Getting out while I still could.

Getting out while I still could.

I recall that about half-way through my medical career I had a premonition of the problems with patient dissatisfaction  that we are now see. It was therefore with dismay, but no real surprise, that I read the results of the British Social Attitudes Survey on patient satisfaction with the NHS and social care. This has shown that growing dissatisfaction continues; now only 57% of people were satisfied with their healthcare while nearly a third (29%) were dissatisfied. These were significant changes, and deterioration, from previous reports and there was a particular drop in satisfaction with General Practice services. Primary Care had previously been the jewel in the crown of the NHS but now was viewed little better than other areas of the NHS. Some areas barely managed a majority of the population feeling satisfied (A&E for example at 52%) and these are generally worrisome figures.

These rates of satisfaction should alarm us. We often hold up the NHS as the “envy of the world” despite its relatively lacklustre outcome measures. We are now watching it slip to the bottom of league tables, of developed European countries, in public satisfaction as well as in performance. Why is this ? It does not seem that it is due to sudden increases in public satisfaction with other European services (though they have generally modestly improved their scores on this matter). It is because of an increase in dissatisfaction with the NHS’s provision and people cite unhappiness with inadequate staffing, delays in being seen, and poor quality of care. They tend to view this as a consequence of inadequate funding and government interference.

These two factors will, without any doubt, foster and magnify dissatisfaction but I am unsure that these factors are as important as they might initially seem. European healthcare funding has been squeezed in all countries but other countries have not witnessed the deteriorations in satisfaction we have observed, indeed, some have even seen slight ongoing increases. It is difficult to quantify government interference but it is a safe bet that this has not been absent in any of our comparator countries. But could there be another factor underpinning this dissatisfaction ? I thought I felt the start of this change many years ago, and this premonition, lead me to leave the practice of medicine earlier than I might otherwise have done.

When I finished University and started working as a practicing doctor I was full of enthusiasm and keen to learn and use new skills. I saw myself as a medical technician; the better I could be at various techniques then the better my patients would fare and the more satisfied I would feel. This was a useful approach, it spurred my education and learning. When a young doctor I had little time for the “professional” hokum that my seniors espoused. It seemed to me to be a way of holding onto power in the face of technological change and advancement they seemed to be using calls to “professional standards” as ways to obstruct needed change. I was certain that I would never become an old reactionary like them.

But time progressed and I learnt my craft and I started to realise that technological skill was only one aspect of healthcare. There was also a large number of other skills that were necessary, political ability for example, to effect change. I also learnt through my successes and, more importantly, failures that there was an art to the practice of medicine which was as important as my knowledge or technical ability. I know that the times that I failed patients it was rarely through ignorance or ineptitude but rather because of a failure to relate to the patient equally and fairly. I recognised that when I failed; it was the times I rushed, did the job but little extra, and paid inadequate heed to the opinions of the patient or their wishes. I started to recognise that I needed more in order to be a decent doctor and began to discover the importance of professionalism.

I grew to learn that professionalism was an asset for both me and the patients I worked with. The NHS was changing around me, a culture of target setting and central planning was reducing the autonomy of clinicians and reducing the choice for patients. It is often said that patients have difficulty in making healthcare decisions due to the knowledge deficit and that they are almost wholly reliant on their medical attendants in order to make these decisions. This is not the case. I grew to be very aware that one skill that patients have is the ability to distinguish between good and bad doctors. They are much better at it than fellow professionals, they know who is good at the job and who is not. But unfortunately they do not get to make that most basic choice – the choice of whom to see, whose advice to seek and with whom they will work to improve their health. In the NHS these decisions are removed; you see the GP that covers your area and the specialist contracted for your area, the patient has little or no say in the matter. If they are lucky they will be paired with the best, on average they will receive average care, and if they are unlucky they may be stuck with the underperforming. You could be referred to the best doctor for people with Parkinsons  disease but if your problem is diabetes then this might be less than wonderful. Patients would rarely make this kind of mistake, systems often do.

