Padraig Colman

Rambling ruminations of an Irishman in Sri Lanka

The Sick Man of Europe

A shorter version of this article appeared in the Sunday Island on March 26, 2023.

According to The Economist, “Britain has endured a grim decade during which perhaps a quarter of a million people died younger than expected.“

Declining Life Expectancy

Between 1980 and 2011 life expectancy in the UK rose at a steady pace of nearly three months every year. After 2011, the rise slowed.  If  Britain’s life-expectancy gains  continued at the long-term trend, then life expectancy in 2022 would have been 2.2 years longer than it actually was. Those 26 months represent around 700,000 additional people that have died sooner than might have been expected in the early 2010s.

Academics from the University of Oxford and the London School of Hygiene and Tropical Medicine   examined global life expectancy ratings between 1952 and 2021. In a league table of life expectancy, seventy years ago, the UK ranked seventh in the world, following closely behind Norway, Sweden, and Denmark. Now, the UK  performs worse than all G7 countries except the US. The  UK dropped from 7th place to 29th in global life-expectancy rankings. Life expectancy for males in the UK between 2018 and 2020 was 79, for females 82.9. Norway’s life expectancy is 80.9 years for men and 84.4 years for women. The number in Sweden was 83.18 years, marking a 0.18 per cent increase from 2021. Seventy years ago, Britons had longer life expectancy than anywhere in the G7. Now people in France, Germany, Italy, Canada and Japan live longer than Britons. Ireland also has higher life expectancy than the UK. Japan has the highest life expectancy at birth – 85 years. (Although , Monaco is at the top of the UN’s league table with 87 median).

The Economist says, “something has gone badly wrong in the past decade, and large numbers of Britons have lived shorter lives as a result. That raises two big questions. How much of this is specific to Britain? And why?” This is not just because places such as South Korea, Taiwan, Hong Kong and Macau have got richer. The pandemic cannot be blamed  for a quarter of a million early deaths since 2011. Britain had already slipped in the ranking before Covid-19 hit and has since returned to its pre-pandemic trajectory. More middle-aged and younger people are dying than otherwise would have. Girls born in 2020 are now expected to die 4.8 years earlier than was expected in 2012, and boys, 4.5 years earlier.    


Analysis by the Health Foundation shows that, compared to life expectancy overall in OECD countries in 2018, only Mexico is lower than the UK. Women in the poorest 10% of areas in England can expect to live on average 78.7 years – significantly below the average of 83.2 years for the whole of England and less than the overall life expectancy for women in countries including Colombia (79.8 years), Latvia (79.7 years) and Hungary (79.6 years).

The shocking thing is that the decline in life expectancy is not evenly spread over the UK. As The Economist put it: “the uncomfortable truth is that the 250,000 do not die in places like the London borough of Westminster (where life expectancy surpasses that in the Swiss canton of Geneva). They die in poorer towns and cities.” Glasgow has the lowest life expectancy in the UK. According to the National Records of Scotland, life expectancy in Glasgow was 78.3 years for females and 73.1 years for males. At the national level, Scotland’s life expectancy was the lowest among UK countries at 76.8 years for males and 81.0 for females.  Life expectancy is 18 years higher for men in the richest part of Kensington (92) than it is in New Cross Gate (74), a poor part of London only six miles to the east. Even within the Borough of Kensington and Chelsea itself there are wide variations in socio-economic circumstances. An area best known for royal  and Russian oligarch and Saudi residents (or non-resident owners  also has pockets, particularly in the north end of the borough,  of severe deprivation. The lowest life expectancy in Greater London for both men (77.0 years) and women (81.7 years) is found in Barking and Dagenham. Healthy life expectancy means the average number of years that a person can expect to live in “full health” by taking into account years lived in less than full health due to disease and/or injury. The Healthy Life Years indicator, also known as disability-free life expectancy or Sullivan’s Index, is a European structural indicator computed by Eurostat. Healthy life expectancy for men in Tower Hamlets is 65.3 years whereas for women it is only 57.8 years.


Severe socio-economic deprivation tends to lead to poor health. Poverty is damaging to health in many ways — through mental illness, a lack of education about nutrition and healthy ways of living and inadequate housing.  Awaab Ishak was a two-year-old who  died because of the fungal mould in the flat in which his family  lived. Data obtained by the all-party parliamentary group for households in temporary accommodation from the national child mortality database found that between 2019 and 2021, temporary accommodation contributed to the deaths of 34 children, most under a year old. Lack of safe sleeping provision was the most likely cause but other reasons were damp, mould and overcrowding.

I spent a year in the UK, after becoming an exile 25 years ago. One can see every day on the streets how unhealthy so many people are. So many people look shabby, downtrodden and depressed. The most striking thing is how many grossly obese people are walking (with difficulty) the streets. Some of them are in wheelchairs. One sees a lot of wheelchairs. Obesity is one league table on which Britain ranks highly, beating all other  Europeans except the Maltesers. Currently 60% of adults in the UK are obese, with the number estimated to rise to 80% by 2060. Obesity used to be a sign of affluence, now it is a disease of poverty. Around one in every four adults and around one  in every five children aged ten in the UK are overweight. The prevalence of reception-aged children living with obesity in 2021-22 was highest in the North East (11.4%) and the West Midlands (11.3%).  It was lowest in the South East (8.7%), South West (8.9%) and East of England (9.2%). Diet-related disease is now the biggest cause of preventable illness and death in the developed world – far greater than smoking.

In his new book, Ravenous,Henry Dimbleby writes: “We are hungrier, ultra-processed foods stop us getting full, so we eat more, and what we eat is itself bad for us.” People are at the mercy of a food industry they do not  understand. Dimbleby resigned from a government role: “I think the ideology of the Conservative Party and the way that they are dealing with the problem of diet-related disease makes no sense. In ten years’ time, whatever government is in power they are going to be dealing with huge problems to the NHS, which is going to suck money from the rest of government spending and cause misery from diet-related disease.”

Politics of Poor Health

From the 1940s to 2010 the state pension age was 60 for women and 65 for men. Since then, the pension age for women has been equalised with men’s, and both raised to 66. Two further increases are due to follow: to 67 by 2027, and to 68 in 2046. The government was hoping it could bring that second date forward in order to improve its fiscal position. Raising the pension age has caused riots on the streets of France. Tory MPs have urged a delay, arguing that ordinary voters would resent having to work longer at a time when the government  has just relaxed tax rules on pensions for the wealthy. One senior Tory MP warned of the “critical juxtaposition” of scrapping the £1m lifetime allowance for pension savings while asking ordinary voters to work until 68 for a not very generous state pension. Prime minister  Rishi Sunak has released his tax returns. They show that he has made large sums outside politics and only paid tax at a rate of 22%.

The government has been tempted by the possibility of £ 226 m in extra revenue if they charged prescription fees to the 2.4m people in the 60 to 66 age group. A 2021 consultation paper suggested that this could be “invested” in the NHS and achieve £ 8.4 bn in improved health. MPs of all parties have found this calculation to be bizarre. Health problems could get worse if people on low incomes are charged for essential medicines. The Royal Pharmaceutical Society urged the government to ensure  that all patients with long-term conditions get their drugs free. A survey showed that many patients go without their medication in order to pay other bills.

Many people, including myself, have written about the downsides of economic growth. Whatever about all that, those who are supposed to be running the UK are pinning all their hopes on economic growth without having any clear plan about how to achieve it. Liz Truss was toppled by her madcap schemes to boost growth. All she did was give more money to the already rich. Hunt and Sunak seem more sensible but in reality are just mouthing optimistic platitudes.

Decline and its Causes

The British malaise goes back a long way and Johnson, Truss, Kwarteng, Sunak and Hunt have done nothing but kick problems into the long grass hoping that they will solve themselves. In The Atlantic, Derek Thompson pithily summarises  the UK today: “Britain is pretty poor for a rich place. UK living standards and wages have fallen significantly behind those of Western Europe. By some measures, in fact, real wages in the UK are lower than they were 15 years ago and will likely be even lower next year.” Thompson continues: “In the past 30 years, the British economy chose finance over industry, Britain’s government chose austerity over investment, and British voters chose a closed and poorer economy over an open and richer one. The predictable results are falling wages and stunningly low productivity growth.” Another pithy summary from Thompson: “The UK is now an object lesson for other countries dealing with a dark triad of deindustrialization, degrowth, and denigration of foreigners.”

Austerity was the Cameron (remember him coming to Sri Lanka telling us how to run our country?) government’s response to the 2008 global financial crisis. That meant cutting public services even further giving  less support for poor people to care for elderly and sick relatives. Brexit was supposed to bring an extra £350 million to the NHS every week. That was a lie. Brexit brought staff shortages to the NHS as foreign workers were made unwelcome. There are food shortages today because there are no foreign seasonal workers to pick the crops and no foreign HGV drivers to deliver to the supermarkets. Imports and exports of food are stymied by hellish bureaucracy.

Where Are the Workers?

Something  I noticed while in England, was that it was very difficult to buy anything because there were not enough staff in the shops. We made three visits to a bank to change some accounts but gave up on finding anyone to talk to. Labour market participation has fallen dramatically since the pandemic. Some of this is because  exhausted older workers decided tey might as well retire and some from the long-term sick. It is difficult to see where Hunt gets his optimism when the OBR (Office of Budget Responsibility) writes: “Gas prices remain more than twice their pre-pandemic level which, when added to the stagnation in business investment since 2016, the recent rise in labour market inactivity, and the slowdown in productivity growth since the financial crisis, means that there remains weak underlying momentum.”


The days have probably gone when the NHS was revered. Public satisfaction with the NHS has slumped to its lowest level ever recorded by the British Social Attitudes survey. Just 29% said they were satisfied with the NHS in 2022, with waiting times and staff shortages the biggest concerns.That is seven percentage points down on last year and a drop from the 2010-high of 70% satisfaction.

A study of 37.5 million patients in 2018 suffering four different sorts of cancer showed that British cancer survival rates were worse, not just than  EU neighbours, but worse even than China’s. China’s breast cancer survival rate is about the same as Britain’s, its prostate cancer survival rate is worse and its lung and stomach cancer survival rates are better. China is  a country in which only half of doctors have university degrees.

A leaked report predicts that NHS staff shortages in England could exceed 570,000 by 2036.The 107-page workforce plan produced by NHS England says the health service is already operating with 154,000 fewer full-time staff than it needs. It says that without radical action, the NHS in England will have 28,000 fewer GPs, 44,000 fewer community nurses and an even greater lack of paramedics within 15 years. Services in rural areas, which already struggle to attract enough staff, will be left unable to give patients – especially older people – the help and treatment they need, it warns. The NHS will not be able to cope with the increasing demand for care that will arise in coming years as a result of the growing and ageing population. The report strongly urges the government to stop relying  on hiring more and more overseas health professionals and spending billions of pounds a year on temporary staff. Overseas staff  now account for one in six of the workforce – double the number in 2014. Jeremy Hunt is playing a key role in behind-the-scenes moves by the Treasury to water down NHS England’s proposals to double the number of doctors that the UK trains and increase the number of new nurses trained every year by 77% – because it would cost several billion pounds to do that. Hunt’s stance is in contrast to his enthusiastic backing, while chair of the Commons health select committee (and not a minister) , for a massive expansion of the NHS workforce and publication of regular projections for how many staff of different types it needed to keep pace with the growing burden of illness.

Municipal Heroes

Most improvements in infant mortality and life expectancy in Britain came not as a result of experiments on animals or investment by drug mega conglomerates  but because of public health measures implemented by local government. Successive Conservative governments have cut public spending, starving local authorities of funds to give social support to local communities. Improvements in nutrition, hygiene, housing, sanitation, control of infectious diseases and other public health measures historically reduced mortality rates. Very old people were rare 100 years ago. Less than one in 150 people was aged 80 and over in the 1920s.  By 1920, life expectancy was 56 years for males and 59 years for females. Males born in 1841 could expect to live to only 40.2 years and females to 42.3 years, mainly because of high mortality rates in infancy and childhood.

The Great Stink of London by Stephen Halliday is a fascinating read.  It recounts how civil engineer Joseph Bazalgette  built London’s first sewer network (still in use today), which helped to wipe out cholera in the capital. The summer of 1858 was particularly hot and humid. For centuries, the Thames had been the city’s main thoroughfare as well as  a dumping ground for human, animal and industrial waste. I travelled at dawn on the Ganges at Varanasi and was shocked to see people brushing their teeth in water that had dead cows and humans floating past.

London’s  population more than doubled between 1800 and 1850, making it by far the largest in the world. By 1858, the stench overwhelmed Parliament and the politicians decided to do something about it. Bazalgette produced a network of  82 miles of new sewers, great subterranean boulevards that in places were larger than the underground train tunnels then under construction.

