What's a health visitor?

If someone stopped you in the street and asked you the name of your health visitor, would you know?  Ok, so you may not see one right now, but in the UK we’ve all had one at some point - do you remember?

What if they asked what they do - would you have any idea?  To my shame, I’d have blankly shrugged at both questions.

But all this is about to change.  If you believe David Cameron (and why wouldn’t you?), by 2015 everyone will know not only who their health visitor is, but also what services they offer.

Part of my new job is to help recruit my region’s share of the 4,200 extra posts deemed necessary to ensure our Big Society is healthy – and that our pubs remain full of students and our glorious leader remains in office.

So yesterday I left my ivory tower and spent the day with a real, bone-fide health visitor.  It was quite an eye-opener.

The morning clinic was a ‘drop in’, and half a dozen mums came with their bundles of joy.  There was a remarkable range, from a proficient professor clutching recent research to a newly-single mum just trying to hold things together.

Babies were weighed and measured, and growth charted against expected progress in the child’s ‘red book’.  The endearingly old-school health visitor obligingly weighed in kilos, but I could see she was translating back to pounds and ounces!

The old and the new also contrasted in the ongoing use of paper notes, despite electronic records now being the norm.   It may be partly inertia, but in fairness the systems are not yet easy to use.  For example, they don’t link to GPs’ network (how can this be?), and can be painfully slow – if you’re lucky enough to get access to a computer.  Rather than realising the benefits of IT, so far computerization risks adding an extra task to already burdened professionals.

Whilst the influx of new, young health visitors may bring fresh thinking (and improved computer literacy), they will be hard-pushed to match the wise reassurance of the seasoned health visitor. 

Mums often came with seemingly minor issues such as feeding, sleeping and cradle-cap - but there were real anxieties, and were calmly and confidently addressed by someone with such a wealth of knowledge.

And after all, how do parents know how to bring up kids?  Is it innate, or must we learn it?  In the time of Call The Midwife, nearly everyone grew up around children, and had first-hand experience of raising siblings, cousins or neighbours. 

In contrast, families now are smaller and more distant, and parents are a lot older – all reducing our opportunities to learn parenting before we become one ourselves.

There are serious problems too, particularly post-natal depression.  I wondered why I never came across this when working in developing countries.  It’s hardly the kind of western luxury we’re thankful for: a staggering 10% of mums suffer from it in some form – isn’t it something we should talk about more?

One mum was clearly struggling to cope with her hyper-active son, and the health visitor arranged to see her for a longer session the next week.  Another boy was clearly autistic, and through gentle questioning the health visitor identified the issues and helped the mother plan how to cope.

After the clinic, a GP asked the health visitor to visit a family with an unemployed, alcoholic dad, who she feared might be a risk to his children.  It was sobering to learn that just below the surface of seemingly affluent areas can lurk drug / alcohol dependency, domestic violence and child abuse. 

Fifteen years ago I spent a fascinating day with a health visitor on the Craigmillar estate in Edinburgh, and was struck by how even people with troubled and chaotic lives clearly distinguished health visitors from social workers - and they certainly knew their names!

By law, health visitors must visit every family with a new child – so they are uniquely placed to improve health and prevent harm in the crucial first few years of life.

One of the most telling comments I heard from a mum showed the value of parents having access to experienced, dependable, sympathetic health visitors:  “I didn’t know who to go to” she whispered tearfully, “so I came to you”.

Whatever else can be said for the present government’s health policies, they’ve got this one right:  I’m delighted to be helping with this recruitment drive.  But I also hope to support those who are already in post to continue the often remarkable, frequently under-appreciated work of health visitors.

John Peel’s Shed

What’s the only London tube station containing no letters from the word mackerel?

If you don’t know, maybe you need to listen to the radio more?  (Specifically, to Steve Wright in his heyday).

But maybe you were more of a John Peel fan.  His weird, wonderful mix was in a different league from the usual commercial mush, or even Radio 1 of the time.

Even as a seasoned presenter he showed more passion and innovation than jumped up DJs half his age.  His Desert Island Discs were recently re-broadcast on Radio 4, where he revealed his original remit was “to look beyond the horizons of pop”.  He surely succeeded beyond all expectations.

But eventually even the great man himself started to drown under a sea of vinyl sent by bands hoping for airtime.  So he offered all the records from his shed to the listener who could best sum up his show. 

The lucky recipient was a student called John Osborne, with the winning phrase: "Records you want to hear, played by a man who wants you to hear them".

Once he’d got over the first problem – he didn’t own a record player – he spent a good part of the next six years working his way through the fascinating, eclectic mix of sounds liberated from Peel’s shed.