This lack of patient choice was worsened by another aspect. The patient didn’t chose the doctor and the doctor increasingly didn’t feel that they worked for them as an individual. The central planning and target setting meant clinicians felt that their employer was the NHS, in its various bodies, not the patient per se. Targets were set at Health Board meetings not by patient-doctor discussion. Many times targets could be thought of as useful but a target which pays doctors to increase the number of people on statins might mean that the elderly man who went to see his GP because of loneliness and poor mobility might find himself on the bus back home with a prescription for a statin he had never thought he wanted. It may be beneficial for him, and it might reduce the cardiovascular morbidity of the group, but that had not been his issue and it is possible that the time taken to discuss the statin left less time to talk about the poor mobility and their fears about this. Taking a professional approach meant that, while we would try and meet the targets put forward by my employer, my first loyalty was to my patient and we had to address their concerns first, agree a plan of action with them, and only secondly try and mesh this with the central dictats which were aimed at improving the group.

Without this professional approach there was a great danger of starting to practice a little like a veterinarian. When you take your hamster to the vet, the vet assesses the hamster and discusses with you how you would like to proceed. If the vet informs you that you will have to sell your car to pay for the hamster’s surgery, or forgo a holiday, it is quite likely that the hamster’s days are numbered. We will all grieve for the hamster and agree that it was for the best. Increasingly I found that patients came to me for advice, for example with Alzheimer’s Disease, and I would consider whether we should start a cognitive enhancer. But I would not discuss this with the patient, who is now in the role of the hamster, but with the NHS prescribing group who was in the role of the hamster’s owner. They (Hamster owner/ Prescribing Group) often decided that economically it was for the best that we didn’t prescribe and while this was true at a group level (in health economic terms) it may not have been at the individual level.

These are always difficult decisions but they are difficult decisions that should be taken openly, after discussion, with the patient. The patient should be able to trust that the advice they are being given is the best advice for them as an individual not simply the best decision for the community. When patients choose their doctors they are seeking the best source of advice, advice they can trust because it is not skewed to meet a third parties interest.

In the NHS patients lack the ability to choose who they see. Doctors and nurses are  becoming increasingly micromanaged and their professionalism, and thus their independence, undermined. Together this leads to patients unable to work well with their medical attendants and unable to be certain that the advice given is the best available. It sets up distrust and discontent, they see that other European countries, with similar healthcare budgets to ours, do better by patients with common serious medical conditions. Patients read that survival rates for breast cancer in Britain are poorer than elsewhere and that we have more infant deaths than the European average. No matter how many politicians tell them that there are more doctors or nurses, or the NHS is doing more than ever before (which is quite possibly true), will counteract their experience of impersonal healthcare and poor quality outcomes. They will become dissatisfied and this dissatisfaction will continue to grow until the primary problems are addressed.

Until individual patients are again at the centre of how healthcare is delivered it is likely that even if we throw much more money at the system (which will probably be the electoral strategy) this discontent will grow. When we look back, we see the Tredegar Workmen’s Medical Aid Society made a great influence on Aneurin Bevan and influenced the development of the NHS. Unfortunately we seem to forget that the workmen in the Medical Aid Society chose and employed their doctors – they voted on who would be employed and sacked those that were felt inadequate to the job. I am sure this choice greatly enhanced the likelihood of patient satisfaction and is something that we need to rediscover.

Before my career had arrived at its natural end, I had premonitions that dissatisfaction by patients would be inescapable and lead to dissatisfaction in  clinical staff also. I could see the first changes in morale and attitude and felt I had to leave. I hope that I will be proved to be wrong in this prediction, as I have been on many others, but recent news has not given me cause for optimism.



