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Evidence for the Generosity etc

In her somewhat sour response to R.W. Johnson’s Diary, Lara Pawson makes two mistakes, one of interpretation and one of fact (Letters, 27 August). First, Johnson’s statement that the proposed NHI scheme would ‘end access to First World healthcare for everybody’ clearly does not mean that everybody in South Africa has access to it at present, but that if the NHI scheme goes ahead nobody will have access to it, because it will cease to exist.

Second, Pawson writes: ‘Even those of us in the First World might dispute Johnson’s earlier and contradictory claim that “First World hospital care” is what saved him.’ Those who rely on Google for information on rare medical conditions might do so, but anyone with any real knowledge of necrotising fasciitis certainly would not. The figures quoted in the articles retrieved by Google quote mortality figures of, typically, 20-30 per cent for those without multisystem failure, and at least 70 per cent for those with it (as in Johnson’s case). These are the statistics for patients treated with First World hospital care: without it, the mortality is essentially 100 per cent. The fact that a man called David Walton died despite being admitted to Cheltenham General Hospital is irrelevant, even if this is considered to be an example of First World hospital care. I write as one who has worked in First World and non-First World hospital medicine since 1965. There is no conceivable doubt that Johnson would have died without exceptionally high level hospital care, given that he needed ventilation, dialysis and maximum inotropic support (adrenaline). I would be interested to know to what Pawson attributes his survival if not to the medical care he received: divine intervention, perhaps?

George Haycock
London SE3


In Ürümqi

I am in complete agreement with Keith Sellars about government-sponsored Han Chinese settlement in Xinjiang and should have been more explicit about it in my article (Letters, 10 September). Since the founding of the People’s Republic in 1949, there has been a concerted effort by the government to ‘develop the west’. The main entity in this process has been the Xinjiang Production and Construction Corps (XPCC), formed from soldiers forced to retire from the People’s Liberation Army. Between 1952 and 1954, 170,000 were sent to Xinjiang to set up state-owned farms (bingtuans) and industries, in many cases on land confiscated from Uighurs. The XPCC is a unique institution in China, in that it is administered independently of the Xinjiang provincial government. It has its own police force and courts, as well as its own network of forced-labour camps and prisons. In one of its marching songs it describes itself as ‘an army with no uniforms’. Many towns in Xinjiang are encircled by bingtuans, which makes it easy for the government to quell any form of unrest. After the 5 July riots in ürümqi, soldiers from the XPCC played a central role in keeping the city under martial law.

Unsurprisingly, the XPCC, in both its economic and military capacity, has been a source of considerable resentment for Uighurs. While unemployment is high among Uighurs, the XPCC has been conspicuously successful: for instance, most petrol stations in Xinjiang are run by the XPCC.

But despite the many grievances of the Uighurs, the most recent unrest in Ürümqi has come from the Han Chinese. On 17 August there were reports of people being attacked with hypodermic needles. As the stabbings continued, the perception grew among the Han that they were being targeted. Although the government stressed that Uighurs and other minorities were also among the victims (of whom only 20 per cent showed any physical injuries, suggesting that many of the claims were due to fear or scaremongering), Han residents demanded that more be done to protect them, culminating in demonstrations in Ürümqi on 3 September. These grew in size until on 5 September, Xinhua, the official news agency, reported that tens of thousands had taken to the streets. Tear gas was used to disperse the crowds, which led to five deaths and many injuries. Afterwards the regional police chief was removed from his post, along with the city’s Communist Party secretary. The police announced that they had charged four suspects, all Uighur, three of whom were said to be drug users.

Though these measures seem to have appeased the Han residents’ anger for now, it remains unclear whether the Han were actually being targeted (given that they account for 75 per cent of the population of Ürümqi, they are most likely to be the main victims). What seems more certain is that the authorities, who are usually politically cautious, will make even greater efforts to be seen to be combating ‘separatism’ – the attacks are already being described by the government as ‘violent, terrorist crimes’. This is likely to lead to continued repression of the Uighurs, which will only provoke greater resentment, and increase the likelihood of further violence.

As regards my original description of reports of alleged atrocities as ‘hysterical’, with which Keith Sellars takes issue, this does seem to me an appropriate way to describe the World Uighur Congress’s claims that people have had their heads placed ‘on a stake in the middle of the street’, not because I doubt the possibility of such things occurring but because of the partisan nature of the source, and more important, the continued lack of any corroborating witnesses or evidence that such events took place.

Nick Holdstock
Edinburgh


How shall we think about Churchill?

Bernard Porter is surely right to doubt Carlo D’Este’s assertion that Churchill (or any other individual, come to that) ‘was the first to introduce marching songs’ (LRB, 27 August). Marching songs must have been around for as long as troops have been required to march in step. William III’s troops marched in 1688 to ‘Lillibulero’, and it is likely that the New Model Army did so before them: the tune, of uncertain origin, had been widely popular, with an anti-papist lyric, since 1641. In America, the Union armies marched to ‘John Brown’s Body’, and both sides marched to their own versions of George Root’s ‘The Battle-Cry of Freedom’. The Confederate troops’ adoption of the traditional song ‘Green Grows the Laurel’ as a marching song is probably the origin of the Mexican sobriquet ‘gringo’.

