Hey chaps, here’s a rape: when is art not art?

And it’s one in the eye for art. Sorry folks, looks like the fat lady’s singing. Oh, wait, that’s Wagner.

The latest production of Rossini’s Guillaume Tell (William Tell) at the Royal Opera House met with boos as a scene involving a female character getting sexually attacked unfolded. Such was the audience reaction that Kasper Holten, director of opera issued a statement: ‘The production includes a scene which puts the spotlight on the brutal reality of women being abused during war time, and sexual violence being a tragic fact of war,’ Holten said. ‘The production intends to make it an uncomfortable scene, just as there are several upsetting and violent scenes in Rossini’s score. We are sorry if some people have found this distressing.’ This statement raises a few questions about the position in our culture of art in general and the Royal Opera House in particular.


This paternalistic and possibly arrogant attitude really appropriate with regards to art? The audience bought tickets for a night of entertainment. They got an eyeful, and also got preached at. Had they wanted to be upset, made uncomfortable and informed about the violence society imposes on its more vulnerable members, they could have curled up with a cup of tea and a report on female genital mutilation. They didn’t. They bought opera tickets. They went for entertainment. Therefore, they’d surely be within their rights to claim a refund under the Trade Descriptions Act.

Bad Business

Presumably art establishments want people to pay to come and see their wares rather than rely on government funding? The basic rule of business is that you need to give customers what they want. Naturally if they want a rape scene, they’re probably not the best kind of customers. The customers in question didn’t want it though. It was imposed on them by a company which thought it knew what their customers should have wanted. As soon as a company adopts this faulty attitude, it will either go bust, or be bailed out by the government. If it gets bailed out by the government, it just becomes a ministry for propaganda. We’re now in a situation where the audience wants entertainment and the company wants to educate them. That’s never going to work. (However, I do agree that the public has got exactly what it asked for with regards to television, which is another matter entirely.)


There is a certain insecurity in art circles with some who seem unable to bear the thought that art is beauty, and entertainment. It doesn’t save lives. It’s not essential to existence – it’s just a really, really good thing to have. They feel the need to use art as an opportunity to preach something or other. It’s OK that art is entertainment. Really it is. It’s good to be entertained. Unfortunately for the past 80 years or so, there’s been a definite movement to make things ugly. It’s got to the point where we can’t enjoy the vivid, melodic, and downright rollicking score of Rossini’s without having to have the rape thing as well. Why can’t things just be nice? We have enough trouble in the world already, why do we have to have it shoved down our throats when we’re trying to relax and get away from it for a bit?


Sensationalising instead of highlighting. There are lot of things about war that are rubbish – the pain, the death, the mutilation, the broken families, the lives forever changed. Loads of stuff. There is also a lot of boredom interspersed with moments of life-threatening action. Interestingly the production concentrated on the less common sexual abuse than the rather more common boredom. I wonder why that is?


I suspect anyone who has suffered sexual abuse, or knows anyone who has, recognises that involving such thing in an evening of entertainment is tasteless at best.

It’s just not cricket.

And here’s the thing. This production is not about raising the awareness of the plight of women. It’s purely to get publicity. Had the company honestly been concerned about a related aspect of the opera, a more effective thing (that wouldn’t have cost a bean) would have been to partner with an organisation that is involved in relieving the suffering of such victims, invite them to submit an article for print in their programme, and to invite donations from the punters. That would have been caring, sensitive, and productive. As it is, they got the publicity they wanted – and all publicity is apparently a good thing, so I suspect there are going to be more ticket sales for this production in that sector of our society that enjoys watching a jolly good rape. I’ll not be there.

Want your art back the way it should be? Too right.

