Monday, 31 December 2012

Stuck In The 1960s



Between social activities I have been reading the final volume of A N Wilson's history of modern Britain Our Times, which covers the coronation of the present Queen up to Gordon Brown's government. Deeply depressing stuff. Wilson skewers what he sees as a succession of charlatans and half-wits who have dominated the UK's political and social establishment in our times.

I don't agree with all that he says and there are some spectacular inaccuracies. His two pages on Welsh devolution are hopelessly wrong. He says that following his success in the 1966 by-election Gwynfor Evans lost to the Tories in the following election (he lost to Labour); more egregiously he suggests that Rhodri Morgan was Blair's placeman to be the first First Minister - it was of course Alun Michael and Rhodri, whom Blair couldn't abide, had to fight to supplant him.

However, much of what Wilson says is all too accurate. There is an especially good chapter on mental health which describes the familiar story of how Enoch Powell as Health Minister (and his successors of both government parties), keen to invest in a range of modern general hospitals, latched on to some trends in psychiatry in order to demolish traditional mental health institutions (to save money) then failed to replace them with modern, community-based services.

Those trends were substantially influenced, as we know, by the repellent patient-abuser R D Laing, the psychiatrist who turned all common sense about mental health on its head - and dealt with the inconvenience of opposition from families and carers by blaming them for causing the problems in the first place.

The extraordinary thing is the extent to which Laing's influence survives to this day where unreconstructed proponents of anti-psychiatry, still stuck in the 1960s, shun the word "illness" to describe such conditions as schizophrenia and continue to refuse to listen to the witness of carers and families.

The problem is that "traditional" psychiatry has also failed to listen to patients and families and so doesn't have the moral authority to challenge all this nonsense. There are excellent psychiatrists about these days - we in Hafal know several - but I do wish they would rigorously redefine their profession's function and their philosophical position on mental illness.

The latest trend among professionals in mental health is at least benign in intent but side-steps the difficult questions about mental illness to concentrate on a wider agenda about the whole population's "well-being". Now, I've no quarrel with a concern for everybody's happiness (though I hope we can all agree that mental health services should not take the lead on that agenda) but the challenge of assisting people with a mental illness remains - and so, therefore, does the need for the mental health charity Hafal.

Wilson usefully contrasts the baleful influence of the opinionated exploiter and "guru" Laing and his gullible followers with his exponentially more humble contemporary Rev Chad Varah who established the Samaritans after presiding at the funeral of a girl who committed suicide. The Samaritans have saved countless lives since.

And what distinguishes the Samaritans? (1) They were not set up by - or even influenced by - mental health services, and (2) Their entire approach is based on listening to people. Work it out - the two points are connected.

Theatre Monkey



I have enjoyed a "two-centre" Christmas holiday in Bristol (see me above admiring the giddy view from the Suspension Bridge) and Surrey, incorporating a visit to London...

At the National Portrait Gallery I take a look at Queen Anne and other luminaries from her time having recently read Anne Somerset's biography Queen Anne - the Politics of Passion. It is quite startling to see intimate, colourful and fresh images of these people from so long ago.

Incidentally, who else spotted the portrait lurking in the background when the Queen visited the Cabinet a few days ago? It was actually Anne's half-brother the "Old Pretender" who, if the Jacobites had had their way, would have stopped the Germans taking over the British royal family including the present monarch - is somebody trying to make a point?



On to the Aldwych Theatre to see the musical extravaganza Top Hat which is a great hoot. Best known as the Fred Astaire and Ginger Rogers film of 1935 this is frenetic escapism at its best - an appropriate tonic today as it was in the economic gloom of the 1930s. The set reminds me of something ... then I recall it is Guildford Cathedral also designed in 1935 with those familiar geometric lines - see this post.

Our seats are fantastic but only £14 (slip seats in the Grand Circle) in contrast to cramped £85 stalls. If you are at all interested in West End shows allow me to let you into a secret which is the brilliant web-site Theatre Monkey. This doesn't sell cheap tickets - look elswhere for those - but gives you the low-down on every seat in every theatre, including tips on unlikely ones which are often bargains.