As to the First World War, in which Churchill served from 1915 to 1916, Eric Partridge’s anthology The Long Trail starts with a section of 33 songs ‘predominantly sung on the march’, followed by another 17 ‘sung on the march, but more often in billets and estaminets’. None can conceivably have been the work of an officer. Not one of them is aggressive or triumphalist or even hortatory. Most were sung to hymn tunes or were parodies of popular songs. They range from the blank resignation of ‘We’re here because we’re here’ (to the tune of ‘Auld Lang Syne’), through ‘We are Fred Karno’s army’ (to the tune of ‘The Church’s One Foundation’), to the bitter tabulation of privilege and rank in ‘The Old Barbed Wire’. The latter (‘If you want to find the quarter-bloke, I know where he is – miles and miles behind the line … If you want to find the CO I know where he is – down in the deep dugouts … If you want the old battalion, I know where they are – hanging on the old barbed wire’) is the story of Churchill’s war, with his private bath and boiler being towed around behind him.

Anyone who remembers Joan Littlewood’s Oh! What a Lovely War will remember ‘When this lousy war is over’, sung to the tune of ‘What a friend we have in Jesus’. Partridge’s version, which he lists as a marching song, starts ‘When this blasted war is over’. But in 1966 I recorded the song from a Kentish traveller, Joe Cooper, who had fought in the trenches, had survived two gas attacks (‘it rolled towards you like the early mist in the hopfields’), had found himself homeless and jobless on demobilisation, and had married a Romany woman and gone on the road. The version Joe remembered began ‘When this wicked war is over’.

Stephen Sedley
London WC1

Bernard Porter refers to Carlo D’Este’s account of Churchill’s ‘much self-publicised “great escape” from the Boers in Pretoria’. Since Churchill himself gave at least three different versions of this story, it has long been time for the truth to be revealed. My grandfather was a fellow POW and my father passed his version on to me in a letter many years ago. My grandfather and others had ‘made a plan to escape, and dug a tunnel under the wire. Churchill, regarded as utterly unreliable, was rigidly excluded from the plan, but managed to discover the escape was planned for a certain night. The night before, he managed to get through the tunnel and escape, destroying all chance of escape for the 20 to 30 men who had dug the tunnel, as Churchill’s absence was immediately noted at roll-call in the morning.’ It appears that two others, Haldane and Brockie, claimed that they had been going to go with him but were left in the lurch. ‘It did not enter my head that he would play the low-down game of going without us,’ Haldane said.

Tim Gallwey
Oloron-Sainte-Marie, France

Bernard Porter wonders whether Britain in 1940 could have found a leader with ‘a better grasp of military strategy’ who might have done the job more quickly and more efficiently than Churchill. But it was Churchill with his singular command of strategy who saw the immediate need, once Pétain had done the deal with Germany, to destroy the French fleet at Oran before it was used by the Germans as the determining factor in an invasion force. Again only Churchill, as a former First Lord of the Admiralty, had the authority to overcome the strong opposition within the Admiralty itself. But with this decision, he showed the world, and America in particular, that Britain, when necessary, could act as ruthlessly as Germany.

Colin Lovelace
Anglet, France


Keep me in!

The list of stories of unjust incarceration for insanity is long, as Susan Eilenberg suggests (LRB, 23 July). Does it still happen? Or have things gone in a completely different direction?

I have been in and out of NHS mental hospitals for more than forty years. The first, following a suicide attempt, was Bethlem Royal, the old Bedlam, by then moved to a huge semi-rural site near Beckenham. On arrival my first feeling was of immense relief; I was in a safe place and didn’t have to worry any more. One almost never saw a psychiatrist; ‘treatment’ consisted of tranquillisers that kept one calm and anti-depressants that did nothing at all; this was in the days before Prozac. But the nurses were friendly and spent all day with the patients, chatting, playing games (Scrabble with schizophrenics can be very entertaining), going for walks in the grounds, even cooking meals with us. The male wing had a full-size snooker table and the female a grand piano, though the eccentricities of women playing snooker and men the piano were tolerated. After the first week or two I could even go for unaccompanied walks in the grounds. It would have been a very nice place to stay if one weren’t mad.

The fact that discharge was never mentioned merely increased my feeling of safety; when after six months I felt ready to face the world again I had no idea how to arrange to be discharged and was a touch afraid that if I asked they might try to keep me in – ‘section’ me, as it’s called. So one day I just walked out. No one came after me.

