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Why the throat?

June 20, 2014 1 comment

I try not to join in twitterstorms, but the one about Michael Fabricant MP’s threat to punch a woman in the throat does bring with it an interesting question.

Why the throat?  Why not the more common concept of a punch to the face or the nose?

Domestic violence-focused literature more than hints at a possible reason: this study finds that 68% in the  ( fairly small) sample of women who suffered domestic violence have suffered from strangulation, and here’s one showing that violent death by strangulation is 6 times more likely for women than men.

The Fabricant tweet may reflect less sudden rage, and more a desire to subjugate, control and make defenceless, and be specific to women.  That’s what makes the tweet more disturbing.

Now, I’m not suggesting that Fabricant is someone prone to violence against women, and of course punching is not strangling..   But I am suggesting that, as part of his making amends as best as he can, he might want to explore why he wanted to go for the throat, and make that exploration public.  That might be a useful service.

 

 

 

Categories: Gender Politics, Law

Improving child protection and family support

enhanced-31052-1402589737-2 (2)While it’s utterly scandalous that the tabloid media has apparently gone and done a cheap photoshop on the picture of Ed Miliband getting ready to get to grips with our submission to the Labour policy review, the important thing is that it has been lodged and that he is clearly taking a keen interest.

The submission is online at the party’s policy review website ‘Your Britain’ (see below if you’re not registered).   If you do read it and support the nine recommendations made, please do take a moment to leave a comment, as evidence of online support is important in getting it up the league table of submissions to be taken seriously.

And it is a very serious submission.

 

Pdf:  SUBMISSION TO LABOUR POLICY REVIEW

Fisking the fisker

January 31, 2013 Leave a comment

I’m not blogging much at the moment, but I still abide by my golden rule of blogging:  if I happen to come across some twat misusing PISA results in defence of Gove, then I will always make a point of calling her/him out, if I can be arsed.

So there’s a total twat, Toby Young by name, misusing PISA results in defence of Gove, and I can be arsed.

Young says, in a piece ‘fisking’ the apparently “hysterical” Suzanne Moore*:

Ah. Here we go. Her [Moore's] views are “evidence-based”, Gove’s are “ideological”. Odd line of argument for a former employee of Marxism Today to pursue, but there it is. In fact, there’s plenty of evidence to support Gove’s policies. Here’s evidence that standards fell during Labour’s 13 years in office. Here’s evidence that free schools have raised standards in Sweden. Here’s evidence that increasing school choice has raised standards in England. Here’s evidence that the academies programme is raising standards in England.

The first link is to the wikipedia entry on the Programme for International Student Assessment (PISA).

And this is what the Chair of the UK Statistics Authority had to say about the blatant misuse of PISA data by Ofsted and the DfE:

While I understand that some users of these data would like to make comparisons between the first PISA study in 2000 and the most recent in 2009, the weaknesses relating to the response-rate standard in earlier studies should not be ignored. The validity of comparisons of national rankings as a result of an increase in the number of countries covered by the PISA study, and the degrees of uncertainty in country scores attributed to sampling and measurement error are also important in this regard.

That is, Young is totally and utterly wrong**.  More on why he’s wrong here***, here, here and, just for completeness sake, the National Foundation for Educational Research review of the PISA 2009 study:

England’s performance in 2009 does not differ greatly from that in the last Pisa survey in 2006.

*  Readers may wish to note James Delingpole’s delightful metaphor on twitter for Young’s attempted fisking of the “hysterical” Moore.   I can’t remember where I put it though.  Anyway, it’s bound to cause a twitterstorm so you may see it before I see it again.

**  Of course, it’s not just that he’s deliberately misusing the PISA data.  His logic is also utterly at sea.  Even valid evidence that England may have fallen down the international ranking wouldn’t be proof that standards have fallen.  It might be as easily explained by other countries getting better (oh, and the huge increase in the number of countries in the rankings).

***  , I note that I asked, in this post about the Chair of the UK Statistics Authority’s October ’12 letter:

Will they continue to peddle the same untruths, secure in the knowledge that the “plummeting down the international league tables” is now well entrenched as a result of lies to date, and much more likely to gain press coverage than a letter from the UK Statistics Authority?

I think we now know the answer.

