Mind Tech unConference – 30 March 2012

Summary

Some thoughts from today’s gathering

It was quite timely on a personal level to have found out about this gathering via Beatrice Bray’s comment in response to On anxiety overload. Over the past week or so I took a number of blows from leftfield that left me on the floor and back on the (smaller dose of) regular medication. Which is incredibly frustrating given that I hoped this attempt to come off the medication was going to be more successful than the one last autumn.

The days prior to Mind Tech involved going to a number of events. These were a social media awareness workshop to councillors in Cambridge, a talk on social media in the public sector for Teacambs, and finally an impromptu presentation for the launch of Idea Transform 2012 straight after, on my ponderings around Open data for transport infrastructure planning. I was also planning on a ‘hard launch’ of my new social media website but the owners of Cambridge First pulled the plug on the newspaper that I was hoping it would be featured in on the week of that launch – hence why I’ve had to have a rethink. Much as I wanted to stay in bed and sulk all day, I dragged myself out and took Puffles down to London.

What was Mind Tech all about?

The pitch was here. The idea of combining two of my interests – digital media and mental health – along with a free unConference set up at a venue I was familiar with, got me interested. There were one or two quizzical looks around the room when I rolled in just before the start with Puffles. This has sort of become normal for me now. It’s like one of the people at the Idea Transform event last night said. “All these other guys came in with business cards. You came in with a dragon. Which one are they going to remember?” Exactly. As it turned out, a number of well-known delegates in the room were already on Twitter and were more than familiar with Puffles – which always helps in these occasions. (In particular Andy Gibson and Mark Brown at OneInFour)  Having some of the big screens in the room displaying the various tweets from the #MindTech hashtag on the day was also more than enough to show to many of the delegates what Puffles was linked to social-media-wise.

Excellent opening pitches

The three opening pitches were brilliant – the two from Jon Cousins of Moodscope and Andy Gibson of Mindapples. Short, sharp, relevant, humorous where it was appropriate, to the point and no death by PowerPoint. Andy’s quotation on comparing dental health with mental health (only one letter difference between them) was picked up by a number of people on Twitter. To paraphrase:

“If dental health was treated similarly to mental health, none of us would be brushing our teeth and we’d be spending millions on dental surgery”

The point being that little seems to be invested in prevention and in good mental health. When the phrase ‘mental health’ is used, it is often in a context of ‘mental health problems’. A number of healthcare professionals also mentioned the issue of trying to break away from the mindset of ‘you go to hospital to get fixed’ in the case of mental health. As I mentioned both in one of the workshops and in my first mental health blogpost Going beyond a pill, one of the big challenges I faced was getting away from the idea that a short course of medication was going to solve things. It didn’t and it hasn’t. If anything, it’s made me realise that medication in my case has only suppressed the worst of the symptoms and that a longer term recovery is only going to be achieved through a tailored/personalised combination of other things.

What was my big idea?

My big idea – which others had also come to similar independent conclusions to – was around the idea of ‘social prescribing‘. Conditions such as moderate to mild depression and anxiety by their nature affect and are affected by the lifestyles that we lead. Every time I’ve been through an acute period of anxiety, depression or generally being ‘a mess’ I’ve tried to pick myself up by trying new actions and activities to deal with it. On a number of occasions I’ve said to myself “I wish I had thought of that earlier” or “I wish I had known about that before”. Doing lunchtime circuit training at a local leisure centre for me is one example – something I only started recently but had I known about it would – and perhaps should have started as soon as I had left the civil service or while I was still in it.

In Cambridgeshire, we have Cambridgeshire.Net which tries to collate information on groups and courses in the county. But it’s not as user-friendly and social-media-friendly as perhaps it could be. For mild-to-moderate depression and anxiety, giving patients and GPs the option of looking at what activities might be beneficial for patients I think would be brilliant. Rather than a course of medication and a few sessions of counselling alone, what about things that can complement such treatments? And how about making them on the NHS? This could include things like exercise classes, cooking classes covering things such as foods that help and hinder conditions such as anxiety. It’s one thing saying ‘avoid X,Y & Z’ but quite another to build it into a lifestyle.

There’s also the concept of the ‘super social worker’ that I touched on in Joined up public services in Cambridge. This is something that goes beyond just mental health. It could be things like poor housing conditions that are having an impact on people’s health – in which case the solution is not necessarily a medical one but a housing one. Given the shortage of social housing and the state of the UK housing stock in general, I don’t know what difference someone who could ‘pull rank’ on others could have, but the point of this is that such professionals would have direct contact with the various public services on behalf of those individuals in most need. For example with housing, education, medical and welfare services.

The above acknowledges that for conditions similar to those that I suffer from, the solution may not be a medical one alone, but one that requires a combination. What is lacking at the moment is information on what is available locally, alongside the funding streams and mechanisms to allow the NHS to cover some (if not all) of the costs of the non-medicinal treatment.

Mental health of organisations

This was an interesting concept raised in the discussion group that I was in – one that had me pondering. Organisations collected various amounts of information on their employees, but I wonder how much of that data is anonymised and then used to help influence decisions taken by their organisations? What does the data appear to say about working practices and culture on the overall health of employees? Are there reasonable steps that can be taken to improve things? After all, it’s not as if corporations are short of cash. A healthier, happier workforce is also surely better for business to, is it not? Are there any examples of employers using anonymised health data to monitor the overall health of their employees in a manner that feeds directly into decision-making processes in the firm?

What made this unConference different?

This was an open gathering of healthcare professionals, activists and service users – and more. Some covered more than one role. This made a huge difference to the richness of the conversations – reflecting the benefits of the unConference format for me. It brought together people who were passionate about the issue, rather than people who, as with corporate conferences are often paid to be there by their employers rather than because they genuinely care about the issue.

