The Hippocratic oath - WMDs and alcohol – dilemmas for doctors

A blog from winter 2010 – still relevant to WMD and to the minimum pricing for alcohol debate

Friday, 12 November 2010

The Hippocratic oath – old and new

I have been aware of the existence of the Hippocratic Oath for most of my life, have probably glibly referred to it on occasion, but until last night, I have never actually read it or understood its exact place in modern medicine.

Events in the Scottish Parliament this week led me to find out a bit more about it, and I now realise that most of what I believed was based on various misconceptions.

1. I believed that it had existed in an unchanged form since Hippocrates – the father of modern medicine - first set it down several hundred years before the birth of Christ. It hasn’t,  and in fact Hippocrates may have had little to do with it …

2. I believed that every medical practitioner was obliged to take the Hippocratic oath. They are not, at least not in recent years …

In fact, the wording of the original Oath, in translation, astonished me. I had hoped to find something in it that would help me to understand what influence, if any, it might have on medical doctors who get involved in politics – say, Dr. Liam Fox, for example. (You may be able to think of others.)

Would anything in the Oath, in its original form or in the more modern principles favoured by the BMA, that try to hold on to some of the essential sense and principles of the original act as any guide to the ethical and moral behaviour of a doctor involved in the pragmatic and often dirty business of politics?

How, for example, could Liam Fox interpret his responsibilities under the oath when acting as a Defence Minister, commissioning weapons of death and mass destruction, and sending young men and women to kill other human beings, and perhaps to be killed or maimed themselves?

Would he take the ethical position that, since he was not practising medicine in this role, the oath was irrelevant? After all, doctors are not like priests, claiming to draw their authority from their god – they are high-level professionals, with high ethical standards, but ordinary mortals nonetheless.

No answer there – the question is beyond my philosophical and analytical abilities.

But how about, say for example, a doctor/politician who in his or her role is obliged to bring medical knowledge specifically to bear on decisions affecting the health of the population?

Say, over egregious abuse of alcohol in a society?

A thorny question also, but perhaps more amenable to Hippocratic analysis, but certainly not hypocritical consideration.

Doctors, like scientists, often reach different conclusions faced with the same facts, the same evidence: doctors debate, discuss, in fact in recent months, I’ve heard them doing it many times at the end of my beds in St. John’s and the RIE, and at the beds of other critically ill patients. It struck me as a vital dialogue - not always between equals, because the medical profession is hierarchical in the extreme - but one where every view is invited, heard and weighed.

Back to the Hippocratic Oath …

I’ll take the classic version rather than the original, which frankly sounds more than a little odd to a modern ear. (It’s also a little odd in the classic version.)

It’s hard to seize on anything relevant to a modern topic such as, say, dealing with the enormous harm to the health, wellbeing, safety and economic strength of an entire nation because of abuse of a legal and freely available dangerous drug – alcohol.

“I will apply dietic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.”

I couldn’t find dietic in my Oxford dictionary, so I presume it means dietetic – relating to diet, i.e. the nature of food and drink ingested.

Alcohol, misused, clearly does harm, and undoubtedly causes injustice, in its supply to people who are by age, immaturity or predisposition to addiction and excess vulnerable to this drug, and to others, who are harmed by violence, by disturbance in public places, in the home, by the overstretching of the caring and public order services, by economic factors – the list is a long one.

Keeping them all from harm and injustice due to alcohol abuse seems to me an appropriate interpretation of the Hippocratic Oath.

“I will neither give a deadly drug to anybody if asked for it, nor will I make suggestion to this effect.”

A difficult one to interpret in the context of a licensed drug and a licensed trade, especially when that drug forms a central part of the economy of my country. One might reasonably expect a doctor to recognise that the drug is only deadly under certain circumstances, and consumed in moderation may actually be beneficial, but to look long and hard at it becoming available too cheaply and too easily to vulnerable groups especially the young and immature.

But where there is a widespread consensus, in the society of which that doctor is a part, by virtually all doctors, the professional association that represents doctors, by the police force of that society, by the established Church of that society, by health workers, addiction workers, careworkers in that country, one might reasonably expect that a doctor/politician would tend to follow that consensus, a consensus of his or her peers and virtually every authoritative voice.

Of course, one must allow for the fact the majority are not always right; that lone voices, driven by burning personal conviction, must follow their consciences, and speak out against the majority if necessary. Such men and women have rendered invaluable service to their profession and to society at great personal cost on occasion.

It would of course be unthinkable that anyone would be influenced significantly or even totally by purely political considerations in going against that consensus, would it not? Let’s hope it never happens …

Well, I am not a doctor, but I owe my life to the medical profession in Scotland, not once, but several times over the last year, and I experienced their dedication,  professionalism and deep humanity at first hand. I also saw how the abuse of alcohol in Scottish society overstretched them, consumed an inappropriate amount of scarce resources, and exposed them personally to violence and intimidation.

So in that respect at least, I feel that I have a right – and a duty - to speak.

The Media, the Booze–and the hidden hand of the booze merchants PR machine

I thought of doing a blog on the media response to minimum pricing for alcohol, but since nothing much has changed in their approach since last October, I’ll just re-run this blog from 2011.

But a couple of points -

The ‘penalise the moderate drinker' argument is bollocks – I’m a moderate drinker, I know a lot of moderate drinkers, and none of them will be penalised. Dependent of their choice of tipple, it will either cost them nothing or very little. And if it did result in them – and me - cutting down to low moderate, it would be no bad thing.