Jackie Ashley on Labour and migration: grammatically, factually and politically incorrect

December 17, 2012 4 comments

Jackie Ashley is by no means the worst Guardian columnist – Simon Jenkins is, by a country mile – but this is horribly disappointing:

We do need to think about the numbers. In a decade, almost 4 million migrants settled in England and Wales, according to last week’s census figures. The population rose by 3.7 million between 2001 and last year; 70% of the rise was caused by immigration.

Though the effects are spread across most of urban Britain, they are most dramatic in London. There, just under 45% of people are white British. Across the country less than 90% are white. Some 7.5 million people are foreign-born; there are apparently around a million households that speak no English……….

There are some fundamentals on which Labour should be more forthright, less mealy-mouthed. One is language. What we want is a strong sense of common citizenship, obligation and rights going together. That’s always been the progressive position. But it’s impossible to fully participate if you don’t speak and understand English. Miliband is talking about this at last, but can afford to push harder.

Alongside this go basic, longstanding progressive positions on women’s rights, free speech, equal educational opportunities for all and individual freedom of choice. In a time when one religion – Christianity – is on the wane, but others are on the rise, the liberal advances won over decades can never be taken for granted.

First of all, Ashley looks to be factually wrong on  the number of “households that speak no English”.  (That’s slipped past the Guardian grammar police, and I assume it means “households in which no-one speaks English”).  She appears to have got the 1 million figure from the ONS findings (pdf via here), which says that in 4% of the 23.4 million households in the country (so roughly 1 million) no-one “speaks English as a main language” (p.18)  Not having English as a main language is quite different from speaking no English, and the ONS makes this perfectly clear in the very next sentence:

People who did not report English as a main language may br fluent English speakers and were able to report their English language proficiency as ‘good’ or ‘very good’.

So the Guardian’s fact-check police appear to have been on holiday too.

The key issue, though, is how this fairly glaring error  fits with the overall narrative that having funny-language foreigners, especially non-white ones, is necessarily a problem that Labour needs to work on.

As I set out the other day, the evidence suggests that, for the country’ s long-term future, the opposite may be true.  Research from the US, for example, suggests that children who grow up ‘language brokering’ for the non-English speaking parents actually benefit cognitively, to the extent that they achieve more academically than peers who don’t have this life-role.  Further, NALDIC reports that children growing up to become bilingual make faster progress in the English GCSE curriculum than their monolingual peers, as well as outperforming them overall in GCSE Biology; Chemistry; Physics; Mathematics; Statistics; Religious Studies; French; German; and Spanish (h/t @barsacq).*

But it’s the last paragraph quoted above which is particularly worrying.  Does Ashley really mean what she says?  Does she really believe that the decline of Christianity and the the rise of other religions provides a threat to “equal educational opportunities”?  Does she really think there are a large number of Muslim/Sikh/Hindu parents intent on denying girls education?

If so, she’s not just ignorant of the research** showing the opposite, she’s also been reading too much the Daily Mail.  As, arguably, have the Guardian sub-editors.

* I was talking about this stuff with people in the pub at the weekend.  It occurred to us that in fact migrant parents not learning English as quickly as they might (or at least not admitting to having done so) may in fact be – at least partially – some kind of learned response (i.e not consciously articulated) around the developmental needs and subsequent life-chances of their children.

Compare, for example, the way in which parents (myself included) feign ignorance about subject areas so as to encourage their children to “teach” them about their new findings about the world, and how this creates not just confidence in the subject area itself but also helps to develop oracy around it.  Could it be that parents do the same as their foreign-born children learn English more quickly than them?

Further, having learned a couple of languages myself by ‘throwing myself in the deep end’ (notably Bangla from scratch but also French-to-working-fluency in a Swiss hospital), I can vouch for how absolutely knackering and even stressful it is in the early stages, when you don’t trust yourself to understand what’s said back to you.  Is it not an appropriate response for parents to provide the safety and reassurance of the first language in the home, to the extent that this becomes a familial norm even when children have got the fluency point?

** Just as two examples of Asian family commitment to female education in Britain:

1) Basit TN (1997) ‘I Want More Freedom, but Not Too Much’: British Muslim girls and the dynamism of family values, Gender and Education, V ol. 9 , No. 4 , pp. 425 - 439:

Research shows that young Asian women who have been to school in Britain are increasingly been allowed to work, if only until their marriage (Sharpe, 1976). However, the assumption that British Asian girls will have an arranged marriage and will not need career advice is not borne out by research (Thornley & Siann, 1991), as the wish for marriage, children and family life does not necessarily preclude the desire for labour market participation amongst girls (Mirza, 1992). British Asian Muslim parents are amenable to their daughters’ desire to work if they are able to attain a good education and go into a career perceived as safe and respectable: one which does not jeopardise the safety and reputation of these young women (Basit, 1996a).

