Lord Protector Outed

Still no fish but as I watch the float bob in the swell I contemplate that Australia's new republican Prime Minister Julia Gillard is not the first Welsh political leader to aim to topple the British monarch. You may have thought that soldier and statesman Oliver Cromwell came from ancient East Anglian yeoman stock but I can reveal, in the latest instalment of my occasional series on closet Celts, that he was in fact Welsh: indeed the ruthless regicide's real name was Williams (as his marriage certificate shows), his great great grandfather up the male line being one Morgan ap Williams. The family used the name Cromwell to associate themselves with Thomas Cromwell, Henry Vlll's henchman, but in fact Morgan was married to Thomas' sister so the correct surname was Williams. He was also related to Owen Tudor, ironically making the Lord Protector a distant cousin of poor old Charles l.

The Welsh got significantly caught up in the Civil War, mainly in the King's cause (unlike O Williams). Poorly-trained, inexperienced and probably uncommitted Welsh conscripts provided much of the Royalist infantry at Naseby. In the worst atrocity of the war Parliamentary cavalrymen slaughtered 100 Welshwomen after the battle - soldiers' wives in the baggage train who tried desperately to defend themselves with kitchen utensils: they cried out for mercy in Welsh but their uncomprehending attackers thought they must be Irish (and therefore fair game) or so they said. It reflects well on those times that there was a great outcry about the massacre but Parliamentary spin-doctors went to some trouble to demonise the women as wild witches or (worse) actually Irish. No such qualms when Cromwell subdued Ireland with ferocious brutality in 1649/50.

Oliver also had significant mental health problems around 1630, certainly depression and possibly bipolar disorder to judge by one doctor's account where his mood was described as swinging from premonitions of imminent death to fantasies about great political power (which transpired of course).

If you want to win money down the pub try the question "Who was the longest-lived British head of state?" The surprising answer is Richard Cromwell (or Williams we should say), Oliver's son and head of state very briefly in 1658/59: unfortunately nobody took him seriously and nick-named him "Queen Dick". Following the Restoration he went abroad and lived until 1712 latterly in England having quietly returned. At 85 he was older even than the present Queen Bess though she may yet unsportingly beat his record if she lives until 2012.

Surely any fish would take the cocktail of sand-eel and rag-worm on my hooks? Otherwise I will resort to dynamite (or the fishmonger).

35th Birthday

It's my birthday and quite a special one. I was 50 a year ago but, now that the pension age has been raised by a year in the budget last week and because I propose to retire at 65 latest as I originally planned, I have no choice but to "lose" a year and be 50 again today. In fact if I factor in an ambition to get my occupational pension up to the level of a public sector one I will need to work another 30 years making me now just 35 years old, the same age as Russell Brand whom I saw in "Get Me To The Greek" earlier in the week (I thought it was going to be a chick flick but it turned out to be a lads' and ladettes' "gross-out" movie which I'm afraid I enjoyed). Brand excites extreme views: Hafal's Deputy Chief Executive Alun Thomas thinks he is an irresponsible layabout while I think he is a philosopher for our age and commend his thoughtful autobiography "My Booky Wook", a useful commentary for anybody concerned with youthful rites of passage and addiction to drugs, alcohol and sex.

This morning I am up at 5.30 am to catch the early high tide but nothing bites, not even barely edible wrasse. I will try a running ledger this pm off the beach (hopefully not many people about because of That Match) in the ambitious hope of a flat-fish. You never know.

I've got a few days off now so don't expect any "shop" posts.

Hawaii Five-0

No surprise that Hafal Wrexham's committed team of staff and volunteers pushed the boat out (presumably one of those giant canoes) for their "Road to Recovery" event this week which featured a barbecue, juice bar and hula dancing in the spirit of America's 50th State.

Our team in Wrexham is among our most experienced in supporting families and carers and I take this opportunity to set out a specific concern for families about the Welsh Mental Health Measure, a key focus of our "Road" campaign. Families want a key addition to the proposed definition of a “relevant patient” in Part 2 of the Measure, specifically to include people with a serious mental illness who are unwilling to engage with secondary mental health services even though there is evidence that their wellbeing and safety would be best served if they did so engage. It is important that these patients should qualify under Part 2 of the Measure, in particular in order to qualify for the requirement that a care plan is drawn up for them (it is not of course proposed that the Measure should in any sense compel a patient to participate in their treatment or care).

