Thursday 20 December 2012

The Marmite Coalition

Conventional election wisdom says that Labour will struggle to win the 2015 election outright. If they do get the largest share of the vote, they will probably have to rely on forming a coalition with the Lib Dems.

I disagree.

The Labour lead has averaged about 11% for a very long time now, but it is true to say that the incumbent government always makes up ground when the reality of an election hoves into view. Even 15 or 20% leads can melt away to nothing when an election becomes a reality.

But this is not a normal time and normal rules don't apply. Not only do I think Labour will win an overall majority, I think the Conservative party as we know it will struggle to ever win an election again. The Tories know this (even if most of Labour don't) and have employed a host of tricks in an attempt to reverse the trend - reducing the number of MPs from 650 to 600, changing constituency boundaries, increasing the vote of no confidence thresholds and no longer making it compulsory to register to vote, would all favour the Tories. As it happens, the first two may never happen anyway, since Clegg withdrew support in exchange for betrayal over Lords reform.

But even if they did, it's too late. As soon as Cameron failed to win an outright majority, despite the worst economic situation for 70 years, a tired Labour party and a hugely unpopular Labour leader, it was clear.

The modern Conservative party as we know it is finished.

It took 13 long years for the public to even think about trusting them again. The scars ran deep. Even when they finally did, they didn't trust them to govern alone and fettered them with Lib Dem concrete boots.

There is a schism at the heart of the Conservatives that has fatally wounded the party. For 20 years, they've staggered on in denial, but the party is divided and nothing has been able to paper over those divisions. So called "compassionate Conservatives" were prepared to compromise dearly held right wing principles in order to govern, but too many will not.

You only have to look at today's media to see their dilemma. It's often hard to tell who hates Cameron more - Guardian readers or Telegraph readers. The right wing press pillory him daily for not being right wing enough, while the left leaning press cry with horror that this is the most right wing government of all time. The Daily Mail and the Telegraph demand "real" Tory policies, but Cameron knows a majority of the public will never vote for them.

Most crucially though, the political landscape has changed in a fundamental way and it will not change back in a hurry. If ever.

For over 30 years, the left leaning vote in the UK has been split. As soon as the "Gang of Four" left the Labour party in 1981, we may as well have taken a gun and shot our own feet. Disgruntled Labour voters would evermore have an alternative. Much as Clegg would deny it now, that is how the Lib Dems were born and right up until the last election, that is how they were seen. People voted Lib Dem for lots of reasons, but few because they were actually Liberals, and even fewer who were comfortable with the "Orange Bookers"

Of course, it's not unusual for the Lib Dems to see a big slump in their support mid-term and they will almost certainly poll more than the scant 10% or so polls have indicated since 2010. But the betrayal voters feel is real. I've lost count of how many people have told me they voted lib dem at the last election and never, ever would again. It's highly unlikely they will win anything like the 57 seats they hold today. It may well be that they could only offer 10 - 15 seats to any future coalition anyway.

For the first time in a generation, left leaning voters only have one place to go. They must vote Labour or risk  a right leaning government.

Right wing voters have no such quandary however. They can give up on the Conservatives once and for all and vote UKIP. If current polls are to be believed, many will do just that. UKIP regularly poll more than the Lib Dems and although this wouldn't necessarily translate to seats won, it will hurt the Tories very much. In many marginal seats it would only take a few hundred voters bailing to UKIP and the seat is lost. Not to UKIP, but lost all the same.

Of course, loyalty and logic may save the day. Natural UKIPpers may yet AGAIN be persuaded not to split the right wing vote, but I don't think they will. There comes a point where logic melts away and strategic voting is not enough. People vote far more with their hearts than their heads. If not, we would never have seen the left vote splinter in the first place.

I think natural right wing voters - the core Tory vote - have seen too many broken referendum promises, too many capitulations to Europe and immigration and crime. They know now that a Conservative like Cameron will never break away from Europe, never give them what they want. This was the last chance saloon.

Since the coalition came to power, they have divided public opinion in a way I've never seen in my lifetime. You either think they are making the best of a terrible situation, taking tough decisions and being cruel to be kind, or you think they are evil baby-eating-neo-cons who want to asset strip the country and eradicate the poor before 2015. There's little in between. On almost every policy question, just 29 - 30% support the government's position. This is core Tory vote territory and nowhere near enough to win an election.

Lurching further right won't help and sticking with a Cameroonian style fudge won't work. Even if some charismatic Tory appeared to unite the party and lead them to glory, screwing with the NHS can never be undone. The public might forgive many things, but they will never forgive anyone who breaks up the NHS.

The polls have been rock solid for many, many months now. Even the Olympics and Paralympics didn't offer a polling boost despite unprecedented national pride and feelgood factor. I've never seen polls stay so resolutely unimpressed through such hive-ecstasy.

As I've said all along, the cuts won't destroy this government, incompetence will. Cameron cheated the public once, then launched detested policies not mentioned in any manifesto. I am convinced they will not let him or - anyone standing under a blue flag - do it again.

Sunday 16 December 2012

The Twilight Times

Oh bloggy-wog, I am in a fix.

As most of you probably know, I am no longer at That Hospital. We must say no more on the matter for now, but it means I’ve had a terrible, painful and horrifying year.

