Monday 23 July 2012

My problem(s) with Dark Knight Rises (spoilers)

Starting, perhaps predictably, with a caveat...I really enjoyed watching the Dark Knight Rises at the cinema, it's a great movie well executed. Not perfect, but very, very good. It's not on the other hand a great Batman movie, I feel. In fact the more I reflect the more I see it as disappointing, and a missed opportunity.

First, let me say, there were good things.

Anne Hathaway's portrayal of Catwoman felt perhaps like the most true to the modern comics than any other characterisation made so far.

The twist of Talia al Ghul was (for me) completely out of the blue. Perhaps because of the detractions from the world I know of Batman in the comics, I'd allowed myself to consider that Nolan would make Bane the son of Ra's al Ghul. I should have guessed it earlier (and no doubt many a bat fan would), but it was a well crafted twist...perhaps more so because of the way the pre-screening media was involved in selling the dummy.

Showing the intelligence of Bane; the path of the previous Batman movies did a great disservice to the only character to truly break the Batman. This Bane was almost everything that he needed to be.

Also, in general, the costume design, the soundtrack, the work that was done on the environment, the locational work...basically the actual filmmaking...was all fantastic. This is the main reason that it'll always be a great movie.

It's the story and the characters other than above that make it disappointing.

The film itself seems to take inspiration from two main stories...though it doesn't take more than a few of the elements that make those stories great. The stories are Knightfall and No Man's Land, arguably the two most defining stories of the 90s for Batman.

The trouble is that Knightfall is a character study in Batman losing all hope and being unable to reach out for help when the odds start to become insurmountable. It's a story of Batman believing that he can get through everything on his own. But in order to do this Batman is beaten down, kept too active and involved in crime fighting super-villains.

This is Bane's plan, to wear Batman down so that when he comes to fight him, it will be a Batman of broken wills and concentration. The film, by contrast, does the opposite and portrays Batman coming from the other direction...with plenty of spirit and a slowly improving (though not peak) physical condition.

The interaction between Bane and Batman, therefore, seems entirely consequential. That the plan is to have Bruce Wayne watch Gotham destroyed as Ra's would have intended seems almost tacked on.

Furthermore the interesting thing about Knightfall is what happens next. Bruce decides to retire as Batman under largely happy circumstances, but only because there is another Batman to take his place, that he has an understanding of, and trusts to do the job. Interestingly Alfred also leaves Bruce during this time as he doesn't want to see him damage his body any more.

Bruce would later come back to retake the cowl, when his replacement goes somewhat crazy and starts endangering the public and taking punishment to a new level.

The film cut this opportunity off, by 'killing' Bruce Wayne off (though it doesn't really explain how Bruce Wayne is perceived in the public eye after the ending) who would be there to come back?

Then there is No Man's Land, perhaps my favourite Bat story of all time, where an earthquake has left Gotham largely destroyed, with criminality running rife as Ra's al Ghul (Bane acting as his proxy in the film) has previously released everyone from the maximum security prison after trying to release a virus around Gotham (Batman Begins, essentially Batman Year One meets Contagion as story lines...I digress). As a result the federal government deciding it has to cut Gotham off from the rest of the country.

The story showcases perfectly Batman's abilities to act as a strategist. With several allies around the city in the form of police, other vigilantes and even former foes, Batman regains control of Gotham enough over time to allow the government to stop their blockade of Gotham.

Is any of this present in the film? Of course not. Batman miraculously recovers from his 'broken', or more likely dislocated, back and makes it back to Gotham (with no money) just in time to stop the city from being destroyed.

No strategy, no organisation, no intelligence.

And maybe this is what bothers me about the film as a bat film...Batman wasn't recognisable in it as the character we know. He pleads and bargains more than he growls and commands, he starts off severely injured and out of the game for 8 years, without any good reason

Batman started to stop criminals, not just super criminals...those like the man that killed his parents. The film already says that crime isn't abolished in Gotham, so why would Batman stop just because organised crime was curtailed?

The Batman I know and love would have, by the time he was 10 years in to life after donning the cape and cowl, become a master detective and be finding his prowess in being a 'war general' of sorts. This Batman is a damp squib, almost emo in personality. While Batman in the comics may use his personal loss and possible depressive outlook to drive him to clean the city up, the film's Batman doesn't use it at all.

In fact the greatest loss in Batman's life in the comics is that of his sidekick Jason Todd, the second Robin. We know from this that Batman's reaction to the loss of someone by the Joker is rage and determination, not depression as happened in the aftermath of Rachel's death. The key is that Batman shouldn't stop doing what he intended to do when he started.

