Adam Kay (2017) This is Going to Hurt: Secret Diaries of a Junior Doctor.

I loved this book. It should really be read in conjunction with Jed Mercurio’s debut novel Bodies. Yeh, that Jed Mercurio that writes scripts for the BBC, Bodies and Line of Duty. Adam Kay is following a similar trajectory, half way between the drama of Jed Mercurio and the upbeat chortleness of Harry Hill. You’re probably thinking why should the tax payer should spend all that money training junior doctors, indirectly subsidising the Australian and Canadian health services, which is bad enough, but now it’s a straightforward path –albeit a long medical apprenticeship—to write for the BBC.   The answer is going to hurt.

Simply, we are screwing the NHS into the ground and junior medics are on the front line. That’s always been the case, but the pressure is more intense. Aneurin Bevin talked about needing ‘to stuff the consultant’s mouths with gold’ in order to get a National Health Service. Consultants then were treated as a rung below God. Not much has changed. In a note Kay sent to a GP, 21^st October 2010,  as a Registrar in Obstetrics and Gynaecology wrote, ‘if  you have any questions whatsoever, please do not contact me.’ It was a typo, what he meant to say was don’t hesitate to contact me, but it worked. The GP didn’t contact him. Kay had this to say about Prof Carrow, theoretically ‘on call for the labour ward.’ But ‘as much use as having a cardboard cutout of Cher’. ‘You don’t see Professor Carrrow during the day, you don’t phone him at night.’ Like a mighty liner navigated by junior staff, which changes every six months, when they change secondment, they learn on the job by that old maxim, see one, do one, teach one. Kay started 14 years earlier as a fresh-faced student and was a veteran of muddling through. So when Prof  Carrow appeared during the day Kay wondered what the occasion was. No doubt when David Cameron’s children were being treated there would have been a consultant monitoring every NHS bed the Prime Minister passed as there was for an extremely wealthy Saudi family. Here it was quite simple. A documentary camera crew was following behind Prof Carrow as he did a ward round. On camera Prof Carrow tells Dr Kay, ‘Sounds like you’ve got it under control Adam. But if you’ve any problems at all during the night, just call me.’ When the camera crew stop recording he acts more like the typical consultant, telling Adam, ‘Obviously, don’t.’

Kay, ad-libs, that one of the problems he faces is that patients don’t really see doctors are being human. His points about low pay and overwork are valid. He looks to his cohort, people he went to school with making six-figure salaries, while the parking meter in the hospital grounds makes more money than him. He suffers burnout (post-traumatic stress) when one of his patients dies. He’s not god, only human and a doctor advises him by the time he’s finished there’ll be a bus full of patients, who have died on your watch. It’s the nature of the beast. He moans about having to take a sideways or backwards step and retrain in another speciality. It would mean a loss of income.

That’s where I’ve less sympathy with Kay. Life seems sharper and speedy when you’re younger and full of seismic spasms, but it recedes like male-pattern baldness no matter how you try. Both his parents are doctors and he tells us his sister has accepted a place in a medical school, but let’s not forget middle-class parents,   getting their kids into medical school is a status thing and a mercenary operation that would make King Herod look like a lightweight.  Working class kids have more chance of playing for Barcelona than being a junior doctor. The moneyed middle-class expropriation of the means of education is a given without the need for banner waving, what Herbert Marcuse called ‘repressive tolerance’.

No meritocracy here. Kay jokes the ideal entry for medical school has A grades and plays rugby, ideal candidates such as Harold Shipman.  I’ll not bother googling how much a senior registrar gets paid. Kay should look below him, try living on the split shifts and gig economy of the hospital cleaners. His joke about the public not thinking doctors are human applies equally to those that have nothing and can expect not much more. Grenfell Towers taught us that. The NHS is staffed by the low paid, so I’m not buying into that the parking meter in the car park makes more money, poor me, I’m skint argument.

His open letter to The Secretary of State for Health is a walk in my shoes argument, ‘you, or your successor should have to work alongside junior doctors’. He makes an analogy ‘If the President wanted to press the big red button and kill hundreds of thousands of innocent people, then first he’d have to take a butcher’s knife and dig it out of a volunteer’s chest himself; so that he realizes what death means first-hand, and understand the implications of his actions.’