English civil engineer Sir Joseph William Bazalgette (1819 – 1891), the first engineer to the Metropolitan Board of Works. He designed much of the Thames Embankment, as well as London’s drainage system. Original Artwork: Woodbury type oval, by Lock & Whitfield. (Photo by Hulton Archive/Getty Images)

Raw sewage was dumped into rivers and coastal areas across England more than 300,000 times last year. In 2023, Britain’s rivers are again full of shit plus a lot of chemicals and microplastics that were unknown in Bazalgette’s time. Untreated sewage released by privatised water companies is responsible for 35% of the pollution of British rivers. Pollution by water companies is particularly high in the south and southwest of England. Excessive use of fertiliser and pesticides in agriculture is responsible for 40% of river pollution. Run-off from roads and towns which contains pollutants such as oil is responsible for 18%. Professor Steve Ormerod, an ecologist at Cardiff University, warns of other threats. He says: “We need to understand the risks which come with emerging pollutants – pharmaceuticals, microplastics. We don’t know, at this stage how big a problem they’re going to be.” The Environment Agency says, “people in deprived and heavily populated urban areas were more likely to live within 600m of a river with poor chemical or biological quality”.

The Environmental Audit Committee’s inquiry uncovered “multiple failures in the monitoring, governance and enforcement on water quality,” carried out by England’s Environment Agency. Since 1993, the number of water quality samples taken annually by the Environment Agency and Natural Resources Wales has dropped by 57%, which the committee says is a result of budget cuts.

Amy Slack, campaigns manager at the charity River Action said: “The government has let water companies monitor themselves … for decades while defunding regulators that fail to enforce the law. The result: more than 600 sewage overflows free to pollute our rivers and seas unchecked.” Fearghal Sharkey, the former Undertones singer and now water activist who has backed The Times’ Clean it Up campaign, said: “It’s time to pull the handle, a full flush, a total restructuring of the industry all the way from No 10 to your local sewage overflow.”

Seven of the UK’s nine water companies gave bonuses to their executives linked to environmental targets last year, despite significant amounts of sewage being dumped into UK waterways. An analysis of water companies’ accounts by PoliticsHome found that overall bonuses were worth a total of over £1.35m shared between 15 different executives across the sector in 2021-2022, even as untreated sewage was released into UK rivers for more than 2.7m hours that year.

Hunt’s Budget

On Wednesday March 17, 2023, the Chancellor of the Exchequer, Jeremy Hunt, presented his budget to the House of Commons, a budget that needed to restore economic health to the UK after the disastrous budget of his predecessor Kwasi Kwarteng. Economic health is an important factor in the physical health of the people of Britain. The physical health of the population in turn affects the health of the economy. Disturbing statistics are emerging which indicate that the health of people living in the UK is declining. A relative worsening of population health has historically been an early sign of severe political and economic problems. The crisis is here for the UK, the sick man of Europe.

Time to Think

Part Two

A shorter version of this article appeared in the Sunday Island  on March 19, 2023

Gender Identity Development Service

In my previous article I reviewed Hannah Barnes’s excellent book Time to Think which is a detailed investigation intothe bizarre and horrific events  at the GIDS (Gender Identity Development Service) clinic operated by the  Tavistock and Portman NHS Foundation Trust in north London. The NHS has closed the clinic after a number of damning reports. This NHS service was said to be using “poorly evidenced treatments on some of the most vulnerable people in society”. Why did it take so long to close it down? An insider told Barnes: “because it was bringing in so much money they could not challenge it.” This is the business-orientated NHS of 2023.  In 2015/16, GIDS’s income was 5.9 % of the Tavistock Trust’s total. Within a year, it had almost doubled to 10.4 %. That proportion grew further. The Tavistock needed the income GIDS brought in.

GIDS was set up in 1989 to provide talking therapies for  young people who were questioning their gender identity. The Tavistock used to be a centre of excellence for psychotherapy (the talking cure) but concerns started as long ago as 2005 that children were not being given any meaningful counselling but were being put on a fast track to gender reassignment through drugs or surgery. By 2011, it seemed that it was routine practice to refer children to endocrinologists for prescription of puberty blockers. In 2011, a child of 12 was on blockers. By 2016, a ten-year-old was taking them. Barnes’s title is ironic. GIDS claimed that children did not have to make a snap decision about gender reassignment because puberty blockers would give them pause and time to think. GIDS falsely claimed that the effects of these drugs were reversible and that they were harmless. The drugs caused various problems on which data was not kept. There is evidence they affect bone density, brain development and sexual function. The children were being used as guinea pigs but they were rarely offered follow-up appointments. GIDS did not keep in touch with its patients in the long term or keep reliable data on outcomes. Keira Bell regretted transitioning from female to male and took the Tavistock to court. GIDS had referred her for blockers at 16 and she had a double mastectomy at 20.Then she had second thoughts.

Dysphoria and Datphoria

Gender dysphoria is a term that describes a sense of unease that a person may have because of a mismatch between their biological sex and their gender identity. This sense of unease or dissatisfaction may be so intense it can lead to depression and anxiety and have a harmful impact on daily life.

The condition has long been thought of as extremely rare, but by 2023,transgender issues have created a lot of conflict. Ambiguity of gender at birth happens very rarely. Incorrect description and assignment on birth certificates happens but is very rare. How is it that we seem today to have an epidemic of people who want to identify as a different gender from the one on their birth certificate? Today, it is puzzling that a very rare condition, gender dysphoria, has become an epidemic and that so many people have become transphobic.

Kathleen Stock writes in her book Material Girls: “something called ‘gender identity’ gripped public consciousness, strongly influencing UK and international institutions, and causing protests and even violence.” According to Stock, “In 2004, it was estimated there were about 2,000–5,000 trans people in the UK. Back then, the popular image of a trans person was mainly of a ‘medically transitioned’ adult trans woman, or ‘male-to-female transsexual’: an adult person of the male sex who had taken hormones over a long period of time to change many aspects of appearance, and who had also had ‘sex reassignment’ surgery to refashion natal genitalia.”

That is not the case today. Today, according to the LGBT charity Stonewall, their “best estimate” of the number of trans people in the UK is “about 600,000”. Many of them opt to keep their natal equipment but still want to use women’s changing rooms and call themselves lesbians and take part in women’s sports.

Kathleen Stock is a British philosopher and writer. She was a professor of philosophy at the University of Sussex until 2021. She has been pilloried for her allegedly “trans exclusionary position.” She  resigned from the University of Sussex in the aftermath of a student campaign that called for her dismissal and allegations of the Sussex branch of the University and College Union of “institutional transphobia.” A group of over 200 academic philosophers from the UK signed an open letter in support of Stock’s academic freedom. On the other hand, a group of over 600 academic philosophers objected to her getting an OBE arguing that Stock’s “harmful rhetoric” contributed to the marginalisation of transgender people.

There was, between 2009 and 2020, a 4,700% increase in the number of girls referred to GIDS. When asked publicly why three-quarters of referrals to GIDS were female, a representative of the Tavistock Trust said they simply did not know. Stephanie Davies-Arai closely followed events at GIDS for many years and founded the organisation Transgender Trend in 2015. She was worried about the increase in young people, particularly girls, identifying as trans. She wanted quality  research about why girls arrived at GIDS with a set of beliefs.

As well as believing that they were boys some of these girls believed they were Japanese or Korean when they were not. Barnes quotes  Dr Anna Hutchinson, one of the many whistleblowers to have gone on the record: “Self-diagnosed adolescent trans boys — natal females — started to fill up GIDS’s waiting room with similar stories, haircuts, even names – ‘one after another after another’. They’d talk about their favourite trans YouTubers, many having adopted the same name, and how they aspired to be like them in the future.”

The whole issue of gender dysphoria had by the mid-2000s become highly politicised. Stonewall declared in February 2015 that it was extending its remit to campaign for trans equality alongside lesbian, gay and bisexual (LGB) equality.

Collective Fantasies

Sometimes a madness overtakes the masses. I have been reading Norman Cohn’s influential book,  The Pursuit of the Millennium: Revolutionary Millenarians and Mystical Anarchists of the Middle Ages, which I first encountered in my student days in the heady 60s. Cohn’s book was published in 1957 and influenced many people such as the French Marxist philosopher and writer Guy Debord and the British author Richard Webster who wrote a book, which I found quite impressive, about false allegations of child abuse, The Secret of Bryn Estyn (2005). Webster helped find lawyers for Dawn Reed and Christopher Lillie, former Newcastle nurses who were falsely accused of sexually abusing children in their care. Reed and Lillie, who were first accused of child abuse in 1993 and only found not guilty in 2002, say that they would probably be dead, through suicide or murder, without Webster’s assistance. Webster said of Cohn’s work: ”All three books seek to establish the role played in history by collective fantasies….” 

Here in Sri Lanka we had the “Grease Yaka ”phenomenon. When we lived in Uva province, there were a number of attacks blamed on bhuthaya, grease yakas or grease devils. Historically, a “grease devil” was a thief who wore only underwear or went naked and covered his body in grease to make himself difficult to grab if chased. In 2011, the “grease devil” became a night-time prowler who frightens and attacks women.

As Sri Lanka was experiencing Grease Yaka mania, riots were erupting all over the UK. Contagion Theory was formulated by Gustave Le Bon in 1896. According to him, crowds exert a hypnotic influence over individual  members. In a crowd,  people abandon personal responsibility and surrender to contagious emotions. A crowd can drive people toward irrational, even violent action.

Today, we have social media to help spread the madness.

Epidemic of Dysphoria

Transsexualism was discussed in the mass media as long ago as the 1930s. Time magazine in 1936 devoted an article to what it called “hermaphrodites”, treating the subject with sensitivity not sensationalism. When I worked in a local social security office in Manchester in the early 70s, there was one client who wanted to change the gender on their official documents but was unable legally to do so. The office staff were a hard-bitten, cynical lot but were sympathetic, if nonplussed. It is good that society has evolved so that practical measures can now be taken to address such  a problem. Unfortunately, sympathy has been distorted by activism. Even Joe Biden has contributed his confused view of the issue by saying that regulations to protect children from transgender medical interventions and to restrict classroom instruction in gender ideology were “close to sinful.”

Transgender Children and Young People: Born in your own body was a book of essays published in 2018. The thrust of the book was that that the “‘transgender child” is a relatively new historical phenomenon, “brought into being by a coalition of pressure groups, political activists and knowledge makers”. “A copy of the book was removed from the Tavistock library. A clinic director who sent an email letting staff know where the book could be purchased more cheaply ended up with a note on his HR file, and the prospect of disciplinary action, for abusing the Trust’s email policy.

The foreword to this book was written by David Bell a distinguished psychiatrist and practising psychoanalyst,  who in 2018 wrote a controversial report about GIDS. He had worked at the Tavistock since 1995. He was disappointed that the “jaw dropping “ things he found did not lead to greater change. In his foreword, he writes: “Many services have championed the use of medical and surgical intervention with nowhere near sufficient attention to the serious, irreversible damage this can cause and with very disturbingly superficial attitudes to the issue of consent in young children.”

According to a report by Policy Exchange, schools are routinely allowing children to switch gender and not telling their parents in a “mass breach” of safeguarding.some schools risk breaching laws by failing to offer single-sex toilets or by allowing organisations involved in political campaigning to provide relationship and sex education lesson resources.

Crowds of Gender Ambiguous

Ambiguity of gender at birth is very rare. Incorrect description and assignment on birth certificates is very rare. While one might sympathise with people in this situation, giving blocker drugs, hormones and irreversible surgery to children is a drastic response. It is indeed a reinforcement of gender stereotypes. Just because very small boys do girly things does not justify physically changing their gender. When I was about four years old, I was fascinated by the pomp and theatre of the Mass and played at being a priest. Thank God my parents did not pack me off to a seminary and force me into a life of celibacy.

Some young people appeared to be experiencing internalised homophobia and some families would make openly homophobic comments. It is not wise to reorder society and suppress freedom of speech because of birth defects in an infinitesimal minority. It is even more foolish to reorder society and suppress freedom of speech at the behest of men who have decided they are women without going for the surgery. One should sympathise and protect the rights of minorities but not kowtow to bullies who want to act out outdated gender stereotypes.

The original founder of GIDS, Dominic Di Ceglie, said that only about 5% of the young people seen at his clinic would “commit themselves to a change of gender” and that “60% to 70% of all the children he sees will become homosexual”. Barnes write: “Many of the young people did not seem in need of a specialist gender service  at all. But because they were being seen by a gender service, it created the expectation for physical interventions. Why on earth would you wait a year and travel miles to receive therapy? this therapist asked.” Clinicians feared they may be seeing fabricated or induced illness (FII), a presentation previously referred to as “Munchausen’s by proxy”.

Mass delusion extended to the GIDS staff. As external criticism grew, the service developed a “siege mentality”. One clinician, Matt Bristow (who happened to be gay), told Barnes that doubts and criticisms were regarded “as a personal affront rather than people raising legitimate professional concerns”. He and others recount how :“It was difficult to voice legitimate concerns when these were construed as a personal attack on people you cared for and admired. “ “It’s tribal, isn’t it? Anybody who speaks out against a system that they’re part of inevitably is going to have a hard time.” Staff who raised concerns about the safety of children were labelled “transphobic.”

