It's all about relationships; well durr!

It was refreshing to hear Iain Duncan Smith and Ed Milliband debating the value of marriage on ‘Today’ this morning. The main point of discussion was the £20 a week tax break for married couples if one parent stayed at home to look after children, but both MPs still managed to tie themselves in knots.

Duncan Smith was asked whether the £20 was a bribe to get more people to stay together and Ed Milliband was trying to say that he thought marriage was the ‘bedrock of our society’ whilst simultaneously saying that he didn’t mind whether people were married or not. Duncan Smith obviously didn’t want to call it a bribe, but at the same time didn’t want to say that the measure was pointless and would have no effect either.

The trouble was that the discussion was framed in the context of money and ‘incentives’. Do we really think that it is possible to incentivise people to have better relationships by giving them more money? It might have some effect on the margins – if a family is on a low income it might ease the pressure of debt, which is a major factor in breakdowns; it might enable a handful of married parents that wanted to stay at home to fulfil that wish, but surely this is just tinkering at the edges. Tax policy is an extremely blunt instrument when it comes to relationships – no wonder Duncan Smith and Milliband couldn’t cut themselves out of the tangled arguments they were having.

The best way to bring up children is in the context of committed relationships. It is not the only way, but it is the best way. I know of virtually no-one who would disagree. I watch friends in stable relationships with good support networks bring up children and I wonder how they manage. I am constantly amazed by the minor miracles that lone parents perform every single day. Ask an exhausted, overstretched lone parent whether they’d like a partner to support them in bringing up their children well and you can guess what they’ll say. To mend our ‘broken society’ as the conservatives call it we need to invest in our relationships – give our time, expertise and yes money to them.

The state of our relationships with our partner, family and friends is the biggest contributory factor to our happiness, but as a society we don’t systematically try and support people to deepen and strengthen them. However good our relationships are we all need to work at that and society needs to create spaces and places that people can do that – relationship health check ups, pre marriage classes, access to counselling and help before a crisis not when it’s already too late; retreat ‘time away’ weekends for couples…the list is endless.

Politicians believe that the only ‘levers’ of power they have are economic ones. Not true. We need people to lead the way in creating a culture where our relationships come first and politicians have a role to play. Bill Clinton in his 1992 election campaign famously posted the phrase “it’s the economy, stupid” – maybe now the sign should read “it’s all about relationships; well, durr.”

20 Questions to a fellow blogger

Paul Burgin over at Mars Hill invited me to answer ‘Twenty Questions to a fellow blogger’ which I did in my normal concise style (!!) You can read it here.

Death and taxes: the NHS has become the battleground for survival

Alice Mahon (former MP) today became the latest in a growing line of people threatening to take legal action against the NHS. Calderdale Primary Care Trust (PCT) have refused to prescribe her a series of injections of a new treatment to prevent her going blind costing several thousand pounds because it has not yet been approved for use by NICE. When Ann Marie Rogers went to court in order to try and obtain cancer drug Herceptin on the NHS she was originally refused, but won her case on appeal. NICE then ordered Herceptin to be made available across the country.

Individuals can’t be blamed for trying every available avenue open to them to secure treatment for a disease that could severely affect quality of life or cause their deaths. However, one person’s successful battle for treatment means another’s cut in funding, extended waiting list and death. In November doctors in Norwich estimated that funding Herceptin for 75 people would mean around 200 people not receiving chemotherapy. There must be hundreds of other examples across the country where one person has managed to work the system to their advantage leaving other services on which people depend without the resources they need to function to save more lives. We may not literally fight each other in the UK for our survival anymore, but the natural instinct for self preservation above all others is still alive and well.

We are all fighting for scarce resources and NICE and NHS trust managers are caught in the middle holding the purse strings having to make incredibly difficult decisions about the most effective use of funds and, to put it bluntly, who should live and who should die. It seems ludicrous that a court of appeal judge is able to make a decision about a drug’s or treatment’s availability without ever having a chance of appreciating the complexity of choices NICE and NHS managers have to make and without having to deal with the subsequent implications for funding of other treatments. If we want the fairest outcome for all people, not just those able to take their claim to court the decision must be left in the hands of the medical experts and trust managers. They won’t always make the ‘right’ decision because managing funding is not an exact science and you can’t always anticipate the consequences of funding a particular treatment, but at least the decision will be made taking into account all the factors. We need a transparent system, with a means of appeal within the NHS so that patients can understand the decisions made, but judges need to recognise that they cannot rule on something so far reaching.

