The GPs who don’t even know your name: Health minister to launch attack on failings of inaccessible family doctors
Jeremy Hunt is to launch a wide-ranging attack on GPs, claiming some do not even know their patients’ names. In a major speech, the Health Secretary will condemn the scandal of out-of-hours services where ‘you speak to a doctor who doesn’t know you from Adam’.
In a frank assessment of the failings of ‘largely reactive’ surgeries, he will insist family doctors must once again take ultimate responsibility for round-the-clock care.
He will liken surgeries to ‘mini A&E units’ where doctors are struggling to cope with the huge volume of patients.
And in a response to growing concern over the quality of care outside office hours, the Health Secretary will unveil a new chief inspector of GPs, whom he says will crack down hard on surgeries that fail to provide a good service at all times.
Patients should know that one family doctor is responsible for them, and even if their GP is not on call it will be clear that ‘the buck stops’ with them, he will say.
The Daily Mail has repeatedly highlighted the scandal of out-of-hours care.
Last week it emerged that Harmoni, Britain’s biggest provider of such care, was paying GPs £1,350 a shift because managers were so desperate to cover evenings and weekends. The firm has also had to use senior nurses to cover whole districts overnight.
In the speech, which he will make to the King’s Fund health think-tank on Thursday, Mr Hunt will also respond to growing problems in hospital accident and emergency units, where admissions have soared because, he says, there is ‘no credible alternative’.
‘Everyone agrees that hospitals should only be a last resort for the frail elderly and that – for someone perhaps with dementia and other complex conditions – A&E departments can be extremely confusing places,’ he will say.
‘But what alternatives do we offer? GP surgeries where it is often impossible to get an appointment the next day; same day appointments but only if you call at 8 o’clock in the morning sharp and are lucky getting through; long waits on the phone to get through, sometimes at premium rates; difficulty in registering with another practice if you move home, or aren’t happy with the service you are receiving; out-of-hours services where you speak to a doctor who doesn’t know you from Adam and has no access to your medical record.’
Mr Hunt will argue Labour made a ‘historic mistake’ by allowing GPs to opt out of out-of-hours care and paying them ‘not for looking after people as individuals, but for complying with a myriad of targets and requirements’.
He is understood to want to move away from a contract which pays doctors for hitting targets to one based on the quality of care round the clock.
Under Labour’s 2004 renegotiation of their contracts, GPs were allowed to hand responsibility for out-of-hours care to private firms such as Harmoni.
The new contract, Mr Hunt will say, removed ‘at a stroke the need to think holistically about a patient’s entire needs.’ It meant some of the traditional work of the family doctor, such as ringing elderly patients just out of hospital, ‘is too often forgotten or left undone’.
He will say: ‘As a member of the public, I want to know my GP. And I want my GP to be someone that knows me and my family.
‘Yet we’ve turned GP practices into places where it’s a daily challenge for receptionists to cope with huge call volumes and GPs to get through to all the people they need to see.’
Andy Burnham, Labour’s shadow health secretary, said: ‘A&E has deteriorated sharply on David Cameron’s watch and it’s not good enough for his Government to blame others – it is a mess of their making.
‘In 2009, 98 per cent of people were seen within the four-hour A&E target. David Cameron should stop trying to blame the crisis in A&E on something that happened ten years ago.’
Grandmother, 71, died of dehydration at care home because of ‘gross neglect’ by staff
Gross neglect by staff at a Birmingham care home led to a grandmother dying of dehydration, a coroner has ruled. Norma Spear, 71, died in Moseley Hall Hospital on November 6, 2011, three days after she was admitted from Druids Meadow residential home in Highter’s Heath, Birmingham.
Ms Spear, from Harborne, Birmingham, developed a urinary tract infection in her five weeks at the home which stunted her appetite and led her to become dangerously dehydrated, the inquest heard.
