Disease in a connected world

The threat of the spread of swine flu is understandably grabbing news headlines just now. Building on previous threats (bird flu and SARS) which have arisen in recent years, the media can be guilty of sometimes inflating the threat to apocalyptic proportions. The fact that people have already died in Mexico from the strain, and the fact that it has already popped up in so many different countries across the world heightens this situation.

Regardless of whether this particular strain of influenza turns out to present a large scale threat to the world or not, the situation highlights the threat that disease poses to us in the interconnected world we live in. The outbreak of flu in 1918 led to a pandemic which killed more than double the number that had been killed in the First World War. This was before the explosion in globalisation which has led to interconnectedness on a scale previously inconceivable.

At the risk of sounding alarmist, imagine the deadly possibilities of an outbreak of flu (or another disease) of the severity of 1918. The swine flu currently being observed seems to have an incubation period 0f 24-48 hours - other diseases can be even longer. This is more than enough time, particularly in the case of a disease with aerosol transmission, for an infected person to have travelled by plane from the country of infection to any where else on the globe, potentially infecting others on the plane with them so that by the time they land, possibly in a major population hub such as New York or London, there are already a number of infections.

Disease has always possessed the means to spread globally - the Black Death was an example of using rodents as a vector - and travel methods are often key to this spread. However, the nature of the world today makes this even easier. Indeed this is why health departments around the world are open about the fact that infections are inevitable - it is not a matter of stopping the spread but rather minimising its impact and health implications.

The monitoring of infectious disease is a key area where more work is required in order to ensure that information is shared to reduce the impact. One of the key issues with the spread of SARS was that there was a delay in alerting the world to its existence, by which it had moved outwith China's borders. It is very difficult to bring together different nations, particularly those whose political contexts make them wary of or hostile to other nations, however it is crucial in this context in order to allow for co-ordinated responses led by the WHO.

Disease is an issue which does not respect national sovereignty, and therefore a globalised response is essential in order to meet the challenges of global infection. Once this particular outbreak is responded to (going on the hopeful basis that its impact can be restricted - certainly the fact that it can be treated by certain drugs gives hope) it is important that the WHO is given more support in developing methods of reporting across the world. As we link up ever more closely we open doors to infectious diseases to spread across the world - it is vital that we respond to this challenge before we are met with a pandemic which could indeed be of apocalyptic size.

For more reading on this matter I would strongly recommend Promed Mail and the Coming Plague by Laurie Garrett. Promed in particular is an absolutely vital resource bringing together front line practitioners from across the globe, and has been at the forefront of responding to emerging situations in the manner that I have suggested we need more of above.

A Place for Paedophiles?

I watched Louis Theroux's documentary A Place for Paedophiles which was on BBC 2 the other day and would recommend everyone to check it out on BBC i-Player. Overall it was surprisingly not as involving as some of his other documentaries (possibly because he himself struggled with the subject matter and the men involved) but the subject itself is a very important one.

The place in question is the Coalinga State Hospital in the State of California. This is an institution built to house convicted sex offenders considered too dangerous to be released back into the community, particularly paedophiles, due to the high risk of them re-offending. There is a programme on offer which potentially offers the 'patients' a chance of release back into the community, however this is not a common occurrence, particularly since the majority of the patients (c.70%) refuse to participate in the programme - these men, barring successful legal appeals, are therefore contained in the Hospital for the remainder of their lives.

Louis identified a great deal of resentment amongst the patients who felt that their civil liberties and constitutional rights were being withheld from them. All of the patients had been convicted of sexual offences and had served prison sentences. Their move to the hospital came at the end of their sentences, when they would have expected that they would be released back into society, having 'served their time'. As their current holding (Louis referred to the hospital as a warehouse) is to prevent potential future crimes which they therefore have not yet committed, they feel that they are being doubly and unfairly punished - as one patient declared "If you are going to lock people up for crimes they haven't yet committed, you'll need to lock everyone up". And this seemed to be a view point shared by some of the therapeutic staff working with the patients.

At first glance it is certainly possible to identify the 'slippery slope' argument which is contained within their protestations. If the state starts to lock up people for crimes they have not yet committed, where will this end? Could it indeed be used to justify locking up anybody and everybody on the basis of some potential future crime?

This is an important point to bear in mind, however it also ignores the reality of the issue which is behind the holding of these men. Their hospitalisation is due to the deep-rooted psychological traits which underpinned the actions which led to their incarceration. The patients in Coalinga are men responsible for systematic and calculated abuse, the full extent of which in many cases has not yet come to light. These are not criminals who committed a crime of acquisition or opportunity, these are fundamentally psychologically deviant men with whom it is impossible (certainly prior to participation in the five phase programme Coalinga uses, and probably even after) to give even a vague assurance that they will not re-offend. For these men there is something 'wrong' with them which serving their time does not solve and which remains, essentially, a way of life which many of them do not consider to be wrong.

