The Children Speak: The World is Your Lobster

I have to say, I could get used to these short weeks. Last week was a very laid back week for me. The Bank Holiday weekend saw the house filled with children and grandchildren, the latter bursting with energy and happiness. The house was alive with laughter, noise and movement. Goats were fed, eggs were collected, piano, guitars, and drums played, a walk or two on the beach and of course chocolate Easter eggs. It was fun. It was happy times.

Tuesday and Wednesday were days spent walking or gardening in the most welcome sunshine. Both are my favourite activities. The only downside being a couple of virtual meetings requiring a shirt to be worn and hair tamed by a bobble. Thursday was a busy day at my hospital. It was a good busyness and it felt great to be back and talking with my colleagues once more. Friday, I was back outside creating a new flower bed to surround J’s favourite place to sit in the garden. Like Tuesday and Wednesday there were some interruptions during the day. It was a day punctuated by phone calls from prospective applicants for the two Non-Executive Director roles we currently have advertised. The whole week left me feeling very content and grateful for what I have and I’m able to do.

One consequence of this rather laid back week, however, has been the fact that I have barely done the reading I would normally do. I have steered clear of social media, and the only television I have watched has been when Ronnie O’Sullivan was playing snooker. That said, I did, thanks to Roy Lilly, read an old report published in early 2018 about Rwanda. The piece possibly caught my eye as it described the fate of asylum seekers from the African continent who made their way to Israel, only to be then ‘relocated’ to Rwanda to start a new life.

I was intrigued by the story, partly perhaps as I had just returned from Israel, and partly because the story appeared to be so similar to the dreadful proposals announced by our politicians as to how the UK were planning to deal with the numbers of asylum seekers crossing the English Channel to reach Britain. In the case of the Israeli migrants, they were all offered £3,000 and promised legal status and safety in Rwanda. The reality was rather different. Often the asylum seekers were allowed to stay in a hotel for up to 48 hours and then were pressurised to move on and out of the country, thus starting their refugee journey all over again. It was an inhuman policy on the part of both countries. Israel also paid the Rwanda government £4,000 for every asylum seeker sent to the country.

By 2018, some 20,000 refugees had been ‘relocated’ to Rwanda – do the arithmetic; it’s a lot of money being spent that brought nothing but misery for so many people. Those that stayed there didn’t get status, can’t get employment and very much live day-by-day with great insecurity. Interestingly, many asylum seekers still in Israel would rather stay there even if it meant being detained in the infamous Israeli prisons in the inhospitable Negev desert. I say interesting, as there were reports in some of yesterday’s papers of asylum seekers in Calais who stated that they would rather stay in the camps there or risk going to prison here rather than being ‘relocated’ to Rwanda.

It is not just the UK that has these plans. Denmark is pursuing a similar policy, also with Rwanda. Australia has long attracted criticism for its policy of holding asylum seekers in both Papua New Guinea and the offshore Manus Island – both places are renowned for poor living conditions. Thankfully, this year Australia has struck a deal with the New Zealand government to offer New Zealand as a final home for asylum seekers.

The British proposal seems fraught with difficulties. Rwanda is not known for its promotion of human rights. Unsurprisingly, despite our Prime Minister’s government saying last year that Rwanda continued to restrict civil and political freedoms and continues to clamp down on media freedoms, last week Johnson described Rwanda as being one of the safest countries in the world. I don’t know what it must be like to feel compelled to leave one’s home and travel sometimes thousands of miles to seek a better, safer and more prosperous life. 

We are perhaps beginning to get a glimpse of what such a situation might feel like through the reports of those displaced and caught up in the atrocious war in Ukraine. As I write this, the war has been going on for 59 days. I cannot imagine what each of these days will have felt like to the families of those caught up in the conflict.

I do know that when I read of these events, it reinforces my sense of no longer taking everything for granted. I am very grateful for the freedoms I enjoy every day. Being able to spend my Easter weekend with family in celebration and happiness was truly wonderful. Of course, I acknowledge the growing numbers of people in the UK who are now really struggling to have lives that have meaning, where they can feed themselves and their families and pay their rent and fuel bills. Collectively we must continue to find ways of supporting each other. We need to be there for each other, to truly value everyone no matter their background or status and cherish the unique contribution each and every one of us can make to our communities.