Absolutely, but the moron’s moron in the White House isn’t really like that. He’s got flunkeys to do that kind of thing. Draft dodger Trump guilty of having a spurious bone spur on one of his feet and now with the biggest arsenal in human history, we have a spurious President Tweeting policy on the hoof. A no-brainer, reality is no obstacle to his egotistical whims. A straight choice between blowing up thirty million Koreans and starting an apocalyptical nuclear winter or being seen as being a weak-fall guy that doesn’t get bogged down in too much (or any) detail, then it’s goodbye world.

Poor people don’t really exist for him and his ilk. The NHS is an aberration and abomination because it doesn’t work for them. Nicholas Timmins wonderful book The Five Giants: A Biography of the Welfare State sums it up, the Americans used to run to us and try and work out how through cooperation and not competition we could provide such an efficient and low-cost service, now we run to America and look at  model that doesn’t work. Cannot solve the problems they create and in the hunt for revenues calls for more of the same, more privatisation, more trickledown economics and taking money from the poorest in society and gifting it to the richest. State subsidies as opposed to handouts for the poor. Adam Kay has nailed it, privatisation is a sham. It costs around £15 000 to deliver a child in the private sector, but when something goes wrong they use public resources. Let’s call it public theft by private means that enrich the already wealthy. That makes me mad. I’m not laughing.

Sam Wilkin (2015) Wealth Secrets of the 1%. How the Super Rich Made Their Way to the Top.

Roll up. Roll up. You too could become one of the super-rich. The kind of person that if they won a couple of million on the National Lottery would hand the winnings to their son or daughter and advise their child to buy lunch and keep the change, but don’t give any to some poor bastard, because they’ll probably spend it  on drink and drugs.

SECRET #1. DON’T BE THE BEST. BE THE ONLY.

I’ve been reading the Sunday Mail’s sly propaganda campaign against Abellio who run the train network in Scotland. It has focused on things that many of us would be familiar with from the days of British Rail. Trains overcrowded and late. The use of rolling stock that is antiquated and dirty. A relatively recent innovation has been to criticise the pay the director running such service gets (I can’t be bothered googling who that is, and does it really matter?) British Rail was a monopoly. Scot Rail a branch of that monopoly had to put its operations out to tender. Are we any better off? The answer is no. And my concern isn’t solely with our poor, dilapidated, rail network. James Meek Private Island: Why Britain Now Belongs to Someone Else shows that in rail, we subsidize other nation’s taxpayers, in this case Holland. Energy companies, water companies, postal services and council housing there has been that old cliché winners and losers. The winners have been the rich and losers the poor, with a regressive tax system taking away the institutions we built and giving them to the rich. Then taxing us again, because they aren’t efficient enough.  The big beast (or elephant) in the room is our NHS. Scotland and England have different systems but both use around a third of our taxation budget to fund the NHS. This is a beneficent monopoly system under siege. And as Nicholas Timmins a biographer of the welfare state observes, post-war America used to come over here looking for ideas on how to run a health service. We’ve flipped that now and look increasingly likely to sell out in the interest or dogma of efficiency savings, that mantra of the rich that penalises the poor and blames them for being poor.

For every Rockefeller rolling up and eating up competition as with Standard Oil in a series of horizontal and vertical acquisitions and mergers there’s a Carlos Slim, who won the right to operate a monopoly in fixed-line telephone services. That might not sound that great. Certainly nowhere near the value of our NHS, but a 2012 OECD report suggested he was the richest man in the world. How did this happen? Simple. Meek touched on it. We can do it or we can let someone else do it for us. Think of the stupidity of not building schools, letting someone else do it, paying them economic rent over an extended period, then complaining later because the walls to schools fall down.   Like cheap and nasty food we always pay more in the long run. Someone eats for free.

 

SECRET #2. BIGGER IS STILL BETTER. The argument goes that diseconomies of scale set in when a business, such as healthcare gets too big. Or the US military, the biggest user of oil in the world. Nobody much argues with the US military. Or Amazon. Or Walmart. Or Microsoft. This reminded me of Philip Green, that former -or is he still-  darling of the Conservative Party. Green whom they asked for advice, gave him a knighthood. Green notorious diddler of  pensioners, whom like everyone else, he ripped off to fund his extravagant life style in a tax haven. Try this trick at home.  One of his regular suppliers was told she was getting x price, then when she fulfilled her quota was taken aside and told she’d need to take y price. Why? Because Green, like Walmart, Amazon or the US military has the big stick, or leverage. A valid argument here is that the NHS, for example, doesn’t use its leverage to ensure profits for drug companies are not excessive. But for the super wealthy, there’s no such thing as excessive.

