In a paper on personal electronic health records in the British Medical Journal, Prof. Trisha Greenhalgh delivers a commonsense statement:

Patients’ involvement in their care is viewed by some as both inherently desirable (empowering) and potentially cost saving.

Even if it wasn’t necessarily cost-effective, or it was too close to call, it is largely seen as good on its own merit.

But there is a counterargument.

Take something the Slovenian philosopher Slavoj Zizek once said:

Today many, even sociologists, have this wonderful idea of how, although we live in a society of knowledge—even scientific knowledge—[it] is becoming more and more contingent, non-binding. I think it was the German theorist Ulrich Beck who drew attention to the simple fact: today we speak about expert opinions. Are we aware how paradoxical this term is? The idea is that we ordinary people have opinions. They tell you the truth. Now experts all of a sudden are telling us different opinions and we have to decide how, who knows, if even they don’t know.

The paternalist might say, the common people have opinions, it is the experts who tell us what the truth is. They don’t have opinions, and when they disagree they are disagreeing on the precise coordinates of that truth, not whether there is truth as such.

I was talking to a GP last week who told me a story that contributes to this debate.

He said he had heard of another GP who, on being given a piece of printed paper by a patient, with details from a website on the internet effectively challenging the GP’s decision about a patient’s medical concern, raised his voice and said: “who went to medical school here?”

The GP I was speaking to said this was the wrong way to go about the new culture of information shared by patients and professionals alike.

He said with his students, what he encourages is for them to consider the bits of paper patients bring in on their merit, not raise their voices, not become indignant, but, in his own words, realise that “we interact with people who know as much as we do”.

Seeing, as Professor Greenhalgh put it in her BMJ paper, “patients as active partners in [their own] healthcare” does not do down expert opinion, but allows them to participate in it, rather than the paternalist notion that professionals can be allowed the knowledge, and patients expected to know their place.

However Zizek is not wrong. If we were all considered experts then this might impact upon the idea of truth. But this isn’t what is happening today, as much as he’d like to think it.

Instead, we are not all experts, and nor do we have expert opinion, but expert opinion is not under lock and key anymore. We are all allowed to enter in to expert opinions. This can be seen in the relationship between patient and GP, for example.

I was last week talking to one well known blogger and contrarian over dinner who told me he thought Alan Sugar would run as Mayor come the next such election – that was until he made his outburst towards Ken during the run-up to the last one.

This said blogger, counterintuitively for those who know him, voted Ken, and said so on his blog to much dismay and confusion from his peers and blogospheric colleagues.

He told me that after the tweets, tantamount to “firing” Livingstone, in Sugar’s inimitable way, the Labour peer could no longer hope to stand against Boris Johnson because this particular episode let him down.

I don’t want to underestimate anybody, but I think we’ll have forgotten a tweet by the time the next one comes along – particularly now that Boris has become the “diginified” mayor with a proper mandate that he could never really be before, seeing as his first win came after a protest vote against Ken.

Again, last night, after the mayoral election had finally come to a close, Alan Sugar came up again. Will he, won’t he? In honesty, I don’t think he’ll have it in him – plus there are others waiting for the chance, some who bottled it last time.

While one chap, a Labour activist, I was talking to last night said Lord Adonis would be a good bet (“he was the best transport minister we had, and the mayor’s job is all about transport”) another, this one also a well known blogger and Labour guy, reminded me that David Lammy would “walk all over Boris”.

As Dave Hill mentioned earlier today, “Tottenham MP David Lammy opted out because he knew he would be crushed. ” Not by Boris, but by Ken. Indeed the person who did eventually step up against Ken, from the Progress-backed Right, was Oona King – and she was crushed.

I recalled the time I saw 2 hustings in London as the Labour mayoral candidate was being decided. One the first night, Oona stuck her neck out to say universal benefits were not helping low-income families, and that subsidising the bus passes of the elderly rich was a privilege we could not afford anymore.

The very next night, she had changed her mind entirely, waxing lyrical on the virtues of universal welfare and the part it plays in a civil society.