Carol Clay said her mother’s stay at the home, during which she lost 35lbs in weight, was only supposed to be temporary and that she was due to return home once a new fire had been fitted.
Birmingham’s deputy coroner Sarah Ormond-Walshe identified 11 failures – five of them severe enough to merit gross neglect – by staff at the home.
In reaching a verdict, following a six-day inquest at Sutton Coldfield Town Hall, Mrs Ormond-Walshe said Ms Spear had ‘died of natural causes to which neglect contributed’.
She added: ‘The failures I found are gross because they were so terribly simple. ‘Without one or more of these gross failures, Norma Spear would have survived. ‘She was at risk of the very thing she died of and that risk had been told to staff by a social worker.
‘It should have been obvious she was not drinking sufficiently for at least the last two weeks. It does not require medical training.’
Most of the errors catalogued centred around the staff’s failure to call a doctor, despite repeated requests from Mrs Clay, and to properly investigate Ms Spear’s worrying weight loss.
Mrs Ormond-Walshe also highlighted four criticisms against some of the GPs attached to Druids Meadow, including failures to establish Ms Spear’s medical history and to properly diagnose her dehydration.
Speaking after the verdict, Mrs Clay, 52, said: ‘It’s a bittersweet feeling really. ‘We’ve got the decision that she would have lived longer and had that confirmed by medical experts. ‘We feel vindicated but it’s an empty win.’
Ms Spear’s granddaughter, Becky Arnold, wept as the list of failures were read out in court.
The 35-year-old mother said: ‘She did nothing but care for other people and she died because she was not properly cared for by other people. ‘I’m disgusted with them and hope it affects them for the rest of their lives.’
Birmingham City Council’s legal advisor, Edward Pepperall QC, said the coroner should feel comforted the home closed in 2011 and that the authority had replaced a large number of its care homes with four care centres.
He said an internal review of how paperwork was updated and stored had taken place and that the Care Quality Commission had carried out subsequent inspections.
Those in charge of the home could still face disciplinary proceedings, he said.
The inquest had been told how Ms Spear was taken to Moseley Hall on June 3, 2011, after suffering a fall at home.
She fully recovered from her injuries and despite needing encouragement to eat and drink, her weight was stabilised at around eight stone.
But her weight dropped and her health quickly deteriorated after she moved from the hospital into Druids Meadow on September 28.
Mrs Clay, who now lives in Hampshire, told the court how she had repeatedly asked staff to arrange for a doctor to see her mother amid fears she was dangerously dehydrated.
Despite her concerns, exacerbated by Ms Spear’s medical history, staff at the home did not arrange for a doctor to see Ms Spear until November 1.
Labour: make work experience compulsory and axe ‘EBacc’
Compulsory work experience will be reintroduced in schools under a Labour plan to get teenagers ready for the jobs market, the Daily Telegraph has learnt.
The party is planning to reverse a Government decision to make two-week work placements an optional requirement before the end of school, it emerged.
Shadow ministers admitted that too many placements in the past involved “making tea and doing the photocopying” but insisted that high-quality work experience was vital.
It was also revealed that Labour is proposing to scrap the Coalition’s English Baccalaureate – a school league table measure that rewards pupils for gaining good GCSEs in a range of academic subjects – amid claims it “distorts” children’s’ options and stops them studying the arts and engineering.
The disclosure is made before the publication on Tuesday of an interim report commissioned by the party into the future of 14-to-19 education, vocational qualifications and skills training.
Prof Chris Husbands, director of the University of London’s Institute of Education, is leading the review amid concerns over education for the “forgotten 50 per cent “ of schoolchildren who fail to go on to university.
Speaking before the publication, Stephen Twigg, the shadow education secretary, said there was currently a “massive gap in this country between the world of education and the world of work” and a number of key reforms were being considered by the party in attempt to bridge the divide.