SECRET #3. THE WORST PLACE TO DO BUSINESS IS REALLY THE BEST. Perhaps not North Korea. But perhaps soon it may be. Bill Browder Red Notice showed that after the fall of the Berlin Wall, when the USSR economy contracted by 50% and the average return on capital was 5% his company, Hermitage Capital, generated returns of 1500%. What’s not to like? Hans Chung’s mantra that economics is politics applies here. The workshop of the world is China, but he reminds us that like his country, South Korea, these used to be considered economic basket cases. The African continent would be a good bet, but with the moron’s moron as President of the richest country in the world and the likelihood of nuclear war ratcheted up, if fallout doesn’t get us, global warming will. Place your bets.

SECRET #4. WHEN LENDERS CAN’T LOSE. YOU WIN.

That old favourite if we give you money we must have a reasonable expectation that we will get it back ( a return on our investment). Unless of course, you’re a too-big-to-fail bank. Let me put that into perspective. Royal Bank of Scotland (RBS) losses since 2008, £50 billion. RBS loss this financial year, around £7 billion. Chancellor of Exchequer Philip Hammond’s budget giveaway to Scotland under the Barnett formula, £350 million, a figure disputed by the Scottish National Party. That’s one bank. Rich people don’t get punished for not paying their way.

 

SECRET #5. YOU’VE GOT TO OWN IT, BABY, OWN IT.

If you live in a council house you are scum. If you rent your house from someone else you’re a sucker, throwing away good money after bad. If you own your own house, outright, you’ve got a revenue stream and money to burn, or borrow. But, of course, to be truly rich you don’t just own property. For example, only around 130 of the 1600 fortunes listed in Forbes Global Rich List are in real estate. You own a portfolio of wealth because you own the people on the land and they create wealth for you. In the post-Soviet collapse billionaires mushroomed overnight.

SECRET #6. SPIN LAWS INTO GOLD.

Britain is a good place to live if you’re rich. It’s a county that keeps giving. The United States advisers, such as Steve Bannon’s aim is, like Lenin’s, to destroy the state. A simple formula: give money to the rich in tax breaks and it will trickle down. It doesn’t. Get rid of red tape. That sounds great. What it means is displacing costs onto the poor for things like health care and to everyone else for necessities such as clean air and water. Simple solutions to complex problems always work for the rich. To borrow a phrase it’s ‘dictatorship by tedium’. Nobody pays much attention to Phil Hammond’s budget speech. We’ve heard it all before. Yawn, more tax on whisky. I don’t drink whisky. Less welfare spending. Serves them right.

SECRET #7. IF YOU WANT TO SUCCEED IN BUSINESS, NETWORK, NETWORK, NETWORK.

Sam Wilkes uses the example of Cornelus Vanderbilt in the 1860s taking over the New York & Harlem Railroad. The incestuous banking network J.P. Morgan created described in a report to U.S Supreme Court sounds very Putinish or indeed Trumpish, or both together:

J.P. Morgan (or a partner), a director of the New York, New Haven and Hartford Railroad, causes the company to sell to J.P.Morgan and Company an issue of bonds. J.P.Morgan and Company borrow the money to pay the bonds from the Guarantee Trust Company, of which Mr Morgan (or a partner) is a director. The New Haven spends the proceeds of the bonds in purchasing steel rails from the United States Steel Corporation, of which Mr Morgan (or a partner) is a director. United States Steel Corporation spends the proceeds of the rails in purchasing electrical supplies from the General Electric Company of which Mr Morgan (or partner) is a director…[and so on].

Good luck making those billions. Just remember to love money more than your friends, because you won’t have any. Not really. You’ll have servants and shape-shifting alliances. I could quote Jimmy Reid’s rat-race polemic here, it still stands true. http://www.independent.co.uk/news/uk/politics/still-irresistible-a-working-class-heros-finest-speech-2051285.html

I’m not with the rats. I’m with the common working man. We find secrets in strange place and, funnily enough, I’m quoting here from a character in another Scottish writer, William McIlvanney’s ‘Laidlaw’ novel, Strange Loyalties:

Any social contract is a two-way agreement. It’s one thing to make the people serve the economy. But the economy must also serve the people. If we disadvantage the present of one section of society, we disadvantage the future of all society. The children of the well-off will not just inherit the wealth of their parents. They will also inherit the poverty of the parents of others. Even self-interest, if it is wise, will concern itself with the welfare of all. Not just the poor will inherit the bad places. All of us will.