I hope The Young Foundation (who were behind this gathering) will run repeated events of this nature. The format seems to work and it raises the possibility of creating grassroots networks of professionals, activists and service users that can help improve things from the bottom up. If – as what seems to have happened with the UKGovCamp & Teacamp network on government digital media – a critical mass of people can be formed, pressure can be put on those above to make real differences.

Civil Service Accountability: Who Guards the Guardians? – A response

Summary

A response to Professor Colin Talbot’s blogpost on civil service accountability 

Some of you will be familiar with my previous posts on this issue – Accountability from November 2011, The Civil Service vs The Public Accounts Committee from February 2012 and Contractual vs Democratic Accountability from March 2012. I also recommend (for those of you with the time/patience/interest this speech by Margaret Hodge MP, Chair of the Public Accounts Committee who has senior civil servants in her sights.

Much as I’d have loved to have gone to that seminar, the likelihood of an anonymous blogger whose best friend is a dragon fairy being invited to such a thing is somewhere between nought and zero. That said, if the Constitution Committee decide to follow through with Professor Talbot’s recommendation to investigate this, I hope they will do things that open up their investigation to a wide audience rather than restricting it to the corridors of Whitehall and Westminster. Why? Because the civil service is not just London-based. In my experience not enough policy officials have had enough experience outside of London to see what the civil service looks like both across the country, and what Whitehall looks like from a distance.

The civil service as a monolith 

The civil service is such a large institution made up of many people that it is very difficult to treat it as a monolithic entity even though it is often derided as one in the media. It’s a bit like when people refer to ‘the PC brigade’ – it’s in some people’s minds but not so straight forward when it comes to naming the individuals who are the decision-makers. The diverse nature of the civil service means that having more senior civil servants appearing before select committees on their own will not be enough.

One of the recent developments with Hodge is the summoning of civil servants to account for their actions in previous posts – the highest profile case being Dame Helen Ghosh. In principle I don’t have a problem with this. What I have a slight issue with on this is whether the same treatment is dealt out to ministers and captains of industry after they have left their jobs. The only recent examples I can think of where such individuals have been subject to hostile questioning is with the banking collapse & the Iraq Inquiry.

Civil servants accountable to local government?

The local delivery element of a number of public services – such as Job Centre Plus gives rise to the possibility of more local accountability to local authorities as the Coalition pursues its localism agenda. Institutionally, how do you manage that? The lines of control within the Job Centre go all the way up to a chief executive who is ultimately accountable to ministers.

Increasing the resources and powers of select committees

Coming back to my point on select committees, in September 2011 I stated that select committees are not nearly as well resourced as they should be compared to the responsibilities they have on scrutiny. (See The impact and influence of parliamentary select committees). Some select committees have huge remits – such as Work and Pensions, Health, Home Affairs and The Treasury in terms of institutions. Proper scrutiny of the civil service and ministers is not going to come about unless select committees have both the resources – and the powers to hold ministers and civil servants to account.

A greater role for the Civil Service Commissioners?

This is an option. At the moment the remit of the Commissioners is very narrow. (See here). Should consideration be given for increasing the remit of the Commissioners as well as formalising lines of accountability to the Public Administration Select Committee and the Constitution Committee – perhaps under a joint committee of both houses to cover the civil service?

Embracing Freedom of Information

Sometimes getting information out of the civil service can be like getting blood out of a stone. Sue Cameron gave senior civil servants a kicking in The Telegraph about this earlier – saying they should not be so defensive. Part of the problem is the hydra that is knowledge and information management. You think you’ve dealt with one head and another three pop up. Yet the costs of trying to bring in a decent Electronic Documents & Records Management System (EDRMS) are prohibitive. Going through the process of purging electronic files of documents no longer needed is a laborious and time-consuming (though potentially fascinating – if you are historically-minded) process. With this I’m not talking about getting rid of really important stuff. I’m thinking about that set of minutes that someone started, saved and forgot they had saved it, then starting on a new version later that week, or that random set of photographs from an event with the junior minister. I’ve not even started on email accounts. So potentially we’re talking needles and haystacks.

Under the Freedom of Information Act 2000 requires public bodies subject to the Act to proactively publish official information. On data sets, transparency campaigners appear to be winning with the development of Data.gov.uk. Transparency though can only go so far. Publishing something is not the same as publicising something. Publishing something does not always assume that people are going to be able to decode whatever it is that has been published. Publishing things all at once (something the present and previous governments have been accused of at the end of every major session of Parliament with announcements) increases the risk of things being buried. Politically convenient but not very public spirited.

Educating the public on how the civil service functions

Hence why I think there is a huge role for helping educate the general public about how the civil service works. Puffles’ House Rule No.6 for those of you who are interested. It was in Puffles’ (and my) remit when I was in the civil service and is still there now. The blogpost Social media guidance for public servants was an example of this in action long after I had left the civil service. The question is who should do the educating institutionally? There’s the Hansard Society for Parliament and Parliament’s outreach programme, but I can’t think of any equivalent where policy civil servants systematically go around the country going into schools, workplaces and voluntary organisations explaining how government works.

Part of that education process could involve (as Sue Cameron alludes to in her article) some of the advice that goes up to ministers after a decision has been made. This could be particularly useful with the emerging processes of post-legislative scrutiny of bills in the years after they have been enacted. Knowing for example what was in the risk registers at the time might significantly aid such scrutiny, rather than trying to keep them under lock and key for years. Coming back to the issue of scrutinising decision-makers after they have long gone, post-legislative scrutiny of the now Health and Social Care Act 2012 would make for interesting viewing in a few years time with risk registers and advice being made public. Whether that will happen though…is another question.

UK digital telly

Summary

Looking at one model of market reform within the digital TV broadcasting market.