The ‘the desperate ones will get it somehow, so price won’t make a difference’ is also bollocks. Addiction, i.e. alcoholism, is a problem for a minority, and as I know from my Glasgow childhood, the desperately poor alcoholic will drink anything – methylated spirits, aftershave, etc. But Scotland’s main problem with alcohol is uncontrolled, excessive social drinking as a lifestyle choice – and it is a choice, especially among the young. Low prices increased this form of drinking and higher prices will reduce this kind of drinking – the evidence is clear.

No one, least of all Nicola Sturgeon, has ever suggested that minimum pricing is a total solution: it is one approach among a complex set of measures, but one that will yield immediate and very tangible results.

I spent fourteen years in the alcohol industry at senior level and worked with them for well over a further decade or more in consulting and training. I know the sophistication and power of their PR and marketing departments, and despite a superficial gloss of “support for encouraging responsible drinking” and token financial support for the councils on alcoholism, etc. their top priorities are volume sales and profitability, and anything that impinges on either will be resisted.

Bluntly, the booze merchants will support any measure. especially the much touted ‘education to change drinking habits’, so long as there is no chance of it actually changing drinking habits and reducing sales of alcohol.

Minimum pricing will change behaviour, it will reduce consumption, it will reduce volume sales, the booze business knows it will – and they will fight it tooth and nail.

MORIDURA BLOG Sunday, 2 October 2011

THE BOOZE –  and “a nice glass of rosé after work”

The Herald and The Scotsman are both panicking about the SNP Government’s measures to combat the twin – and related – Scottish curses of alcohol abuse and sectarianism. Show me a violent bigot and I’ll show you a drunk. They are caught between a rock and a hard place – they must pretend to condemn alcohol abuse and sectarianism, but are terrified that the SNP’s measures might actually succeed in addressing these these ancient evils, because both abuses operate against the Scottish people developing a real national consciousness and democratic will for freedom and independence.

The enthusiasm with which both papers last week seized upon a ‘spontaneous’ demonstration’ - complete with large and elaborately crafted anti-SNP banners - by a small group of old firm ‘fans’ who wanted to protect their right to bellow out sectarian chants - in the name of freedom of expression and sport, God help us – was contemptible.

And today, we have The New Sunday Herald, with an ambivalent front page – Canning the drinks ban – which develops into a thinly-disguised attack on the SNP’s legislative measures to combat cheap booze promotions by supermarkets. Jackie Baillie, Labour, that stout defender of the rights of of Scottish people to have WMDs on their doorsteps and to be protected from any measures that might really help them to stop destroying themselves with cheap hooch, appears rapidly on the scene, accompanied by her sister-in-arms in these matters, Mary Scanlon, Tory, both anxious to shift the attack on alcohol abuse from minimum pricing – which will work - back to the booze barons preferred measures, empty exhortations to behave better (called ‘changing behaviour’) – which manifestly has never worked, and never will work.

Both these women are their party’s Spokeswoman for Health, rather as Tony Blair is Peace Envoy for the Middle East.

The Sunday Herald also wandered into the streets with a camera and picked entirely at random six young Scots who are against the legislation, who all ‘like a nice glass of rosé after work’, or its equivalent, and feel they are being unfairly penalised by the legislation.

They even managed to find a nurse who seemed to be against the legislation, although her views are rather confusing – if reported accurately – since her opening remark calls for ‘an overall ban on low booze prices’, but she feels that ‘it’s ridiculous and might extenuate (sic) other problems in the NHS …” and concludes with The Scotsman’s, The Herald’s, the Tory and Labour spokeswomen for Health’s and the booze business and supermarkets’ favourite solution – ‘dealing with the root cause, by educating people from school level.’

The only thing missing from the nightmare scenario was crazed latte drinkers, driven mad by caffeine.

The Sunday Herald, with no sense of irony, called this ‘sample’ of public opinion VOX POP. Well, I suppose a ‘nice glass of rosé ‘ is as close to pop as you’ll get from a supermarket’s alcohol shelves.

This randomly selected group must be congratulated for standing alone against the consensus of the BMA, the nursing profession, the police, health workers, alcohol and harm reduction workers, etc. who supported minimum pricing and control of price as a desirable and significant move to combat alcohol abuse.

I will find it hard to sleep tonight, thinking of the sad plight of of those unable to afford a nice glass of rosé after work because of this legislation, not to mention those other oppressed Old Firm consumers of rosé at Ibrox or Celtic Park, no longer able to brandish a wee bottle of Mateus on the terracing or bellow out sectarian songs as they wave the flags of nations other than Scotland.

And I will spare a tear for the directors and senior managers of Tesco, crouching round an oil lamp, down to their last few million pounds, as they weep inconsolably over the 0.3% impact on their profits, and desperately try to think up new ways to circumvent the law and democratic government.

Scotland, the Booze and the Hippocratic Oath

• Moridura music audio

Something I said during the peak of Labour and Tory blind, destructive opposition to minimum pricing back in November 2010

Moridura Blog - Friday, 12 November 2010

I have been aware of the existence of the Hippocratic Oath for most of my life, have probably glibly referred to it on occasion, but until last night, I have never actually read it or understood its exact place in modern medicine.

Events in the Scottish Parliament this week led me to find out a bit more about it, and I now realise that most of what I believed was based on various misconceptions.

1. I believed that it had existed in an unchanged form since Hippocrates – the father of modern medicine - first set it down several hundred years before the birth of Christ. It hasn’t,  and in fact Hippocrates may have had little to do with it …

2. I believed that every medical practitioner was obliged to take the Hippocratic oath. They are not, at least not in recent years …

In fact, the wording of the original Oath, in translation, astonished me. I had hoped to find something in it that would help me to understand what influence, if any, it might have on medical doctors who get involved in politics – say, Dr. Liam Fox, for example. (You may be able to think of others.)

