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Health and Humanity Part 3: Charity Begins At Home

Fri 26th Feb 2016














Health And Humanity

Last time, and indeed before, we discussed the best way to conceptualise humanity’s interactions. At least, I think we concluded that we should start 2016 off with some mindful meditation, and subsequently use logical thought and reasoning to do our bit for humanity. So, using our own health (ie. our own biopsychosocial wellness and core) as a basis to then go out and help others and our environment.

Charity Begins At Home: NGOs and corporatisation of charity

A non-governmental organization (NGO) is an organization that is neither a part of a government nor a conventional for-profit business. Usually set up by ordinary citizens, NGOs may be funded by governments, foundations, businesses, or private persons.” Wikipedia

Hardly a day goes by when either a charity, or this more nebulous entity of an NGO, receives significant airtime in the media, often associated with a positive spin though sometimes less so. Increasingly, it appears charities and NGOs are behaving in a corporate fashion, which may or may not be a good thing.

Here in the UK, charities have found themselves involved in various issues which broadly relate to how they generate funds. Thinking logically about charity raises a few issues.

When I was younger, I believed that charities and charity workers centred upon pro bono contributions and people donating their time. Modern corporatised charity clearly revolves mainly around money collection, pyramidal corporatised structures and logistics. I concede that modern charity is probably the only solution at present to get aid to the most needy in far off lands. But in a world where technology enables us to work remotely, to travel around the world with relative ease, and where many traditionally disadvantaged economies are improving, I cannot help but think there must be a better way to be charitable.

Ultimately, I would suggest kindness and compassion for our brothers and sisters both at home and around the world is the most powerful and fundamental tool we have. And the most valuable thing we can give is our time.

A (very brief and personal) History of The National Health Service

The NHS was created in 1948, on the basis of free healthcare for all at the point of access. I have spent several decades involved in the NHS in professional and personal capacities. All of the positives we all know and feel about the NHS should be taken as read. Healthcare is becoming increasingly politicised as well as corporatised.

Recent relevant changes include the Health And Social Care Act (2012) which abolished primary care trusts and brought in clinical commissioning groups (with one concept being that General Practitioners would have more of a direct role in commissioning services) and the Modernising Medical Careers initiative in the noughties, which was linked to the European Working Time Directive.

During my own training, I found myself amongst the last cohort of ‘old fashioned’ surgical training. When Modernising Medical Careers was on the horizon, there was a great furore that the inevitable reduction in training hours would result in modern doctors being undertrained. With the widespread adoption of the European Working Time restrictions, training hours per year of the modern doctor have been significantly reduced.

The obvious problems facing the modern NHS are largely attributable to increasing demands and needs from the population for this publicly funded service. There is already a great deal of subcontracting and private money flow within the NHS. Observers cannot fail to have noticed the increasing corporatisation of the NHS itself, not least in the recent ‘NHS England’ evolution. The principal thing that a lay politician who is put in charge of healthcare can do is strive to balance the books as best as s/he can.

The general principle of the present government’s agenda of weekend staffing levels being on a par with weekdays seems reasonable. Providing elective surgery or procedures seven days a week may be desirable but I doubt this is achievable. However, providing urgent and emergency care 24/7 with consultant-provided patient centred care is surely a logical goal. The demands on the NHS will only increase and with perpetual budgetary constraints, a new NHS will have to evolve.

Educationalism, intelligence, reasoning, expertise and the media

Three recent conversations I had, and one item I saw on the media news last month, started me thinking about the above. Educationalism, like charity seems to be big in the modern world.

In a conversation with medical colleagues, I was directed to a lecture on ‘TED’ by an ‘educationalist’ who is apparently a well known knight of the realm here in the UK. I watched his whiteboard animation which was set to one of his lectures. In a précis of modern educationalist ideas he did not dwell on or even allude to, as far as I could make out, the role of critical and logical reasoning or thinking in education.

In a conversation with a headteacher who described herself as a ‘knowledge dispenser’, I asked her whether she was a distiller of knowledge or a facilitator of reasoning. Knowledge is transitory and changeable for the most part but logical thinking should be perpetual and ubiquitous.

“It is not so very important for a person to learn facts. For that he does not really need a college. He can learn them from books. The value of an education in a liberal arts college is not the learning of many facts, but the training of the mind to think something that cannot be learned from textbooks.”