In the meantime as a country it is time to start deciding what our priorities are – do we want to invest in quality of life or length of life? Is dying with dignity more important than curing all diseases? In a consumer society this is a tough conversation to have because we are used to the idea that we can have everything if only we can discover it and pay for it. We hide from our collective mortality, even when dealing with our frail ill health. But however much money gets taken from our payment packets and ploughed into the NHS we will all still get ill and die. The NHS proves once and for all that however hard you try you cannot avoid death or taxes.

The magnificent man still in his flying machine: Tony Blair vows to fly on.

Tony Blair has announced that he has no plans to stop using long haul flights, although under pressure he has announced that all his flights, both ministerial and personal will be ‘carbon neutral’.

Offsetting Carbon emissions by planting trees is fine as a short term mechanism and certainly better than nothing, but what happens in 40 years when the trees rot and decay? The carbon in them is released again. These articles and diagrams from the New Internationalist show clearly why offsetting will salve some consciences, but is not a long term solution.

It is true that not flying is the biggest single action that an individual can take to reduce their carbon emissions. One short haul flight can wipe out hundreds of saved car journeys and thousands of energy saving lightbulbs. Flying already contributes 3% of the UK’s CO2 emissions and is expected to grow significantly. Blair argued that not flying would damage the economy, but the Stern Report showed that not dealing with climate change would have a far bigger and possibly devastating impact on the world economy.

If we’re going to change our lifestyles in any way reducing our flights is the best option.

In addition to not flying we ought to choose not to fly we ought to write to an airline explaining our decision: Carbon free flying is estimated to be 35-50 years away at the moment – if airlines became worried about their profits that timescale could be dramatically reduced. (Incidentally this is also why I support airlines being bought into the Carbon emissions trading scheme with tough year on year reductions in credits to incentivise green innovation.)

However, I’ve argued before that we must seek largescale scientific and political solutions to climate change that involve China and India whose emissions of C02 are rising exponentially – we don’t have time to be messing around recycling.

The unsightly media scrum descending on Tony Blair’s personal choices is therefore not only slightly distasteful and puerile, but more importantly misses the point. Unlike most of the rest of us, there are dozens of political decisions that Blair could prioritise that would have a massive impact on the environment. I would happily swap Tony Blair commuting from Sydney every morning by private Concorde if he prioritised:

a) pushing a tough EU wide carbons emissions trading scheme,

b) investing the same amount of money into clean energy technology as into Trident

c) facilitating fast, effective and cheap technology transfer to China and India

d) a tidal barrage on the Severn (5% UK electricity), a new generation of Nuclear power stations and a solar panel and wind turbine on every new home.

If he did all this he could even take John Prescott, his long-lost great-aunt-Doris and the entire England Cricket team with him if he wanted.

Hands up if you want a debate!

‘Would those who would like to discuss whether or not we have a debate please raise your hands now?’ Listening to the news this week I thought I’d been transported back to the Students’ Union. People from across the political spectrum were arguing about whether or not we should talk about abortion. Each morning I would turn on the radio anticipating that the debate would actually have started. Each morning I was disappointed. Just another hand raised in favour of debate.

If and when a debate does start let’s hope it’s a proper one. The early signs are not encouraging. The focus has been on whether the law should allow abortions at 24 weeks, 22 weeks or 20 weeks. This is tinkering around on the edges based on an unspoken consensus that a) we shouldn’t abort babies who might survive apart from their mother with the help of science and b) we shouldn’t abort babies who look like babies. The fact that if the parents waited another couple of weeks it would survive / look like a baby seems to be conveniently forgotten. If it was remembered the discussion seems almost irrelevant. A debate based on this consensus is a debate on quicksand.

We need an alternative starting point. A simple statistic can provide it. In the UK in 2003 were 695000 births and 181600 abortions. Factor in an estimated figure for miscarriages and 19% or almost one in five of recorded pregnancies in the UK is aborted.1 Whatever your view on a women’s right to choose or a baby’s right to life everyone should be able to agree that are too many abortions happening in this country. Whether a woman or couple choose to abort a baby or not the psychological trauma involved is huge and often life long.

I’m not sure I am in a position to tell a woman or couple whether or not they should have an abortion in a unique and difficult circumstance that they find themselves in. I do know that we need to find ways to reduce the number of women that face that choice in the first place. If we’re going to have a debate, these are the things we need to be talking about.

Note
1. There are no official statistics on miscarriages, although approximately one in eight pregnancies miscarry, mostly before ten weeks.