Robert Sharp

Pupil Barrister

Tag: Diary (Page 12 of 30)

Health Tourism

2 February 2010 / / 0 Comments

Empty Hospital Ward at Hillingdon Hospital, Uxbridge, UK. Photo by Alex @ Faraway

Empty Hospital Ward at Hillingdon Hospital, Uxbridge, UK. Photo by Alex @ Faraway, Creative Commons Licence


Last week, I fell into a long discussion with a group of doctors on the problem of health tourism.  This, they say, is when people visit the UK specifically to take advantage of the NHS for treatment of ailments, major and minor.  In particular, women from Africa who think (or know) that they are HIV-positive will visit the UK in order to give birth.  Their children will therefore receive proper medical care and whatever medicines and retrovirals that the current clinical guidelines recommend.  My interlocutors were of the opinion that this was a major drain on resources, especially in the urban centres where they work.
For the avoidance of doubt, these were not the same medics who held the illiberal opinions of marijuana usage, but I did detect in them a slight note of discontentment.  Not intolerance, yet, but certainly exasperation.
If health tourism is widespread, then such feelings of irritation amongst the medical class are also likely to be common, which is not good.  More to the point, it would mean our health system is being abused, perhaps to the tune of millions of pounds.  Definitely not good.
My hypothesis is that health tourism is actually an extremely localised problem, centred around inner-London.  This is where strong immigrant communities already exist, and where health tourists can stay with British residents while they get their treatment.   If this is the case, then it is clearly a particular challenge for the health service in London, rather than a structural issue for the NHS as a whole.
I have put in a poorly worded Freedom of Information request to the Department of Health to find out what statistics are available.
Why bother, though?  What could we possibly do with this information, when we have it?
Simply put, quantifiable information on such an issue will immediately put it in perspective.  Is it a major abuse of the system that we could correct, or just another example of patient-led inefficiency that we will never eradicate?  My suspicion is that it will turn out to be the latter, something akin to the problem of hypochondriacs, that we know is a waste but nevertheless do not have the heart or the stomach to actually address (turning away pregnant Africans at the automatic doors never feels good).  Either way, it will at least address the mutterings of the doctors who see the issue on the ward floor, but have no sense of whether it is a problem beyond their particular hospital.
Second, it may allow for a rather deft sleight-of-policy at the Department of Health.  If the NHS is indeed providing millions of pounds worth of care to people it does not have to, over and above the call of duty, then they could with some legitimacy put that expenditure into a different accounting column.  They could, perhaps, claim it back from DfID or the FCO as a form of targeted, useful government aid.
Let us not be so naive as to think that my request doesn’t carry some risk.   While I do not believe that such statistics (whatever they may be) will actually inspire xenophobia, it is certainly possible that someone might try to use the figures to further some anti-foreigner agenda.  I’m not sure I know what to do about that, but I don’t see this possibility as a reason not to ask the question.  Better me than someone else, I reckon.
What do you think?
On the Ward in Bbowa, Uganda. Photo by Paul Evans. Creative Commons Licence