12 Rules for Life

12 Rules for Life

I watched an interview of Jordan Peterson by Cathy Newman recently and was rather surprised by what I saw. I was bewildered by Cathy Newman’s approach to her subject, she obviously found his views distasteful and was trying very hard to trip him up and reveal his dark and unpleasant, presumably misogynistic, side. She failed to do this and he remained placid, un-rattled, and replied fully and reasonably. Now I have seen her interview many people over the years and she is usually an excellent interviewer; able to debate with the best and able to handle herself in an argument She is, without doubt, one of the best news journalists we have on British television.  I was therefore surprised to see her have such difficulty with this subject, to the extent that at one point she was literally struck dumb and at a loss for words.

At this point I had not heard of her subject Jordan B. Peterson, a Professor of Psychology at Toronto University, nor did I know of his views. But, spurred by this interview, I read a little about him. It became clear that he has become very popular on account of his most recent book and also for his lectures on psychology which are available on YouTube. He is a clinical psychologist and academic who has made a bit of speciality of examining the role of religion in culture and personal psychology. But it became clear that this was not the reason for his widespread, and increasing, fame (or notoriety), this was because of his position on the issue of “compelled speech” (in regard to pronoun usage with transgendered people) and because he has recently published a book which has become a surprising best seller “12 Rules for Life : An antidote to chaos”.

The book, a self-help psychology text, has been very successful with young men and his position on free speech has caused him to be seen as a darling by the “alt-right“. The latter problem is a common difficulty experienced by those of us who try and safeguard free-speech. Those on the far-right often like to profess a support for free-speech as they think it protects them when they spew their bile, particularly their misogynistic or racist ideas. They do not realise that those who support free-speech do so specifically to be able to debate with such hateful ideologies and, through debate, destroy them. The best way to get rid of hateful erroneous ideas is to debate with those who hold them and make them, and their fellow-travellers, feel embarrassed and ashamed town such thoughts.

The fact that his book was popular with young men was interesting as this is a demographic not often drawn to reading. This in itself did not cause me concern, despite Cathy Newman’s obvious distaste for the book, but it did suggest to me that I should read his book. A quick trip to the kindle store and three days later  I was finished. It was a gripping read and one of the best books I have read in a long time.

To be fair this is a “pop psychology” book. It is written in easy chapters, each describing a basic rule. For example  “Chapter 6 : Set you house in perfect order before you criticize the world“, and so on. He writes well and is an erudite thinker with a wide knowledge base. He starts each chapter with a story to outline his thinking on the subject or rule. He then considers the cultural history and scientific knowledge about the issue before completing the chapter with practical advice on how to apply this knowledge to your own life.

Much of his thinking is based on current knowledge of scientific psychology but it is mixed with practical experience of working in clinical psychology, especially in working in the field of deep insight orientated psychology. He refers back to Jung, Neitzsche and Adler as well as to recent neuropsychologists. But perhaps more interesting is his use of knowledge of religious history. He looks at how the major religions have addressed psychological issues such as suffering, death, guilt and happiness and points out, whether you believe in a deity or not, that religion was mankind’s way of making sense of our life experience and many of the lessons learnt millennia ago are just as applicable today.

In essence, I discovered a very readable and wise book. I am glad it has been successful as it will prove much more valuable that many of the faddish self-help bibles which have come and gone. The chapter on parenting is a valuable counterpoint to many of the prevailing mistakes we are making today.  I found no evidence of misogyny or racism at all. Certainly there were some areas where he suggests that our evolutionary history has meant that some biological factors continue to influence our gender behaviours and he does not agree that this is entirely a social construct. Indeed, this might be his heresy. Today, we are meant to believe that all aspect of gender are socially constructed and that, barring organs of reproduction, there are no differences between men and women. This is clearly not true and the scientific literature attests to this. Unfortunately this is becoming a rather inconvenient truth and one that is not allowed to be said. I think this was the dynamic underpinning Cathy Newman’s interviewing style.