Perhaps we should consider that, even as we see things start to get tougher in the UK, many of us remain in a much better place than those seeking asylum or who have been displaced from their homes by conflicts. I believe we should continue to try and help them find a pathway to a better life. Sending folk to Rwanda is not the way to do this. As one of my grandchildren said last week, ‘the worlds your lobster’ – I’m not sure where in his 10 years of life he heard that phrase, although he did understand the need for us all to find ways of changing and adapting when things that are very familiar to us suddenly disappear or are lost.

Easter reflections, and of course, Easter eggs

I have to say these past few days I have felt rather discombobulated. I have twice gone to the supermarket to get cabbages and greens for our goats and twice come back with bags of groceries, but no greens. On Thursday I took a shower and then realised I hadn’t shaved first; male readers will understand the significance and yesterday I tried paying for a pint of milk with US dollars. Today is the first time I have posted anything on Twitter for nearly a week, which is not like me. So yes, a little discombobulated for sure. Hopefully the long Easter weekend will see normal service resume.

It may well be the exertions, time differences and so on of our recent Holy Land pilgrimage which has left me feeling out of sorts. Our last day was Tuesday and we had a late departure from Israel. It was an exhausting journey home. Ben Gurion airport in Tel Aviv was packed to the rafters with people trying to get away before the Easter rush. We waited over 3 hours to get to the baggage desk and then another 1 hour to get through security. Inevitably our plane was delayed but at least we didn’t miss it. Wednesday, we travelled up from Heathrow airport, and after getting on the train back to Blackpool we were finally able to sit back and enjoy a couple of hours of quiet relaxation. Thursday I was back at work, but thankfully the roads were quiet. Getting up at 04.30 though was a bit of a challenge.

Don’t get me wrong, it was a fantastic trip and we packed so much into each day. It was incredible to stand in so many places that were familiar to us from Sunday School days. Each stop brought the stories and readings from the Bible to life. That said, there were one or two places where your imagination was tested. It seems over the centuries, any geographical site that had a religious significance to whoever was ruling Israel at the time (what we now know as modern day Israel, Palestine and Jordan) built a church, mosque or cathedral to mark its sacredness. One such church, was built over a rock that Jesus was said to have used to climb on to the donkey he rode into Jerusalem days before the Last Supper. Feel free to make your own mind up, all stories are important in one way or another.

With such a busy itinerary the one thing I didn’t do while away was to read the news stories – I simply lost track of what was going on in the UK, and the rest of the world. I have made up for it on my return. Sadly, as I write this blog, the war in Ukraine has been raging for 53 days, with no end yet in sight. I felt very humbled reflecting that while I had been away, this war was still being fought. Covid is still causing problems for the effective running of the NHS (and many other organisations and services). Harry said hello to his Mum for the first time in two years, promising to bring the kids next time. Our Home Secretary’s new bright idea is to send channel crossing migrants off to Rwanda. You couldn’t make it up. Thankfully the UN refugee agency appears to have stepped in and shown the humanity, generosity and compassion that we should have expected from our own politicians.

Now regular readers of this blog know I try and steer clear of politics, but with both our Prime Minister and the Chancellor being fined for breaking the Covid laws they imposed upon the rest of us just defies belief. Equally, that they are still in post is almost unbelievable. Sadly perhaps, not quite as unbelievable are the comments made by Michael Fabricant. He is the Conservative MP for Lichfield. As an aside, in a world of pronouns identification, what category or person he is, is up for debate.  

Last week, in defending the PM’s fine, imposed for breaking his (the PM’s) own laws, Mr Fabricant said that the PM was no different from teachers or nurses who during the pandemic, and after a long shift would retire to the staff room for a quick drink. Whilst the memes on social media were quite amusing, I was left thinking just how ignorant, disrespectful and out of touch so many of our politicians are. To say I was incensed with his comments would be an understatement. I quickly emailed my MP, another Conservative, but a man I greatly respect. Equally promptly he emailed me back. He absolutely despaired at Fabricant’s comments and disrespect for all those who had done, and continue to do, so much for others, since the beginning of the pandemic. I felt his despair, and I’m sure the absurdity of the story and how it landed played into my discombobulation.  Thankfully I was rescued from this emerging existential crisis by a story about the meaning of Easter – which is all about eggs. Of course. 