Although it is acknowledged that it is difficult to draw up a care plan in these circumstances this can be very important for this often vulnerable group of patients, for example by giving assistance to carers and family members whom the patient may be prepared to engage with even though they will not engage for the time being with secondary mental health services. Further, patients may continue to engage with their GP and others concerning physical health issues, and, if there is a care plan under Part 2 of the Measure, the GP can address issues in the plan and encourage the patient to take up secondary mental health services. See Hafal's full position on the Measure here.

Meanwhile the microbus is in such great demand that it made an additional stop this week in Colwyn bay to be greeted by live music and opportunities to engage in kite-boarding on the beach...



The microbus is holding her own in her hectic drive around Wales, so far not experiencing any break-downs. We will be protectively locking the bus up in a secure garage this Sunday in case her German origins invite the attention of English visitors in retaliation or celebration of whatever may occur. I think it looks rather bitter and twisted for the Scots and Welsh to support other teams against England so my own neutral position on the match is to hope for a draw which can then be quietly settled by whatever means are used to determine the matter in those circumstances.

Welsh Australian Rules

Barry girl and daughter of a psychiatric nurse Julia Gillard is now the Prime Minister of Australia - apparently her hero is Nye Bevan. More Summer reading: earlier and unwilling Welsh immigrants to Australia feature in Robert Hughes' brilliant history of transportation and the early (European) history of Australasia "The Fatal Shore" - for me it was good enough to relieve much of the agony involved in flying back from Sydney last year.

More Budget Reflection

We won't know quite how bad the cuts to public expenditure in Wales will be until the autumn (and there might be some modest easing if the promised review of the Barnett formula acknowledges Wales' current disadvantaged position). In any event there will be severe cuts in the coming years and those of us seeking to protect and enhance mental health services need to get our tactics right. My guess is that the Assembly Government will attempt to protect the NHS budget but even an index rise really means cuts because of the insidious "NHS inflation" which means its costs rise more than everybody else's.

A reasonable campaigning position would be to aim to sustain real-terms, current NHS spending on mental health as a high priority compared to other health areas - not unreasonable since mental health is a declared priority of the Assembly Government. The Councils may take a greater hit and I predict a hard fight to protect mental health social care.

Meanwhile patients' groups like Hafal need to offer practical ideas for efficiency savings which can be used to improve services where standards are not yet being met: here's two for starters...

(1) Accelerate the repatriation of patients from expensive care providers whose approach is to overstaff and overcharge for untherapeutic services.

(2) Rationalise the proliferation of specialist community teams alongside a wholesale reorganisation and refocusing of the core Community Mental Health Teams (see this post).

It is interesting to see that the Royal College of Psychiatrists is moving towards the idea of CMHT rationalisation: I gave evidence to their Service Redesign Enquiry in February and this and other ideas feature in their report here published this week.

Austerity Budget News

See the BBC's summary here and note the following of particular relevance to people with a serious mental illness...

The Government will reform the Disability Living Allowance (DLA) to
ensure support is targeted on those with the highest medical need. The
Government will introduce the use of objective medical assessments
for all DLA claimants from 2013-14 to ensure payments are only made for
as long as a claimant needs them.

The Government will use the CPI for the price indexation of
benefits and tax credits from April 2011. The CPI provides a more
appropriate measure of benefit and pension recipients’ inflation experiences
than RPI, because it excludes the majority of housing costs faced by
homeowners (low income households are subsidised separately through
Housing Benefit, and the majority of pensioners own their home outright),
and differences in calculation mean it may be considered a better
representation of the way consumers change their consumption patterns in
response to price changes. This will also ensure consistency with the measure
of inflation used by the Bank of England.

At any rate I won't have to eat my hat (see this post) as VAT will be rising to 20%.

Bipolar Popular?

Intriguing news this week that Bipolar Disorder (which has largely replaced the term "Manic Depression") may be a "desirable diagnosis": see the story here.

Apparently many people are diagnosing themselves as bipolar because there is much more information in the public domain about the illness; it is also seen as more “acceptable” because clever and creative people like Stephen Fry have spoken about their experience of the illness. This must generally be a good thing but there are also risks. Obviously if somebody accurately diagnoses their own bipolar illness (in other words it is confirmed subsequently by a clinician) then it is all to the good that they can get help soon – indeed many people with serious mental illness never seek help through lack of insight so if more people are checking out their condition that’s great.