Would anything in the Oath, in its original form or in the more modern principles favoured by the BMA, that try to hold on to some of the essential sense and principles of the original act as any guide to the ethical and moral behaviour of a doctor involved in the pragmatic and often dirty business of politics?

How, for example, could Liam Fox interpret his responsibilities under the oath when acting as a Defence Minister, commissioning weapons of death and mass destruction, and sending young men and women to kill other human beings, and perhaps to be killed or maimed themselves?

Would he take the ethical position that, since he was not practising medicine in this role, the oath was irrelevant? After all, doctors are not like priests, claiming to draw their authority from their god – they are high-level professionals, with high ethical standards, but ordinary mortals nonetheless.

No answer there – the question is beyond my philosophical and analytical abilities.

But how about, say for example, a doctor/politician who in his or her role is obliged to bring medical knowledge specifically to bear on decisions affecting the health of the population? A thorny question also, but perhaps more amenable to Hippocratic analysis, but certainly not hypocritical consideration.

Doctors, like scientists, often reach different conclusions faced with the same facts, the same evidence: doctors debate, discuss, in fact in recent months, I’ve heard them doing it many times at the end of my beds in St. John’s and the RIE, and at the beds of other critically ill patients. It struck me as a vital dialogue - not always between equals, because the medical profession is hierarchical in the extreme - but one where every view is invited, heard and weighed.

Back to the Hippocratic Oath …

I’ll take the classic version rather than the original, which frankly sounds more than a little odd to a modern ear. (It’s also a little odd in the classic version.)

It’s hard to seize on anything relevant to a modern topic such as, say, dealing with the enormous harm to the health, wellbeing, safety and economic strength of an entire nation because of abuse of a legal and freely available dangerous drug – alcohol.

“I will apply dietic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.”

I couldn’t find dietic in my Oxford dictionary, so I presume it means dietetic – relating to diet, i.e. the nature of food and drink ingested.

Alcohol, misused, clearly does harm, and undoubtedly causes injustice, in its supply to people who are by age, immaturity or predisposition to addiction and excess vulnerable to this drug, and to others, who are harmed by violence, by disturbance in public places, in the home, by the overstretching of the caring and public order services, by economic factors – the list is a long one.

Keeping them all from harm and injustice due to alcohol abuse seems to me an appropriate interpretation of the Hippocratic Oath.

“I will neither give a deadly drug to anybody if asked for it, nor will I make suggestion to this effect.”

A difficult one to interpret in the context of a licensed drug and a licensed trade, especially when that drug forms a central part of the economy of my country. One might reasonably expect a doctor to recognise that the drug is only deadly under certain circumstances, and consumed in moderation may actually be beneficial, but to look long and hard at it becoming available too cheaply and too easily to vulnerable groups especially the young and immature.

But where there is a widespread consensus, in the society of which that doctor is a part, by virtually all doctors, the professional association that represents doctors, by the police force of that society, by the established Church of that society, by health workers, addiction workers, careworkers in that country, one might reasonably expect that a doctor/politician would tend to follow that consensus, a consensus of his or her peers and virtually every authoritative voice.

Of course, one must allow for the fact the majority are not always right; that lone voices, driven by burning personal conviction, must follow their consciences, and speak out against the majority if necessary. Such men and women have rendered invaluable service to their profession and to society at great personal cost on occasion.

It would of course be unthinkable that anyone would be influenced significantly or even totally by purely political considerations in going against that consensus, would it not? Let’s hope it never happens …

Well, I am not a doctor, but I owe my life to the medical profession in Scotland, not once, but several times over the last year, and I experienced their dedication,  professionalism and deep humanity at first hand. I also saw how the abuse of alcohol in Scottish society overstretched them, consumed an inappropriate amount of scarce resources, and exposed them personally to violence and intimidation.

So in that respect at least, I feel that I have a right – and a duty - to speak.

Labour ducks in a row again, Tom Harris and minimum pricing for alcohol–Bob Doris and Jackie Baillie

Tom Harris MP has yet another outing on television, this time as the first of the three Scottish Labour leadership candidates to be interviewed on Newsnicht.

But before I address the content, let me indulge my pedantry -

Glenn Campbell opens with a phrase and a sentence construction that is all over the media like a rash – the may be … but construction. It seems to open almost every political analysis these days, and if it isn’t opening one, it’s closing one. Glenn’s example is -

“It may have only just begun but already …” What Glenn is referring to is the Labour Leadership contest. There is no may about it it, Glenn, it has already begun.

The word may indicates a possibility that contains alternatives – Prince Charles may become king, but then again, he may not. But this would be wrong – “Elizabeth the Second may be queen but she is an old lady …” There is no may about it, she is the queen.

Tom Harris may become Labour leader, but he may not. The disjunctive coordinating conjunction but is all you need to make your point, Glenn. “It has just begun … but already …”  You could have used the admittedly lengthier construction of “Despite the contest having just begun, already one party member ..” or alternatively “Although the contest has just begun, already one party member …”

Remember Dean Martin -

You may be king, you may possess

The world and its gold

But love won’t bring you happiness

When you’re growing old

Dino isn’t addressing a king or a rich man – he’s exploring future alternatives and offering good advice for choosing between them.

 

THE LABOUR LEADERSHIP CONTEST

Glenn Campbell explores Uncle Tam’s candidacy with him, and attempts to find out what he’s all about, with as little success as previous interviewers. (Isabel Fraser successfully exposed the vacuum at the heart of all of the three candidates’ policy thinking, but couldn’t fill it.)