There was, between 2009 and 2020, a 4,700% increase in the number of girls referred to GIDS. When asked publicly why three-quarters of referrals to GIDS were female, a representative of the Tavistock Trust said they simply didn’t know. Stephanie Davies-Arai closely followed events at GIDS for many years and founded the organisation Transgender Trend in 2015. She was worried about the increase in young people, particularly girls, identifying as trans. She wanted quality  research about why girls arrived at GIDS with a set of beliefs.

Satanic Abuse

“The history of medicine is scattered with psychosomatic diseases that appeared, spread like wildfire and then disappeared”. In Creating Hysteria: Women and Multiple Personality Disorder, published in 1999, journalist Joan Acocella described how a disease so rare that most doctors never came across it turned into an epidemic. I had dealings with the Tavistock Clinic in the 1990s when they were promoting the idea of Satanic Ritual Child Abuse. Who believes in that now?

According to her website, “Dr Valerie Sinason was Consultant Child Psychotherapist at the Tavistock Clinic from 1987 … Valerie founded the Clinic for Dissociative Studies in 1998.”  In 1994, Valerie Sinason edited a collection of essays entitled Treating Survivors of Satanist Abuse that claimed satanic ritual abuse existed in the UK and that she had treated victims.

On her Substack blog, Suzanne Moore wrote: “In ten years’ time, a lot of the men (and women) currently  advocating for permanently harming children will no doubt have rewritten their roles in the history of these turbulent times. It’s what they do. There won’t be a backing-down, just tweeted revisionism. Others may learn something about the need for evidence and many will keep some vague faith.” Sinason has put her satanic abuse nonsense behind her and is calling herself a poet.

In those days I worked at the Department of Health as a ministerial advisor on child protection and I studied Sinason’s work very closely. I found that she presented very little evidence to support her claim and she kept recycling the same anecdotes under different guises.  She hounded the Department to take action and eventually my boss, Rupert Hughes, agreed to meet her and listen to her views. I was present at the meeting and it was an embarrassment. Rupert destroyed Sinason with cold logic and common sense. I also met Beatrix Campbell who was peddling similar views. Sinason  was recycling a small number of anecdotes to fit different scenarios.

As a concession to her, the Department of Health commissioned anthropologist Jean La Fontaine to investigate. I edited the subsequent book, Speak of the Devil, which was published in 1998. Professor La Fontaine found that all of the cases of alleged satanic ritual abuse that could be substantiated were cases where the perpetrators’ goal was sexual gratification rather than religious worship. The satanic allegations by younger children were influenced by adults. She said that there were indications that most allegations were sparked by investigations supervised by social workers who had taken SRA seminars in the US. LaFontaine responded to an attempted rebuttal of her book by Sinason and Robert Hale saying “It is not surprising to me that patients who are having treatment by Valerie Sinason would produce stories that echo such topical issues as the recent trial for receiving internet pornography and the publicity for the film Hannibal. There is good research that shows the ‘memories’ of abuse are produced in and by the therapy.”

I attended a conference on child protection in Bristol where I was horrified at the religious zeal of the social workers promoting the idea of satanic abuse. It reminded me of a pyramid selling convention a neighbour took me to. These professional social workers seemed about to burn at the stake for heresy a police forensic psychologist who argued rationally against their zeal and said she had never heard of any evidence to support their case.

Hope for Common Sense?

David Bell wrote: ”Like many, I am acutely aware of the way that proper critical debate has been shut down leaving a near hegemony of a peculiar kind of thinking, or I should say non-thinking, that has come to dominate this discourse.” Bell continued, “silencing has been remarkably successful, resulting in a simplification of a very complex problem that needs to be understood at both individual and socio-cultural levels.” Joe Biden take note.

What on earth is happening in the UK?! Gary Lineker was excoriated for saying that the language used by supporters of immigration control was reminiscent of 1930s Germany. Graham Linehan was savaged on BBC by the daughter of a former leader of the Labour Party for saying that use of puberty blockers could be compared with the practices of doctors working for the Nazis.

Graham writes: “I was offered £200,000 to walk away from the Father Ted musical because I object to the medicalisation and sterilisation of gender nonconforming children, the destruction of single-sex spaces such as shelters and rape crisis centres, the homophobic rape culture that puts men on lesbian dating apps and the misogynistic abuse levelled at anyone who dares object. Because of my work defending women’s rights, Hat Trick and Sonia Friedman Productions folded to activists within their own company and robbed the public of the Father Ted musical.”

Nick Cohen has written on his blog: “writing in his preface to Animal Farm in 1945, George Orwell said that ‘the sinister fact about literary censorship in England is that it is largely voluntary. Unpopular ideas can be silenced, and inconvenient facts kept dark without the need for an official ban’.” Barnes submitted her manuscript to 22 publishers who did not want to touch it. Junior staff at publishing houses prevented the publishers from going with the book. Once the book found a publisher, junior staff at bookshop chains worked hard to prevent readers from buying the book. Cohen comments “The British state wasn’t trying to silence Barnes. Publishing houses were attempting to enforce a quieter but no less effective form of censorship.”

How has transgenderism reached the point that the Labour party is endangering its chance of toppling a horrible, inhuman and incompetent Tory government by signing up to issues that it does not really understand and that mean nothing to most voters? Promotion of trans rights has already contributed to the downfall of the previously unassailable Scottish first minister, Nicola Sturgeon. Nick Cohen: “A similar blowback helped knock Nicola Sturgeon out of politics after she took gender theory to its logical conclusion and tried to house a rapist who said he identified as a woman in a women’s prison.”

Can we hope that the madness can be contained? I leave the last word to Helen Joyce: “liberal, secular society can accommodate many subjective belief systems, even mutually contradictory ones. What it must never do is impose one group’s beliefs on everyone else.

Time to Think: The Inside Story of the Collapse of the Tavistock’s Gender Service for Children by Hannah Barnes is published by Swift Press (£20). I got mine from Kindle.

Time to Think

Part One

Sri Lanka’s first president, JR Jayewardene, famously boasted that the newly-created executive presidency gave him the power, “to do anything, except make a man a woman, or a woman a man”. Today, there is much conflict in many countries about making a man a woman or a woman a man. The issue recently contributed to the downfall of Scotland’s First Minister, Nicola Sturgeon, who had seemed unassailable. There are some who believe that if a man says he is woman – “self-identifies” as a woman – then he is, indeed, a woman. Wishing makes it so. Those who dispute this are labelled “transphobic.”


On February 23, 2023, A Time to Think by Hannah  Barnes was published.

Time to Think: The Inside Story of the Collapse of the Tavistock’s Gender Service for Children by Hannah Barnes is published by Swift Press (£20). I got mine from Kindle.

I preordered the book so I could  quickly read it for you and report back as soon as possible. Barnes regards her work as an investigation into flawed healthcare – not an attack on Trans rights.

The subject of the book is GIDS (Gender and Identity Development Service) run by the Tavistock and Portman NHS Foundation Trust. Hannah Barnes had investigated the clinic for the BBC’s Newsnight programme.

The NHS has ordered the  clinic to be closed. The Hippocratic Oath requires a physician to swear upon the healing gods to, “first, do no harm”. The treatment promoted  by GIDS did a lot of harm. Barnes spoke to over 60 clinicians, psychologists, psychotherapists, nurses, social workers as well as  clients and their parents.

The clinic was launched in 1989 by Domenico Di Ceglie to help people aged 17 and under struggling with their gender identity. They “ended up with three or four cases” in its first year. True gender dysphoria is very rare. The term describes a sense of unease that a person may have because of a mismatch between their biological sex and their gender identity. This sense of unease or dissatisfaction may be so intense it can lead to depression and anxiety and have a harmful impact on daily life. Barnes quotes Di Ceglie , “And then somebody said to me, ‘But is it that you, [by] creating a service, you are creating the problem?’” The number of people seeking the clinic’s help is 20 times higher than it was a decade ago.

Cass Report

Dr Hilary Cass,  a leading paediatrician, was commissioned to review and report on the service provided by GIDS. Cass said the Tavistock clinic needed to be transformed. She said the current model of care was leaving young people “at considerable risk” of poor mental health and distress.

Cass reported that:

  • The service was struggling to deal with spiralling waiting lists
  • It was not keeping “routine and consistent” data on its patients
  • Health staff felt under pressure to adopt an “unquestioning affirmative approach”
  • Once patients are identified as having gender-related distress, other healthcare issues they had, such as being neurodivergent, “can sometimes be overlooked.”

Affirmative Approach

In the acrimonious debates about transgender issues, one has to  carefully unpick the meaning of words. Words sometimes lose the meaning to which we have common-sensically become accustomed. When Cass says, “affirmative approach”, she means that very young children who were confused about whether they were male or female were put on a fast track to receive puberty blockers. The most commonly used puberty blockers are gonadotropin-releasing hormone agonists, which suppress the production of sex hormones, including testosterone and estrogen. There is very little research about the side effects of these medications but there are well-founded fears that they cause deficiencies of bone density. There are also well-founded fears of blood clots and cardiovascular disease. There is little doubt that puberty blockers cause infertility and difficulties in achieving orgasm. It is unlikely that anyone who opts for this treatment will have a happy sexual life.

“Neurodivergent” means that most of the children that GIDS dealt with had a lot of problems apart from gender. This means that issues about whether they identified as male or female were, in reality, secondary to other issues including “non-suicidal self-harm, suicidal ideation, suicide attempts, autism spectrum conditions (ASCs), attention deficit hyperactivity disorder (ADHD), symptoms of anxiety, psychosis, eating difficulties, bullying and abuse”. of the children would have developed into a reasonably happy life as homosexuals if GIDS had not fast tracked medical intervention to alter their gender. Over 90% were lesbian. Some of the patients  interviewed by Barnes thought they might be happy as neither male or female.

Early Intervention

“Early intervention” is another term bandied about. It means doing nasty things to children below the age of consent. What it means is that pre-adolescent children have been chemically castrated with drugs designed to be used on sex offenders. Alan Turing was technically a sex offender because homosexual acts were illegal in 1952. Turing is widely considered to be the father of theoretical computer science and artificial intelligence. He accepted hormone treatment with a non-steroidal oestregen medication as an alternative to prison. He developed breasts and became overweight. He committed suicide. His image  appears on the current Bank of England £50 note.  

Claims are routinely made that puberty blockers are reversible. There is no data to support this view. Decisions are made by parents which can have a disastrous effect on children’s lives. The lower age limit of 12 was removed as the GIDS  clinic moved to a “stage” not “age” approach, allowing younger children to be referred for puberty blockers.


There are many mentions in Hannah Barnes’s book of a charity called Mermaids. This was founded in 1995 to provide support for transgender youths up to 20 years of age. The influence of Mermaids and Susie Green on GIDS’s practice and policy seems egregious, nay, sinister. Susie Green was the chief executive of Mermaids from January 2016 until 25 November 2022. Her son Jack became a girl called Jackie. She took him to Boston when he was 12 for a course of puberty blockers. On his 16th birthday he had gender reassignment surgery” in Thailand. In plain English this means orchiectomy, castration, which would be illegal in Britain for a 16-year-old. Would Jack have been happy as an adult gay man? Who can say? Homophobia is a recurrent theme in all of this. After taking her child to Boston in 2007 to receive puberty blockers, Susie Green worked to make them available in Britain from GIDS. In response, GIDS began prescribing blockers from 2011 onwards, making them widely available in response to demand from families.

In 2017 Susie Green gave a TED Talk in which she admitted that her now ex-husband had disciplined her son for playing with feminine toys as a child, and that the boy began identifying as a “girl” after those toys were taken away from him. Green and her husband appeared to be more comfortable having a “trans kid” who was “really” a girl than having a feminine boy who was probably gay.  Irish Comic genius Graham Linehan, creator of those wonderful TV comedies Father Ted and Black Books, has long battled with Green and Mermaids. When he  voiced concerns about Mermaids in 2019, he was viciously attacked and YouTuber HBomberGuy raised £125,000 for Mermaids in retaliation. This was made possible by a large number of famous people who proudly contributed to the Mermaids cause. On February 21, 2023, Graham reported that Susie Green’s TED Talk had been removed from TED and YouTube. Graham wrote: “Susie’s talk can be summarised thusly: ‘Kid seemed a bit gay, Dad didn’t like it, so we cut his penis off and told him he was a girl’”

According to the Daily Telegraph, Green was forced out of Mermaids because of  a staff backlash over her “incapable” leadership. An internal audit, launched earlier this year by the Social Justice Collective (SJC), a diversity group, is understood to be highly critical of Ms Green’s handling of complaints of racism, safeguarding, the vetting of trustees and her “shoving her head in the sand”.

Domenico Di Ceglie and his successor, Polly Carmichael, would regularly attend meetings of Mermaids and upon their return encourage staff to change practice.

