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In the last two posts I made the point that people of all political persuasions and academia make a fundamental mistake when they do not factor human fallibility into their thinking. That was why there are so many cock-ups and, by way of illustration here, the disastrous policy of Inclusion in special education. In this one I want to make one further point. The other thing that they often do not factor into their thinking and, in this instance, encourage is the quest for excellence. This is more important not less when you are making cuts and economies to make the money go further.

Excellence is an elusive commodity. You can sense its presence. You can sense even more its absence. The Royal Family parade it. The Royal Opera House at Covent Garden exudes it. Eton and Oxbridge sell a form of it. The UK would be a poorer place if they didn’t. I know that they give people the feeling that it is something to do with elitism, with affluence, with money, but don’t be deceived. Money no doubt helps, but it is not of the essence.

I want to explore its essence. It is not money. It is an attitude of mind and it flows from the heart. There has to be some passion, some feeling for it. Charles Darwin, for one, understood it. It is as natural as the roses in your garden, and, when you find it, every bit as beautiful.

In my own life I have tried to pursue it, tried to create it, not always successfully. Sometimes I have just lighted on it; I have sometimes simply found other people of the same mind and purpose, very much so today in the residential care home I chair.

This post enables me to mention Barbara Priestman School, a school for physically disabled children with a learning difficulty in Sunderland where my own involvement with Special Educational Needs began. Not to tell the story of why it is still there today, because that is in the history book of my diary, but because it exemplifies what I want to write about here.

When I became a governor of this school and then chair of governors it was already a school wearing the badge of excellence, giving meaning and substance to its mission statement Whole School Whole Child.

What made it so? A clear sense of purpose from the top – from the Head teacher and his deputy, shared totally by his staff, enjoyed by pupils and appreciated by parents.

What ultimately took me over was witnessing the sheer vandalism of the attempts to close it and others like it. Fortunately the Sunderland Local Authority came round to respecting the wishes of parents, and it is there to this day.

I was not quite so fortunate with Qualitas where again I found like minds in UK’s Furniture and Carpet Industry; manufacturers and retailers, who wanted to improve the way their products were sold, making sure that they were properly tested with labelling as to use of a kind you will find with electrical equipment. Not everyone had the same agenda and when the pressure from Government for change evaporated so the enthusiasm for excellence waned. Pity, even though ultimately it led to Qualitas Conciliation Service and now to the Furniture Ombudsman.

What I am trying to say here is that the pursuit of excellence must come from the top and it must be shared. It also must be sustained. When it is present, it will be enjoyed. When it is absent, its absence will be suffered, most recently if you are a tourist to Britain arriving at Heathrow.

But what I also want to say here is that there are many people with a different agenda. They see no virtue in it. They begrudge it, see it as intrinsically unequal which it is. That’s why they got rid of State Scholarships when you should invest in the best. They are jealous of those who exhibit it and they breach the Tenth Commandment “Thou shalt not covet”. Remember Stephen Lawrence and kids like him. This explains why they were murdered. Others pour scorn on the competitive spirit that is natural to it and on those who aspire to it, the boys they label “swots”. And they will do their level best to thwart it as they validate their own destructive cynicism.

In the words I have given to Tracy in the closing moments of my play, I describe these people as “Termites” – people whose main preoccupation in life is to build and defend their own nests.

Sarah Teather, UK’s Minister in charge of special education, said all the right things in a Government Green Discussion Paper in the Spring of 2011 and promised a White Paper with specific proposals in the Autumn and, yet, here we are, in May 2012, with absolutely nothing so far on the table. I suspect that the “termites” must be hard at work.

Meanwhile even as I write this I read an article by Kerra Maddern in this week’s Times Educational Supplement entitled “Stamp of failure. Is the special needs system being used to excuse underachievement? – SENtenced to failure?” . A White Paper may be about to emerge. But what the article makes clear is that the policy of Inclusion as it has been implemented is a disaster and that the system has totally lost sight of those children with needs that should be addressed by trained teachers and therapists in amongst those only loosely categorised as having special needs but who are just deprived or otherwise socially disadvantaged. They need a different policy altogether.

But let me end up on a positive note. When so much we read in the newspapers or hear on TV is depressing, it is all the more important to treasure the good and the excellent things around that are widely enjoyed.

The Sage Gateshead is one of them.

Visit http://thesagegateshead.org. and you will see what I mean.

Everything about this Concert Hall bears the stamp of excellence. The original vision by Gateshead Local Authority. The design of the building with its superb acoustic properties by Norman Foster. The resident orchestra, the Northern Sinfonia under its director Thomas Zehetmair. The general management under Anthony Sargent and his team. The range of music from Classical to Folk, Jazz and Rap. The performers from around the world, from Senegal to Sweden, India to Iraq, Brazil to Norway and the home grown stuff too. The encouragement of young musicians , most recently the presence of the National Youth Orchestra and the competition for the BBC Young Musician 2012.

I could go on. Suffice it to say that a fine building brings the best out of all the musicians who play here, and I and many others enjoy the blessing of listening to it.

Likewise there are many fine and dedicated people around in all the professions and in all walks of life. We shouldn’t continue to allow “bad apples” to spoil the pie.

Yes, factor into your thinking human fallibility, but also factor in the quest for excellence and encourage it. Down with mediocrity, and with equality too, when all that it means is trying to put everyone through the same blending machine.

Three cheers for Diversity and for all those who want to make the world a better place, not just an equal one.

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I have suggested that if you come up with a good idea the first thing you should do is to factor in human fallibility, and certainly you should do this before you start implementing it.

(Visit if you have not already done so http://goo.gl/CoVvY)

Can I test this out with one of the best ideas in the 20th Century, the NHS – healthcare meeting the needs of everyone, free at the point of delivery?