One in five children in Scotland are classified as living in poverty. My loyalty is with these people, not the pampered rich, super-rich or mega-rich. Whatever way you want to put it, they haven’t been paying their way. The problem is ours.  Rat race. You better believe it.

Brexit and fuck-you politics.

Ha-Joon Chang, The Little Blue Book:  ‘Economics is politics.’

Charles Darwin urged the ‘weak in mind and body’ to refrain from marriage. That’s why I never married. Contemporary disciples of Francis Galton’s scientific racism now favour that dismal science of pseudo-economics. Economic racism doesn’t discriminate against the rich. It is premised on it. The poor are feedstock for those that have accumulated land and wealth. A propaganda war, which we used to call ideology, or even Marxism, has been running against those without both for the last thirty years. It’s based on trickle-down economics. That means rich folk saying fuck you, I’m doing alright, whilst continuing to take an increasing share of the national income from the poor. Thomas Piketty, Capital shows with extensive research and an analysis of national figures the feebleness of this approach.  To paraphrase the US giant, General Motors.  What’s good for the economy is good for the rich, or so they keep telling us –ad nauseum.

The demonization of the poor is highly popular entertainment, cartoon demons that can be traced to the loss of the idea of social security. All being in it together. Remember that old David Cameron whopper, from our soon to be, Brexited, Prime Minister. Look at our glorious history. This was epitomised by the idea of homes fit for heroes after the First World War. After the Second World War, Britain led the way with the Beveridge Report and the welfare state and modern states followed our lead.  The American term welfare was exported back to us at great social cost, a  catch-all term and negative imagery carried by association. Prostitutes, junkies, alkies and council-house scum. (See for, example, ripostes from Owen Jones’ Chavs or Lynn Hanley, Estates.) Proof that welfare wasn’t working and dragging the nation down. Poor people,  whipping boys for the private sector and the top five-percent of  Eton educated and Oxbridge sponsored prevailing government ideology. Indeed, like Happy Gilmore with one golf club, they continued to beat all before them, slaughtering the poor, the public sector, and those on welfare while sweeping those before them in election after election with one idea. Rip up the social fabric. Trust us.  Give them less and us more. Nicholas Timmins, The Five Giants. A Biography of the Welfare State joked about the Tories mimicking the George Bush, Texas model, and meeting in a closed room and allocating public resources to their chums to run as part of their personal fiefdom. Who’s laughing now? Look no further than the recent debacle of those rich citizens paid rent to build and maintain local-authority schools, and even though bits were falling off, structural damage some cynics may call it, but moving sideways, with a neat trick economists call vertical integration and running the schools they build. This wasn’t called profit, but economic rent. Getting what they were due.  A quick fix was the idea of calling local-authority schools, Academies. In any language this is called monopoly. For all its faults the European Economic Union wasn’t that keen on these ideas, hence their challenge of Google’s monopoly powers to shape choices on the internet. The European Economic Unions determination that companies such as Microsoft, Apple and Facebook that have hundreds of billions in revenue pay some tax. But, of course, London is the greatest money laundering system in the world.   In comparison, try counting on one hand the number of media posts and television programmes depicting the lives of those on benefits, receiving government money. The latest ruse was to show that some of them had the gall to live in houses with more than one bedroom. Smokers. Drinkers. Obese. Round up the usual suspects. If there was such a thing as the Anglo-Saxon English race they were losing was the subtext and war cry.

Enoch Powell’s ‘river of blood’ speech in the late sixties tapped into popular zeitgeist. If they’re black send them back. A group of white working-class men were shown chanting, ‘niggers go home’ on a recent More4 programme, ‘Born on the Same Day,’ which showed the experience of a Jamaican immigrant, Ewart, growing up in multicultural Great Britain.

Remember the signs on private-let housing:

No blacks

No Irish

No dogs.

Add to that list: No DSS. NO WELFARE. NO REFUGEES HERE.

