We make a living by what we get, but we make a life by what we give – Winston Churchill

Much has been written of late about the ‘obscene’ city bonuses paid out at the end of last year. It has been claimed that over 4000 city workers took home more than £1 million each in bonuses. Along with that have come the increased pay packets of ‘top bosses’, which according to some sources, have grown by over 40% in the last 12 months. Peter Hain, Northern Ireland Secretary, and more importantly, candidate for the Deputy Leadership of the Labour Party, tapped into the ‘Left’s’ disgust at the size of these financial rewards by calling for the recipients to give two-thirds of their windfalls to charities that help the poor.

Ignoring the blatant attempt to woo the left of his party, Mr Hain’s call should strike fear into the hearts of city folk. He implied that a future Labour administration could increase tax and regulation on the City if those who have have received a bumper Christmas bonus were not charitable enough. In saying this, Mr Hain revealed his Old Labour heart.

I recognise that the City of London, and its enlightened regulatory structure, are of great importance to the British economy. The high-bonus earners in the City that Mr Hain so despises are wealth creators – for example, making vast sums of money for pension funds. They also generate the wealth that would be taxed so heavily by the likes of Hain, Johnson and Cruddas to pay for their proposed increase in the size of the state. My fear would be that an increase in the burden of that taxation would lead to the capital, offices and jobs moving abroad. We could easily see London’s pre-eminence as a financial centre disappear should private equity and other such financial organisations be singled out for more punitive taxation. Private equity funds increase their financial returns by increasing companies’ profitability. They achieve this by increasing efficiency and improving output, beyond the plans of the established management team. This, in turn, increases capital, thereby benefitting the whole British economy.

However, I also recognise that the image of a successful few, spending their money ostentatiously, can lead to social imbalance, and the politics of envy. The recipients of these bonuses should be encouraged to earn more, but in doing so, be also encouraged to spend their hard-earned wealth with more social responsibility. That is why I think Boris Johnson has a point in yesterday’s Telegraph. The successful few have benefitted greatly from our capital city’s historic location near the centre of the global economy. That position will only be strengthened and maintained by proper investment in the talent of the future. What better way to spend a proportion of a city bonus than on investing in university education. Not only do I think it would be more worthy of each individual, it would also have a better long-term reward for their families than a new yacht. Philanthropy is commonplace in America. It should become so here.

Obesity is a big problem. It is the second biggest cause of cancer. People who are overweight are more likely to suffer from coronary heart disease, type 2 diabetes, and some types of cancer. Furthermore, women are more likely to have complications during and after pregnancy. A recent report estimated that in England 30,000 deaths per year are obesity-related. Not surprisingly, the healthcare cost implications are very significant. Society, be that government or individuals, have a responsibility to address this problem.

Juxtaposed the issue of obesity is the growing problem with eating disorders in the young. A report released today suggests that young people are increasingly concerned about their bodies. More than half of girls aged 12 to 16 years felt that their body image adversely affected their relationships with boys. It is this negative view of body image that leads to the onset of an eating disorder. Research indicates that the typical age of onset for an eating disorder is between 14 and 25 years. We know that the present younger generation are bombarded by images of thin women; the ‘body beautiful’ sells clothes, music and films. The recent furore over ‘size zero’ fashion models highlighted the public’s growing concern about the adverse impact of such images. With these reminders of supposedly ‘ideal’ bodies, in combination with the well-documented teenage stresses of exams, peer pressure and family conflict, is it any wonder that eating disorders in the young are on the increase? Indeed, what about the increasing incidence of depressive illness in puberty?