2) Afsha H (1989): hopes, expectations and achievements of Muslim women in West Yorkshire, Gender and Education, Vol. 1, No. 3  pp 261 – 262:

Muslim women in West Yorkshire, like their male counterparts, place an inordinate trust in the ability of the educational system to act as a means of delivering their children from the drudgery of poverty. Although in practice there is not enough evidence to support their optimism, women of all backgrounds, regardless of their own levels of educational achievement, seek to promote their children within the school and further educational systems and are increasingly doing so for their daughters as well as their sons.

For a wider review, try Stevens, Peter A. J (2007). Researching Race/Ethnicity and Educational Inequality in English Secondary Schools: A Critical Review of the Research Literature Between 1980 and 2005.  Review of Educational Research  Vol. 77, No. 2, pp. 147 – 185.

The advantage of migrants not learning English

December 14, 2012 5 comments

There’s been plenty of coverage of Ed Milband’s speech on ‘cultural integration’ in Tooting today, and I don’t intend to repeat stuff.  For the record, I agree that it was an attempt at celebrating cultural diversity, along with some decent enough policy points about protecting migrants from some of the worst excesses of capitalism.  I still don’t see how the labour movement can really claim the high ground on how we all live together until it confronts once and for all its shameful institutionally racist past, which helped create the divisions of today, but that’s another post (here’s one I wrote earlier).  As it stood, it was on ok speech.

But this bit was strangely strawman-like:

Where there are Home School Agreements, English language learning should be included.  Which too often doesn’t happen at the moment.  That would ensure that both schools and parents share the responsibility for helping foreign-born children learn how to speak English.

Is Ed Miliband really suggesting that there’s a substantial number of parents out there who are keen to stop their children learning English at school – children who can only be saved from a lifetime of  English-free non-integration by making their parents sign a piece of paper which presumably they won’t be able to read anyway?  If so, who and where are these people? Because the research I’ve seen about migrant parents’ attitude to their children’s education suggests quite the opposite of what Miliband appears to be suggesting is going on.

For example, Haleh Afshar’s research back in the 1980s found that:

Muslim women in West Yorkshire, like their male counterparts, place an inordinate trust in the ability of the educational system to act as a means of delivering their children from the drudgery of poverty. Although in practice there is not enough evidence to support their optimism, women of all backgrounds, regardless of their own levels of educational achievement, seek to promote their children within the school and further educational systems and are increasingly doing so for their daughters as well as their sons.

And later (2002), Tahir Abbas found in his study of Asian families in Birmingham that, while social class may play a part in attitudes to the importance of education:

In general, both parents and their children are convinced in their enthusiasm for educational achievement, with research continuing to show the importance of parenting to secondary schooling.

If Asian and Muslim communities – arguably the broad group in Britain most demonized as separating themselves off from the ‘mainstream’ – are so keen for their children to participate and succeed in school (for which presumably a grasp of English is necessary), what other groups are out there actively denying their children access to the lingua franca?  Is Miliband suggesting that ‘foreign-born’ children are affected by a a whole new set of attitudes from parents which don’t seem to be held by earlier migrants? I just don’t get it.

But perhaps I’m being too pernickety.  Perhaps Miliband was merely seeking to point out the importance of newly arrived parents learning English as quickly as possible so that they can help their kids out at school, so that those kids get over the barrier of a late start and catch up as best they can. That would sound much more reasonable.

Oddly, though, the research doesn’t seem to support such a thesis. On the contrary, the research that has been done (in the US) on children of migrant families who learn English while their parents don’t suggests that their role as ‘language brokers’ is a significant factor driving their educational achievement.  Dorner et al (2007), for example*, studied “the regularity with which the children of mostly Mexican immigrants in Chicago interpret languages and cultural practices for their families”, and found that:

[S]uch “language brokering” is related to academic outcomes. Using data collected from a subset of children (n=87) longitudinal regression models, which controlled for early school performance, showed that higher levels of language brokering were significantly linked to better scores on fifth- and sixth-grade standardized reading tests………The practice of language brokering that we have identified has not received much attention from educational researchers seeking to boost students’ achievement. And yet it is a literacy and numeracy practice that takes place every day in the homes of immigrant families, and it is one that may have measurable payoffs for children’s school successes across a range of subject areas. While not all language brokering situations may have uniformly positive benefits—and earlier research has demonstrated the trade-offs between cognitive and psychosocial costs and benefits—standardized test score gains may indeed occur for the children of immigrants who accomplish deep and varied brokering tasks.