In his intro, Glenn signals the blandness of, and lack of differentiation between the candidates. He picks up with a previous comment from Tom Harris in the Isabel Fraser group interview that Labour could cease to become relevant in the next few years. (It has in fact been irrelevant for decades – it just took the Scottish voters a long time to notice it.). Uncle Tam replied lugubriously that it couldn’t be any more serious, in fact, he sees this internal party election as a watershed event. He’s probably right, but of course his remarks serve to talk up the importance of his involvement in this historical moment – as an essentially marginal Labour figure, threatened, as all Scottish Labour MPs are by independence, he’s hoping for a political lifeboat to carry him to either a fully independent or a still devolved Holyrood, and despite unionist protestations, either outcome would suit him nicely.

He is throughout refreshingly and brutally frank about the failings of Scottish Labour and the campaign – he can afford to be because he was not part of it, whereas his two opponents were, something that hangs uneasily in the air of cosy consensus they try to generate.

“What are the right decisions – what is the key to the party’s survival?” asks Glenn. Policy and structure “doesn’t really matter at the moment” replies Tom – “We’re deciding who is going to lead the Scottish Party …” And Tam is not interested in being the Leader of the Scottish Labour Party – he wants to be First Minister, and he sees this as the key perception that voters should have of the candidates – who can stand up to Alex Salmond?

“What makes you different and better than the others in this contest?” If Glenn had put that question to an American candidate in a leadership contest, they would have seized the opportunity to talk policy and character differentiation with both hands. But Tom retreats into coy blandness - he modestly confesses to good communication skills and the ability to sell a vision of Scotland to voters – he can “portray a positive vision for Scotland within the United Kingdom”.

All this PR, spin doctor, media man stuff reminds me of marketing men addressing harassed front end sale people in commercial organisations, to be met with cries of “Never mind the gloss and spin, the product is crap – what are you going to do about that?” There is a scene in the film version of Barbarians at the Gate, (see final YouTube clip) the story of the RJR Nabisco takeover in the 1980s, when James Garner discovers that the new product, a cigarette that is going to save the company, tastes of shit. Cognitive dissonance is literally in the air as the senior executives try to convince themselves that everything is OK with the brand …

What’s Tom’s big idea? It appears to be to abandon the unemployed and those on benefit, and presumably the poor, the disabled and all the other inconvenient parts of society that demand our compassion and our help, and focus on people in jobs, shoving them up the social housing list. All of this will be achievable as part of the union with a strong devolved Parliament – and of course the inevitable concomitants of that – war as the operating principle of the state, nuclear weapons and WMDs based in Scotland, lunatic foreign entanglements, and power, wealth and influence – and Scottish resources and revenues - drained to the South East of England.

But Uncle Tam will still be in a job – the Uncle Tams of this world always are …

The three ducks were all in a row again in STV’s new Scotland Tonight programme, which I was unkind about on its first outing, but which has improved in leaps and bounds since. There was little that was new – more vacuity, more equivocation, more self-justification. But the battle lines are clearly drawn as follows -

TOM HARRIS: You two ****** it up in the last Parliament and the election campaign …

JOHANN LAMONT/KEN MACINTOSH:  Naw, we didnae – there wis just a perception that we ****** it up …

MINIMUM PRICING FOR ALCOHOL – JACKIE BAILLIE AND BOB DORIS

We had what may now become a recurrent media phenomenon last night – the same topic with the same spokespersons running twice – once on Scotland Tonight and once on Newsnicht. It must be something to do with neutrinos and the speed of light. But if you had only watched the first programme, Scotland Tonight, feeling that the second, Newsnicht,  was redundant, you would have missed important differences …

Bob Doris gave his impression of a killer shark, eyes glittering coldly, homing in on his prey.  Jackie Baillie gave a formidable impression of his prey, waiting pluckily but apprehensively to be devoured. Jackie, of course, has no defence – her position is deeply flawed, intellectually, arithmetically and morally.

But Newsnight Scotland highlighted two key points missed by Scotland Tonight – one, that supermarkets won’t experience a windfall by minimum pricing if it actually works, since sales will fall. (Exactly how this will translate in money will already be the subject of frantic analysis by the supermarket bean counters – the media will take a long time to get round to it.) Two - the 45p figure is out of date and will be revisited on the re-run of the model, as Nicola Sturgeon has been explaining all over the media.

And of course, Labour and Jackie Baillie’s argument over supermarkets profiting is fatally compromised by their opposition to the Tesco Tax. The Scottish voters can smell hypocrisy a mile off, and Labour, the Tories and the LibDems reek of it.

The Booze – and VOX POP, Sunday Herald version

Don’t forget my little credo on the referendum – read here Google Docs and download and send to whoever you think appropriate if you agree with it. The SNP defence policy statement, reproduced here in my blog late last night, contains a voting mechanism on nuclear issues – go to the site and cast your vote for Scotland’s future - SNP defence and nuclear policy

 

THE BOOZE –  and “a nice glass of rosé after work”

The Herald and The Scotsman are both panicking about the SNP Government’s measures to combat the twin – and related – Scottish curses of alcohol abuse and sectarianism. Show me a violent bigot and I’ll show you a drunk. They are caught between a rock and a hard place – they must pretend to condemn alcohol abuse and sectarianism, but are terrified that the SNP’s measures might actually succeed in addressing these these ancient evils, because both abuses operate against the Scottish people developing a real national consciousness and democratic will for freedom and independence.

The enthusiasm with which both papers last week seized upon a ‘spontaneous’ demonstration’ - complete with large and elaborately crafted anti-SNP banners - by a small group of old firm ‘fans’ who wanted to protect their right to bellow out sectarian chants - in the name of freedom of expression and sport, God help us – was contemptible.