So, in the light of the growing incidence of anorexia and bulimia, addressing the issue of obesity in children becomes more difficult. One clearly must avoid sending the wrong message about ideal body form to young people. As a GP, I have unfortunately encountered the ramifications of eating disorders and depression. The frequency of these problems are sadly on the increase. Of particular concern to me, however, is that over 20% of boys and almost 30% of girls are either overweight or obese. Those statistics contribute significantly to the fact that Type 2 diabetes is projected to increase over the coming decades. So much so, that it is thought that 25% of the entire NHS budget will be taken up treating diabetes alone by 2025. Hence, this childhood obesity phenomenon needs addressing now.

Some research has indicated that an increased awareness of body image can be of benefit when addressing childhood obesity. A study by a team from Bath University divided children into two groups – only one of the groups was asked to draw pictures of themselves (an apparently subtle approach to eliciting ideas about self-image). Both groups were then shown two adverts about healthy breakfasts – one urging children to slim down, the other providing educational information about the benefits of eating well. The study found that 75% of those who had been asked to draw pictures of themselves before viewing the adverts had felt encouraged to eat more healthily and do more exercise. Interestingly, only 58% of the other group responded in the same way, the conclusion being that getting young people to think about themselves made them much more receptive to healthy eating campaigns. More food for thought I believe (pun not intended).

I am a firm believer in choice in life. However, that freedom of choice applies to adults not children, since they are not fully informed, competent individuals. For that reason, society does have a responsibility to look after its young. Government is a part of society and hence as an important role in legislating to protect children. Part of that involves responsibility for getting tough on childhood obesity. Not by being ‘fattist’, but by promoting healthier lifestyles in our children. For example, we need to encourage competitive sport in school, not sell off playing fields to local developers. School catering standards must be improved and maintained to guarantee a decent diet for our children. Not only that, we should also be drawing parents’ attention to the food they are buying for their children, and not be shy to indicate where mistakes are being made. I believe public information films have a role here.

Obesity shortens life and it can kill. Eating disorders can also ruin lives and kill. Getting the balance right on body imagery for young people is difficult, however, to do nothing would be wrong. Not only do doctors and parents have roles to play, the media, and in particular, advertisers, need to recognise their own responsibilities to the society in which they operate. If you think sending out the wrong message about body image cannot harm, have a look at this (Hat Tip: MT).

“Marriage is a noble daring” wrote Agatha Christie. If one looks at the statistics the famous author was not far wrong. In 2004, 270,700 marriages were registered in England and Wales, 109,400 of which were re-marriages for one or both parties, and 153,399 divorces were granted. 1 in 5 men and women divorcing in 2005 had a previous marriage ending in divorce. There has been a long-term, steady decline in the marriage rate from the peak number of 480,285 marriages in 1972 to 311,180 weddings in 2004. In that time, a trend towards marrying at a later age has occurred, and furthermore, an increasing number of couples have chosen to ‘just’ live together. Last year, Iain Duncan Smith’s Centre for Social Justice reported that Britain had become a world leader in family breakdown, with the highest level of divorce and lone parenting in Europe. It begs the following questions: what role does politics have in trying to address this social problem? Is it a problem that politicians should address? What practical difference can they make?

The failure of relationships in society is a problem that politicans cannot ignore. I suspect all families have been scarred by divorce at some point. From memory, over 20% of my primary school class members had divorced parents. This is not a new phenomenon. The difficulty for politicians is that most studies indicate that with an increase in marital breakdown has come an increase in adverse outcomes for society. These range from poor educational attainment in children from broken homes to increased rates of crime. Male delinquency, in particular, has been associated with the absence of a male role model during formative years. In my own professional experience, relationship breakdown can lead to all manner of adverse health outcomes.

The practical difficulty for politicians is that wading into the debate over marital problems brings with it the charge of interfering in people’s lives. That charge, accompanied by, for example, an expose of a politician engaging in an extramarital affair, often elicits the accusation of hypocrisy. And, furthermore, not all divorces lead to the problems highlighted above, so any policy announcement could unintentionally offend a number of people. Consequently, most politicians have concluded that interfering in people’s private lives tends not to attract their votes.

