There’s a fascinating article in the Economist on IT in the health-care industry. Basically, it points out something which anyone who’s visited a healthcare professional knows already: that doctors just don’t get IT. They don’t want to. And this is very bad:

“One study in America estimates that IT could prevent 2m adverse drug interactions and 190,000 hospitalisations a year. Another study reckons that electronic ordering of drugs can reduce medication errors by 86%. By contrast, research published in March in the Journal of the American Medical Association warns that IT, if the software is badly designed, could actually increase errors. But almost everybody agrees that well-designed IT is essential to improving quality in health care.

The same goes for its cost, an increasing burden to ageing societies in the rich world and even in poor countries such as China. HP’s Mr Miller reckons that redundancy and inefficiency account for between 25% and 40% of the $3.3 trillion the world spends on health care every year, and could be eliminated with proper IT. A study from a clinical research centre at Dartmouth College in New Hampshire reaches a similar conclusion, estimating that a third of America’s $1.6 trillion in annual health-care spending (as of 2003) goes to procedures that duplicate one another or are inappropriate.”

What has this to do with the election? Only this: that Britain is one of the few countries in the world trying to sort this out:

In fact, Britain’s—or rather England’s—NHS is among the pioneers worldwide. This year, it will begin rolling out a £6.2 billion ($12 billion) project in which five regions in England will form networked IT“clusters” so that 18,000 NHS sites, including all family doctors and acute-care hospitals, can share standardised information on patients. These clusters will eventually be linked through a “spine” (called the N3 and run by BT) with huge bandwidth to create, in effect, one national network. Scheduled to be completed by 2010, the plan, like most IT projects, has had some early hiccoughs and has been greeted with cynicism by some doctors. But other countries will be looking to it as a model.

A great example of the fact that massive investment in the NHS will pay enormous dividends for the health of the country. It will save countless lives and make the country as a whole a better place to live and a more productive place to work. It is already having an impact, but, just as the public sector cuts of the Eighties took years to make their full impact known, the result of massive investment now may not be felt for a while. Which is why it was tremendously brave of Labour to invest as much as they did, to raise national insurance when they did. Vote Labour and save lives.

So, Iraq. The great dividing line through the middle of the Labour Party. The reason, so we’re told, that so many thousands of people aren’t going to vote Labour at the election next week.

All I have to say on the matter is this: if you’re really prepared to make a decision on the future of this country based on the war in Iraq, you’re being deeply, profoundly, silly. You’re engaging in schoolboy politics. You’re turning the infinitely complex nature of modern Britain into a stupid yes or no question. At the end of the day, you’re not voting on policy, you’re voting on tribal instinct. You’re voting because you don’t like Tony Blair.

So read this, silly person, and consider the wisdom of Dickie Attenborough:

“I don’t for a moment doubt the integrity of the prime minister. Unlike many of his critics, I have had the satisfaction of knowing him for a considerable time, and I find it utterly impossible to accept that he behaved other than with absolute honesty. I can but repeat I am convinced that he did what he believed was right, although I wish it had been possible to go to the UN for the second occasion and gain its support. That was my view then, and it remains my view today.

But the idea that this difference, however major, might prevent me supporting Labour at the next election is something I cannot contemplate. There is too much to be done at home and abroad, too much hard-won progress that could be undone.

I would ask those who might be thinking of staying at home or voting for another party to remember why we have supported Labour and to reflect on who would suffer if the party fails to win its third term. We joined because we wanted to improve people’s lives, and this is certainly what the Labour government has done.”

And if you’re still anti-Blair, well, you’ve always been anti-Blair, haven’t you? You were just waiting for the right bandwagon to jump on. Read Christopher Hitchens on why he’s pro-Blair, and give yourself a small schoolboyish frisson of outrage. Then go and campaign irresponsibly with George Galloway in Bethnal Green, where decades of racial integration is being swallowed up in the gigantic egotistical maw of Gorgeous George. And wallow in Richard Gott’s sublime silliness. And leave us to try and change the real world, where people get ill, children need to be educated, poorer people need assistance and bad people need to be locked up.

In summary: it’s perfectly possible to be anti-war and pro-Blair. To say otherwise is entirely silly unless you’re a Liberal Democrat or a Tory already.

Nothing to say about this other than: what a fantastic picture! This picture is from an Economist article about the outsourcing boom and its impact on Bangalore. Blade Runner is already here…

From today’s Economist (subscription required):

CARLOS GHOSN is a Brazilian who, from next month, will be spending 40% of his time in Paris as the new boss of Renault, 35% in Tokyo where he will continue as the head of Nissan, and 25% elsewhere, most of it in America. Jean-Pierre Garnier is a Frenchman who heads a British drugs company (GlaxoSmithKline) but spends up to 70% of his working life outside Britain and France. Who is first in line for the tax on these executives’ not inconsiderable incomes? And, er, have they got the necessary work permits?

These two bosses are the most visible examples of a growing army of mobile workers who are giving human resources (HR) departments a new sort of headache: how to track where they are and when, for tax and visa purposes. Brian Friedman, president of Ernst & Young’s Institute for Global Mobility, says this is a major challenge for such departments. Gone are the days when working abroad was merely a matter of signing a formal expatriate package - with an allowance for differences in the cost of living and the quality of life - before waving goodbye for three years.