According to GIDS staff that Barnes interviewed, “Mermaids became more political and harder to work with. Their position appeared to be that there was only one outcome for these children and young people – medical transition.” Clinical psychologist Kirsty Entwistle, on the GIDS staff from 2017, said: “Those who’d connected with Mermaids were terrified, because they’d been told that their child was going to kill themselves if they didn’t get blockers.” Entwistle was shocked when her clinical partner cited a female patient’s early love of Thomas the Tank Engine as evidence she should be referred for puberty blockers.

Child Abuse

Mermaids appointed Dr Jacob Breslow to their board, regardless of the fact that he is a known advocate of paedophilia. Breslow appeared at the  B4U-Act conference. B4U-Act is  an organisation founded in 2003 by convicted child abuser Michael Melsheimer. An undercover investigation by the Daily Telegraph found Mermaids were sending breast binders to teenage girls without parental knowledge or consent. 

Kellie-Jay Keen-Minshull (who blogs as Posey Parker) was reported to the police by Susie Green for referring to male to female trans surgery as castration on Twitter. There is no doubt that the procedure involves chopping off  of the ould gonads. Kellie-Jay,  mother of four said, “I am not part of a grooming gang or paedophile ring, I haven’t hurt anyone or abused anyone. I am a woman with an opinion.” West Yorkshire police underwent a training session on transgenderism led by Mermaids. Graham Linehan reported on February 23, 2023, that Kellie-Jay has again been summoned by the police and had to pay £ 3,000 in legal fees. British police have given up any pretence of investigating burglaries and other crimes but have time to waste scolding people about their use of pronouns. GIDS was strongly influenced by someone who castrated her own son and bullied people who criticised her.

Under the influence of Mermaids, GIDS was “routinely offering an extreme medical intervention as the first-line treatment to hundreds of distressed young people who may or may not turn out to be ‘trans’”. The normal rules of medicine and children’s healthcare did not  seem to apply. Puberty blockers are touted as a means of giving young people “time to think” as in the title of Barnes’s book. In reality, in excess of 95% of young people who start on puberty blockers opt to take cross-sex hormones. Puberty blockers are just the start of the conveyor belt.

No Talking Cure

The Tavistock was, for many years, seen  as a centre of excellence for psychoanalysis and psychotherapy within the NHS since being included at its founding in 1948. The Tavistock’s reputation was based on psychotherapy – the talking cure. Distinguished people who passed through the Tavistock’s portals include Freud, Jung, John Bowlby, Lily Pincus, RD Laing, HG Wells and Samuel Beckett. I had dealings with the Tavistock in 1994 when one of their psychotherapists, Valerie Sinason, was spreading disinformation about “ritual satanic child abuse.”. I will deal with that in my next article. There was little therapy of any kind available at GIDS. “The ‘fundamental problem’ was that the team could only ever carry out ‘limited’ psychological work with young people and families.”  New staff could not be trained quickly enough and patients were disorientated by seeing new people at every appointment. Children were referred for drugs sometimes after only two sessions.

I Had not Thought Delusion Had Undone so Many.

Part of the madness was that children were turning up identifying as other ethnicities such as Japanese. Why is there an epidemic of young people with gender dysphoria? Why are so many of them girls who want to become men?” The number of teenage girls with gender dysphoria  had risen by 5,000% in seven years.

Dr Anna Hutchinson, a senior clinical psychologist at Gids and part of the senior team, joined the clinic at the start of 2013 with significant experience from a number of London’s leading hospitals, including Great Ormond Street Hospital.

By late 2014, GIDS’s activity was “increasing faster than staffing”. Barnes quotes  Hutchinson, one of the many whistleblowers to have gone on the record: “Self-diagnosed adolescent trans boys — natal females — started to fill up GIDS’s waiting room with similar stories, haircuts, even names – ‘one after another after another’. They’d talk about their favourite trans YouTubers, many having adopted the same name, and how they aspired to be like them in the future.”

Cancel Culture

Barnes had submitted a detailed proposal to 22 publishers. None of them wanted to publish the book. Barnes recalls: “Of the 12 who responded, all via email, not one publisher said anything negative about the proposal. In fact, several praised it, saying that it was an important story that should be told. But, essentially, not by them. Some mentioned that other authors they published would be “sensitive” to the material, others hinted that it would be difficult to get it past junior members of staff.” She said, “Ten other publishers did not respond to my proposal, something my agent tells me is very unusual.” Mark Richards and Diana Broccardo, the owners of the small, independent publisher Swift Press agreed to publish the book. The book received uniformly positive reviews and is selling very well.

I do not think I have ever seen a positive book review in Private Eye, the UK’s biggest-selling magazine (to which I have often contributed). The reviewer (he is anonymous but I believe him to be Marcus Berkman) generally chooses a book he knows he is going to hate and proceeds to pour scorn. He has nothing but praise for Barnes’s investigations. In the light of the overwhelmingly positive reaction to the book it is surprising to learn that it was rejected by 22 publishers, many no doubt wary of the potential backlash involved in covering a story with the potential to inflame culture warriors on all sides.

The trans wars raise issues of free speech which are widely relevant in any country, even Sri Lanka. According to a December 2019 report by Equal Ground, a non-profit group that advocates for LGBTQ rights in Sri Lanka, there are some 122,000 people in Sri Lanka aged 18-65 that identify as transgender. Dimuthu Attanayake wrote about trans people in Sri Lanka suffering because of the economic crisis and resorting to sex work to make a living. This issue has been covered in the Sri Lankan media. RoarMedia (to which I have contributed) published a balanced article back in 2016. 

Ceylon Today published a series of articles by my good self in 2021.

In my next article,  I will deal with the issue of moral panic and mass delusion.

The Decline and Fall of the British State

Part the Second

A shorter version of this article was published in the Sunday Island on February 26, 2023.


Last week, I wrote that, for decades, there had been a thriving literary genre consisting of works that portrayed Britain as the sick man of Europe (as the Ottoman Empire used to be known) and, indeed, in poor health globally. Much of this declinist rhetoric came from the right but there were also voices on the left. Tom Nairn, who died on January 21 at the age of 90, was one of those voices. Nairn was a Scot who graduated in philosophy from the University of Edinburgh and , thanks to a British Council scholarship, spent a  year at the Scuola Normale Superiore in Pisa, where he learned Italian, discovered Marxism and explored the writings of Antonio Gramsci. Together with Perry Anderson at the New Left Review he developed a thesis to explain why Britain did not develop in a “normal” way. “The decline, mediocrity and archaism are also related to something else, less visible. As well as the socio-economic peculiarities of the United Kingdom, one should take into account its distinctive state. What seems to be happening in the new phase of British problems is that a long-standing illness of society is turning, rapidly and unmistakably, into a crisis of the state. For the first time outside the experience of war, ‘crisis’ has grown sufficiently acute to involve and threaten the form of state power.”

Diminishing Returns

Since 1948,  spending power has increased in the UK, doubling every 30 years. It was about twice as high in 1978 as in 1948. It was close to doubling again by 2008, before the financial crisis intervened. Since then, stagnation.The Resolution Foundation notes that average real earnings have fallen by 7% since a year ago and predicts that earnings will take four or five years to recover to the levels of January 2022.  A quarter of the people the foundation surveyed said they couldn’t afford regular savings of £10 a month, or to spend small sums on a night out, or to replace electrical goods, or to turn on the heating when they were cold.Had the pre-banking crisis trend continued, the typical Brit would by now be 40% better off than they are now. Instead, they are slipping ever backwards. What Britain has instead is a broken polity and people who cannot afford to heat their homes. Taxes are high but public services are appallingly bad. Voters have lost trust in the police (who are not investigating crimes but adding to them by raping and murdering) , the NHS, public utilities, ability to renew a passport or driving licence, the freedom to get from one place to another on time without paying a fortune and suffering extreme discomfort.

Causes of Decline 

The current government doggedly attributes the sorry state of the country to the pandemic and the Ukraine war, which they claim have led to inflation throughout the world. Critics of the regime look elsewhere and put the blame on an ongoing incompetent response to the 2008 financial crisis, the austerity policies of the Cameron government and Brexit. There is also the matter of ministers spending all their psychic energy on the problems of a hopelessly fragmented, fractious and fissiparous Tory party rather than attending to the needs of the nation. Veteran political commentator Nick Cohen makes a good point in his blog Writing from London: “It’s not wholly the fault of a succession of failed prime ministers that Ireland, a nation the British once patronised as a rural backwater, has surpassed it.” Ireland was Britain’s first colony and now it is in better health than its former master. Being part of the EU has something to do with Ireland’s success. Astra Zeneca is planning to build a new state-of-the-art manufacturing plant in Blanchardstown in Ireland rather than in Macclesfield, citing Britain’s “discouraging” tax regime.Those failed prime ministers (I have lost count) will not be able to convince voters that they are blameless for what has happened during the 13 years of their rule. The tendency is to blame someone else including a Labour Party that has had no control over events.


I exhausted myself a few years ago writing about the dangers of Brexit. I was one of the doom mongers, the Remoaners. I used to write a column on Europe for two Sri Lankan business magazines. Looking back at those columns, I am not surprised to find that all of them were critical of the EU. I was not blind to the corruption, the undemocratic lack of accountability, the arrogance. However, it was clearly the height of folly for the UK to withdraw from a successful trading bloc without having a plan.Liz Truss made a terrible hash of being prime minister but she is now back claiming that the current regime under Rishi Sunak is stifling growth by not cutting taxes. This ignores the obvious fact that growth has been retarded by willingly stepping out of the nearest (and powerful and influential and successful) trading bloc and failing to get better trade deals elsewhere. The trade deal that she negotiated with Australia did not go any way to replace the beneficial relationship with the EU. The minister, George Eustace, who negotiated it has recently said it was useless.

There were Leavers and Remainers, now we have Regretters. A poll by Savanta, found that , of people who voted to leave the bloc in 2016, 30% said they wanted the relationship with the EU  to be closer. Of those surveyed, 29%  believe Brexit is the primary reason for staff shortages in the UK, 29%  believe Brexit is the primary reason for staff shortages in the UK, impacting a range of sectors like the National Health Service and agriculture. The proportion of respondents said Brexit was partly to blame for gaps in the labour market was 34%.

There are countless convincing reports that conclude that Brexit was a disaster for the UK economy. The OBR (Office for Budget Responsibility)  has predicted that, over the 15 years from 2016, Brexit will reduce the UK’s GDP per capita by 4%. The Irish think tank the ESRI (Economic and Social Research Institute) released a report on 19 October 2022 showing reductions in trade from the UK to the EU reduced by 16% and trade from the EU to UK by 20%. Brexit has led to a significant decline in trade with the UK in almost all cases although by varying magnitudes. For most countries across the EU, the size of the impact is broadly similar for both export and imports. Ireland stands out as having had a particularly large reduction in imports from the UK relative to its other international trade patterns. Exports from Ireland to the UK, on the other hand, continue to perform in line with those of other markets with no notable impact to date of Brexit on the total levels traded.

I Deny that I Am in Denial

Jeremy Hunt, the Chancellor, declared that the UK’s new long-term economic plan is “necessitated, energized and made possible” by post-Brexit freedoms. We should face the future with bright eyes and confident smiles, because “declinism about Britain is just wrong“.What planet is he living on?

Adam Tooze summarised the argument against Hunt’s delusions: “For most of the last 60 years when critics have spoken of decline, they have tended to exaggerate the extent of the malaise. GDP and per capita income actually continued to increase. In the 1970s they did so quite buoyantly. By contrast, since 2009 there is nothing exaggerated about declinist talk. For a significant part of the British population real incomes actually fell. The shocking novelty lies in the fact that decline and stagnation are not figures of speech, but a literal reality.”

Private Affluence and Public Squalor

I am not an economist but I have seen this decline in the streets and in the shops – the pound shops, the charity shops, the food banks, the pawnbrokers. There were legions of homeless people sleeping in the street in freezing December because the government is too incompetent to provide enough affordable housing. Data collated by multi-agency database the Combined Homelessness And Information Network (Chain) and published by the Greater London Authority showed a 23% increase in the number of people permanently living on the streets in the third quarter of the 2020-21 financial year, compared to between July and September. There was also a 10% rise in the number of people who occasionally slept rough but were not deemed to be a living on the streets. I wrote in these pages how the elegant city of Bath Spa is so accustomed to homelessness that there is a statue of a homeless man and his dog.

Food banks are struggling to meet record demand from people who are in work – including NHS staff and teachers. More than 80% of people running food banks reported supporting a significant number of people using them for the first time, while many said demand was growing among pensioners and families with babies.

Rishi Sunak helped out at a soup kitchen and asked a client if he was interest in a career in financial services. The man said he was interested in finding a home. Sunak’s wife has a pair of slippers designed by JW Anderson that cost £570.

In London, people are dumping old clothes in the streets and I have seen with my own eyes seemingly respectable people picking through them. People are dumping old furniture and soiled mattresses on the street. Everybody looks drab, shabby and tired.