The show has little serious to offer but Irving Berlin has clear advice on achieving "mental well-being", superior to any humourless NHS pamphlet and which works for me...

Heaven, I'm in Heaven,
And the cares that hang around me thro' the week
Seem to vanish like a gambler's lucky streak
When we're out together dancing, cheek to cheek.

Oh! I love to climb a mountain,
And to reach the highest peak,
But it doesn't thrill me half as much
As dancing cheek to cheek.


Quite right - you can get through the troubles of working Monday to Friday by climbing up Snowdon (or similar physical activity) and, above all, through exciting personal contact.

I snapped this picture looking west from Waterloo Bridge on the way home (click on the picture to expand)...


Tuesday, 25 December 2012

Sparrow-Sized Turkey



Not so much a New Testament Nativity as an Old Testament Flood as my picture of the Towy Valley shows. I'm sorry for those who are actually disrupted by the rain but I find apocalyptic weather oddly soothing as it puts one's personal daily challenges into a spectacular perspective, more so than news of dramatic human events (such as the long lost war in Afghanistan) because by contrast these examples of human folly seem close to home (though not literally so) and, I suppose, matters for which we are disturbingly responsible.

But enough of these musings. I'm up at 6 a.m. this morning for a croissant stuffed with ham and cheese and to open a present from Mrs Blog - a 225g tub of "Prince" shaving cream from Lush, with the strapline "Because no girl wants to be prickled by her prince". This is very welcome and it's in addition to a subscription to a scurrilous magazine which I already knew about. Mrs B is pleased with her presents too, the highlight being a blue scarf with a nautical motif and a pair of pliers for removing bones from fish.

And before I forget - Happy Christmas! And a special Happy Christmas to all Hafal's clients and their families and to Hafal's excellent staff, not least those working today.

A sparrow-sized turkey will be roasted later today but yesterday we had native oysters (this means the flat, meaty ones rather than the flimsier Portuguese-style ones which are equally good and better for beginners) followed by lobster risotto (using a frozen lobster from Lidl - £5.99 - see picture below). The recipe is originally from Bill Granger, the ever-smiling Australian chef, and I've refound it on this link - you can halve his ingredients to make two generous portions or four good starters using one Lidl lobster. It is worth taking the trouble to make the stock using the lobster shell - Mrs B does this but using a base of light, white fish stock. This a really delicate dish (no Parmesan please!) and you do need a nice clean starter to complement it - hence the oysters.



Friday, 21 December 2012

Sandy Hook



I have pointed out before that the United States has almost exactly 100 times the population of Wales (just over 300 million to Wales' just over 3 million) which makes the arithmetic relatively easy when comparing statistics.

There are probably many Welsh people who would not be surprised if they were told that there were two homicides involving firearms each week in Wales. This would be a small number in terms of personal risk. In other words it would scarcely constitute a reason to change behaviour or to buy life insurance; nor, being such a remote possibility, would it logically be a reason for living in fear, though of course fear isn't always logical.

In fact two homicides involving firearms a week emphatically do not occur in Wales - that is the number we would see if we had the same rate as the USA. In reality the numbers in Wales are so tiny that no one year is typical but, based on UK figures, we might average about 3 each year.

So homicides involving firearms are rare in the USA and over 30 times less likely in Wales, not a reason for panic in either country although, all other factors being equal, if the USA had the same gun controls as Wales then they might save nearly all the lives of people killed by guns each year - that's around 10,000 people.

I have always tried not to scoff at the (to us) eye-popping libertarian tendency of US citizens which finds its most improbable manifestation in the right to bear arms. Many US citizens consider UK subjects (a word they think apposite!) to be abjectly passive and feeble in preserving our liberties and they have a point - look at the apparent popularity of the Leveson Report's recommendation to reintroduce state controls on the UK press for the first time in 300 years.

So I listened carefully to what the USA's National Rifle Association had to say in today's press conference following the Sandy Hook tragedy. But they have nothing useful to say, predictably suggesting armed guards in schools so that they can "fight back".

