Parents of a Down’s child must make painful choices

Eugenics is one of those knock-down words used to silence argument. It was used several times last week, in radio discussions and articles about women choosing to give birth to babies with Down’s syndrome. The subject came up partly as advance publicity for a Sky Real Lives television documentary this Wednesday about a heroic young woman who adopted seven babies with Down’s, whose mothers had rejected them. There was also a BBC news story last week suggesting that more women these days are knowingly choosing to give birth to babies with Down’s. In fact the news story was misleading. Actually, the proportion of pregnant women who choose to abort their foetuses when antenatal screening has detected Down’s syndrome has remained constant since screening started, at about 91%. Also the number of Down’s abortions has tripled since 1989. The total number of babies born with Down’s each year has indeed increased since then, but not by much. This small increase may be due in part to the fact that many women have children when they are much older these days, and some of them refuse antenatal screening. This misleading news story provoked an impassioned response. Several parents of babies and children with Down’s, and representatives of pressure groups, said publicly how much love and happiness such children bring, despite any “challenges”, and how they can, with support, live happy, independent lives. More or less disguised was a strong tone of moral disapproval of anyone who feels that the birth of a Down’s baby is a misfortune, to be avoided if possible. Hardly anyone now dares to say so. The word “eugenics” is often used by Down’s lobbyists to make the nasty suggestion that people who think it is right to abort a foetus with a Down’s diagnosis are as bad as Nazis. This is argument by abuse. I protest out of long personal experience. Someone close to me in our family has a learning disability, which has been a handicap and a sorrow to her, and my lifelong experience of children and adults with learning disabilities, including many with Down’s, as they have grown older has given me a different perspective. I am convinced that it is a grave misfortune for babies to be born with Down’s or any comparably serious syndrome. It’s a misfortune for their parents and their siblings as well. Sad observations over decades have convinced me: a damaged baby is a damaged family, even now. I resent the moral condescension of those who claim that people who think like me are not only wrong but hateful; there have been vicious attacks on me in the blogosphere by disability-lobby extremists. My point of view does not make me a heartless eugenicist. For one thing I do not think that any woman should be pressed, for any reason, to have an abortion. To do so would be wrong. She must be free to choose and free to make a bad choice. What’s more, I firmly believe that people with disabilities should get all possible help and understanding to lead fulfilling lives, from society in general and from the taxpayer. My belief that certain foetuses would be better not coming to term has nothing, logically, to do with my belief that everything possible should be done to help babies who do come to term and are born among us to share our imperfect world. There are some strange contradictions surrounding the question of abortion. People who reject abortion as always wrong are consistent and one cannot argue with them. But anyone who thinks abortion is acceptable under some circumstances, and who yet disapproves of what’s emotionally seen as “eugenic” abortion, is in an untenable position. After all, people accept abortion for certain “social reasons”, and what more powerful “social reason” could there be for an abortion than the virtual certainty that the foetus would be condemned to a life of frustration, disappointment, dependence, serious illness and poverty, to the great sorrow and hardship of its family? I listen with amazement and sadness to new parents of Down’s babies describing a rosy future of love, acceptance and independence (with “support”, of course). The truth is, though people are too compassionate to point it out, that support is in short supply and is expensive. With or without it, Down’s children face a future blighted by low or very low intelligence and by a high risk of heart defects (30%-50%), intestinal malformation, leukaemia, kidney and thyroid disease, poor hearing and vision and early-onset Alzheimer’s (25% as opposed to the normal 6%), as well as increased chances of diabetes and seizure disorders, including impaired executive function. In a hyper-sexualised culture that worships bodily perfection, beauty and sexual success, adult life is also bound to be painful for people with Down’s. When they are babies and children, that may not be a problem. What happens, though, when the Down’s child becomes a teenager, interested in how he or she looks and keen to discover love and sex? It is all too predictable – a growing sense of sexual rejection. Any babies born will be taken away, probably rightly. It is heartrending. In every other way the doors to adult life will seem all but closed, despite everyone’s best efforts to push them open. Without a great deal of help, a person with Down’s will find it hard to get and keep a job. At a time of recession, with social services understaffed and underfunded, there will be little money for social care. Even now there is nowhere near enough money to help everyone with learning disabilities lead a full and semi-independent life. Then comes the hardest question of all – what happens when the parents die? The best of social services can do only so much, and it is never enough. Loving brothers and sisters may help, and help a lot; they may well have to, until they die, though they themselves did not choose to take on such a time-consuming, lifelong responsibility. Most pregnant women instinctively understand all this. That’s why nearly all choose abortion. Those who choose differently should understand they are choosing hardship, perhaps great hardship, for their child and for their other children. This has nothing to do with eugenics and everything to do with the painful complexity of moral choices.