The issue draws back to what our prison service and penal code is for. There are three core reasons for imprisonment - rehabilitation, punishment and protection. Imprisoning a paedophile for his (or her) crimes demonstrates the punishment for the crime, society's way of saying we caught you so you must be punished for this. However, the punishment is invariably a short-term pointless term in prison which serves no purpose other than to act as a slap on the wrist. Certainly there is no chance for even a stab at rehabilitation. And this is fundamentally the crux of the matter for me - if there is no rehabilitation possible in the time available then more than just punishment is required. In this case the third purpose, protection, must come into force.

This protection is for society as a whole, as without a long term period of rehabilitation and therapeutic support systematic paedophiles present a very real and ongoing threat to the communities they live in. This sort of sexual dysfunction is therefore a continuing motivation and cause of danger - certainly with the pathetically inappropriate prison sentences, lack of rehabilitation in prison and scarcity of support outwith prison, it is naive in the extreme to believe that paedophiles will be able to self-regulate their behaviour completely on their own.

It is therefore wrong to see institutions such as Coalinga as punishments for crimes which are yet to be committed; rather they are institutions designed to protect both the patient and society from the urges and dysfunction which is beyond their control. This lack of control is not an excuse or justification for their actions - regardless of the dysfunctional psychological state they may possess, they are still responsible for making choices to offend. However, the lack of control is the basis for continuing to hold them away from society until a time when it can be demonstrated that their urges have been brought to a regulated level.

I don't agree with the logic behind laws such as Megan's Law or Sarah's Law where the presence of convicted paedophiles in the community must be made available (to the point, in the US, of addresses being available online). This leads to two dangers - vigilante behaviour and also, ironically, false sense of security which can create conditions for abuse. The majority of sex offenders are known to the person concerned, with many being parents or guardians - 'Stranger Danger' ignores this reality. In addition, many sex offenders are unknown to authorities due to not having been caught - they will therefore not appear on any registers or lists. However, the demand behind measures such as these do reflect a public perception that the current response to sex offenders is not working. The pointless and inappropriate prison terms coupled with the recognised lack of rehabilitation and support demonstrate to the public that this is an issue which is not be handled effectively by the state, with the danger being left for their communities and families - a situation which is always guaranteed to cause anger and reaction.

The existence of Coalinga is not a cheap one (it costs roughly $200,000 p.a. to house each patient) and it does raise controversy about civil liberties. However, it also serves to protect society from individuals who present a clear and lasting threat - in this case prevention may well be better than reaction. Certainly in the UK we need an in-depth review of all sentencing and support for sex offenders to ensure that imprisonment and monitoring following release meets all three of the reasons behind imprisonment. It is not enough to merely impose a short term sentence and then wash our hands of these offenders - our society and its vulnerable members deserve more from us. Maybe the UK has need of an institution like Coalinga in order to protect society from those whose dysfunction prevents a threat to it. We wouldn't release a sociopathic serial killer back into the community, whose psychological dysfunctions present a continuing risk to society - is it not time to realise that sexual offenders represent a similar threat?

Let Battle Commence...

The lines have been drawn, the election is in full swing and Labour is coming out all guns blazing - if we're gonna lose, it's gonna be a glorious last stand.

OK, that's a bit of an overstatement of the Budget I admit, but the raising of the top rate of tax, whilst its economic impact may or may not be negligible, is a clear fire fight with the Tories. The next election will be between the Labour Party, looking to claw back some of the money that the rich have accrued during the times of plenty; and a Tory Party reverting to their traditional stance of protecting the interests of the rich above the rest of society.

It won't get to this level of clear distinction, however, for several reasons. Firstly, the public blame the Government of the day for economic travails which the country suffers, and that Government is a Labour one - therefore there is a desire to punish the administration. Secondly, the public perception of the Tories which was rooted in the right wing excesses of the Thatcher years is not as prominent as it once was meaning the public do not necessarily associate them with the rich to a greater degree than they do the Labour Party (plus, of course, it has to be remembered that many people in England were very pleased with Thatcher's approach to government). Finally, Cameron is too shrewd an operator to slip into the trap of expressly defending the interests of the rich above all others, regardless of what his real intentions may be. The move does present an interesting conundrum for him though - does he support it, potentially picking up public support but possibly alienating the City and other core Tory support? Or does he oppose it and run the risk of appearing elitist and out of touch? I think it'll be the latter, but he'll base his opposition on the belief that the move won't be effective rather than outright support for entrepreneurialism/defending the wealthy.

Overall there are some interesting aspects to the Budget, with the rise in child tax credits and the provision of work or training for under-25s beneficial moves. However they may be lost amidst the levels of public borrowing and the optimistic forecast which the Chancellor has based his figures on.