It will coincide with the raising of the education leaving age to 17 from this September and 18 in 2015. This includes:
* Requiring all teenagers to study English and maths up to the age of 18 through GCSEs, A-levels or other qualifications to raise standards in the three-Rs;
* Introducing a requirement for independent careers advice – reversing a Government decision to devolve the function directly to schools – because of fears schools with sixth-forms are steering pupils towards A-levels over other options such as apprenticeships and further education colleges;
* An overhaul of apprenticeships to tie them more accurately to specific careers sectors.
But some of the most high-profile reforms are being planned for the 14-to-16 phase where Labour claim the Coalition is failing to prepare children for the workplace.
Last year, the Government dropped a requirement for compulsory work experience placements as part of a review into vocational education by Prof Alison Wolf, from King’s College London.
Mr Twigg said it should be reinstated in some form but insisted the length of placements had yet to be decided, adding: “The quality of it varied. Certainly there were cases where people were in a workplace just making a cup of tea and doing the photocopying, but actually there were also brilliant examples of workplaces that did it really, really well. Giving young people that chance to see a real workplace is really fantastic and if anything two weeks isn’t enough.”
But a Government source said Mr Twigg backed the Wolf report, adding: “Either he doesn’t know what is in the Wolf report or he is being hypocritical for political gain.”
Mr Twigg also said the so-called EBacc would be scrapped. It currently ranks schools by the proportion of pupils gaining at least a C grade GCSE in five disciplines – English, maths, science, foreign languages and either history or geography.
But he said it had a “negative effect in areas like creatively and engineering, which get put to the fringes”.
“[The EBacc] is at best an irrelevance and in some cases it is distorting young people’s choices so they are not doing things that are best for fulfilling their potential,” he said.
A Department for Education spokesperson said: “We are giving young people the skills they need for further education and employment.
“Raising the participation age to 18 and expanding work experience post-16 will give all students the chance to complete high-quality, relevant work placements.
“We accepted Alison Wolf’s recommendation to remove the duty on schools to provide work experience for pupils under 16s. Schools continue to have the freedom to offer quality work experience.
“The EBacc is not the limit of what young people should study – it is a common core, to which each pupil can add the subjects and qualifications which are most suitable for them. There should be plenty of time in the timetable for arts subjects as well.”
‘How Jill Dando’s death convinced me everything you know about crime is wrong’: NICK ROSS tells the shocking truth about the murder of his friend and the real cause of crime
Nick Ross surely has a point below about the importance of prevention but turning every home into a steel-shielded fortress seems impossibly expensive. And how do you prevent street crime? And even with an armed citizenry — as in some American States — there is still a lot of crime
Crime has been with us since Adam and Eve and, surprisingly, God didn’t spot the solution.
Rather than punishing the miscreants, it might have been better had he put the forbidden fruit higher up the tree. We have been too slow to realise how strongly crime levels are dictated by temptation and opportunity.
It took a lot of research to persuade me of this. When, in 1984, I started presenting Crimewatch, I shared everyone’s presumptions that crime is caused by criminals. It seemed obvious: If we want to cut crime we must cut criminality. Three years later, quite by chance, I had an epiphany.
I was reporting for the BBC and, at the start of China’s astonishing race towards modernisation, I stood on a top-floor balcony in a dusty town with the local mayor. He proudly pointed out the local hospital, a big school and a prosperous cluster of new houses.
Why, I asked, were some of the new homes surrounded by barbed wire? The mayor responded sorrowfully: ‘Burglaries,’ he said. ‘Mostly televisions.’ I said I hadn’t realised burglary was a problem in China.
‘It wasn’t,’ said the mayor.
‘So what changed?’ I asked.
The mayor recoiled slightly as though it were a trick question. After a moment he responded gravely: ‘We didn’t have televisions.’
Human nature remains more or less constant from one generation to another but situations change, and it is those evolving situations that largely determine how much is stolen, how many people are assaulted and how many citizens get hooked on drugs or even child pornography.