Favourites included a fantastic punk take on boybands called Oizone, and the incomparable Screeming Lord Such, famous not for his faultering pop career but rather as founder of the marvelous Monster Raving Loony Party (whose policies including making winter shorter by scrapping January and February, bringing peace to the middle east by rebranding the 'roadmap' as a satnav - and stopping the country going to the dogs by banning greyhound racing).

Osborne was desperate to share his new-found treasures, and approached ‘Future Radio’, his local community station.  They sound like something from Alan Partridge, but were clearly astute enough to give him airtime.  There followed a book and now a theatre show, taking the records as a starting-point, but also waxing lyrical about radio in all its varieties.  

Having just re-watched Radio Days, Woody Allen’s cinematic eulogy to the golden era of the wireless, it was interesting that it now falls to a form of stand-up to make the case.  But he makes it well, having spent each day listening to a different radio station whilst surviving his mind-numbing data-processing job at Anglia Windows.  His gentle, humourous journey takes us not only through music, but also the stories told inbetween tracks. 

These range from a rare, touching tale in between Virgin Radio’s mundanity, through to the strangeness of Resonance FM’s ‘Me and My Floor’ (the ambient noise from leaving a mic on a lounge floor for an hour – different floor each programme).

Despite the range of radio he experienced, his two best clips were probably from the ever-present Radio 1.

Terry Wogan told a corking story about an aunt who sent her niece a card at Christmas containing just the message ‘Get your own presents this year’.  Imagine how she felt when she realised months later that she had forgotten to include the book tokens!

And Steve Wright’s fishy brainteaser – the answer to which, of course, is St John’s Wood. 

My first record, bought with my brother Jonny, was by the Buggles, a band worthy of John Peel airtime.  The track, naturally, was Video Killed The Radio Star. 

Happily it didn’t – radio has evolved, just as the music it plays, but even in this image-heavy age the trusty wireless continues to form an important and enriching part of our lives – long may it continue!  

The hard sell

Mr Hypotec:  [Smiling]  Congratulations, your mortgage came through!

Oly:  [Excited]  A shed of my own!

Katja:  [Dreamy]  I think lilac for the lounge…

Mr Hypotec:  You have buildings insurance?

Oly:  Should we?

Mr Hypotec:  No buildings insurance, no mortgage.

Oly:  Um, ok, if you could get us a quote…

Mr Hypotec:  You’ll be wanting contents cover too?

Katja:   How many shoes fit in that downstairs cupboard?

Oly:  Naah, we’ve nothing worth nicking...  and  I doubt Iffley hill is often under water!

Katja:  There were floods when I first arrived in Oxford - I went to the shops to buy boots, but I hardly spoke English.  It took ages and my feet got soaked – probably as I was asking to buy ‘willies’!

Mr Hypotec:  Heh heh, well it’s your shout - but what if the house burns down?

Oly:  Yeah I guess – it’s just that where we’ve just been living you can’t even get insurance – you kind of ‘insure your self’. 

Katja:  Is that fizzing noise our Cambodian fairy lights?

Oly:  Actually, maybe a quote on that too…

Mr Hypotec:  With pleasure.  Now:  do you travel?  Like to ski?

Oly:  Is the pope a Catholic?  But we get annual travel cover from our Coop bank account.

Katja:  He’s German also, the pope.  And he loves cats, like me.  But they're not allowed in his palace.  

Mr Hypotec:  You’ll be wanting life insurance of course…

Oly:  Will we?

Mr Hypotec:  [Signs]  Well, what if you die?  Could Katja pay the mortgage?

Katja:  It’s ok - for $15 you can buy a little cardinal hat.  For the cat.

Oly:  I agree that some insurance you have to have:  if you want to buy a house, you need buildings insurance;  if you choose to drive, you have to be insured.  

Mr Hypotec:  Agreed.  And if you take a mortgage, you need life insurance, yes?

Oly:  No!  For everything else – including life - you choose whether to buy insurance or to cover the possible cost yourself.  It depends on your attitude to risk – and the cost of the premium.  

Mr Hypotec:  Well, everyone gets life insurance - including the poor chap your age I saw just last week who's now dead of a terrible brain disease called  defectum discrimine ratio...  I mean, are you really saying you’ll insure yourself against the unlikely event of a ski accident, but not the certainty of your own death? – and for a man like you, isn’t Katja worth £100 a month?

Oly:  Woah, that’s more logical fallacies than straw men at an Iowan corn-dolly convention!

Mr Hypotec:  [Resigned] Oh dear, another philosopher.  Well I’ll leave you to think through your insurance options.  Congratulations again on the mortgage!  [He finally leaves].