Floppy morals and the Clarkson Debate

I’ve just realised my morals are bendy. Hitting people is wrong. Clarkson hit someone, and in any other job it is highly likely that this would have led to instant dismissal – and yet…

I find myself rooting for Clarkson, partly because the BBC’s the BBC. But I’m clearly not as immune to ‘packaging’ as I thought. For example, the 50 Shades of Grey thing? That’s just domestic violence with pretty people. As long as the people are pretty and/or rich (preferably both) then the mainstream media – and therefore the collective conscience – is OK with it. I’m no feminist, but I was shocked that women would go to watch a film that is purely about glamorising abuse.

The problem? People don’t really think any more, and were happy to accept opinions as packaged by the media. And it’s the same with Mr Clarkson – I like him; I find it difficult not to like him with his cleverly un-clever humour – but I’ve realised I’ve developed a double standard right there. He’s funny and I like him, so I let him off the hook and am indignant that the BBC should sack him. The media reaction was entertaining with journalists not sure whether to root for their colleagues, or pour scorn on the BBC, I enjoyed that immensely.

Interestingly the BBC, socialist entity as it is, is now being held up as the very thing its journalists hate – the large corporation against which the little person must struggle. We’re now in the position that hitting people is wrong, unless of course you’re being punished for it by a large corporation, and then it’s OK.

Was it right that the BBC should sack him? Probably, but what a waste of grumpy, middle-aged, yet lovable talent. Now what will we do? For those of us who still have TVs, it’s going to be that ‘midwife programme’ or a poke in the eye.

For Mr Clarkson, it’s a question as to how much rebranding and positive PR is really necessary.

That’ll be a no to Celebrity Big Brother then?

The ‘Heart-Friendly Town’ and the Scourge of the Defibrillator

A community defibrillator? Surely that’s a no-brainer?

It’s an emotive issue and the received response is ‘Of course I’d want to see one in my high street or whatever’. Defibs save lives, and if money were no object (and we have to be realistic here) it would be great to have them everywhere.

At the risk of being completely shot down by the establishment, I’d say it needs a bit more thought. The question should not be ‘Do you want a defib on your High Street?’ but rather ‘Do you want more lives saved?’ And then following that, ‘How can we save the most lives with the resources we have available?’ Let’s not get distracted by the ‘Defib or no defib’ debate, it’s much more complex than that.

Buying a defib is emotive – surely it’s a good thing! But I’d encourage people to consider the opportunity cost – what other intervention could have been implemented, and would it have been more effective? As far as I know the BHF is still offering help to buy community defibs, and it is tempting to take the funding because it’s ‘free money’ – but if you donate to charity you hope it’s being used effectively, and there are other measures that would be good to implement and would benefit many more people. Yes, I’d like to see defibs but only as part of a wider health campaign.There’s a danger in installing a defib, ticking the box, and thinking that’s it, you’re done.

Heart attacks are frightening experiences for all involved. The likelihood of one happening in the first place should be of considerable concern, at least as much maximising survival rate when one actually does. Here’s a fact – most of them happen in the home. Not in the high street. Therefore there is more likelihood they could be successful if installed in a built up residential area rather than a shopping area. Why are they installed in high streets? Perhaps because the research on ideal placement is not done, or perhaps because decisions are made by those who have the budget but not the awareness (and pointing no fingers here), perhaps it is a political decision to make people feel cared for, or it’s an emotional decision – or perhaps for PR.

The defib only provides a return on investment when it is successfully used and a life is saved. It’s not enough to install one – it needs to be secure from thieves, but also accessible immediately to those who need it, with no wasted seconds. So I’d respectfully suggest that most of them are installed in the wrong place.

So what do we do if most heart attacks occur out of the range of where most defibs are installed? Of course look at relocating the defib (obviously!) But also look at other measures that could be implemented – is a defib the best solution? Naturally, if it’s a defib or nothing, I’d go for the defib every time. I want lives saved. However, I think the resources can be better deployed to greater effect in the same community by different interventions.

