Tagged: Politics

Drip debate

Capture

Not many people turned up and most of those who did were useless. However, these MPs did a great job:

And the others…? Julian Huppert seemed incapable of making a reasoned argument. Interestingly and worryingly when someone wondered why it wasn’t an open vote, Jack Straw shared his views on the importance of the whip system, toeing the party line – essentially the importance of blindly following the parliamentary party and ignoring constituents, i.e., the people who vote these useless MPs in.

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An argument against payment-by-outcomes for mental health

I have just seen a report on Payment by Results (PbR) for the adult Improving Access to Psychological Therapies (IAPT) programme and have concerns about the approach. The conclusion of the summary is that “the system appears feasible and the currency appears to be fit for purpose” which seems to suggest that the approach is going ahead.

This IAPT PbR proposal is outcomes based, so that the more improvement shown by service users, as partly determined by patient-reported outcome measures (PROMs), the more money service providers would receive. This is a worry as there is evidence that linking measures to targets has a tendency to cause the measures to stop measuring what it is hoped that they measure. For instance targets on ambulance response times have led to statistically unlikely spikes at exactly the target, suggesting times have been changed [1]. A national phonics screen has a statistically unlikely spike just at the cutoff score, suggesting that teachers have rounded marks up where they fell just below [2]. The effect has been around for such a long time that it has a name, Goodhart’s law: “Any observed statistical regularity will tend to collapse once pressure is placed upon it for control purposes” [3]. Faced with funding cuts, how many NHS managers will be forced to “game” performance-based payment systems to ensure their service survives?

PROMs have been criticised by therapists for leading to an “administratively created reality” [5] and being clinically unhelpful, perhaps even damaging. However, evidence is building that feeding back results from PROMs to clinicians is helpful for improving care [4]. It would be very sad indeed if this useful tool were destroyed by payment systems, just as many mental health practitioners — and more importantly, service users — are seeing the benefits. Linking outcomes algorithmically to finances at all seems to be a bad idea in general — it’s especially bad when PROMs are just beginning to be trusted in routine practice.

References

[1] G. Bevan and C. Hood, “What’s measured is what matters: targets and gaming in the English public health care system,” Public Adm., vol. 84, no. 3, pp. 517–538, 2006.

[2] L. Townley and D. Gotts, “Topic Note: 2012 Phonics Screening Check Research report,” 2013.

[3] C. A. E. Goodhart, “Monetary relationships: A view from Threadneedle Street.” 1975.

[4] C. Knaup, M. Koesters, D. Schoefer, T. Becker, and B. Puschner, “Effect of feedback of treatment outcome in specialist mental healthcare: meta-analysis.,” Br. J. Psychiatry, vol. 195, no. 1, pp. 15–22, Jul. 2009.

[5] J. McLeod, “An administratively created reality: Some problems with the use of self-report questionnaire measures of adjustment in counselling/psychotherapy outcome research,” Couns. Psychother. Res., vol. 1, no. 3, pp. 215–226, Dec. 2001.

Some of the reasons why I’ll be on strike on Tuesday 3rd Dec

  • Over 10,000 employees in UK universities are paid less than the Living Wage. [1]
  • University vice-chancellors earn around 15 times more than their lowest paid staff – one of the largest pay gaps in the public sector [2]
  • 13% cut in value of pay since 2008 (taking inflation into consideration) [3]
  • Median pay has dropped in absolute terms since 2008 by over 2% [4]
  • “The most vulnerable and the lowest paid jobs, often part-time and fixed term, are disproportionately held by women and BME colleagues” [5]

Hewitt and Harman v. the UK

This is an interesting case from a while back. concerning Patricia Hewitt and Harriet Harman.

“In 1985, evidence emerged that MI5 (also known as the Security Service) was systematically infringing the applicants’ rights under the [Euro Human Rights] Convention when a former officer of MI5, Ms Cathy Massiter, made certain allegations to this effect on a television program. According to Ms Massiter, the applicants had been classified as subversive and as communist sympathizers, and these grave libels were published within MI5 and were available for publication to other agencies with whom MI5 had a relationship. Their files recorded details of passport applications, data from surveillance by local police, Special Branch and by special agents, and references to them or by them on telephone intercepts picked up under warrants issued in relation to other persons. Such intercepts, in the second applicant’s case, were likely to include confidential conversations which she, as a practising solicitor, had had with certain of her clients. The first applicant’s file included information about her personal relationship with a former member of the Communist Party. Surveillance of both applicants was continued after they had left the National Council for Civil Liberties on the basis that they were both candidates for elected office.

“On 19 May 1986, the applicants lodged an application with the European Commission of Human Rights against the United Kingdom government alleging breaches of their right to privacy (Article 8), their right to freedom of expression (Article 10), their right to freedom of association (Article 11) and their right to an effective remedy (Article 13) in respect of the violations arising from the nature and consequences of the surveillance to which they had been subjected by MI5. The application was declared admissible on 12 May 1988.