Having just come back from a pilgrimage around the Holy Land you might find this strange (or simply discombobulating). So, with tongue firmly in cheek, and fingers crossed behind my back – here is the story. Eggs have been central to our existence for thousands of years. Eggs are the very microcosm of our universe. Indeed, research conducted by NASA suggest that the universe is an ellipsoid. That is, egg shaped. Its shape of an egg makes it almost impossible to crush in the palm of your hand. Its shape protects the potential life inside. I say potential as we have a cockerel (called Gregory Peck) who every morning (and it has to be said, throughout the day) will regularly get it on with his hens. We think about this with every egg we eat. Yet every egg contains almost the perfect mix of amino acids required to build human tissue – it’s second only to a mother’s breast milk.

The egg is both simple and complex – rather like how we might use it. For example, if you ask Google the question ‘how do I boil an egg?’ you will get over 2 billion hits. Despite chocolate Easter eggs being around since 1875 (thank you John Cadbury), this year we decided not to give our children chocolate Easter eggs. We gave a gift of money instead. Just like the Israeli – Palestinian conflict (which sadly since our leaving Israel has once again flared up) I believe the journey towards peace and harmony can only come from looking forward and not backwards to history. The last word must go to our Palestinian Christian guide, Bassam, who noted that the future of Israel and Palestine will only be secured when the rivers of blood spilled over the years become water under the bridge. Wise words indeed.   

Freely give and you shall also receive

Today is Palm Sunday, and I am writing this blog from Jerusalem. I have long wanted to come here and visit the Holy Land. I’m not particularly religious, but coming on this pilgrimage felt like something I had long wanted to do. It has been a challenge. The conflict has not gone away, even on a weekend like this one. I have been surprised at how real the differences are and how they get played out. Although I do have Jewish ancestry, on my mother’s side, I’m not Jewish. If it counts, I did once have a small flock of pedigree Jacob sheep that were registered under the name of Gold-a Meir. For younger readers of this blog, Golda was the fourth and only female Israeli Prime Minister. She was often compared with Margaret Thatcher, the first UK female PM. All that said, I have felt a huge connection to the place and the people. 

Of course, it wasn’t just me in our house who wanted to come to Israel. It has been a lifetime’s ambition for J too. We have both had three places on our list of places to visit - the Great Wall of China, Machu Picchu, and the Holy Land. I have now done two of these, and Machu Picchu is still there waiting to be conquered. I have no doubt we will eventually do all three together. I will come back to our Israeli trip next week when I have reflected more on my experience, but first I do want to return to last week’s blog and my mention of Audrey Tang.

Audrey was a keynote speaker at the Stronger Things 2022 conference organised by the New Local organisation. She was a sensational presenter. Audrey was born in 1981. She was a child prodigy. By the time she was 5 years old, she had consumed most works of classical literature, had conquered mathematics by the age of six, and started computer programming aged just 8 years old. She learnt Perl at the age of 12. 

If like me you don’t know what Perl is, it is a computer programming language, that is immensely difficult to learn. It is often referred to as the ‘duct tape’ that holds the internet together. By 2000, aged 19, Audrey had held many positions in Silicon Valley as a digital entrepreneur. She was very successful. Returning to Taiwan, she became a core member of G0v (pronounced gov zero) which is a largely anonymous collective of digital technology designers, programmers and activists. Apple and Microsoft they’re not, and as a group, they genuinely believe in freely sharing open source software for the wider good.

In late 2005 Audrey began transitioning to a female, which included changing her Chinese and English names. She became involved in Taiwanese politics during the Sunflower Student Movement demonstrations of 2014. It was the start of great things. She helped the students, as they occupied the parliament buildings, to communicate their messages online. This so impressed the Prime Minister at the time, that he invited Audrey to build a media literacy programme for Taiwan’s schools. In 2016 she was appointed Minster without Portfolio for digital affairs. She was just 35 and the youngest member of the cabinet. In 2019, Audrey identified herself as being ‘post-gender’ or ‘non-binary’, becoming the first transgender member of the government. Her position, knowledge and attitude to life, would stand Taiwan in good stead when the Covid pandemic arrived in 2020.