If defibs are going to be installed, I’d prefer to see them as part of a wider initiative. How about having a ‘heart-friendly town’ where organisations and individuals work together to tackle the root causes of heart disease? How about awareness evenings? More GP referrals to exercise outlets? Health buddies? A commitment to living healthier for longer rather than just longer? You might think that this is over-ambition – and maybe it is. But I’d argue although it’s more time-intensive than buying a defib, it stands to improve health in every generation in the community, for longer. It will prevent people needing the defib in the first place.

People need to take back control of their health. As a community we need a healthier outlook. There is a correlation between what life choices they make and what benefit or disbenefit this brings them.

I’m a nurse, and I can honestly say that the joy from seeing someone succeeding in reducing their cardiovascular or diabetes risk considerably is like no other. Seeing people take control, and get their lives back – seeing them excited by what they’ve achieved is indescribable. The change this brings to themselves and their families is amazing.

By making changes, you not only reduce the risk of needing a defib:

  • You decrease your future need of diabetic drugs
  • You increase your body image
  • You increase self-esteem
  • You increase confidence
  • You facilitate healthier relationships with those you love
  • You have a lighter mood.

I have seen all these outcomes and more. I would like to see health promotion – proper health promotion at the top of the community list. It’s all too easy to install a ‘just in case’ box on a wall and leave it at that – but do we not deserve better than that? In fact a project in Salford, Manchester was set up to address health inequalities and ended up achieving all sorts of unexpected outcomes as a result – and for every £1 invested it yielded £12 of social and health benefit for the participants and their communities – and this carried on as long as the project was running; even afterwards, much of the benefit remained as people maintained the changes they’d made and reaped the rewards.

Yes, a defib is great, but what if in 20 years it has saved no lives? In terms of return on investment, there are many other concepts that will be more effective for more people, for much longer (even permanently). Lives are complex; save a life, and you’ve saved a father, grandfather, cousin and uncle in one go; you save a family’s grief, you save hardship, pain, anxiety, fear, and uncertainty. Faced with the choice between possibly saving one life and definitely saving 50, I’d go with the 50 every time. Yes, in health as with in everything, it is a numbers game.

Whatever a defib costs, it’s likely more lives can be saved by using the investment another way. I applaud the sentiment with which people campaign for more defibs, but the people in our communities need, and deserve, more than just that. Let’s aim bigger. Let’s live better. 


Santa is not a well man.

He’s been doing the same high-level stressful job for as long as anyone can remember, and now he’s doing it for our children. Yes he gets the best part of a year off, but just how long can he keep going?

I don’t want to appear preachy, but be aware that with his current lifestyle and obligations, Santa is not going to go on forever. Don’t be surprised if one year, you have to deliver all those gifts yourself and pretend it was Santa.

Just look at the evidence:


  • Job in logistics – renowned for being a sector of decreasing returns, when taking into account tariffs, fuel and duty, and infrastructure
  • High public expectation, huge responsibility = massively unfair level of stress on one person
  • Dealing with animals, and therefore animal welfare people. Do you know the regulations for keeping working reindeer? Nope, neither do I. 
  • Dealing with elves; renowned for being tricky customers, these little chaps are hot on their ethnic minority, disability, and human rights laws. ‘Elf and Safety, mate. 


  • Long periods of static position and limited leg room in sleigh. Plus, new sleigh models have a smaller parcel shelf, so smaller parcels may need to be suspended from ‘curry hook’ in passenger foot well.

Metabolic syndrome:

  • The classic combination of increased girth, increased blood pressure, high cholesterol and high glucose. Just look at the diet and lifestyle of this chap.
  • Mince-pies and clotted cream – diet high in sugar and saturated fat – hypercholesterolaemia and hyperglycaemia leading to increased risk of diabetes and cardiovascular events

Cardiovascular disease:

  • Excess fat in diet, being overweight, and not getting sufficient cardiovascular exercise to strengthen heart muscle contribute to risk of cardiovascular disease
  • High blood pressure and stressed lifestyle likely to cause complications.