Every second person you see is grotesquely obese and struggling to walk. Nearly two-thirds of adults in England are overweight, according to new data from a government public health agency. There are 19 district local authorities where more than 70% of adults are overweight or obese. Copeland, Cumbria, has the most overweight people in England – 75.9% of Copeland’s population are overweight or obese. Obesity is a disease of poverty not affluence. Many people in London look unhealthy and there are countless  wheelchairs. Today’s high taxes are not purchasing quality public services. It is a Kafkaesque nightmare embarking on a train  journey. People are carrying Pringle cartons to pee into because the toilets are shut. People are dying while waiting hours for an ambulance to arrive. Those who are lucky enough to get to hospital wait for hours on a trolley in a corridor. In a declining country, even high taxes cannot provide sufficient funds to improve public services or reduce the national debt.

The water companies are giving out huge dividends to their foreign shareholders but cannot control the leaky system and the rivers and beaches are full of shit.

Secretary of State for the Environment

JK Galbraith wrote of “private opulence and public squalor.” That is Britain today and successive Tory governments, Truss’s mayfly regime being the most egregious, have pursued policies which give to the already rich and take from, not just the poor, but the middle class. They will surely pay the price for rising public anger.

When I was studying Civics at school, I was asked to consider how the Conservatives ever achieved power when the majority of the populace was working class. We were told about the deference vote. People used to vote Conservative because they thought  the party would  improve their chances of having a decent job and secure home. The stagnation in real wages since 2010 and extortionate rents and house prices have denied those ordinary ambitions to millions That old deference has disappeared. Nick Cohen: “the country regards the Conservative party with the contempt a conquered people regards an occupying army, and Labour is heading from its worst election defeat since 1935 to its first election victory since 2005.” 

The Decline and Fall of the British State

Part the First

This article was published in the Sunday Island on February 19, 2023

There is a certain class of Sri Lankan citizen who believes that their country would be better if still ruled by the British as part of its benevolent Empire.  This is pure fantasy because the Empire was never benevolent and there would be no chance of Britain ruling again in any of its former colonies. Today Britain cannot govern itself but retains its imperial arrogance in trying to tell the rest of the world how to conduct itself. The UK’s persistent  criticisms of Sri Lanka at the UNHRC while ignoring its own  misdeeds in recent times is an example of this arrogant impudence. I will not here go into the bungled invasions of Afghanistan and Iraq, the atrocities committed by British troops and the shambolic withdrawal.

I have dealt at length elsewhere with the appalling barbarity of the British, civilians, women as well as men, as well as military and police, in Kenya.

Declining Years

I took an interest in UK and US politics from my early teens and later got an Honours degree in American Studies.  I noticed even in the early 60s a vogue for writings about the decline of Britain. There was much lamentation about poor productivity, idle and obstructive workers, poor management, failing exports. Britain was much weakened by the effort put in to win the war against the Nazis and there was much resentment when the West German and Japanese economies began to do rather well while Britain agonized over poor GDP and balance of trade deficits and national debts.

The war would not have been won without the Empire but the country was so weakened by the war that it could no longer afford to run an empire. British troops, including young boys conscripted under National Service (luckily I was too young to enjoy that treat) continued to fight bloody colonial wars in Malaya and Cyprus, as well as helping the Americans out in Korea.  I missed the opportunity of joining the Glorious Glosters and winning a Victoria Cross like James Carne at the Imjin River.

Harold Wilson has not been given enough credit for keeping Britain out of Vietnam. The UK realised that it had to grant independence throughout the Empire. The Empire became the Commonwealth. Britain’s first colony, Ireland, became independent in 1922 and refused to join the Commonwealth. (It has still not joined, although other countries’ colonies such as Rwanda and Mozambique have. Ireland has also not joined NATO but has long been an enthusiastic member of the EU.)  Ireland formally became a republic in 1949, the same year that Ceylon became independent.

Good things happened such as the foundation of the National Health Service and the Welfare State but right wing critics saw these institutions as part of Britain’s problem rather than a glorious achievement. Those views have become stronger today.

Britain still tried to punch above its weight. The year 1956 is seen as a symbolic marker of Britain’s decline. Sir Anthony Eden was a weak but arrogant prime minister. When Colonel Nasser took over the Suez Canal,  Eden, expecting American support, sent in British troops to take it back. Egypt had not been officially a British colony, but it was one of those countries, Argentina was another, where Britain exerted undue influence. British intervention in Suez went very badly and the nation’s reputation never recovered.

The  IMF recently forecast that the  UK GDP would  shrink by 0.6 % over the course of this year, making it the only country in the G7 to fall into recession. This compared with 1.2 % growth in Canada, 1 % in the US and Japan, 0.9 % in France, 0.1 % in Italy and 0 % in Germany. Even Russia’s heavily sanctioned economy is expected to expand by 1 % this year.

Industrial Relations

Popular culture, with films like I’m All Right Jack, portrayed the British worker as an obstructive layabout ready to down tools at the slightest excuse. The Callaghan Labour government lost power to Thatcher’s Conservatives in 1979 because of the Winter of Discontent with local authority workers among those going on strike leaving corpses piled up in morgues and rubbish filling the streets. I remember going to see Robert Altman’s film A Wedding at a Manchester cinema and experiencing a large rat  running across my foot.

Today’s deputy prime minister (he could be gone by the time this is published) contributed to a book, Britannia Unchained, which carried on the theme of lazy British workers. Former short-lived pm Liz Truss also contributed to the book.

Look who is striking today. Nurses  and medical staff were applauded during the worst days of the pandemic but the government continues to cut their pay and will not even talk to them. Sunak’s contribution to the debate is to rehearse the old canard of the Labour Party being in hock to union paymasters.

The Office for National Statistics confirms that  2022 was the worst period of strike action since 1989 – with 850,000 working days lost in December alone. 4.1 million working days were lost to strikes in 1989. 

Sad Decline of the NHS

I spent most of 2022 in the UK and saw and experienced for myself the difficulties people are have dealing with the NHS. Rather than try to describe the problems myself. I will rely on the BMA (British Medical Association). On their website they list the following:

Chronic understaffing – Staff shortages have been growing in the NHS for years. This has been driven by inadequate workforce planning and lack of government accountability – including insufficient funding and infrastructure to train enough new doctors. This is exacerbated by poor retention. Demoralised staff do not want to stay.

Declining wellbeing – Excessive workloads are normalised by continuously requiring overstretched staff to fill gaps that should not exist. The physical and emotional toll includes rising prevalence of stress, fatigue, burnout as well as suffering mental health and wellbeing through chronic stress

Growing pressure on general practice – Stagnation in the growth of the GP workforce has meant the average number of patients per FTE (full-time equivalent) GP has increased by 15% since 2015. This puts increasing clinical and administrative burden on them and other practice staff.

Insufficient funding – Recent funding injections have been on the back of below-average growth in the health budget in recent years so the system never catches up.

Deteriorating fabric – After years of insufficient capital spending, parts of the NHS estate are increasingly unfit for purpose. The cost of bringing deteriorating assets back to suitable working order (known as the maintenance backlog) rises each year.

Shortage of beds -The number of general and acute beds available in English hospitals has been rapidly falling since 2010. The UK now has one of the lowest number of beds per head in Europe, an insufficient critical care capacity that has been exposed by the pandemic.

Long waits and waiting lists for patients – In recent years, patients have been waiting longer for emergency, routine and cancer treatment. The NHS has been increasingly struggling to treat patients within safe operational standards.

More about this and other self-inflicted wounds next week.

Upwardly Mobile Incompetents

A shorter version of this article was published in the Sunday Island on February 11 2023

I have always dressed to the left and cannot contemplate any circumstances in which I would ever vote for a member of the Conservative Party. I have always voted for the Labour Party except for one occasion when I engaged in tactical voting. When I first went to live in Wimbledon, it was a Tory stronghold. In 1982, the MP for my area was Sir Michael Havers, father of the more famous Nigel Havers, actor and TV star. I was a little creeped out to receive a letter from Sir Michael welcoming me to the constituency. How did he know I was there? Sir Michael retired and was replaced by Dr Goodson Wickes. I voted for the Liberal candidate Adrian Slade  in 1987 in the hope of preventing  the election of the good doctor but my ploy did not work, although Slade came second with a respectable 13,237 votes. The seat (miraculously) went to Labour in the 1997 Blair landslide. The seat is now Conservative again.

In 1982, I moved from Manchester to London to take up a job as assistant secretary to the SSAC (Social Security Advisory Committee) which was then chaired by Sir Arthur Armitage who was vice-chancellor of my alma mater, Manchester University. Sir Arthur introduced me to Lady Armitage thus, “Michael has the great good fortune to be a Manchester graduate.” Sir Arthur was a gruff old Tory with alarming eyebrows. The Masonic Temple on Great Queen Street, Covent Garden, was within easy walking distance of our offices. I once went into Sir Arthur’s office when I thought he was not there to find him changing into his Masonic gear ready for a meeting. I was unlikely to warm to a Tory Mason. I had taken part in student protests against Sir Arthur at Manchester University. Nevertheless, I became very fond of him and was sad when he died. He seemed to be bumbling and disorganized when chairing meetings but I found that the minutes wrote themselves because he had shaped the discussion. His successor failed miserably to manage the committee.Uncle Arthur, as Henry Hodge called him, was a lovable old Tory.

Meetings were attended by very senior civil servants. I was amused to note that these mandarins were avid followers of the BBC TV comedy Yes Minister. I recall standing at a urinal with the permanent secretary, Sir Geoffrey Otton, on my left and his undersecretary on my right. They were calling each other “Sir Humphrey”.

Ministers were often invited to SSAC “working lunches”. Wine was available but I stuck to orange juice and ate very little for fear that I might fall asleep in the afternoon. Some SSAC members were not so cautious. I recall one member (Neil Kinnock’s GP) snoring loudly after lunch. He often spent the morning sessions reading Private Eye or the New Statesman and intervening with remarks that had nothing to do with the discussion everybody else was having.

The Secretary of State at that time was Norman Fowler. He never accepted an invitation from the Committee. Tony Newton (now Lord Newton of Braintree) did attend and he was charm itself. He went out of his way to thank me.

Rhodes Boyson also attended and he was a surprise. I had seen him debating in the House of Commons on the same day that I witnessed Gordon Brown’s maiden speech in 1983 I took the easy lefty’s view of Boyson as a reactionary cretin. He had a very successful career in teaching and had adopted a Dickensian persona which made it easy to compare him with Wackford Squeers, the brutal headmaster of Dotheboys Hall in Nicholas Nickleby. When he came to lunch he was very affable. I was doing my best to keep in the background. I tried to introduce him to Sir Arthur but he surged forward and said “Never mind about him . Who ois this fellow here!”

I subscribed when a sixth former) the Critical Quaternary edited by CB Cox and AE Dyson hose two fellows collaborate with Boyson to publish the Black Papers which argued a hard line on education. I was rather hurt when my hero Brian Cox called me an idle bastard when he was less than impressed with an essay I had written on TS Eliot while at Manchester University. Described in a Guardian obituary as “more intelligent than he was shrewd.”

One of the SSAC members I got on well with was Henry Hodge, who was well known as a human rights lawyer. He later became a judge which was unusual for someone who was a solicitor not a barrister. His wife was Margaret Hodge who was then leader of Islington council, which was characterised by the right-wing press as “Loony Left”. SSAC held a meeting every year in Belfast and I went there twice. We had dinner at a hotel out in the country and Chris Patten, who was then a junior minister at the Northern Ireland Department, was invited. Henry introduced me to his old friend from their Balliol, Oxford days. I noticed when I went to the toilet that a large man was cleaning a gun. This was Patten’s minder. Patten said that he had that very day upset the Reverend Ian Paisley by saying “Derry” instead of “Londonderry”.  Derry is what Catholics call the city. Patten is a Catholic.

Another SSAC member I got on well with was the Reverend Harold Good. I have communicated with Harold in recent years. He is mentioned in two books about the Northern Ireland peace process as being a crucial actor in the talks on decommissioning of IRA arms. Although he is a protestant, Harold said he was proud to call Martin McGuinness his friend.

We had meetings at Stormont  and during a break I went to the gents. I hope that I do not give the impression that I am constantly hanging around toilets. While I was relieving myself, a cheery voice called out, “good morning to you.” I responded and noted that my greeter was none other than the Reverend Martin Smyth, Grand Master of the Orange Lodge. Nearly a decade later, I enjoyed a concert of Portuguese Polyphony at St John’s, Smith Square. As I was walking from the venue, along the Thames beside Parliament, a cheery voice called out, “good evening to you.” It was the Reverend Martin Smyth. Was the man stalking me?

Tories Used to Be Human

In subsequent jobs, I had many encounters with ministers. These were Conservatives under the premierships of Margaret Thatcher and John Major. When I was working on fraud prevention, Sir Nicholas Lyell, the attorney general, praised my work. What was notable at that time was that Conservative ministers took a firmly liberal line on human rights issues. There was considerable public pressure to introduce identity cards to combat benefit fraud. Lyell and other ministers consistently resisted such calls.