If his forecast turns out to be right, or at least closer to the mark, then this Budget may turn out to be a very successful one, however, if the consensus is closer to the mark then we could have a very difficult period ahead of us. What is needed is a fundamental review of how we approach government and what we want for the country - a greater focus on social housing, support for the unemployed, job creation and fairness in taxation and wealth distribution rather than fire fighting is needed if a fourth term is to be even remotely possible.

The tax rise may succeed in grabbing the headlines and may even revitalise some Labour activists, but the Budget must only be the start. It now requires a period of bold and innovative government to demonstrate that Labour can continue to be in power and to focus the minds of the electorate on the possibilities of the future rather than the challenges of the present and past. This is an uphill task for any administration - it is up the Prime Minister and his team to prove that they can do it.

Failing Grade for Scottish Education?

"Scotland's Education System is the best in the world - all other nations look to us to see how it is done."

During my time at teacher training college this was probably the most repeated phrase I heard. We had it drummed into us that Scottish education was the best in the world, at the forefront of pedagogical theory, and certainly much better than the excuse for a system which operated south of the border.

Sadly, this is no longer the case. Yes, Scottish education has a long and proud history and did set the trend for its peers. However the ball has been well and truly dropped. Other nations have taken on board the successes of Scotland and introduced them in their own systems. However, unlike Scotland they have then proceeded to evolve and improve them, leaving the Scottish system looking stagnant in contrast. The laurels have been so thoroughly rested upon that they are now flat and crushed.

The Scottish think tank Reform Scotland have made another contribution to this research, analysing the difference that devolution has made to education in Scotland. It would have been fair to presume that 10 years of specifically Scottish control of the system (rather than interference from UK wide bodies who supposedly do not understand the system up here) and increased spending (spend per head for secondary school pupils has roughly doubled over the period) would result in increased success. Sadly, this presumption is wrong.

The Reform Scotland research uses the same measurement of academic achievement which is used for England and Wales, which measures the percentage of pupils achieving five good grades, including English and Maths, by the end of compulsory education in S4. This measurement is considered more robust than other measures as it includes all pupils and avoids the artificial inflating of grades by means of including 'easier' exams.

These measurements find that the percentage of good grades achieved in England is now greater than Scotland, and further that the Scottish percentage has shown an overall decline since an initial improvement following devolution's inception (which could potentially be ascribed to the decisions made by the UK Government in any case).

This is a disappointing and alarming statistic, which requires intervention from the Government to counter-act. The problem is that the presumption of Scottish academic success has, at least from I've seen, hindered the development of innovative educational advances. I have
argued before that fundamental changes are required in how we approach education in Scotland, let alone how we fund it, yet it often appears to be the same old story, with ministers praising all and sundry without actually suggesting new directions.

Reform Scotland certainly have suggestions, their report Parent Power advocating the introduction of school vouchers, amongst other measures, as a means for improving schooling in Scotland. The voucher argument is one that, perhaps due to the perception that Scotland is a left of centre nation, has not really been discussed on a meaningful level, however statistics such as those demonstrated by Reform Scotland will certainly open up a means for that debate. There is therefore a requirement for those who support the current system of public education to elucidate its strengths and demonstrate the way forward in regard to changes and improvements that are required.

Scotland's education system can be potentially the best in the world again, if the welcomed increase in funding is matched by a desire to make education more than just rote learning, solely targeted at the achievement of examination qualifications which, if are being brutally honest, count for nothing beyond entering Further Education or possibly a first job (important roles, but not outcomes equal to the importance, and therefore pressure, attached to the exams themselves). Parent power is a good concept in regards to seeking to involve parents in the life of the school, but the Scottish Government must also be ensuring that the curriculum delivered in the schools is tailored to the development of our young people as rounded individuals equipped with a broad range of skills and experiences for life.

This broad approach has long separated Scotland's education system from that of south of the border and is to be treasured. Likewise the commitment to ensure that all of Scotland's young people are able to access high quality public education regardless of social situation or geographical location is one that we should defend. However, our system as it stands is failing to match these ideals, leaving a postcode lottery whereby luck and parental attitudes have as big, if not indeed a bigger, role to play in the educational achievements of the young people than the curriculum and teaching they receive.

This report is to be welcomed for the challenge it provides to the comfortable status quo and the difficult questions it asks. Now it is time for different suggestions to be put forward, to ensure that Scotland's education system again becomes the envy of the world.

More information can be found at Reform Scotland and the BBC.

Provoking Political Participation

Glasgow City Council is looking to ban political posters during elections, with the Executive due to vote on the measure this Friday. Unlike most things in Glasgow this seems to have cross-party support and therefore will come into force.

The argument behind the move is an environmental one - the ban comes under the Clean Glasgow campaign and is designed to cut down on waste and the cluttering up of public property with tattered signs. In addition it has been expressed that this will help re-engage the electorate with the democratic processes.