For all its faults, I stayed at That Hospital for 18 years. Incredibly, The Great Twitter Incident wasn’t an isolated example of the patient “care” I had accepted as normal for all of that time. The stroke they insisted was just an attention-seeking panic attack; the operation I woke up from with no pain relief, writhing through 6 hours of torture until the pain made me lose consciousness; the bullying little nurse clique who sent me home haemorrhaging with a urine infection after they withdrew care a few days before they discharged me.

Why on earth would a human being accept that? What could possibly be worth all that desperation, humiliation and fear?

I am an odd medical phenomenon. I just don’t present in any way as a patient who’s bowel is blocked. I don’t get much inflammation or active disease, so my blood test results always come back fine. I don’t blow up like a balloon, so my physical examinations are always fine. To complete the set, my scan results rarely show much structural damage, so my bowel usually appears to be fine.

This meant that I spent my childhood being told that I was “just” anorexic, or “just” depressed and a six year wait for the diagnosis that would entitle me to any treatment.

Even at That Hospital, it probably took my consultant 5 years to truly believe the evidence in front of his eyes. Without fail, every time I got very sick indeed, the tests would not really justify surgery and every time, they ended up rushing me in as an emergency and finding impossible tangles of pus and ulceration and tumour-like blockages.

In the end, he just knew that we only really had my symptoms to go on and we settled into a fairly regular arrangement. I would take all the steps you must take to get the crohn’s under control myself – put my steroids up to settle any inflammation, modify my diet to the optimum healing regime, supplement my diet with liquid feeds for nutrition if necessary, administer painkilling injections for a few days to get over nasty little flares. I knew all the rules.

If all of those things failed and the pain just kept increasing, like an insistent child demanding immediate attention, it was getting serious. Super-Doc always stressed that there are a few lines in the sand you just do not cross. He trusted me to act sensibly and do the right things.

-If you bloat up suddenly, your abdomen becoming hard and rigid, it’s straight to A&E

-If the pain becomes constant, reliant on the strongest drugs to give any relief, things are bad.

-If I start vomiting continually, sweating and puking and heaving, hour after hour, you call an ambulance after 48 interminable hours.

-If a hard, distorted abdomen hurts more when you let go than when you press, it’s straight to A&E

-If I start to lose weight despite all of my efforts, I need treatment quickly, before I get so malnourished and underweight, surgery would become impossible.

There are funny little “stricture hiccups” you get when your bowel is blocked – more of a gasp-squeak than a burp and a stricture “talks to you” in a constant, rumbling rrow-rrow-rrow grumble.

So with all of those things in mind, it is far from impossible to diagnose atypical obstruction if you know what to look for.

But I have to start all over. Like a hospital virgin, I must wait coyly for invasion. No reason to need emergency treatment, no apparent cause for the unbearable pain, no belief in the possibility I could be endlessly vomiting. I have not yet passed the probation period, and as such, am guilty until proven innocent.

No-one at my new top-secret, undercover location has read my previous notes. (I know, but it’s true. I even had them couriered here at my own expense, but they sat unopened in a box for three weeks.) They haven’t spoken to my old consultant. They haven’t done any scans since August – convinced as they are that the first can only be good enough. They insist on treating me medically, repeating all the steps I have taken myself at home. They speak to me as though I only heard what crohn’s was yesterday, though I almost certainly know more about the disease than they do.

I have all of the signs I list above. At least once a week, they all come on at once and I writhe and vomit my way through 2 or 3 more intolerable days, delirious and frightened. I keep bouncing back to hospital, aware that these are symptoms that Must Not Be Ignored and each time, they intone the zombie like assertion that things-must-be-ok-because-the-book-says-they-are. Baffled and confused, I go home, bear it as long as I can, and then the whole cycle starts again.

We have reached an impasse. I believe that I am dangerously ill and like a drowning man, cling to my symptom-life-rafts. They believe surgery can wait and are convinced they won’t find much to do that will give me any comfort or relief anyway. I can’t phone my old consultant and they refuse to phone him themselves – why, after all, would world-experts in bowel disease need to trouble another world expert with something as simple as a diagnosis of obstruction? Oh the professional shame of it!!

So, I’ve tried everything, done everything I can to make my case. I can do no more. I must simply go home – over the Xmas holidays when emergency teams are thin on the ground if something goes wrong - and hope I survive until this mirage operation might become a reality. I must hope even more that this isn’t the time I’m wrong or I will never have any credibility with this new team again. The pressure is entirely on me to know when to insist, when to contradict.

My Mum and my husband, already on the brink of despair, must watch me writhe and oh-so-nearly-fade-away through each violent bout, powerless to do a thing about it. My kids must settle for Victorian style daily visits to my bedroom as they wait for Santa and decorate the tree. They watch their Mum, stagger from her bed, bathed in sweat, her bird-like legs carrying her agonisingly slowly to the bathroom, her lips blue and her hair wild. My room smells of disease; gloomy and un-natural with curtains closed.

I have no idea how a human could be expected to “just tolerate” this. But I am and I must.

Somehow, I must try to lose no more precious kilos, though days pass where even water refuses stubbornly to make it anywhere near my kidneys.

I imagine the surreal image of me, with my wonky paper hat and tinsel streamers, shoving needles in my arse under the dinner table, as Dave carves the turkey.

So just for you, George Osborne, a glimpse of what really goes on behind at least one set of closed curtains