And today, we have The New Sunday Herald, with an ambivalent front page – Canning the drinks ban – which develops into a thinly-disguised attack on the SNP’s legislative measures to combat cheap booze promotions by supermarkets. Jackie Baillie, Labour, that stout defender of the rights of of Scottish people to have WMDs on their doorsteps and to be protected from any measures that might really help them to stop destroying themselves with cheap hooch, appears rapidly on the scene, accompanied by her sister-in-arms in these matters, Mary Scanlon, Tory, both anxious to shift the attack on alcohol abuse from minimum pricing – which will work - back to the booze barons preferred measures, empty exhortations to behave better (called ‘changing behaviour’) – which manifestly has never worked, and never will work.

Both these women are their party’s Spokeswoman for Health, rather as Tony Blair is Peace Envoy for the Middle East.

The Sunday Herald also wandered into the streets with a camera and picked entirely at random six young Scots who are against the legislation, who all ‘like a nice glass of rosé after work’, or its equivalent, and feel they are being unfairly penalised by the legislation. They even managed to find a nurse who seemed to be against the legislation, although her views are rather confusing – if reported accurately – since her opening remark calls for ‘an overall ban on low booze prices’, but she feels that ‘it’s ridiculous and might extenuate (sic) other problems in the NHS …” and concludes with The Scotsman’s, The Herald’s, the Tory and Labour spokeswomen for Health’s and the booze business and supermarkets’ favourite solution – ‘dealing with the root cause, by educating people from school level.’ The only thing missing from the nightmare scenario was crazed latte drinkers, driven mad by caffeine.

The Sunday Herald, with no sense of irony, called this ‘sample’ of public opinion VOX POP. Well, I suppose a ‘nice glass of rosé ‘ is as close to pop as you’ll get from a supermarket’s alcohol shelves.

This randomly selected group must be congratulated for standing alone against the consensus of the BMA, the nursing profession, the police, health workers, alcohol and harm reduction workers, etc. who supported minimum pricing and control of price as a desirable and significant move to combat alcohol abuse.

I will find it hard to sleep tonight, thinking of the sad plight of of those unable to afford a nice glass of rosé after work because of this legislation, not to mention those other oppressed Old Firm consumers of rosé at Ibrox or Celtic Park, no longer able to brandish a wee bottle of Mateus on the terracing or bellow out sectarian songs as they wave the flags of nations other than Scotland. And I will spare a tear for the directors and senior managers of Tesco, crouching round an oil lamp, down to their last few million pounds, as they weep inconsolably over the 0.3% impact on their profits, and desperately try to think up new ways to circumvent the law and democratic government.

Scotland’s First Minister, Alex Salmond –and the Three UK Stooges

Isabel Fraser quizzes the Holyrood opposition leaders on why they blocked the SNP's attempt to introduce minimum pricing for alcohol, a measure supported by medical experts, nurses, the police, alcohol harm reduction agencies, etc.

Iain Gray trots out his ridiculous argument that the measure would have been illegal, only to have it gently pointed out to him by Alex Salmond that the government is prohibited by law from introducing a bill for legislation that would be illegal, and that the law authorities in Scotland has certified that the bill was legal.

 

Iain Gray clearly does not understand the contradictions inherent in his policy on knife crime - after all, he is advised by Andy Kerr, who gave a train-wreck interview to Gordon Brewer on this recently.

But Annabel Goldie is a lawyer - she must know the implications of what she is proposing, yet she peddles this backwoods Tory nonsense for expedient electoral gain.

Tavish Scott at least emerges from this with some credit.

Only Alex Salmond offers calm, reasoned criticism of the Labour and Tory policy. He, of course, listens to the police and those who understand law and order and justice issues, unlike Gray and Goldie, who seem driven by the tabloids and misguided populist instincts

 

If you are a public sector worker in Scotland - listen carefully, and decide where your vote should be cast on May 5th. Only the SNP unequivocally supports the public sector and respect its vital role in Scottish society and the commitment of its workers.

If you are a public sector union member in Scotland, ask yourself why your union leaders slavishly support the party that is committed to attacking your jobs - or "reducing bureaucracy", as Iain Gray prefers to call it.

If you are a public sector full-time officer, try to forget your career aspirations and the high road to England for long enough to serve the interests of your members, instead of supporting the Scottish Labour Party.

If you are a public sector Tory, God help you - the Tories are the sworn enemies of the public sector, except when it provides cosy sinecures for their favoured few. Remember which coalition parties are trying to destroy the NHS.

Vote for a vibrant, well-resourced, well-respected public sector -

Vote SNP on May 5th!

MacAskill and Baker - Law and Order - Who would you prefer as Justice Minister of Scotland?

Who would you prefer as Scotland's Justice Minister?

A qualified lawyer, former senior partner in a law firm, principled, and with a proven record of reducing crime - including knife crime - and putting more policemen on the streets - a man who is hard on crime, but recognises the vital need to reduce the re-offending rate - a man who doesn't reach for simplistic, knee-jerk solutions - a man committed to tackling the alcohol problem, which is a prime cause of crime in Scotland - Kenny MacAskill.

Or would you prefer Richard Baker, a traditional, lock-em-up, flog-'em, bring-back-the-birch-type Tory - although he's LABOUR, with no track record, except that of opposing minimum pricing for alcohol, thus blocking something demanded and endorsed by every expert in Scotland, including the NHS and the police?
 
Watch these clips and decide ...

You've already guessed who I would choose? I'm astonished!

Vote SNP - vote for a crime free Scotland

Vote for your ain folk.

And lest we forget Labour's double-dealing and hypocrisy over the Megrahi issue, watch this again ...