The concern must be that if, as the article implies, some people resort to the diagnosis as an explanation of an erratic life-style or mood swings (which trouble many people without a serious mental illness) they may not address problems systematically in order to sort out their lives; there is also a risk of doubt being cast by the wider public on the validity of bipolar disorder as a serious problem requiring treatment and care if the diagnosis is used loosely by individuals who believe it will in a curious way make them more exotic and excuse some forms of behaviour – I have observed this phenomenon outside the context of my professional life.

To his credit Stephen Fry has not simplistically absolved himself of responsibility for problems arising from his mental illness. In a sense he was forced out into the open by his famous running away from Simon Gray's play "Cell Mates" in 1995 (yes, that long ago!) but while disclosing his health problems he nevertheless acknowledged his responsibility for the play's closure and the impact on all concerned with it. Bipolar disorder can cause great hardship for those who experience it and also serious problems for their families and colleagues: this reality makes the notion of a "desirable diagnosis" most inappropriate but let us cautiously celebrate the effect Fry and others have had in disclosing their illness. All experience suggests that the main route to tackling stigma lies in increasing contact between the wider public and people with a mental illness whether they are celebrities on the telly or neighbours in your community who feel able to share their experience.

Of course we also need people with experience of schizophrenia to speak to the public: there's no sign of that becoming a trendy diagnosis but there are brave pioneers, not least among Hafal's Members and staff, prepared to share their experience of schizophrenia as well as bipolar and other illnesses - let us hope that one day in an enlightened future we will be able to look back in some surprise at these days when a few courageous men and women first stepped forward to use their humanity to overwhelm public fear and misunderstanding of mental illness.

If you want more information please follow these links on bipolar disorder and schizophrenia. And if you think you might have an undiagnosed mental illness don't speculate - see your doctor!

Thrill in Rhyl

Rhyl Golf Club welcomed the microbus on its first stop in North Wales - more here. Hafal's supporters in Denbighshire highlighted the importance of supporting families and carers of people with a serious mental illness. We are concerned that services for carers may be vulnerable to cuts on the grounds that they are "secondary" to services for patients but this would be both unfair and a false economy - carers provide a substantial part of the support needed for patients in the community and well-targeted services can enhance that crucial role to everybody's advantage.

Hafal's 10 Point Plan for carers, based on the experience of over 400 experienced carers, can be seen here.

Talking Pollacks

A quiet weekend aside from a 30 second visit to the local fete (picture) with a Beach Boys tribute doing a desultory set in the bandstand, an interesting use of the not inconsiderable precept levied by the Town Council. The Prime Minister has invited us all to think about what the state should and shouldn't do: so, if you're reading this, Dave, maybe local Councils should leave fetes to the local great and good, vicars, etc. But before I embark on a Poujadist diatribe about my wallet this might be a good time to reflect on some feedback about Bill's Blog...

You will have noticed that there is no opportunity for comment on the blog. However, Hafal is presently developing a Facebook presence mainly for the purpose of enabling people to comment on and engage with our on-line services, specifically the corporate Hafal website and our news and information site Mental Health Wales. When the Hafal Facebook pages are fully set up I will put up a permanent link on this (non-corporate) blog so that people can comment on the "shop" issues which I cover. Meanwhile anybody can e-mail me at bill@hafal.org about any matter. To judge by the spookily informative analytics device monitoring this blog there are 300 plus people taking a look each month averaging 3 visits each and taking an average 2 minutes per visit which seems generous in these days of short attention spans - but I promise not to try your patience by getting yet more verbose.

Among the most vital feedback received so far is the advice that I should be calling "pollack" (see fishy post here) by its new name "colin" - pronounced French-fashion. The basis for this correction can be found on this link describing a rather desperate attempt to dignify this low-rent species as something worth choosing in place of cod (as instructed by millionaire foodie - and oppressor of poor people daring to buy ordinary chicken - Hugh Fearnley-Whittingstall). I thought "colin" was French for hake but I am happy to call any fish Colin in the spirit of compromise. However, I am not happy to choose Colin (aka pollack) over delicious, snow-white, firm-flaked cod. I am afraid that if I was left in charge of the last surviving breeding pair of cod there would come a Friday when, well, I just might not be able to resist...