Oly:  Phew!  He’s a decent mortgage advisor – and so he should be, we’re paying him £600 for that.  But do we really need life insurance?

Katja:  Hmmm?

Oly:  Well, all this insurance stuff – do you think he’s just putting on a hard sell as he’s on commission?  

Katja:  Should we get pet insurance for Tiddles?

When is it ok to park on the pavement?

After living in poor, 'uncivilized' countries for the past three years, I have to admit I’m thoroughly enjoying being in a rich and developed one again - for the timebeing at least!

It’s great to be close to family and friends again (the blighters refused to put their lives on hold whilst I was away).  I’m loving the cultural opportunities – theatre, cinema, galleries, watching (and playing) football.

Major benefits also include the absence of landmines, border wars, rampant corruption, poor people with no medical care, and peasants with backbreaking, heartbreaking struggles through the mud.

There are little mercies too: snuggling under a duvet beats sweating under a mozzie net. Cycling over a twig is more relaxing knowing it's not a snake.  Drinking water from the tap. Chocolate and cheese.  Electricity and internet.  Freedom from being pointed out and laughed at (well, less often).  Dammit, we even have pavements and public toilets!

Perhaps one of the biggest pleasures is transport.  The UK has (much improved) trains, whereas there are none in Cambodia, or indeed Rwanda where I was before.  Busses and taxis here are modern, frequent and safe.  Occasionally there are even wonderful things called cycle lanes!

In contrast, Cambodia has developed a transport problem.  In the absence of public transport, cars have sadly become a status symbol.  You must be rich to have one; you don’t get rich by being nice; so cars aren’t driven nicely (might is right, and if you own a car you’re a big man and perfectly entitled to drive like one).  When not hogging the roads, they block the way for others.  In a previous post I complained that “only tossers of the highest order park cars on pavements; sadly, Phnom Penh has multitudes of major culprits. Oh for some traffic wardens!”

Of course back in the UK we’re far too civilized for that kind of behavour, right? 

Sadly not.  There are many upsides of being back, but witnessing the inconsiderate behaviour of car owners who park on pavements is not one of them.  And this is not just an occasional selfish thug – in my new ‘hood of East Oxford it is widespread to the point of being normalized. 

The Highway Code is clear: “You MUST NOT park partially or wholly on the pavement in London, and should not do so elsewhere unless signs permit it.  Parking on the pavement can obstruct and seriously inconvenience pedestrians, people in wheelchairs or with visual impairments and people with prams or pushchairs” (section 244).

The problem is that people are not obeying the rules – and the authorities (police and councils) are not enforcing them.

So here’s the deal.  If you choose to drive (here it’s a real choice – plenty of busses, great cycling country, easy to walk for most), then it’s your responsibility to park your car legally and responsibly. 

If there is not enough room on the road directly in front of your house without, say, preventing a fire engine or bin van from getting through, then you need to find somewhere else to park.  What you are not entitled to do is park on the pavement instead.  If you do you are breaking the Highway Code, and you are behaving like a selfish tosser. 

As I say, we are fortunate here to have such civilized amenities as pavements and public toilets.

So answer me this:  if I visit a public convenience, I have just as much right as anyone to do my business in one of the loos - agreed?  But if all the cubicles are already being used, what should I do?  Should I wait, or go elsewhere – or do I put my ease and expediency above the needs and rights of everyone else, and just shit the sink?

The Lady

For the first time, a woman is elected to lead her country.  She is strong and determined, urging reform, even when unpopular or misunderstood. 

Politics remains a man’s world, and she must fight vested interests at every turn.  Yet her opponents underestimate her powerful mix of charm and authority, and she makes a great – as yet unfinished – impact on world affairs. 

Oh, and there’s a feature film just released about her.

Well yes, Margaret Thatcher does fit the bill, and Meryl Streep is lauded for her disconcertingly believable performance in Phyllida Lloyd’s The Iron Lady.  But the above description actually relates to Burma’s Aung San Suu Kyi, celebrated in another biopic, Luc Besson’s similarly entitled The Lady.

And the comparisons don’t end there.  Both are sustained by their deeply-held beliefs as well as supportive families.  They broke the mould of politics in their countries, not just as women, but as leaders with a new and radical approaches.

But whilst one’s Ghandi-like non-violent approach in her own country wins her the Nobel Peace Prize, the other shows dogged (and dirty in the case of the Belgrano) determination to regain tiny territories the other side of the world. 

Suu Kyi is presented as having greatness thrust upon her thanks to her father being a national hero, whereas Thatcher was an ordinary grocer’s daughter who used her guile, determination and naked ambition to make it to the top.