It does make him less keen to trust people with his identity, and getting close to him though, which is what makes he film's portrayal even more confusing as he seems to readily hand over the mantle to 'John Blake' without really knowing much about him and his ability to not get killed the first time he faces danger.

But then Nolan is clearly trying to wrap up his Trilogy, and he does it in style (albeit of questionable physics). But from the initial niggles in Batman Begins of allowing Ra's al Ghul to die (as much as that character can, and having guns on his vehicles ) the concerns only grow. Dent/Two Face killed readily in the Dark Knight, then Talia and Bane killed in the Dark Knight Returns. The obsession with killing off villains seems to have grown and grown.

And then there is letting everyone know or find out his identity so easily; He talks about why he wears his mask in the film, yet does everything he can to ensure people know it is Bruce Wayne underneath it.

This might all sound like I'm being overly critical, and perhaps I am. As I said at the top of this post, I enjoyed the film a lot for what it was and it genuinely entertained me. I just also see from my previous knowledge of the stories a lot of missed opportunities, fundamental mistakes with the character that I'm surprised DC signed off, and avenues cut off for potentially keeping this particular universe going.

But then given how this character of Batman was left, not my Batman but someone else's that had the privilege to bring him to the big screen, I'm not sure that I would particularly want to see any more of 'The Dark Knight' Batman anyway.

Roll on the 'reboot', as long as it's not another origin story!

Friday 13 July 2012

What's the fuss with the NHS cap on private income?

After a significant misinterpretation by the New Statesman, a lot of people got very concerned on Twitter about the potential for the rules on how much income NHS hospitals could make from private sources.

I feel this is a subject that is incredibly fraught with symbolism over substance, and wanted to just delve in to the realities of the cap, the law, current reality, and how it all ties together.

What is the cap?

There are rules over how NHS Foundation Trusts (FTs) operate. these FTs were created by Labour to enable a form of lessened state control, local staff and public were intended to drive the direction of their local NHS services. In return they get to keep any profits they make, can work with and are in essence in competition with other FTs.

It was privatisation of sorts, just without the (direct) commercial influence of a company running the board, and it started the whole ball rolling to where we are now.

To balance the extra freedoms they have to operate, a means of capping how much money these FTs can make from private patients was introduced. It's disparate and not necessarily "fair", in that it is whatever their income was in 2003. This means that some hospitals have much higher caps than others, but all under the currently proposed less than half of all income level (erroneously referred to as a 49% cap, but which I'll use as it's understood when talked about).

In fact the reality is that less than 1% of all money coming in to FTs this country is from private healthcare sources.

Side Note: NHS Trusts

The whole situation with the NHS is complex, FTs aren't the only providers of care, NHS Trusts that provide services in the more "traditional" structure are being essentially abolished with the new NHS reforms, the intent is to give patients more say and the only way the government (both the current and the last) sees that as being practical is by trusts becoming FTs.

Of course this is why you'll hear people claiming that the 49% cap is new, and that there was no cap for NHS Trusts before. Technically it's true, but it's a bit of a side point as they are being told to become the equivalent of foundation trusts, which means they would have been capped, albeit at an income level of lower than 49%...hence why this is still ultimately a rise on the potential income hospitals can make.

Reaching the cap?

It's no surprise, when looking at the FTs figures, that analysts and those in the sector aren't actually too bothered about this cap; in the short to medium term at least there is little chance of foundation trusts reaching the 49% cap anyway.

With only a handful of hospitals having significant income from private sources, it is inconceivable that all NHS hospitals will suddenly be putting NHS patients second to a vastly increased private constituent, in only as the rate of rise would be completely out of step with the amount of private money circulating (the amount FTs took from private patients DROPPED compared to 2010/11, presumably due to recessional forces).

The reality is that the law as set out isn't about capping anything, given there is no need for most FTs to have such a high cap anyway, it's about symbolically enshrining in law that hospitals are primarily there to provide services for NHS patients, not for private ones.

This doesn't mean less beds for those using the NHS

One way that opponents of the raising of the cap put their case is that they make grand claims about resources being requisitioned for private patients, meaning they won't be there for normal NHS patients. Some go as far as to claim (as Polly Toynbee tried) that it means that half the beds could be reserved for private patients.