Think Again

It is a sign of the times that nobody seems very concerned about the electronic tagging of mental health patients currently being piloted by the South London and Maudsley NHS Foundation Trust (see this link). This idea arose after a homicide where, so far as I can see, the enquiry which followed the patient's absconding while under escort indicated not a faulty procedure but a failure of the Maudsley to follow the agreed procedure. You might have thought that the more reasonable response would be to ensure that the procedure was followed correctly in future rather than to shackle and thereby humiliate patients. It is being emphasised that patients' permission is being sought: but what kind of choice is that for people in the power of their gaolers? Of course a logical case can be made, just as a case can be made for compulsory ID cards, ubiquitous CCTV, universal genetic databases, you name it: but what price liberty and dignity?

But this idea is worse because it singles out some of the most vulnerable people in society whose illness may lead them to feel greater distrust or paranoia about the intentions of those caring for them. It is not going too far to say that if this scheme is adopted it may very well increase risk because it will reinforce the reluctance of many people experiencing psychotic symptoms to seek help - reluctance which results from fear that in seeking help they will not receive comfort and care but rather suffer distrust, compulsion and repression. The Maudsley should think again.

Freud and Wales

(front) Sigmund Freud, Sàndor Ferenczi, Hanns Sachs (back) Otto Rank, Karl Abraham, Max Eitingon, Ernest Jones

I am asked for some Summer reading recommendations and so trying to think of things I've read with mental health relevance but not too heavy-duty to get stuck into under a parasol in Tenby or Torremolinos. So no textbooks or self-help you will be relieved to hear...

Kingsley Amis’ “Stanley and the Women” describes the troubles of a father whose son is diagnosed with schizophrenia. Real life carers could pick holes in it but for all that it captures some of the disempowerment and poor service which families often experience. It also (as the title suggests) reflects Amis’ difficult attitude to women ("Would you say, would you assent to the proposition that all women are mad?" Stanley replies, "Yes. No, not all. There are exceptions, naturally.") – be warned. My favourite Amis is “The Old Devils” based in Swansea about corrupt and sexually incontinent academics and celebrities – not much about mental health except... well, everything about mental health.

Sebastian Faulks’ “Human Traces” is a long and quite demanding fictional account of the development of psychiatry. I couldn’t put it down because it so entertainingly describes the strengths and weaknesses of psychoanalysis and the ethical dilemmas of psychiatry. His “Engleby”, a scary story of personality disorder, is also interesting but might be distressing for some people personally affected by mental illness.

Learn about the only English-speaking (as a first language) member of Freud’s inner circle – his loyal biographer Ernest Jones who rescued SF from the Nazis in 1938 - in Brenda Maddox' “Freud's Wizard - The Enigma of Ernest Jones”. Jones, born in Gowerton and an early Welsh nationalist, was a colossus in the development of psychiatry especially in the English-speaking world. You might expect him to be the object of great respect in Welsh mental health services but he was involved in a serious scandal in his early career which I think subdues public recognition today – read and judge for yourself.

More fun with Freud in the detective novel "The Interpretation of Murder" by Jed Rubenfeld in which Freud helps an American psychologist solve a murder.

My favourite novelist (now out of favour) is Anthony Burgess whose “End of the World News” (out of print but look for a cheap second hand copy on the Amazon link) uses an apocalyptic world catastrophe to explore the lives of both Trotsky and Freud - don't ask: you have to read it. Burgess was that rare thing, an English fan of the Welsh people, language and culture. He also said that, although people think that the great Welsh vice is drink (his Welsh wife certainly died of it), in fact it is sex. I leave it to you to decide whether that makes you feel better.

Meanwhile don't forget all the valuable publications available from Hafal here.

Rain Doesn't Stop Play

To an outdoor production of "The Tempest" by the Festival Players at Newton House, Llandeilo. A real downpour lends unbrechtian verisimilitude to the storm called up by Prospero to ship-wreck his enemies but equally on cue there is sunshine to reflect the magic island when the tempest abates (thank heavens as water has penetrated my cagoule and is gradually soaking my Levis - this is not the place for black tie). This is a popular play but nobody can agree quite what it's about. It's often interpreted as a final statement by Shakespeare as he retired from full-time work: on this reading Shakespeare is Prospero whose magic (which plays with people's fortunes) equates to writing plays. But that is I think just fancy born of the frustration of experts who can actually find virtually nothing definitive about the author's personality in the historical record or in his work. This production (see this link for lots of other venues in England and Wales) is excellent and does justice to what the play is really about - the triumph of good and compassion over cruelty, greed, low cunning, and megalomania, with layers of insight into human behaviour explored through the magical powers of Prospero and all framed in Shakespeare's very best poetry (better than the sonnets because so vivid and musical). Anyway, "Flout 'em and scout 'em And scout 'em and flout 'em! Thought is free" seems like a good mission statement for Bill's Blog.

