Cities in the Future

Some simple statements and observations to spark discussion:

The nations state project is cracking and waning. Nation states as they are have become unsustainable and unmanageable and the imagination needed to hold them together is beginning to falter. They are too complex, un-relational and imperial in their make up.

I believe the shift towards a federation of city states with regional, interconnected, interdependent, intercultural and relational ways of operating is something we are going to move towards in the next 30-50 years.

So, now is the time for cities to start having key conversations across the whole spectrum of society and begin a process of reimagination. It is vital that the marginalised are given a voice and not just ‘represented’ at this table of discussion so that the cities of the future become a place where neighbourhoods of desolation are fully restored. It is time for the artists to to help us to visualise some fresh alternatives and for experiments in economics and kenarchy to be given some fresh space to discover new ways of being.

The Power of Forgiveness

Forgiveness can be both utterly painful and gutsy but carries with the opportunity to be completely freeing. I see so many patients with complex problems, which present to me as a physical or psychological pain. After I have listened intently to their story and the subtle things they reveal or omit, we explore together the possible reasons for their condition.

Once we have excluded any obvious causes through history, examination and tests (where required), we meet again and probe a bit deeper. Time and again I have found in such situations where there is no obvious medical cause, that that there was some kind of hurt caused to them, which they have never been able to forgive. Many times they don’t want to forgive and sometimes they don’t know how to.

Choosing not to forgive someone always has its benefit to us, in some way, otherwise we simply would not hold on to grudges. It can be that which let’s us feel superior or something which justifies our own feelings or patterns of behaviour. But the cost of unforgiveness can be absolutely crippling, leaving a root of bitterness in our lives which can manifest itself in physical, psychological, relational and emotional pain.

I never put this idea onto someone, but have been amazed as I ask an open question to a  person about what they think the root of their problem might be, how often this issue of (un)forgiveness rears its head. They have become stuck in a moment and they can’t get out of it. (U2)!

Over the past few years I have been astounded to watch people make the brave decision to revisit past hurts and memories. Some of the memories have been so traumatic and horrific that being with them in the process has been both heart-wrenching and humbling.

But the change I have seen in people’s lives as they have chosen to forgive, to be forgiven, to restore and to be restored has been extraordinary. There are so many things that the science of medicine cannot explain. We are so uniquely knit together – mind, body and spirit and the complex intertwining relationship of these is not to be underestimated. I have seen major changes in the symptoms of MS, Chronic Fatigue, Back Pain, Unexplained Numbness, Depression, Anxiety, Addiction and Abdominal Pain (to name just a few) as people have forgiven the “unforgivable” behaviour of others or even of themselves.

James Thwaites defines health as being in right and true relationship with others, with the creation and with God, rather than necessarily the absence or presence of disease or infirmity. If he is right, and I certainly tend to agree with him on this, then the forgiveness of ourselves and others has the ability to heal us of deep pain and shame and helps us to find a beautiful healing, wellbeing and wholeness.


The Powers and The Seemingly Powerless

Galadriel: Why the Halfling?

Gandalf: I do not know. Saruman believes it is only great power that can hold evil in check, but that is not what I have found. I found it is the small everyday deeds of ordinary folk that keep the darkness at bay… small acts of kindness and love. Why Bilbo Baggins? Perhaps it is because I am afraid… and he gives me courage.

The Hobbit: An Unexpected Journey’ 2012

What good are our small acts of love and kindness in the face of such oppression within the systems we work in? Be encouraged today. They are the very things that bring empires to their knees and transform the world.

The Powers and The Oppressed

There is so much that could be written under such a title – several books worth, but I will keep this brief!

Standing up for the oppressed and more importantly helping them realise that they are empowered and therefore powerful is likely to get you sidelined, silenced, imprisoned, exiled or killed. Paolo Freire did exactly this in Brasil through an amazing education program and was indeed exiled. Jesus did it in 1st Century Palestine and he ended up crucified.

The powers are completely fearful of a multitude who begin to see that the status quo does not have to be maintained, who hear that their voice is important and just as valid as that of the powers and then begin to use their voices to call for something entirely different.

I am discovering that in the middle classes, we have enough power to believe that we are not really oppressed (which btw is not true, because we are slaves to a system in which we are either passive or complicit without meaning to be) and so we are actually pretty ok for things to stay much the way things are. An overwhelming passivity has gripped us and we have become numb to the news cycles that might previously have shaken us to something wholly more radical…..The powers do not really fear the middle classes, unless….unless a people movement begins that does not have the ego at the fore. For change to occur we need to be concerned with the need of others before ourselves…..and this takes a change of our hearts…..

But, the marginalised……if they really found and used their voice……if they refused to be silenced……if the middle classes refused to stay silent on their behalf…… If the oppressed threw off the shackles and realised they are princes and not slaves, as God calls them…..well, that would be exciting. Is it beyond our imaginations? Conversations springing up all over the place that could change the world?!

Food Banks

I had a fascinating conversation this week with a lady who was telling me she doesn’t really like food banks. It’s not because she thinks they are unnecessary or has some dimwitted view of the world. It’s because she realised that in the one she works in, most of the food handed out is processed, high in salt content and generally bad for people.

Instead she has started doing something, which I think is remarkable. She is befriending everyone who comes to the food bank, putting together a parcel, including a knife, a potato peeler, some washing up liquid and a scrubbing-brush/cloth and she goes to their house with them. She helps them clean their kitchen, has an honest chat about money, works out the most basic of shopping budgets, takes them to a supermarket and then teaches them to cook some cheap but nutritious meals. She’s not a superhero, she knows what it is to have very little and to be a single mum with significant health problems, but she’s determined that life at the bottom does not have to be lonely and it does not have to be full of dregs. On the contrary it can become a place of great creativity and love!