A week later, this confusion started to play havoc for Oona’s own activists. In a hustings in Camden, Wes Streeting, the former President of the National Union of Students and current chief executive of the Helena Kennedy Foundation, stepped up to the podium against Ken in place of Oona who was stuck the other side of the country. On the topic of means-testing bus passes Streeting knew exactly where Oona’s principles were. It was just a shame, Ken made no bones about pointing out, that Oona herself didn’t.

Because of the Qaradawi affair, I had considered backing Oona – I found her far more likeable than Ken, who is by design a man keen to make enemies. But I couldn’t; she was too awful. Many on her side agreed.

Ken last night, during his very emotional speech, decided that this would be his last time running for Mayor of London. On this I withhold comment. What there is to think about now is who will take his place.

Of course this will be decided properly closer to the relevant time, but speculation on this has been going since before the election result was called.

Now that Ken has gone, maybe Lammy will put his bid in. He’s a unifier, not a divider political figure, and he has suitably outlandish opinions. He is a Londoner and he is liked, not just by Labour’s lot. Boris, as I was reminded last night, will find it very difficult to be the bumbling buffoon around him, because Lammy will walk all over him.

Ken having gone will mean there is no obvious candidate, which may make the left/right debates when we come to have hustings again, a little more exciting and fractious. But maybe there is someone willing to leave the divisions aside. After all, isn’t the point of a Mayor to incorporate all. Was this not Ken’s downfall?

Perhaps Lammy could be that candidate.

Update:

BRIAN COLEMAN HAS LEFT THE BUILDING!!

In a post last year, after detailing the expenses of Britain’s best paid councillor, I asked “how long will he get away with it?“

The answer, now, for one Brian Coleman, Conservative Party politician and member of the London Assembly for Barnet and Camden, might be: not for much longer.

With 55% of the votes scanned, and 39% verified, Labour’s Andrew Dismore leads Coleman.

Could this be to do with the recent “mad” episode? Or is there *a lot* more that this man has done to upset the electorate?

For the record, here is my post from last year:

For 2010-2011 this is no different, as his London Fire Brigade expenses will reveal. At a time when we’re all in this together, some notable claims made are:

• 21/11/2010 – Taxi (invoiced) – Taxi journey for Chairman and Chairman’s Lady – from the Cenotaph, Whitehall SW1 for Annual Service of Remembrance (£66.09)
• 12/11/2010 – Taxi (invoiced) – Taxi journeys: Chairman and Chairman’s Lady – to GLA Annual Remembrance Service at City Hall, SE1; Chairman only – from GLA City Hall to CLG Eland House, SW1 for Fire Futures Steering Group; from CLG Eland House to Bevis Marks Synagogue, Heneage Lane EC3 for Service of Thanksgiving; from Bevis Marks Synagogue to home (£145.93)
• 27/10/2010 – Taxi (invoiced) – Taxi journey from Houses of Parliament SW1 to Union St. (£19.20)
• 12/09/2010 – Taxi (invoiced) – Taxi journeys with Mrs Coleman – drop off at Church of St Bartholomew the Great, EC1; pick up from St Pauls Cathedral, EC4 – Firefighters Memorial Trust Annual Service of Remembrance (held in two different locations) (drop off at Church of St Bartholomew the Great, EC1; pick up from St Pauls Cathedral, EC4 – Firefighters Memorial Trust Annual Service of Remembrance (held in two different locations) (£140.55)

Anyone would think he didn’t get free travel around London worth £1,700.

But for all his misgivings about firefighters having two jobs, Mr Coleman in fact has four. And he’s not short of a few bob either (something to be considered when you think how much he costs the taxpayer for car mileage and the congestion charge – when we’re all in this together).

Investigative journalist David Hencke did some number crunching to reveal his income:

Brian Coleman holds down four jobs all funded by the taxpayer. They are:

Member of the London Assembly                                                      allowance: £53,439

Cabinet member Barnet Council                                                         allowance: £38,177

Chair London Fire Brigade                                                                   allowance: £26,883

Chair LGA* fire services management committee                    allowance: £10,365

Grand Total from the taxpayer                                                                                £128,864

*Local Government Association, a voluntary body funded by councils from council taxpayers.