Brexit  tapped into a popular state-sponsored hate campaign.  Racism has long roots. Rudyard Kipling summed it up. ‘All the people like us are, We, and everyone else is They.’ It’s no coincidence that Robert A Douglas in That Line of Darkness, The Shadow of Dracula and the Great War has consecutive chapters on ‘Fear and Loathing of the Underclass’ (the working class) followed by ‘Xenophobia, Anti-Judaism and Anti-Semitism’ (replace with anti-Muslim rhetoric). It’s worth quoting Douglas below on those nineteenth-century patterns when Britain had an Empire to fleece, patterns which are recognisable today, with spokesmen such as Nigel Farage echoing the same sentiments, playing on xenophobic fears of the other, and being taken up by the Conservative Party and possibly the next Prime Minister, Boris Johnson:

Several commentators worried about Britain’s capacity for assimilating such large numbers and potential economic difficulties; however the more virulent spokespersons fed on the fears of crime, disease and tribalism to lobby for immigration restrictions…

A Conservative Prime Minister, Edward Heath took Great Britain into the EEC. Another, David Cameron, has taken us out. Britain no longer has an Empire. It no longer has the protection of a market to which we export most of our goods and services. We currently import around seven percent more than we export. That’s one deficit we really should worry about. When trading blocs such as the US and China, and now the EEC, play hard ball with small nations that have little or no leverage who can blame them? For we’ve voted to become a third-world nation. Fear of the other has made us a pariah nation. But the biggest fear is other nations will follow. Then with most countries resorting to protectionism there will be no common market. No market at all. What brought the world wide and general depression of the 1930s to an end was the Second World War. What brought the ideology of xenophobia and the pseudoscience of eugenics to an end was the Nazi death camps. Little England has never looked or felt so small. Fuck you, I’m alright Jack the triumphant calling card. For opportunist politicians such as Boris Johnson (and Donald Trump) that’s the only invitation they need. Fear of the other. I fear these ghoul-like creatures we have voted for most of all.

 

 

George Osborne’s bumper Christmas Compendium

I wasn’t sure how to structure this. I’d a vague idea about explaining the significance of the tax-credit U-turn by George Osborne and the jibes about Mao’s Little Red Book, a joke that backfired and made the Shadow Chancellor seem the more foolish. I also thought about telling you about my visit to the dentist. We are an ageing nation of shrinking gums. So I guess I’ll start there.

I’m good on nostalgia. The dentist I go to is the same dentist I went to forty odd years ago. We used to scale the wall in the same way we got our teeth scaled and steal the needles from the dustbin. They smelled of different planets and we’d lunge at each other, wild with excitement. Boredom set in quicker than rain. We’d fling them away. Back then the dentist prodded and poked at your teeth with a hooked pick until he found a hole to fill, a tooth to take out, usually, both. It’s the same rooms, upstairs or along the extended hall, with faded white paint, but it’s a practice now, a business, the hook comes out before you’re allowed to see the leading practitioner, or business man, or woman.  Receptionists want to know who is going to pay for treatment. There’s different kinds of forms for different kinds of patients. You can get your teeth whitened for £250. An older woman, a pensioner, was told she had the wrong kind of mouth for a plate, and the practice couldn’t be expected to carry the cost.

As surely as my tongue runs over a newly-fitted filing this is the future of the NHS. People will be turning up with the wrong kind of body.  An estimated £20 billion is needed to keep our NHS treating patients until 2020. Osborne has fronted some of the money, which is a politically astute move, as it stops some NHS trusts threatening to shut at Christmas. Bah Humbug! But it’s never enough, because too many old people are living to long. Let’s call them bed blockers.

Where do all these bed blockers go when they come out of hospital? Most bed blockers become the responsibility of local authorities.  Local authorities have had between fifty and seventy five percent of their budgets cut over the last five years. The Monty Pythonesque leaked letter exchange between out glorious leader David Cameron (with less that twenty-five percent of the electorate voting for him, the ‘great ignored’ as Cameron termed them before the 2010 election, leaves me thinking what we’d call the other 75%) and The Conservative Prime Minister writes to a Conservative council leader Ian Huspeth in Oxford and asks him why he’d made such dreadful cuts to ‘front-line services’ such as care of the elderly. Couldn’t the councillor made savings by sacking people that weren’t needed and not hired people that were needed, and sold off some surplus land or council properties. But says Councillor Huspeth I’ve already cut off our arms and legs, fell on my sword, sacked 2 800 staff, sold off all our ‘surplus property’ to try and make up our £72 million deficit because we get 37% less from central government than we got last year. And this is one of the more affluent front-line areas.

Service cuts are uneven. Even the Conservative-controlled Local Government Association talks of a postcode lottery. Councils in poorer areas can no longer afford home care service for the elderly. Social care is in an inverse relationship to health care.