Slithery Jacqui Smith wants a backdoor ban on prostitution

The curious thing about common sense is that it is so uncommon. Jacqui Smith, the home secretary, is so short of it that at times she seems uncommonly silly. Last week she unveiled a proposal about prostitutes that is clearly silly, regardless of one’s opinions about the control of prostitution. Her central idea in these proposals is to make it illegal for anyone to pay for sex with someone who is being controlled for another’s gain. And, crucially, her plan placed the duty on the punter to discover whether the prostitute is controlled by a pimp, a trafficker in human flesh or a drug dealer. Ignorance would be no defence. Anyone with a tittle of sense would see that this is unworkable and unfair. Yet Smith insists she sees no disadvantage at all, apart perhaps from the necessity of “marketing” the idea to men. I think she is going to have considerable difficulty marketing it to women as well, even to those who disapprove of prostitution in any form. How could any punter, no matter how well meaning and fearful of the law, find out for sure that the woman of his choice is with him by her choice as well? If she is under duress, she will certainly deny it out of fear of her pimp or of the villains who have bought her into sexual slavery. So will everyone around her. If the punter comes to the wrong conclusion about her he will be prosecuted for a criminal offence, even though he thought he was within the law. Of course it is wrong to force women into sex against their will in any circumstances. To do so is to break laws that already exist against rape, sexual assault and trafficking. It is also true that there must be some situations that are obviously dubious and that any law-abiding man ought to get out of as fast as possible. If, for example, the girls are very young and speak hardly a word of English, it is a fair bet that something is wrong. Normally, though, how is a man to tell? I’ve come across a lot of prostitutes, some in the red-light districts of Hong Kong, Bangkok and Luang Prabang in Laos, some in the smarter parts of London’s Mayfair. I once spent the weekend on a boat on the South China Sea with a Playboy Miss April, who distinguished unselfconsciously between “jobs” and “f***-jobs”. I even know of a few women who, between alimony cheques, have occasionally turned a few tricks for men of their social acquaintance, whom they would not normally dream of charging for the privilege. And I know of one woman who charges her lawfully wedded husband for sex. Feminists used to say that marriage itself is prostitution and, to judge from the tabloid newspapers, in some cases it is. From all this one thing stands out. Prostitutes vary enormously (as do punters) and so do their situations. Some are forced, more or less; others are not. Some are wretched; some seem content. And if there is no way that a man could find out reliably whether a woman is under duress, then to prosecute him for his ignorance is in effect to trump up charges against him. It is unmistakably unfair. When confronted on Radio 4’s Today programme by this knockdown argument, Smith repeatedly ignored it; she said instead – and irrelevantly – “I’ll tell you what I think is more unfair and that’s that there are women in this country who are effectively held in slavery.” That is a perfect example of what used to be called female argument – irrelevant, emotional and beside the point. In talking like this she may have revealed her true motives. She would, like Harriet Harman, the minister for women and equality, like to ban prostitution but accepts that the public is “not ready at the moment” for that. However, she knows that voters are strongly opposed to trafficking and sexual coercion. So perhaps she has come up with a ban by the back door. In the name of protecting those unfortunate women who are genuinely controlled for another’s gain, she has proposed a plan that she knows is unworkable and unfair. Its real point is that it’s designed to make men “think twice about paying for sex”. All men with all prostitutes, in effect. A virtual ban. What she wants is to deal with the “demand side” of prostitution: if only men didn’t demand sexual services, there wouldn’t need to be any nasty supply. The otherworldliness of this was bettered only by Baroness Warnock’s recommendation last week that rather than use prostitutes men should masturbate – a quaint variant on “let them eat cake”. The justification Smith gives for making men think twice (and go home to follow Warnock’s advice) is that “the majority of women don’t want to be involved in prostitution”. How slithery. Her proposed law is supposed to protect a particular group of bullied prostitutes, not all prostitutes. Now suddenly we hear about a majority of women who don’t want to be involved with prostitution. Which women? Which majority? And what about the freedom to choose of those women who do want to be involved in prostitution? Niki Adams of the English Collective of Prostitutes is sceptical about the home secretary’s statistics. She believes that most prostitutes do not work for pimps or traffickers. “The government figures are completely fabricated,” she claims. Even the Home Office estimates that of 80,000 prostitutes here, about 4,000 are trafficked – an unacceptable but still small minority. If Smith’s main motive were to protect the most vulnerable prostitutes, there is a way to do it. All prostitutes should be licensed and all should work off the street and only in licensed premises run by licensed people. This would have the side effect of legalising prostitution, which many would regret. However, it would have huge advantages: if every prostitute had to get an up-to-date licence showing her photograph, birth certificate, nationality, licensed place of work and registration with the police and show it to every punter to prove she was not under duress, many of the worst traffickers and pimps would be forced out of business. The punter could have a photocopy of his prostitute’s licence to protect him in case of any future prosecution. Once again this government is trying to override common sense, human nature and personal freedom in the interests of a policy not fit for purpose. Judging by Smith and Harman, if there’s one thing worse than the man in Whitehall who knows best, it’s the woman in Whitehall who knows best.

