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Do I have to?

Can I make two small corrections to Rosemary Hill’s review of A Scribbler in Soho: A Celebration of Auberon Waugh (LRB, 7 November)? I was not ‘allowed to leave’ after Anthony Powell’s decision to resign as chief book reviewer of the Daily Telegraph in 1990. I stayed on exactly where I was, as literary editor of the Daily and Sunday Telegraph, until the editorial departments of the recently merged newspapers re-separated 15 months later, at which point I made the decision to leave in order to write full-time.

Neither was there anything really very ‘obscure’ about the circumstances in which I commissioned Auberon Waugh to review Powell’s Miscellaneous Verdicts. Waugh had that month joined the Sunday paper as our new chief book critic. It seemed at the time, without the powerful binoculars of hindsight with which everyone shortly afterwards was equipped, in the natural order of journalism to ask him to reflect on the collected reviews of his veteran twin, so to speak, on the sister paper. Contrary to what some choose still to believe, it was not a targeted assassination so much as a consequence of my inexperience and ignorance, which the additional responsibility of having to run two sets of books pages on successive days in this instance exposed only too rawly. Despite having made three BBC documentaries for Arena about his father, Evelyn, I confess I had no knowledge of Auberon Waugh’s antipathy towards Powell; nor did he register his antipathy when, in a thin week, I telephoned to ask if he would kick off our arrangement by reviewing Miscellaneous Verdicts. Waugh’s response – ‘Oh, do I have to?’ – may have lacked enthusiasm, but it was not hostile.

I was abroad, on holiday, when Waugh delivered his review, in which he lambasted Powell for his ‘abominable English’ and likened his celebrated novel sequence to ‘an early upmarket soap opera’ which had enjoyed a cult among expatriate Australians. It was published unaltered by my deputy, John Coldstream, who remembers thinking: ‘This is not only a spanking piece of writing, but also a pretty good instance of our policy of showing no special favours to our own contributors.’ I was sad to learn on my return that Powell had resigned, and, much regretting that this unfortunate turn of events had happened on my watch, I offered my resignation to the editor, Max Hastings, who refused it. After stepping down as literary editor in 1991, in an ironic twist that would not have been lost on either Powell or Waugh, I was retained as the Daily Telegraph’s chief book reviewer, which I remained for the next 25 years.

Nicholas Shakespeare
Sutton Mandeville, Wiltshire

Thank you, Rosemary Hill, for correctly identifying the shutdown of Times Newspapers, including the Supplements, in 1978-79, as a ‘lockout’. For a long time afterwards the BBC described the shutdown as a strike, which it was not. The print unions may have caused much disruption, but they didn’t close down the titles for almost a year. That was done by TNL management, at a cost of £39 million, paving the way for the Murdoch takeover. It took two years on my part, having been the Times official reporter on the dispute, to make the BBC tell the truth. Perhaps that tells us something about the Corporation’s attitude to industrial action.

Paul Routledge
Keighley, West Yorkshire


The NHS Dismantled?

John Furse makes a number of assertions about NHS reforms that are misleading or simply incorrect (LRB, 7 November).

Since 2017, he writes, Integrated Care Systems (ICSs) have been ‘deciding who gets which services, which are free and which … we have to pay for’. The emerging ICSs are partnerships of NHS organisations and local authorities, and may also involve the voluntary and independent sectors. They are not statutory bodies in their own right. They have no legal duties or powers beyond those of their constituent bodies, and no powers whatever with regard to charging for healthcare services.

Furse claims that the 2012 Health and Social Care Act included the ‘abolition of the health minister’s responsibility for national healthcare provision’. The Act in fact says that ‘the secretary of state must continue the promotion in England of a comprehensive health service … the secretary of state retains ministerial responsibility to Parliament for the provision of the health service in England.’

The number of Accident and Emergency Departments, Furse writes, is ‘being cut from 144 to about fifty’. This is doubly misleading. It presumably refers to a 2013 review by Sir Bruce Keogh, former medical director of NHS England. Keogh actually wrote that ‘we expect the overall number of Emergency Centres … to be broadly the same as the current number of A&E departments.’ In any case, the review is not being implemented.

On general practice, Furse writes that ‘patients are exhorted to use privately owned, profit-making online and app consultancies such as Doctaly, GP at Hand and myGP … GPs are merging their practices into competing, large-scale organisations … open to takeovers by private companies.’ The reality is that almost all GP practices are already private businesses, and have been since the founding of the NHS. New entrants such as GP at Hand work under exactly the same contract as other practices. They may work and treat patients in a different way – and they do need to be monitored carefully to make sure they don’t suck in more money than they should – but they are no more and no less private. The same is true of GPs combining into networks. These alliances are made up of collections of already private practices. They cannot be sold without those practices’ agreement.