“In its Report dated 9 May 1989 the Commission concluded by a majority that given the existence of practices in the United Kingdom permitting secret surveillance and given further the reasonable likelihood that the applicants were the subjects of surveillance the compilation and retention by the Security Service of information concerning the private lives of the applicants constituted an infringement of their right to privacy under Article 8 (1) of the Convention. The Commission further concluded that the domestic law of the United Kingdom contained neither legal rules formulated with sufficient precision nor a framework indicating with the requisite degree of certainty the scope and manner of the exercise of discretion by the Security Service in the carrying out of secret surveillance activities to render interference “in accordance with the law” within Article 8 (2). Finally the Commission concluded that since no information was forthcoming in relation to how the United Kingdom had chosen to provide an effective remedy under its domestic law that the applicants did not have an effective remedy as required by Article 13.”

 
There’s some interesting detail in there about the workings of the Security Service, e.g.,
 

“The procedure for opening a file is strictly controlled. It may start as a temporary file, which has a maximum life of three years, when there is uncertainty whether the criteria for opening a permanent file are satisfied. These criteria have their basis in the Service’s functions and require high standards of accuracy. If and when these criteria are satisfied, the permanent file will be opened. The Service then applies a system of colour coding which controls how files are used. Once a file is opened, there is a period coded “green:, during which inquiries may be made about the subject. The length of the green period varies according to the reason why the particular file was made. It may be extended as a result of the receipt of new information. At the end of the green period it changes to “amber”, under which inquiries are prohibited, but any relevant information that the Service receives about the subject may be added to the file. After the designated amber period the file is coded “red”. During this period, inquiries continue to be prohibited and any addition of substantive information is also prohibited. Finally, after a period of red coding, the file is microfilmed. The hard copy is destroyed and the entry for the file in the Service’s central index is transferred from the Live Index to the Research Index. The Research Index is usually consulted only when it is thought that old files may exist which are relevant to current work. In practice the volume of check against the Research Index is small: for instance, it is not consulted in vetting checks.”

What’s left?

I didn’t know much about Nick Cohen before picking up What’s Left? from the Swiss Cottage market book bloke. Here’s what Google told me:

First, Craig Murray:

Let me summarise Nick Cohen’s book for you. ‘If you are against eating Muslim babies, you are a supporter of Islamofascism. If you are perturbed by Guantanamo Bay, you would not have fought in the Spanish Civil War, are probably a fan of Hitler and have no right to call yourself a Liberal. Neo-Conservatism is the New Left.’

There, now you don’t have to read it. Believe me, I have done you a favour.

Or how about  Peter Wilby?

Cohen appears to think this book shows he has put infantile leftism behind him and attained a new maturity. Alas, it shows that he is, and always was, a political innocent.

Johann Hari?

…once Cohen’s blind faith in neoconservatism becomes clear, many of the accusations he makes against the left begin to look like acts of psychological projection rather than serious political arguments.

What’s left?

Here are some examples elaborated in the book which might help you decide whether you want to read it:

  • Companies from West Germany supplied Saddam Hussein with “one of the largest chemical weapons manufacturing industries in the world” (p. 47). East German communists provided Saddam’s forces training.
  • France built a nuclear reactor for Saddam, which was blown up by the Israeli air force before the nuclear fuel arrived.
  • The slow response  of Europe, including the then UK Tory government, to Slobodan Milošević, Butcher of the Balkans — leading to the Srebrenica genocide.
  • Some evidence that Virginia Woolf might have been a “screaming snob” who hated the working class. Here’s an example, to give you a flavour of his argument, of what she said: “What rather appals me… is the terrible conventionality of the workers. That’s why — if you want explanations — I don’t think they will be poets or novelists for another hundred years or so.”
  • A quotation from George Galloway saluting Saddam Hussein: “Sir, I salute your courage, your strength and your indefatigability. And I want you to know that we are with you until victory, until victory until Jerusalem.”
  • Evidence that the reason for war in Iraq was a lie, Cohen writes: “If Blair had levelled with the British people he would have said that he couldn’t be sure if Saddam was armed, and even if he was there was no imminent danger, but here was a chance to remove a disgusting regime… Instead he spun and talked about chemical weapons…”

I don’t agree with everything in the book, but I am deeply suspicious now of those who think leftish people should avoid it.

A cup of coffee and a tent

“Can’t they be about… sorry… we… er… eh… no no no no… it’s just so obvious I can’t be bothered…

“You don’t have to want to return to a barter system in the stoneage to complain about the way the financial crisis affected large numbers of people in the world, do you? Even if you’re having a cup of coffee and you’ve got a tent!”

— Ian Hislop responding to Louise Mensch on Have I Got News For You, 23/10/2011

Authority

“… all authority is quite degrading. It degrades those who exercise it, and degrades those over whom it is exercised. When it is violently, grossly, and cruelly used, it produces a good effect, by creating, or at any rate bringing out, the spirit of revolt and Individualism that is to kill it. When it is used with a certain amount of kindness, and accompanied by prizes and rewards, it is dreadfully demoralising. People, in that case, are less conscious of the horrible pressure that is being put on them, and so go through their lives in a sort of coarse comfort, like petted animals, without ever realising that they are probably thinking other people’s thoughts…”

Oscar Wilde, The Soul of Man under Socialism, 1891