As a film, The Lady unfolds chronologically, with tension created as we travel between the exoticism and lush paddies of South East Asia and the grand, rainy suburbs of Oxford (a journey familiar to me!), moving to an unfinished ending.  In contrast The Iron Lady has a more interesting cinematic structure, being told largely in flashback from the viewpoint of a rapidly declining Thatcher.

The two differ greatly not only as women, but also as mothers and wives.  Suu Kyi stays in her beloved Burma to lead its fledgling democracy, knowing that to leave will see her exiled.  But she is distraught by her separation from her two boys and loving husband, who is smoking himself to an early grave.  Thatcher too relies on her Denis, but pushes him aside and neglects her children as her ambition takes hold, later demeaning her caring daughter Carol whilst idolizing Mark, her absent, no-good son.

The portrayal of Suu Kyi is uncomplicated, maybe even uncritical.  But after all, what’s not to admire?  Meanwhile, Thatcher’s legacy is bitterly disputed.  Occasional footage of the miners, poll tax riots or the Falklands attempt to offer some balance, but it’s told in a way in which you can’t help but side with the heroine.  

In fairness, she had a difficult inheritance:  the country was a basket-case, gripped by unbridled unionism and welfare dependency.  But Thatcher’s medicine was to mercilessly destroy the country’s industrial heartlands, and promote individualism to the point of uncaring greed.

As one who grew up in 1980’s Britain – unwillingly one of ‘Thatcher’s children’ - I feel her legacy was less one of the principled, steadfast leader portrayed on screen, and more of a 'headstrong, obstinate and dangerously self-opinionated woman' who plunged the nation to unknown depths of selfishness.  (Not my description, but rather that of an ICI interviewer on rejecting a 23 year old Miss Roberts!).

One of her most damaging legacies was that Britain became the ‘dirty man of Europe’, with a truly shocking environmental record.  Thatcher’s selfish approach is summarized by her policy on green transport:  "A man who, beyond the age of 26, finds himself on a bus can count himself as a failure."  Whether or not she actually said it, she clearly actioned it, and the country is only just recovering from her misguided promotion of cars and disastrous destruction of public transport.

Lloyd’s film is bravely-structured and superbly acted, but gives an unduly rosy picture of the tumultuous Britain of the 1980s.  Besson’s work may be cinematically cautious and ideologically less challenging, but the story and scenery left me feeling it gives the truer representation of a great lady.

The Iron Lady will get the Oscars.  But the true plaudits should go to The Steel Orchid.

First week at work: the critical importance of milk

My first week in a new job!

It's an intense experience - a new commute to navigate, complicated buildings to explore, different people (and systems, and politics) to understand.  And of course an exciting fresh role to get my teeth into.

Meeting new colleagues is interesting and stimulating, but also exhausting - desperately failing to remember names and fit them into my blurry mental map, whilst all the time giving a decent first impression.  Five days in and I'm truly shattered.

I distinctly remember my first day at school:  I had firmly decided to stage a raging tantrum on arrival, only for a towering six-year-old, none other than the angelic Beverley Davies, to gaze into my teary eyes, hand me a warm bottle of milk and simmer "You know me, don't you?"...

First day in Cambodia was rather different - at first a deserted hospital, then an interminable meeting where I risked dying of hunger, boredom or piles from the hard wooden bench.  Later came the undeniable temptations of a bare-headed moto ride, a platter of pigs trotters and my first afternoon getting drunk with the boss.

Compared to these, my first week here seems straightforward...  On retiring to the kitchen to gather my thoughts I realised that, based on several workplaces, I have perfected a quick and highly accurate assessment of how well an organisation functions.  Forget key performance indicators or satisfaction surveys, the crucial test is... the milk!

You see, my worst workplace was a dire hospital in southern Glasgow - not only physically collapsing (bits falling off the roof, walls crumbling), but also an organisation in meltdown.  Staff were uniformly dispirited, suspicious, paranoid.  Nobody shared anything, from important information to the time of day.  And all this was reflected by a mouldy fridge, packed with dozens of individually, defensively-labelled milk cartons - it really was each for themselves!

In contrast, the best places I've worked - and happily there have been several - really valued their staff.  They didn't necessarily pay well, but they genuinely cared, launching a virtuous spiral of happiness and good behaviour to both other colleagues and clients alike.  And you guessed it - without exception, the very best places to work are distinguished by having a clearly arranged milk rota (with extra credit for teabag provision, fridge cleaning arrangements and barrels of biscuits!). 

Given the statistically significant correlation between the micro (refreshment system) and the macro (organisational functionality), how does my new place rate?