Remarkably, in the two years of the pandemic, Taiwan had just 24,033 infections and 853 Coronavirus-related deaths. Compare that to the UK which has seen nearly over 21.4 million infections and 17,000 Covid-related deaths in the same period. Audrey and G0v, using shared open software solutions, developed a world-beating tracing system (which didn’t need a £37 billion budget either) that used a QR code system which required everyone to scan their location wherever they went. Every time. In the event of an outbreak of community infections, public health professionals could retrace an individual’s movements and require anyone who may have been in contact with the infected individual to quarantine. It was a massive task, only made possible because of the very low case rates; that and the population’s acceptance of such governmental surveillance and intervention. Audrey described how during the pandemic, there was a growing shared sense of self-preservation and also social solidarity.

G0v programmes were also used in managing the vaccination programme, tackling Covid misinformation, and are now very much in the front line of dealing with new variant outbreaks. They have got track and tracing down from 24 hours to 24 minutes!

Finally, let me bring you back to Israel, and J and my Holy Land Pilgrimage. As I noted above, whilst I need time to process our experience, there are some in the moment thoughts I can share. Our first hotel stood on the shores of the Sea of Galilee. We were able to visit the ruins of Capernaum, and stand on the Mount of Beatitudes (where Jesus gave his Sermon on the Mount). Yesterday we were in Bethlehem  and saw the very place that its said Mary gave birth to Jesus. It wasn’t a great experience. Today we are in Jerusalem, and our hotel is just a couple minutes’ walk away from the Damascus Gate, which is the main entrance to the Old City of Jerusalem. The Old City is a fascinating place. To walk though, something weJ did yesterday evening. On this Palm Sunday, we will join the procession from the Mount of Olives to that Old City, and we have our palm fronds ready! 

Israel also managed the pandemic well. It has a superb public health infrastructure, including probably the best and most comprehensive electronic medical record system in the world. They have the highest life expectancy in the world, at almost 83 years. Their health care system is the result of sustained investment over the past 70 years. Like many other countries, the Israeli health care system benefits from highly skilled health care professionals (and there’re more of them per head of population than in the UK). Using this resource, they very effectively used vaccinations much earlier than other countries to limit the impact of Covid. Whilst perhaps they’ve not been quite as successful as Taiwan*, Israel’s death rate is less than 11,000 Covid-related deaths during the entire pandemic.

Both Taiwan and Israel continue to effectively use new digital technologies (in different ways) to both support health care interventions, and to communicate and engage with their populations. Both countries have high levels of social cohesion and utilise community power well to bring about change. This brings us back to that Stronger Things presentation I liked so much. When Audrey was asked if there was just one thing that she would like to leave us all with, she said, yes, and it was something from her favourite (and mine too) song writer, Leonard Cohen. I thought her answer was perceptively apposite to both dealing with the pandemic, and maybe also to resolving the conflict in Israel and elsewhere too. 

Ring the bells that still can ring

Forget your perfect offering

There is a crack, a crack in everything

That’s how the light gets in.

 

 

*Comparisons are always difficult, but even where population controls are used, Taiwan and Israel have done better than the UK, US and many other European countries regarding Covid mortality.

Community Power: it’s a way to make a difference every day

Goodness me we are in April already. The days seem to slip past so quickly at present. Last week went by in a blur, but it had lots of highlights. One of which was the Stronger Things 2022 conference. Now I haven’t been to a face to face conference since 2018. Mainly because since then, conferences had ceased to feature so prominently in my life. In the previous 20 years I had presented 116 papers at conferences in 25 different countries. That was a lot of words written and many miles travelled. Thankfully on this occasion, I only had to travel to London, and best of all, I had no paper to present and was attending simply as a conference delegate – sheer luxury. 