To make matters more difficult for national politicians this week, the Archbishop of Canterbury provoked a debate over the absence of “commitment” in relationships . He said, “if you want to grow, to move, to expand, to be enlarged as a human being, if you want to pass on that enlarged sense of what humanity is all about to another generation, well this (marriage) is the way to do it.” He was also scathing about marriage critics, “The fluidity, changeability of relationships and the transience of marriage may look perfectly fine if you belong to the commentating classes of north London but you don’t have to go many miles to see what the cost is for people who cannot take that sort of thing for granted.” By the “commentating classes of North London” I presume he meant journalists and influential members of the Labour Party.

I am not so sure I am with the Archbishop on this one. Politicians are elected to represent people and to serve their best interests. Yes, taking a moral lead can be part of that duty, however, to start criticising people for their choices in life would not only be inappropriate, it would be seen as judgemental. Furthermore, whether we like it or not, active religious observance has become a minority pursuit in this country. Some surveys have indicated that regular church attendance is undertaken by little more than 5% of the population. Consequently, I am not convinced that the Archbishop is speaking for the majority on this issue.

Having said that, I do wish that the divorce rates in this country were lower. Marriages between people should be the bedrock of our society. It is also preferable that children do not come from ‘broken’ homes. However, solutions to these problems cannot, and should not, just come from government. British society also needs to take stock. What do we all want from life? In support of the Archbishop of Canterbury, I would agree that the senior religious figure of this country certainly has a role to play in discussing that broad question.

Where I think government can address the ramifications of marital breakdown are in the areas of taxation and family law. By taxation, I mean the reintroduction of the marriage tax allowance. By family law, I mean legislating to recognise the legal rights of a mother and father to share equally the up-bringing of any child, irrespective of the success of the marriage. Child rearing should not just be about organising finance. By doing those two things, I believe that government would encourage marriage and its continuance. That is, however, as far as I would advocate any political party to go. Remember, unlike the Archbishop, politicians are subjected to regular votes of confidence by the public.

That this House, while accepting that the legal aid system is in need of reform, is concerned that the Government’s planned implementation of Lord Carter’s proposals could force several hundred law firms out of business leaving vulnerable clients without access to effective representation; is concerned that the proposals identified in the Carter Review could further endanger the supplier base; notes that the changes to the proposals announced by the Government on 28th November 2006, while welcome, do not go far enough…and calls upon the Government to guarantee a legal aid system ensuring quality representation and fair access to justice for all – EDM 537

Yesterday, I spent the day shadowing an MP friend of mine. During the course of the day, I had the pleasure of meeting three lawyers who had come to Westminster to lobby for support to fight the imposition of the ‘Carter’ reforms to legal aid in this country. I am ashamed to admit that this important issue has, up until now, passed me by.

In recent years, much has been written about what British society is about. Much of this national introspection has been caused by the terrorist attacks of recent years. One constituent part of that society,I would argue, is the access to justice. A civilised nation should guarantee that every person receives proper defence in court, irrespective of nationality and financial means. Until now, legal aid has been the British way of ensuring that access.

The Carter Report was commissioned because of widespread concern that the legal aid system was inefficient and, in some high-profile cases, appeared to be misused. Even if some of those concerns were justifiable, the reality for most lawyers working in legal aid cases, was that costs were already more than the monies received in return from the state. One lawyer told me yesterday that on present terms his ‘legal aid’ time was valued at approximately £60 per hour, out of which he had to cover his business costs before paying himself. That hardly struck me as an excessive amount, indeed, I am concerned that it is so modest that future generations of lawyers will be put off covering legal aid cases. Why be a legal-aid lawyer when one can earn more as a plumber?