The Office for Budget Responsibility suggests that the Osborne has to find £22 billion of cuts from 15 departments with a total budget of £77 billion. Here’s the rub. Their budgets have already been cumulatively cut by 30% since 2010, spread unevenly with local authorities’ grants in particular hardest hit and with backtracking on tax credits and policing all signs point towards being cut even more.

This is politics at its basest level. It’s personal and it’s ideological. Beveridge described the five giants on the road to reconstruction. They were poverty, disease, ignorance, squalor and idleness. All are related and feed into the roots system of the other. Whatever way you measure them they are all on the increase. The idea of welfare has been a stick used to beat us.

I’m with William Keegan on this one: ‘Personally, I always preferred the older term ‘social security,’ which gives a better indication of what the social settlement during those early post-war years of austerity was all about.’

The terrorist attack in Paris dominates the headlines, as it should, when we really are all in it together. Kenan Malik idea of social and political hegemonic influence gets it about right: ‘Evil…is not simply about defining an act of being particularly wicked, it also about defining the space within which we can have a meaningful debate about good and bad, virtue and wickedness’.

France spends around 54% of its GDP on public services. The United Kingdom currently around 38%, spends less that all other G7 countries with the exception of the United States. Trying to balance the books is a good story and achieve a surplus like China is an even better story. It fits in with the Dickensian notion expounded by Mr Micawber’s famous, and oft-quoted, recipe for happiness:

“Annual income twenty pounds, annual expenditure nineteen [pounds] nineteen [shillings] and six [pence], result happiness. Annual income twenty pounds, annual expenditure twenty pounds ought and six, result misery.”

There is an element of truth in this, but only if Mr Micawber didn’t have his own printing press in his basement and wasn’t allowed to print money quicker than the Japanese. Added kudos, if like the most successful company in the world in terms of share value, Apple, they could choose to fund their growth by borrowing at in interest rate of almost 0%. Indeed buying and selling money is what the United Kingdom does best. Before the Crash of 2008 it accounted for almost a quarter of all UK tax receipts. It allowed Chancellor of the Exchequer, Gordon Brown, to build hospital and schools and invest in the infrastructure of the country, which was seen as the common good. This has been turned on its head.

We are not fighting a war against Isis, not yet anyway. Government debt has rarely been lower over the last 300 years, but with every bomb we drop over Syria (if or indeed when Cameron is given his mandate) can we expect to think there goes another public library in Islington. There goes a Sure start Programme in Drumchapel. There goes another mental health unit in Belfast. There goes free school meals. Some wars are more pointless than others. We have been lied to for too long. Shakespeare gets it about right with Shylock’s promise that he will outdo the evil that was done to him.

The quality of mercy is not strained.
It droppeth as the gentle rain from heaven.

William Keegan suggests in the aftermath of financial crisis and fiscal policies pursued since the summer of 2010. ‘If the historical pattern of growth had been allowed to continue, output in the UK would have been up to 20 per cent higher in 2013-14 than proved to be the case.

Martin Wolf of the Financial Times in the 2013 Wincott Lecture: Monetary Policy clearly and decisively failed to promote recovery. Animal spirits were completely destroyed. Demand fell. It was a machine designed to fail.’

Joe Stiglitz notes the same pattern over the other side of the Atlantic. Subsidies for the rich, mass poverty for the poor.  A race to the bottom. The Big Mac Index, for example, is an economists attempt to measure the relative expenses of living in different countries. Stiglitz describes working for McDonalds as the income of last resort, with more than a thousand applicants for every job. Martin Ford describes how a worker for McDonalds in October 2013 called his employer’s financial-help hotline, asking for help, and was advised to apply for Food Stamps and Medicaid. Yet, the fast food industry continues to grow, at around £6.9 billion in the UK in 2012.

We don’t –as yet- pay directly for our healthcare. But Nicholas Timmins, The Five Giants: A Biography of the Welfare State, noted the paradox of we used to send experts to the United States to advise them how to run health care, but now that has been reversed. Advisers come from the States, with the most profligate health service in the world (see Pickwick) and advise us. It’s no great surprise that Jeremy Hunt, our Health Secretary, doesn’t believe in the NHS. He’s rich and will never need it. Neither will any of his colleagues or friends. Only poor people will (short-hand for scroungers).

A programme was recently shown on BBC 2. Unlike those Jeremy Kyle-type programmes on Channels 4 and 5, and the Hollywood movie Friends With Benefits, it was meant to show the diversity of Scotland and it’s working population. For example, bespoke food from land and sea for the tables of the rich in London. Compare this with the idea of bespoke care for the poor. The elderly poor. It would cost too much. The idea is ridiculous. The difference between a fish farm and a granny farm is one of them is under water. Southern Cross and other ‘caring’ companies threaten bankruptcy unless local authorities give them more money.

