Sunday, 31 August 2014

Malnutrition - public health people are lying to us about its incidence


The Guardian writes this:

Doctors and hospitals are seeing a rise in children suffering from ailments caused by poor diet and the faculty has linked the trend to people's inability to afford quality food. Latest figures show there has been a 19% increase in people hospitalised in England and Wales for malnutrition over the past 12 months but experts say this is only the extreme end.

From this you would conclude, would you not, that there are hordes of starving children with distended stomachs filling up our hospitals? Whether the author did this deliberately is unclear but the truth is that all of that increase in malnutrition relates to the elderly. Every year, for as far as records of malnutrition go back, there are around 200 children admitted to hospital with conditions related to malnutrition.

The main reason - here from 'fullfact' -is this:

People with certain long-term health conditions can’t always retain all the nutrients they need – particularly the elderly, who might also struggle to make the trip to the supermarket. With this in mind, the higher incidence of malnutrition might also reflect broader demographic trends, including the fact that the UK’s population is ageing. The most recent Nutrition Screening Survey showed that those aged 65 plus were more likely to be malnourished than those who were younger. In addition, it may also be that hospitals are now more likely to screen a patient for symptoms of malnourishment.

So the Faculty for Public Health (and Tracey McVeigh in The Guardian) are misleading us about malnutrition because it suits their political agenda. There has been no increase in child malnutrition and the numbers are very small (200 hundred cases in a cohort of nearly 12 million) but we continue to be told that there is a problem. That is, of course, when the Faculty for Public Health isn't telling us that all our children are obese because of "junk food" and fizzy drinks.


Saturday, 30 August 2014

In which I agree a little bit with Owen Jones


It's OK folks, I've not turned overnight - as if in some Kafka-esque horror - into a socialist. But I think that Owen Jones, Boy Socialist has a point when he talks about the elite and what the Americans would call 'corporate welfare':

Who are the real scroungers? Free-marketeers decry 'big government' yet the City and big business benefit hugely from the state – from bailouts to the billions made from privatisation. Socialism does exist in Britain – but only for the rich

Now our youthful leftie then goes on to spoil his argument a little by missing out on some of the corporate welfare but his points have some merit. Indeed, I would go as far as to say that Owen's criticism of what he calls 'privatisation' also has merits.

The point however relates to a different cause than Owen suggests and the solution lies in less socialism not more socialism. The problem with what Owen calls privatisation is that it is nothing of the sort. Privatisation involves taking a state-owned monopoly and placing it - usually through sale - into an open market environment. We did this with telephones, gas, electricity and water with considerable success (although the state kept its fingers in the pie by fixing all these markets in one way or another - mostly to the benefit of businesses rather than consumers).

Issuing contracts to run trains on a state-owned rail network is not privatisation. Nor is outsourcing the collection of municipal waste or the commissioning of hernia operations. This is just the state opting to buy rather than do itself - for it to be true privatisation you have to change the customer - to have to have a system where consumers make choices in a free (or relatively free) market.

However, to return to Owen Jones, he is wrong when he argues that big business rejects 'statism' but right when he points to the benefits that the grandees of big business get from big government. The switch to a smaller state with more of what we call 'public services' delivered through the market simply doesn't suit those powerful businesses that deliver those public services on contract. Or indeed the equally large businesses that fund those businesses allowing them to compete for large public contracts.

However, the problem here isn't just the fact that public services are outsourced but that the market is, mostly because of regulation and legislation, seriously constrained. Owen points to the big public services contractors like Serco, G4S, Atos and Capita and makes reference to the 'Big Four' accountancy firms. What he describes here is a marketplace constrained by the scale of the contracts and by the specification of those contracts. While the Transatlantic Trade and Investment Partnership (TTIP) would partly open this market - and some of the regulations, its main outcome for public services would be opening up EU 'markets' to large US contractors (and vice versa).

The problem is that, so long as people like Owen insist that services are delivered through a planned system rather than a market, the producers - whether state employed management or the managers in private contractors - will fix the system in their own interests rather than in the interests of the consumer. And while there are areas - basic scientific and medical research, for example - where only the state will invest, in areas where a market can operate there will be more investment under capitalism than in a state-directed monopoly.