The current Tory government is bringing in a a law that will require all voters to show photographic identification to cast a vote, beginning with local elections in England next May. Under the new law, which has been called “legalised voter suppression’ by opponents, voters will be compelled to show a piece of Government-approved photographic ID before being allowed to vote.A new poll conducted by pollsters Omnisis, finds that with just 10 weeks to go until polling stations open for the May local elections, 52% of all voters under 40 remain unaware of the new requirements.The youngest cohort of voters are the least likely to be aware of the need to show ID. 63% of voters between the ages of 18 and 24 are as yet unaware of the new requirements, according to the poll. This compares to just 34% of those over the age of 40. The lack of awareness among young people is particularly alarming given the limitations placed on which forms of ID will be accepted at polling stations.While various forms of ID, such as pensioner bus passes, are included in the official list of accepted IDs, young people’s bus passes and other forms of ID widely used by young people have been excluded.

When I was a ministerial adviser on child protection I provided briefing and wrote speeches for John Bowis. He was also open to liberal views. He insisted on me accompanying him when he met a Conservative MP who was arguing a case for an aggrieved constituent. The MP walked off with my umbrella. Sometime later, I was watching the news while staying with friends in the Cotswolds. The main headline was that Alan Howarth (now Lord Howarth of Newport) had left the Conservative Party and joined the Labour Party. “That’s the man who stole my umbrella!” I ejaculated.

I wrote a speech for Bowis to give to a charity called Parentline and I was in the audience when he delivered it. It was gratifying to hear people laughing at my jokes. One of the celebrity patrons of Parentline was Jane Asher, an actress who was once famous for being Paul McCartney’s girlfriend. She later married the cartoonist Gerald Scarfe and achieved fame for making cakes on TV. She donated a cake to Parentline and then sent them an invoice.

Bowis lost his Westminster seat in the 1997 Blair landslide and later served as a member of the EU parliament. My friend worked as his diary secretary in Whitehall and said he was a decent man who was a pleasure to work for (unlike Dominic Raab). There was no indication that Bowis was gay and I don’t think he was – he was married with three children- but he was well-respected by the LGBT community for his support. He served as president of Gay Conservatives, an LGBT group within the Conservative Party.

I one wrote a speech for John Major. Right at the end of my working life, I wrote a speech for Baroness Julia Cumberlege, responding to criticism by Esther Rantzen. Late one evening, I had to sit in “The Box” in the House of Lords while she delivered my speech. My job in The Box was to hand her scribbled notes to help her respond to questions from the Noble Lords. Two interventions I recall were from Gerry Fitt who had been a leading politician in Northern Ireland and Len Murray who had been general secretary of the Trades Union Congress.

Julia (I was also on first name terms with two other Lordships – Herbert Laming and Liam Donaldson) was pleased with the way the event had gone and rewarded me with a huge gin and tonic in the Lords bar. I clinked glasses with Robin Eames, The High Primate of All Ireland (a bishop not a monkey).

I had an interesting conversation with an official from the Home Office about her boss, Michael Howard, who had been criticized by one of his junior ministers, who had said that there was “something of the night” about the then Home Secretary. Howard was somewhat oleaginous but he compares well with successors such as Theresa May, Priti Patel and Suella Braverman. He also had the courage and integrity to sack Boris Johnson for lying to him.

Purging of the Talents

It is a different Tory party today, much further to the right. Human rights are under threat. Boris Johnson in his determination to “get Brexit done” at whatever cost purged the Conservative Party of all its decent and competent people. He removed the whip from 21 MPs. Removing the whip used to be rare – between 1979 and 2019 only 20 Tory MPs ever had the whip removed. The party lost a lot of talent – Philip Hammond, Dominic Grieve, Oliver Letwin, Kenneth Clarke, Nicholas Soames (Winston Churchill’s grandson), Alistair Burt (met him), Justine Greening, Amber Rudd, David Gauke, Rory Stewart, Caroline Nokes, Ed Vaizey.

Rogues’ Gallery

Today the parliamentary Conservative Party is a nest of unprincipled chancers, spivs and sexual predators. Boris Johnson was chancer in chief and is reportedly trying to take over his fan Nadine Dorries’s safe constituency in order to make a comeback. The list of rogues seems endless. David Warburton was accused by two women of sexual harassment and cocaine use; Charlie Elphicke was jailed for two years after being found guilty of three counts of sexual assault – his wife took over his seat; Matt Hancock was caught on camera embracing a woman not his wife. More seriously, as health secretary he handed out Covid contracts to his cronies and billions of taxpayers’ money was lost to fraud and waste; Chris Pincher drunkenly groped two men; Julian Knight, had the whip removed after a complaint to the Metropolitan Police. He claims that he has received blackmail threats; a still unnamed Tory MP was charged with rape; Neil Parish was caught watching porn in the House of Commons; Rob Roberts was accused of making unwanted advances to a man; Imran Ahmad Khan was jailed for 18 months for groping a 15-year-old boy; Conor Burns was cleared of allegations that he had put his hand on a man’s thigh. He claimed that the allegations were part of a politically motivated “stitch-up”.

Failing Upwards

In a recent exchange at prime minister’s questions Keir Starmer showed how failures in the probation service led to the rape and murder of Zara Aleena. The man mainly responsible for that was Christopher “Failing” Grayling. The political commentator, Ian Dunt, wrote : “Grayling is at the top of that system of failure. He is that little bit more intellectually, presentationally and ideologically useless than all the others and therefore deserves special mention. But he is merely the totem of a culture that has singularly failed the country.”

Patrick Cockburn in the i-paper describes Liz Truss’s attempted comeback as “frightening indication of how far political promotion has been detached from actual performance.” He describes her tunnel vision as being “not so different from straight stupidity… it can also attract those who mistake inflexibility for determination in pursuit of a well thought-out plan.” Britain is a country in decline and people are wishing for a “golden bullet” to reverse that decline. Some thought Brexit was the magic cure but, as well as ruining the economy, it blighted the political class by elevating “a leadership cadre poorer in quality than any other in British history. Saner and abler politicians and civil servants were systematically sieved out.”

Overall Climate of Sleaze

A shorter version of this article appeared in the Sunday Island on February 5, 2023.

When asked  about Conservative Party chairman Nadhim Zahawi’s  £5 million payment to HMRC (His Majesty’s Revenue and Customs) by Labour MP Alex Sobel at prime minister’s questions (PMQs) on Wednesday, January 18, Rishi Sunak said his “honourable friend” had already addressed the matter in full, and there was nothing more Sunak could add. Nothing to see, move on. At prime minister’s questions on Wednesday January 25, 2023, Sunak’s line was that he had passed the matter on to Sir Laurie Magnus, his ethics advisor, for a full investigation so he was not able to discuss it. Move on.

Magnus found that Zahawi breached the ministerial code on seven separate occasions by repeatedly failing to declare his tax affairs. Magnus also decided that Zahawi had lied to the media by denying that he was under investigation by HMRC. Subsequently, he failed to correct the record.

“The subsequent fact that the investigation concluded with a penalty in relation to the tax affairs of a Minister also requires declaration and discussion. It is a relevant interest which could give rise to a conflict, and particularly so in the case of HM Treasury Ministers and the Chancellor of the Exchequer, who has responsibility for the UK tax system. As a result of my inquiries, I conclude that Mr Zahawi failed to update his declaration of interest form appropriately after this settlement was agreed… that details of the earlier HMRC investigation and its outcome were declared.”

Magnus damningly continued: “I also conclude that, in the appointments process for the governments formed in September 2022 and October 2022, Mr Zahawi failed to disclose relevant information – in this case the nature of the investigation and its outcome in a penalty – at the time of his appointment, including to Cabinet Office officials who support that process. Without knowledge of that information, the Cabinet Office was not in a position to inform the appointing Prime Minister.”

Going back to 2021 Zahawi was under investigation but did not declare it to permanent secretaries. He claimed complete declaration of interest but did not mention the investigation. There is a credibility gap here as yawning as the Grand Canyon. Why did Sunak appoint him? Why did he not ask more questions?

Zahawi blamed the media. He claims that he told Sunak about the tax problems before Sunak made him chairman. He is still an MP. The whip has not been withdrawn.

At PMQs on February 1, Sunak dodged jibes that the whole world knew about Zahawi’s tax dodging but he appointed him anyway.

Vigilante Man

Within hours of my article on this issue  being published in the Sunday Island last week, Rishi Sunak sacked Nadhim Zahawi. I will not claim the sole credit for that. If any one man can claim credit for the toppling of Zahawi it is Dan Neidle. Who he? Neidle is a retired tax lawyer. Neidle spotted an item in the Independent newspaper which aroused his interest. The report claimed that Zahawi had been the subject of an investigation by the National Crime Agency, the Serious Fraud Office and HMRC. Neidle started digging at Companies House and elsewhere and found that Zahawi was linked to a Gibraltar-based  company called Balshore Investments, which held shares in YouGov, the polling firm Zahawi founded in 2000. Balshore was owned by a trust controlled by Zahawi’s parents. Balshore Investments held the founder shares in YouGov, which normally Zahawi would have received himself. Balshore had made a £99,000 gift to Zahawi out of its YouGov dividends — direct evidence that  he benefited from the trust. Because Balshore was based in Gibraltar, about £24 million of gains on its YouGov shares, plus dividends, went completely untaxed.

Neidle also discovered that  around the same time, Zahawi’s UK property business had received £26 million of unsecured loans from an undisclosed source. Neidle’s  theory was that Zahawi did not want to be taxed on profits from his  YouGov shares, so he put them in the company owned by his parents’ trust; he still regarded them as his assets, so he accessed the  cash through gifts and (unsecured) loans. Neidle knew that “there are half-a-dozen tax rules designed to stop this sort of thing.” Neidle surmised, accurately as it turned out, that there was approximately £3.7 million in tax that Zahawi should have paid.

SLAPP in the Face

Neidle published his  findings on his Tax Policy Associates website on July 10 and posted a thread on Twitter. He posted further  findings on July 13. On July 16, he received a message from a libel partner at Osborne Clarke, who wanted to speak “off the record”. Later that day Osborne Clarke sent an email demanding that Neidle retract his allegation of “dishonesty” that same day and said that if he published the email there would be  “serious consequences”.

The term SLAPP (strategic lawsuit against public participation) refers to a lawsuit issued with the intention of scaring off critics and publishers. Neidle is clearly no shrinking violet. On July 22, he alerted the SRA (Solicitors Regulation Authority) to the fact that Osborne Clarke were sending secret libel letters. On November 29, the SRA sent out a general note warning solicitors to stop sending libel letters that falsely claim to be confidential.

“You ain’t seen me, right?”

Neidle thinks that the libel issue is the most important in this case. He told Times Radio, “I had no idea that a senior politician could say things that were just not true and threaten to take legal action on that basis.” Neidle was not one to be cowed. “Zahawi and his advisers made the tactical mistake of accidentally SLAPPing someone with plenty of financial resources, time, litigation experience, and plenty of contacts and friends in the legal, tax and media worlds. I’m sure Zahawi spent a small fortune on advisers — but my team would probably have cost ten  times as much (had they charged me). Goliath accidentally started a fight with a bigger Goliath.”

This is  a government of bullies, con men  and liars. Bad news  about the deputy prime minister, “randomly rude Raab”, continues to surface.

Incompetence at the Heart of the British State

HMRC insiders  said major blunders had led to its releasing incorrect information. Officials say the department failed to reveal to the Financial Times in response to a legitimate query that Zahawi was under investigation because they did not do a broad enough search. HMRC now admits that it failed to properly look into the issue. The organisation responsible for collecting the nation’s taxes was too incompetent to answer a basic question.

The HMRC investigation into Zahawi began in April 2021, and he had a meeting with officials in June 2021. Did they fail to make it clear that he was under investigation? Zahawi told Magnus that  he had failed to realise it was a formal investigation. Magnus said he should have realised it was an investigation and treated it as a “serious matter”. It looks as though Zahawi may have started negotiating a settlement with HMRC while he was chancellor, from July 5 to September 6, 2022. That is a monstrous conflict of interest. It is unbelievable that Sunak knew nothing about this. Every journalist in London knew that the man responsible for the nation’s taxes had paid a huge fine for tax dodging.

Careless People

Zahawi tried to downplay the HMRC’s fine by saying that they had not criticised him harshly because they said his “error” was “careless and not deliberate”. This is disingenuous on Zahawi’s part as he must be aware (as a successful millionaire businessman who was briefly chancellor of the exchequer) that HMRC are using technical terms. They are not absolving him in any way. If they had judged that his offence was deliberate the penalty would have been even higher. By any normal standards Zahawi’s efforts to avoid tax were premeditated and persistent not accidental. Jim Harra, First Permanent Secretary and Chief Executive of HMRC, told MPs , “there are no penalties for innocent errors.”

Agile Con Men

Zahawi was careless back in 2013 when he got caught up in the MPs’ expenses scandal and “apologised unreservedly” after it was reported that he claimed £5,822 expenses for electricity for his riding school stables and a yard manager’s mobile home. It is unbelievable that a man of his immense wealth would cheat the taxpayer of such a petty amount.