Three or four years later I was in hospital again: this time at Broadgate, near Beverley in Yorkshire, a huge Victorian place with its own farm. Things were much the same as at Bethlem. Uniquely, I was privileged to see the chief consultant psychiatrist once a week, but that was because I played trumpet to his trombone at the Saturday dances. The nurses spent all day with the patients here too, the only difference – in retrospect an ominous one – being that they had to write brief daily reports on the patients. This duty was taken lightly; one report I saw said: ‘Patient rose at ten thirty and spent the rest of the day in a horizontal position.’ I came across a lot of people shuffling about the corridors who had been in the place many years: however they had come to be there, their only ‘madness’ now was that they were quite unfitted for life outside. Again, after six months I simply walked out.

Looking back, those two places did me a lot of good, in spite of the absence of real treatment. Merely being in a sheltered environment, protected from self-destruction for as long as I needed, was therapy enough. For many years I managed to avoid going into hospital, except for a year at the excellent, intensive, highly successful and soon closed down Paddington Day Hospital.

But about nine years ago I was close to suicide again and found myself being taken into another hospital. Things had changed. Now we had the policy of ‘care in the community’. All notion of protection, of asylum, had gone: a patient (or was it ‘client’?) information leaflet explained that one’s stay would be as brief as possible. Nurses no longer spent much time with patients: they were closeted together in an office filling in ‘care plans’, and could get quite cross if one knocked on the door to point out that a patient was smashing up the furniture or another patient. Usually, in fact, knocks on the door were ignored. True, we saw psychiatrists as often as once a week, but their concern was to see whether we were ready to be discharged. We lived in dread of being called before the psychiatrist: many, including myself, tried to seem madder than we were in the hope of delaying discharge. I managed to stay a month – twice as long as the ‘target’ period – before being ejected despite my vigorous protests.

I was soon back. Returning to the same hospital I expected the nurses to be surprised and disappointed to see me again; they batted not an eyelid. Soon I noticed familiar faces among the other patients; people who had been discharged during my earlier stay and who were back again. Nine years later I have lost count of how many times the NHS has ‘cured’ me of severe depression. Clearly the new policy is statistically – and that’s what counts – very successful. It must have cost them far more than one long stay, but they’ve had half a dozen cures instead of one.

At present, two kinds of people are admitted to NHS mental hospitals: those bonkers enough to be a social inconvenience and those depressed enough to be ready to do away with themselves. If one’s desperate enough to want to get in, the magic word ‘suicide’ whispered in a suitably shamefaced sepulchral tone will do the trick. But mad or sad, one will be out again in two weeks. And back again in another two.

Simon Darragh
Walmer, Kent


Speaking up for the 1970s

It was disappointing to read Ian Jack echoing rather than challenging all the old prejudices about Harold Wilson’s premiership (LRB, 27 August). He must by now recognise that many of the fables and legends about Wilson are unfair and inaccurate. Wilson was a more effective figure than, say, Tony Blair both as prime minister and as leader of the Labour Party – and not only in his policy on Vietnam compared with Blair and Iraq.

The gossip about his drinking habits is quite out of place. Until his final years he was an extremely modest drinker. His ‘brandy period’ was entirely reflective of seriously failing health. At the height of his powers he was unmatched as a parliamentarian, and only now are we beginning to appreciate his handling of that most complex period, the 1960s, which Ian Jack describes as ‘a transformative decade for most people in the Western world’. At the same time he was far from ‘off his trolley’ in suspecting the attempts to destabilise his government, as I explain in my book From Bevan to Blair. I worked closely with Wilson in the 1970s and he was in my view one of the most important, talented and civilised of our postwar prime ministers.

Geoffrey Goodman
London NW7


More Disadvantaged than Thou

Walter Benn Michaels argues that erasing race inequality in a place like Britain would be a pointless exercise without confronting its deeply ingrained hierarchical class structure (LRB, 27 August). Such a society would merely give everyone an equal chance of becoming unequal. I’m in agreement with Michaels that ‘the correction of disparities within classes rather than between them’ is a lost cause.

Which is why I was surprised to find that he attributes this line of thinking to the authors of Runnymede’s Who Cares about the White Working Class? Perhaps the provocative title is misleading, but it paraphrases the question: when and why does the working class matter to those in power? In any case, I recognise neither the British context he describes, nor the views he ascribes to me.

In recent years, we have heard a lot about the white working class being the losers in the struggle for scarce resources, while minority ethnic groups are the winners. We wanted to ‘shift our attention from who fights over the scraps from the table, to think instead about how much the table holds, and who really gets to enjoy the feast’. What outrages us, in other words, is a situation in which ‘it is permissible to use class as a stick to beat multiculturalism with, but not as a demand for increased equality for all.’

I don’t think this corresponds to the ‘neoliberal multiculturalism’ Michaels describes. But the fact of the matter is that ethnic inequality is a persisting issue in Britain. Class inequality is rampant, but racism adds a further dimension of discrimination, so the fight for race equality is as important as ever. I share Michaels’s view that a more-disadvantaged-than-thou way of thinking benefits no one, and doubt Michaels would want to suggest that tackling class inequality would automatically rid us of racism.

Kjartan Páll Sveinsson
Runnymede Trust, London EC2