Coalition Plan to destroy the NHS - the beginning of the end?

The Lansley Plan launched by David Cameron today will be the beginning of the end for the NHs if it goes ahead. Some of Cameron’s pals are already gearing up to profit from it.

Private Eye reports that Great West Commissioning Consortium - you couldn’t make it up! - a pathfinder consortium with 57 GP practices based in Hounslow, set up by Andrew Lansley, Health Minister, has signed up UnitedHealth to help reduce the number of patients referred for hospital treatment by putting them through a facilitation service to be vetted by UnitedHealth staff.

UnitedHealth website

Private Eye reports that Simon Stevens, Executive Vice President in the US - and make no mistake, this global company’s roots are American - is a former health adviser to Tony Blair, a former Labour PM and multi-millionaire with the blood of hundreds of thousands on his hands, due to appear before the Chilcot Inquiry for the second time on Friday to answer questions about alleged discrepancies about his previous testimony to Chilcot.

Simon Stevens

Now, while Scots may deplore what is about to happen to our English cousins, they may think that we are safe, since health is a devolved matter, and is currently in the safe, ethical hands of Nicola Sturgeon, Deputy First Minister of Scotland and the SNP Government under Alex Salmond.

But would it be safe under a Labour administration in Holyrood, compliant tools of London-based Labour, once the big money started to flow into private healthcare, the lobbyists got to work, and Westminster pressures were exerted, by the Coalition or by a UK Labour Government if the coalition falls before its term?

You can bet that it wouldn’t. Labour joined contemptibly with the Scottish Tories and LibDems to defeat the SNP governments attempt to combat the largest single menace to the health of Scots - cheap alcohol - by minimum pricing. They were led by their health spokesperson, Dr. Richard Simpson, who managed to differ from virtually every significant senior health body and spokesperson in Scotland, including the BMA, his own professional association, the police, health workers, the nursing profession, etc..

This three party opposition block was driven, not by the interests of the Scottish people, not by the health arguments, but by a cynical desire to defeat anything of significance put forward by the SNP, and their wish to curry favour with the big companies in the alcohol business.

(They have just repeated the trick in their defeat of the attempt by the SNP Government to place a tax on the big retailers like Tesco, one that would have created a more level playing field for small shops and retailers.

Protect Big Business, bugger the little guy seems to be the Holyrood Opposition parties’ motto.)

I must say that I believe that Dr. Richard Simpson’s personal opposition to minimum pricing for alcohol was not driven by cynicism, but by genuine personal conviction. I make this judgement based on a radio exchange of views with him on Call Kaye on BBC Scotland recently. He was just plain wrong, in my view, despite his considerable experience of addiction and alcoholism in his role as a GP and addiction counsellor.

Where we are now headed towards is a model of profit-driven, cost-cutting healthcare on the American model, the one that Barack Obama has desperately attempted to reform. one that ensures inadequate care for the poor and vulnerable and makes it safe to be sick only if you are well-off enough to afford private treatment.

The NHS was never safe with the Tories. It now isn’t safe with LibDems, and the thing that used to be the Labour Party is fatally compromised in its values and principles, so it isn’t safe with them either. You can bet that Anthony Lynton Blair supports the Lansley rip-off, even if he doesn’t say so publicly. He can afford to be sick, with a £15m annual income.

Be careful how you vote in May, Scots - especially if you are ill or old, or both. The SNP is on your side, and the NHS in Scotland is safe in their hands.

Labour wouldn’t protect you from the abuses of alcohol - it won’t protect you from abuse of your health care either.

A history lesson …

Continuing my history binge, I have now finished reading Professors T.C. Smout’s A Century of the Scottish People 1830 – 1950 (first published 1986).

Historians are always erudite, sometime objective and occasionally partial, but Professor Smout has another quality, a deep and compassionate humanity, a much rarer commodity among historians.

Some historians excite my admiration for their broad perspective and scholarship (Andrew Davies, Tom Devine), some make my gorge rise (Niall Ferguson, Andrew Roberts, David Starkey) but Professor Smout makes me feel like a member of the human race, part of the continuity and wonder of homo sapiens: he illuminates the human condition.

One extract that struck me as saying something about Scotland now, seen through the prism of the past -

DRINK

Scotland appeared to her critics a land peculiarly steeped in drink. John Dunlop, Greenock magistrate and temperance reformer, described a world in which the middle classes vied with the working classes to create occasions for another glass. Chapter VI, page 133.

We might, in 2010, speculate that John Dunlop might observe that the middle classes – and their elected opposition MSPs in the Scottish Parliament – vied with the booze peddlers to keep Scotland and all classes in it, but especially the young and the poor, “peculiarly steeped in drink”, by opposing the one measure - proposed by the Scottish SNP Government - for reducing this evil that had the approval of the medical profession,  the police, addiction agencies and the churches, namely, minimum pricing for alcohol.

The Hippocratic oath – old and new

I have been aware of the existence of the Hippocratic Oath for most of my life, have probably glibly referred to it on occasion, but until last night, I have never actually read it or understood its exact place in modern medicine.

Events in the Scottish Parliament this week led me to find out a bit more about it, and I now realise that most of what I believed was based on various misconceptions.

1. I believed that it had existed in an unchanged form since Hippocrates – the father of modern medicine - first set it down several hundred years before the birth of Christ. It hasn’t,  and in fact Hippocrates may have had little to do with it …

2. I believed that every medical practitioner was obliged to take the Hippocratic oath. They are not, at least not in recent years …

In fact, the wording of the original Oath, in translation, astonished me. I had hoped to find something in it that would help me to understand what influence, if any, it might have on medical doctors who get involved in politics – say, Dr. Liam Fox, for example. (You may be able to think of others.)