This is a problem. Womens’ rights have improved over the recent years but there is still a long way to go. If we are to obtain equality and fairness we will have to continue to fight for it. However, if there are uncomfortable facts, if there are biological factors influencing our behaviours, then we need to know about them and discuss them. It will not help our progress to pretend they do not exist and to cry “heresy” when people raise them. Biology is not necessarily our destiny but it has a bigger influence when it is ignored or denied; as a man I may be more prone to aggressive behaviours than a woman (on group averages) but knowing this only means I need to be more mindful. It is not an excuse and has no exculpatory power. For example, if I want to be a good man I need to know how to control and curb my aggressive instincts, to pretend that these  impulses are not there helps no one.

I think therefore, on this occasion, Cathy Newman was wrong. Rather then trying to explore or debate his ideas she tried to shut him down. Others, with a similar agenda, have  tried to minimise his works by smearing it, and him, as alt-right or similar. This means that his genuine insights are not considered but more importantly those young men who find meaning in his writings will be pushed and corralled into the area occupied by those who are indeed of the alt-right. This is a danger, as Peterson is aware, we need to help men to maturity and insight in our society, we need to make them more self aware, strong and confident because if you think tough men are dangerous, wait until you see what weak men are capable of”






Boys will probably be boys.

Boys will probably be boys.

I am obliged to go against the current cozy consensus, to say something different to the accepted viewpoint and, in the process, lay myself open for criticism. I am going to say something that is shocking, probably heretical, and in the current climate may lead to my being ostracized. I am going to say that there are differences between women and men, between boys and girls, which are not socially created but relate to our biology. There are innate differences in a some of our behaviours, our drives and our instincts which arose after millennia of evolution as a species. There, I have said it, let the heavens open. This is simply a fact, although unusually for one of my opinions, a fact with which most of science agrees.

Why have I found myself spouting heresies today ? Well, it all has to do with a racing car driver. I can confess that I actually felt rather sorry for Lewis Hamilton today. Why do I feel sorry for the handsome, wealthy, skilled and famous car racing star ? I felt sorry for him as he was forced to make an apology for a piece of playfulness with his nephew which revealed he did not toe the party line. In a piece of family banter, in a jovial mock-angry voice he said that “boys don’t wear princess dresses” while teasing his nephew, who seemed to be enjoying the attention from his famous uncle. Cue synthetic shock and horror from the social media watchmen who called out his “horrific” “transphobia“. After a short period of sustained attack, Lewis Hamilton came back with the required abject grovelling apology. However, it seems that this may not have been an adequate Mea Culpa as he is now being criticised  for inadequate sincerity in his shame. The intolerance of the social media clerisy is quite remarkable, they will not tolerate any views which deviate from the current accepted norms, no alternative views will be brooked.

Now I think Lewis Hamilton was wrong, of the things which might be social constructs I am pretty certain that styles of clothing is amongst them. In different cultures, and across different times, that which is suitable for girls and boys to wear has varied; style sense is not inherited (Although I can’t think of a culture promoting princess apparel to its boys). But it does not matter that he is wrong. He expressed his opinion and he has hurt no-one. He should be free to do this without the fear of mock outrage. Further, it is the family’s role to rear children and to instil values and attitudes in them – nobody else has that right. I disagree with many religions but believe that religious parents  have the right to instruct their children as they wish. I disagree with my conservative voting neighbours but do not feel that I have any right to stop them passing their opinions onto their children. Indeed, as long as they are not harming their children, I want families to instruct their offspring as it is them who teach the young how to be good, how to be moral, how to be a good man or a good woman. Sometimes their views on morality and goodness will not concur with mine, but these differences are the grit in the oyster of our culture which generates discussion and change. Tolerating these differences is one of the hallmarks of a civilised and open society. Watching people publicly shamed for unfashionable opinions is reminiscent of the stocks or the show trials and should cause free thinking people to be concerned.

