Thursday, January 11, 2018

Thoughts from Galicia: 11.1.18

Spanish life is not always likeable but it is compellingly loveable.
- Christopher Howse: A Pilgrim in Spain. 

If you've arrived here because of an interest in Galicia or Pontevedra, see my web page here.

  • Lenox Napier of Business Over Tapas reports that the secessionist parties - JuntsxCat and the ERC - have agreed to hold the investiture of Puigdemont in Barcelona, with the candidate himself appearing as a TV image. As Lenox opines: It seems doubtful if the Constitutional Court is going to let that one fly. 
  • Reader Sierra and I are regularly amused by the Spanish penchant for several decimal places. I've long suspected this is to give specious validity to questionable statistics. Anyway, Sierra has kindly provided this example, in respect of fees in a Lugo parking, or underground carpark: The first 92 minutes of stay cost €0.0297584 per minute and from 93 to €0.0198391 per minute.
  • My neighbour's son tells me that most of the pupils in his class fail English. This has left me wondering whether it's still believed here that, if your pupils don't pass their exam, it's because you're a tough - and therefore good - teacher. I was staggered to meet this percecption when I came here 17 years ago and had hoped it'd disappeared.
  • Stephen Spender - a famous English poet - wrote this in his journal in March 1975: Where Italy and France impress me with a history which recedes into the past, history in Spain seems a past which forces itself on the present. Art and even landscape are still locked in past conflict. How, in Southern Spain, can the relationship of the European and the Arabic seem so fertile and productive – in this the country of fanatical Catholic orthodoxy, of the Inquisition, and of the savage conflict between Spanish and French, depicted in Goya's disasters of war? The landscape, the literature, art, and architecture all seem to ask these questions. Of course, this was written before the omerta declared after the death of Franco.
  • Just in case you missed it last time round, here's The Local's view of the best Paradors in Spain.
The EU
  • Here's Don Quijones again on banking in the EU. Taster: Rather than helping to address the myriad systemic issues plaguing Eurozone banks, the ECB’s multi-trillion euro monetary policy measures have merely delayed the inevitable while creating a mass culture of monetary dependency at the very top of Europe’s shaky economic edifice. Because sound economics are subordinated to politics, of course. And because there's no democratic control over EU politicians, bureaucrats and bankers. Mark my words, it will end in tears.
  • Click here for an 'Anglo' riposte to Catherine Deneuve and the other 99 French women who've taken issue with the Me-Too movement. I suspect neither woman really understands the other and makes claims about their views which are exaggerated, if not entirely wrong. Maybe one has to have lived in both an Anglo and a Latin culture to understand why this is a dialogue of the virtually deaf.
  • Here's a site which I think would be useful to those Americans accused of not being able to get irony. I thought of apologising for repeating this canard but I realised that no American friend of mine and no American reader who enjoys this blog could ever be unfamiliar with irony.
  • One example of a statement which a large percentage of site users see as truly ironic: If you have a phobia of longs words you have to tell people that you have  . . . . . Hippopotomonstrosesquipedaliophobia.
The UK
  • Here's a headline from one of our local papers that could be printed word for word in every UK newspaper. Anually:-
  • A propos, below is an article which proposes a solution to the endemic inadequacy of the UK's National Health Service.
The World
  • See the interesting second article below on what's happening around the globe.
The English Language
  • I forgot to mention yesterday that, as with phrasal verbs, the saxon genitive was something I'd never heard of in my reasonably long life before I came to Spain.
Social Media
  • I was astonished - and dismayed - yesterday to come across this service being offered by a major airline:-
  1. Simply activate [our] app when you check-in online, automatically associating your Facebook account with your booking.
  2. When selecting your seat on the aircraft, you will be able to see the Facebook profiles of the other passengers who have also checked-in socially.
  3. Then just choose to sit beside the person who seems most interesting and, who knows, you might make a new friend on board!
Two scenarios immediately spring to mind:-
- A large number of men – some of them decidedly dubious – trying to sit next to an/any attractive woman, and
- A poor sod sitting next to the window, alongside the only 2 empty seats on the plane.
  • More positively . . . Thanks to reader Jan and my elder daughter, I now know that less intrusive alternatives to Gmail and Whatsap are readily available. In the latter case, it's Signal. Onwards and upwards. Or it it downwards?
  • There's been a huge amount of media attention given to a local murder suspect, the one who was foiled recently when trying to repeat his alleged crime. I don't know what the law is here about reporting in these circumstances but it's hard to believe that – if a jury is involved – the accused could ever be given a fair trial. And, given how long things take here to get to the actual trial, there's going to be an awful lot more media coverage of just about every aspect you can think of.
  • A very large number of Gallegos relinquish their inheritance rights. The main reason seems to be that the assets won't cover the taxes and the debts which the deceased ran up during the boom years 2000-2007. Another reason is that taxes aren't waved on overseas properties owned by expired locals, meaning cash flow problems for their heir(s).
  • In 2000, Portugal's Oporto airport had about the same number of passengers as Santiago de Compostela's. Last year, it had more than double the total number of people passing through Galicia's THREE not-that international facilities. Local politics. YCMIU.
  • The ubiquitous grafitti apart, the city doesn't suffer much from vandalism. But it seems that some idiot(s) simply can't refrain from regularly breaking off the walking stick of this statue of local writer and poet, Valle inclan:-