This, I suggest, is more than an esoteric research point.   It suggests that significant numbers of children coming into schools and not just learning English for themselves but using their new language to help their families navigate through their new lives in Britain might, if the proper teaching resources are in place to help, actually be beneficial for educational standards overall, with native-born children carried along in the wake of these growing competencies and life skills.  It even provides one partial explanation, dare I say, for the impressive surge in the achievement across London’s very diverse schools (p.18 of report), which, as Chris Cook at the FT has pointed out, is difficult to attribute entirely to improvements within the schools themselves (though this is undoubtedly important).

In short, maybe immigration is making for a cleverer country.  Even the Daily Mail might have trouble arguing that that’s a bad thing.

That is not to argue, of course, that we should be actively seeking to deny parents access to English tuition so that their children can grow into even more rounded, talented people than they will be anyway.  That would be pretty stupid, given the other advantages that having parents who can communicate freely in their new country will bring.

But it is to point out that, sometimes, this stuff about ‘cultural integration’, and the creation of a problem just so that Ed Miliband can offer the papers a thoroughly New Labour, managerial solution (Home School Agreements for Gawd’s sake), might not actually be a very good idea, and that a wholesale defence and celebration of immigration, in the interests of the (One) Nation,  might actually end up being a winner, if Labour has the balls for it.

* For more, see also Halgunseth, L. (2003). Language brokering: Positive developmental outcomes. In M. Coleman & L. Ganong (Eds.), Points and Counterpoints: Controversial relationship and family issues in the 21st century: An anthology (pp. 154-157). Los Angles, CA: Roxbury.

Nursing’s existential crisis (part 1)

December 9, 2012 2 comments

At PMQs on Wednesday, Cameron was confronted with Ann Clywd’s personal testimony on standards within the NHS.  He concluded his reply with:

I set up a nursing care quality forum that I have attended myself to discuss these issues with nurses and nurse leaders. There is no silver bullet and no magic wand, but some simple steps, such as asking every hospital to carry out a friends and family test, asking the patients and the staff whether they would be happy for their family or friends to be treated in that hospital, can make a real difference. So can hourly rounding, which is not something to do with statistics but the idea that the nurse should be there by the bedside of elderly patients once an hour checking that they have had water and something to eat, that they do not have bedsores and that they are properly looked after.

This is utter shit.

I have written before about Cameron’s arrogant, ignorant and patronising insistence that hourly “intentional” rounding promises to embed within nursing a managerialism which will, in, short order, actually reduced standards of care, not improve them. It is difficult to see how a process which requires up to 150 boxes per patient per day to be initialed by nurses will do anything else.

When I wrote to Cameron’s Nursing & Care Quality Forum about this, setting out the kind of implementation research they should study before going down such a path, my letter was at first ignored and then, when I demanded a reply, was dismissed with the assurance that they had seen “some research” from the US with promising results.

It is with a certain grim satisfaction, therefore, that I note that the Hospital Trust where Ann Clwyd’s husband suffered such a sad and lonely death introduced “intentional rounding” some three years ago.  A Cardiff & Value University Health Board document reads:

Many improvements are thanks to a new process called ‘intentional rounding’ which guides nurses to deliver more structured care.  It includes hourly checks on patients to look at any potential risks such as the position they are lying in and the condition of their skin.  In the wards, nurses have made a real difference to patients’ mealtimes.  By implementing simple measures such as colour coding food trays and patient food charts, patients’ dietary needs are being more easily recognised and met.  The colour coding systems enables nurses to understand what a patient needs, in terms of assistance at meal times, which is important if a patient has difficulty communicating.  There is ample evidence, from research and from hospital visitors and family members, that nutrition has direct implications for patient recovery and length of stay.  Importantly, it also ensures mealtimes are as enjoyable and comfortable as possible.
Of course, one of Ann Clwyd’s area of complaints is that, as her husband died, a cheery shout about mealtimes resounded in the ward.
There is an existential crisis in nursing.  The crisis is exacerbated by tbe cuts. but it wasn’t started by them.  To suggest otherwise, as this piece does is denial of the type we saw from some on the left in the Winterbourne abuse case.  Nor is it because the “wrong people” go into nursing (as Ann Clwyd has suggested on the Marr show this morning).
The crisis has complex roots, including the changing class relations between doctors and nurses and the physical architecture of hospitals which have not taken nursing into account, as well as the long decline is staffing levels, but perhaps the biggest issue has been the abject failure of the profession’s main union, the Royal College of Nursing, to take responsibility for what really goes on on wards.  Rather, just as Cameron has done, it has sought to put the problem in the management in-tray, and blame “poor leadership” when it goes wrong.
More in part 2.

What we don’t hear about forced marriages and gay men

I recently reviewed a report for HuffPo that shows how London Police Services are underprepared for a rise in serious crime. The report by the Victims’ Services Advocates (VSA) can be downloaded here.

One of the figures the report mentions, which I didn’t have time to highlight in my review, was one by the Metropolitan Police which shows that there were 298 Forced Marriage incidents / crimes reported in 2010 (including 333 actual and prospective victims – i.e. living in fear of forced marriage).

Of those people forced into marriage, the gender breakdowns reveal:

  • Female: 297
  • Male: 35
  • Unknown: 1

One of the inferences based on interview material, and the MPA’s own assessment, is that many of the men who are involved here are actually gay, and forced into marriage because of this.

The MPA didn’t check sexual orientation (save for one person)  as part of the course, so it is hard to evaluate, but there has been some attention given to this type of marriage over the last few years – and it is deeply disturbing.

Back in 2010 the Forced Marriage Unit (FMU) said there had been a surge in cases where men and boys are being forced into marriage because their families suspect they are gay or bisexual.

In that year the number of calls from men to the unit increased by 65%, from 134 in 2008 to 220 in 2009, and many of the cases involved families from south Asia, particularly Pakistan, India and Bangladesh.

Comparable figures need to be shown today, to see whether this is an increasing problem, and to see who is targeted.

If the figures are worrying then this only adds to the VSA’s findings that there needs to be improved communication lines between the police authorities and victims.

Really, Ms Brierley

May 29, 2012 2 comments

This is an open letter to Sally Brierley, the Chair of the Nursing & Care Quality Forum, the creation of which was announced by David Cameron in January. 

It concerns her letter of ‘initial recommendations’ sent to Cameron on 18th May.

Dear Ms Brierley

I wish to offer my comments on nursing and care quality to the forum, and I do so in the context of your letter of initial recommendations to the Prime Minister of 18th May.  I will cover three specific issues: membership of the forum; staffing levels; and intentional rounding.

Membership of the forum

In your opening preamble you say:

When you announced your intention to set up the Forum, this was against a backdrop of high-profile failures in the quality of care, from isolated cases reported in the media, to systemic problems at Mid Staffordshire NHS Foundation Trust and Winterbourne View. These cases have demonstrated that there are problems with the quality of some nursing care, and some of these problems are very serious.

Given your concern about Winterbourne View, it seems odd that your forum contains no members from the private care industry. 

While you might wish to argue that some quality of care issues are generic to both the NHS and private sector, it would surely be remiss of the Forum not to examine whether there are any factors specific to private care which create the risk of patient abuse of the type seen at Winterbourne View.  Surely, therefore, the Forum needs someone on it with an understanding of the private care industry.

I recommend that you take early action on this point, so that issues relating to private sector care are adequately addressed by your forum.

Staffing levels

The professional press has picked up quickly on your initial finding that:

We heard overwhelmingly that staff are concerned about staffing levels and skill mix within their teams and the subsequent impact that this has on the quality and safety of care, and people’s overall experience of the care they receive.

You go on to make the central recommendation that Boards or their equivalent should conduct bi-annual reviews of staffing levels and skill mixes, and that the Care Quality Commission should seek assurances that these are being conducted.

This is fine in itself, but it is not enough.  Managerialism is fine when there are sufficient resources to manage; managerialism becomes part of the problem when there are not.