Some of you may have seen the Panorama report that contained allegations about hacking of the now defunct “ONDigital” platform. It makes this column in the Telegraph from back in 2002 all the more interesting.

I followed the trials and tribulations of OnDigital – later ITVDigital with interest back in 2000. As Fleet Street Fox said, there were a whole host of other reasons why the company failed, with or without what has been alleged. At the time, the two big things for me that stood out were:

  1. the massive contract ONDigital signed with the Football League which was one of the key reasons why the firm went into administration
  2. the much smaller package that ONDigital offered compared to Sky – which the latter made hay with in its advertising.

One of the jokes going around at the time regarding the football deal was that the number of subscribers were so small it would have been cheaper to have put pay-per-view subscribers up in an expensive accommodation, drive them to the games in limos and give them lots of spending money instead of paying to broadcast the games. The fallout from ONDigital – subsequently renamed ITV Digital (before it went under) was that it put football league clubs in a precarious position. The problem for the clubs was that the Football League had failed to secure guarantees from the company’s backers – Carlton & Granada. Hence when the League tried to sue the latter two, they lost.

This left Sky with huge monopoly power over the digital TV market, one that has proved to be a huge cash cow for its shareholders – reflected in the desire by majority shareholder News International to bid for control of the whole company. (Something that was ultimately derailed by the allegations around phone hacking.) As an aside, one of the other things worth noting just before the millennium was the blocking of BSkyB’s bid for Manchester United – this was before the Glaziers came in. One wonders what things would have looked like for both digital TV and sports journalism had that bid succeeded. Could it, for example have led to further bids for other football clubs, leading to a system of ‘franchises’ similar to that in the USA?

Bundling

One of the features of the communications market is the ‘bundling’ of services – TV, internet and phones. You could say that ITV Digital and Sky were & are examples of bundling within television – being commissioner, producer, broadcaster and platform provider for TV services. A few years ago both the BBC and Channel 4 were forced to open up their systems of commissioning, which is one of the reasons why you see the logos of a variety of different companies at the end of the credits when programmes end. Before then, much of the production was done in house – I assume. (Either that or I just didn’t notice as a child).

For the likes of Sky, I can’t help but think that there’s a clear incentive for say the producers of the sports channels to give a better deal for the company’s digital TV platforms than to other providers such as Virgin or BT – and the now defunct ITV Digital. The illustration of this was the move by the regulator OfCom to force the former to reduce its wholesale fees to rivals. The model of digital TV providers being broadcasters at the same time strikes me of a model similar to that of now defunct tube maintenance firm Metronet. It caused a huge headache for the government of the day. It also left a huge tab for the taxpayer – nearly half-a billion pounds worth. One of the key reasons was the parcelling out of contracts to the shareholding firms, rather than engaging in competitive tendering that happened on non-Metronet-maintained lines. This made me think: Should there be a formal separation of broadcasting channels from the providers of digital TV platforms?

Would would separation of functions look like?

Each channel would be responsible for negotiating with the digital platforms (e.g. BT/Virgin Media/Freeview/Sky) for the terms and conditions for their content being broadcast. Rather than the bundling up of packages, it may – and in the grand scheme of things should – lead to a system where customers can pick and choose which channels they want in their digital TV package and which ones they do not.  Would such a system make for a more genuinely competitive market both for TV audiences and for digital TV platforms? Would it also reduce the control that the major broadcasters have on TV output? The figures from OfCom on who has what market share make for interesting reading.

The one thing I haven’t considered in this is the blurring of the lines between TV and the internet. What impact is this likely to have? Would such a separation of functions support new internet-based TV channels going mainstream?

Lobbygate returns

Summary

Who’s going to shine a light on what lobbyists do?

Twitter had a field day when the Cash for Cameron storm broke last night. It would almost be funny if it were not so serious. SturdyAlex’s blogpost “The C-word” covers a number of the points I wanted to include in this post, so refer you to his post on the ‘cash for access’ issues – in particular ‘The Leader’s Group’. This allows me to focus on two issues: Transparency and political literacy.

Are the problems systemic?

Political parties are not subject to the Freedom of Information Act. They are however subject to regulation by the Electoral Commission. I imagine today’s events will provide a little bump for traffic heading to its website on party funding. Party funding is an issue that has not gone away. It was a shame that John Major vetoed Nolan’s original inquiry into political party funding – which was around the time of Cash for Questions. That’s not to say he’d have been any more successful than his successor looking at this issue, Sir Hayden Phillips. Since then we’ve had Cash for honours, Cash for Access Mk 1 and the MPs’ Expenses Scandal. We also had another lobbyists’ scandal just before Christmas 2011. I can’t help but think that the problem is systemic – i.e. cannot be put down to a few bad apples that happen to have been caught out.

Transparency

While transparency on the whole is a good thing, it can only go so far. This is especially the case with MPs’ interests. Jacob Rees Mogg and Nick Raynsford are good examples. The information is public, but within the Westminster world these sorts of ‘remunerated extra curricular activities’ are seen as acceptable. The same is the case with members of the House of Lords, who by their nature have more time on their hands for directorships and consultancies – something that did not avoid the attention of campaigners against the Health and Social Care Bill.

Should peers (& MPs for that matter) be barred from voting on issues where they have a direct financial interest? At the moment all they have to do is to ‘declare items in the register of interests’ under their name at the start of each speech. Few people actually take the time to look at what those interests are, and even fewer report on them. It feels as it’s ‘the done thing’ and the rest of us have to live with it. With peers, censureship is particularly hard because no one can vote them out of office.

Who knows what lobbyists do?

Articles from the archives of the mid-1990s are becoming interesting reading again in the light of recent news. The first time I came across the term ‘lobbyist’ was during the dying days of the Conservative administration, when the name Ian Greer seemed rarely off of the front pages – in particular with the Neil Hamilton case. As that linked article states, Greer was one of the first of a new breed of professional lobbyists that emerged in the 1980s. Their numbers have since proliferated and you can find a number of them advertising vacancies on the House of Commons-funded website W4MP.