A truly great idea but, when you have read this, you may feel as I do, that this is precisely where they went wrong in the first place and where they have stayed wrong in the umpteen reorganisations ever since. They didn’t factor in human fallibility …. or even the human condition, but I will come to that later.

And they still don’t.

Yes, many doctors, nurses and therapists are highly skilled and dedicated to their profession, but some are not. Many civil servants and administrators are highly competent, but some are not. And, as important as anything else, many people who look to the NHS to address their health needs do as much as they can to keep themselves healthy, but some do not.

You like me will have seen plenty of examples of the good and the bad and the ugly. They are reported in the press, with the bad and the ugly making most of the headlines. Underneath those headlines there is always pain, suffering and COST. You may also have seen it closer at hand with friends, family and neighbours.

The latest headline relates to obesity that costs the NHS a fortune trying to cope. Binge drinking that fills A & E on a weekend is another and doesn’t do kidneys much good either. Smoking among the young leading to cancer another. Drug addiction another. Meanwhile how many get health checks? How many men over 45 get their PSA test to head off prostate cancer?

These are always presented as insoluble problems. The only answer seems to be appealing to people to mend their ways. But they never do.

Before I suggest ways of facing up to human fallibility, I must make it clear that I do so as a beneficiary of the medical profession and the NHS. I would be dead three times over by now without them, without the mass Xray when I went to University that disclosed TB and the treatment afterwards, and a BUPA health screen in 1996 that showed an elevated PSA and prostate cancer and the treatment for that. Between times the NHS saved me from peritonitis and addressed a few orthopaedic ailments and more as well. My writing is a way of saying thank you.

The one great lesson I learned in all this is that it was a mistake to depend entirely on the NHS to know what was best. When I was diagnosed with prostate cancer a good friend of mine urged me to be responsible for my own body and choose the best way to treat it.

That was when I realised that the system should encourage people to do the same, and accept some responsibility for their own bodies, not just expect the State to do so all of the time.

The other lesson I learned is – and I have commended it elsewhere – that promoting excellence is not so much a matter of money as an attitude of mind. I am sorry it will be unequal, and it won’t be everywhere but if you keep chuntering on about equality you end up with mediocrity, as we have now.

So here are three suggestions to address human fallibility. Much better than thinking on the one hand that all you have to do is throw money at the problem. There’ll never be enough. Much better than thinking that all you have to do is eliminate waste. You’ ll end up with enough false economies to fill a bathtub. So here we go!

1. Take National Health Insurance right out of National Insurance and use it specifically it to fund the NHS . Charge it on those who can afford it until they die with employers contributing as now, but don’t stop it when people stop working. Fund it for those who can’t afford it; give a tax credit to pay the premium. For those at work this should be tax neutral. And provide insurance cover in case you need a care home or a nursing home at some time in your life. That may not be tax neutral as much as tax necessary.

When National Insurance was introduced it was assumed that most people would die soon after they stopped working. The NHS has done its job too well – for people like me, as I have said! For my lunchtime companion today who had a heart transplant over twenty years ago! It has helped to raise life expectancy so that those born today, short of some disaster, should expect to live many years after they stop working, maybe until they are centenarians!

Those who dreamt up the NHS never saw the cost of that alone. It wasn’t just that they didn’t factor in human fallibility. They didn’t factor in the human condition either and the exponential growth in the cost of health care to provide for it. Leading edge medicine doesn’t come cheap.

2. Don’t focus on privatising health provision, instead give it to the Insurance companies to collect the premiums and privatise paying for it. They already manage private health care, and manage it very well; and private health care would remain as a top-up for those who could afford it – giving some extra choices that with the best will in the world the State will never be able to offer to everyone, and certainly not on its own. Stop pretending that it ever can. As I have said elsewhere, fairness not equality should be arbiter.

And don’t sneer at Insurance companies here. As long as the State provides the rules, they will play the long game – that is one of their virtues – and they will, in competition with each other, drive up standards and drive down costs. They will want both.

3. Then pay people to keep healthy! This is not such an outrageous suggestion if you think about it. Give people credits if they do the right thing: watching their body weight ratio, having regular health checks, going to health clubs etc. But by the same token load their policies if they don’t: if they over eat, over smoke, take drugs, end up in A & E on a Friday night &c. This works eminently well with car insurance where drivers can have no claim bonuses if they drive carefully, but loaded premiums if they drive carelessly or with alcohol in their blood.

And to those of you are thinking “why does the person on the touchline always seem to think he knows more about football than those on the playing field?”, I have myself a question “Why do those on the playing field never tell you that what I am suggesting is how they do things in Germany? Why, 60 years on, do we still fight the last war on our TV screens while Germany continues to walk off with the prizes? Why do they never tell you about Kaiser Permanente in the States . It is a non-profit making health care organisation and now has 8.9 million health plan members, 167,300 employees, 14,600 physicians, 35 medical centres and 431 medical offices.

There are more ways than one to crack a nut.

I’ll tell you why. It is not because they can’t see the fly in the ointment. They don’t want to see it. It is, as I have said elsewhere, the fly in their ointment. They never like to own up to their mistake. Sorry to harp on it. It is the same as with Inclusion and special education. But if you never admit to a mistake, you will never correct it.

I like metaphors. Death of a Nightingale is a small story but a gigantic metaphor. I’ll give you another one. I have already used it in ispy. There badly needs to be an abattoir for some sacred cows.

PS to ispy No Cheers for Academia 0 out of 10 http://goo.gl/cFrzK The Master and his Emissary by psychiatrist Iain McGilchrist is an important read. Here’s an intro’ http://t.co/uMUSnSrz

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