Distracted by myths, Furse fails to mention the major problems the NHS is actually facing. The most significant of these is a shortage of staff. There are currently about a hundred thousand posts vacant, in a workforce of around 1.3 million. Meanwhile the NHS has been starved of capital investment for a number of years; the bill for ‘backlog maintenance’ of creaking buildings and equipment now stands at some £6.5 billion. Notwithstanding the promises painted on the side of a bus, leaving the EU’s single market is likely to raise costs by hundreds of millions of pounds, and if Brexit is used as an opportunity to clamp down on migration it risks worsening the staffing crisis.

The biggest threat posed by a prospective US trade deal is not privatisation, but the push by American pharmaceutical companies to get the NHS to pay more for medicines. In the US these firms enjoy a system that is extremely ineffective in bargaining down the cost of drugs. They resent the NHS’s ability to get better value by doing so.

Helen Buckingham
Nuffield Trust, London W1

John Furse sketches a chronological account of the influence of US health policy on successive British governments in their approach to reform of the NHS in England. Chronology can imply coherence, but what is missing from Furse’s narrative is any sense of how haphazard the changes have been. Far from some grand – let alone secret – plan to ‘privatise’ or ‘Americanise’ the NHS in a comprehensive manner, reform has involved a series of convoluted compromises.

These can be traced back to the inception of the NHS and its relationship with the private healthcare sector. Section 5 of the National Health Service Act 1946 made provision for consultants to continue private practice alongside their NHS workload. (‘Stuffing their mouths with gold’, Bevan called it.) The ‘pay-beds’ of the original NHS have now been superseded by private patient units in NHS Foundation Trust hospitals. New Labour’s policy of ‘patient choice’ between the NHS and private providers was made explicit by Tony Blair: ‘We should give poorer patients … the same range of choice the rich have always enjoyed.’ More recently, Andrew Lansley’s attempts to equate NHS reform with the privatisation of utilities in the 1980s met with controversy both before and after passage of the Health and Social Care Act 2012.

But while Furse accurately points out some of the links between the Ridley Report and subsequent policy developments, it is something of a stretch to argue that the current situation has evolved in accordance with a secret plan. Instead, diverse threads of competition and ‘privatisation’ have been knitted together, and proper understanding requires that we unpick them. One such thread is the expanding role of the Competition and Markets Authority (CMA) regarding not only NHS providers treating private patients, but also private providers treating NHS patients. Furse is incorrect to link the CMA with the Section 75 regulations relating to competitive tendering. These regulations, which put the previous New Labour government’s rules on a legislative footing, were introduced as a concession by the coalition government in response to mounting criticism of Lansley’s reforms. This has proved problematic in various ways, but the involvement of the CMA isn’t one of them. In fact the CMA has acknowledged that there is only a limited role for competition in the NHS, and Furse overlooks its potential to play a beneficial role – for example, in fining pharmaceutical companies which overcharge the NHS.

Furse begins his piece by remarking that ‘the Americanisation of the NHS is not something waiting for us in a post-Brexit future. It is already in full swing.’ If, by ‘Americanisation’, Furse means competition reforms and ‘privatisation’, then these are indeed not new, but have developed at a national level, entirely independent of EU law and its safeguards. He is right that there is currently no prospect of markets being removed from the NHS, but we cannot yet be sure that Brexit will not mark a turn against the deregulations proposed under the NHS Long Term Plan. Or perhaps Furse is suggesting that the NHS is being transferred to a US-style insurance-based system. But this neglects the fact that Conservative, Labour and Conservative-Liberal Democrat coalition governments have all sworn allegiance to the core principle of universal access to healthcare. How this allegiance works out in practice may well be found wanting, but there remain clear distinctions between the two systems.

Mary Guy
Lancaster University


Wittgenstein flees

Jonathan Rée writes insightfully about Wittgenstein’s life and work, but he does skate over one crucial detail (LRB, 21 November). After six years working in village schools in the Austrian Alps, Rée remarks, Wittgenstein ‘gave up teaching and returned to Vienna’. He doesn’t say why. During that stint, Wittgenstein had a habit of boxing the ears of his less intelligent pupils. On one occasion he struck a particularly unresponsive boy, Josef Haidbauer, several times. The child lost consciousness and later died; it transpired that he suffered from haemophilia. Wittgenstein fled the village the same night.

Rory Allen
York


All That Gab

Eli Zaretsky is suspicious of James Wolcott’s designation of Susan Sontag as the author, with Philip Rieff, of Freud: The Mind of the Moralist (Letters, 21 November). He would prefer that Sontag, then Rieff’s wife, be named merely as the editor of the book. It may not be fashionable to trust the teller in these matters, but given that style is something of an authorial signature and the book has rather more in it of Sontag’s style than of Rieff’s, I’m tempted to trust Sontag’s account of the book’s making. In an interview with me for BBC Radio 3’s Night Waves in January 2002, when Rieff was still alive, Sontag told me with a laugh that of course she had written the book. Back in the 1950s, when she was in her late teens, it wasn’t unusual for women to help their partners out when they were blocked. The deal was that she would write his first book and in turn he would write hers. By the time his turn came, they were divorced. Sontag never claimed the ideas in the book were hers. It’s easy to imagine the older Rieff, already a professor, lecturing the teenage Sontag. Brilliant student that she was, she made notes, took it all in and wrote in her inimitable way. What gives this account added credence is that she called her own first book Against Interpretation. What better way to kick back against Rieff and the other American Freudians of the 1950s, who were indeed moralising?