Today’s global business is creating a new sort of worker, termed the “stealth expatriate” in a recent worldwide survey by Cendant Mobility, a firm that helps firms to relocate employees. The survey found that 78% of HR departments either have, or suspect they have, stealth expats within their firm. Yet 83% of these companies admit that they do not have systems in place to track such people.”

Interesting, but I particularly like that phrase “78% of HR departments either have, or suspect they have, stealth expats within their firm”. What, don’t they know?

OK, my good friend ElectricOrange makes a very good point: if the LibDems are so close to me, politically speaking, and if I’m so very very pissed off with Labour over arrest without trial and ID cards, why not vote LibDem?

Here’s why: I don’t believe them. I don’t believe a single word they say. Them or the Tories. Their manifesto is thin, their frontbench team callow and untested, their philosophy is unproven. I just don’t buy it. Both the LibDems and the Tories make a show of having thought through all the issues facing Britain but neither of them have, really (this is particularly true of Howard’s shower of rubbish, but this post is about LibDems).

Take local income tax. It seems like a nice idea and everything. But I don’t believe it. I really don’t. I think reality is going to be more complicated than anyone in the LibDems is giving it credit for.

This isn’t particularly thought through, of course. There’s a large dose of Labour tribalism in there, and possibly some aging conservatism as well (why change an experienced team?). But Labour worked really, really hard in the early 90s to learn about government, to gain authority, to do the work. That’s one of the big things that made them electable in ‘97. A vote for LibDems or Tories or anyone else isn’t a vote for a political programme - it’s a punt, pure and simple.

Which isn’t particularly healthy for democracy or anything, but it’s a lot more coherent than this nonsense from George Monbiot.

If you don’t have an opportunity to vote for them, I would suggest taking the first stop on the following line: 1) a strong radical independent, such as Reg Keys in Sedgefield; 2) an anti-war Labour MP; 3) a faintly credible micro-party; 4) Liberal Democrat. It’s a far from perfect choice. But it recognises that electing a new opposition might not be the best way of building one.

George, George, George. You vote for a government, not an opposition. That’s how democracy works.

I have always kind of obsessed about note-taking. About how hard it is to do properly, about why I never go back and check my notes, about why I do it at all. But then along came Working Smart: Recovering the Lost Art of Note-Taking to answer all my questions, and now I know.

Just completed the test on Who You Should Vote For, results are below. I’m thinking it must have been coded by someone who’s Liberal Democrat. Or perhaps it just shows the disjunction in my head between being centre-left and voting for a party that will introduce imprisonment without trial. We live in strange times.

And I’m not voting Lib Dem. Get real.

Who should I vote for?

Your expected outcome:

Labour

Your actual outcome:

	Labour 8
Conservative -33
	Liberal Democrat 44
	UK Independence Party 7
	Green 22

You should vote: Liberal Democrat

The LibDems take a strong stand against tax cuts and a strong one in favour of public services: they would make long-term residential care for the elderly free across the UK, and scrap university tuition fees. They are in favour of a ban on smoking in public places, but would relax laws on cannabis. They propose to change vehicle taxation to be based on usage rather than ownership.

Take the test at Who Should You Vote For

Thanks to John Naughton for pointing me to this excellent essay by Stewart Brand, in which he challenges environmentalists to embrace genetically modified crops, nuclear power and urbanisation - for the good of the planet. Particularly telling are Brand’s comments on how urbanisation is driving population decline, and why this should be embraced and celebrated as a means of lessening humanity’s demands on the Earth:

The environmentalist aesthetic is to love villages and despise cities. My mind got changed on the subject a few years ago by an Indian acquaintance who told me that in Indian villages the women obeyed their husbands and family elders, pounded grain, and sang. But, the acquaintance explained, when Indian women immigrated to cities, they got jobs, started businesses, and demanded their children be educated. They became more independent, as they became less fundamentalist in their religious beliefs. Urbanization is the most massive and sudden shift of humanity in its history. Environmentalists will be rewarded if they welcome it and get out in front of it. In every single region in the world, including the U.S., small towns and rural areas are emptying out. The trees and wildlife are returning. Now is the time to put in place permanent protection for those rural environments. Meanwhile, the global population of illegal urban squatters - which Robert Neuwirth’s book Shadow Cities already estimates at a billion - is growing fast. Environmentalists could help ensure that the new dominant human habitat is humane and has a reduced footprint of overall environmental impact.

(Via John Naughton.)

Because the Labour manifesto is magnificent. Yes, I know it’s a cynical ploy to make me think that they’re serious minded not glossy but dammit there’s some fabulous stuff in there. Here’s just the first of a series of policies which are inarguably progressive and inarguably non-Tory:

Raise the minimum wage to £5.05 from October 2005 and £5.35 from October 2006. Nothing the Tories have said on poverty can match that. They fought against the minimum wage tooth and nail, and predicted all sorts of misery arising from it. They were wrong. A minimum wage is the sign of a modern, progressive democracy, and Labour do NOT get enough credit for introducing it.

This is beyond belief:

“The Conservatives also promised to overhaul the national curriculum with a review led by controversial former chief schools inspector Chris Woodhead.”