Owen Jones is right to identify corporate welfare as a problem but completely wrong in offering a 'solution' that merely transfers the self-interest to the managers of state enterprises. If Owen wants real change he needs a system where the self-interest is transferred to the consumer of the service - you and me, the public. And this system - in most circumstances - is called a free market.


Friday, 29 August 2014

Friday Fungus: The Zombie Ant Army

Be afraid! Be very afraid! You know the Threat Level thing? This is Threat Level Zombie Ants!

The research focused on a species from the genus Ophiocordyceps — known as “zombie ant fungi” — which control their ant hosts by inducing a biting behavior. Although these fungi infect many insects, the species that infect ants have evolved a mechanism that induces hosts to die attached by their mandibles to plant material, providing a platform from which the fungus can grow and shoot spores to infect other ants.

This little fungus takes over the ants brains and leads them to a place where the fruiting head can grown and spawn the source for more zombie ants!


Politics and science...

"A soldier, having seen traces of a horse in the sand, will immediately pass from the thought of a horse to the thought of a horseman, and from that to the thought of war...But a farmer will pass from the thought of a horse to the thought of a plough." Spinoza

There's a tendency for some educated scientific people to consider that you can reduce the process of political decision-making to an exercise in the scientific method. Some sort of 'test' is conducted and the results mandate the policy decision. Most often the 'test' isn't an actual experiment (these are, as those scientists should know, pretty hard to construct in real human populations) but some sort of meta-analysis of smaller tests and analyses. From this process we arrive at statements like 'the science is settled' and 'nearly all scientists agree' despite the scientific truth being a whole lot more nuanced.

A related approach is to assume that a human problem identified by 'science' must require the intervention of the state for its resolution. At this point I can hear some on the left peeling away from the argument but bear with me because this really isn't about left/right or big/small government but about the role and purpose of two different things - science and politics. It would be a rum do if we used politics to determine the outcome of science. Why then do some people not see an equivalent problem in trying to use science to make political decisions?

Scientific and political questions are framed very differently. This is for good reason. A scientist would not, for example, ask "Should Scotland be an independent country? Yes/No". Yet this is an entirely valid question in a political context that will lead to a clear decision. A scientist might ask 'what would Scottish independence mean for X' and then try to construct some sort of test to answer the question. And the findings from that scientific enquiry might well help people answer the political question. But the science does not provide the answer.

The second point about that independence question is that is it absolute - the 'right' answer is that answer securing the most votes. Fifty Per Cent Plus One is enough. For science that isn't enough. Read any piece of good scientific research and you will see caveats - a section perhaps entitled 'limitations' setting out the constraints of the test being conducted and towards the end of the paper a piece on the need for further research. Good scientific research doesn't answer questions so much as turn one question into a myriad of other questions. Such an approach is fantastic if we want to understand the world but worse than useless if we want to decide whether or not Scotland should be independent.

So when a writer - as happens here - singles out one political ideology as peculiarly anti-science this is the result of either a profound ignorance of politics and the political process or else the presentation of a personal ideology as if it were scientific fact. Indeed, we can observe the same from other political perspectives - the adherence of many on the left to the view that GMOs are bad, nuclear power peculiarly dangerous and pesticides destructive is a fine example of how scientific evidence is routinely ignored.

If we are to 'respond' to climate change this does not mean that there must be more government, more regulation and some sort of crusade to stamp out any capitalism bigger than the corner shop or the local agricultural co-op. Those who choose to say 'I don't believe a word of it' also cannot be dismissed because they might just be right.  The problem is (and here's some science) that our ideology - political bias - means that we do one of two things: either we make choices that fit our existing bias or else we select particular findings while ignoring others again to fit a prior bias.

To return to that Scottish independence question again. Were I a 'Yes' supporter seeking evidence to support my case, I would select those studies, tests and experiments that support my contention that Scotland should be independent. I would also ignore the element of choice involved in political decisions. There are costs and benefits to every decision but political or ideological bias leans us towards emphasising only the costs or only the benefits.

To give another example, the argument that alcohol costs the UK £21bn each year is, say public health people, derived from scientific enquiry. It may well be a true figure. But against that figure we have to set an estimate of the benefits society gains from alcohol not just jobs, businesses and exports but the pleasure we get from a glass of wine or a pint of beer.