A joint investigation by Open Democracy, Source Material and the Times has revealed further murky financial dealings by Zahawi. Crowd2Fund was set up by Chris Hancock, the brother of Zahawi’s political ally Matt Hancock (who was health secretary responsible for Covid restrictions until he was caught on camera breaking the rules himself by snogging and groping his lover’s buttocks in his office)  and has benefited from political decisions. It was, for instance, one of ten companies selected to take part in a Treasury and Department of International Trade programme aimed at giving fintech businesses the chance to profit from the Australian market.

One of Zahawi’s most significant moves in his brief period as chancellor was to introduce legislation to further deregulate financial services. He claimed the Financial Services and Markets Bill would “unleash growth” by replacing EU laws with “agile” regulation for the UK. That seems like a careful move to protect his own profits. This is not just carelessness.

The Zahawi affair gave Keir Starmer the opportunity to embarrass Sunak by referring to Sunak’s own family’s tax affairs. Sunak’s wife, Akshata Murty,  has £700m worth of shares in Infosys, the Indian tech company founded by her father. These have earned her tens of millions of pounds in dividends in recent years. In April last year, it was revealed that Murty saved millions of pounds while living in No 11 as the Chancellor of the Exchequer’s (the man responsible for gathering taxes) wife by using non-dom status to minimise her tax bill. News has just broken that Infosys is in dispute with HMRC over a corporation tax bill of about £20m.

These are people who are careless about the sufferings of others but who take great care to maximise their profits. Paul Waugh wrote in the i-paper about yet another diversionary Tory campaign against “”benefit scroungers”: “The image of a millionaire Prime Minister scapegoating some of the poorest in society for his own lack of a coherent childcare, skills and welfare policy is not a nice look. It’s neither the “compassionate Conservatism” nor the pragmatic politics that Sunak’s supporters had hoped for.”

Lack of Trust

A survey conducted by pollsters Omnisis, found that 65% of British voters now agree with the statement that Rishi Sunak’s party is “institutionally corrupt”, with just 18% disagreeing. Just 31% say the same of the Labour Party. Omnisis found that 72% also agreed with the statement that senior members of the Conservative party are “more interested in personal gain than serving the public” with just 16% disagreeing. There is also a strong public perception that more psychic energy and public funds are being concentrated on the fate of the Conservative Party that on the well-being of the nation or its people.

Sunak’s basis of support was and is shaky. His political skills are meagre and he has few allies. He appointed some dodgy characters in order to become leader and has clung on to some of them in a doomed attempt to unify the party. One of his dodgy allies is Dominic Raab, who is unlikely to survive the report into allegations of bullying against him. Starmer made strong challenges on this at this week’s PMQs and will continue the attack in coming weeks.

Integrity, Professionalism and Accountability

A shorter version of this article appeared in the Sunday Island on January 29, 2023. Just after my article was published, Nadhim Zahawi was sacked. I claim no credit for this.

When Rishi Sunak  became prime minister of the UK, he stood outside  Number 10  and promised, as the anti-Johnson, the not-Truss, to deliver, “integrity, professionalism and accountability” at every level. As Paul Waugh put it in the i-paper: “Every inch the former Head Boy he was at school, Sunak from the outset staked his premiership on being someone who followed the rules rather than broke them. The other clear promise was that he was a fixer of problems, not a creator of them.” How is that working out?

The W Word

When Boris Johnson was shambling towards being an ex-prime minister, many surmised that opposition leader Sir Keir Starmer would be sorry to see him go. People pontificated that it was easy for Starmer to look good, competent and, well, normal, when up against Johnson’s buffoonery. When Johnson was finally ousted, there were suggestions that Starmer would be done for if the Conservative party chose any halfway competent leader. In his leadership campaign,  Sunak claimed that he would be able to outshine Starmer in a general election, whereas Liz Truss would not. We did not have to wait for a general election for Truss to demonstrate that she was a disastrous choice. She lasted a mere 44 days in office – long enough to wreck the UK economy.

If Starmer  can make allegations of weakness that stick, voters will think that, if the prime minister cannot control his own ministers, how can he show he has a firm grip on the government of the country? This is probably a conscious echo of  Tony Blair saying about John Major in 1995: “I lead my party, he follows his”. Starmer has broken the taboo of the Corbyn years and started talking about the successes and competence of the previous Labour government, led by the Iraq-invading Bush-poodle Tony Blair, compared to the shambolic Conservative government of 2023, now into its omnishambles thirteenth year, with its second prime minister chosen by the party not the electorate.


At prime minister’s questions (PMQs) on Wednesday January 25, 2023, Starmer’s first question was about a report by the chief inspector of probation into the murder of Zara Aleena. Sunak came prepared with the usual blah. Lessons will be learnt, deepest sympathy for the family, terrible tragedy, talented young woman’s life cut short,  blah-de-blah. In my days as a civil servant I churned out that kind of crap by the yard. Sunak is not much of a politician but goes in for a lot of politician’s hot air and bloviation, while accusing Starmer of playing politics. Starmer is an accomplished lawyer who received his knighthood for his service as Director of Public Prosecutions and he was not going to let the prime minister get away with his feeble response.

Starmer quoted Zara’s family, who said that ministers had blood on their hands. Jordan McSweeney sexually assaulted and murdered Zara nine days after being released on licence from prison. He had 28 previous convictions for 69 separate offences going back 17 years. Starmer quoted the report’s criticisms of  systemic failures in the probation system. The report described staff shortages and judged that privatisation had led to inefficiency and  evasion of responsibility by ministers. The name of Christopher Grayling was not mentioned but I will call him to account.

Failing Grayling Part Two

Focusing on a vital public service which is on  its knees after 13 years of Tory rule is a line that can be used in many contexts. Stuff isn’t working, there are excessive workloads and staff shortages throughout the UK, demonstrably caused by Tory policies of spending cuts, outsourcing to cronies who don’t know how to do the job,  and ending the free movement of labour.

Nadhim Zahawi

Starmer  moved on to the subject of tax dodging. This is a sensitive area for Sunak as he was embarrassed when he was chancellor by revelations about his wife’s financial arrangements. It has been estimated that she avoided paying £ 2.1 million a year in UK taxes (perfectly legally of course, but then, the laws were overseen by her husband).

Nadhim Zahawi briefly held that post, the one where he was responsible for bringing in taxes to support the welfare of the nation. It now seems that, at that time, he was under investigation for avoiding taxes. The Guardian estimated that the total amount he paid after being caught out was £5 million  – the amount owing was estimated to be £3.7 million, to which a 30% penalty was applied, as well as interest. It seems Zahawi has been lying about his offshore investments.

Starmer stuck the knife in and twisted it. “His failure to sack him, when the whole country can see what’s going on shows how desperately weak he is.” Starmer  snarled,  “we all know why” the PM was reluctant to ask Zahawi questions about his tax affairs.  Starmer said that someone not paying taxes should  not be in charge of taxes. He referred to family tax dodging, clearly a dig at Sunak and his wife. The prime minister’s tax returns are due to be published soon. The Sunday Times estimates that the prime minister and his wife are worth £ 730 million. How can he empathise with people who cannot pay their fuel bills? How can he understand why nurses and rail workers are striking for better pay?


Starmer took the opportunity on 25 January  to reprise his attacks from January 18. Starmer had asked then: “It’s three minutes past 12. If somebody phones 999 now because they have chest pains and fear it might be a heart attack, when would the prime minister expect an ambulance to arrive?” The government was, Sunak replied, “rapidly implementing measures to improve the delivery of ambulance times”. Optimistic Ukridgean promises about what might happen in the  future, ignoring what actually happened in the real world in the past 13 years.  As Sunak would not answer the straight question, Starmer did. In Peterborough, a patient calling at 12.03 would not get an ambulance until 14.10, in Northampton 14.20 and Plymouth 14.40. Starmer concluded by telling the story of Stephanie, aged 26, who died while waiting for an ambulance.

Sunak uses private health care.

Sunak’s only response was  to blame the unions representing nurses and paramedics taking industrial action against a government which will not negotiate with them on their claim for a living wage. The Labour leader said: “So that’s his answer to Stephanie’s family: deflect, blame others, never take responsibility. If he won’t answer any questions, will he at least apologise for the lethal chaos under his watch?”

Johnson Hangover

Sunak is a teetotaler but managed to get himself fined for attending one of the drunken parties that contributed to Johnson’s downfall. Sunak  is suffering a hangover because he retained too many tainted figures from Johnson’s soiled regime. He brought in damagingly compromised characters to try to heal the rifts in the party. There is not a great deal of talent from which Sunak can choose.

There was surprise when Johnson gave Gavin Williamson a knighthood. The former fireplace salesman and adulterer was generally seen as a comic figure. He is often referred to as Private Pike, after the cretinous Home Guard in the TV series Dad’s Army. He told the Russians to just go away, They didn’t. I see him more as Frank Spencer the hapless and disaster-prone husband and father in Some Mothers Do  ‘Ave ‘Em.  Now a brutal side has been revealed with a number of allegations of bullying. The Guardian alleged that, while serving as defence secretary, he told a senior Ministry of Defence official to “slit your throat” and “jump out of a window”.

Anne Milton, the former deputy chief whip,  made damning claims about how Sir Gavin behaved when he was her boss. He kept a tarantula in a jar in his office and a bull whip on his desk. He threatened blackmail about MPs’ sex lives and used financial inducements to establish control. He boasted of “owning’ an MP who had got into financial difficulty. More recently, there were leaked messages in which he used foul language to deride Liz Truss’s chief whip, Wendy Morton, over a failure to invite him to the Queen’s funeral

He was sacked as Defence Secretary by Theresa May for leaking national secrets. He was sacked as education secretary by Boris Johnson for his  calamitous mismanagement of the exams season during the pandemic. People were baffled when Sunak brought him back as Minister without Portfolio – some said, Minister without a Clue. It seems that Sunak had the vain hope that Williamson would use his bullying skills to bring discipline to the warring Tory factions.

Another alleged bully is deputy prime minister, Dominic Raab. Marina Hyde often fantasises about Raab being a serial killer having a lock-up with a freezer full of bodies. We have during interviews seen how a vein throbs in his forehead as he tries to control his anger.  Unlike Prince Andrew, he  sweats a lot when under pressure and sometimes the words won’t come out as he tries to suppress his rage. As I write, I am reading a report that 24 civil servants, some in senior roles have made complaints that Raab  “belittled and demeaned them” and was “very rude and aggressive” on many occasions each day. Some sources say there are more than 30 complaints, some people claiming to have been physically sick before meetings, regularly in tears and, in more than one case, feeling suicidal. The complaints cover his time as Brexit secretary as well as foreign secretary and justice secretary. The inquiry report by Adam Tolley KC , which is expected soon, could result in Raab being sacked.

“Cruella” Braverman is the daughter of immigrants but her main aim in life is to stop immigration. There have been many doubts about her abilities and there were allegations that she has faked her CV. There was some surprise when Liz Truss appointed her home secretary but she was sacked over allegations that she leaked government secrets through her private email. There was even greater surprise when Sunak reappointed her as home secretary despite her serious breach of the ministerial code.

When Will the Pain Be Killed?

Stephen Bush wrote in the Financial Times, “Sunak is essentially the political equivalent of a painkiller. He is easing some of the symptoms of the Conservative party’s electoral malaise, but he becomes less effective at doing that from overuse.” It is small comfort, and not a good omen for a general election, that Sunak  is seen merely the best available leader the Tories have for the foreseeable future.  The gene pool was much diminished by Johnson’s purges to get his oven-ready Brexit done-deal. According to Bush, Sunak “has helped to drag the Conservative party poll rating from the depths of ‘apocalyptically bad’ to merely ‘utterly dreadful’.“ That is progress.

At PMQs, Starmer kept repeating he word “weak” and finished by asking  Sunak if the job was too big for him. This was seen by some as a non-PC reference to Sunak’s diminutive physical stature. Sunak did not answer – he rarely does. Weak, filthy rich, geeky and lacking in empathy. He is not of our world, and the voters will eventually notice that he is bit, how shall I put it, weird. They have not been given the opportunity to voice their opinion as the Tories continue to shuffle their no-hopers without electoral consent. Democracy UK-style.


Finding Arthur

A review of a novel by Shama Perera

As I was reading Finding Arthur, the word picaresque kept coming unbidden to my mind, because the plot revolves around a journey during which interesting and scary things happen to the protagonists. The author, Shama Perera, told me that one of her aims in writing the book was to take the reader on a journey around Sri Lanka. “The whole project was motivated by trying to get many readers to fall in love with Sri Lanka and want to visit.” Picaresque is not quite the mot juste though, because the definition of the literary term is “an episodic style of fiction dealing with the adventures of a rough and dishonest but appealing hero.” The definition of picaresque was first coined in English in 1810 and is still used in modern literature today. Examples would be Don Quixote or Tom Jones. Arthur is certainly appealing but not a quite a picaro – he is not rough or dishonest. Arthur is morally impeccable and loyal.

Arthur is a Golden Labrador.