On the Ward in Bbowa, Uganda. Photo by Paul Evans. Creative Commons Licence

10 Tactics

6 December 2009 / / 0 Comments

Alaa Abd El-Fatah, Technologist, Egypt. Animation by Toby Newsome

Alaa Abd El-Fatah, Technologist, Egypt. Animation by Toby Newsome


Last Friday night I spent an interesting evening with the folks from the Tactical Technology Collective, who show communities and campaigning groups how to use new technologies to their advantage. I’ve long been a fan, because I think that their NGO in Box project (in its several iterations) is a simple idea that’s probably extra effective because of good design.
We were at the Frontline Club in Paddington for the screening of their documentary, 10 Tactics, which gave real world tips for digital advocacy. The tactics include presenting a visual message, using humour and animation to reach difficult groups, and amplifying personal stories to make a more effective message. We saw what free and open source tools were available to do this.
Much of the film focused on working in developing countries, where IT technologies are still emerging and people don’t have information at their fingertips. Many of the tactics have information delivery as an end in itself, for example, telling Zimbabweans where to vote or rural farmers in India where to find information on their land rights. This direct communication with what charities might call their “beneficiaries” is very different from many UK charity campaigns, which tend to be about raising awareness of a problem amongst people who are not suffering from it (in the case of PEN, say, we spend a fair amount of time campaigning to let our members in the UK know about the censorship and persecution of writers overseas). I would describe this type of campaigning as presenting a second order message (not “do this” but “do this for other people”) or even a third order message (“the government should do this for other people”) – I’m sure hardened charity campaigners have a more sophisticated taxonomy for these different types of message. One criticism I heard about 10 Tactics is that it did not offer enough advice for this second and third order campaigning. Perhaps we need another film which explains how to call people in the UK to action. Or maybe that’s a red herring, and the need for direct first order campaigning in the southern hemisphere should be the priority.
The after-film discussion was led by Darius Cuplinskas of the Open Society Foundation, who raised a concern that many people who are otherwise excited by New Media seem to have: what happens when “noxious” civil society groups use these tactics for “nefarious” purposes? Worse, how do we guard against the possibility that oppressive governments will use new technologies to spread disinformation?
Sameer Padania of WITNESS was bullish on this point. First, he said, activists learn from other campaigns around the world. Protesters in the Saffron Revolution in Burma in 2007 posted videos and images of their marches online, allowing the authorities to identify and punish them. But when it was the turn of dissidents in Tibet and Iran to protest, they had learnt the lesson of Burma, and covered their faces! They are also learning about ways to communicate when authorities shut down parts of the communicaions network. So people become much more savvy about the power of technology.
And with this savviness (says Sameer) comes a better visual literacy and media literacy. People have a greater understanding of how images and video can mislead. They are more likely to recognise propaganda and photoshopping in the first instance, and also more likely to question the veracity of sources, and to fact-check. We saw this in the #IranElection protests, where an important task of the Twitter community there was to fact-check itself, double-sourcing reports and debunking rumour. Very quickly, certain users gained more authority and trust than others.
My own addition to this thought is an idealistic one, which is that truth carries it’s own authority. Fakers and fraudsters can be exposed, but if you’re telling the truth then you can’t be caught out. Perhaps that’s the best tactic of all.

Geoffrey Robertson QC and Alan Rusbridger

17 November 2009 / / 0 Comments

Now then: Guardian editor Alan Rusbridger has resigned from the PCC code committee.  Last week he said that the PCC report into the allegations that the News of the World had been hacking people’s phones was “dangerous to the press” and that it was behaving “uselessly” as a self-regulator.
That was last Monday, 9th November.  But I wonder if Rusbridger’s mind was finally nudged in favour of resignation the following day, by the Human Rights lawyer, Geoffrey Robertson QC?  Robertson was speaking at the launch of English PEN and Index on Censorship’s Campaign for Libel Reform, at the Free Word Centre.  He had this to say on the subject of the media and the PCC:

The media … have for years committed a fraud on the public and on their readers by presenting this confidence trick of the Press Complaints Commission, as though it were a real court, as though it were significant.  The Press Complaints Commission has been funded by the press, in order firstly to provide a poor person’s libel court (which has now gone by the board because now everyone who sues uses CFAs); it has been funded secondly to prevent the encroachment of the law of privacy – and its too late now, because we have a law of privacy: ill-designed, vaugely worded, European Gobbledegook for the most part, which is being implemented in a ham-fisted way by the judiciary.
So, there’s no point in the PCC.  If the editors of Fleet Street had any real integrity they would withdraw.  As Ian Hislop said, as the editor of the only organ that refuses to accept PCC judgements, he wouldn’t want to live up to the ethics of the newspaper editors who are on the PCC’s ethics committee!

Alan Rusbridger, crouched in the aisles and listening with a wry smile, duly reported some this criticism via Twitter.

Geoffrey Robertson QC

Geoffrey Robertson QC

After The Debate

16 November 2009 / / 0 Comments

I promised I would put up a few afterthoughts on the Political Correctness debate I particpated in last month.  Its hardly a live story now, but I do think it is important to write follow-ups to such happenings.  I should say at the outset that our side eventually prevailed, 221-177.

Whose language?

One of the more forceful dissents from the floor, which addressed my speech in particular, asked why we needed to change our language when it gets misused. Surely that is giving into the racists if we allow them to ruin our language for us?