Assets such as the buildings in which old folk have been corralled have been separated on the balance sheet from the cost of caring (price) of caring for residents. The problem of liquidity fits into a larger narrative of Freidrich Hayek, the title whose book The Road to Serfdom could be rewritten and neatly quipped as the slippery slope towards totalitarianism any government intervention entails.  Milton Friedman and the problem of demand is one of supply. If money is cheap enough demand for it will grow and problems such as unemployment will disappear, but only if the government doesn’t interfere. Chile’s Pinochet was an admirer. After the fall of the Berlin Wall advisers from the Chicago School helped to create a new Russia from the old Soviet Union modelled on Friedman’s principles.

The new kids of the block of the early eighties Margaret Thatcher and Ronald Reagan had won the Cold War and already set out their stall to roll back the state. Simple equation government = bad (totalitarianism). Free market = good (liberalism). The hidden hand, I want for Christmas, had never had it so good.

Why fling good money after bad on a defective product?

But it doesn’t begin and end there. We’re all familiar with the idea of bureaucracy = power. And bureaucracies become bloated and create their own reason for being. Think local government. Think any government. Companies listed on the stock exchange. They are not off the raider. They too are bureaucracies

Predatory lending. Is there any other kind? What does non-predatory lending look like? It looks like James Stewart, a man you could trust. You may remember James Stewart playing someone that was not James Stewart, George Bailey, who looked confusingly, for us old timers, very much like a young Henry Fonda, in a feel-good film, shown every Christmas about the value of non-predatory lending. It wasn’t called The Value of Non-Predatory Lending, but the more striking It’s A Wonderful Life.

It’s a simple equation: Non-predatory lending = It’s A Wonderful Life. ‘Every time a bell rings an angel gets its wings’. Clarence Oddbody, that’s a good name for an angel. The run on Bailey Building and Loan would be something familiar to those over thirty watching this film on telly every Christmas, those living in small-town America of the hungry thirties, or the citizens of modern-day Greece. ‘I’ll stroll, you fly,’ was George’s advice to Clarence, but Oddbody’s however quick he or they travel can’t save Bedford Falls. George appeals to reason, those paying in and having a stake in the Building and Loan were bankrupting themselves. They weren’t just borrowers but lenders. That Tom’s money was tied up in Ed’s house and Ed’s money tied up in Mrs Davis house and when they hadn’t worked for a while George didn’t chase them for repayment. He knew they’d come good. George was just asking for the same consideration for the Building and Loan. He wasn’t asking how much they wanted, but how much they needed to get by. They were shaking the same tree.

George, of course, has hard cash to back up his rhetoric, a thousand dollar bills set aside. He runs a thrift and he’s thrifty. ‘How much do you need Tom?’ George asks the first customer, pushing to the front of the line. ‘$242,’ Tom demands, ‘and that’ll close my account’.

‘Have you no romance in you?’ asks George. The thousand dollars is, of course, money he’s set aside to travel with and for his honeymoon.

‘Yes, I had some, but I soon got rid of it,’ answer Tom.

Tom has made a rational choice and not a romantic choice. Ed, next in line asks for $20. Mrs Davis asks if it’s ok if she gets $17.50. George kisses her on the cheek. State regulations means that the doors of the Building and Loan need to stay open until 6pm. George and Uncle Billy kick out and have a party as they carry two crumpled dollar bills and deposit them in the vault. They have made it through the day without Old Man Potter closing them down.

Henry F Potter is a twisted crocodile. In the opening scenes he rides in a carriage and one kid asks another ‘who’s that? Is he a king?’ He is of course. But a king without subjects. Peter Bailey (senior), at the dinner table, explains to his son George why they should feel sorry for Old Man Potter. Henry F Potter has no future. He is unmarried. No children. ‘What’s he going to do with all that money?’ The message is he’ll get his comeuppance.  Later in the film, when Clarence grants George’s wish not to be born Bedford Falls becomes Pottersville. There’s bars on every corner, where people go to get seriously drunk and half-dressed girls spilling out of every club. Full employment and housing to rent. Pottersville sounds like my kind of town.