The rights of the individual are closely allied to the family unit. The family unit allows us to act and exist outside of the state and the state has, for a long time, had an ambivalent view of the family : positive in that it cares for the young and the sick, negative as it may instil ideas of which it disapproves. It is still largely within the family that we develop our moral compass although the state’s roles in education and healthcare have reduced this somewhat. Capitalism sees less need for the nuclear or extended family, from the market’s viewpoint the more people producing and the more people consuming the better. Traditional families are perhaps inefficient in market terms in the developed west, the family model works best as a unit of production rather than as a unit of consumption. Socialist thinking has been more generally hostile to the family, it recognised that the family is a place of education and instruction which is not under state control and therefore potentially problematic. In 1920 Alexandra Kollontai wrote the set text on family organisation under communism. She wrote :-

The old family, narrow and petty, where the parents quarrel and are only interested in their own offspring, is not capable of educating the “new person”. The playgrounds, gardens, homes and other amenities where the child will spend the greater part of the day under the supervision of qualified educators will, on the other hand, offer an environment in which the child can grow up a conscious communist who recognises the need for solidarity, comradeship, mutual help and loyalty to the collective.

 and promised that :-
She need have no anxiety about her children. The workers’ state will assume responsibility for them
The woman who takes up the struggle for the liberation of the working class must learn to understand that there is no more room for the old proprietary attitude which says: “These are my children, I owe them all my maternal solicitude and affection; those are your children, they are no concern of mine and I don’t care if they go hungry and cold – I have no time for other children.” The worker-mother must learn not to differentiate between yours and mine; she must remember that there are only our children, the children of Russia’s communist workers.
Unfortunately it seems that this attack on the family where different opinions might flower continues. If we allow this censorious and intolerant development our future abilities to recognise and defeat authoritarianism will be sorely damaged.  Policing the family has always been a priority for authoritarian regimes, recall the importance given to the Hitlerjugend and the Komsomol in Germany and the Soviet Union, and remember that these were very early developments of fascist societies. A society which will not allow dodgy joke between family members is treading a dangerous path.

The Old Lie

The Old Lie

Left to our own devices we can become farmers and bakers, tailors and cobblers, plumbers and engineers, astronauts and programmers. Our possibilities are limitless as we cooperate to help ourselves and each other. “What a piece of work is man”. It takes a state to turn us into soldiers and sailors to make us kill and maim ourselves and each other. On Remembrance Sunday we should take time to think on all those that died or were injured during war and pledge never to be fooled again, by the old lie, that it is sweet and honourable that we die for our state.


Dulce et Decorum est

Bent double, like old beggars under sacks,
Knock-kneed, coughing like hags, we cursed through sludge,
Till on the haunting flares we turned our backs,
And towards our distant rest began to trudge.
Men marched asleep.  Many had lost their boots,
But limped on, blood-shod.  All went lame, all blind;
Drunk with fatigue; deaf even to the hoots
Of gas-shells dropping softly behind.

Gas!  GAS!  Quick, boys! —  An ecstasy of fumbling
Fitting the clumsy helmets just in time,
But someone still was yelling out and stumbling
And flound’ring like a man in fire or lime. —
Dim through the misty panes and thick green light,
As under a green sea, I saw him drowning.

In all my dreams before my helpless sight
He plunges at me, guttering, choking, drowning.

If in some smothering dreams, you too could pace
Behind the wagon that we flung him in,
And watch the white eyes writhing in his face,
His hanging face, like a devil’s sick of sin,
If you could hear, at every jolt, the blood
Come gargling from the froth-corrupted lungs
Bitter as the cud
Of vile, incurable sores on innocent tongues, —
My friend, you would not tell with such high zest
To children ardent for some desperate glory,
The old Lie:  Dulce et decorum est
Pro patria mori.

Wilfred Owen 1920



Foodbanks; sign of failure and of hope.

Foodbanks; sign of failure and of hope.



Today’s daily prompt, about the egg, got me thinking about food and the basics of life. In particular, it made me think about the furore over foodbanks in Britain. These charitable concerns were set up, initially, by church groups such as the Trussell Trust, in order to help the poor and hungry in our society and to allow its members to do the most important thing that we can do as people – to look after our fellows.