Lisa Appignanesi
London N19


Spinose

Katherine Rundell’s ‘Consider the Hedgehog’ is so cute and verbally spinose that I hesitate to point out her apparent conflation of the Old English ilespil (etymology obscure) with the early modern ‘urchin’, as used by Shakespeare in The Tempest (LRB, 24 October). Shakespeare’s word is cognate with the Middle English irchoun, which derives from the later Latin ericius – a spiked beam used for military defence and, by analogy, a hedgehog or porcupine. In the first English or Wycliffite Bible (c.1390), ‘irchouns’ take refuge among the rocks (Psalm 103:18). In a medieval cookery book (c.1450), they are a kind of finger food: small pâtés stuck with slivered almonds for spines.

Michael Kuczynski
New Orleans


Moby-Dick with Claws

‘Grizzlies loom large in North American history, folklore and popular culture,’ David Trotter writes, ‘as the exemplification of man-hating ferocity, Moby-Dick with claws’ (LRB, 7 November). When I was a child I had a book of stories by Ernest Thompson Seton called The Biography of a Grizzly. As a child in the early 1950s I remember my father reading ‘The Cubhood of Wahb’ to me. There is a passage in which Wahb’s mother and three siblings are shot by a hunter and Wahb’s hind leg is injured.

As cold night came down, he missed [his Mother] more and more again, and he whimpered as he limped along, a miserable, lonely, little, motherless Bear … not lost in the mountains, for he had no home to seek, but so sick and lonely, and with such a pain in his foot, and in his stomach a craving for a drink that would never more be his. That night he found a hollow log, and crawling in, he tried to dream that his Mother’s great furry arms were around him, and he snuffled himself to sleep.

By this time tears would be pouring down my cheeks while my father struggled to get his voice under control so that he could continue the story. Wahb survives to be the biggest and fiercest grizzly on the Graybull but never has a mate or exacts revenge on hunters. He dies of old age.

Jane Campbell
Oxford


On David Jones

Thomas Dilworth doubts my use of the phrase ‘those years’ in connection with David Jones’s participation in the First World War, as represented in the poem In Parenthesis (Letters, 21 November). I was referring to Jones’s active service, his long war, all of it held in the poem’s mirror, even if the narrated time of In Parenthesis is limited to the seven months culminating in the Somme. Because the biography does not engage more than circumstantially with Jones’s writing, it does not address the senses in which In Parenthesis might be other than ‘an informational source’. I had no interest whatever in suggesting that Dilworth leans excessively on the poem as a document, or that he does not know where it is inaccurate or chronologically deviant.

Dilworth may not have meant to suggest that Jones converted to Catholicism to re-establish community with the past, but that is what Jones himself says – ‘It seems to me that only by becoming a Catholic can one establish continuity with Antiquity’ – and it is what the biography says (to qualify its arresting thought that ‘Jones did not become a Catholic to save his soul’).

The Grail Mass and Other Works had not appeared when my review was written, but to say, as Jamie Callison does, that it ‘introduces a third book-length poem’ into the Jones canon invites qualification. The Grail Mass is an editorial event, certainly: a composite ordering of manuscript materials whose textual procedures are complex. The result is a version, just as The Roman Quarry (edited by Harman Grisewood and René Hague in 1981) offered an alternative conjectural route through the Nachlass.

Everything Jones wrote after In Parenthesis – including the ‘fragments of an attempted writing’ known as The Anathemata – was in a sense posthumous. He spent the rest of his life ordering what he had written before the latter appeared (in 1952), publishing instalments in periodical or pamphlet form, which he then gathered in The Sleeping Lord shortly before his death in 1974. He thought of his work in progress variously as a ‘continuation’ of The Anathemata, as a different poem, or (most plausibly) as a force-field of related sequences. The more of it he released the less stable his intentions became: the fragments undo the whole. The new edition properly acknowledges the Penelope-like aspect of Jones’s project – in one letter he compared it to a dream work – and the paradoxes attending any attempt to publish it as a work which can be judged on its separate merits.

What is needed now is for Jones’s official publisher to commission a proper edition of the letters and a critical edition of In Parenthesis (still in its original setting, eighty years on). Jones’s neglect, which Dilworth has done so much to broadcast, begins at home.

Paul Keegan
London NW5


A Plea

Can I put forward a plea to UK publishers in general to make greater efforts to eliminate errors and omissions from indexes, which are after all one of the most useful features of non-fiction works?

Andrew Huxtable
London SW20