Monday, December 18, 2006

Christmas Charity

One of the adverts currently playing on loop on TV is the Oxfam Christmas one. You've probably seen it - "You're Gorgeous" is the soundtrack, even though the juxtaposition of that song and a goat seems somewhat incongruous. (This man may disagree).

There is one thing I wonder about the amount of money spent by charities on advertising at this time of year, though. Is this really the best use of the donations given to them? After all, to advertise on national TV is very expensive, even assuming production costs are minimal. Regardless of what you think of any charity's work, the donations that are given are assumed to go to a charitable purpose, not for the promotion of the charity on advertisements.

Surely Oxfam has a high enough profile that it doesn't need to be wasting thousands of pounds on expensive TV slots? Surely the money fulfils the aims of the charity far more if it is directed towards aid?

Friday, December 15, 2006

Whatever Happened To Agency?

The victims of the serial killer in Ipswich are, it goes without saying, the victims of a terrible tragedy. One can only hope the monster responsible for these crimes is identified soon, and put away where he can be no danger to the public.

In the last few days, however, there have been articles appearing in the Times that have focused on the heroin addictions of the victims of the murders. The women who were killed were prostitutes, and in most cases were out on the streets to feed a drug habit. Alice Miles and Mary Ann Sieghart, the Times columnists, have both written in the past week to use this as evidence that more money should be invested in drug rehabilitation, including the state buying heroin to help wean victims of addiction off it.

I have no doubt that drug addiction is an awful affliction, and heaven forfend that anyone close to me ever suffers from it. But to read Sieghart's plea for the "medicalisation" of heroin, it would seem as if it is a disease that you just catch, a bit like the flu, or cancer. "Drug addiction is a medical condition; it should not be treated as a criminal offence."

Well, I'm sorry, but it's a self-inflicted medical condition. You have to take the illegal drugs before you can get hooked on them. And what's more, heroin and cocaine are illegal. It's not as if this is unknown - vast amounts of money are spent by police forces spreading this message in schools to warn children of the dangers of using these drugs. There is clear personal agency behind drug addiction. It is not only a self-inflicted condition, but it is also a condition that should not occur in a law-abiding society.

And yet the taxpayer, through the NHS, funds drug addicts seeking treatment to a large extent. To a much greater extent, for example, than diabetics. When I was diagnosed over ten years ago, we had to use syringes for our injections. Never mind that people who used insulin pens spent less time in hospital per year. Never mind that 75% of teenage diabetics had been taken into police custody for carrying syringes on their person. The needles for an insulin pen were 0.001p more expensive than a syringe, and so the NHS wouldn't fund them. Meanwhile, drug addicts were given needles 4p more expensive at the same time.

Pen needles are now funded on the NHS, after much lobbying. But they are still not the best treatment available for diabetics. That would be the insulin pump - which is the most accurate means of simulating the work of the pancreas that is currently known. The cost of providing the insulin for a pump and for pens is not much different; but the pump itself is significantly more expensive. These costs are offset by the fact that better control means less need for other hospital care, which results from complications caused by diabetes. But common sense never seemed to play a role in health policy!

The fact is that people suffering from cancer, diabetes, heart failure, kidney disease and all kinds of other problems have not fallen ill because of their own, conscious choice to break the law. And yet in many cases, on cost grounds, the NHS refuses to give them the best available care. All the while, those who have chosen to take drugs and seek treatment to deal with their problems have a lot more cash spent on them.

Trying to turn drug addicts into victims because of the consequence of their own conscious choice removes personal agency from the equation. That should never happen. It is the same as condoning crime because of troubled upbringings. No matter what the circumstances, there is a knowledge that such actions are wrong. And it should not be the business of the state to provide a better standard of care for those who break the law than for those who are ill through no fault of their own.