It is a shame, therefore,  that foodbanks have become the current political football. Rarely are they mentioned but to complain about there presence – “There should be no need for charity in a rich country like ours” – is the common refrain. The existence of foodbanks is used in many political debates as a stick to beat the opponent as a symbol of their failings. However, I would contest that it is heart-warming to see the growth of charity and people trying to help their brothers. Voluntary, local organizations such as this are better than centralised government agencies.

Man is a social animal, it is in his nature to help his fellows. Left to his own devices he is cooperative and adventurous and works in groups to increase the wellbeing of his group. An integral part of this is charity. 150 years ago there was boom in self-help and mutual aid organisations (mutual societies, friendly societies, insurance schemes, religious and trade groups) and over three quarters of working men had some form of health and unemployment insurance. These growth of these schemes was seriously hampered by the development of the current welfare state which rapidly became the monopoly provider (with all the consequent problems that monopoly providers have).

I would guess that we would all agree that we want to help those less fortunate than ourselves for whatever cause and it was this desire which promoted the developments of those schemes. Unfortunately, there has been the development of very negative views on the left and on the right of the poorer in our society. On the right there are concerns that they might be indolent or reckless and need some punitive element to their assistance to try and correct what they see as bad behaviour. On the left the poorer are seen as incompetent, unable to organize and requiring central planning to take over. The left also tend to view us all as egocentric and greedy who would not look after our neighbours were we not compelled to by act of law and threat of punishment.

Both of these views have damaged societies abilities to develop better local schemes. The welfare state has created a gap between donor and recipient, which is poor for both parties – donors can not easily influence how their assistance is used and recipients become increasingly seen as “the other”, something outside of society – apart and lesser. (However, as an aside, I have to say I am grateful of this gap when it allows me not to feel too close to the decision to use my tax payments to kill some Yemeni child.)

Welfare states may not make people lazy, there is really no evidence for this, but they do often cause dependency, and apathy, and often can have perverse incentives which reduce the ability of individuals to return to work and sometimes damage family structures. Welfare states, by their national basis, are often the reasons for people’s dislike of free movement – incomers are seen as jumping into a scheme they and their families had not established (thus felt to be receiving benefits without entitlement) rather than being viewed as possible new partners with whom to work and grow (all studies find immigration strengthens economic growth).

As we now use the term “poverty” to define a group a specific distance from the mean wealth of the population we will always have people in poverty – unless there was no deviation whatsoever in incomes (an unlikely scenario) there will always be the relatively poor and we will always need and want to aid them. All the great religions and philosophies have seen this as a cardinal act of humanity (“If anyone with earthly possessions sees his brother in need, but withholds his compassion from him, how can the love of God abide in him?” in the Bible and the Koran’s recognition that there is a “” to our wealth”) Those, often religious groups, who wish to do this through foodbanks should be applauded for their actions. We should not give all power and planning for assistance away, the less charity there is in a society the less human, less cooperative and less kind our society becomes.

Via : Daily Prompt – Egg

Explain by doing.

The important thing is to help

In many areas of education a demonstration is better than a simple explanation. This article from FEE suggests that more people might understand the compassionate aspects of libertarianism if they saw more people “walking the walk” rather than just “talking the talk“. I felt that this needed reposted to be spread more widely. 

I volunteer for American Red Cross as a disaster team leader in the Detroit area to help people in need with basic necessities such as food, clothing, and shelter for the night. An acquaintance of mine recently said to me, “I’m shocked that you’d do that. I mean, you’re a libertarian, aren’t you? Shouldn’t those…

via Be a Libertarian Who Cares — from FEE

Every single lash .. ..

Every single lash .. ..

