Recently
On this page you can see the notes of previous monthly meetings in the current iU3A year. They are exactly as were written at the time, and will not be 'updated' as time goes by.

October — ‘The Catalan Crisis and its Links to Current European Politics’, presented by Professor Sebastian Balfour. The presentation was particularly topical in the light of the recent heavy sentences, against which there have been fierce demonstrations, imposed on nine Catalan politicians.

He focused on two aspects of the story, the process that led to a referendum, and the Catalan position from an international perspective: the roots of the Catalan experience date back to the early 1700s and many feel, even today, that they do not belong to Spain by virtue of their different history, language and culture. Catalonia was at that time part of the Mediterranean Empire, which stretched from Catalonia to the Duchy of Athens. A sense of separateness further emerged with the industrialisation of the rest of Spain and the growth of the middle classes, which failed to establish a sense of identity for the whole of Spain.

In the 20th century many Catalans saw autonomy as part of the struggle for democracy and Catalonia was given autonomy in 1932. However, at the end of the civil war in 1939 attempts were made to wipe out all expressions of Catalan identity including language and self-government, which compounded the Catalan sense of victimhood. It was not until 1977, two years after the death of Franco, that greater autonomy for the region was restored. This, however, was not without its problems: Catalans felt that other regions of Spain were given greater autonomy and more powers. In 2006 a new statute of autonomy was agreed for Catalonia.

The recession of 2008 led to a movement of popular protest as social fissures began to appear and there was much political corruption amongst the elite. A Catalan national assembly emerged: it argued that independence was the answer. But many Catalans, as had been the case for some in the past, were developing a strong sense of a dual identity and there was much immigration, both from other parts of Spain and from abroad, which made many feel they belonged to both Catalonia and Spain.

In 2012, for fear of losing electoral support, the Catalan national assembly jumped on the bandwagon of a separatist cause. A referendum for independence was held in October 2017. This was ruled as illegal by the Spanish Government and there was, as many saw it, a violent repression against a democratic exercise. Despite a low turnout, 90% of those who voted wanted independence. The Catalan government declared unilateral independence. Its MPs were subsequently arrested. A new referendum, organised in Dec 2017, revealed that 51% of Catalonia wished to remain in Spain and 45% wanted independence. Today there is no explicit programme for an independent Catalonia: there are fundamental differences over strategy, and deep divisions within the separatist movement. There is no process for a truth and reconciliation debate and there is a legacy of pain and sadness.

The movement, however, has had a ripple effect throughout Europe. The recession of 2008 and the austerity measures that went with it, have made people in many countries feel alienated from mainstream politics. This has given rise to national populist movements on the right and of the left.


September — 'The NHS at 71 - is it time it retired?', presented by Valerie Iles, who started by giving a brief overview of seminal events in the NHS over the last 70 years: new management structures post-war; the creation of District General Managers in the Griffiths reforms of 1983; purchaser-provider split in 1991 under the Thatcher government; new GP contracts in 1991 in which GPs took on public health issues; and New Labour's A&E and treatment targets in the later 1990s. Valerie argued that for 50 years we have all contributed to the problem of 'McDonaldisation' — thinking that everything can be measured and that key performance indicators should be used to measure progress towards a goal. But this leaves professionals feeling treated like a resource whose productivity is constantly measured. She suggested it is more useful to differentiate between a puzzle — for which there is one right way forward; a problem — in which there are various ways to proceed; and a mess — which is a complex interacting system where we can only proceed step by step and see what works.

Valerie argued that privatisation is not the real issue — we need to liberate people from McDonaldisation and think about the kind of care we want for people and what national system will encourage this. This means building relations, not management, so clinical staff are supported and enabled to be the best; investing in junior staff; using money more wisely by helping people better understand costs; involving senior clinical staff in strategic decisions not external consultancies; innovation and a focus on patient experience; being ambitious for all diagnoses — dementia as well as cancer; understanding how flows through a system work; effective good value treatments for all conditions instead of privileging pharmacology; citizens' juries for difficult and political decisions. She suggested that the key issue is choosing between a single system or a market. There are many different market models, some of which (eg Netherlands health market and compulsory health insurance) work well, particularly as we now have much health data for designing services. She advocated a moonshot approach in which we would specify our priorities and potential health care providers would design services to achieve them — but this would require cross party political support!

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