Would anything in the Oath, in its original form or in the more modern principles favoured by the BMA, that try to hold on to some of the essential sense and principles of the original act as any guide to the ethical and moral behaviour of a doctor involved in the pragmatic and often dirty business of politics?

How, for example, could Liam Fox interpret his responsibilities under the oath when acting as a Defence Minister, commissioning weapons of death and mass destruction, and sending young men and women to kill other human beings, and perhaps to be killed or maimed themselves?

Would he take the ethical position that, since he was not practising medicine in this role, the oath was irrelevant? After all, doctors are not like priests, claiming to draw their authority from their god – they are high-level professionals, with high ethical standards, but ordinary mortals nonetheless.

No answer there – the question is beyond my philosophical and analytical abilities.

But how about, say for example, a doctor/politician who in his or her role is obliged to bring medical knowledge specifically to bear on decisions affecting the health of the population? A thorny question also, but perhaps more amenable to Hippocratic analysis, but certainly not hypocritical consideration.

Doctors, like scientists, often reach different conclusions faced with the same facts, the same evidence: doctors debate, discuss, in fact in recent months, I’ve heard them doing it many times at the end of my beds in St. John’s and the RIE, and at the beds of other critically ill patients. It struck me as a vital dialogue - not always between equals, because the medical profession is hierarchical in the extreme - but one where every view is invited, heard and weighed.

Back to the Hippocratic Oath …

I’ll take the classic version rather than the original, which frankly sounds more than a little odd to a modern ear. (It’s also a little odd in the classic version.)

 It’s hard to seize on anything relevant to a modern topic such as, say, dealing with the enormous harm to the health, wellbeing, safety and economic strength of an entire nation because of abuse of a legal and freely available dangerous drug – alcohol.

“I will apply dietic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.”

I couldn’t find dietic in my Oxford dictionary, so I presume it means dietetic – relating to diet, i.e. the nature of food and drink ingested.

Alcohol, misused, clearly does harm, and undoubtedly causes injustice, in its supply to people who are by age, immaturity or predisposition to addiction and excess vulnerable to this drug, and to others, who are harmed by violence, by disturbance in public places, in the home, by the overstretching of the caring and public order services, by economic factors – the list is a long one.

Keeping them all from harm and injustice due to alcohol abuse seems to me an appropriate interpretation of the Hippocratic Oath.

“I will neither give a deadly drug to anybody if asked for it, nor will I make suggestion to this effect.”

A difficult one to interpret in the context of a licensed drug and a licensed trade, especially when that drug forms a central part of the economy of my country. One might reasonably expect a doctor to recognise that the drug is only deadly under certain circumstances, and consumed in moderation may actually be beneficial, but to look long and hard at it becoming available too cheaply and too easily to vulnerable groups especially the young and immature.

But where there is a widespread consensus, in the society of which that doctor is a part, by virtually all doctors, the professional association that represents doctors, by the police force of that society, by the established Church of that society, by health workers, addiction workers, careworkers in that country, one might reasonably expect that a doctor/politician would tend to follow that consensus, a consensus of his or her peers and virtually every authoritative voice.

Of course, one must allow for the fact the majority are not always right; that lone voices, driven by burning personal conviction, must follow their consciences, and speak out against the majority if necessary. Such men and women have rendered invaluable service to their profession and to society at great personal cost on occasion.

It would of course be unthinkable that anyone would be influenced significantly or even totally by purely political considerations in going against that consensus, would it not? Let’s hope it never happens …

Well, I am not a doctor, but I owe my life to the medical profession in Scotland, not once, but several times over the last year, and I experienced their dedication,  professionalism and deep humanity at first hand. I also saw how the abuse of alcohol in Scottish society overstretched them, consumed an inappropriate amount of scarce resources, and exposed them personally to violence and intimidation.

So in that respect at least, I feel that I have a right – and a duty - to speak.

A Holyrood day that will live in infamy

Or as Kenneth Williams once said “Infamy, infamy! – they’ve got it in for me!”

Not quite Pearl Harbour, but the rejection of minimum pricing for alcohol by the Holyrood opposition parties is truly shameful. Holyrood's health committee backed a Tory amendment to strike from the Alcohol Bill plans for a minimum price per unit of alcohol of 45p.

Brian Taylor, the BBC’s highly respected political correspondent expressed the view that the decision would probably not influence voting at the Holyrood elections in May 2011. I’m not so sure …

Every time a health professional finds themselves deflected from vital professional care duties by violent drunks, abusive and shouting in A&E, they will remember who opposed the measure, in spite of the support of the BMA and the almost universal support of health professionals and doctors.

I say almost universal support - I exclude, of course, Doctor Richard Simpson, Labour’s health spokesperson in the Scottish Parliament, a medical doctor and former GP, who knows better than his professional body, the BMA, knows better than his church, the Church of Scotland, knows better than the police, better than most health professionals and addiction counsellors – in fact, knows better than almost every professional voice in the Scottish Nation.

Every time a police officer deals with rioting, drunk teenagers in a town centre, they will remember who opposed this measure – Labour, the Tories and the LibDems.

Every time a minister of religion finds that his or her church has had its environs vandalised, and picks up a litter of empty cans of cheap lager and bottle of cider in the churchyard, they will remember who opposed this eminently sensible provision – Labour, the Tories and the LibDems.

Every time a couple of retired, law-abiding citizens look outside their window late on a Friday or Saturday night because a violent disturbance is taking place in the normally quiet street, they will remember who opposed a measure that might have reduced such incidents – Labour, the Tories and the LibDems.