Of course some of the homicides involving firearms in the USA are committed by people with a mental illness, including some of the most prominent and memorable tragedies. It may prove the case this time too - we'll see. It is just common sense that there will be far more homicides where firearms are readily available because there will always be people momentarily ungrounded by extreme anger, panic in the course of committing a crime, or indeed mental illness, for whom the availability of a firearm turns what would otherwise have been an ugly but unmemorable moment into a shocking tragedy which destroys the lives of both victims and perpetrators.

Incidentally 20,000 people take their own lives with firearms each year in the USA but I guess the wretched NRA is at ease about that too.

Tuesday, 18 December 2012

Spaghettini Alle Vongole



Some links for people with a mental illness and their families who want to have a good Christmas but may have some anxieties...

• For the NHS Choices advice on keeping healthy at Christmas go here

• And for their specific advice on keeping your cool during the festivities go here

• And for their advice for people alone at Christmas go here

• Some great tips from our friend Andrew McCulloch at the Mental Health Foundation can be seen posted on their Facebook site yesterday here

My view is that it is the pressure of expectations - one's own, other people's, and the media's - which lead to difficulty. Problems can then range from the trivial, such as disappointment that the big meal doesn't live up to Nigella's seemingly effortless version, through to the very serious, such as those who feel sad feeling even sadder and left out because "everybody" says you have to be jolly at Christmas.

In truth we are the same people at Christmas as we are the rest of the year. We don't become celebrity chefs magically and nor do we suddenly acquire contentment and happiness if we didn't have them in November.

So the clue is to be yourself - and true to yourself - rather than put on an act which will put you under strain and won't in the end please other people if they really care for you.

My final tip is ... sea-food. Traditional Christmas fare is very heavy and best confined to a small number of special meals. If you want to have other special meals over the holiday then why not invest in some cockles, prawns (regular or Dublin Bay), mussels, crab, lobster (quite affordable frozen ones in Lidl), or more exotic stuff like razor clams - not expensive on Swansea market. All these make lovely meals which contrast with the traditional stuff and can be a lot healthier. Take a look at your fishmonger or check out the fresh and frozen stuff in the supermarkets.


Try this Welsh Italian delight:-

Cook 8oz/200 grams spaghettini (thin spaghetti - available in supermarkets - you could use ordinary spaghetti but go with me on this one) according to the instructions on the packet in very salty water - don't overcook (spaghettini cooks very quickly) and so keep "al dente".

Meanwhile heat two tablespoons of olive oil in a frying pan, add finely chopped garlic to your taste and cook lightly, add a very tiny amount of chilli (the heat should only just be discernable in the final dish), add a splash of white wine if you've got it and boil off quickly, stir in up to 4 oz/100 grams cooked Welsh cockles and heat through for a few seconds, stir in the cooked, drained spaghettini and some chopped parsley, adjust seasoning (a grind of pepper perhaps) and serve.

This does two hearty meals or four substantial starters. Don't add parmesan as this would be a crime under Italian law (or should be). If you want to make it look good add a few cooked cockles in their shells to the mix. An inauthentic but very pleasant variation is to add some chopped bacon (fry in the oil before you add the garlic) and/or, if you need the comfort, stir in a blob of crème fraîche (but again don't tell the Italian food police). Yum.

Monday, 17 December 2012

Stinking Billy


Queen Anne and William, Duke of Gloucester - by Sir Godfrey Kneller

An active weekend - 12,000 steps on the pedometer on Saturday and 15,000 on Sunday - but I still found time on these long nights to finish reading Anne Somerset's biography of Queen Anne: The Politics of Passion .

I confess I didn't know much about the last of the Stuarts but this filled the gap. It was a hard slog because the politics is complex, not just the comings and goings of Whigs and Tories but the added problem of James II's son the "King over the Water" (Catholic/Jacobite version) otherwise known as the "Old Pretender" (Protestant/Hanoverian version) - so called because allegedly not a royal at all but a "supposititious" infant smuggled into the queen's bedroom in a bed-pan - and the inexplicable and ultimately pointless War of the Spanish Succession (Blenheim, Ramillies, Oudenarde, Malplaquet - all those battles won by the Duke of Marlborough). I said it was hard.