The message is that if you want to cut crime, you need to spend more time on low-hanging fruit.
By seeing crooks as the big issue, we tend to not to notice how important immediacy is. We favour solutions which are remote – improving parenting, for example – rather than improving security at the scene of the crime.
We still need to catch offenders – I am a proud trustee of Crimestoppers – but we cannot arrest our way out of trouble.
I started looking to criminology for answers but found a lot of political diatribe and pseudoscience.
When my co-presenter, Jill Dando was murdered in 1999, I proposed a more rigorous approach and, with public support, we founded the Jill Dando Institute of Crime Science at University College London.
It is now thriving and has helped me see that almost everything we are told about crime – certainly everything I once thought I knew – is wrong.
In some ways, my argument is a challenge to everyday reporting of crime. The human condition recoils from the mundane untidiness of reality.
Who, for example, can resist a good conspiracy theory – whether it’s flying saucers, or that 9/11 was organised by Mossad, or that Princess Di was murdered?
Take what happened after the murder of Jill.
She was then the most popular presenter on TV, so her shooting caused a sensation and, given her role on Crimewatch, people leapt to the idea that she had been killed because of one of her appeals.
Within hours, I was trying to calm the speculation down.
The immediate facts made a contract killing improbable but in any case the revenge motive would have been entirely without precedent in modern mainland Britain.
As more evidence emerged, the conspiracy theory became even less sustainable. The killer had hung around with no disguise at the wrong address – it was chance she turned up. He had no getaway vehicle and so had to walk away down a long straight street with no turn-offs.
He didn’t have a real gun or ammunition but home-made versions of both. He held the weapon in contact with his victim’s head, which would have showered him with tell-tale forensic evidence. And so it went on. All in all it was about as amateurish and clumsy as a shooting can be.
So I became alarmed when the inquiry seemed to be taking the conspiracy theory seriously.
I wrote privately to the head of the investigation, pointing out that when celebrities are shot, like John Lennon, the killer invariably turned out to be a loner.
It turned out that Britain’s top profiler at the National Crime Faculty agreed with me, but nobody took much notice. It was a frustrating as well as an upsetting time for me and for Jill’s other colleagues on the programme.
Yet, when this first conspiracy theory began to fade, I could not have imagined that another intrigue would replace it, one that was not just unconvincing but risible.
According to this new hypothesis, the author of Jill’s murder was Slobodan Milosevic. The reason was that a few weeks before Jill’s death, she had fronted an appeal for victims of the civil war in former Yugoslavia and there was conjecture that the Serbs had taken umbrage. Then, when a Serb TV station was hit by a NATO air strike on Belgrade, a plot was hatched to kill her.
However improbable, this Balkans theory made front-page news and became one of the most popular and persistent explanations for Jill’s death.
For the record, the idea was based entirely on a mild letter of complaint to Jill written by a Serb. It was so low-key that Jill’s agent only mentioned it to police, ‘clutching at straws’, some weeks later.
She thinks the Yugoslav connection is ludicrous and so do the detectives and all Jill’s colleagues who have been on the inside track of the inquiry. Yet crime and conspiracy theories go together as readily as Bonnie and Clyde. We love ’em.
Myth One: ‘Crime is caused by a broken society’
Liberals and Left-wingers are convinced crime is caused by unfairness and poverty, and social conservatives are equally certain it is down to lack of discipline and failing values.
Yet there can be few clearer illustrations of the huge part played by temptation and opportunity than the rise and fall in car crime.
Car numbers reached ten million in 1970, or one for every two households, and that turned out to be a tipping point. Car theft boomed. Some 20,000 were reported stolen in 1968, and then, suddenly, in 1969 thefts rocketed six-fold.
Did something happen in that time to breed more deviance and badness? Less authority, less self-control, perhaps? Or more unfairness and therefore less compliance?