Some within the lobbying profession have tried to tighten things up – whether the Code of Conduct of the Association of Professional Political Consultants, or Mark Adams’ blog Stand up for lobbying. (Adams’ blogposts are worth browsing through to get a feel for life closer to the front line of lobbying).

One area that has been on the radar for some time is the way some lobbying firms use All Party Parliamentary Groups to influence agendas. I first stumbled across this at a conference I was invited to where I got talking to someone who was the secretariat for one such group. Being the curious type I asked lots of questions about how she got into the field that she did. Innocently I asked if she was paid for by Parliament. When she replied that she wasn’t, & that she was working for a professional lobbying organisation, alarm bells in my head started ringing. In the main, most MPs don’t have the time to scrutinise what’s happening in the APPGs that they are members of. (If you work for an MP, please note this guidance). This potentially gives whoever is running the secretariat for such groups a significant amount of influence – face time with MPs, the drafting of Parliamentary Questions (PQs), even tabling of amendments to Bills. How many MPs and Peers have signed their names up to amendments to Bills without knowing what the detailed implications of their amendment actually are? It reminds me of the example former MP, Minister & TV-AM presenter Gyles Brandreth mentioned in his diaries (1990-97) when a ministerial aide got Brandreth to put his name to a written PQ even though Brandreth had no idea what the question was about.

While it might have been fairly straight forward to keep ‘the dark arts’ of lobbyists within the Westminster bubble in the 1990s, I’d like to think that in social media world some light can be shone onto said arts. What might seem acceptable in Westminster might not be outside of it. We saw this with the MPs’ expenses scandal. But it wasn’t just the transparency that had the impact, it was the publicity too. I wonder if there are any lobbyists out there who would be more than happy to do a ‘public service’ and start putting up some blogposts and digital videos to explain to the general public what lobbyists actually do, & show some [annonymised] case studies of where they have had an impact on government policies.

Political literacy (i.e. people’s understanding of basic political/constitutional processes)

One of the purposes of this blog is to help explain to people some of the things that happen in the world of politics, policy-making and public administration. Citizenship classes in schools also goes some way to helping teach some of the basics of how politics functions (or malfunctions as the case may be). I’d like to think that social media and recent campaigns has increased levels of political literacy. It has certainly been good for awareness-raising and enabling people to ask more targeted informed questions to their political representatives. How do we break it out of the politics’ social media bubble?

This is one of those strange paradoxes. Do scandals like this make people more angry to the extent that they want to get more involved in politics, or does it reinforce already negative views they may have about politicians and politics? If it is the latter (and more people disengage from politics in general), does it make politicians and political parties ripe for the picking by small groups of powerful vested interests?

 

Minimum alcohol pricing

Summary 

Is minimum alcohol pricing a magic arrow to binge drinking or is there more to it? A blogpost with more questions than answers.

“I like drinks, not drunks” is my general attitude towards alcohol. As with many teenagers I went through a stage of drinking and clubbing. The really strange thing is that some of the councillors in my local area who were struggling with binge and teenage drinking in the mid 1990s are still around now…thinking that further clamp downs will have the desired effect. The only impact I can recall of pubs and bars being strict on “ID” were that they drove teenagers into the hands of drug dealers. During the mid-1990s it was easier for me to get hold of illegal drugs than it was alcohol. The law of unintended consequences?

The problems related to alcohol – domestic violence, anti-social behaviour, addiction, health problems, family breakdown etc are well-known. I don’t intend to go into detail in this piece – primarily because I don’t have much direct experience of the above. (For which I’m grateful).

Isn’t this part of a broader strategy?

It is – but the minimum pricing (as often happens with these things – think “Granny Tax” and The Budget of 2012) is the thing that’s caught the headlines. This is part of the Home Office’s new alcohol strategy. One interesting part of it is this:

We will also end the notion that drinking is an unqualified right without any associated sense of responsibility. [Para 3.19]

The whole of that paragraph is worth reading, and it will be interesting to see what the results of the pilots will be.

From an anecdotal personal experience, two of the things that seem to be missing are a focus on bars. In particular those that have few seats and stupendously loud music. In a bar that plays loud music where there are no seats but where it has no licence for dancing (& no dance floor), there’s little else to do but drink. (You’re allowed unamplified morris dancing but it seems that’s about it). A brief internet search has come up with a couple of studies on loud music too. (See here & here). I can’t say I found the experience of going to such bars incredibly enjoyable or stimulating. More a case of standing around with drinks in hand ‘being cool’. (I’m not cool. Never have been. Never will be. My best friend’s an effing dragon fairy. How can I be!?!? My point on the above is whether the Government should be looking to gather evidence on bars in particular.

On data

One of the things we have now that we did not have in times gone by is data – lots of it – along with the power to process it far faster. A basic example of this is the police’s crime maps. Does the power of data allow public authorities to go after those establishments that demonstrate a higher number of alcohol-related offences associated with their activities? If so, how should public authorities respond?

On cafe culture

There has been much spin and hype around the Licensing Act 2003 to reduce some of the drinking restrictions. The aim was to deliver cafe culture France stylee. Unintended consequences again? Was the mindset of turning us all into continental philosophers reading a book by Descartes while sipping on a glass of red & smoking a cigarillo in the bright warm sunshine never going to work in the rain shadow of the Western England?