Some Good News from 38 Degrees

An encouraging email from the 38 degrees campaign group today. Protest does work! People movements can change things.

Dear Andy

Some very, very good news. We did it! The government has accepted our amendment to the hospital closure clause in the House of Lords. [1]

Without our amendment the hospital closure clause would have given the government new powers to close any hospital in England, even if local doctors were against it.

The clause was voted through by MPs back in March, after the government made some concessions. Their changes didn’t go far enough, but it seemed like the government wouldn’t budge any further.

The clause was due to be passed today. So the government’s decision to accept – almost word for word – the changes proposed by lawyers funded by 38 Degrees members came right down to the wire – and it was a big surprise.

Our people powered pressure worked and our hospitals are now safer. Thank you for everything you’ve done to make this happen. Hurrah!

David Lock QC, an NHS expert lawyer, has checked the government’s changes and here’s what he said:
“This is a very satisfying outcome. It recognises the compelling logic of the position taken by 38 Degrees members.”

38 Degrees members, alongside others like the Save Lewisham Hospital Campaign, have been campaigning on this for months:

  • Over 150,000 of us signed a petition calling for the plans to be scrapped
  • After meeting with 38 Degrees members, Lib Dem MP and ex-health minister Paul Burstow tabled amendments to the clause. The government, fearing a rebellion from within its own ranks, made some concessions but they didn’t go far enough.
  • The campaign then moved to the House of Lords. Baroness Finlay, a well-respected doctor and influential crossbench peer, led the charge. 38 Degrees members funded briefings and advice from legal heavyweights and we wrote to peers. [2]

In the end, everything we did together – alongside other campaigners and parliamentarians like Baroness Finlay, Paul Burstow MP, Andy Burnham MP – worked. The government has made the changes that they needed to.

Regardless of what happened today, we’ve still got a huge amount to do to protect our NHS. But wins like this, especially on the NHS, don’t come along that often. Today gives us more proof that when we work together, we can achieve great things, and make the government sit up and listen. So for today, let’s celebrate.

Thanks for everything you do,

Becky, Blanche, Rachel, Ian, Rebecca, Maddy and the rest of the 38 Degrees team

PS: Here’s what Baroness Finlay said:
“I am delighted that the Government have recognised the need for equity and the importance of safeguarding good patient services in a population.

The campaign to achieve this would not have been as effective without the support of 38 Degrees members.”

The Powers

This last week I was sat in a meeting with several maternity service users and a splattering of health professionals and managers of varying sorts. We were talking about the enormous deficit that is in our health budget and therefore some of the difficult options that are ahead of us. The government likes to call these options “efficiency savings”, everybody else knows that we are talking about cuts to services.

I always start my presentations by talking about the difficulty we find ourselves in, how we got here (a massive national debt, which all nations are in because our entire economic system is built on debt and none of it is real and they just keep on printing more money to solve it, made far worse by people who get massive bonuses and a >£2billion reorganisation of the NHS that no one wanted or asked for, which had we not had, we would now not be needing to make so many cuts!) and what our options now are.

I then offer a revolution, and other than a few smiles and the odd chortle, no one seems to think this a realistic or viable option….But, if we didn’t reinvest in Trident, or if we did charge greedy corporations appropriate levels of tax, then we wouldn’t need to cut services in the NHS.

Anyhow, I then talk about the fact that no decisions have been made and that we are genuinely in a process of listening (something the government really didn’t do before inflicting this reorganisation on us) and wanting to come to a place of collaborative agreement. But I am fast learning two things. The first is that nobody wants the thing they really care about to be cut or refashioned in any manner. They understand that safeguarding their piece of the pie means that others will miss out, but they don’t actually want to make any sacrifices – I understand that. I also understand more clearly that isolated health budgeting doesn’t work……more on this anon….

The second and starkest realisation I’ve had though is just how dreadful the new legislation voted in by parliament really is.

You see, the Secretary of State for Health now has new powers, never had before to close any services or hospital he/she deems fit, not if they are performing badly, but if it makes better financial sense to do so…..And this is where the rubber hits the road in our public consultations and discussions with patients and service users. If we don’t come up with a solution to cut our services (oh sorry, I mean make efficiency savings – memo to self – stop referring to “efficiency savings” as “cuts”), with the public in some sort of agreement (although they won’t be, because who wants their services cut?!), then what will happen is the government will simply do the following:

They will tell us our sums do not add up, they will tell us that savings/cuts must be made, they will get rid of those of us who are trying to reach a point of agreement with our service users and they will bring in their own board aka Monitor. Monitor do not have to consult with anybody, they will simply cut/burn/slash whatever is deemed necessary and their decision cannot be challenged or overturned!

This is nothing other than bullying. It is what Georgio Agamben talks about when he refers to ‘The State of the Exception’ and with this grim stick of threat held up behind us, it makes our work of trying to reach a collaborative agreement on the redesign of services completely impossible. What are we to do? The challenge is here: how do we subvert the system, making it absolutely clear that we do not play this game, and yet submit back into the system so as to allow love to win the day.

The Powers have shown their strong arm. But they have forgotten that there is a power far more ancient and far more beautiful…….life laid down love……love always wins and it will win in the end in the face of all oppression.