And of course his expenses:

Brian is a great expense claimer never knowingly underclaimed. He can claim for expenses for three of his four jobs – the LGA don’t allow him.

He is a big patron of London cabbies claiming once over £10,000 a year  from the London Assembly on trips (2006-07). He is now more modest – claims have varied between £8000 -plus a £1700 travel card (2007-08) and £345 for 2009-10. All from the taxpayer.

His fire brigade expense claims are not much different.These include a £119 taxi fare to the Fire Service Awards Ceremony in  May 2009 and £143 to attend Westminster’s Lord Mayor’s reception for the Lord Mayor of London. He also spent £402 on a  rail ticket to go a LGA conference in Manchester. Little difference in 2011 -with a £145 taxi fare for him and his mum to go to a  firefighters service of remembrance  and meetings in London.

His red letter claims day is May 12 this year – where he managed to claim car mileage, congestion charge and over £67 in taxis  for a dinner -all on the same day.

His gifts include four dinners (three of them before the company won the contract) and a £350  Harvey Nichols hamper from the head of AssetCo, John Shannon, the company which has a £9m PFI deal with his authority and provided strike cover.

There’s also some interesting details on his home life, and his landlords the Methodist Church in Finchley.

Colman justifies all this by saying he works 100-hour weeks with few days off, but this hasn’t been enough to convince the website, aptly called Is Brian Coleman a tedious cock?, who remind us that:

• Brian Coleman thinks peaceful, friendly, good-natured political protests scare off tourists.
• Brian Coleman, as head of the London Fire and Emergency Planning Authority, lied about when you should dial 999, to smear a political opponent. The London Fire Brigade called him out on it.
• Since July 2006, Brian Coleman has run up over £14,000 in taxi fares, paid for by London tax payers — who already pay £1,700 for his travelcard.
• What do ordinary members of his own party think about Brian Coleman? Here’s how they reacted to his views on one of their former leaders.
• Brian Coleman has received more free gifts of dinner than any other Greater London Assembly member. Instead of being grateful, he publicly complains.

A litter of Labour’s known online commentators have decided not to put Ken as their first option in the mayoral elections today, one deciding to vote Green with a tactical eye on granting Livingstone his second preference, while the other this morning decided to accept a blue rosette given to him and do Boris’ counting with activists.

Various Lords have given Ken the snub, MPs are not actively out campaigning for him and some well-known journalists such as Jonathan Freedland long ago decided that Livingstone and the Jewish question was a touch too far.

I agree this should be near the top of our heads when voting for a mayor. After all the Mayor of London engages with international figures and therefore has to have a rigorous internal conversation about how to conduct oneself on matters of world political issues.

The meeting, therefore, with Egyptian cleric Yusuf al-Qaradawi plays havoc. Further, Ken’s present failure to recognise a problem here gives us reason never to trust him again, let alone trust him with political office.

But also the recent “beacon of Islam” political theatre, along with dalliances with PressTV, under rule of Mahmoud Ahmadinejad’s clan of autocratic criminals, doesn’t sit well alongside his comments that Jews are “rich” and “wouldn’t vote for him anyway.”

Why does he feel the need to say he’ll make London a “beacon of Islam” anyway? At best that was the foulest form of political posturing; at worst it is divide and rule politics.

All these things should give us reason to kick up a fuss – but as Ken is “our man” we should keep Mum, lest we tread on our own supposedly tribal instincts.

The Economist in their recent editorial, supporting Boris, said that the Blonde blue candidate is the right candidate for the wrong job, and that the role of mayor should cover far more important ground.

I agree, but obviously not for Boris. But, then, not for Ken either.

Peter Hain, in his recent autobiography, said:

…I wanted to be effective, to be able to make a real difference. And that meant learning what not to do from Ken Livingstone … he seemed to go out of his way to make enemies…

And this holds true today. A London mayor should not be one whose sole aim it is to make enemies, in fact the opposite is true.