I am therefore most concerned that you feel able to say to the Prime Minister, in your opening statement:

Of course, more money and more staff would always help, but we need to ensure we use the resources we have available to deliver more effective and efficient high quality care. Nurses need to rise to this challenge, backed by strong leadership at every level.

This reads to me like an early abdication of responsibility on the part of the forum, and yourself as its chairperson. 

I see nothing in the remit of the forum which requires that it offer recommendations only within the constraints of existing funding to NHS Trusts and private sector organisations.  If it transpires that, ultimately, there are simply not enough resources being made available to ensure good quality care – and this is what your early findings do suggest – then it your forum’s responsibility to bring this to the attention of the Prime Minister (assuming you keep up your correspondence to him), and argue for more resources.

You will, I am sure, have seen Monitor’s most recent set of financial assumptions, setting out the eye-watering level of ‘savings’ that Trusts in both the acute and non-acute sector are being expected to make over the next five years, and further to the massive reductions in resources they have already suffered.    The staffing level/skill mix problem is only going to get worse, and if your forum chooses not to engage with this reality, then I am afraid it will become part of the problem itself, rather than part of the solution that both you and I hope it will be.

I recommend therefore that at your next forum meeting your lead agenda item should be a revisiting the parameters you have set yourself for your work, in light of your key early findings of resources constraints, and that subsequently you write to the Prime Minister to inform him of the outcome of your decisions.

Intentional rounding

I note that the forum wants to:

accelerate the implementation of person centred approaches such as ‘rounding with intention to care’ – where every individual receiving care knows they will have at least hourly contact with staff – and we believe that wherever possible, handovers should be done alongside and involving those we care for. Therefore, we will identify and work with demonstrator sites in a range of care settings (including hospitals, care homes, mental health and community settings) and use the lessons learnt to support others on their implementation.

Clearly you will be aware of the issues relating to patient confidentiality with bedside handovers, and I am sure you will be addressing those. 

However, I wish to raise a much more fundamental concern about ‘intentional rounding’ which I feel has been insufficiently explored to date, and which governmental/prime ministerial pressure to be seen ‘to do something’ about care quality risks being wholly set to one side, with serious negative impacts on that care quality in the medium to longer term.

At his visit to a Salford Hospital on 6th January, the Prime Minister announced the creation of the forum you now lead.  At the same time he made the pronouncement that he was in favour of ‘hourly intentional rounding’ and that he wanted to see it rolled out across hospitals nationwide.

This was, frankly, an insult to the nursing profession.  Imagine, by way of comparison. if the Prime Minister had visited an operating theatre on the same day, heard from an anaesthetist that he was now using a new anaesthetic drug which appeared to offer less post-operative  side effects, and then announced on the spur of the moment that he [the PM] now wished to see the use of this drug rolled out nationwide.  Imagine, then, the uproar that would have ensued from the medical profession.

Yet the nursing profession appears to be expected simply to say ‘Yes, Prime Minister’, and get on with ‘rolling out’ a method of nursing which is a) unproven in terms of its medium-to-longterm effectiveness;  b) despite the addition of ‘intention to care’, still bears some of the hallmarks of the ‘back round’ that both you and I were  subjected to as young nurses, and which a newly confident nursing profession moved on from in the 1970s and 1980s towards models of care which did not depend on mindless routines, but which took individual patient needs into account.

I note that the forum is wary of intentional rounding becoming an exercise in box-ticking.  Yet I fail to see how it can realistically be anything other than that (though it will be box initialling rather than ticking). Daily rounding sheets that I have seen have between 120 and 150 different boxes where an initial must be placed to prove that the care has been provided, or the question asked.   That is 120 boxes every 24 hours for every patient. How can that not become an exercise in itself?

There is a rich body of research literature – sadly apparently  untouched by the nursing profession – known as implementation studies, which looks at the way in which policy is implemented ‘on the ground’, largely beginning with the groundbreaking work by Michael Lipksy in the 1970s (Street Level Bureaucrats: Dilemmas of the Individual in Public Services).

This research studies the way in which policy imposed from above is inevitably interpreted by those tasked with implementing it, and how in situations where both resources are constrained AND worker initiative is restricted, the outcome is often one of  ‘alienation’ and degraded public service.

You can see this process of alienation and degraded service on hospital wards today. Where resources are scarce, and staff are undervalued, you get the inevitable result of staff  ‘shutting down’ their empathy as a coping mechanism, and the results are all too clear: nurses ignoring patient needs, huddling at the desk in a mixture of resentment and guilt, unwittingly part of a downward spiral of the type seen at Mid-Staffordshire.

