You know you are living the dream when you are blogging political commentary on your birthday. The last time I thought about politics on my birthday was 2001 when Tony Blair was voted in for his second term, which seems a long time ago. Far more is at stake now. My work spans three worlds: medicine, science and education. All three sectors are jeopardised by Brexit, but there are more important problems than Brexit on the table. Like all public services, these three have already been strangled by cuts. Information, what we stand for, and what we stand against have become the areas most crucial to how I am voting.
In the NHS, we are governed by evidence-based medicine, where we try to use the best possible data to inform our decisions in healthcare. In research, we plan the best way to find answers to questions by gathering data when it does not exist, and analysing that which is available. In teaching, we equip people with the skills and the knowledge to facilitate the best use of available data in their decisions. Information is the thread running through everything I do. Despite the age of "big data" and near ubiquitous internet access, data in this country and under this government has never been so threatened. Like water, data can be polluted by the source, the supplier's inadequate cleaning or the consumer's lack of filtering. Examples of source pollution are reinforcement of incorrect information (e.g. the supposedly huge net cost of immigrants to the UK economy), bias (e.g. media giving UKIP a voice when they have no MPs), and suppression of data (e.g. abuse of "purdah" rules to prevent full disclosure of NHS debt and performance measures before this election). The unclean supply of data is perpetuated by partiality (e.g. considerably more questioning of Corbyn's stance on funding for Trident than flows of arms and funds to the Middle East under May's watch in the Home Office, or imbalanced coverage of nationalisation of certain services) and intimidation of suppliers (e.g. bullying and harassment of whistleblowers, whether in NHS, police or education). Our filtering is limited by our capability to discern true from false data (e.g. excess weekend mortality in the NHS which was entirely unscientifically blamed on junior doctors). Without clean data, its wide coverage and our ability to interpret it, data may as well not be there. In healthcare, we talk about "informed consent" where you need information to give your consent. We have moved away from "informed democracy", with considerable worsening in the last 5 years, as exemplified by the flagrant disregard for facts during the Brexit referendum. I hope that removal of the May government will lead to cleaner water for all of us.
What should we stand against in the UK? We can all agree on several things I am sure, including terrorism and human rights violations. However, the current government has picked some unconventional opponents within our own society. First, Michael Gove's declaration that the "people in this country have had enough of experts" before the Brexit vote last year is symptomatic of how Tory politicians have encouraged our mis-education. I would always argue that everybody has limits to their knowledge and expert opinion is required by all of us to encourage debate, to be informed and to make decisions. Ironically, the UK's experts, whether in academia or industry, in science, arts or economics are valued overseas, bringing hard and soft power and income to the country. Second, nothing has united police officers and nurses, social workers and council employees, teachers and prison officers like austerity. In the NHS, we cannot provide the services we could a decade ago, not due to the "ageing population" but due to deliberate under-resourcing, and I have worked next to colleagues using food banks for the first time in the 21 years since I started medical school. In the education sector, we are charging higher tuition fees than ever before, endangering access to education. In research, universities are being forced to cut jobs, while struggling to recruit staff and students. Access to health, healthcare and education are human rights and are the most powerful determinants of all manner of outcomes across our lives, from survival to income. The public services of this country are the means by which we give people a chance in life, and again, ironically, have been used as exemplars abroad for decades. Theresa May's anti-public service stance has reduced access to services which a high-income country can provide to its citizens. Moreover, when the country faces an emergency, it is these public services, not corporate entities, which we all rely upon and which deliver, as the recent attacks in Manchester and London illustrate. Third, there is no effort to connect with the "common man". It is serving this government's purposes to increase the divide between rich and poor, within and across communities. The government is well-served by targeting the wealthier segment of society which loathes rising taxes and increasing government intervention. Anti-expert, anti-public service and anti-populist ideologies ensure that we can be manipulated on the basis of our fears rather than information, such as Theresa May's call for change to human rights laws.
What makes us civilised? What should we stand for in the UK? The most patriotic on our island hark back to a time when Britannia ruled the waves and the sun never set on the British Empire. Instead, I would argue that our civilisation is in our views, our equality and our safety. First, the UK is open-minded, welcoming and outward-looking and whether in healthcare, education or research, our institutions and our systems are respected the world over. There really is nowhere I would rather be than the UK to do what I do. However, under May's watch, the UK is becoming more divided inside and out, and looking inward when it should be embracing the outward opportunities. Second, these institutions need feeding and watering, but like the public service workers, they are being starved to make way for private companies, where unsurprisingly, government conflicts of interest are rife across all sectors. We do not take conflicts of interest seriously enough in political life in the UK. These trends are not only creating inequality in access to service which is against our British values. They are creating income inequality, educational inequality and health inequality on a scale which a G7 country should not be aspiring to. Third, the safety of a country and its citizens is what makes it "strong and stable", not words. We have all understood how chronic underfunding of policing and anti-terror missions can reduce our security this month, but that same underfunding lies at the root of the lapses in "cyber-security" in the NHS less than a month ago. Moreover, the underfunding of healthcare, welfare and education will ultimately lead to insecurity in our communities.
The alternative is that we aim for a more open, more equal and safer society, where the great things in the UK are preserved. It doesn't matter who you vote for as long as it is not Mrs May. That would be the best birthday present for me and the best present for future generations.