Ymlaen Llanelli

While I am in Edinburgh the VW microbus visits my home County of Carmarthenshire on the "Road to Recovery": pictures show the bus on the coast path in Llanelli (incidentally note the brilliant hill-free cycling for softies from the Loughor bridge all the way to Kidwelly). Hafal's campaign has a particular focus on the forthcoming Mental Health Measure (Welsh law) which is currently under formal scrutiny. On Thursday I attend the WaMH in PC's conference in Cardiff and use my speaking spot at the start of the day to draw attention to the need for enforceable time-limits in the legislation. Health Minister Edwina Hart AM makes a forthright speech including an unscripted lashing of NHS senior managers for not communicating effectively and an aside expressing a new-found warmth towards the USA (what can she be referring to?). I ask her about the time-limit issue and she makes it obvious that for now she is inclined to follow the cautionary advice of some providers that time-limits would be too "inflexible" in respect of the varying needs of patients. This seems a good moment to review this matter...

Hafal's Members believe that there is a need for a legally-enforceable timescale between referral by a GP for assessment for secondary mental health services and the undertaking of that assessment. This is vital because otherwise there will be instances where those requiring secondary mental health services may wait a long time to be assessed and during that period they would not have the Part 2 rights under the Measure. This would be likely to cause anomalies and it cannot be right that a patient, who in the opinion of a GP may well require secondary mental health services, could wait indefinitely before they were assessed as qualifying for the Part 2 rights. We argue that the maximum time limit should be 30 days. There is a further significant weakness in that at the point where an individual does qualify as a relevant patient under Part 2 they could wait indefinitely for the development and completion of their personal care plan. We recognise that the process of developing the care plan must begin at the point where they qualify but without an enforceable time limit there would be instances where many months could go by during which services could argue that they were “setting about” developing the care plan but not actually delivering and completing it. We argue for a maximum time limit of 60 days between qualifying as a relevant patient under Part 2 and the completion of a care plan. Regulations could tighten the timescale (or have varying intelligent timescales) below the 60 days limit.

So what about this issue of flexibility? I think people are misunderstanding what patients are saying about this: time limits enforceable in law do not indicate average or optimal timescales but absolute maximum limits - of course there will be varying urgency within the timescale. If clinicians or others have a problem with this they should tell us what they think the realistic absolute maximum time limits are so we can debate that. One final point: don't be deceived into believing time limits will require additional resources - that is an old fallacy of the NHS bureaucracy. The rest of us know that time and money cannot be saved by putting off doing things (because you still have to do them in the end!): on the contrary delay means additional resources are likely to be required as vulnerable patients deteriorate for want of planned treatment and care.

Edinburgh

Tuesday and Wednesday in Scotland meeting Hafal's sister charities in the British Isles: Rethink (England), NSF Scotland, Mindwise (Northern Ireland), and Shine (Republic of Ireland). We discuss the future role of our organisations all of whom have their origins in families coming together to address the hidden scandal of neglect of people with schizophrenia. Although we all now reach out to people with other severe illnesses including bipolar disorder we all still hold a clear focus on those with high needs (the experience of perhaps 1 in 30 of us in our lifetimes) who require some 80% of all the resources dedicated to mental health services. The other distinctive characteristic of our organisations is a pragmatic, consumerist approach (no doubt a result of being controlled by mass memberships of people personally affected) uncluttered by stale old debates about "medical" versus "social" models of care and similar doctrinaire stuff. For a practical, holistic approach to care and treatment see Hafal's recovery plan here but please also follow the links above to see what our friends have to offer - and note this important conference in November organised jointly by the two Irish organisations.

Aberystwyth Mon Amour

The “Road to Recovery” led to Ceredigion last Friday and the microbus parked on the sea-front in Aberystwyth to spread the word about recovery, mental health legislation, and the future of services for people with a serious mental illness in Wales. These three issues are connected: there is an opportunity in Wales, in spite of the impending cuts in public spending, to put mental health services on a new footing which genuinely empowers people with serious mental illness and their families. The ambition must be to revolutionize the approach to delivering services by making individual care plans the paramount driver for policy and resources in place of the traditional top-down commissioning.



