by his mother after his birth (echoes of Moses in the bullrushes here), and is initially fed by a gazelle (!). He grows up and learns about his environment, how to feed himself, how to hunt and shelter himself. Alone, he has all the time in the world to think, to reflect, to contemplate and to figure things out. And he works out the differences between animal, vegetable and mineral, experiments to find out where life resides in living creatures, and eventually comes to reflecting on cause and effect, which leads him to the prime mover and the idea of God.

Having attained enlightenment, towards the end of the story he meets another human being, a man who moves to his island to become a hermit. The two of them return to the main island to offer their message of enlightenment to everyone and are rejected, and so decide to return to their peaceful isolation and contemplation.

It’s obviously fiction, and with a didactic purpose: man as a rational creature should be able to deduce the idea of a creator and offer due veneration. It’s a tale of a man alone on an island, and apparently Defoe had read an English translation which appeared towards the end of the seventeenth century, so about thirty years before Robinson Crusoe was published. It doesn’t really read like a novel, though: obviously it comes from a completely different literary tradition which does not need to be judged against or compared with western standards, and anyway was written some six centuries before the novel developed in the west. If anything it reminded me of tales like Rasselas or Candide, which aren’t really novels either; they are fiction as in made-up, but the message the author wishes to communicate to the reader is far more foregrounded than any other aspect such as plot or character. We are on the way to the novel, but not there yet, by any means.

I found it an interesting read, though over-philosophical in places, and it was another reminder of the wealth of learning, knowledge and speculation that developed in the Arab world during our so-called ‘Dark Ages’.

Ismail Kadare: Le Grand Hiver (The Great Winter)

May 3, 2017

51xrmj+pVjL._AC_US218_Ismail Kadare has been a prolific writer of fiction, although a good deal of it is still not available in English translation, and for a long while novels that did appear in English were actually translated from the French rather than the original Albanian. Some of the novels deal with late twentieth century Albanian politics – like the one I’m writing about here – whereas others are more allegorical, or deal with Albanian history and mythology.

The Great Winter (Le Grand Hiver) deals with the break between Albania and the rest of the socialist camp in the early 1960s, pitting Enver Hoxha against Nikita Khrushchev, the Stalinist against the de-bunker of Stalin. It’s a very long and detailed novel which in many places is much more like a drama-documentary than actual fiction: think recent televised reconstructions of historical events and you have the idea. The times, the people and the attitudes may feel like ancient history now, but the hopes and fears of the characters were very real at the time – the first split in the socialist camp, the isolation of one of its members, and the possibility of war.

In some ways, I suppose, it’s meant to be socialist realism: along with the main (fictional) character Besnik, a young translator and journalist who is deeply involved with the crucial meeting at which the rift finally comes into the open, and who is plagued by guilt that he may have mis-translated at a crucial point, thus precipitating events, there is a myriad of minor characters presented in thumbnail and more detailed sketches as a cross-section of Albanian society of the time. One gets quite a clear impression of the limitations and restrictions on life in a strictly-controlled state, with impressions of secret police lurking in the background; equally there is still a great deal of youthful enthusiasm for the construction of a socialist state, and national pride in being able to stand alone.

I kept being reminded of some of the epic Russian novels I have read, and certainly a list of all the characters and their part in the story to be able to refer to, would have been a help while reading; the careful and detailed end-notes clarifying the manoeuvres of politics at the time were useful.

In the end I found it a very depressing novel. Firstly, the hero gives up – initially through neglect and then later almost through deliberate choice – his fiancee and upcoming marriage because of the momentous importance of the events in which he has become involved: there is no time for the personal. He finds himself anew through political commitment at a time of crisis, in an existential manner. Secondly, it’s depressing because, of course, everything in terms of politics, socialism, enthusiasm for building a new world, has now completely vanished, almost as if it had never been – all that will and power and energy wasted. And this does not mean that I approve of all the evils of those times and hanker after Stalinism: I just wish that some of the bright hope and enthusiasm of those days had survived.

I have found myself wondering about Kadare’s attitude to Albania and its rulers at that time; into some of his more allegorical works – The Pyramid, for instance, or The Palace of Dreams – criticism of various aspects of totalitarianism and personality cults may be read, but this novel, and another similar one which I shall probably re-read soon, The Concert, appears quite fair and balanced in its approach. I wonder what a reader in a century’s time will make of such a novel and such a writer. And yet both are needed, to preserve the memory of what once was and how people once were…

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