If Ken becomes mayor again, which he very much could do tomorrow, then he is more likely to stand next time. Even more, if he wins, the Labour party will find it nearly impossible to throw him out – and I think it’s time they did.

Ken isn’t simply a renegade who cannot be tamed, but his politics and demeanor have become embarrassing and offensive. And we haven’t even raised the tax situation, yet.

There is also something in what Andrew Gilligan, another ex-PressTV partner in crime with links to the Father of Syria’s President Assad, said recently, on what would happen if Ken lost:

If Ken loses again this week, in a city where Labour is currently 19 per cent ahead in the polls, Labour will have no option but to face all these realities.

Boris on the other hand will use a mayoral reelection to further boost his designs on Conservative party leader.

(Could we foresee a lightbulb fight between Yvette Cooper and Boris Johnson yet?)

Boris is clearly not in this for the right reasons, whereas Ken thinks he is doing the right thing, really means it, and is often left looking foolish as a result.

Dan Hodges probably has this right: it is a fight between Ken and Boris. That seems obvious. But he is wrong to support the latter.

I can’t say anything other than vote Ken. I’m not tribal, it’s just I don’t want to see Boris back as Mayor. But I’ll be honest nor do I want to see Ken back either. Sadly, there is no other way. Vote Ken, then insist he is sacked immediately. This inharmonious position seems to be all we have in the sensible camp. I blame politics.

Happy National “cc all your e-mails to Theresa May” Day to you and yours.

May again recently defended Government proposals to monitor all calls, emails, texts and website visits, by saying ‘the new powers will be vital in catching terrorists, paedophiles and serious criminals.’

As to be expected, many groups came out in defiance of this move, noting that it would account for “unprecedented intrusion”.

Rather than increase our feeling of safety and protection, which presumably was had been intended by the Home Secretary when she called for such a monitor, we feel like we are being snooped upon.

This ties in with some other findings, especially those made regarding our “online selves”.

The author Eli Pariser found this when he was researching for his book The Filter Bubble: What the internet is hiding from you. As is well known, there is a lot that can be gained from access to people’s personal information, such as their consumer habits or browsing rituals. Certainly it would be profitable for a company to get hold of such information as part of their marketing strategies.

Pariser finds many examples where just that happens. We have gotten used to much of what happens to our online selves. For example behavioural advertising is just an everyday part of surfing the web now. Other types of tailored advertising, such as restaurants who know which area you are in, are also part of the online furniture now.

But more sinister elements are allegedly in the pipeline. Pariser quotes Chris Coyne, the founder of the dating site OkCupid, who envisages a time where a person can walk into any bar, use a camera to scan the faces of the clientele, feed those photos back to the internet and allow the dating site’s cluster of servers to rank which is likely to be the perfect match.

Certainly research on this suggests we are generally worried about privacy online.

One survey from PC World, of 1500 Internet users, found that 88 per cent of participants were concerned about websites sharing their e-mail addresses, while 91 per cent were concerned about being tracked while using the web.

Alan Westin, whose 2004 book Privacy and Freedom, is well-known for its dialogue on privacy attitudes and concerns, differentiated three different aspects of personal online privacy. They were: a) privacy fundamentalists (the ones for whom privacy is the be-all and end-all); b) privacy pragmatists (who naturally weigh up the sharing of their details with its perceived import to society, but are generally of the opinion that privacy is important); and c) privacy unconcerned (those who are nonchalant or completely care-free about privacy).

Sarah Lacy in her book Facebook, YouTube and MySpace: The people, the hype and the deals behind the giants of WEB 2.0, re-told a story that might only bolster those general fears, what she called the “dark side” of social networking sites.

In March 2007 the Washington Post reported that Yale law students were posting slanderous messages about other students which, by design, were impacting negatively upon their job prospects.

As Lacy says, “In many ways, that’s worse than identity theft. It’s certainly more emotionally devastating”.