  • The woman almost wearing a red dress in the foto I posted the other day goes by the name of Blanca Blanco.


Call Dr Stalin: the NHS must be forced to unify: Camilla Cavendish

Cash is not enough — the only cure is a properly joined-up health service

Everyone in the NHS dreads the first week of January. Norovirus and flu stalk the land. Revellers clog up A&E. Ambulances fume outside hospitals, unable to disgorge their patients because hospital beds are full of frail elderly people with nowhere to go. Routine operations are cancelled. Staff trudge grimly through hellish scenes and the rest of us worry about falling ill. We are all equal in the face of turmoil.

Does the NHS need more money? Yes, if it is to go on providing all the services people expect. The strains on A&E are eating up resources that should have been used for reform. Either we find more money, perhaps through a dedicated tax, or the prime minister must have a grown-up conversation with the public about what is possible.

Should we keep performing complex operations on old people with a low chance of survival? (Many doctors think we should not.) Should over-the-counter remedies such as paracetamol be free on prescription? Can we afford expensive drugs that prolong life by a few weeks? What is going to give?
Theresa May attempted to face the public with some uncomfortable facts last year, with her manifesto pledge to make people pay more for social care. But it was less of a conversation than a bombshell. 
The cack-handed way in which it was sprung on the public backfired spectacularly. A grown-up conversation about healthcare needs a long run-up and a grown-up opposition. It may even need a royal commission involving all the former Labour, Liberal Democrat and Conservative health ministers who privately agree on almost everything, while their parties fill the media pretending otherwise. [As Jeremy Corbyn is currently doing, of course.]

Instead, we get small amounts of new money to prop up ailing services. We get a slow, disorderly rationing of things by managers whose job is to make ends meet, not to work out — for example — how much a physiotherapist might save the whole NHS if she helped an elderly person who would otherwise never get out of bed again.

And here’s the real problem. The system doesn’t put the physios where they are most needed, because the system isn’t a system at all. The NHS is not the monolith of popular imagination, but an alphabet soup of 700 different organisations: acute hospital trusts, mental health trusts and regulators — plus 8,000 GP surgeries in England and Wales. It is a ramshackle lifeboat held together with dotted lines and goodwill.

When my father was admitted to hospital two years ago, a succession of staff came to ask us questions. What medicines was he taking? Had he been ill before? Did he live alone? He was in no state to answer. It took five days for the hospital to get his medical records, because in England your medical records are held by your GP. We must be almost the only civilised country in the world where you can black out in your own home and fetch up in your local hospital and be treated as though you have dropped in from Mars when you have lived in the same town for 50 years and paid taxes all your life.

That’s not the only divide. The reluctance of many GPs to visit care homes adds to A&E visits, because residents whose early symptoms were not treated are rushed to hospital after they fall over or fall ill. And the strains on “community services” mean elderly patients remain stuck in a hospital bed because there is no one to dress their wound, or give them chemotherapy, outside. Community services — cottage hospitals, district nurses, occupational therapists — are the invisible glue holding up the edifice. But the obsession with the numbers of hospital nurses and doctors — which the government has kept increasing — means that little attention has been paid to the virtual halving in expert local nurses in a decade.

Money follows power. And power lies with the chief executives who run the big hospitals. Outside Northumbria and Salford, few hospital trusts run community services, so they don’t have an immediate financial interest in supporting them.

To bridge these divides, governments have spawned endless agencies: clinical commissioning groups, primary care trusts, Healthwatch. They have tried to limit monopoly power. But in our desire to avoid monopolies we have ended up with a bureaucracy in which the payments made by different health fiefdoms to each other cost anywhere between 4% and 14% (depending on whom you talk to) of the entire NHS budget.