In the end we have become rather too dependent on scientific enquiry in answering (rather than framing) political questions. And the risk here is that the scientist, once removed from the constraints of experimental investigation, is likely to be just as ideologically biased as the non-scientist. Indeed, what we get too often is a complete misrepresentation of the ideology with which the scientist is disagreeing. To suggest that somehow 'libertarians' balance "individual rights against the rights of others" is a complete misrepresentation both of libertarianism and of the small-government conservsatism that the author was actually criticising.

One of the curiosities about what we might call the 'scepticism movement' is its ideological attachment to a sort of social democratic human engineering view of politics. I compare this to the commonplace view among the centre-right that everything would be fine if only we put businessmen in charge. For the 'sceptics' the solution appears to lie in sort sort of post-democratic technocracy where the task of politics is to implement the 'findings' of the scientific consensus and that politicians should be slaves to the selected and presented evidence. A side effect of this concept in politics is the modern idea of leadership - politicians' task is to 'lead' the reluctant and recalcitrant populace towards to consensus defined by the technocrats' 'science'.

None of this is to dispute the value of science. Rather I want to step back from the fetishising of scientific enquiry as the only worthy decision-making system. Instead of a "science says yes" process called evidence-based policy making, we need to understand that the purpose of the evidence is to inform our decision-making not to do that decision-making for us. And the point and purpose of democracy - lost in translation all too often - is for the people or the representatives of the people to make choices about things that can't be (or aren't) made in the market.

Like everyone else scientists are prejudiced, have irrational attachments to ideological positions and allow personal likes and dislikes to colour their thinking. I take the view - like many of those libertarians - that most of the time decisions are better taken in the marketplace where mutual benefit and added value determine the outcome. But this is an ideological position - one with a great deal of scientific support as it happens - and others will believe differently. As we've seen with the independence debate, scientific enquiry can only inform the choice that people have before them.


Wednesday, 27 August 2014

Quotes of the day...


"One young person told us that ‘gang rape’ was a usual part of growing up in the area of Rotherham in which she lived."
"...fathers tracked down their daughters and tried to remove them from houses where they were being abused, only to be arrested themselves when police were called to the scene."

"One child who was being prepared to give evidence received a text saying the perpetrator had her younger sister and the choice of what happened next was up to her. She withdrew her statements."

"Within just a few months, Child B and her family were living in fear of their lives. The windows in their house were put in. She and her family received threats that she would be forced into prostitution."

"The social worker’s assessment was that Child C’s mother was not able to accept her growing up. In fact, she was displaying what are now known to be classic indicators of child sexual exploitation from the age of 11. By the age of 13, she was at risk from violent perpetrators, associating with other victims of sexual exploitation, misusing drugs, and at high risk."

 "An initial assessment accurately described the risks to Child D but appeared to blame her for ‘placing herself at risk of sexual exploitation and danger’."

"Notes from the children’s unit files at the time suggest there was a level of chaos surrounding the care of Child E and other children in the unit, with staff powerless as older children in the residential units introduced younger and more vulnerable children like Child E to predatory adult males who were targeting children’s homes."

"Her father provided Risky Business with all the information he had been able to obtain about the details of how and where his daughter had been exploited and abused, and who the perpetrators were...Three months later, the social care manager recorded on the file that Child H had been assessed as at no risk of sexual exploitation, and the case was closed."

"Time and again we read in the files and other documents of children being violently raped, beaten, forced to perform sex acts in taxis and cars when they were being trafficked between towns, and serially abused by large numbers of men. Many children repeatedly self-harmed and some became suicidal. They suffered family breakdown and some became homeless. Several years after they had been abused, a disproportionate number were victims of domestic violence, had developed long-standing drug and alcohol addiction, and had parenting difficulties with their own children, resulting in child protection/children in need interventions. Some suffered post-traumatic stress and other emotional and psychological problems, often undiagnosed and untreated. Some experienced mental health problems."

Most of the men who did this to these young girls are still walking the streets of Rotherham. Or rather crawling along in their cars looking for a new batch of girls to ply with drink and drugs before raping them with their mates. A civilized country?


A brief note on the Rotherham abuse report...