New Statesman Political Editor Mehdi Hassan

New Statesman Political Editor Mehdi Hassan


Mehdi Hassan responded to that immediately by saying that he really didn’t want to be called a ‘Paki’, thankyouverymuch. However, later, during David Aaronovich’s speech, the conundrum resurfaced when a person who was disabled said he didn’t find the term ‘spastic’ offensive, and that he would like to reclaim the name for his condition as a normal word, not an insult.
This was, I think, a reasonable dissent to my argument about respecting the names people chose for themselves, but there are a few retorts. The first is that his own preference may not be shared by others. The second, which answers the wider point, is that languages have evolved and changed according to the needs of the time. They are not immutable. There is nothing necessarily precious about certain names, that mean we can’t abandon them if they come to have offensive overtones (or histories, to carry forward my argument from the debate). In other circumstances, it is possible to reclaim words and shave off the offensive meaning. Think of ‘Nigga’ versus ‘Nigger’ (though many would argue that the former has unpleasant overtones of it’s own).

Involving the Police, and the ‘chilling’ effect

Alex Deane, Director of Big Brother Watch

Alex Deane, Director of Big Brother Watch


Both Medhi Hassan and myself were keen to point out at the start that we did not want to defend any police interference in matters of speech, except when it relates to incitement. This is not the sort of ‘political correctness’ we want to have anything to do with. I made an off the cuff remark that the police visit to Lynette Burrows, after she made some homophobic remarks on the radio, was a “one off” – Ann Widdecombe pointed out in a highly inconvenient ‘point of information’ that this was not the case. Later, in her speech, Widdecombe derided the tendency for one state agency (e.g. Local councils) to call another (the police) to investigate citizens on matters of speech. I’m still not sure how prevelant it is, but that is neither here not there. There exists, as Alex Deane pointed out in his summing up, a “chilling effect” of Lynette Burrows being visited by the police, regardless of whether or not she was charged with anything. This is a staple argument for the free speech campaigning we do at English PEN, so I had forseen the argument, and had been hoping (for the purposes of winning he debate) that no-one would bring it up. Alex Deane did just that, and in doing so made one of the most powerful arguments for his side, opposing the motion.
However, while the “chilling effect” is an issue, I don’t think it fatally undermines the political correctness argument. When Deane challenged me to account for what might have inspired the police to visit Burrows and others, I replied that I thought leadership was the problem. I think the principles of political correctness are pretty clear, but public sector employees are not given clear guidance and proper moral support, then you get cowardice on the one hand, confusion on the other, and ill-advised busy-bodies making decisions they shouldn’t. Thus we have the fiasco of Lynette Burrows encounter with the police, and the pathetic dictats like “Baa Baa Rainbow Sheep”, a litany of which made up the entirety of Ann Widdecombe’s speech. What I believed before the debate, and still believe, is that these nonsenses, the real political-correctness-gone-mad-stories, are outliers and anomalies, elevated by tabloid sensationalism. They are not, as Will Burrows claimed in his speech, genuinely part of the fabric of the nation. I think the audience realised this, which is why they ultimately voted in our favour.
David Aaronovich said he wished that someone would Google all Ann Widdecome’s PC-gone-mad examples after the event. I thought this rather stepped outside the boundaries of the debate, which depends on the rhetoric and facts you can bring into the chamber. Nevertheless, I would love to see a site like Fight The Smears which collected all Widdecombe’s examples in one place. Those that are false could be exposed in he manner of Oliver Burkeman’s fine debunking of the so-called ‘War on Christmas’. Those that are true would present a robust challenge to those of us who defend political correctness, because instances of stupidity really do undermine the cause.  It might even discourage a repetition in the future.   And of course debunking tabloid myths is always to the good…

Forbidden Words

Conservative MP Ann Widdecombe

Conservative MP Ann Widdecombe


Deane also derided Medhi, Aaronovich and yrstruly for uttering all the un-PC words in the manner of giggling schoolboys. I stood up to sincerely point out that I took no pleasure in saying those words. Widdecombe’s retort was “well, why say them, then?”
Quite. Having spent quite a bit of time recently working on a libel campaign, I guess I had it in my head that I should repeat the words as part of some sort of “qualified privilege“, to show that the offence of the words lies in the context.  But on reflection, I think this was unnecessary.

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