I have observed the NHS for more than 10 years: as a journalist, as a non-executive director of the NHS regulator Care Quality Commission, as a patient and relative, and as head of David Cameron’s policy unit in No 10. Unlike many patients, I have a map. Yet like many patients, I can still feel lost. There are more job titles in the NHS than in many multinational corporations — some of them jobs that exist simply to tie together the disparate pieces.

What if we really had one truly unified national medical system? What if GPs were based in hospitals with access to CT scanners, instead of having to write a letter to a consultant asking for a test in four weeks’ time? What if hospitals ran community services, so they could see the need to hire district nurses? What if patients could go to one place, tell one story, and see the pharmacist at the same time? Until we have one united medical system, we will have to rely on “goodwill” alone. But “goodwill” soaks up enormous amounts of time. I meet brilliant doctors and nurses, who seem to spend half their time in well-meaning committees.

What strikes me is how many NHS leaders are trying to bridge divides. The GPs who have persuaded hospitals to let them open clinics in A&E. The heads of hospital trusts, in places such as Northumbria and Greater Manchester, who are taking over GP practices and community services. Simon Stevens, the NHS England chief executive, is encouraging this. But he needs to be more prescriptive. Every A&E should have a GP surgery with proper diagnostic equipment. All GPs should be salaried (half already are). Hospitals should run community services.

Some readers will worry I am proposing some kind of Stalinist NHS that would hold taxpayers to ransom. Perhaps I am; but the current system isn’t working. Others may think I am just shuffling deckchairs, when what is needed is cold hard cash. I agree more cash is needed. But it is not just about making economies, real or false. As Professor Sir Mike Richards, the cancer expert and former chief inspector of hospitals, is fond of saying: “The cheapest way to look after a patient is to diagnose them the day before they die.”

Whatever happens this winter, I do believe the NHS needs more money. But I would pay it to those who can create a unified medical system. One system that doesn’t pay people to ask you the same questions again and again, but treats you early and gets you out of hospital because it works off one budget. One system, which means that none of us ever need to be lost in the NHS without a map, ever again.


For how much longer can the sweet spot in the world economy last?

Politics and economics tend to be regarded as inextricably linked, such that we even have a term for the way the one orders the other – the “political economy”. Sometimes, however, we assume government to be more central to the macro-economy than it really is. One of the most striking features of economic conditions today is that they seem almost entirely unaffected by the hopelessness of our politics.

Globally, the economy has returned to a period of relative health, with all three major economic regions – America, Europe and Asia – in synchronised growth, the first time this has happened since the financial crisis nearly ten years ago.

Yet politically, the situation looks dire. Among the G7 group of major advanced economies, only Canada and Japan have remotely stable or effective government. In America, we have a petulant and dysfunctional presidency whose daily outbursts and absurdities are a source of almost universal international derision, and more worryingly, continues to pose a serious threat to the global trading system.

In France, a self-styled Napoleon rules at the Élysée, yet his reform agenda is already effectively dead in the water. Lest it be forgotten amid all the guff about how Macron has turned the tide against populism, nearly half of French voters opted for eurosceptic alternatives in the last election. France’s newly acquired reputation for responsible, centrist government is a mirage that disguises still deep seated political discontents.

In Italy, the anti-establishment Five Star Movement has emerged as the country’s most popular party; opinion polls ahead of March’s general election point to the formation of a government with strongly eurosceptic views. Any such coalition would in practice be most unlikely to pull Italy out of the euro, despite the threats. Even so, the election threatens a previously untested degree of political turmoil.

As for Germany, there is no government at all, with Angela Merkel still struggling to cement a workable coalition after an election that gave the far-Right a significant presence in the Bundestag. Britain is meanwhile mired in the constraints of minority government and the obsessions of Brexit, paralysing virtually all other gainful activity. Labour sits there in the wings, threatening the imposition of the most hard-Left, populist government in decades. 

Political crisis is for the European Union as a whole a more or less permanent state of affairs, but with British withdrawal, things could get much worse, punching a big hole in the bloc’s budget. In the scale of things, the sums involved are trivial. They none the less have the potential to create major problems. Only reluctantly will other big net contributors cough up more. The conditionality attached to these payments will drive a further wedge between the EU and its Visegrád members, several of which are already in open rebellion against the EU’s obligations and requirements.

Turning now to the economy, it is as if none of this is of any consequence. It was said that both Brexit and the election of Donald Trump would plunge the world economy into chaos; so far, they have not. The American recovery has strengthened further since Trump’s victory, Europe has turned the corner, and beyond the impact on real wages of a devalued pound, even the UK economy seems to have been largely unaffected by the vote for Brexit.