There is rightly a lot of sound and fury about a report into the systematic abuse of some 1400 girls and young women by mostly Pakistani men in Rotherham. Indeed, as the author of the report made clear when interviewed, the 1400 figure is a 'conservative estimate'. And the report doesn't pull its punches, at least in setting out the failings of the political and social services leadership and management in Rotherham nor are we dealing with something minor or marginal:

In just over a third of cases, children affected by sexual exploitation were previously known to services because of child protection and neglect. It is hard to describe the appalling nature of the abuse that child victims suffered. They were raped by multiple perpetrators, trafficked to other towns and cities in the north of England, abducted, beaten, and intimidated. There were examples of children who had been doused in petrol and threatened with being set alight, threatened with guns, made to witness brutally violent rapes and threatened they would be next if they told anyone. Girls as young as 11 were raped by large numbers of male perpetrators.

The Report is clear that the problem continues today - that the authorities are more aware seems to be a matter of external pressure rather than a committed attempt by those authorities to face up to a serious problem within their town and, specifically, within one particular community in Rotherham.

My concern is that, while the Rotherham case is especially shocking because of its scale, the nature of the crimes and the manner of the abuse is repeated elsewhere. We have seen similar reports from Keighley, from Preston, from East Lancashire, in Derby, in Oxford and in Luton. All of these cases involve mostly Pakinstani men - primarily in their 20s but also men in their 30s and 40s, married with their own families - targeting vulnerable teenage girls, plying them with alcohol and drugs and taking them to 'parties' where they are raped and abused.

I don't know enough about the Pakistani community to understand how this behaviour has come about - I have Pakistani friends who are as shocked and horrified, perhaps even more so, as I am over these reports and events. There seems almost to a be a form of omerta here, an unwillingness to speak out, to point accusing fingers at the reasons for the problem arising.

However, there is no doubt that that failures identified in the Rotherham Report have made matters worse. It appears - again I don't know whether this is the case elsewhere but I suspect it is - that management within the police and social services were unwilling to respond for fear of being accused of prejudice and racism. Even now, when the scale of Rotherham's problems are made clear, there are people falling over themselves to deny that there is a specific problem within the Pakistani community in that town. This sort of response does not protect the girls and young women involved and does no favours to either 'community cohesion' or the Pakistani communities in the UK.

It's true that the sexual exploitation of girls and young women isn't solely an issue for the Pakistani community- we've seen the extent of Operation Yewtree and other examinations into historic allegations of abuse. And we read of other abuses, often organised abuses. But this form of abuse - targeting girls and young women, plying them with drink and drugs and then sharing the victims round like playthings - has been all too frequent among Pakistani communities. Not just among young men captivated by gangster culture but, just as with other child abuse in the wider community, among otherwise respectable men in their 30s and 40s.

I'm reluctant to call for enquiries - most often they serve either to push the issue into the fog of the future or else to provide a platform for the worst sort of human rights lawyers to make a load of cash. But, given the number of similar cases from right across the country, it would seem worth considering whether an enquiry would help both the professionals dealing with the problem and the Pakistani communities to develop a more effective response to these 'grooming' cases.

In the end though, the real lesson is that those authorities charged with protecting children and young people from abuse are too often simply not up to the job. A combination of that politically-correct fear of racism accusations and the preference of senior management for meetings to discuss strategies has resulted in front line officers who feel unable to act quickly, effectively and robustly when they know abuse is happening.


Monday, 25 August 2014

Food heroes of the day - Ninewells Hospital, Dundee...


Assorted health fascists and nannying fussbuckets are frothing at the wonderful dish served up at Dundee's Ninewells Hospital:

The pie is crammed with sausage, bacon, black pudding and beans and is topped with a fried egg. It is available from a takeaway counter at the Dundee hospital.

This is a hospital, people are gloomy, ill, depressed and in need of some decent nosh - hence such a fantastic pie. But the nannies  hate it:

Professor Mike Lean, a former government advisor and chair of human nutrition at Glasgow University said it was a "shocking" example of a meal.

"It should never be anywhere near a hospital," he said. "It is laden with fat, salt and without a vegetable in sight. There should be strict guidelines for all food sold in hospitals."

And Tam Fry, the self-appointed obesity expert shouts:

"What we have here is a heart attack on a plate. It should be absolute obligatory for the NHS to have wholesome food whether it is from a takeaway shop within hospitals or on menus."

I don't get it at all - what could be more wholesome that a fry-up in a pie. At least it's not deep fried (yet).

A good view of the pie (and a fine sight it is, if not for the faint-hearted) can be seen here.