The numbers add up to a different story: Half the homes in Britain now had hundreds or thousands of pounds’ worth of property sitting out on the street unguarded and it was temptation on an ostentatious scale. It was also staggeringly easy.
My first car, a Mini, had almost no security at all. You could force the flimsy lock with one hand or prise open the sliding window and unlock it from the inside.
By 1990, there were 20 million cars and half a million thefts a year and by 1993, when ‘taking without owner’s consent’, or ‘twocking’ reached its peak, the annual risk of a vehicle being stolen was one in 30.
Then, in 1995, the problem started to decline, which is where social theories hit another problem. Community divisions like income inequality were growing, not diminishing.
Right-wing beliefs also faced a contradiction. There had been no return to hanging, birching or religious observance, and more and more children were born out of wedlock.
Yet car theft tumbled. Within ten years, recorded numbers halved, and by 2011 twocking had dipped below 100,000, the lowest figure since 1968.
For once, politicians were involved in wholesale and dramatically successful crime reduction. They put pressure on car-makers to mend the vulnerabilities in their products.
Immobilisers, intruder alarms, central locking, sophisticated keys, tougher door and boot designs were introduced and much more besides, and all of them had an immediate effect – especially immobilisers, which prevented hot-wiring of the ignition. In little more than a decade, car crime plummeted in England and Wales by around two-thirds.
Myth Two: ‘British justice is the best in the world’
When I started Crimewatch, I thought British justice was the best in the world.
After 30 years’ experience, I am now in contempt of court. It is not as open as it claims, it is slow, costly, and still believes that debate is the best way to establish facts. It is also more concerned with offenders than with victims.
When my 90-year-old father-in-law woke one night to find an intruder, the police were all one could have asked of them. His front room was strewn with glass, drawers and cupboards had been rifled and a random selection of trinkets stolen.
My father-in-law had come down the staircase brandishing his walking stick (‘Well,’ he told us, ‘I was in the Army’), shouted at the intruder to get out, and got a vague impression of someone climbing back out through the broken window.
The police made sure he had a cup of tea and stayed a reassuring half an hour. The next day, a forensic officer found a bloody fingerprint – the burglar had cut himself as he fled through the broken shards. So far, so good. And that was the last we heard.
Or at least, it was until we called them and were told they had identified the villain – a prolific burglar – but would not press charges because, at 90, my father-in-law would not make a good witness. The matter was dropped.
It was a classic illustration of how the legal process has divorced itself from decency and common sense.
It should not have mattered if my father-in-law, nonagenarian, living alone, frightened and in semi-darkness, got the description wrong.
The fingerprint and blood left by the burglar were proof enough. The offender went on offending and the victim was abandoned.
What police will not have known (and since nobody kept in touch, how could they?) was how that small nocturnal trauma ruined the rest of my father-in-law’s life. Thereafter, he couldn’t sleep. He began hallucinating, seeing a strange man in his room and wandering round his house, a man who used his toothpaste and toyed with his possessions.
His confusion and anxiety were not caused by the burglar – it was diagnosed as a form of dementia – but the form it took undoubtedly was. At his insistence, after a lifetime of domestic tranquillity, his house was thereafter encased with burglar-proof steel mesh.
Myth Three: ‘Poverty is the main cause of crime’
Instinctively, almost everyone thinks poverty is the prime cause of crime.
This is especially true for the liberal Left, for whom it has been an article of faith, but even Right-wingers at heart share in the assumption that the poor are somehow dangerous.
Yet surveys show there is no correlation between a society’s experience of crime and its sense of fairness.
In any case, crime rose exponentially at a time of unprecedented prosperity when, in the famous words of Prime Minister Harold Macmillan, Britain had, ‘never had it so good’.
Whatever else was causing crime to rise, it was not poverty. On the contrary, it was wealth, which brought with it progenitors of crime, including: higher wages and more credit, thus more to steal; more spare time; more late night carousing; more alcohol and drugs; more social mobility; more travel; and more anonymity.
