Archive for the ‘Uncategorized’ Category


Time for Constitutional Reform

May 23, 2009

The recent expose of MPs expenses has brought out into the open the disdain and lack of respect that most people in the UK today have for elected politicians.  I believe that this has always been the case to some extent, but since the days of Margaret Thatcher and accelerated under Tony Blair we have now moved to the point that that lack of respect is justified. Parliament plays no effective role in scrutinising or introducing legislation.  Individual MPs and select committees are the stooges of the party whips, and the government can effectively exercise untrammelled power free from scrutiny by parliament. Only the judiciary occasionally raises its head against the government.

We used to have an unwritten constitutional settlement (well we still do).  The executive and judiciary were all bound in with the legislature-the executive with the house of commons and the judiciary with the house of lords.  Although not an ideal arrangement constitutionally, it used to work effectively because of the respect that members of each of the three elements had  for each other and for the freedoms whiuch were preserved by the complex interactions such a constitutional arrangement engendered.

No More. Successive prime ministers have emasculated the house of commons, taken over the house of lords and filled it with stooges, and shown scant regard for the judiciary.  This current crisis of confidence is in fact the greatest opportunity to correct all this.  What we need is now:

1) A wholly elected house of Lords.   I would favour election by FPTP of 100-200 members geographically based around English local authority or county boundaries. This would be the “English Parliament”.  Devolved matters would be referred to the local parliaments or assemblies of Scotland,Wales and Northern Ireland, and matters affecting only England would have to pass this house

2) The house of Commons reduced to between 400 and 500 members.To be elected by PR with STV system

3) The Prime minister to be directly elected and to serve a maximum of 2 parliaments

4) Government ministers not to sit in the commons.  If an MP is appointed to the government there should be a bye-election

5) The houses of parliament, not the government to control the business of the commons-both the timetable and the composition of  select committees

6) Fixed term4 year parliaments

I believe this would give power back to parliament, solve the West Lothian question, Reduce the size of our government by 50% and restore self-respect and, eventually, public faith in MPs. 

Only one person has the power tomake this reality.David Cameron.  I hope he has the courage to do so


Leaders-born or made?

May 9, 2008

I have spent the last couple of days attending a course on leadership.  I have to admit to having been rather sceptical that one could teach leadership.  Indeed one of the exercises we did was to think of people we considered great leaders.  Some of the responses were typical, some less so:  Winston Churchill, Gandhi, Aung San Suu Kyi, Don Bradman, Mike Brearley, Margaret Thatcher, were a few of the names we came up with.  It struck me that the one characteristic they shared was that they hadn’t ever attended a leadership course!

On the other hand I was made to think about the nuts and bolts of leadership.  I think it will help me to make the most of my (limited) gifts, and it may make me a more effective leader.  I wonder whether it will make me a “better” one.  My instinct is still that some people have it and some don’t.  The difficulty is in knowing which side of the line you are


A good doctor?

April 24, 2008

back after a long layoff:  I have decided that if I post only infrequently then I won’t get too many readers so I can be more than usually self-indulgent

For some reason I went through a period of what we used to call at medical school an ILA or “involuntary life assessment” today.  As part of this I was asking myself if I am a good doctor.  Certainly by most objective criteria (patient and colleague feedback, publications, grants etc) I do well.

On the other hand I know that I am a much better doctor at the beginning of someone’s cancer journey than I am at the end of life.  I am not alone in this, certainly.  But I and many other cancer specialists I suspect struggle with the transition from giving hope when there was little (at which I am good!), and knowing how or whether to maintain hope when there is none.  All of my patients have thought about dying, each in their own way, and many of them are happy to talk about it.  Some are not.  very few will introduce the subject. How does one know?  In reality there are a myriad of verbal and non-verbal cues.  What should I say?  Honesty of course-they deserve that.  But do people want or need to be told the bare facts-“You will die within the next few days,weeks,hours”.  At such a time what people need is a friend, not a doctor.

A famous professor at the Royal Marsden said to me words to the effect that an oncologist should be a guide on the journey, a strong ally in the fight and a friend in death.  I fear I am a very good guide, an excellent ally but perhaps a poor friend.

No amount of communication skills courses can give me that.  I hope experience will


Asleep but not dead…

June 13, 2007

In the meantime, who do you think will be the new health secretary?

Click here to take the survey now.


Bread for the masses

May 18, 2007


I am all for freedom of choice, but for the life of me I can’t see what’s wrong with THIS


Into the ears of babes and sucklings…

May 15, 2007


I went to a football match on Sunday. I took my 7 year old son. I haven’t been to a live footie match for several years-in fact since I became a father. There was a moving moment of solidarity with the McCann family. After that, the singing started. Here’s a sample of what the Chelsea fans were singing to their Everton visitors.  (Those of a tender disposition do not read on)

In your Liverpool slums
In your Liverpool slums
You look in the dustbin for something to eat
You find a dead rat and you think it’s a treat
In your Liverpool slums

In your Liverpool slums
In your Liverpool slums
You s**t on the carpet, you p**s in the bath
You finger your grandma, and think it’s a laugh
In your Liverpool slums

It goes on and it doesn’t get any better. Now I know that I wasn’t in the family enclosure, although I was surrounded by children. I know that football is an emotive part of may peoples lives. I think I have a sense of humour which is not especially delicate, and I have a more or less complete mastery of Anglo-Saxon vernacular, which I use regularly. But I don’t want my children or anyone else’s growing up learning to hurl ritual abuse at people. I don’t like them thinking it’s normal to be so tribal. I want them to be able to think as individuals, not as part of a baying mob. I also don’t see how it is very different from racist abuse. Not of course that I particularly like Liverpool myself!

Maybe that’s my prudish middle class background. I certainly don’t remember having the same objections 20 years ago. But I’m not sure I will take my son back to Stamford Bridge, at least not for another 5-10 years

Which is a shame because he absolutely loves football


Its really true…

May 10, 2007


He’s really going


Miss him already

(Good to see George W believes in wearing a condom, though its not a brand I recognise!  And I like the merkin, too)