Consent, Divorce and Brexit

images-1Sometimes people change their mind, especially when new evidence comes to light! For example, in the medical profession, the process of consent stays open right until the operation is about to take place. It would be ludicrous to tell someone they have to go through with a leg amputation, even after it’s been discovered that their leg is in fact healthy and savable, simply because the consent form is signed! I think Brexit feels like that, except in our case, we are the leg and we’re about to cut off the body to which we are joined! Or we could compare it to a couple being forced to go through with a divorce, with all the pain involved, even after they rediscover that they are really great together, have believed lies about each other, and will both be worse off without each other. Yes – they may have some things to work through and they may need to totally reimagine their relationship, but to force the divorce through just because they were going through a rough patch, might be hugely regretful. I think Brexit feels like that – a very sad outcome to what could have been a totally different kind of conversation.


Yes, I accept that there are things about the EU which have made many across the UK find it difficult to want to stay in a relationship with her. But we’ve been led to believe some things about Europe which are wholly untrue and our vision got really clouded. When we step back and recognise all the good things about the relationship, knowing that it isn’t perfect and would still need a lot of work; mediating a reimagined future is so much more preferable than what a divorce is going to mean. And sometimes, it’s only after you call something off that you begin to realise that it isn’t a break-up that you want, it’s just a different kind of relationship. We are literally about to make an unbelievably terrible mistake, but it’s not too late to change our minds. 


Unknown-1Let’s be honest, through the unraveling scandal of Cambridge Analytica et al. we now know that Brexit was NOT the result of a “democratic process”, and the idea that we now can’t change our minds, (even though the evidence is clear of how bad it will be), is beyond ludicrous. Yes, it’s true, we were told it would be a once in a lifetime vote, and that not leaving the EU will break people’s trust in our political system – but last time I looked, there wasn’t loads of faith in it anyway! The leave campaign broke the law in terms of what they spent, told many lies, and hard though it is for us to face up to, used immorally targeted psychological manipulation to get the vote they wanted, driven by hyper-nationalist media moguls. And so NO, we don’t actually have to take the result and live with the dire  consequences. It is time to stop this madness, say sorry to our European friends and renegotiate a New European Union that works for everybody. Clearly there are some huge problems, which is why we are seeing the rise of the far right across the continent. Many people feel un-listened to. Europe has forgotten how to create a positive story of the future and so we are retreating into narratives of fear and separation. But, rather than leave, what we need to do is come together with a bolder and more positive dream of what it means to be in Union together and then we can begin to face up to some of the really complex issues we face at a global level.  


images-2We’ve been worried that being part of the Union means that we are losing our own national identity. It doesn’t mean that at all! Have you seen the Dutch fans at a football match?! When I married my wife, I was still me, she was still her, but we also became something new together! The EU really doesn’t limit our sense of individual nationhood, rather it expands our sense of partnership! We’ve believed that that the union prevents our ability to make good and sensible laws, but this simply isn’t true! Rather, the EU upholds human rights and helps us to embrace ‘otherness’. Europe and the European Union is extraordinarily amazing, but it absolutely needs to modernise, change and embrace the positive new power movements which are emerging. In the bloodiest continent on the planet, we have managed to live at peace with each other for over 70 years, and more than that to have become friends with each other. 


Compared to many nations in Europe, we are not as amazing as we might like to believe. We have one of the highest levels of poverty, some of the least happy people, the widest inequality gaps by an absolute mile and some of the lowest spending on public services. We have the highest property prices and rents in Europe and significantly declining productivity. To top it all, we have the worst pension deal. This is not the fault of the EU, but of the economic systems we have championed but which the rest of Europe have been more careful about monitoring.


imagesSo, leaving the European Union will help us how? £350 million extra a week for the NHS
or social care, or education, or policing? Nope. A better deal in life for those living in our most economically deprived areas? No again. Will we be safer? The police chiefs tell us not. Will our borders be more secure so that we can control all the immigration that we are told is the root of all our problems? Well no, and although immigration is a complex issue, Brexit is not the answer to it and we need to resist a rhetoric of fear, division and hate. . Might we create division across a well-healed Irish border? Yes. Will we potentially lose loads of manufacturing jobs across the North? Yes (just look 
at the new manufacturing deal Japan have struck with the EU). Will many of our businesses suffer heavy losses? Yes. Will the NHS struggle to recruit workers when our workforce is already hugely overstretched? Yes. Are there likely to be food shortages and will food become more expensive? Yes. Are we more likely to see the break up of the UK? Yes – and what of our great sovereignty then?! England is a very small place on its own! We need to wake up!Unknown



I know, we had a referendum and the ‘remoaners’ lost. But we are all about to lose so much more if we actually go through with this madness. We don’t just need a people’s vote, we need some humility and some hope that we can restore the damage we have done to our friends across the continent and together face the huge complexities in front of us over this next century – climate change, the refugee crisis, the plastic in our seas, water shortages and so much more. We cannot face these things alone as isolated nation states, but together, in union, we can! So, enough with Brexit! Let’s stop this now and find a new way forward together. #togetherwecan










NHS in Crisis?

imgresAnd so it begins……the year of a General election and the NHS takes centre stage. Some serious hyperbole. According to our tabloids we have ‘A 3rd World A&E’! Please! I’ve worked in the developing world and this is nothing. Despite all the rhetoric, the WHO still says the NHS is the best and fairest health system in the world… perspective is important.