We forget that the class system had been a huge restraining influence on the majority.
Its breakdown has changed our dreams and made us hope that they really might come true. It has made us aspire and made us envious.
As the pitilessly direct Conservative sage Lord Tebbit put it: ‘When I look at what we denounce as the appalling conduct of “ordinary people” I see the way the rich have always behaved.
‘It’s just that they have had the resources to deal with the fallout.’
Myth Four: ‘A ‘wicked’ minority is behind crime
The truth is that most of us cheat and steal and almost all of us can be persuaded to. Yet we rationalise our own behaviours, while we denounce the sins of others.
We have constructed a fantasy world in which we, the goodies, must be protected from a minority of potential baddies.
Most of us break the law. A third of British males born in the 1950s had acquired a criminal conviction by the time they were middle-aged.
If you think that sounds fantastic, several follow-up studies have shown similar results.
And what about the other two-thirds? Have they never been criminals? Or could it be that they never got caught and convicted?
A 2003 survey found almost half of us would evade income tax, two-thirds would dodge a fare or install illegal software, almost as many would steal office stationery and over a quarter would filch a hotel towel. For ‘would’ one might reasonably substitute ‘had’.
We all have ethics, and each of us has different limits, but sainthood is not the default position of humanity and for most of us our morals are for sale if the price is right.
Myth Five: ‘There is more crime than ever before’
The more historical archives are analysed, the more it seems that violence was once a much larger part of life than it is now.
Historical records show the homicide rates in 13th Century England were about twice as high as those in the 16th and 17th Centuries, and those of the 16th and 17th Centuries were some five to ten times higher than today.
Recorded crime rose slowly from 1900 to 1930, then accelerated to the 1950s, after which there was a fearful lurch upwards that continued for 40 years.
After that, crime did not just dip, it plunged.
Almost all the downward trends were masked at first by figures recorded by police, but police statistics can be hugely misleading because most crime – including serious violence – is not reported.
Property crime began to tumble around 1995 and violent crime subsided five years later. Hospital attendance for wounding fell every year from 2001 onwards.
Homicide seemed to have peaked in 2002. The speed of crime’s decline had come to mirror the ferocity of its ascent.
So deeply rooted are our assumptions about crime and criminals that it sometimes seems as though no amount of evidence will shift them: the curmudgeon’s myth that crime is always rising, the deviancy delusion that offenders are abnormal.
But it really is true that opportunity makes the thief. To a vast extent it also creates the football hooligan, drink-driver, and knife-wielding youth too.
This is why crime rates rise, and it is how we make them fall. It is why burglary as well as car theft rocketed until we became serious about home and vehicle security. It is how we so radically curbed football violence and road fatalities.
It is the reason why so many British politicians got caught with their hands in the till until their expenses protocols were changed.
Crime requires more than a predisposition to offend. It will flourish when we make it easy and shrivel when we make it hard.
Freedom philosophy embodied in London buses!
It sounds unlikely but Boris Johnson makes the case
I remember what the doubters said when we first announced a new bus for London – a replacement for the beloved Routemaster. They said I was mad. The Labour Party said I was deranged. My opponents said I was a swivel-eyed loon, or words to that effect. They said we were showing an arrant disregard for health and safety, and that in any case, it would never be built.
Where is it, they used to sneer at me, as Sir Peter Hendy and Transport for London began the necessarily lengthy process of procurement. When’s the bus due, eh? And when the first prototype finally turned up in 2011, the machine managed to conk out on the M1 (because someone had forgotten that a diesel hybrid still needs to be filled with diesel). The sceptics laughed their pants off.
So it gives me unbridled joy to inform you that the new bus will shortly arrive en masse. A whole gleaming fleet of them is about to take over Route 24, from Pimlico to Hampstead Heath; and in the next two years they will cease to be a curiosity – a rare species of charismatic megafauna that you might spot once in the course of a safari. They will be a glorious and regular addition to London’s streetscape, as famous and as emblematic as the elephants of the Serengeti, whose noble and domelike brows they faintly resemble.