At the core of the proposed Mental Health Measure (Welsh law) is the legal right to an individual care plan for everybody who needs secondary mental health services – the Measure can prescribe the content and format of those care plans and if we get the regulations right they should set out how individuals can as of right work towards their recovery by taking action on all the areas of life which together can rebuild mental health. There is an excellent precedent for this in the Welsh Code of Practice for the Mental Health Act which prescribes nine areas which must be covered in care plans, namely medical treatment, other forms of treatment including psychological interventions, personal care and physical well-being, housing, work and occupation, training and education, finance and money, social/cultural/spiritual, and parenting or caring relationships.

Of course if those responsible for mental health services treat these care plans as bolt-ons to traditionally-commissioned services then they will have missed the point: all secondary mental health services should be subordinate to and justified by individual care plans – this is hardly rocket science because how can any mental health service be needed if it doesn’t feature in those individual care plans?

The jury’s out on whether the Assembly Government will follow through the logic of the Measure and insist that Local Health Boards and Councils work towards commissioning all mental health services in response to analysis of individual care plans. A further ambition should be to enable individual service-users to choose where they get their services from, whether that is through the bureaucratic Direct Payments system or (preferably) a new streamlined mechanism covering health as well as social care.

Ceredigion is special for me as my family were cattle dealers in Tregaron until my grandfather took holy orders and went off to minister to the handful of Anglicans holding out in Nonconformist Ammanford (he was a leading proponent of antidisestablishmentarianism). Hafal's Company Secretary Nicola Thomas hails from Adpar just North of the Teifi and we frequently hear mutterings of discontent from staff about the impossibility of any slack being cut on financial control because of senior management's county of origin: but, to borrow Millwall FC's unofficial motto, "Everybody Hates Us, We Don't Care".

"Kylie is Welsh" - Official

Late last night I am to be found dancing at a friend's wedding to "Can't Get You Out of My Head": see picture to learn the correct posture and hand gestures for the over-fifties performing this manoeuvre safely - and also note the Sweet William (geddit?) button-hole picked from my garden that morning. It occurs to me in the cold light of day that I should add Ms Minogue to the list of famous people who need to be outed as Welsh like William Shakespeare (see this previous blog). Kylie's mam was from Maesteg so she definitely qualifies under WRU rules (and who knows she might have made up for similarly diminutive Shane Williams' absence in yesterday's nail-biter). I can speak with some authority about KM having both been to Ramsay Street and seen the exhibition of her costumes at the V&A in 2007 (escorting a fan I should perhaps add). The music establishment sneers at Kylie but she has confounded all her critics to achieve enormous success. I don't think she needed to try to rival Madonna's naughtiness by showing everybody her pants - I mean with her in them while singing "Can't Get You..." rather than at the V&A though they were there too - and for my money it didn't work as she remains the wholesome and plucky "girl next door". She must also have done a bit of good positively fighting breast cancer: so good on you Kylie fach! Meanwhile if you know of any closet Welsh people whom I should "out" email me at bill@hafal.org

Elementary

To Newton House, Llandeilo, on Thursday night to see "Sherlock Holmes and the Wicked Women" created and performed brilliantly by local drama students. On arrival we mingle with the cast in role and I find myself in discussion variously with Dr Watson, sultry women of the night, and some early suffragettes who berate me for not giving them the vote. By the end of the evening I am not sure they should have it as the performance consists of a parade of murderesses, gold-diggers, lady bigamists, and other assorted female felons who portray womankind as scheming and violent but ultimately weak-willed and unable to take the heat: this makes for an accurate parody of Victorian prejudice - or I should say some Victorian men's prejudice having recently read this biography of John Stuart Mill - a bit of a bore to be honest but with an honourable role in advancing women's rights. The men in the play don't come off that well either, comprising blackmailers, arch-snobs and sadistic bullies plus the usual gormless Watson and a convincingly lean, cocaine-dependent Holmes with implausible powers of deduction.