None of this is any thanks to the politicians. If anyone can claim the credit, it is the central bankers, who, riding above the political circus, have kept their foot flat down on the monetary accelerator ever since the financial crisis, and even now, with the economy in many respects back to normal, continue to provide it with extreme levels of support.

The truth is that when it comes to the economy, even the president of the United States will much of the time have only marginal influence. Far more important are the natural ups and downs of the business cycle and the actions of the Federal Reserve.

Most economists think the Trump tax cuts will have some positive impact, all other things being equal, but few believe it will be huge. If on the other hand they generate a boom, then the Fed will act to dampen it down. In his conceit, the president likes to think that both an accelerating economy and the soar-away stock market are the result of his own genius; possibly at the margin, his various business friendly initiatives have indeed helped unleash pent up animal spirits. At root, however, continued economic expansion is merely cyclical. Trump is neither positive nor negative.

Much the same is true of Europe. The rebound has nothing to do with the structural reforms forced through at great political and social cost during the eurozone debt crisis, and virtually everything to do with Mario Draghi’s ultra-accommodative money printing.

None of this is to argue that the politics are irrelevant. In the long run, and sometimes even in the short run if policy is reckless enough, bad government will destroy an economy just as effectively as irresponsible bankers. American hegemony also vests the US presidency with the power to invoke geo-political crisis, the economic consequences of which can be devastating.

Even so, we shouldn’t be so surprised that the world economy is motoring again, despite the failings of our political leaders and systems. If demand is growing, supply will respond regardless.
What we also know is that at some stage the cycle will turn. The present US expansion is already only months away from being the second longest in US history. What is more, it is sustained only by the persistence of ultra-low interest rates,which have in turn crimped productivity growth and supported a debt fuelled bubble in asset prices. There is a sense in which the true adjustment to the financial crisis has yet to happen.

Dysfunctional government may not matter very much when the economy is growing, but it will matter a lot come the next big shock. It is hard to believe, for instance, that today’s ragbag of cowed, inward-looking political leaders would be capable of the co-ordinated and relatively effective international response that was mounted to the financial crisis. The complexities of today’s world frequently require a multilateral response; yet we seem fast to be retreating into the pinched, national solutions of the past.


Sierra said...

Two more for your Spanglish file - "cruising" and "el dogging":

jan frank said...

Don't know where you got that idea that "there's no democratic control over EU politicians". It depends on what you mean by "EU politicians" and what you mean by "democratic control". If, by EU politicians you mean MEPs, well, we (the great unwashed) do elect them and we have just as much control over them as the British public has over its democratically elected MPs, i.e. none. However, if you mean the bods making the actual decisions, well those are made by the Heads of State of the EU, and those people are elected, usually by their party, and again, the party is democratically elected. Although, as the case of Mrs. May illustrates, some may not have been directly elected by the electorate. By and large, the EU is no more and no less democratically controlled by the electorate than, say, the UK.

Colin Davies said...

Yes, I'm very aware of this (specious() argument. And also of the (more accurate) argument that the British government is an elected dictatorship. But British voters can change it. How does any EU electorate get rid of those who have power in Brussels?

MEPs. Don't make be laugh, Jan. Just a gravy train. Wish I'd thought of becoming one 20 years ago. No authority/power, no responsibility and no accountability. Just a talking shop. How about a list of 3 things they've achieved.

You'll be telling me next that the continental List system is as democatic as locally chosen MPs who at least have clinics with their constituents . . .

Perry said...

The NHS is funded for a population of 60 million people & the 20126 population estimate is 65,648,100. That about 10% over capacity. What's the solution?

87.1% White
7.0% Asian
3.0% Black
2.0% Mixed
0.9% others


jan frank said...

That comment by Perry is the most disgusting racist contribution I have seen in years (I don't visit obviously racist blogs). As all comments on this blog are moderated, I presume that this comment has been read before being posted. If that comment is permitted without further comment from the moderator, I can only presume that the moderator regards this as a legitimate opinion. But you'll have to do without me - I am one of those 0.9% others.

Colin Davies said...

Your assumption is wrong. But you are free to be wrong, of course. As Perry is. If you read the comments here regularly, you'll know that Perry is very much his own man who who holds views that many others wouldn't subscribe to. I don't believe in censorship and prefer dialogue, however distasteful the views of others might be. I have close American friends who are ardent supporters of President Fart. I have even closer British friends whom I regard as pretty nutty in their religious views. I don't believe in telling them they're imbeciles, as I prefer to exchange views and to try to understand where they are coming from.

Eamon said...

Jan Frank you may be disgusted with Perry's comment but he did quote Wikipedia. So don't rush away as I have been following your comments which bring more life into Colin's blog.