I suspect that this complexity is why students stick to the Tudors - much easier to understand! Also Anne was the first British monarch never to execute anybody for treason - noble on her part (especially in view of the provocation) but not so much fun for "Horrible Historians".

Somerset tries to make Anne seem her own woman but failed to convince me that she was more than a limited personality who mainly influenced policy through delays and obstruction rather than proactively. She was arguably therefore the first truly constitutional monarch whose ministers really ran the country. We've never looked back.

Not that her family was much better. I already knew that her father the deposed James II was a clot with tyrannical tendencies but I hadn't fully appreciated what a boorish and prickly character was his usurper (and Anne's brother-in-law) William II - also known as William of Orange or "Sweet William" (to Protestants/Hanoverians) or "Stinking Billy" (to Catholics/Jacobites).

But nobody comes out worse than the appalling Sarah, Duchess of Marlborough, who patronised and exploited Anne mercilessly and then betrayed her confidence and put it about that she was gay - a cruel "outing" in those days even if it had been true but it almost certainly wasn't.

Poor old Anne went through 17 pregnancies but was predeceased by all her children including William, Duke of Gloucester, who died aged 11 (you can see the signs of hydrocephalus which killed him in the picture above). Had he survived they wouldn't have had to import those Germans who still squat like cuckoos in the privileged nest of British monarchy.



Postscript:

20 years ago my Catholic friend Nick dragged me across Paris to Saint-Germain-en-Laye to look at the palace and memorials of the Jacobite court in exile which struggled on to launch the 1715 and 1745 rebellions and then slowly became objects of romanticism for Sir Walter Scott, Queen Victoria (oddly enough, given that she was their usurper's descendant), and latterly Hollywood (eg Errol Flynn in
The Master of Ballantrae - 1953).

Interesting, but I wasn't moved. In truth they were a snooty and despotic lot without a care for ordinary citizens. The ones we ended up with instead may not be much better but they soon relinquished any major function in running the country so that today their successors' personal qualities and views of the world can be matters of indifference to us.


Postscript 2:

My Mum tells me that my story about the bigamous marriage (see this link) is incomplete: the mayor who inadvertently witnessed the illegal ceremony was also the daughter of the Archbishop of Canterbury. You couldn't make this up.


Friday, 14 December 2012

Downing Street "Domestic"



The drugs legalisation debate has started up again and overnight I read that this has turned into a "domestic" between the PM and Deputy PM who are scowling at each other across the Downing Street breakfast table - see the story here.

I am sceptical of some claims of a direct correlation between drug use and specific mental illnesses but I am in no doubt that drug use is a major contributor to mental health problems and a major obstacle preventing many people with a mental illness from recovering. However, I may be missing something but I cannot work out how legalisation could assist in diminishing drug use - which is surely everybody's objective aside from a few ghouls who celebrate intoxication and addiction.

Of course not legalising drugs doesn't mean authorities can't act proportionately. So, for example, most people agree that there is rarely any point in prosecuting individual users - and that is indeed the usual practice of the police. But the illegal status of drugs does give the authorities some leverage to push those who are at risk from their addiction towards treatment and recovery.

The illegal nature of supply obviously creates its own problems and risks and, yes, you could put a lot of criminals out of business and ensure some quality and safety standards if you permitted drugs to be freely and cheaply available - but who believes that would reduce drug use and addiction?

There appears to have been a small drop in drug use in recent years and that is to be welcomed. Nobody can claim that the decrease is because of hugely effective law enforcement but equally who doubts it would have gone up if drugs had been legalised?

The majority of people steer well clear of illegal drugs because (1) drugs are a bad idea, (2) they wouldn't readily know where to get hold of them, (3) they don't want to do business with criminals, and (4) they don't want to get into trouble with the law. Legalisation would cast doubt on reason (1) and wholly remove reasons (2), (3), and (4).