Even in death our organs are not for the PM to snatch

History, if it has any sense, will come to judge Gordon Brown with deep moral disapproval. Somehow the man has managed to blind most of us to his obvious faults, but I will take only one – his obstinacy in clinging, with all the force of his moral authority, such as it is, to morally dubious policies, against all advice and in defiance of the evidence. I mean his emotional support for a scheme to turn us all into organ donors, willy nilly, unless we individually opt out. In January Brown went public in an impassioned newspaper article, saying a system of presumed consent could save thousands of lives and “close the aching gap” between the benefits of organ transplants and “the limits imposed by our current system of consent”. This is wrong in so many ways it’s hard to know where to start. Fortunately, and embarrassingly for the prime minister, the organ donation taskforce he set up will firmly oppose presumed consent this week. The experts think such a system would do little or nothing to help the people who now face avoidable deaths because of the shortage of organ transplants. However, the real objection to the scheme is more serious than the practical one. It is an objection in principle and it would apply even if a system of assumed consent might save more patients. The idea lets in an evil and dangerous political principle – the assumption that the state owns our bodies. Brown and Labour governments before him have tried to nationalise our private lives; now he wants to nationalise our private parts. The thinking behind this is pure socialism. You and all your assets belong to the state to tax, teach, reeducate, redistribute and, generally speaking, harvest as it sees fit. It is an attitude that was tested to destruction in the bitter miseries of the 20th century but, like Dracula, it is mysteriously undead. The more civilised view, surely, is that although we share our assets with others, and they with us, it is because we feel a common duty to give, not because anyone has a right to take. We pay our taxes, most of us, and give to charity, by political choice and out of a sense of solidarity, through democratic agreement. However, our bodies and our incomes and our talents and our thoughts are our own, most particularly our bodies. This is an essential assumption of freedom and personal autonomy. For now, compassionate Gordon only wants our kidneys or our livers when we are dead. How about other parts, like organs of generation? Last week a baby was born as a result of an ovarian transplant, given by a woman to her twin sister. With assumed consent, working ovaries could be harvested from dead young women, which would mean that not just our own bodies, but those of our children and grandchildren, could be owned and disposed of by the state. How long would it be, on the principle that our bodies belong to the state, before the idea of consent would wither away? How long, for example, before the man in Whitehall claims entitlement to bits that we can afford to lose while still living? How about compulsory blood donation from people with highly unusual blood groups? Or bone marrow from the tiny number that has the right type for a particular patient? Or a few eggs for the infertile? How about minuscule bits of our DNA, from those few of us who are resistant to plagues? My view about this has nothing to do with religion. The argument in principle has no need of the usual religious arguments, many of them quaint. If anything, they weaken the case. However, I do think the case is strengthened by some practical matters. For one thing the NHS is grotesquely inefficient in many places; the expensive IT scheme is proving a failure and management is widely incompetent. I would not trust the system to know who has withheld consent, or indeed which body to take organs from. There are examples of NHS patients having the wrong leg cut off, or the wrong person given a cancer diagnosis. Last week it was reported that our health service is worse than Estonia’s, although we spend four times as much on each person. The NHS came 13th in a European consumer report by the think tank Health Consumer Powerhouse. Would you trust such an outfit with your fragile opt-out, dead or still living? It is bad enough that Brown should have come up with such a totalitarian scheme. What makes it worse is that he did so because he didn’t know, or chose to ignore, the facts. The real reason that people keep dying for lack of life-saving transplants, after 11 years of Labour spending on the NHS, is not that there aren’t enough donors. There are plenty of donors – 14m have signed up. Their organs just aren’t used. As Tim Statham, chief executive of the National Kidney Federation, explained last week, about 1,500 people die in the UK every day and 400 of them, statistically speaking, have signed the organ donor register. That makes about 800 available kidneys a day, not to mention all their other organs. Wasted. Denied to the living and buried or burnt. The real problem, as Brown and his people ought to have known, is that there isn’t enough surgery to make use of all these organs. There aren’t enough teams ready and waiting in enough hospitals. There aren’t enough surgeons or theatres or intensive care unit. As Statham pointed out, in Britain only five transplant operations are done each day. To meet the need for kidney transplants alone, there would have to be 10 kidney transplants a day. The problem is that there is no transplant culture here. Transplants don’t happen. “Let us be clear,” he said. “It is the shortfalls of the [NHS] service that is killing our patients, not the unwillingness of the public to sign up to a register.” What is needed is a proper, coordinated, vastly extended nationwide transplant service to use the many organs that 14m good citizens have already chosen to offer. But how much easier and cheaper for Brown to hold us, the innocent citizenry, responsible for all this suffering, to distract our attention from his own inexcusable failures with the NHS. Nice one, Gordon, but history won’t be fooled.