But these horror stories are just one small side of it. The antidote to snooping or misuse of data should not be regressive individualism.

Research from Harvard shows how personal interconnections, through social networks, for example, can affect our health positively. Social networking has unlocked a different type of interaction, and human interaction can, in the words of Anthony Komaroff, Editor in Chief of Harvard Health Publications, spread happiness “in much the same way that germs spread through communities.”

There are more equitable reasons in health for a person not to react to misuse of data with regressive individualism.

Last year the department of health initiated the 3 million lives campaign whose goal is to improve the lives of three million people through the use of telehealth and telecare, leading to improved levels of self-care, especially for patients with long term conditions. This in turn provides greater opportunities and benefits for patients having access to their own health information and records.

Not only would this provide major savings for the NHS by reducing unnecessary admissions and visits to the hospital, it will also reduce patients having to repeat vital health details to clinicians and GPs, and make it easier to share information where paper records once were inadequate.

The government has also announced the aim for all patients to have available online access to their GP-held electronic health record by 2015.

As Dr Mohammad Al-Ubaydli, founder of Patients Know Best put it, regarding the sharing of a patients’ data “in most cases, the fears are theoretical while the benefits are tangible.”

Privacy is important to us, and this is reflected in many of our attitudes towards things such as the internet that can often put privacy into jeopardy. Feeling like a balance can be drawn from privacy and trust in others, often isn’t helped by attempts to monitor emails or companies profiting from browsing behavior.

But there are many good things that can come from being more open and trusting, both on and offline.

Let’s not let the snoopers grind us down.

If the 2012 US election was based on cool, I wonder who would win out of Barack Obama and (presumably) Mitt Romney?

Vs

The Democrats have it!

I have an article on the New Statesman blog “Current Account”. Read it here.

Update: proved wrong. 13.00

Jubilant UK Uncut activists yesterday claimed vindication – one among them recalling how, at the time the protest grouping interrupted an LSE talk given by Jeremy Hunt, many criticised the moves as premature and worse.

For UK Uncut, at least, they were right then, and they were right now.

But what happens now?

Many have said they are looking forward Prime Minister’s Questions, not least because Ed Miliband will have a pop. Others have expressed caution – namely because, now the country has fallen back in favour with Vince Cable, the one who “fended off Murdoch camp’s overtures”, previous statements made by Miliband may come back to haunt him.

In 2010, finds Stephen Tall for Liberal Democrat Voice, Ed said:

Having apparently breached the ministerial code and having said what he said, he shouldn’t be remaining in office and I fear that David Cameron has made this decision not because it’s good for the country, but because he is worried about the impact on his coalition of Vince Cable going.

In short, and as the news items ran with it, “Labour leader Ed Miliband said he would have sacked Mr Cable”.

Clearly concerned about this, Tom Watson made his apologies this morning.

the saddest thing in this affair is that all of us in parliament knew these shadowy contacts existed and failed to act. It was as if nobody was prepared to challenge the might of Rupert Murdoch. The one person who looked like he was prepared to stand up for something was Vince Cable. But caught in the Daily Telegraph sting he had to stand down for expressing what most people now know to be true: it is wrong to give Murdoch yet more control over our country’s TV and newspapers. Poor Vince. I criticised him at the time and I shouldn’t have done. I apologise to you, Mr Cable. Your methods were wrong, but your motives were right.

It would provide political capital in more ways than one if Ed Miliband put up his hands in PMQs and said Vince Cable was right and that he was wrong at the time – as much as Cameron would want to draw points from Ed’s admission he couldn’t given the context and nature of Vince’s sudden vindication.

Cameron will lose today’s PMQs – but this is just theatre for the Westminster village.

Rupert Murdoch is up with Leveson today and as the Telegraph have it, “is expected to disclose his private meetings with a series of senior British politicians”.

This should put the willies in both Cameron and Jeremy Hunt.