Albert Einstein

I was reading an editorial written by Dr Tomasz Pierscionek a few years ago in this journal in which he mentions the role of experts presented on a daily basis by the commentariat. Like ‘educationalism’, beliefs and even ‘knowledge’, expertise is difficult to define or quantify. Last month in the news an educationalist ‘expert’ was presenting his view on why times tables should no longer be taught to primary school children. Whilst times tables do not present logic as such, I would argue they are one of the few ‘pure’ modes of thinking that primary school children can be taught. An educationalist may debate this point. I have to concede a brilliant piece of television ensued whereby in the midst of said educationalist expert’s flow, the journalist asked “so, what is 11x12?” Predictably said educationalist gave the wrong answer and this reminded me of a prominent pseudo-economic politician, who shall remain nameless here, refusing to answer similarly basic mathematical questions from young people around the time of the last general election.

Just as placing a politician, who has no actual relevant skills or training in the field, front and centre of say healthcare or the economy, does not make a great deal of logical sense, thinking that children no longer need to know how to multiply in the modern age is nonsensical I am afraid. Intelligence, or moreover the ability to think, should have far more value placed on it in the modern world. At least if, for example, the politicians who were entrusted with running our economy or healthcare system were ubiquitously logical thinkers, this would be a great start. If they were truly experts in their respective fields, that would be even better. A problem with the latter, which relates to the entirety of this section, is that logical thought may compete directly with knowledge which is dispensed by experts and educationalists. So, for example, if I worked in financial services the first thing I would hope to be taught is about double entry bookkeeping. The third conversation I alluded to at the start of this section was with someone who works in financial services at a middle level. We got onto the subject of the function of commercial banks. When I said “most people think that the function of commercial banks is to pair up debtors and creditors" (ie. lending savings and charging to do this), he replied “yes that’s right”. I said, “no money is created out of thin air when someone applies for a mortgage, for example, by the process of double entry bookkeeping.” His eyes glazed over. I have little doubt that the majority of people working in financial services have no idea how modern money mechanics works. And this problem is of course not confined to finance.

Technology

Technology should be our greatest achievement as a race. However, we must use it for the greater good. The Internet has revolutionised our lives over the last couple of decades. But has it actually improved humanity in any tangible way? In terms of the intraspective of beliefs-reasoning-knowledge, the Internet can provide knowledge primarily, and beliefs may form from this knowledge, but truly reasonable and reasoned reasoning is far more difficult to come by, either in cyberspace or in the real world. No amount of information or technology at our fingertips can facilitate logical thinking. That has to come from within, or be taught from an early age (see above). In lieu of logic as a taught subject, we should all work on our thinking or moreover, in the first instance, we should all learn to think, logically and critically.

The Bull, The Bear and The Elephant

In this spirit, we return again to finance. As we watch the money markets on the news, and as presented on the web, what anyone should be able to see is volatility on an unprecedented scale in recent times. So, what was a bull market is now a bear market. Such is life in the modern economic world, many would say. The view presented largely by the commentariat at present is that the far east is the root cause of the problem. In the west, we are told, the economy continues to grow, albeit somewhat slowly, and that the outlook is good if somewhat uncertain. An alternative viewpoint might be that the trillions in bail outs circa 2008 have merely papered over the cracks of a world economy which is debt based and that modern money mechanics is the elephant in the room.

The fact that Bernie Sanders in the US and John McDonnell here in the UK have gained grassroots traction by suggesting that there is something seriously wrong with the money system demonstrates that many of the thinking masses know that the economy requires serious work, and that printing money is not going to be the long term solution.

Fundamental issues such as the function of central banks, double entry bookkeeping and money creation by commercial banks, and the derivatives bubble and bank bail ins all need to be frankly discussed by and for humanity.

Until the elephant in the room (the modern money system) is confronted, the bear and bull will indeed continue their tussle. But if all we are doing is creating money out of thin air, then there is only one path for modern currencies in the long term.

MQ Bismil is a medically qualified and surgically trained; writer and thinker. He has been commissioned to write a series entitled Health And Humanity for the London Progressive Journal in 2016. His views are his own and unrelated to his medical practice.

In this series, the generality of health is discussed. Please do not construe this as specific health advice, and please consult a physician if you wish to consider making changes to your lifestyle.

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