The lethal medical arrogance behind the Liverpool Care Pathway | Melanie Phillips.

Melanie Phillips, not my favourite journalist, has been writing about the "Liverpool Care Pathway." Something Goebbelish about the name of this route to death is enough to make decent people suspicious, but that's modern Britain for you; all marketing mouth and no trousers.

My point is not about the "pathway" itself, but the response from the medical profession to Phillips' criticism of how it is sometimes misused. The arrogance is disturbing but unsurprising. During 20 years of living abroad, Mrs P and I had occasion to use the services of doctors from time to time. We were always pleasantly struck by the difference in their approach to that of their colleagues in Britain. They did not give "orders", they discussed our issues. They looked at us while they did so. They gave us time and treated us with respect. They did not dish out government propaganda and were not subject to government incentive schemes to adopt particular approaches. In short, they treated us like I treated my clients.

At the French-run Moscow clinic we used for a while, an NHS trained doctor came to work. She lasted a few weeks before being dismissed at the request of patients. She treated patients as so much meat, did not give them time or listen properly to what they had to say. Worst of all (and inexplicable to patients with no experience of Britain's Soviet-style healthcare) she reached for some kind of NHS manual for guidance as to approved treatment. Her patients expected more than that. They wanted to see the exercise of intelligent, professional judgement based on reasoned discussion. They didn't want judgements handed down from Mount Olympus by a self-appointed god. 

The NHS is a state monopoly enterprise. As such things will, it has steadily morphed into a worker's co-operative. The interests of staff take precedence over those of the customers-with-no-choice and the attitude to said customers tends to the dismissive. That's inevitable, because of the moral darkness at its heart; it is funded by force. The good opinion of patients is therefore not required. Promotion within the organisation depends upon contribution to its own goals, not those of the sick people it exists to serve. They are indeed routinely and insultingly described by NHS aparatchiks as a "cost" to the NHS, though they - collectively - pay for it.

There's nothing wrong with these medics that would not be fixed by exposure to competition and the humility it brings. You may say that they already have competition from the private health care industry but that's not really true. The doctors in private hospitals are overwhelmingly NHS consultants earning a bit on the side. Their primary source of income - and pension - is the state monopoly. They are with few exceptions trained by that monopoly and imbued with its stale ethic. If the system were fully private, they would have to provide A&E services, but instead they just offer a luxury add-on. I am fully privately-insured, but if I have an accident I will end up in the NHS's tender care. There is no way out of that in Britain.

It is indeed "our NHS" as the Tories feebly insist. I wish it bloody wasn't.

Past Lives and Present Misgivings – Part Six. — Anna Raccoon.

The Marshmallow Test, Revisited - At the Edge (usnews.com).

The Tyranny of Utility: Behavioral Social Science and the Rise of Paternalism | The Freeman | Ideas On Liberty.

I notice an unusual number of visits from academic servers and assume the intellectuals at the Battle of Ideas have been reading what I said about them, while disdaining to comment. So be it. I can understand the community around this blog must seem strange and hostile to visitors from such cosy, intellectually monochrome, worlds.

While I briefly have their attention, however, could I ask them to read this old post from four years ago? I was then still living in Russia (I left for China at the end of 2009). I think it's to the point and should give them more pause for thought, perhaps, than my crude hammering at them in the past few days.

It's vain and probably against netiquette to quote myself, but just by way of a teaser to persuade them to follow the link;

Next time you hear an appealing abstraction weighed against the interests of an individual or a family, please picture a man making barbed wire to imprison his uncle or my neat little secretary typing a death list. They served abstractions too.

I love and have faith in my fellow men, even the ones I believe have fallen into dangerous, wicked error. If I could save a few such influential people from repeating some of the worst mistakes in history, my life would not have been in vain. Here's hoping.

In the last year five times more Labour people were appointed to public bodies than Tories The Tory Diary.

The Tories over at Conservative Home are in a tizzy about dilettante Dave's failure to be as ruthless about political patronage as New Labour was. I can see their point. The Civil Service used to be, at least in theory, impartial but Blair and Brown packed its highest echelons with their people. Indeed my one contact within the judiciary tells me they were similarly ruthless there, which - as judicial impartiality is a keystone of civilisation - is even more worrying.

Perhaps the problem is more fundamental? Is the British state simply now too enormous to be staffed by competent, conservative-minded individuals? Most such people would anyway presumably prefer, because of their world-view, to be in profit-driven ventures? Labour-minded individuals, on the other hand, can presumably be relied upon not to give a damn about whether their lives are economically productive, as long as they get to boss people about, indoctrinate their children and conduct socialist agitprop at the taxpayers' expense?

Raedwald: Votes for cons in cans.

Jimmy Savile: It’s not Liz MacKean who should be leaving the Beeb - Telegraph.

I predicted yesterday that the lady reporter on Newsnight who criticised the BBC would not be long in her place. It seems she has already taken voluntary redundancy. I am sorry to be right.