Searching Every Which Way

Perhaps Finding Arthur belongs to the category of  Quest Literature. Examples of Quest Literature would be Beowulf, The Grail Legend, Lord of the Rings, Harry Potter and the Deathly Hallow, and, in cinema, John Ford’s masterpiece,  The Searchers. Arthur goes missing and the search for him takes a family all over the island and into some hair-raising situations, introducing them to some bizarre characters. More significantly, the quest brings out some features of relationships between friends and family which would not have been revealed had not Arthur’s kidnapping provided the catalyst. “There have been too many secrets kept in this family for too long.”


Brothers Dilan and Sujith run a bar in Mount Lavinia. The bar is named after Arthur the Golden Labrador who has been with them since  they were all puppies. Their parents, Amal and Nilani  Alwis, have been separated for some time but are not hostile to each other, even though their paths have not crossed much. Nevertheless, Nilani can write, “Words cannot express my disappointment in you and what you have done to our sons. I know everything.” There is a good deal of   banter among the family members. “We installed a security camera a few years ago to capture the lane because Thathi was concerned that there were undesirables wandering around the property. This was a dig at their bar and the customers they were attracting.” The boys can joke about their mother having affairs but, ”Amma chuckled to herself. They all knew full well that the only visitor to see her bedroom had been the occasional cockroach.”  Amal says to Ronnie, “‘We were happy, machan, we were very happy until we weren’t. I can’t even pinpoint when things started to change between us.”

Bibi (Brigitte) is the daughter of the forbidding Dr Fernando. Dr Fernando’s wife, Tana,  was killed in an accident and he has not recovered from his grief at losing her so young, still sad after ten years. Dr Fernando is not the ogre Dilan takes him for  but Dilan “had had a brief platonic liaison with one of the neighbour’s daughters and she had threatened to cut his bits off should he ever come near her again.” Bibi is pregnant and her father clearly thinks Dilan is a prime suspect for paternity.Dr Fernando takes a compassionate and relaxed attitude to Bibi’s pregnancy and does not press her to reveal the identity of the father. Bibi says, “He asked me who the father is, and when I refused to tell him, he just left the subject alone and has been carrying on as normal ever since.”

There are many intriguing plot twists but I do not want to spoil your enjoyment by giving away any surprises. The opening words intriguingly hint at the finale of the story: “The man had climbed over public safety barriers and up a dangerous stretch of rock to get there. He remains still in a trance for the longest time before inching his toes closer to the edge, until they peep over the stone. All he would need to do now is tilt forward.” The publicity material on the book mentions a heart-warming and engaging story and beautiful landscapes but there is clearly dark matter here amid the fun.One of the characters we encounter in passing on the trail of the missing Arthur is a brothel owner called Royce Perera. The questers think Arthur is inside Perera’s house and are surprised at the lack of security at the premises. “Mr Perera doesn’t worry about thieves; they all work for him anyway. There are no cameras anywhere on our street.”

Uncle Ronnie, a policeman married to Nilani’s sister, Bernie,  arranges for the searchers to have the services of a driver who has a number of useful skills and has experience of “special projects.” “Nimal is an exceptional driver; he speaks fluent Sinhala and Tamil and he is trained for combat as he is ex-special forces. Yes, he has a reputation for being able to handle himself––”.  Nimal proves to be a surprise: “Nimal was what can only be described as a jolly-looking fellow. He was on the small side, probably Amma’s height at around 5ft 4″ and a little rotund. He reminded them very much of a rather enthusiastic Labrador as he bounced about stacking boxes and having a chat with them all. Rather ironic given the nature of their trip. Nimal certainly didn’t look like an assassin.” Rather than the thug they were expecting, Nimal seemed to be a recruit from a meditation class although he did seem a little too efficient in putting an injured peacock out of its misery with a deft twist of the neck.

Shama writes with a light touch but some of the imagined permutations of relationships are dark enough for  August Strindberg or Tennessee Williams and some of the twists are complicated enough for a Shakespeare comedy. Another serious aspect among the frivolity is the theme of suicide. One of the reasons that Arthur is such a pillar of moral fortitude is that he saved Dilan’s life when he was feeling in the depths of despair. “Arthur, who had been sleeping in Dilan’s room, had woken up and started to watch Dilan. He gently stood up and walked over to him, placing his head on Dilan’s lap. But Dilan didn’t budge. He had continued to stare at the tablets in his hand. Arthur jumped up onto Dilan and started to lick his face which caused Dilan to come out of his trance…”

According to the publisher’s blurb, Finding Arthur is based on real events. I asked the author about this and she confirmed that there is a real Labrador called Arthur and he was taken in a three-wheeler and traced to the Northern province. However, she stated categorically that her father, the  late Royce Perera, who sadly left us during the pandemic, had never owned  a single brothel.

Shama Perera is a mother of three who lives in London. For 20 years she has worked in the corporate world, particularly in international law.  Shama’s first writing project was in 2018 when she produced a children’s book called Big Bad Bunty’s Boat Trip from Brazil. She was invited to participate in the Children’s programme at the Galle Literary festival in 2019 and enjoyed being amongst renowned writers like Anthony Horowitz and Sir David Hare. Finding Arthur was written during lockdown in London.  Shama has adapted the story into a six-part TV series in order to give potential tourists a visual introduction to the country. This is a well-organised piece of work, combining light and shade, with engaging characters, humour and serious themes. I look forward to the TV version. I will even buy myself a TV set.

Finding Arthur by Shama Perera is published by The Conrad Press and is available from Amazon and can be downloaded from Kindle. 

Recruiting Foreign Health Staff

Every foreign nurse gained by the NHS is a nurse lost to a poorer country.

On November 8, 2022, in her column in I-News, Yasmin Alibhai-Brown took strong exception to comments made by Keir Starmer on BBC Scotland’s The Sunday Show.  Starmer had said that the NHS is “recruiting too many people from overseas” and we should be “training people in this country”. Ms Alibhai-Brown took this as an indication that Starmer was racist and described him as “a Labour leader who seems to walk only rightwards even when the party is way ahead in the polls.” She mentioned that the SNP MP Stewart McDonald tweeted about a “grubby dog-whistling for votes.”

In an interview on November 6, 2022, with BBC Scotland’s The Sunday Show, Sir Keir said he would like to see immigration numbers go down in some sectors – including in the NHS. “We need a long-term plan.”

According to Adam Bychawski on Open Democracy, “Since 2017, 50,000 of the nurses who registered to practise in the UK were trained in countries that have too few of their own nurses to provide the standard of healthcare recommended by the United Nations.“

The latest NHS Digital shows the NHS in England faces a shortfall of 46,828 nurses and midwives as of June 2022, which is a vacancy rate of 11.8%, while NMC (National Midwifery Council) data from October revealed that international recruitment has increased 135% in the last year. According to a Nuffield Trust report, foreign nurses are contracted to work longer hours.

I have lived in Sri Lanka for over 20 years. When I told English friends that I was moving to Sri Lanka one said: “How can you risk leaving behind the National Health Service?” As it turned out, I found the Sri Lankan health service to be excellent whenever, which fortunately was not often, I had to use it. When I lived up in the mountains, I received first class treatment free of charge at Bandarawela Cottage Hospital when I slipped and cracked my head open. In similar circumstances in England I would have had to wait for hours in Accident and Emergency in the company of violent drunks (patients not doctors) and screaming children.

The Sri Lankan authorities responded far more effectively to the 2004 tsunami than did US authorities to Hurricane Katrina. Sri Lanka’s past investments in a broad-based public health system and community awareness of basic sanitary and hygienic practices ensured that there were no disease outbreaks. Essential medical aid, emergency food, and other relief supplies were mobilized within a day. We made several visits to Hambantota and witnessed the relief operation.  It was possible to feed, clothe, and shelter survivors; provide the injured with medical attention; and ensure that the thousands of bodies were quickly cremated or buried.

Despite international criticism, the health services coped well in 2009 with the closing stages of the war against the LTTE (Liberation Tigers of Tamil Eelam) and the aftermath of the 300,000 internally displaced persons (IDPs). The extremely dire outbreaks of disease in the IDP camps predicted by foreign NGOs just did not materialize thanks to an efficient health service.

The then prime minister, Prime Minister Wickramanayaka claimed that public financing for healthcare began in Sri Lanka more than 2,000 years ago when Buddhist kings established public hospitals and maintained them with royal revenues. Ancient records show that 18 hospitals were established by King Dutugemunu in the second century BC This tradition was strongly influenced by Buddhist culture which accords high priority to actively caring for the needy, the poor and the sick.

According to the World Health Organisation, a modern health service can be said to have started in Sri Lanka in 1858 with the creation of the Civil Medical Department under a Principal Civil Medical Officer (PCMO). The department initially concentrated on the establishment of new hospitals in large towns. Primary care facilities at village level were initiated in 1877. Initially, preventive medicine was confined to measures aimed at preventing the spread of major communicable diseases. Sri Lanka has long had a very good record (which compares well to western countries, particularly to places like Louisiana and Detroit) of steady improvements on health indicators such as infant mortality and life expectancy.

Sri Lanka is far superior to England in the matter of diagnostic tests. There are diagnostic centres in all localities and it is easy to get the tests done (without an appointment or waiting list) at a reasonable cost and get the results quickly on home PC or mobile phone.

Reintroduction of private practice for government doctors and liberalization of drug imports resulted in the growth of private hospitals in urban centers. There is a thriving private health sector, particularly in Colombo, which boasts a number of modern, well-equipped and well-staffed hospitals such as Apollo, Asiri, Nawaloka and Ninewells Gynecological Hospital. There have been efforts to encourage foreigners to come to Sri Lanka for treatment.

In Colombo, there is an excellent service where one can pay an annual membership fee to have an ambulance with doctor and paramedic call at one’s home when the need arises. They also call at one’s home to take blood tests and deliver the results. The doctors operating this service also work at the government general hospitals. In Badulla, the provincial general hospital (free care to all) is a fine modern building with the latest in modern technology. A new private hospital recently opened in Athurugiriya, where we now live. Way back in the 1990s, I found it difficult to get affordable dental treatment in London. I have had no problem in Sri Lanka.

The Sri Lankan health service took a battering when Covid struck. Initially, Sri Lanka coped far better than many western countries, including the UK and the USA. The armed forces played a big part in organising tracing and testing and roll out of vaccinations. Things went wrong later when the authorities took their eye off the ball.

The economic meltdown in 2022 severely pummeled a health service already undermined by the pandemic. The previously excellent universal health care system is on the point of collapse. Hospitals are short of essential drugs and urgent operations are being cancelled. Doctors and nurses working in bad conditions in Sri Lanka might well be tempted by the siren call of the NHS and might think they will have a better life in the UK – if they ignore the news about strikes in the NHS and impending severe recession. I am all for the free movement of people but I do not think it is racist to point out that poaching trained staff from other suffering nations might not be wholly  ethical.

On May 29, 2022, the Sri Lankan Sunday Times reported on a Memorandum of Understanding, between Sri Lanka and the UK, initially for four years, but to be renewed automatically, under which, “The governments would undertake a recruitment project to develop a sustainable recruitment pathway for nurses and other healthcare professionals from Sri Lanka to the UK; intensify bilateral exchanges of policy thinking with regard to nursing and healthcare workforce development and best practices in the delivery of healthcare; involve professional staff and healthcare managers in the project, particularly in relation to the education and training of Sri Lankan nurses and other healthcare professionals and draw up an action agenda to implement the project–especially with respect to addressing any gaps in the entire process of the recruitment of nurses and other healthcare professionals.”

A Department of Health and Social Care spokesperson said: “It is misleading to suggest that the UK actively recruits nurses from countries where there is a shortage of nursing staff.”

Why is Ms Alibhai-Brown condemning Keir Starmer when the blame clearly lies with successive Tory governments?  According to Adam Bychawski, “The number of foreign-trained nurses registering to work in the UK has increased sixfold since the government axed a fund for training NHS nurses in England in 2016. Then-chancellor George Osborne scrapped £800m worth of bursaries that covered the tuition fees and part of the living costs of students training to be nurses.”

Matthew Taylor, chief executive of the NHS Confederation, said the problems stemmed from “the failure of successive governments to provide a fully funded workforce strategy to help tackle the NHS’s 132,000 vacancies, to address the maintenance backlog of £10 billion, and to provide proper support for social care, with local communities and frontline staff all paying the price”.

Sylvia Watkins DM FRCP has written a paper called Migration of healthcare professionals: practical and ethical considerations for the journal Clinical Medicine. “Recruitment of healthcare professionals from developing countries to the UK is escalating rapidly and is severely damaging the fragile healthcare systems of the countries involved. This is happening in spite of the Code of Practice of the Department of Health, which, although voluntary, was supposed to restrict such migration; unfortunately it has not proved effective so far. Steps are now urgently required to reverse this trend, in order to prevent the total collapse of some overseas health services.”

Is Dr Watkins being racist when she writes, “Other measures, including promoting the retention of locally trained staff in the UK, are urgently required”?

Padraig Colman

Rambling ruminations of an Irishman in Sri Lanka

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