Thursday, January 10, 2013

The Epidemic around the corner

The outbreak of Norovirus in the UK has been greeted with the customary restraint and good sense we know so well from the British press. It is certainly an unpleasant infection, and anecdotal evidence suggests that it has been particularly nasty this year. Yet in fact the disease is relatively safe in that, in almost all cases, the symptoms will clear up quite quickly by themselves. 

However, the breakdown in several areas of the healthcare system that have come as a result of the outbreak should absolutely terrify us. If the infection was one that needed medical intervention in order to treat, then it is clear that the British NHS would struggle to cope. The benefits of large, centralised hospital centres of excellence, that are much touted for the treatment of non-infectious diseases, such as heart conditions or cancer, become huge liabilities when trying to contain a large scale outbreak of infectious problems, such as Norovirus. Healthcare professionals are amongst the first to succumb in such outbreaks, and this can lead to dramatic knock-on effects across the healthcare system.

Chronic infections, notably TB, are growing ever more difficult to treat, since they have developed resistance to a huge spectrum of anti-biotics. In some cases TB is becoming difficult, if not impossible to treat. We already have an increasing collection of multi-drug resistant pathogens. What happens if one of these drug resistant strains of virus or bacteria becomes as infectious as Norovirus? The answer is clear- an outbreak like the Spanish Influenza epidemic of 1918

The British NHS has been designed to a budget- and healthcare costs in the UK are rising significantly, both in absolute terms and in relative international terms. Yet the basic structure- larger and larger entities, both at primary care level and hospital level- is increasing the risks that a major outbreak of an infectious and difficult to treat pathogen could lead to a major public healthcare crisis. Already these large hospitals are reservoirs for drug resistant diseases, such as MRSA. It may not be long before the centralised model of healthcare in the UK leads to a meltdown.

The Norovirus is the writing on the wall, and the politicians are not nearly scared enough about what could happen. 

Wednesday, January 09, 2013

Nigel Farage, Political bounder

Nigel Farage could be name from the pen of  PG Wodehouse, and if so, it would clearly be a name to represent a bad lot

In real life the actual Nigel Farage, with his tobacco scented, saloon bar heartiness and rather loud taste in shirts, in fact comes close to the Wodehousian archetype. He is a man who Jeeves would undoubtedly view with disfavour- too loud and somehow too... well, vulgar, a wide boy, rather than a gentleman. Mr. Farage himself would probably cheerfully concur, regarding his personal brashness with some pride, as the antithesis of the machine politician that he affects to despise. In the looking-glass world of UKIP, a gaffe is not a mistake, but proof of humanity, and populist point scoring is not political immaturity, but a respect for the democratic process.

Except that in the real world, UKIP has a huge mountain to climb to even match the Green's single, lone representative in the House of Commons. UKIP support is broad, but shallow and in no Parliamentary constituencies does it look as though Mr. Farage can get over the line and into the elected national political assembly. Neither does the party have much local representation, so the idea that "UKIP can be part of a coalition, post 2015" is really pretty fanciful. 

Yet, the fact is that UKIP has had considerable indirect influence. The Conservatives, much against the initial better judgement of David Cameron, are poised to try to address the issue of British relations with the EU, and up until now, it is the anti-European skein of thought that has been making the running. Yet, as the prospect of an in/out referendum looms, the realization of how much Britain has to lose is beginning to settle over business leaders, and there is now the beginnings of a serious fightback against the isolationist wing of the Conservatives, who have come under the spell of UKIP. The Anti-Europeans have had all the air time, so it is hardly surprising that the polls show growth in their support. Yet the reality is that the debate is only now beginning to take place- and in the end, far from the "antis" looking set for victory, it may well be that they face a final and complete defeat. There is a substantial body of opinion in the UK that views the prospect of a semi-detached membership, still less a withdrawal, with profound concern. 

The critical problem for the Conservatives lies in simple electoral calculation.  That is to say the indirect impact that UKIP can have on Conservative votes in marginal seats. There are several seats where the UKIP vote is greater than the majority of the winning candidate- and this has certainly already cost seats for the Conservatives. If the UKIP surge were to continue, then the Tories, who already face a difficult task to secure a Parliamentary majority, will find that it would take a truly massive lead over Labour in order to secure even the most minimal majority.

The conventional wisdom suggests that Labour's unprincipled populism will deliver them a majority in 2015, yet it may well be that Labour loses the popular vote. What then would be the legitimacy of such a government in such circumstances? Of course as always there is the pressure of "events". The shambles that Mr. Farage has made over the removal of the leader of his party's Youth organisation suggests that things may be very far from plain sailing for UKIP in the coming months. Likewise Labour too may face greater scrutiny, as they yield to their authoritarian populism- banning Frosties and the like. 

Neither "Libertarian" populism nor Authoritarian populism are likely to deliver successful policy.

So as we enter 2013, the bounder Nigel Farage is full of beans. Yet, as Jeeves could tell him,  bounders and cads rarely prosper in the longer term. The denouement for this particular comedy is unlikely to prove entirely what the wide boy Mr Farage expects. 

Perhaps 2013 may give Messrs. Miliband and Balls some pause too.