However, while the hue and cry for a dead man continues, it seems that all may not be quite right with the canned Newsnight story. Anna Raccoon of this parish was, it seems, there at the time and casts doubt on evidence currently being taken as gospel. Even more oddly it seems that Meirion Jones, the producer of the canned story, is the nephew of the lady in charge at Duncroft at the time of the alleged incidents. Anna is even in a position to direct investigators to the written records of the institution so they can verify the claims of the alleged victims. Or not. It seems Newsnight neither consulted the producer's aunt, nor reviewed Duncroft's records.

The plot thickens. This blog however is about civil liberties and I don't want to join in the national frenzy of salacious gossip. My point simply remains that BBC is an organisation funded by force and is therefore, by its nature, immoral. That when bad things happen in such organisations, the collective protects its own should be no surprise to anyone.

There was a constant theme at the recent Battle of Ideas event that disturbed me greatly, but which I didn't address in my previous long accounts. Time and again I heard people say that equality was justice because those who had more or less success owed it all to chance. Not only did they see the City of London (wrongly) as a "casino", but the whole world.

Luck plays its part in life. Bill Bryson expressed the notion that we are all, whatever our circumstances, just lucky to be alive;

Consider the fact that for 3.8 billion years, a period of time older than the Earth's mountains and rivers and oceans, every one of your forebears on both sides has been attractive enough to find a mate, healthy enough to reproduce, and sufficiently blessed by fate and circumstances to live long enough to do so. Not one of your pertinent ancestors was squashed, devoured, drowned, starved, stranded, stuck fast, untimely wounded, or otherwise deflected from its life's quest of delivering a tiny charge of genetic material to the right partner at the right moment in order to perpetuate the only possible sequence of hereditary combinations that could result -- eventually, astoundingly, and all too briefly -- in you.

I don't have the relevant book to hand but I seem to recall he said we had won a 1 in 400 million lottery just by being born. I also get it that chance affects talent, strength, skill, beauty and other factors that can affect our journey through life.

My wife took great care of her health and well-being. She ate the right foods, exercised regularly, drank (mostly) in moderation and would not even try one single drag of a cigarette to understand what the fuss was about. She never even saw an illegal drug. Yet cancer took her from me. So of course I don't deny that luck, good and bad, has a role to play. In fact it infuriates me that the very same egalitarians who deny her credit for what she achieved in her life seek to blame her for her death by prattling about scientifically-dubious (and often contradictory) carcinogenic lifestyle choices or by praising survivors for winning their "fight" against the disease, as if she chose to surrender. They can't have it both ways.

For all that I recognise the role of luck, good and bad, in life I am convinced that it's what you do with your luck that determines who you are. That every boy and girl, however crap their circumstances, however bad the hand life has dealt them, can move off towards the light or the dark by choice and have a good chance of achieving some or all of their goals. If there is no free will, life is just a worthless joke that is simply not worth having. This is so central to my world-view that I don't think I could live if convinced it is wrong.

I could have succumbed to peer pressure at my crap comprehensive school. I could have been deflected by my relatives who thought I must be "queer" to read so much or want to act in plays or take part in debates or play chess or watch films with subtitles. My beloved grandfather told me on his death bed that I had disappointed him by never following in his footsteps as a cricketer, but that he was at least glad I had not turned out, as he feared, to be homosexual. These were not circumstances conducive to academic success. The path was hard, but I decided to take it and to hell with what people said. Was that decision pure chance? Were the days and nights spent studying and reading widely chance? It infuriates me that these bloody people think so.

I wanted to learn and I wanted to "get on" and I did. If it was all chance, then I can take no pride in it. I can have no self-respect and I couldn't bear that. Even allowing for 20 years paying personal taxes elsewhere, I have more than paid my way in the UK, repaying the costs of attendance at my crap state school and university as well as covering my contribution to infrastructure. I have remitted profits to the UK to be taxed in the hands of my former partners and I have helped to build businesses that are still producing taxable income.

Furthermore, I took not one single benefit (not even child-benefit) for my own children from the British State, because I wanted them to be free range; to look their would-be farmers in the eye, owing them nothing. They were privately educated from kindergarten onwards, mainly because after our experiences as pupils (and in my wife's case as a teacher) in state schools we had decided we would not have children unless we could avoid exposing them to the nastiness, class-hatred and leftist propaganda there. Was this chance; that our brains were configured thus? Was there no morality to our choice?

The event was studded with insults to the British people. Our public intellectuals regard us, at various times, as vulnerable fools to be protected or lab rats to be experimented upon. They are as condescending and self-righteous as any feudal baron ever was. But none of their insults are worse than to compare our lives to a mere throw of the dice - and a throw that can never been remade.

Samizdata quote of the day | Samizdata.net.

I am honoured by words of mine having been chosen as a Samizdata "quote of the day". Samizdata bills itself as

A blog for people with a critically rational individualist perspective. We are developing the social individualist meta-context for the future. From the very serious to the extremely frivolous... let's see what is on the mind of the Samizdata people.

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