The introduction of intentional  nurse rounding will – I can guarantee – lead, perhaps after initial improvements, to worse care in settings which are already under staffing pressure.  Excellent nurse leadership may slow up the downward spiral in some cases, but in most cases even that will not help. From there, mangerialism will again kick in, with the blame attached to staff when it turns out that intentional rounding did in fact become a giant, cynical box-ticking exercise, and that patients in their care become even more dehumanized.

 I urge the forum to get a grip of the implementation studies literature to which I refer, and to look back in history to see why routinised care was dispensed with by the nursing profession first time round.

The forum should then think again about its ‘demonstrator sites’; the evidence base for intentional rounding simply does not exist, especially in terms of its longer term effects, to justify ‘demonstration’ over ‘pilot’, and as noted the move towards national rollout in compliance with the Prime Minister’s uninformed wishes will not just be dangerous for patient care; it will be an expression of abject acquiescence on the part of the nursing profession, with your forum as key representatives, and a massive step back for the profession in terms both of its credibility and self-confidence.

Yours sincerely

 

Paul Cotterill, ex-RGN (registration now lapsed as result of ubiquitous 1980s nursing back injury)

 

 

 

 

Lower the VAT rate on all sanitary products to the zero rate (0%)

February 22, 2012 5 comments

Sign the petition

From January 2001, the rate of VAT for eligible sanitary protection products was lowered from the full rate of 17.5% to the “reduced rate” of 5%. Now we must pick up the campaign to see all sanitary products (including sanitary towels; sanitary pads; panty liners; tampons; keepers and maternity pads) be reduced to the zero rate (0%) alongside most food items, books, newspapers, magazines and children’s clothes.

They are very necessary items and rates on them disproportionately hit women the most. Some common sense on behalf of the government is needed.

Sign it

Time to demand no platform for women

November 23, 2011 17 comments

Emma Burnell, who puts together conferences and events, is understandably angry that men dominate conference platforms.  She offers a challenge:

Find me an all male panel – in fact, find me any topic on which you could reasonably hold an informed public debate – and I’ll give you the names of five women who could hold their own on the panel.

I think it’s the wrong challenge.

The problem is not primarily that men dominate platforms.  The primary problem is that there are platforms for them to dominate. Platforms are reflections of patriarchal domination in the first place, and simply reinforce patriarchal power structures.

 The real challenge is not to change the gender of who gets to dominate the rest of us from the platform, but to get rid of the platform entirely, and in so doing create the ‘informed public debate’ which is actually so lacking from the usual event format.

I don’t go to many conferences or events.  Partly this is because I live miles away from most of them, but mostly it’s because they’re generally shite.

When I do go I quickly get sick of the high-profile types – mostly men - who swan from conference to conference on conference-type fees.  Generally, they tell me what I already know and/or agree with, and expect me to sit and listen to their advice on what I/the movement/the party should do next.  I might get to ask a polite question which they then answer with varying levels of condescension (or flannel about if they don’t know).  Then I get to  go home again, none the wiser, but a bit more deflated. 

The more radical, power-reversing approach, is not to ask the important people what they think the less important people in the room should think and/or do, but to develop ‘bottom-up’ formats (more here), whereby the less important people can make demands of the more important people, with these demands focused on how the latter can take action themselves in support of the grassroots.  Of course the important people should have the freedom to express their opinion based on their expertise in the subject area – that’s why they’re there –  but in the end the focus should be on how they can help take the ’cause’ forward.

The Left should therefore seek to alter the structure of political conferences, making the high-profile (remunerated) participants work for their money, by briefing them pre-conference on their obligation to agree actions in support of whatever cause the conference is about.  If they fail to deliver on the commitments agreed at the conference (and if they are too onerous they shouldn’t agree to them), they won’t get invited back the next year;  the message will soon spread that they are just windbags, who need to be replaced on the circuit.

Then, I suspect, you’ll start to get gender equality amongst paid participants, no longer ‘platform speakers’ in the traditional sense, but something like ‘expert facilitators’.  The male windbags (and a few female) will fall off the conference gravy train, to be replaced by women committed not just to the display of their supposed expertise, but to using it for the common good.

Categories: Gender Politics
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