Types of alcohol, types of people and types of establishments

I’m throwing in some ideas for discussion here more than anything else. Should the “all or nothing” mindset of “you can’t buy alcohol until you’re 18 but when you are you can buy whatever you like” be looked at? Should there be a lower age limit for weaker alcoholic drinks but higher ones for spirits? Should people under 18 be allowed to drink in pubs if they are, say accompanied by a responsible adult over the age of…say 25? Should some there be licensing for such establishments to enable under 18s to drink in them so long as say they were having a meal and with a responsible adult? Or is this the state micromanaging to a ridiculous extent?

Pubs vs Supermarkets

The struggle that many pubs are facing is often reported – especially locally when a pub is at risk of closure. The challenge for the Coalition is one of joined-up-government. Can they join up policy on tackling binge drinking & minimum pricing with one that can help save community pubs? I’d like to think that it can, but I fear the lobbying power of the supermarkets and the drinks industry will put more than a few spanners in the works…as well as the inefficiencies of a machine as big as the Whitehall policy machine.

Who to consult?

The drinkers for a start. For they are the ones who (along with the police and emergency services) see the consequences of binge drinking on a regular basis. I’d guess that many people on a night out don’t want to end up in a fight, in casualty or in the gutter. Getting drunk is one thing, ending up in a state of physical harm is quite another. You never know, it might just be that some innovative solutions come from (in particular the young) people in who witness the negative impacts weekend-in-weekend out.

 

The unintended consequences of adult education policy

Summary

Why adult education should be invested in, not cut.

Some of you may be aware that I’m doing an introductory engineering course with the Open University. After the exam this June my relationship with the institution will probably end. The reason for that is the inflation-busting hike in fees.

I’ve torn into the political establishment over the course of higher & adult education funding in a previous blogpost, and on the behaviour & actions of one of my former university’s in another.

Education vs training.

It’s not just David Willets’ outlook that in my view is wrong on this, it’s the political establishment’s outlook too. This stems from the actions of the previous administration where John Denham, Secretary of State for the short-lived “Department for Innovation, Universities and Skills” took a kicking over his (or rather Gordon Brown’s) cuts to the adult education budget in 2008/09. A quotation from my MP at the time, former Health Secretary Frank Dobson said of John Denham in the Commons:

I find it hard to believe that this is being done by good and decent people such as my right hon. Friend the Secretary of State for Innovation, Universities and Skills. He is my friend and he is honourable, but he is not right; he is wrong on this occasion.

What are the establishment getting wrong? In my view they are equating education and training as the same thing. They are also equating education with the assumption that it will lead to people getting a higher paid job. This is the pillar of the current system of loans. If that assumption was not in place or was accepted as to be wanting, the whole rationale of the system of loans for everything would crumble.

“You are trained to do a job, you are educated to become a citizen”

The above gives some idea of my ‘worldview’ of education and training in general. The former is tied very much to a job, profession or career while the latter goes far beyond it. The moment the latter is tied hook, line and sinker to the former, education suffers. I remember Charles Clarke, the former education secretary around the time of the Iraq war took a bit of a kicking for alleged remarks about humanities. Defenders of history and philosophy remarked that if he knew anything about philosophy he would not have signed up to the philosophical arguments in favour of the Iraq war, and that if he knew anything about history he’d have known what was said the last time a British General marched on Baghdad…as well as how well that one turned out.

Education for the love of it?

I don’t have any particular desire to become an engineer after seven years in the civil service, but I wanted to broaden my mind. There are many others in that situation too. Should the state subsidise us? That depends on your point of view & the sort of society that you want to live in. There are those who take the view that in order to improve themselves, individuals should self-fund whether through loans or their own savings as it’s the individual who primarily benefits. I disagree. The state, wider society and future employers also benefit.

Future (and even current) employers benefit because their employees have a wider pool of knowledge to draw on for the work that they do. Where this is job-specific training it is easier to quantify. But in the world of work there are many occasions where people draw on what may seem like completely random knowledge that they can apply to what they do at work, even though it may have come from somewhere far away from their vocational field. This happened all the time with me. This sort of knowledge and these sorts of benefits are very difficult to measure and quantify. As such in economics they end up in this hazy field otherwise known as ‘positive externalities that cannot be measured’.

How does society benefit? Cameron’s been big on the Big Society and Ed Miliband on the Good Society. Think of all of those people who bring their knowledge to bear for voluntary and community organisations…for free. While recreational classes may be derided by some as subsidies for middle classes at the expense of more essential basic skills training for those unemployed and without qualifications, my take is that such comparisons are pointless. You could make the same comparison with corporation tax breaks vs spending on basic skills…and so on till the cows come home. One of the reasons such comparisons are made is because of the ministerial silos that exist. Within a fixed budget, Denham at the time had to choose between spending money on basic skills or adult education because those were the parameters he had to work within at the time. The problem with these sorts of silos is that sound policies in one part of them can have positive impacts far beyond them. For example bringing people together using recreational classes, workshops and events can have a positive impact on community cohesion. Bringing people together in this manner can have a positive impact on the health of individuals – for example those with mild to moderate depression. Inside the silo, this is a very difficult thing to appreciate, let alone measure.

A job for life?

Once you’ve got your first degree, you pay full whack like everyone else – again, another fallacy of policy in my book given the world we live in. If we lived in a world where people really did have jobs or careers for life, that would be more understandable. Yet when leaving school in the mid-1990s, we were told in no uncertain terms that the job for life was going, and that our generation onwards would have several careers and would have to train and retrain. Yet the system loads debt after debt after debt onto people. For those who are from more economically deprived backgrounds, you get one shot with financial support and then that’s it.

The system of loans and debt again feels like it has been cooked up in a policy silo that has ignored living costs. It feels like we’re being priced out of existence by rising house prices, rental prices, fuel costs, public transport fare rises and rising food costs…at a time when wages for many people are stagnant. My take is the policy of loan upon loan for retraining us unsustainable.

Why has the burden shifted away from employers and the state onto individuals?