Every time a drunk teenager or young adult crashes a car while under the influence of cheap supermarket alcohol, killing their passenger and the occupants of the vehicle they collided with, the families of the victims will remember who opposed provisions to limit the consumption of cheap booze – Labour, the Tories and the LibDems.

As young mothers with young children pick their way in disgust through the broken bottle, empty beer cans, cider bottles and vomit in their local park, they will remember who opposed the sensible, moderate measure that would have limited this revolting pollution of our public places – Labour, the Tories and the LibDems.

And perhaps they will then remember Nicola Sturgeon, the health minister who championed minimum pricing for alcohol, the justice minister who supported it and the First Minister and the party – the SNP – that tried to do something real, for the first time, about the plague that afflicts our Scottish Nation.

Kaye Adams, Henry McLeish, Richard Simpson – and Peter Curran on Call Kaye

I put my tuppence worth in on the Call Kaye programme on Radio Scotland this morning Call Kaye 10th Nov. 2010 first with Henry McLeish at the 19 minute mark, and secondly with Dr. Richard Simpson at the 29 minute mark.

The sound quality on my contribution was poor because my freedom phone battery was running low, and I unforgivably missed Kay’s query, after I said that I had spent 14 years in the alcohol industry - “In what capacity, Peter?”

I could have told her that it was as Personnel Director, Scottish Brewers, the wholesale trading operation of what was then Scottish & Newcastle and is now Scottish Courage. I also know the industry intimately as a management consultant and management trainer in the Scottish whisky industry for over twelve years, a lot of it with Diageo.

I was also born and brought up 100 yards or so away from Tennent’s Wellpark Brewery in Glasgow, and since the Tennent family have been brewing on the Wellpark site since about 1550, and are very close to Glasgow Cathedral and even closer to the Molendinar Burn where Fergus order Mungo to build a church, that makes me the Glasgow equivalent of a London cockney – born within sniffing distance of hops, malt and barley. But my first teenage drink was a McEwans screwtop …

The political expediency of Labour over Scotland’s alcohol problem

Watch and listen to this Newsnight Scotland report – consider the weight and authority – and passion – of the various people and august bodies supporting the SNP’s minimum pricing for alcohol bill, pleading with the Labour and Tory Opposition parties in Holyrood to support it, and abandon their deeply cynical political posturing and absurd nonsense about caffeine and Buckfast.

I watched the Newsnight Scotland discussion, chaired by Gordon Brewer, with Michael Matheson for the SNP and Dr. Richard Simpson for Labour.

Yes, you read it correctly – Doctor Richard Simpson, a medical doctor, a GP from 1970 to 1999, according to his biography, a member of the British Medical Association, who lists his religious affiliation as Church of Scotland, Member of the Health and Sport Committee.

Doctor Simpson has undoubtedly clearly heard and clearly understood the arguments offered, and the full support given for minimum pricing for alcohol by the BMA, by the Church of Scotland, by the Police, by alcohol harm reductions agencies, and by virtually every authoritative agency and body involved in this urgent problem for the health and welfare of the Scottish people and the Scottish nation.

But he opposes the measure proposed and will doubtless vote against it today in Holyrood, as will every Labour MSP and every Tory MSP, unless some of them re-examine their consciences before today’s vote.

I find myself lost for words in the face of such actions, and feel a deep sense of sadness that fellow Scots can come to this in the name of politics.

Ann McKechin MP – Shadow Scottish Secretary

I ought to like and respect someone like Ann McKechin – a guid Scots lassie, a lawyer by profession (Scots Law  at Strathclyde University), widely experienced in politics and representing the Glasgow North constituency.

But I find it hard to do either. She has been in Westminster since 2001 – the year of the Afghanistan invasion, and has been a loyal member of the Blair and Brown governments. No MP survived and prospered in either regime, as she has done, without submerging their liberal instincts and the values that used to be held by the People’s Party.

Who can touch pitch, and not be defiled by it ?

Corinthians

Her voting record shows the contradictions and the struggle with conscience that bedevilled some of the members of the Blair/Brown regimes’ more principled MPs.

She supported gay rights, was anti-hunting, sort of against Trident, and wanted an elected House of Lords, and to her credit, three years into her career, voted strongly against the Iraq War. I applaud her unreservedly for that.

But when the career chips were down – and you can bet they were down - she supported the most illiberal Labour regimes ever to have disgraced their party, Westminster and betrayed the country in the other contemptible things that defined Blair, Brown and New Labour.

She voted strongly

for Labour’s anti-terrorism laws

for a stricter asylum system

for allowing ministers to intervene in (i.e. intimidate) inquests

for ID cards

against laws to stop climate change

and she voted very strongly against an investigation into the Iraq War.

She was Jim Murphy’s right-hand woman in the Scottish Office, and together with the series of Labour apparatchiks - Wendy Alexander, Iain Gray - who replaced the men of stature who once led Labour in Holyrood - Donald Dewar and Henry McLeish – she actively participated and supported the blocking of almost every initiative by the SNP government under Alex Salmond to address the fundamental problems facing the Scottish people.

Here she is, attempting to justify the contemptible, politically expedient opposition to minimum pricing on alcohol, something supported by just about every objective Scottish institution – the Police, the Health Service, the  churches, etc.

Ann McKechin has now been rewarded for all of this by Ed Miliband by becoming the Shadow Scottish Secretary, and will sit beside the members of the New Labour Scottish Old Guard who were up to their necks in that betrayal of Scotland, – Murphy, Alexander et al – and will become Westminster’s woman in Scotland, if Labour are re-elected instead of being Scotland’s woman in Westminster.