Old Man Potter is sick and he wants to infect George and the town with his values. He’s tried everything and now he tries buying George. He offers him a salary of $20 000 a year to manage his affairs. George admits the offer is tempting. Cost-benefit analysis. Money’s tight. He’s got four kids now. Around $40 a month.  An old barn of a house.  Old Man Potter offers George a thick Cuban cigar, time to think about it, reminds him that’s starting salary and if he plays along he could make more. The answers, ‘No’. The answers always no. ‘You spin your little webs,’ George tells Potter.

The problem that Bailey Building and Loan faced was they had the wrong kind of money tied up in buildings and loans. Think of poor Southern Cross and other care companies with properties full of poor people, which they could monetise and sell separately from their services. They had no way of knowing who was going to pay, when they were going to pay and if the Bailey Building and Loan would be there for them to pay into. Modern economists make short shrift of that thrift. Thrift is shorthand for the thousands of Savings and Loan companies spread out throughout the United States and loosely bound by US government support for home ownership,  the biggest franchises being Government National Mortgage Association (Ginnie Mae) owned and run by the US government; the Federal National Mortgage Association (Fannie Mae), around 1 in 10 US mortgages at a very conservative estimate of $100 million mortgages on its books and is backed by the US government; Federal Home Loan Mortgage Corporations (Freddie Mac) was a corporation created by Savings and Loan companies were backed indirectly by the US government. These organisation had like the Bailey Building and Loan, which George bailed out with a handy $1000, a problem of liquidity.

Everything is a problem of liquidity if you look at it properly. Let’s get back to George Osborne’s speech to the Conservative Party conference, October 2013, and his claim to have a seven-year plan to achieve an absolute budget surplus before 2020.

How to define it as a problem of ‘idleness’.

Here it is wrapped in the Stars and Stripes with mum’s apple pie: ‘We had the oldest secret in the world, “hard work”’. This from a man endorsed by fellow Texans George W Bush, his father George H W Bush and further afield Bill Clinton. These Presidents of the United States whom Lance Armstrong on speed-dial helped quash an FBI investigation into the activities of the seven times Tour de France winner. Let’s put a figure on Lance Armstrong, career earnings of somewhere between $70 and $100 million. That sounds a lot to me and you (who can forget Margaret Thatcher going to the European Union and crowing that she’d saved Britain a million pounds a year) but Armstrong’s career earnings were the kind of loose change ‘geek’ bond traders such as Michael Lewis of Salomon Brothers could lose without burning anybody important. Perhaps I should put in here that David Cameron was a stockbroker as was his father before him… Lewis tells us that Salomon Brothers the directors boasted that they had the equivalent of $80 billion worth of securities in portfolios every night. Multiply that by 365 and you’ll get an estimate of their annual income. Bigger than the combined profits of all other Wall Street operations. Bigger than the Netherlands GDP. Salomon Brothers, of course, later went to the wall. Financial institutions are the auteurs rewriting the economic script of what is meant be profit and loss, success and failure as they went along. In the years 1977-1986 when Salomon Brothers had almost a monopoly on new bonds they had helped create in regard to housing the trading floor jumped from millions to billions to $2.7 trillion, with ‘mortgages so cheap your teeth hurt’. That was the ‘gospel’ of the rich. What Lance Armstrong was selling was a message rich people wanted others to hear. Compare Armstrong’s message with, for example, the message Aaron Schwartz was selling, and the outcome of the subsequent FBI Investigation into Schwartz’s activities.

Mao’s Little Red Book? Simple. A problem of liquidity. We’ve been giving rich folk billions of pounds every day to help poor folk. We can’t keep doing that (see Pickwick).  We’ve being building nuclear reactors since the end of the 1950s, but we’ve asked the Chinese Government to send experts to build one at Hinkley Point. This creates in the region of 25 000 jobs. With or without the Chinese, or any other nationality this creates around the same number of jobs. Crucially, though, the Chinese have agreed to finance it. In the short-term they transfer a few digits from their machine’s finance model, we add it to ours. We agree to the costs of any mishaps and the hundreds of thousands of years it takes to get rid of spent fuel rods. We subsidise the Chinese economy by moving money from the poor in this country to the rich in the Chinese economy. I suppose it makes a little change from subsidising the rich in this country. Win-win. Apart from the far more worrying Balance of Trade deficit. But that’s another story. I’m sure when that nice Mr Osborne will deal with it when he’s Prime Minster in five years’ time. Merry Christmas, Boris Johnson. Now there’s an angel for you. He doesn’t look like Clarence Oddbody for nothing. He winging it for now, but we’ll see how he turns out.