The problem with Carter is that it appears to be suggesting further cost-cutting. The most controversial change, replacing hourly solicitors’ fees with fixed or graduated payments, is particularly concerning for legal firms. By some assessments, these changes will lead to up to 800 law firms¹ - double the number originally predicted by Lord Carter himself- being forced to close business. There are apparently already so-called “advice deserts”, areas of the country where legal advice is not readily available, e.g. Isle of Wight. My understanding is that there is a real fear that these deserts will become larger and more numerous.

On 15th January, a debate in the House of Commons took place to discuss the Carter proposals. Vera Baird QC, Legal Aid Minister, confirmed that the government had adopted the ‘direction of travel’ of the Carter reforms. She confirmed that there was no prospect of extra money for legal aid. The EDM (Early Day Motion) quoted above has been circulated and has attracted cross-party support from 112 MPs. If I was an MP it would get my support. The “What Price Justice?” Campaign started by the Law Society, and supported by many organisations including NSPCC and MIND, has been instrumental in raising the profile of this important issue.

I could see yesterday that there are lawyers who have a sense of public duty when it comes to legal-aid cases. I could also sense their anger and frustration with the Carter proposals. As Desmond Hudson, chief executive of the Law Society of England and Wales, has said: “Solicitors go into legal aid work with a commitment to public service, but that commitment must not be exploited.”

The importance of a properly-funded legal aid system cannot be over stated. Clearly, proper regulation of the area is needed, however, to implement changes that could erode access to justice would be morally wrong. Ironically, this Labour government could be introducing legislation that could harm the most vulnerable people in society, the very people they claim to best represent. My fear is that without proper and fair legal representation, the families and friends of these people could be driven to exact their own justice, hopefully, not in the way that Michael Caine’s character did in that infamous 1970s film.

¹ LECG

Because there is nothing new about women selling their bodies for sex, is not justification enough for the tolerance of prostitutes on our streets today. The images of the five unfortunate Suffolk women displayed on our TV screens nightly reminds us of the ultimate dangers of life as a ‘working girl’. The great majority of these women had been taking the well-known risks of prostitution to fund further risk-taking behaviour with drugs, invariably using heroin or crack (or both).

This appalling case in Suffolk has stimulated a further debate about the most effective way to handle one of the oldest professions known to the human race. What should society’s attitude be to women (and men) selling their bodies for sex? And where do you draw the line as to what “selling your body” constitutes? Are lap dancers acceptable? What about lingerie models? Indeed, what about any photographic model? My own reaction to the appalling events in Ipswich is to wish that working girls did not exist. The list of things I wished did not exist, however, is not a short one. What about paedophiles, heroin, racism? And not wanting something to exist certainly does not help those trapped in the position that these five women found themselves.

I do not have a daughter so I have no way of knowing how the fathers of the five women in Ipswich feel about each daughter’s apparent daily existence. What I do know is that I hope that no daughter of mine is ever a working girl. I hope that no daughter of mine ever feels the need to raise money in that fashion to feed an opiate drug habit. But what if she was a working girl. How would I want my daughter treated by society in those circumstances? For how she was treated would, on the evidence of the last few weeks in Suffolk, influence her personal health and ultimate security.

A few thousand years ago the picture above adorned the interior of a Roman brothel. How further forward has our policy on prostitution moved in the last two millennia? By calling for the re-introduction of brothels are some commentators going back in time or are they being realistic about human behaviour? Are those who call for more “traditional” policies denying the truth about people’s sexual behaviour? It would on the face of it appear to be an argument of pragmatism versus idealism. Arguments about social policy often are like this.

I am not sure where I stand on this issue. Instinctively, I tend towards pragmatism when it comes to social policy, however, if I do not want any future daughter of mine to be a working girl, then why should I tolerate someone else’s child being one? As it stands today, though, I would rather live in a society that protects its citizens, whatever their chosen form of employment, than condemn them to darkened streets so that they may be more easily preyed upon by murderers and rapists. Just because we cannot see something occurring does not mean that it does not happen. Allowing the present situation to continue makes us all complicit in the murders of working girls today, in the past and in the future.