The conference was held at the wonderful Guild Hall in London facilitated by New Local. This is a fabulous organisation that operates as an independent thinktank. It has a mission to transform public services and to do so through ‘unlocking’ community power. It was this mission that drew me to the conference in the first place. 

Legislation currently going through Parliament aims to see a more integrated health and social care approach to service provision being developed. The pandemic showed us all just how vulnerable the NHS is, a consequence of many complex interrelated issues. Here are some of these issues:

Money has long been an issue for the NHS. The pandemic masked this fact as the Government paid whatever it took to keep people safe and well. However, with the ‘living with covid’ concept comes a return to a more familiar financial regime. Like Councils, in the future, NHS organisations will have to deliver a balanced financial budget each year. This is something it has never had to do before.

There continues to be many issues impacting the health and care workforce. In the main, there are big shortages of qualified staff across all the professions. Given the nature of education and training of many of the professions, there are no quick solutions to these problems.

We are all living longer, although not always healthily. The numbers of folk living with complex long term conditions continues to rise. There was a pandemic hiatus in people seeking health care early, with the result that for many people, treating their condition has been made more difficult. The pandemic also exposed the real impact of the growing societal inequalities and how these play out in terms of healthy lives. We continue to see a rise in numbers of people with conditions such as obesity and diabetes, often a consequence of the choices we make over our eating and physical activity habits.

Whilst the legislation going through Parliament addresses all of these issues to one degree or another, the most exciting aspect of the proposed changes is what can happen at a local, neighbourhood level, what is being described as ‘placed based care’. Place based care is where community power comes to the fore. At every stage of our lives, we all need the support of others to grow healthily, to develop a moral code to live our lives by, to become educated and knowledgeable, and build relationships that nurture us. Some of us will need greater support than others. That’s where communities and community power come to the fore. It was Hillary Clinton who popularised the Nigeran proverb ‘that it takes a village to raise a child’. The sentiment resonates. 

In many places that sense of community, of being there for others has been lost. Today the wisdom and support that once might have been available from within close knit communities can be hard to come by. I think it’s why so many people end up presenting themselves at their local Emergency department. Nonprofessional advice about life problems, particularly health problems can be difficult to access, even with Google. Equally, professional advice, such as that found in primary care settings can be equally difficult to access.

Don’t get me wrong, hospitals have their place in communities, but the magic of community power, is the possibility of taking a different approach to health and wellbeing, an approach that is part of the very fabric of the communities we all live in. If we can help more people to help themselves and those around them, then we can reduce the number of people who might need professional health care to keep them well and enjoying a good quality of life.

My background is in mental health. Practitioners in mental health services have long recognised the value of seeing individuals as being experts by experience. Often, people are themselves well placed to identify what would help them to thrive. There were many presentations at the conference that drew out what such interventions might be. In the main these were not health interventions. However, where this might be necessary, we heard of examples of how health professionals truly partnered with individuals to find solutions that worked best for the individual. That awful modern term ‘co-produce’ was sprinkled throughout many of the presentations, and although I dislike the term, it did seem appropriate as a description of the experiences being shared by many of the speakers.

It would be impossible to name check all the presenters, but there were some folk who stood out for me. Angela Rayner was an absolute delight to listen to, as was Danny Kruger, an MP from the other side of the house, Donna Hall, who always talks with such great wisdom and experience, drew on her experiences in Wigan and Bolton; Oliva Butterworth was in fine form, and spoke with great forthrightness and authenticity, and when you think about where she works, I thought she was remarkable. There were many other’s. One person who really chimed with me wasn’t a presenter, but a delegate like me. She was a lady called Clare Redfern, and she worked for Stockport Council. Clare has a long history of using community power in areas of social housing, fuel poverty and other aspects of social care. She also heads up a charity called Blood Bikes, see here. I said I would give a mention for this remarkable charity, so Clare, a big thank you to all that Blood Bikes continues to do for the NHS.

My favourite presenter of the conference, however, was Audrey Tang. She was totally inspirational, and I intend to come back to her in my blog next week, which will be posted from a country I have never been to before. There is a time difference, so forgive me if the blog doesn’t get posted at my usual 05.00 next Sunday.