I normally steer clear of issues of gender politics. The arena is so toxic and tribal that it is difficult to have constructive discussions of how we might improve matters. This is not because the subject is inherently difficult, indeed it is blindingly simple ; all humans are born with the same few inalienable rights, which apply equally, and their gender and race play no part in this. Unfortunately this is not enough in this area where tribal loyalties and blind dogma seem to rule and ensure that all discussions degenerate into bad-mouthed squabbles.405

It is therefore with trepidation that I write to complain about the current cover of “Glamour” magazine and its false #poweredbywomen tagline. This caught my eye in the supermarket and was successful in that it made me think about gender disparities in the workplace. I note that they stated that in these issues the magazine would be 100% made by women” and that “Every photo in our pages? Taken by a woman. Every hair coiffed. Every lash curled.(by a woman)”.  Which made me think about the divisions of labour. While I am fairly certain that “every lash curled” was curled by a woman I wondered how different this was to another day of the week. I have a sneaky feeling that in the world of lash curling or hair coiffing there is already a female preponderance. But what about other areas of the magazine’s production ?

I think we can sleep easy that the gender disparity in forestry has not been tackled.  In this hazardous industry with an appalling death rate amongst its workers 99% of those working outdoors are men. We can bet safely that is was a man who clambered up the hill in the rain or snow, to use the chainsaw, to cut down the trees to make the magazine’s paper.  Another industry with a dreadful record of safety for its workers is the haulage industry. Of those people working outdoors in lonely lives, often having to sleep in their lorry’s cab in a car park far away from their families, 99.5% are men. I think we can be sure than glamour magazine was not shuttled by a fleet of women lorry drivers from the factories to the shops.

While there is better gender ratio in the printing industry as a whole (70:30) this masks a wider split – white collar office jobs are predominately held by women while dangerous factory jobs are overwhelmingly male. All of this is before we step further back in the supply chain to prinking ink and those who obtain the pigments, the miners who mine the ores that create the metals from which  the machinery is made, and the assembly line workers to create them. There are lost of jobs where there is a disparity and none of these will have been tackled by Glamour’s mock feminism.

The cheek of this magazine to put its model on the front page with her fist of solidarity at odds with her winsome smile, perfect coiffure and model good looks. She is no ‘Rosie the Riveter’, no image of female strength and ambition;  just another model on the front page showing women how they should look. It really does take exceptional degree of irony to to take up the fight for increasing the proportion women in the workplace in one of the few industries where this is not a problem. I think that fashion journalists, glamour consultants, fashion models, hairstylists, make up artists and the rest have already cracked this problem. Indeed we should perhaps be arguing for more male models to try and reduce the effects of the objectification of women by this industry. I don’t think I have seen a worse case of “virtue signalling” since the campaign to give away tampons at Glasgow Airport to end period poverty;   if one group of women are less likely to suffer from this, then it is wealthy people stepping off aeroplanes –  surely “To those that have, shall be given“.

How could this campaign got off to such a ledebad start in missing the gender disparities in its own industry and how could it be so crass and blinkered. Perhaps a look at the group behind it will give a clue.  This group of predominately white, young middle class women will have a biased view of the world.  Where are the people of colour, does the cosmetic industry  feel that this is too poor a market ? Where are the older people, the glamour industry doesn’t tolerate the elderly? Where are the plain people,  this industry ejects you when your looks fade ? Where are the disabled, its hard to break into this industry if you deviate from accepted definitions of beauty ?

We do have pressing issues on inequality of opportunity and pressing issues on inequality of remuneration for work, but boosting the cosmetics and glamour industries profile is not one of them. This industry does enough damage to all of us, but especially women, as it is and we don’t need them to steal feminism to create a marketing strategy. Lets campaign for real changes, equal pay, equal parental leave and responsibility and pick some priorities. Here in the west they might be the lack of male teachers to give our boys a role model to encourage learning and academic aspiration, the lack of female taxi drivers to widen the choice for passengers, the lack of male nurses to encourage men to come forward more readily with health problems, and the lack of female manual workers in the days of mechanisation there is no real call for brute strength, look at our female athletes they are clearly the match for men. And lets get rid of magazines that tell women how they should look, how they should dress, how they should use cosmetics, and , increasingly, how they should think. It is not a woman’s lot to “curl a lash” any more than it is a man’s to fell a tree. Stop pigeonholing us.