The reality is that if we look at those FTs generating a lot of income from private sources, it's through infrastructural investment and partnerships that involve new technologies and better facilities being developed for the express purpose of bringing private patients in from outside the area, not only from within the UK but from around the world. Some people just want to have the opportunity to pay for what they see as the best specialist services in the country, even if they wouldn't usually be able to on the NHS (or at all, because they are international patients).

The result of this is money coming in from wealthy sources to provide profits for an FT that can be reinvested in NHS services, while at the same time having newer, better facilities on site that NHS patients can also be using to the improvement of their health. Indeed by allowing partnerships with private hospitals (and to , and therefore being able to provide a "better" experience for private patients (through finding them a space, and thus a shorter waiting time, with the partnered institution), the side effect is more capacity to deal with non-private patients at NHS facilities.

Of course this causes it's own issues, with it being clear that cashflow will largely pool in London and the South East, with little prospect for the North; indeed this is why the overall private patient income gained by FTs is so low despite those like Royal Marsden already commanding significant percentages of income from private sources.

The misplaced outrage over no cap

So if the 49% cap is symbolic, almost entirely unable to be reached, what is the problem with a removal of the cap? Opponents to the idea (and I must stress, I'm not in favour of a removal of the symbolism of the current law) claim that it would lead the the wholesale privatisation of the NHS, that normal patients would be put second.

I say this is rubbish.

For NHS FTs to generate 100% income from private sources it would have to also become a requirement in this country for everyone to take private insurance, and for hospitals to HAVE to generate it's income from private insurance. It would also require the current reform laws to change to allow hospitals to be selective over how they treat people, and what their duty is.

On the second point there, let me just reiterate what it says in the reform act...

(4) Monitor must exercise its functions with a view to enabling health care services
provided for the purposes of the NHS to be provided in an integrated way
where it considers that this would—
(a) improve the quality of those services (including the outcomes that are
achieved from their provision) or the efficiency of their provision,
(b) reduce inequalities between persons with respect to their ability to
access those services
, or
(c) reduce inequalities between persons with respect to the outcomes
achieved for them by the provision of those services.

The same is said of the Secretary of State for health, of the Clinical Commissioning Groups and the board that monitors those CCGs. It is a core principle in the law that the NHS is not to introduce policies or to integrate in such ways that those without private health insurance see a widening gap between the quality and effectiveness they receive versus a private patient.

Even if this was not the case, until the law is changed to require people to take private insurance, ala the US of A, and that the state will NOT provide funding for patient care it is fundementally impossible for a 100% private income situation to be reached, and can we honestly see this happening given how vociferously opposed to these rather tame (in comparison) reforms has been?

While people look at the removal of the cap as something that means privatisation, I just can't see it adding up to that. Those who complain about the idea of a FT making 50% of it's income from private sources completely ignore that this could be achieved without reducing the level of income from non-private care. In essence hospitals could DOUBLE their income from current levels, provide no worse care for NHS patients, and hit that 50% income level from their private patients.

Is this really a problem, assuming that all the various levels in the new structure of the NHS do their job and ensure that hospitals adhere to the principles of increasing quality and effectiveness of care for NHS patients, and a commitment to reduce inequality between patients on the issue of ability to pay? I'd say that in practice, it is not.

Tuesday 10 July 2012

'Lib Dems did nothing about the NHS', and other nonsense.

Just for reference, I feel I may be sending a few people to this over the next few weeks...









Monday 9 July 2012

Thinking about Lords Reform...

Lords reform is a tricky subject, one that isn't really about the Lords in isolation but the function of the wider political system of creating, scrutinising and implementing legislation. The current plans being put forward by the coalition are for a partly elected chamber to replace the currently appointed lords.

How it currently works:

Right now people sit in the Lords because the leaders of various parties ask them to be there. They have no obligation to attend (some Lords barely ever attend debates, vote or provide evidence on legislation, yet still claim tens of thousands of pounds in tax free tax payers' money), and due to more and more appointments they are become a partisan bunch of individuals that consist of more and more ex-MPs, MPs that the country has had enough of while they were in the commons yet now carry on taking a public wage for political work.

The problem:

The problem is that we currently have two halves of a bad system. On the one side we have people that are completely unaccountable, "unswayed*" by public opinion. This shouldn't be a problem because the Lords should be independent and expert in dissecting legislation. This is where the other half of the system comes in, with more and more Lords being aligned to a party of some kind, indeed being put in to their position by the leader of their party. Independence is a distant memory (if it was ever there before) and worse still expertise in relevant fields is being washed away in favour of a few reliable and loyal voters.