  • Excessive alcohol intake increases concentration of uric acid in blood increasing likelihood of developing gout
  • Obesity, high blood pressure, hypercholesterolaemia and decreased kidney function can all contribute to increased risk of gout

Chronic kidney disease:

  • Developing type 2 diabetes and having prolonged high concentration of glucose in blood over time can damage fine capillaries in kidneys, decreasing kidney function.

Type 2 diabetes:

  • Obesity through high-calorie diet – waist circumference now a risk factor for diabetes – due to increased percentage of body fat, likely increased insulin resistance, leading to over-production of insulin to compensate.
  • Likely impaired fasting glycaemia or early stages of diabetes, as has been overweight for a considerable  time. However, there has been no over-frequent incidence of Santa using people’s toilets, and he usually sticks to ‘just the one’ sherry at each house so unlikely to be experiencing osmotic symptoms of diabetes such as increased thirst or need to wee.
  • Night-time working and long hours have also been connected with developing type 2 diabetes (admittedly in Italian shift-workers) – and this chap must have the weirdest body clock ever.

Erectile dysfunction:

  • Sustained hyperglycaemia leads to damage of penile capillaries. Decreased incidences of nookie with Mrs Christmas may lead to marital problems.

Clinical depression:

  • Well if you had all that lot, there’d be a greater chance of being depressed, right?


Fifteen minutes to care?

Yesterday the Leonard Cheshire Disability organisation revealed that agencies and councils are often routinely scheduling 15 minute long visits for care staff to provide care for people in their own homes.

Fifteen minutes isn’t enough to take someone frail or unsteady to the loo, administer medication or make a simple snack, because as any nurse knows, it’s not just about that. It’s about providing company and a friendly face to someone who may not see another person from one day to another. It’s not enough time to make sure a person feels secure, has everything they need and is comfortable, and is safe to leave alone.

So why’s it like that? Because social and nursing care is not appreciated, nor is it respected. The reason agencies and councils are unable to provide decent levels of care consistently is down to resources. Because resources are finite, we have to ration them. For as long as nursing and social care is not respected, it won’t be adequately funded. With nurses only being paid marginally more than unskilled workers, it’s clear to see that the problem is deeply embedded.

The fault is our own. For as long as we don’t speak out, for as long as we sideline nursing and social care in favour of funding more exciting issues, the sick, frail and vulnerable in society will not receive the care and respect they deserve.

Those who have grown up and grown old in the shadow of the NHS, will find in the words of a 94 year old I nursed, ‘It’s not there for me. I’m too old. I paid my taxes since I was 14, thinking the NHS would be therefore me when I needed it. I need it now, and they told me I’m too old.’

Why are fifteen minute care visits the norm? Because that’s all you need to accomplish the minimum. Surely we should want more than the minimum for the people who have no choice but to rely on it?

Labour exposed. Again.

Watching the political manoeuvring at the Labour party conference after the revelations of Mr Brown’s book is like lifting a rock and discovering lots of wriggly things squirming.

Dangerous Clegg deployed on global issue

As the world breathlessly watches, Mr Nobama meets with our illustrious Comrade Putin to discuss the trouble down in Syria with the Dentist of Damascus. As they come to an agreement (would have liked to have eavesdropped on that one), it seems a solution is at hand. Mr Hague, not sure exactly what he did, talks as though he certainly had something to do with it. Mr Cameron quietly takes on the economy. Everyone’s busy. Everyone?

Ah yes, Mr ‘Secret Weapon’ Clegg. Clearly no one was quite sure what to do with him, or indeed where to put him. So he’s meeting the Cleggerati for their annual do, and it emerges that his project for this term has been addressing that ticklish global issue of excess carrier bags. Well that’s a relief. If it weren’t for the comedic aspect, it would be quite sad that the poor chap has got so near to the top in politics, and yet so so far. Chin up, Mr Clegg, maybe if you pull this one off, they might let you do something with bus passes for the aged, or perhaps municipal swimming pools. The possibilities are infinite for a chap with the audacity of hope and plenty of time.

Be careful of the one on the right