But is the NHS in crisis? It is, and it’s not just the emergency departments. General Practice continues to be in a major crisis too and so if the answer to the A&E (ED) crisis lies in General Practice then the crisis in the community is doubled! But my ED colleagues are having an horrific time and the answers to the conundrum are not easy ones.

Labour have called for an emergency summit on Accident and Emergency and the NHS in general, as if the writing has not been on the wall for quite some time. Short term solutions will do nothing to create a safe and sustainable NHS, accessible to all.

We do have some hard truths to face in the UK and we have to understand the cost implications to some of the possible solutions. But I do believe there is real hope and that there are creative solutions available. It is time for a revolution in our thinking.

The problems are as follows:

1) We have an aging population with increasingly complex health needs.

2) Our social services at at full capacity and we have a break down in a sense of community in how we care for and love our ‘neighbours’.

3) We have adopted a health philosophy that is about ‘killing disease’ instead of ‘promoting health’. This is due to a combination of far too much power being given to the advertising, fast food and alcohol lobbies, taking exercise out of schools and too much screen time generally for kids and adults alike.

4) We have adopted a way of life that has driven up stress significantly causing a rise in mental health issues.

5) We have deliberately under trained doctors and nurses in this country, relying on free market principles that we could recruit staff more cheaply from abroad, (not caring that we are seriously destabilizing other health economies in the process). In the same way, we are losing many of our young doctors and nurses to other nations who will pay more for less hours (like Australia and Canada).

6) In order to keep the NHS afloat, managing structures in the NHS have become increasingly bullying, creating low morale, high sickness records for staff and a sense of despair. This is turn has a direct effect on poorer care for patients.

7) We have over-medicalised life and given far too much power to the pharmaceutical lobby. Targets have been set which are meaning tighter and tighter control of people’s health with medication, creating ever more health anxiety and increasing illness behaviour.

8) We have developed a sense of entitlement and self-centredness overall, which puts huge strain on systems, especially A&E. There is a huge abuse of the system and misuse of services without consequence.

9) There has been a significant lack of local people being able to be involved in any way with how taxation is spent whilst greedy corporations and banks can act exactly as they please, leaving a lack of investment in healthcare to the tune of several billion pounds.

10) We don’t trust our own immune systems to work and have become over reliant on antibiotics.

11) We are afraid of death and having conversations about it in any kind of mature way. We keep on treating people endlessly with antibiotics in nursing homes, when we should allow people to die (not be killed) in a dignified manner.

12) We have far too much waste and too many barriers/walls within a complex system, leaving key sections of the system in direct competition rather than collaboration/cooperation with one another.

13) Oh yeah, and we had a 2 billion pound reorganisation of the NHS which happened despite a ‘listening process’ which strongly warned against it.

And some solutions-based, hopeful, practical thinking?

1) Change the way we think about health. We have to live healthily andimgres
promote healthy living from time of conception to time of death. We need healthy pregnant women, more breast feeding and healthy diets and exercise from a young age. We need to be more responsible….

2) Change the way we think about health. The biggest breakthroughs in medicine by a mile were clean water, sanitation and immunisations. We need to trust our immune systems to do the job they do very well, and care for our selves better before needing to run off to the health professionals to fix us.

3) Change the way we think about health. Try being grateful for the incredible healthcare we already have.

4) Change the way we think about health. We need to understand the impact of our chosen way of life on our physical, mental, social and spiritual health. We have become slaves, the fodder, the raw material of an economic system that eats us up and spits us out, allowing 85 people to hold more combined wealth than the poorest 2 billion on earth. If we haven’t understood that this awful injustice crushes our spirits and therefore our well-being on a daily basis, then we have understood little. The mountains must be brought low and the valleys raised up. It is a proven fact that people are least happy where the gap between rich and poor is widest. The UK has the widest gap in Europe by some margin! We go to work to earn enough money to pay our debts which drive the system. We come home, hypnotize ourselves in front of the TV and return to the same thing the next day, not wondering if we actually destroying the planet, other people and ourselves in the process. And if we don’t live this way anymore? Perhaps we could find more creative ways to live that bring a more beautiful future to the fore?

5) Change the way we practice healthcare. We need to transform tired systems and help them integrate to provide far more stream lined and effective care. The walls between primary and secondary care must come down and new collaboration be found.

6) Change the way we practice healthcare. We need to create a culture in the NHS which is life giving for staff (see earlier posts).

7) Change the way we practice healthcare. We need to allow people to die with dignity, especially in conditions like end stage dementia, rather than keeping people living on and on, just because we can.

8) Change the way we practice healthcare. Involve local people to create a groundswell of change, with a far greater sense of caring for the ‘other’ and our ‘neighbours’ with greater local decision making in how money is spent.

9) Change the way we practice healthcare. We must see a reduction in  power of the pharmaceutical lobby in parliament. The influence of this lobby on healthcare policy and provision is utterly corrupt and has caused much of the unsustainable mess we are in.

10) Change the way we practice healthcare. We must train people more effectively and make the NHS a desirable place to work in once again.

And the list could go on. A revolution in our healthcare system is needed. Transformation is really possible. We must not seek answers which lead to death elsewhere. We have some tough choices and changes to make, but there is so much hope.