EDITORIAL : THE GUARDIAN, UK

           

 

Syria: States of emergency

It is tempting to see regional opportunities in Syria's turmoil – but no Arab spring has yet been nurtured by foreign intervention

Weeks of demonstrations in Syria reached a turning point this week. In the country's third city, Homs, a Tahrir-style sit-in was broken up when police fired into the crowd. More than 20 pro-democracy demonstrators have been killed in the town since Monday. But the switch in many minds happened earlier. It was when President Bashar al-Assad announced he would end nearly half a century of emergency rule. Far from being placatory, he patronised. It was all a problem of communication, he explained. There was a conspiracy (the demonstrations), there were reforms, and there were "needs" of the citizens, not only economic ones. He was sure his citizens understood, but how could they appreciate what was going on when the government did not explain to them what was happening?

President Assad's audience understood only too well. Accused by the regime of being Salafist infiltrators, Muslim Brotherhood stooges, saboteurs supported by Lebanon's Saad Hariri and Saudi Arabia's Prince Bandar Bin Sultan, or agents of the Mossad and the CIA, the protesters demanded to be heard as Syrians. Chants for reform gave way to chants for regime change. "From alleyway to alleyway, from house to house, we want to overthrow you, Bashar", mourners chanted at one funeral. Ever since, they have been attempting, at great cost, to recreate a Syrian Tahrir Square, a physical epicentre of revolt in any major city.

The Assad family (there is Bashar's brother Maher al-Assad, commander of the Republican Guard, and his cousin Rami Makhlouf) now find themselves with fewer political levers to pull, although there are plenty of military ones. Interior Ministry statements go unheeded. Protests continued overnight in Zabadani, Jabla and Aleppo. In Homs, the shops stayed closed, a sign that the urban Sunni population is starting to join in. They will not be mollified by sacking the governor in Homs or the chief of security in Banias. What started with a brutal, but routine, local incident, when police beat up and tortured a group of graffiti artists in Deraa, has become a nationwide protest.

It is tempting to see regional opportunities in Syria's turmoil. This is not just paralysing the Arab League, which postponed a summit scheduled for May, but also encouraging the belief that Assad's rejectionist allies, Iran, Hezbollah, and Hamas, would stand to lose with his departure. Some may be tempted to conclude that fomenting dissent in Syria is a risk worth taking. This is folly in any part of the Middle East but particularly for a country with Syria's borders. No Arab spring has yet been nurtured by foreign intervention. It could yet be killed off by one.

NHS plans: In the waiting room

Getting back on track and staying there is going to be incredibly difficult in the absence of any strategy

Likened by its rightwing detractors to a national religion, the debate over the NHS is far from theological for people who are being told to wait for an operation. All the arguments about governance structures, control of purse strings and even the private sector's role pale into insignificance when the waiting lists start to become longer again. The King's Fund yesterday produced a report which interviewed health service finance directors, and crunched the official data on waiting times. It found an upward trend for "all stages of waiting ... [since] June 2010". There is plenty of evidence that managers are embarking on redundancies, closures and rationing that could make things worse.

It is true that the health service was in for a rough ride whoever won last year's election. An unprecedented expenditure squeeze that would lead to rationing and delays was always in prospect. But the coalition has squandered its claim to the argument that there is no alternative to cuts because David Cameron made such a point of promising to protect the service. The coalition's credibility is further undermined by suggesting that the cuts which the public are already witnessing must be an illusion. The claim to be increasing resources in "real terms" relies on a statistical cigarette paper at best, and ignores the raid which the bankrupt care system has been invited to make on the budget. The government has aggravated the consequences of parsimony, first by initiating wild "reforms" of the English service, and then by pressing the pause button when its dubious revolution is already under way.

Andrew Lansley staked everything on his marketopian theories. One of his first acts as health secretary was to instruct his department to stop central management of Labour's waiting guarantees. His assumption was that the rigours of competition would be enough to keep medics on their toes, leaving him free to do away with a tainted target culture. In fact, the eventual commitment to end-to-end treatment within 18 weeks was more supple than earlier strictures that had targeted every waiting list separately, and so perversely encouraged the shuffling of patients between them. By 2010, while the system remained far from perfect in large parts of the country, dangerous waits for things like cardiac care were consigned to the past, and public satisfaction reached a record high . Now the 18-week benchmark is being missed again. Admittedly, not by much , but as Whitehall belatedly scrambles to remind the service that the target remains in its constitution, getting back on track and staying there is going to be incredibly difficult in the absence of any strategy.

Staffed by temporary execs, and in the midst of disbanding themselves, primary care trusts are not going to provide one. Last financial year, some were already arbitrarily refusing operations of extraordinary and documented clinical value, such as knee replacements. This week the Federation of Surgical Speciality Associations warned such stark refusals could spread, while the King's Fund has uncovered plans to "manage demand" through crudely "reducing activity".

Of course, there are areas where resources can and must stretch further to answer growing needs, particularly in respect of long-term conditions such as diabetes. Changes that put power in the hands of the patient could make a real difference, but they will not come about until the government has a coherent plan. Instead, we are at an impasse, with ministers acknowledging that they need to change their plans but giving no sense of how. The outcome will turn on trade-offs and crass party politics – whether it is the coalition's blue or yellow wing that requires placating after the alternative vote referendum is counted. For patients listening to the painfully slow tick of a clock, it is a sick joke indeed.

In praise of: a Lords moratorium

Many new peers cannot do their job properly if they are turned into ermine-clad battery hens

Posh club declares itself closed to new members shock! In other circumstances, it would be right to ask why peers are backing a report that says the House of Lords is full. Are their Lordships struggling to find space in the tearoom or short of sunny spots to sip G&Ts on the terrace? But this report, from UCL's Constitution Unit and an all-party array of peers and MPs, makes a serious point. It is a pity that it was dismissed, instantly, by Downing Street yesterday morning. Caught in a sort of half-life before promised reform, the Lords was packed by the last government and is being packed again, only partly in the interests of political balance. In the last year 117 peers have been created, including 39 Labour ones, taking the House to a complement of 792 members. If its membership was proportional to the last general election result, as the government wants, 269 more peers would be needed and the Lords would have 1,061 members. This is absurd. Not only is it expensive – many new peers have been vigorous in their take-up of daily expenses – but they cannot do their job properly if they are turned into ermine-clad battery hens. The report also criticises the way peers are appointed: there is too much patronage and too many former MPs, eased into the upper house after an inglorious Commons career. The answer is not just a smaller chamber – the US Senate manages with 100 members – but also democratic reform. In the meantime, "house full" signs should be hung on the door.