It’s not as if big corporations cannot afford it with their huge cash surpluses. Shouldn’t they be putting at least some of that money back into training and education? Shouldn’t the government have been taxing large corporations at a higher rate to pay for things like education and training. Shouldn’t large corporations have been paying their frontline staff more given the size of the surpluses? (Shouldn’t the shareholders be demanding bigger dividends?) As an aside, my principle is that if your firms are multinational, your regulator needs to be too. How you make the latter work (& accountable to the people rather than to corporations is a separate debate – one to get Europhiles and Europhobes excited).

My basic point remains: It’s not just the individual that benefits from investment in education – even if it’s recreational investment. Firms benefit from a happier workforce that has a greater pool of knowledge to draw from. The state benefits from more cohesive, connected and inclusive communities, whether in reduced policing and healthcare costs to increased tax revenues from individuals and firms that live within those communities.

By cutting budgets for adult education, politicians risk undermining work in a whole host of other areas that they may not have even thought about. Rather than seeing adult education as a non-essential cash cow to be culled, how about seeing it as an asset to help deliver in areas far beyond the education silo?

A digital bill of rights?

I picked this one up from @KerryAtDell (who I met in 2011 at a social media conference) who tweeted a link to a blogpost at “Our Digital Rights” on a possible digital bill of rights from across the pond.

I’ve listed the key points as below, but credit http://ourdigitalrights.org as the source of the original article. (I am not the originator – just a signpost!)

 

Digital Bill of Rights

Preamble

This Digital Bill of Rights applies to the sanctity of the digital self.

The digital self should be afforded equal standing as the physical self before the law and society.

Rights

1. Right to transparency

  • I have the right to know who collects, uses, shares, or monetizes my data and how they do so
  • I have the right to know how my data is protected and secured
  • I have the right to know the value of my data

2. Right to privacy

  • I have the right to privacy by default

3. Right to choice and control

  • I have the right to give and withdraw permission to collect, use, share or monetize my data
  • I have the right to view, access, correct, edit, verify, export and delete my data
  • I have the right to own and/or use freely the “golden copy” of my data
  • I have the right to buy the product or app and not “be the product”

4. Right to safety

  • I have the right to expect my data to be stored and transported securely

5. Right to identity

  • I have the right to have different personas in context
  • I have the right to anonymity

6. Right to minimal use

  • I have the right to have my data collected, used, shared or monetized only for the specified purpose and context
  • I have the right to be forgotten after my data has served its purpose

 

What do you think of the above? Is there anything missing? Is there something that you would want to take out? What about “A digital bill of responsibilities” to cover things like trolling & hate?

For whom the road tolls

Summary

On Cameron’s proposals for privatising roads

The first time I came across road tolls was on a visit to France with my late aunt & uncle. My uncle explained that the advantage of tolls was that all users paid for them, & that this made sense with lots of non-French lorries driving on their motorway network. He aso said that tolls were more difficult to introduce in the UK because we did not have the huge lengths of road or the tracts of land needed to make tolls work without creating huge traffic jams. I was…13 at the time.

There was much lampoonery on Puffles’ Twitterfeed when they heard the announcement late on Sunday. Was it a distraction for the Lords’ Third Reading of the Health and Social Care Bill? Will minor royals be privatised? Will constituencies be sold off to the highest bidder to save on costs of running an election? Guardian columnists were on fire over the whole thing – in particular John Harris.

Will privatised roads mean private roads?

I hope not. This was one of the things I explored in The privatisation of public places in the context of shopping centres. Roads that previously had highway rights end up becoming private property as a result of developers applying for and receiving “stopping up orders” (that ‘stop’ highways rights that had previously existed). Instead, the property becomes ‘private property’ in which the public are given a licence to ‘enjoy’ the facilities of the area so long as they don’t do anything ‘anti-social’ – which more often than not covers protesters. One of the first questions for this policy is what it will mean for highway rights.

Won’t tolls raise money from all road users rather than just UK tax payers?

This is one of the big ‘in principle’ arguments in favour of tolls. Tolls are not the only policy that ministers have been looking at. A year ago one newspaper reported on the possibility of a daily charge for non-UK lorries using UK roads. Tolls – especially ones funded and run by private companies deal with two issues: The first is the funding of road infrastructure – it nominally stays off of The Treasury’s balance sheet – at least I think it does. The second is that it deals with the issue of non-UK lorry drivers not being subject to UK road duties.

If tolls are brought in, what will UK motorists (& large interests such as the RAC, the AA & the Road Haulage Association) demand from ministers in return? The AA has already voiced concerns. Will we see a like-for-like reduction in say vehicle excise duty or on fuel taxes?

One of the things tolls would do is transfer part of the burden off of the general motorist and onto the heavier/more regular users. In one sense this makes sense – those who use more pay more. Yet one could argue that this already happens as a result of the levels of tax on fuel. Who would the cost of tolls hit the most? Supermarkets for a start. Will tolls lead to fewer more larger deliveries as firms seek to cut costs? Will it also lead to a drive towards video conferencing in some industries that require a lot of road travel from place to place?

There’s also the issue of large lorries trying to avoid the tolls & driving through villages, possibly breaching weight limits. What will be the prevention & enforcement systems? This was something that a number of commenters raised on Cambridge Evening News’ article on the prospect of the A14 becoming a toll road.

Transport corridors

One of the things that has my mind ticking over is the possibility of road and rail lines running side by side. On the A10 between Cambridge and Baldock a line when sitting in the car en route to above-mentioned relatives I’d always watch to see if the train would overtake the cars & vice-versa. Ditto as an adult on the commute – only to see if the train was doing more than 70mph. (A column of fields separated the two – little risk of cars crashing onto railways for most of the route).