All signs point to Hunt being scalped. Cameron is shallow in the polls, the Daily Mail poll asking whether Hunt should “resign” has the overwhelming majority saying yes, and last night on Newsnight nobody came to Hunt’s defence – oh apart from Jacob Rees-Mogg who, when asked if he had seen Hunt recently, explained that they hardly know each other.

For Cameron, giving Hunt the boot looks like the better of two shitty options. Hunt has been hunted, caught out, and Cameron, through sacking him, can at least look as though he has some kind of moral direction.

The question is when will Hunt go?

If he was sensible, Hunt would have gone before Murdoch gave his evidence to the inquiry. But then if Hunt was sensible he wouldn’t be in this mess to start with.

He’ll be gone by tonight, but I do wonder why Hunt’s last act of stupidity, and Cameron’s one of many such acts, was to stick it out until Murdoch has turned the knife one last time.

As per here

Question Time was a real treat last night. Yvette Cooper kicking Theresa May when she was down, as Baroness (portfolio of nothing) Warsi tried and failed to defend her honour, while Tim Farron was a hoot, trying to hold the inharmonious position as comic and reluctant defender of the coalition government.

Of course the main event was George Galloway and David Aaronovitch, head to head.

Scarcely a few moments had passed until the pair were at each others neck, and the attempts to de-legitimise Aaronovitch’s arguments were quite familiar.

Instead of answering questions Galloway instead made reference to Aaronovitch’s previously held Communist convictions.

He did this, too, to Christopher Hitchens in that famous debate back in 2005, in New York. Unprepared to tackle the issues, he appealed to the lowest form of argument: the ad hominem.

You will remember the lines:

“What Mr Hitchens has done is unique in natural history; the first-ever metamorphosis from a butterfly back into a slug. I mention ‘slug’ purposefully, because the one thing a slug does leave behind it is a trial of slime”.

On Question Time, Galloway made mention of the fact that in the way he believes in God, Aaronovitch believes in Stalin.

These “blows” were used instead of engaging with the point raised that Galloway has done nothing by way of condemning the behaviour of Assad – in fact, going so far as to “flatter” him.

But is this projection of Galloway’s?

Did he not protest-too-much in the 2002 interview with Simon Hattenstone:

What is that position? “I am on the anti-imperialist left.” The Stalinist left? “I wouldn’t define it that way because of the pejoratives loaded around it; that would be making a rod for your own back. If you are asking did I support the Soviet Union, yes I did. Yes, I did support the Soviet Union, and I think the disappearance of the Soviet Union is the biggest catastrophe of my life. If there was a Soviet Union today, we would not be having this conversation about plunging into a new war in the Middle East, and the US would not be rampaging around the globe.”

He wouldn’t define it that way because of the “pejoratives” loaded around it – any anti-Stalinist would have far better reasons not to define their politics in that way.

Not convinced?

What about when George Galloway described his old chum John Reid:

“John’s a very good political operator – remorseless, unremitting and practical. Just like Stalin.”

Clearly complimentary there.

But lastly, to throw one final log on the fire, what about Galloway’s criticisms of anti-Stalinist George Orwell, and the comments that he was traitorous (via Paul Anderson):

“But for a bullet in the brain on the Ebro [...] Rupert John Cornford [English poet who fought in the Spanish Civil War] might have loomed as large as George Orwell in the British left-wing lexicon [...] Orwell would probably have informed on him to his bosses in British Intelligence. For Cornford was a Communist [...] their memory has been sullied by Orwell’s slanders, unfortunately reinforced by Ken Loach’s film Land and Freedom.”

Indeed as Anderson in his commentary about this writes:

“Orwell did nothing to sully the memory of the International Brigade volunteers. He did expose the vile role of the Stalinists in suppressing the Spanish revolution in 1937″

Why would Galloway, here, be doing Stalin’s work for him? You don’t think, maybe, perhaps…

Galloway dishes it out, but it looks, on deeper inspection, like projection.

As David Aaronovitch posted on Twitter last night:

Just back in the hotel after #bbcqt. GG [George Galloway] brought a whole retinue with him. They ate the food and returned to Blackburn or Bolton or Bradford.