Drugs should remain illegal but we should recognise that law enforcement only keeps an unstable lid on the problem. Education for those not yet using drugs and for those who have started using, plus assertive treatment for addiction are the way ahead but nobody said it was going to be easy.

Register Office


St Cadog's Church, Llangadog

My father married hundreds of people. No, this is not a tale of wayward parenting and childhood woe - he had a Saturday job (in addition to his Monday to Friday one running a local authority) as a Superintendent Registrar which involved checking out couples' paperwork then marrying them at the Register Office (sic - it's not a "Registry Office").

He had some good stories including the occasion when a couple turned up without a witness: my dad suggested they pop out into the street and find a passer-by which they did and by chance it was the Mayor who sportingly came in and duly acted as a witness. Some time later it was discovered that the marriage was illegal because one of them was already married - cue small town embarrassment all round.

Perhaps it is memories of this that make me ponder the institution, especially in these times of debate about gay marriage. Personally I have no problems with gay marriage but I do have an unusual proposal which might assist the Prime Minister as he grapples with the antis. Why not just pull the state right out of marriage? There is very little legal meaning to marriage these days because the law quite rightly concentrates on the welfare of children and fairness between couples who separate whether or not there is a marriage.

Without state involvement churches or anybody else could "marry" people and give them any certificate they fancy - but none of it would have any state endorsement. What's to lose? Who wants or needs the state to validate their private decisions about who they want to live with and what ceremony or form of agreement they want to use? And there is a lot to gain - no need for Registrars, Register Offices and the state could give up all that pointless paperwork and concentrate on the issues of children's welfare and fairness on separation. And of course there would be no role for the state in considering who can and can't marry - that sounds right.

Just an idea.



Postscript:

I got married in church for reasons of form and tradition rather than faith, something which involved some economy with the truth when the future Mrs Blog and I were quizzed over tea and rich tea biscuits by a Trollopean Rural Dean who probably didn't believe our protestations of religious fervour (he'd never seen us before) but couldn't do much about it.

Of course English heterosexual sweethearts can force their Established Church parson to marry them even if they are paid-up Jedi Knights - the seventh most popular religion in the UK according to the 2011 census although worryingly at 176,000 adherents it has halved in 10 years. O tempora o mores!

Thursday, 13 December 2012

Jerusalem



Imagine a time and a place in the future where people with a mental illness can choose which psychiatrist they go to and choose where they go for treatment and care - and where that choice isn't confined to the NHS but includes private and third sector provision too.

Quite a thought, eh? It could really shake things up not just because patients could get the help they want but mental health practitioners and services would be compelled to take notice of patients' wishes instead of just saying "here it is - take it or leave it" (or, if the patient is subject to the Mental Health Act, "take it whether you like it or not"). Patients could vote with their feet and services would have to work really hard to provide courteous, respectful, and effective services - because if they didn't they would go out of business.

"And what is the point of this day-dreaming about building Jerusalem, Bill?" I hear you ask. But it isn't a dream. That place is called England and the time when it happens is April 2014: see the story here.

Come on, Welsh Government, don't get left behind. You've done a good job with the Mental Health Measure but - read my lips - YOU WILL NEVER ACHIEVE EXCELLENT MENTAL HEALTH SERVICES IF YOU DON'T GIVE PATIENTS CHOICE AND CONTROL OVER THEIR TREATMENT AND CARE.



Postscript:

England's unofficial anthem "Jerusalem" is of course by William Blake who had some symptoms of schizophrenia, in particular vivid visions which he ascribed to God. Many of his contemporaries thought he was mad but the conventional wisdom these days is that he was just a genuine free thinker ahead of his time. I think he was probably both...

The music to which Blake's poem is set is by Sir Hubert Parry. I would like to be able to tell you that Parry was Welsh - and indeed many people think he was because of the name and because there are so many famous Welsh composers of hymns - but he wasn't.


I will not cease from mental fight,
Nor shall my sword sleep in my hand,
Till we have built Jerusalem
In England's green and pleasant land

Wednesday, 12 December 2012

What's In A Name?