Should any new roads built have to have rail lines parallel to them? Should there be road-rail freight terminals at strategic points along the line? Do any of the pre-Beeching lines (as on my favourite railway map) provide for any opportunities for new routes? Will this potential extra private funding help compensate for previous transport funding being London-centric? (Something I also covered halfway down in On national pay bargaining).

Finally, who remains accountable in all of this? In this drive for privatising and outsourcing everything, principles of accountability are, I think, at risk. With privatised roads, how will Parliament ensure that transport ministers do not relinquish their responsibilities for delivering a public service – an issue that has plagued Andrew Lansley during the passage of the Health and Social Care Bill.

Let’s see what comes out in The Budget 2012.

Short post: On healthcare professionals’ threat to stand in next election

Some of you will have seen the letter in The Independent on Sunday alongside the associated headline article where Dr Clive Peedell and colleagues have said they’ll target Coalition MPs in the next general election. This is a short blogpost covering some of the issues.

Historical background

Some of you may be familiar with the case of former MP Dr Richard Taylor who took the Wyre Forest seat from junior Labour minister David Lock in 2001 as an independent. Even more of you may be familiar with the high profile victory of Martin Bell over Neil Hamilton in 1997 – where Bell overturned the second largest Tory majority in the country to take the seat. In both cases, the Liberal Democrat candidate stood aside to let Taylor & Bell respectively have a free run. Labour also stood aside in 1997 too. (I imagine some within Labour ranks are regretting the fact that Bell said he’d only stand in Tatton for one term. In the 2001 election he stood elsewhere (and lost), leaving the seat open to one George Osborne.

What chance do Dr Peedell & co have?

There are a number of key factors that history tells us could be key. These include:

  • The willingness of Labour (& other) candidates to stand aside &/or campaign for an independent
  • The profile of the healthcare professional’s standing within the local community
  • The ability of the above to withstand the inevitable political attacks (both above & below the belt) that will inevitably arise
  • The strength of, & the profile of incumbent Coalition MPs
  • The strength of feeling locally about the NHS – for example will it be stronger in areas with larger hospitals or a local hospital that is also valued by local people as an essential service

Martin Bell was a very rare example of a parachuted independent turning up late and ‘seizing’ the seat. (Actually, the electorate gave it to him via their votes). This is one of the criticisms thrown at the far left – who always seem to change their name in the run up to each election. Socialist Alliance, Respect Unity Coalition, Left List & the Trade Union and Socialist Coalition are just a few of the ‘brand names’ I can think of over the past decade, despite the same people being involved.

Standing as an independent gives you the flexibility of not having to account to a party machine. The disadvantage is that you don’t have the support of an established party machine to fall back on should things get complicated. By this I mean that the larger parties will have a group of people who will be ‘the policy experts’ for their given field, and will produce briefing for party members. As I said in MPs and political parties, MPs cannot be experts in everything. What they rely on is someone with similar values to them but with expertise in the field to have done the detailed thinking to produce the briefing concerned for other politicians to run with.

What approach will Dr Peedell and co take? Will they be a loose federation of independents with a small number of core themes or will they try to organise themselves on party lines? (A similar approach was tried with the Jury Team coalition in 2010, but to little effect). He tweeted a couple of items about the possible impact of social media, including this one.

After Ken Clarke forced NHS reforms in 1991, doctors challenged at ballot box, but failed. But this time we have Social Media on our side

That’s not quite the case. The Conservatives in the 2010 election were much stronger on using social media than Labour were. Labour only started to catch up when the trade unions started putting some significant resources behind a number of social media projects. What he probably meant was that supporters may find it far easier to organise as a result of social media tools being available. But if that applies to their supporters, it applies to their opponents too.

The 2010 election threw up many anomalies which left the all-nighters analysing things on election night coughing on their biscuits. I don’t know how much of it can be attributed to social media & the internet or to other local factors. What we do know is that far more people will be using social media in the 2015 election. But do candidates risk “over-egging” social media at the expense of face-to-face canvassing as George Owers and Andy Bower (Labour and Tory politicians local to me) stated this morning.

What are the other challenges that Dr Peedell and co face? Comments as always in the field below please.

On anxiety overload

Summary

Me vs anxiety overload, with some thoughts at the end on wider public health delivery considerations for treating mental health.

It’s been about a week since I last took my last dose of medication for this cursed anxiety disorder, and about two weeks since I stopped taking it regularly. This was the stuff I was on from December 2006 until recently.

Generalised anxiety disorder

Back in the early 2000s I was diagnosed with depression. The anxiety was always there from childhood, though the depression started kicking in during the mid-1990s & only really shrunk from my conscience about a decade later. The psychological symptoms (as listed in this NHS article) are all there, as are some of the physical ones such as difficulty falling asleep (my overactive mind thinks too much), tension on the outside of my head & what feels like a muscle spasm of my intercostal muscles in my chest.

2006 was one hell of a roller coaster ride for me – from the lows of being made surplus within the old regional office I used to work in for the civil service, to the high of getting that letter saying I had succeeded on getting onto the Fast Stream, along with various foreign travels and other events. I started having CBT privately (my NHS provider wouldn’t refer me for it) in the autumn of that year, but there were so many things going on in my head at the time that its impact was limited. I was genuinely fearing for my future career having been turned down for several promotions within the civil service. It was one of the reasons why the ‘high’ of getting onto the Fast Stream was so intense – it was a promotion two grades above my existing one and one grade above the one that I was aiming for.

At the same time, the thought of commuting to London and working in a pressure cooker environment had me asking serious questions about my mental health. I knew the symptoms of trying to get onto the medication would be awful – and they were. It was lucky for me that it was the run up to Christmas because that gave me a good two weeks to get over the side effects. Spending an entire week not able to sleep and barely able to sit or stand up (let alone walk) because of the head rushes is not pleasant. But I got through it.