When I went to Antrim last week, and saw dozens of them being made in the new Wrightbus plant, I felt a sense of awe, and the deep certainty that this was the most wonderful project I had ever been involved in. It has clean, green hybrid technology. If the new bus fulfils the promise it has shown in tests, we will be able to save so much on fuel that it will actually come out cheaper than our current hybrid buses. With 600 of them on the streets by 2016, they will make a significant reduction in nitrogen oxides and particulates, and will help us to improve air quality in the city.
The bus is a masterpiece of design, conceived by Thomas Heatherwick, the magician who created the Olympic cauldron. It helps to drive employment throughout the UK – unlike the wretched bendy buses, which were made in Germany. London’s buses are creating hundreds of jobs at the plants in Northern Ireland, but it does not stop there. The engines come from Darlington, the seats are made in Telford, the seat moquette in Huddersfield, the ramps are from Hoddesdon and the “Treadmaster” flooring from Liskeard. Oh, and the destination signs are from Manchester.
It is the embodiment of the point I often make, that investment in London boosts the rest of the UK economy, directly and indirectly. We have stimulated the very best of British technology, creating jobs in this country, and yes, we are now looking to potential export markets.
All these features make the bus remarkable; but there is one more thing about it – the best thing of all. This bus stands for freedom, and choice, and personal responsibility. It not only fulfils a promise often made to Londoners by bringing back conductors; it restores to the streets of London the open platform at the rear – and in so doing, it restores the concept of a reasonable risk.
We all remember the pleasure of the old Routemasters. It wasn’t anything to do with the way their flanks heaved and throbbed like wounded old warhorses. It wasn’t the boggler-boggler-boggler noise or the fumes of diesel. It was the way you could sit on those banquette seats at the back, high over the wheel arches, and watch the road passing you outside. And if the bus got stuck in traffic, or at the lights, you knew that you weren’t a prisoner. You were allowed to get on and off at will, provided the thing wasn’t moving, and now that freedom and benefit will be restored.
Of course, you will have to be careful. You should look around to make sure there aren’t any motorbikes or cycles approaching. But if the road is clear and the traffic is stationary, and you want to hop off and do some shopping – or if you have missed the bus at the stop, and you want to scoot down the street to catch it up – then the option is there. You can hop on and hop off, like the hop-on hop-off hoplites [heavily armed soldiers of Ancient Greece] who were trained to leap from moving chariots and then back on again.
Yes, of course there is a risk; but that risk is manageable; and without it you have no opportunity to ascend or escape the bus if you want to. It is, as far as I know, one of the few recent examples of a public policy that actually gives back, to sentient and responsible adults, the chance to take an extra risk in return for a specific reward.
We need to develop this thought, because I worry that in the post-crisis world, we have become all too paranoid, too risk-averse. Yes, the banks made grotesque errors, largely because they could not understand the risks they were taking. But unless we allow businesses and banks to take reasonable risks, they will never hit the jackpot at all.
Why is it that Britain hasn’t produced a giant like Google, or Facebook, or Amazon? It is because such a business, in the UK, would not have been given access to the capital required. We are more hostile to risk, and, indeed, we are more hostile to reward. If you go to San Francisco, where so many of these tech giants were born, you can see the most bizarre tram I have ever set eyes on. People hang from it like gibbons as it swoops and clangs through the streets. It would never be allowed in Europe. But the San Francisco authorities evidently believe that Americans are more robust – more willing to be free, more willing to make their own assessment of a reasonable risk.
If you look at the state of the eurozone, and you compare it with the US economy, you can see the possible advantages of this approach. And that is the point of the hop-on hop-off platform. In restoring a culture of reasonable risk-taking, it is a platform for growth.