The options:

There are several options that are referred to with Lords reform, and it makes sense that while it would seem a simple and unifying issue when all three parties want reform of the Lords, the variation in what is possible offers the opportunity of disagreement and the usual political theatre.

The choices that I've seen put around, though not all are even remotely being considered, are:

  • A partly elected house of Lords with some remaining appointed (the current preferred option)
  • A fully elected house of Lords
  • A fully appointed house of Lords (as per the current system)
  • A fully appointed house of Lords, starting afresh with people that are experts first and foremost in several fields and in legislative scrutiny
  • Abolish the lords completely and just function on the house of commons
  • A "citizens jury" appointed for each piece of legislation (lol)

Further complicating the above list is that when elections are talked about, some favour STV style proportional elections, some party list, some a fully proportional national party list vote, and so on.

My view:

As I said above, Lords reform isn't and shouldn't be about the Lords alone. While they make terrible decisions from position of vested interest in their medical insurance companies or telecommunication empires, and follow a party whip on key government votes, in other cases they come in to their own as defenders of subjects such as human rights and privacy.

My personal stance is to fully elect the Lords, every 5 years.

Of course there is a concern that with a partly or fully elected chamber of Lords that we will have a drain on expertise of those available to scrutinise. Certainly with only a 5 year term this is even more likely (read on...). There is also a claim that it is the wrong thing to do while we are trying to cut the cost of politics in the UK. Also with the elections comes natural partisanship and towing of the party line.

Party lines and the Lords:

I don't, perhaps surprisingly, see this as a problem. I dislike the party system but understand that it will always come to naturally exist. My main problem with the party system is that currently one party tends to hold disproportionate power and is able to force through threats of blockades in an MPs career or even deselection at local level to ensure people vote to maintain the power of that party.

With a second chamber elected proportionally, whether through STV or open-list (the system being proposed), the power of the party is diminished. I feel this is one reason why so many Tory MPs are rebelling against the idea of this reform, they know that one things is true:

Lib Dems will finally get the power that they proportionally deserve in the scrutiny of legislation, and they (with their ambition) will never have sole discretion to power through changes such as abolishing or reverting various aspects of healthcare, education or welfare.

While the commons, elected through FPTP, will continue to be disparate to the wishes of the country, the second chamber would be one of temperance. I believe this operates as the perfect "yin" and "yang" of politics. One chamber inflates public opinion to get an idea of what they desire to be direction of policy for the UK. The second chamber, in turn, ensures that the policy brought forward is in line with the real wishes of the public.

This would mean that while the Tories could get a majority (or any party) and decide to abolish the NHS, they would not get it through the second chamber due to the unlikelihood of the some 70% of the other "Lords" being unlikely to vote for such measures. This is a good thing, and anyone presenting this as "gridlock" is glossing over the fact that only bad legislation that the public has not actually voted for will be blocked.

The cost:

I dislike arguments about cost when it comes to politics. When you walk in to a garage and they quote you £50 to do your car repairs, while the rest quote £300, you deserve everything you get if you choose that cheaper garage, and all the problems that follow.

The answer to making politics more reasonable in the eyes of the public is not to reduce the cost, all this will do is reduce the numbers of politicians, reduce how long they have to balance meeting their electorate with reading up on the laws they're passing, and in turn make people more angry when bad legislation is passed.

Politicians need to be seen as more valuable. Their salaries may be high but people wouldn't complain about this if they actually understood the country better, instead of being so constantly and hopelessly out of touch.

A such this idea of trying to do things cheaper isn't one I entertain. If (and it's still only an if) the new proposals lead to more expense then so be it. If they perform their function better than the current Lords then we have got a good deal.

Besides, any such expense will still be a complete drop in the ocean compared to the public purse.

5 Year Terms:

I don't agree with the idea of a 15 year non-returnable "term" of standing for election in the second chamber. It is inflexible to changes of current opinion, and if you are using a proportional system of election then your intent must be to reflect the will of the nation. Restricting elections to only turn out one third of all politicians in the second chamber every 5 years, leaving everyone in post for 15 years each, means that proportionality will only exist in bubbles.

While I'm not against the idea of staggering the elections, much in the way council elections are done (which can actually help to maintain proportionality and avoid chaotic swings of power) every politican should be out of their post after 5 years. That is unless they are re-elected.

Yes, there is no reason to say after 15 years that someone is "done" and no longer able to be a politician. If they are good at their job, and the public/party agree with that, then they should be able to keep standing. MPs can, so there is no reason why someone in the second chamber couldn't.