Every so often there would be what I’d call ‘panic episodes’ or times when I could not sleep at night. If anything, they were exacerbated by things going on both in work and outside – perhaps because things weren’t going as well as I’d hoped. Depression and anxiety-related conditions for me are not ones where the medication or the treatment does all the running while you sit there waiting to get better, as perhaps might be the case with a more ‘conventional’ short term illness like a common cold virus. What happens in the outside world has a real impact on your state of mind and overall health.

On leaving the civil service

My overall condition in late 2010 – and my overall outlook in the context of my mental health was a huge consideration in my decision to take a voluntary exit from the civil service. One of the big questions I asked myself was: Is this sustainable? At a wedding earlier that year I looked at how much weight I seemed to have piled on. “That’s not what I want to look like!” was one of my first reactions – just as the person I felt I’d become was not the person I wanted to be like. The same was true of where I was workwise as 2011 rolled in. “This is not the existence I want to lead”. Basically it felt like I was living to work at a time when lots of sand was being kicked in the faces of public servants – as it still is.

Taking the decision to leave (rather than being told “You’re out”) was a huge weight off of my shoulders. There were similar feelings both on my last day and also when I used my payout to clear off my debts that had hung around my neck like a huge millstone ever since university. It’s one of the reasons why I feel so strongly about higher fees and student loans. Ministers & those in favour of such a system talk about debt as if it is “impact neutral” on people’s behaviour, mindset and mental health. Debt is a prison. It was a prison for me as it is for so many other people. I can’t help but think that if the country was able to deal with the consumer/household debt crisis it might also have a positive impact on the mental health of people.

How long did it take to come off medication?

About eight months overall. I came close in October last year but crashed at the last hurdle. Coming off of long term medication is not the same as coming off a cold remedy or a short course of anti-biotics for a chest infection. It’s only been in recent weeks that I’ve realised the medication was suppressing rather than curing the anxiety symptoms. The emotions and symptoms I was feeling in the autumn of 2006 have returned. The challenge for me is overcoming them – without medication.

So what does this ‘post-pills-plan’ involve?

I threw it all together on about nine pages of A4 on the back of the last ‘panic episode’ last week. (No, I’m not going to type it all out here).  Key things include a HUGE amount of honesty with the longer term causes of “how I got to here”, along with trying out new stuff. Diet and exercise almost go without saying, but there’s something still ‘missing’ in the exercise that I currently do – mainly swimming.  It lacks the intensity of circuits (that I’ve been doing on/off since the late January) & lacks the sociability of a team sport. I miss playing football, but since I started wearing glasses regularly I’ve hardly played. (My eyes don’t like contact lenses). I also no longer get the ‘buzz’ from dancing that I once got some five or more years ago.

My overall point on recovery (as I set out in Going beyond a pill) is the number of changes that are needed for any chance of success. I worked this out back in 2002 when I first started down the road of recovery against depression. Like a bespoke jigsaw without the picture to work from, the challenge I face is putting all of these things together.

What I’ve learnt & what we’ve learnt.

The advances in knowledge and the changing of attitudes since I first really became aware of all of this in the mid 1990s have been significant. As with many things, there’s a part of me that wonders what things would have been like if I had access to the knowledge that we have now. Every so often I’ll stumble across something that raises my interest. This was the case when I first heard about CBT and Neuro-Linguistic Programming (NLP) – though the latter’s ‘celebrity endorsements’ have made me more rather than less sceptical about its usefulness. It’s one of the reasons why I try to go to the source of where the research, rather than the write-up in mainstream media.

One example is “transcranial direct current stimulation” – where one newspaper has written about it having an impact on depression while the BBC wrote about it ‘enhancing’ the human brain, noting a comment that some may see it as a method to help people pass exams. I guess there is the “physical pain needs physical intervention rather than ‘talking’ intervention” mindset that I have on this – in particular with the permanent tight chest and the tension within my head. A sort of “Oooh! A very mild harmless electric shock (the sort say that you’d get from an electric fence in a field full of livestock) might have an impact on those muscles that seem to be permanently tight” viewpoint. It was this sort of mindset that I got hold of one of those massage pads in the hope that it would help alleviate long term muscle tension. (Short term, yes; long term, no). It also got me looking into ultrasound massagers (in particular for my intercostal muscles) but it seems like one of those things best used by a professional.

On patient choice (Again)

Some of you may have read my earlier blogpost about this. One of the things that I didn’t cover was having enough relevant information in order to make such a choice. The internet is full of ‘noise’ and part of the challenge of using the internet is being able to just whether something is credible or not. Perhaps with a generalised anxiety disorder there is ‘choice’ – just not in the manner that politicians think or talk about. By this I mean the series of lifestyle choices that we make (& that I have to make) in order to deal with it.

From a public health delivery perspective, what I think is missing is something that people can go to when diagnosed with depression or an anxiety-related condition that says something along the lines of: “These are the things you need to consider, here are some actions you can take, and here are the people, places and organisations that can help” – with specific links to each action. (In civil-service-speak it would be called something like “The depression and anxiety patients’ framework”). GPs already do this with libraries where patients are pointed in the direction of certain self-help books. They also have information on local self-help groups too. It would be nice if public services could get together and expand it to things like exercise classes or courses on cooking to help people improve their diets.

Some might say the above is going a little bit over the top, and that people should take responsibility for themselves. With depression, getting out of bed itself can be a challenge. With an anxiety disorder, stepping outside of the front door can be a challenge. It took me about three months to summon up the courage to start doing circuits this year. If something like what I’ve described above would help both patients & GPs, then why not? Sometimes having a GP saying “Here are a list of options locally, which ones would you like to commit to doing?” Especially on something like exercise which bring in all of the complications of body self-image, having reassurance that group classes will be with people ‘just like you’ rather than athletic types, can go a long way.