Deutsche Ingenieurwissenschaften

So it is sixty years since the first VW camper rolled out of the Saxon industrial hub of Wolfsburg: see this BBC link. It was based of course on the Beetle made in the same plant since the 1930s. When the British took over the factory after the war the plan was to ship the plant to the UK : this was not just "victor's spoils" but part of a policy to reduce Germany to a peasant economy producing nothing more industrial than bratwurst (the Allies relented in case you hadn't noticed). But British car manufacturers didn't want it because "the vehicle does not meet the fundamental technical requirement of a motor-car; it is quite unattractive to the average buyer; to build the car commercially would be a completely uneconomic enterprise". Presumably they had their eye on developing the Morris Marina so who can blame them?

Hafal's own microbus is proving a great success on its "Road to Recovery" tour around Wales but we hope that the anniversary may help us to sell her at the end of the campaign - if we can bear to part with her. Our plan from the start has been to recoup all costs and in fact we are quietly confident of turning a small profit.

A nice illustration of the VW's iconic place in Sixties counterculture is in Arlo Guthrie's anti-Vietnam ballad "Alice's Restaurant": see him performing here . Nobody in this office had heard of it because they are all too young (or too square).

Nature Versus Nurture

Now let me be clear - it wasn't my idea to go to the Hay-on-Wye Literary Festival this Bank Holiday. Arty festivals can be precious at the best of times but, whereas a theatre festival (for example) has the merit of providing an opportunity to stage plays, by contrast a literary event doesn't really offer an opportunity to read books - best done at home on the sofa - leaving only the pretentious bits i.e. self-congratulatory mingling and the doubtful thrill of being in the same space as Salman Rushdie or whoever. The only cultural festival which is truly democratic, effortlessly combining high-brow poetic composition with primary school dancing schlock, is the National Eisteddfod. But truthfully I was easily coerced as I have been curious about the Hay fest since it began and so motor into Hay early Monday and walk into the tented field with a rather graceless air of scepticism.

Before I have time to pass judgement I am whisked into a tent to listen to international celebrity and genetics egg-head (and Welshman) Steve Jones whose book "Darwin's Island" I am reading at the moment. Prof Jones is good value, repeating (and simultaneously withdrawing) his thoughtful, academic critique reported last week of fellow geneticist Craig Venter - he called him "a bit of a pr**k" here : the distinguished Professor says that Venter has e-mailed him to say he didn't like the "bit of a" bit, confirming that these guys don't care much what you think of them as long as you don't belittle them, as it were. Anyway, I have grabbed a front seat and get to ask Jones a question on behalf of my blog-readers: "Do you believe that in time we will be able to predict serious mental illnesses like schizophrenia through genetic analysis of individuals or does nurture play a significant part as well as nature?". Jones gives a substantive reply which I will try to paraphrase here...

• Schizophrenia had been identified as a distinct disease since Kraepelin's classification of symptoms

• This sort of approach to mental illness had also led to a more liberal view of mental illness in the context of criminal justice, for example the "McNaughton Rules"

• However, the classification of schizophrenia has over time become much more problematic and therefore . . .

• Though there are clearly genetic links there may be several genes causing several different illnesses

• Somewhat is contrast there has been more solid evidence of simpler genetic connections to bipolar disorder, resulting in credible diagnostic (if not yet preventative) tools

• However, the point about “nature or nurture” (terminology first coined by Shakespeare) is critical in the context of the complex symptoms and behaviours associated with mental illness

• Compare the famous “gay gene” much publicised a couple of years ago. There may well be a gene (or several genes) which link to homosexuality (not a disease of course!) but consider also the environmental factors – Nelson’s Royal Navy took a lenient view of homosexual behaviour once ships had been at sea for several weeks.

Jones’ point is well – if rather colourfully – made. We must surely pursue the study of genetic links to serious mental illness but environmental factors must also be significant. We simply do not know yet whether many people with a genetic predisposition to schizophrenia do not in the event experience symptoms; nor do we know whether some people without any genetic predisposition nevertheless develop such symptoms because of what happens in their life. Incidentally the Shakespeare reference is at Tempest 4.i where Prospero descibes Caliban as "A devil, a born devil, on whose nature / Nurture can never stick; on whom my pains, / Humanely taken, all, all lost, quite lost". Meanwhile if you want to know more about treatments for serious mental illness please check out this guide.

I emerge to look at the rest of the festival. Ernest "Modern Parents" drag their bored children around veggie juice emporia and preachy environmental stuff about rain forests and earthworms (what's this got to do with literature?): like those children I crave a sandwich containing red meat, some pop, and wild open spaces so after 30 minutes we set off over the Gospel Pass and picnic at Llanthony Abbey.