The blog is notes to myself that might sometimes be picked up by others who may find some useful insight.

I write things down to clarify and consolidate thoughts because I find that it is easy to have the illusion that you have a view or opinion which turns out not to be so when you try to articulate it. I have still not resolved what I should write about, though not things that are about my main activities. Probably there is 10% of general interest material that I would like to comment on, but where is the lifetime?

If I wanted to write about my main activities in depth I would have to start dedicated blogs, and how does one get the right balance of doing things and writing about the doing?

I marvel at the reams that some bloggers manage to post. Maybe are more talkative people than me.

I realise how little people read of what one writes because I read some other blogs and note how little I read, and I know how little my own friends read of what I write. It is worth giving thought to this to optimize one’s activities. I may start the optimize-blog blog.

I heard Fisk in person for the first time yesterday, after reading his books and articles over the past 20 years. He speaks as crisply as he writes. I find him one of the great reporters of the past decades. I did not learn anything new of his opinions, but there was one interesting comment. His driver in Lebanon is a Sunni Muslim who wishes him “Happy Christmas” in late December as honestly as Fisk wishes him “Eid Mubarak” during the Eid festival. Fisk’s comment was just what I also say to people; why are we so afraid of offending people in the multicultural UK by playing down Christmas celebrations as though people cannot tolerate the festivals of others. I hope to keep gaining a better understanding of Middle East matters from Fisk’s articles for many years still.

Many years (decades) ago in the pre-internet age when I used to go into book shops, on one visit to Blackwell’s science department in Oxford I suddenly saw a book by ‘me’ on cell biology; that was quasi-namesake-me. Because of this blog another quasi-namesake has contacted me, who has some of my interests in programming and music, though with a generational shift I guess of about -1.5 to -1.9. He has a well written blog: http://robertdyson.com/

The Robert who wrote on cell biology is www.gatewaywomensclinic.com/staff-dyson.php and has now delivered nearly 10,000 babies. Oddly there was a point when I thought I might switch to medicine and do obstetrics.

I wonder if names influence people. If we were to take cohorts of quasi-namesakes would we find unexpected correlations? I know that my given name is a real namesake and was chosen by my mother because in the 1930s she saw movies with the actor Robert Taylor and found him attractive.

This is the most inspiring talk I have heard for ages: Anil Gupta: India’s hidden hotbeds of invention.

The TED summary just hints at what is being done: “Anil Gupta is on the hunt for the developing world’s unsung inventors — indigenous entrepreneurs whose ingenuity, hidden by poverty, could change many people’s lives. He shows how the Honey Bee Network helps them build the connections they need — and gain the recognition they deserve.”

One valuable comment Anil makes is that we often discard solutions to a problem because “they do not scale”. He reminds us that if people in a locality find a solution for an issue that works only in their area – that is enough for them. Probably we are better off with a million local solutions than one global solution. This is like Darwinian evolution; let’s develop what fits in each niche.

I read about Ramon Niekrash, a surgeon at Queen Elizabeth Hospital in Woolwich, who was suspended for raising concerns about patient care: NHS targets and secrecy are hurting patients. He took his case to an employment tribunal and won. I was stuck by the information that, He was suspended on 9 April 2008 for “excessive” letter writing and because two senior managers from the surgical department had complained, in writing, on the same day, about his conduct, attitude and, most worryingly, his clinical competence. He was writing letters about his concerns for patient care. Apart from the personal issues and the patient safety issues something is seriously wrong when a publicly funded organization is determined to keep its problems secret. This fits with the book I read recently Putting Patients Last.

REWORK (in my reading list) has many recommendations that could be applied. I realize that there is a difference in scale between an organization of 10 people and one of 1.5 million but the NHS consists of hospital departments and surgeries where there are 10s of people that in many ways work autonomously, though linked for patient care. So there may be things to learn and apply from small organizations. One piece of advice is “hire managers of 1″, which in the context of the NHS would mean keeping management minimal and local to the department. It seems from the Ramon example that the department is in the service of the ‘higher’ management, whereas the ‘higher’ management should be in the service of the departments. This fits with the mission statement of putting patients first; the clinicians are in the service of the patients and the administrative staff should be in the service of the clinical staff. In particular this is not to imply a hierarchy of power merely a flow of service. REWORK has rough comment on Mission Statements!

The management’s concern for the good of the universal NHS (to steal a recent (mis)quote from somewhere else) is clearly more to do with self protection than public protection. By this I do not mean to blame individual managers anymore than one can blame any creature that finds a niche from growing and protecting itself. We are all to blame for not doing what Ramon did and demand openness and honesty in public organizations.
A wonderful comment has come from the Chief Constable of West Yorkshire, Sir Norman Bettison: I’m not worth £213,000. This wage bill is mad. He comments on the Sheehey recommendation that top public sector jobs should match private sector CEO pay: “What nonsense! Furthermore, it now looks to have been costly and irresponsible nonsense. People join, and remain in, the public sector because of a sense of vocation — to make a difference to society or to the quality of people’s lives. The best leaders are those who can secure long-term public value and a vision for their staff. Not some mercenary performance manager peddling a short-term fix.”

Founders of British obstetrics ‘were callous murderers’ and The incredible story of the most important woman in the history of modern medicine. The research on which the first article is based presents circumstantial evidence that the pioneers of obstetrics, Hunter and Smellie between 1749 and 1774 procured the death of women (probably rural girls who had come to the city and could disappear without questions) in various stages pregnancy in order to study the details of the anatomy of the process. The second article is about cervical cancer cells taken from a slave descended woman in 1951 at the Johns Hopkins Hospital in Baltimore. The woman died but these cells have been propagated for research ever since as they propagated aggressively in culture, with an estimated mass of cells to date of millions of tonnes. Neither she nor her children have had any benefit from this use, but commercial companies have enjoyed large incomes and the cells have been invaluable in helping develop treatments.

These histories bring to mind the Christian hymn, God moves in a mysterious way, written by William Cowper who wrote an anti slavery poem, The Negro’s complaint, and was a friend of John Newton at one time a slave ship commander (after spending time as a slave himself) who wrote Amazing Grace and who presided at the funeral of William Cowper. The tortuous sentence is meant to match the tortuous history.

I remember Bryan Gould from the early 1960s and liked his approach when he became an MP. Here he has come up with something that I gave my view on in this blog some weeks ago. He has had some insider experience so it is comforting to know that his view is the same as mine – Tony Blair saw himself as a World Statesman and wanted to consolidate that position: The real reason for the Iraq war. We never escape our inner nature. Here is a small comment on the outer natures of some politicians that relates to Brian’s point: Don’t give up the day job – how artists make a living, ‘ A recent waitressing shift at the Houses of Parliament didn’t go quite so well: “It was one of the most ­horrendous days of my life – everyone treated you as if you were scum. I wanted to cry, and on my way out I said, ‘I’m afraid I can’t make tomorrow’s shift.'” ‘. This points to the same inner natures that lead to some making unjustified expense claims.

I wonder what inner nature drives the target policy: This social work by computer system is protecting no one. I think we need more human-human interaction than human-machine interaction [message to myself!] The two humans can also both be oneself in introspection.

Yet some tick boxes can be good: The doctor taking safety to new heights. The problem is that we cannot avoid having to make judgements; there are no eternal rules. Some religions think there are, some don’t. My favourite Buddhist story is where Gautama is told by people that some come and tell them one thing and others come and tell something different so what does he think they should believe. He tells them to think it out for themselves.