I support the measure, but I think that the intention, particularly the belief that it will increase participation, is misguided. My support for it is based on the fact that I don't believe the posters do very much to inform the electorate. Voters do not seem to notice who has put posters up - if anything the focus seems to be on who hasn't put anything up, forcing parties to waste time, effort and money on pointless signage merely so that voters don't complain about a lack of input from them.

However, the absence of posters is not going to stimulate political participation from its moribund levels. Working in the field, I find it depressing how common it is to hear people express the belief that politics does not matter. At all. In any way. Now, I hold that with most people you can find something political in five minutes which affects them, however the disconnect is firm and deep, and is incredibly damaging to our democracy.

This disconnection is only being further strengthened by the ridiculous mess that is MP's allowances. I am honestly hard pressed to think of a way, particularly during an economic downturn, that would be more successful in turning people off politics. The country is suffering, people are losing their jobs, businesses are closing - but it's ok, our politicians are still managing to claim money without receipts or indeed any justification. And we wonder why people are fed up!

The climate of disconnection is a very dangerous one and is helping to fuel the growth of extreme groups such as the BNP. To combat it we are going to need to do much more than simply ban political posters. We need a fundamental reimagining of our entire system of politics.

When I worked in Shettleston constituency (the most socially deprived constituency in the UK) a common response when I tried to get people interested in politics was "it is only for old, wealthy, university educated men". Working with the ethnic minority population in Scotland now, the response is identical except for the addition of the word 'white' to enhance the exclusion. This is a very sad reflection on the state of our democracy. Traditionally one of the greatest strengths of our system has been that it has been open to everyone. Whilst in the US it is virtually impossible to ascend to higher office without vast personal wealth (enhanced with corporate funding), in the UK it has been possible for people (well, if I'm being honest I should say men) from all walks of life to be elected - John Prescott would never have been a Congressman or Senator in the US, let alone second in charge. However, this is dying out. So many of our elected representatives are now professional politicians - coming from middle class backgrounds, studying politics at good universities, working for politicians before being elected.

There always will be this type of politician, and in themselves they are not necessarily a bad presence. However, when they start to become the dominant feature of our elected bodies then it is clear that we have lost our links between communities and their representatives. When voters look at the elected bodies, they seem distant, isolated and elitist structures, swathed in arcane practice and exclusive language - clearly these have no relevance to them. Choosing to become involved in politics is daunting for anyone, but when all interactions are focussed through language which requires a narrow and unrealistic education history to be understood, the vast majority of citizens will be excluded, leaving a political caste to run the country.

We need to increase political education - there is far too much information that is taken for granted. People from all walks of life struggle with terminology and concepts which are regularly used in the media and by politicians with no explanation. This presumption excludes people - if anything, the presumption should be of less knowledge and worked up from there.

We need to create methods for supporting people who wish to become involved in elected representation so that they can be trained and supported. This should be a no-brainer for the political parties. From my own political perspective, if the Labour Party could be encouraging and supporting a wider range of candidates to stand for election (young people, women, ethnic minorities, non university education people) then the bonds which used to exist with many communities in Scotland could be reforged.

We need to reform the expenses system so that every single penny is clearly and easily justified. Politicians do a difficult job but they are substantially paid for a role which, in my opinion anyway, is vocational in nature and should be about more than just money. A complete review of the system, the introduction of online accounts accessible to all of the public, and strict punishments for those misusing or abusing their positions must be implemented to try and restore public faith in politics.

I, for one, won't be upset to see the back of political posters on lamp posts - I was involved in putting them up at the last election and found it a waste of time when I could be knocking doors - but it is ultimately a superficial measure which will not halt the decline in the relevance of our democracy. That is a challenge which will require a new direction and a new politics. This is a task which may be beyond those already elected and embroiled in the system - perhaps this could be the role which the much maligned blogosphere can take as its own, and serve as its greatest contribution to society?

Rumours of my demise...

...have been completely fuelled by my own blogging inactivity! What can I say, it's been a hectic period, what with the bambino on the way and silly things like work getting in the way - if only there was a way to be paid to stay at home.

On the baby front, we are now 14 days away from his arrival! *Gulp* Of course, babies don't seem to function to any timetable of human design, so he could arrive tonight, tomorrow, next week or indeed whenever he decides! It does make things a bit harder to schedule, but c'est la vie. Certainly I am very excited now and can't wait for him to arrive - I promise there will be photos on here (and indeed anywhere else that I can put them - I am definitely going to be one of those fathers who bores everyone by talking about their son!).

I will try and get back into the blogging swing of things now though, at least until fatherhood takes over. There has certainly been plenty going on which I could have been adding my tuppence worth to, so be prepared for renewed attempts at pouring electronic drivel onto my site.

In the meantime, I hope everyone had a lovely Easter.