Lots of interesting stuff coming out of the Inquiry into the Schizophrenia Label - see this link.

I don't inhabit the wilder shores of antipsychiatry but I do think there is quite a lot of hocus and dodgy science in psychiatric diagnosis - and schizophrenia is a case in point. It sounds (because it's Greek?) like a definitive diagnosis but in reality it depends on some rather arbitrary scoring of disparate symptoms which don't add up convincingly to a single, specific illness.

And yet... many of those who experience schizophrenia, their families, and those of us who work to support people with a serious mental illness know very well what schizophrenia is and it's obviously an illness even if we can't pin it down scientifically.

So I'm not sure I can agree with the Inquiry's view that "it is time to move away from psychiatric diagnoses and support people as fellow human beings rather than as people with a medical illness". This is in any case tendentious because of course you can give somebody a psychiatric diagnosis and also support them as a fellow human being. The serious question remains whether diagnosis makes sense and, on balance, I do think you have to give illnesses a name and indeed many patients draw comfort and understanding from knowing their illness is recognised, not unique to them, and that there are tried and tested treatments (however imperfect) and pathways to recovery. Of course the diagnosis of schizophrenia is very difficult to bear but calling it something else or nothing at all isn't going to make things better sadly.

What is needed is much greater honesty about the vagueness of the diagnosis and I certainly agree that attention needs to be placed on recognising and treating the specific symptoms of individual patients rather than focusing on the schizophrenia label - good psychiatrists do just that in our experience but there isn't consistent practice.

For an honest decription of the illness see Hafal's leaflet on schizophrenia here.



Postscript:

Many people will recognise this post's title from Romeo and Juliet (Act II Scene 2) -

What's in a name? that which we call a rose
By any other name would smell as sweet

Less well known is the immediately preceding half line -

O, be some other name!

So says Juliet wishing Romeo wasn't a Montague and some people would say the same about the schizophrenia label. But, as with the rose, name changes don't alter the reality
.



Tuesday, 11 December 2012

Crime-Fighting Dentist



People with a serious mental illness are frequently victims of crime on the streets of Wales for a host of reasons:-

• Bullies who know about their illness may pick on them as easy targets

• Thieves may similarly mark them down as targets

• The stigma of mental illness can lead to hostility based on irrational fears

• Odd behaviour - talking to oneself, involuntary movements and facial expressions (often the result of medication) - can draw unwelcome attention

• If patients are "ungrounded" or over-confident (for example when on a "high") they may make poor judgements when communicating with strangers

• Genuine misunderstandings can occur if somebody is suffering illusions - not that this excuses a criminal response

• Homeless people - many of whom have a mental illness - are disproportionately exposed to crime

Sadly a high proportion of patients and their carers have stories about low level assaults and occasionally about much nastier events. For this reason we should take a lively interest in schemes to reduce violence on our streets and in that spirit we should celebrate the work of Professor Jonathan Shepherd of Cardiff University who is making a name for himself in this field. Today it is widely reported that the authorities in Amsterdam have beaten a path to his door to find out how to reduce the effects of violence in the Dutch capital.

So is Prof Shepherd a criminologist or high-tech security expert? Indeed not - he is actually a dentist. But we shouldn't be so surprised as it is dentists who see the results of all too many violent assaults where teeth, jaws and mouths are so often damaged. The professor's brain-wave was to suggest looking into where his patients got hurt in the first instance (these assaults are often not reported) and share that with the police and others so that the problem can be addressed in an intelligent, targeted way. This approach has already been taken up across England and Wales.

The results are impressive. See the story here and the professor's web page here: note that he has got the psychiatrists and psychologists aboard his team too.

Friday, 7 December 2012

Welsh Blamed For World War



I recently commended A N Wilson's brilliant history The Elizabethans - see this post - and this led me to log onto Amazon (I know, I shouldn't because they aren't paying enough tax) to buy and read his substantial history of the first 50 years of the 20th century After The Victorians: The World Our Parents Knew .