There is a danger, I feel, if the system was introduced that parties would simply use the second chamber as a "training ground" for the commons, putting younger candidates through 15 years of legislative scrutiny before letting them finally stand in a seat if they've proved loyal enough to get a seat in the commons, and perhaps a governmental position. Such things would belittle the political system, not enhance them.

Expertise:

The trouble is that expertise isn't guaranteed with elections, especially not with 5 year terms (unless someone happens to stay elected for decades!). We can rely on the open-list system, and hope that parties will put forward experts in their field rather than pliable individuals with a loyal heart, but that would be foolish.

It is entirely natural that with these changes we will lose experts. It is probably for this reason that the consensus is to keep some Lords appointed, such as Bishops, so as to keep a buffer of "expertise" around, especially on the issue of religion.

However I believe that looking at this issue of a "brain drain" on the second chamber is missing the point.

Three "chambers"

Let's say that somehow political deals are made great enough for this legislation to pass, if any referendum is forced then the public vote yes because the main faces of each party all go out together and campaign shoulder to shoulder for greater democracy (Yeah, I know...)

What we're left with is two chambers, one that is responsible for the proposal of laws, ensuring it's "primacy" or power over any others, and that is used to create the executive, and the other that is purely legislative and only exists to scrutinise legislation, passing it through the filter of a proportionally elected set of politicians.

What we are missing is independent scrutiny that has power.

Right now we have independent experts turn up to provide evidence on legislation. Where law is involving human rights especially we will see organisations such as Liberty pitch up and suggest their amendments to legislation, while the Police may give counter-claims and a different perspective that supports the law as written.

None of it is binding though, these are people that are incredibly informed and knowledgable about their field and yet their word is only advice. How it is taken depends entirely on the integrity of the politicians listening to them.

A third "chamber" which operates on a much more fluid basis, with permanent individuals with solid constitutional and legal knowledge to deal with legislative concerns both domestic and European, and temporary experts drawn in to provide their experience and knowledge to the process of amending law, would serve to take from the responsibility of the commons and a second chamber (currently the Lords) the requirement of ensuring that the law is workable, in line with all other laws, and doesn't result in any unintended side effects.

A good case in point would be the ridiculous "Auto-block porn" law that has resurfaced. While the two chambers can argue as much as they like about the merits of requiring ISPs to block porn as default, an expert chamber would be able to write off pretty much all of the law in the bill due to it being simply impossible to put in to action or enforce. Even the current Lords, with all of their alleged expertise, are likely to fail to understand such nuances, and given the highly religious motivation behind the law there will be pressure to ignore actual knowledgable people that can currently only give their advice.

Of course this chamber will, unfortunately, never exist. It will always be criticised by both elected chambers as a "wrecking chamber" that doesn't act to the wishes of the public. Even though it is doing the most important work of all, in grounding the law's provided in reality, and protecting everyone's legal rights against existing laws and standards, it's hard to wrench the power away from politicians that want to write laws that can be ambiguous enough to be exploited later on.

Edit: To clarify, I would see this "chamber" or body as something that is formed for every bill BEFORE it is put to scrutiny. The biggest problem with legislation is that it's hugely flawed and there is only enough time to fix it slightly. This level of input at a "draft" stage would ensure that the truly insane side of some legislation would be filtered out before MPs had to waste their valuable time arguing against it too (if they catch it at all).

Conclusion:

Even though it may be imperfect, I still stand behind a fully elected second chamber. I don't believe that we will lose a great deal of expertise as long as the parties have a level of integrity over who they pick to run, but I also don't believe that the Lords is a universal board of knowledge that stops bad legislation all the time anyway.

In the balance of all things, my priority will always be for legislation that is forced to follow public wishes. Aside from a few examples this reform will by itself stop extreme legislation through the dilution of power in a second chamber.

But ultimately such a change will not change the world. It won't stop workfare, it won't create more jobs, it won't stop people with no technical knowledge of the internet continuing to erode freedoms. It may over time help though, and I firmly believe if we had a Lords that was formed as it is intended in the programme set out by government, the changes to the NHS, to the welfare system and to those on benefits would have been no-where near as severe as they have been.

Tories may shout this as an example of why it is such a bad idea, but I believe they are in the minority, and that the majority of us wish we had that protection of "gridlock" in the last couple of years.

----

*I say this in reference the the public being able to apply direct pressure. There is no question that the Lords, like anyone, understand the mood of the nation. However they aren't necessarily pressed to vote that way as there is no way to punish them for going the wrong way.