Good news:  a clean, well stocked fridge and large, shared milk cartons was a great start (though there were two separate bottles, so there is not yet complete harmony).  The provision of free tea and coffee, a water filter and even a dishwasher were also excellent signs - this is going to be a great workplace.

Having established a positive baseline, I will now specifically assess how well my new colleagues work as a team.  Drawing on years of office experience and my indispensible master's degree in management, I know exactly the way to find out.

I just need to watch and see:  will anyone refill the kettle?

Don’t be afraid of the dark

It was meant to be remembered for other reasons.  My friend Ben hadn’t been to his beloved Anfield for over 20 years, whilst it was my first time in the famous stadium.  Maybe - just maybe - Oldham’s underdogs would cause a famous upset.  Could this be a night of which FA Cup dreams are made? 

Travelling north we talked a bit about politics, the long-overdue Stephen Lawrence convictions, Diane Abbott’s ill-advised comments.  But mainly we luxuriated in footy chat:  could Liverpool survive with Suarez banned for racist abuse? might plucky Oldham spring a surprise?  most pressingly, would they let us bring our own crisps into the ground?

It didn’t disappoint.  Our snacks passed unconfiscated.  And on the half hour the unthinkable:  Oldham fired home a magnificent strike.  I yelled and punched the air – but only in my head, as I was in the middle of the Liverpool end (all visitor tickets sold within hours).  Latics fans were even beating the stunned home supporters on banter, chorusing ‘Where’s your famous atmosphere?’ to usually chirpy scousers.

But it didn’t last.  Liverpool were strong, even without their talisman Suarez.  Led by the impressive Steven Gerrard they were back on level terms in minutes, and went on the score four more (all flukey offside deflections). 

I must say it was a moving experience – the crowd clearly worshipped ‘King’ Kenny Dalglish, chorused ‘you’ll never walk alone’ with every scarf unfurled, and ended with a moving rendition of ‘stand up for the 96’, in memory of those killed in the Hillsborough disaster.

Yet this match will be remembered for all the wrong reasons.  Just ten minutes from the end, Oldham defender Tom Adeyemi raced towards the Kop end, pointing angrily.  The game was stopped for several minutes, and it took players from both sides to eventually calm him.

What had happened?  Maybe someone threw a coin?  Was is something someone said?  In the media buzz afterwards it transpires Adeyemi complained of being racially abused by one or more fans.  Apparently they were wearing Luis Suarez shirts. Police are investigating.  Oh dear.

The taxi driver returning us to the station was angry.  “This is a decent club, a family club.  This is the last thing we need. Suarez was bad enough, but this - what were they thinking?”.

But is this really a surprise, given the terrible example the club set to their own fans? 

Presented with irrefutable proof of Suarez repeated racial abuse of Evra, Liverpool failed to come clean.  Instead they shamefully squirmed, trying to defend the indefensible, refusing to criticise the clear wrong their star player had done. 

Their defence that the word ‘negro’ may sometimes be used affectionately in south America may be strictly-speaking true.  After all, I was referred to as mzugu (white man) when working and travelling in East Africa, and it felt like a (rather obvious) statement of fact, not abuse.  Friends even called my Rwanadan colleague mzungu after he saved enough money to build a house fit for a rich whitey!  Cambodia was the same:  constantly being called barraing (Frenchy) was a little irritating - wasn’t there anything more important by which to define me (the kind volunteer? the potato eater? the crazy cyclist? the super footballer?), but I never felt abused.

But Suarez’s defence was a pathetically disingenuous smokescreen.  The fact that it was used seven times during a heated argument, including the phrase "no hablo con los negros" (I don’t talk to blacks), shows this was simply ugly, racist abuse.

I can’t say I’m surprised – Suarez may be a great talent, but his history of bad behaviour is a matter of record.  I was particularly sickened by his unashamed cheating during the World Cup, and very dubious as to whether he should be forgiven and given a fresh chance to impress in the Premiership.

Now I’m a safe distance from Merseyside, I have to say that I think Kenny Dalglish got this very wrong. Perhaps he can’t be blamed for taking a chance on signing a flawed genius.  But a true leader would have ensured Suarez understood and quickly admitted his wrongdoing, and made a proper apology.  Failing this, he should have sacked Suarez:  he may be his best player, but no player is bigger than the club. 

Sure, Kenny was badly advised – but he was also weak and unprincipled, unusual and disappointing in such a great player and manager.

The ultimate irony was to hear fans from Oldham – place of my birth, and scene of some of Britain’s most recent and shameful race riots – chanting to Liverpool ‘you’re just a club full of racists’.

They’re not – but they need to do a much better job of showing it.