Wilson famously annoys many people and he certainly enjoys being a bit naughty about iconic if not saintly people and institutions. Wilson doesn't ignore Wales and he must be the first historian to suggest that the Welsh Disestablishment movement was one cause of the First World War - in as much as the British Government saw it as one of a number of threats to the British Empire which might usefully be placed to one side if war was enjoined, notwithstanding the fact that Disestablishment was achieved under the Welsh Church Act in 1914.

My family is entirely innocent in this, I should say, as my grandfather was a leading proponent of Antidisestablishmentarianism. I had wondered uncharitably if he might have been motivated in part by the £800 a year plus elegant house which he enjoyed as vicar of Ammanford but it is good to know that he was actually attempting to prevent the satanic forces of Welsh Nonconformism from precipitating a holocaust on the fields of Northern France.

Conversely one might note (Wilson doesn't) that the only serious popular opposition in Britain to the war in 1914 came not from international labour solidarity (as some expected but in reality all those ties between workers evaporated instantaneously) but from...Welsh Nonconformism, the pacifist instincts of which were only with difficulty overwhelmed by the old goat Lloyd George himself.

Wilson also doesn't shy from mentioning the anti-Jewish riots in the Valleys in 1911, something not much discussed today because they upset the saccharine and false memory of an idyllic solidarity in those communities in the industrial age, a mythic fantasy according to which the only conflict was with capitalists. Sadly poverty and oppression don't necessarily make people nice to one another.


My picture shows a detail from Guildford Cathedral (1936) which I visited last weekend having read about it in Wilson's book.

Beau Geste



Last week I attended the annual conference of my "trade union", that is the Association of Chief Executives of Voluntary Organisations. You might expect this to be a gathering of progressive, bleeding-heart liberals but actually they are quite business-like - and literally look and sound like business people as I suppose we are. ACEVO's eccentric but effective Chief Exec Stephen Bubb was knighted a year ago adding to the Establishment feel of the organisation.

It is valuable to catch up with colleagues as you can learn from the successful ones and discreetly take selfish comfort from listening to the ones who have come a cropper - and take note how to avoid the same pitfalls.

My Mum had been talking to me the night before about the recently-published Counting One's Blessings: Selected Letters of Queen Elizabeth the Queen Mother edited by William Shawcross (I think my Mum thinks I have been a bit rude about the late Queen Mum - see this post - whereas the letters apparently show she had some sense and sensitivity).

Anyway, at the conference the same William Shawcross shows up because he's the new Chairman of the Charity Commission. In his speech he suggests that the Commission is going to desist from taking a look at whether certain religious groups actually do society any good. I don't agree at all as I think the Commission should indeed take a long, hard look. I'm not thinking of the poor old embattled C. of E., Catholics, Muslims, etc but those disturbing cults you can't name because they sue on the least provocation.

He also indicates he wants to reestablish the principle that charity is essentially about private philanthropy. When he takes questions I challenge this because he ignores the modern phenomenon of charities using statutory funding to deliver services when they are the best people to do this, especially if led by their beneficiary group (like the exemplary Welsh mental health charity Hafal). He replies reassuringly about "just taking a look" but we must keep an eye on this. Of course there are great charities which depend on private donations but also suspect ones which spend too much on seeking those donations. Charities are not morally superior because privately funded. Good to see Sir Stephen agrees with me - see this link.

We also hear an amusing speech on "Leadership Under Pressure" from Corporal Johnson Beharry VC. I'm not sure if his compelling story of derring-do will help me much practically when I come under pressure in my job but I now have some tips about what to do if I ever find myself driving an armoured car into a Taliban ambush in Afghanistan - unlikely in terms of risk management but it's as well to be prepared.



Beharry's story is not the stuff of classic, one-dimensional Beau Geste nonsense but truly a tale of redemption following a startlingly misspent youth. He has also spoken out frankly about his mental health problems and the need for better mental health care for soldiers and veterans.

The conference is next to the Tower of London, enabling me to take this picture with the Shard behind...