Even a child murderer may deserve a little compassion

The celebrated moral philosopher Baroness Warnock and the child murderess Joanne Hill have something in common. In the past few days they have become figures of public loathing. Their shared interest in a final solution for people with disabilities has hit the news and they are now generally regarded as neo-Nazis.

Horrifying though both women are, however, I think this outrage against them is not entirely what it seems. Part of the anger has to do not with what they’ve done or said but with the way both women have pressed us up against hard questions that we prefer to turn away from.

Warnock, from her exalted position as one of the great and good, has been pronouncing for years on morals and medical ethics. In an interview with the Church of Scotland’s magazine Life and Work, discussing the predicament of old people with dementia, she spoke of “a duty to die”.

If you’re demented, Warnock said, “you’re wasting people’s lives – your family’s lives – and you’re wasting the resources of the NHS”. Consequently, she believes, there is nothing wrong with feeling you ought to be allowed to die – helped to die – if you are a burden on others or the state: “Actually I think that’s the way the future will go, putting it rather brutally. You’d be licensing people to put others down. Actually I think why not . . . ”

As far as I know, Warnock has not translated thought to action. But Hill “put down” her own daughter. She drowned four-year-old Naomi in the bath because she didn’t wish to live with a child who had mild cerebral palsy.

Accounts vary, but it seems that she was ashamed of her daughter (who had to wear callipers to walk) and resented the extra time needed for her care (she had various medical problems, including incontinence). Naomi’s disabilities were only physical; mentally she was unimpaired and a bright and loving child, according to her father. I doubt whether her mother took a considered view that Naomi had a duty to die, or was a burden on the state, but clearly she felt her little girl was an unacceptable burden. When her husband refused to agree to let Naomi be adopted, Hill killed her.

It ought to be obvious that what Warnock said and what Hill did was wrong and that one leads directly to the other. The thought is father, or rather mother, to the deed. What’s alarming is that Warnock has had official influence on public policy in such matters. All the same, I think there is room for more compassion and careful consideration in both cases.

People who don’t have a disabled child may not understand how difficult it can be. Quite apart from any practical problems, which can sometimes be overwhelming, the mother (or father) will probably have many sadnesses and fears to contend with. We live in a world that is obsessed with bodily perfection and where children who are peculiar are teased and bullied mercilessly.

Then there are feelings that are not allowed to be named – in a hypocritical culture where the expression of feeling is usually compulsory – and shame is one of them. Commentators spoke disdainfully of Hill’s alleged feelings of shame about her disabled child and pointed out (inconsistently) that Naomi was only mildly disabled anyway – would shame have been okay if she’d been severely disabled?

Having grown up close to such questions, I’ve come to realise that shame is not only natural but understandable. One feels at a deep level like a failure as a mother or father. Men often feel this much more strongly than mothers and don’t want to be associated with a damaged child. Well-adjusted people are able to put this shame behind them and I think it’s a mark of a good person in a civilised society that she or he can do so. But it may be difficult. A poorly adjusted person may find it impossible.

Hill has had a history of marked mental illness since the age of 17 and suffered serious postnatal depression after Naomi’s birth: she was a heavy drinker and clearly a problem person with a failing marriage. She knew she was not proving a good mother, so clearly that she asked for her child to be adopted. That is highly unusual; she could hardly have sent out a clearer signal of alarm. It was ignored.

None of this makes her innocent of murder, but it is ground for some compassion and understanding rather than righteous indignation. I suspect the indignation comes from an unwillingness – an inability – to confront the inescapable harshness of disability and the painful truth that it is indeed a burden.

As for the preposterous Warnock, there is little reason and still less incentive to try to defend her. In fairness, however, she has said such things before and her comments to the Scottish magazine were mostly taken out of context.

It is silly of her to talk of a duty to die. It shows her seigneurial indifference to what most people feel and to what the media will pick up. She seems to have no idea of what someone in her position can and cannot say, or that the public arena is not a philosophy seminar. However, the phrase comes, as she explained in the interview, from the title of an essay she has written for a Norwegian periodical, entitled A Duty to Die?. And it has a question mark.

The question mark is the point. Nobody has a duty to die unless he or she independently thinks so. It is wrong to suggest it to anyone and to frighten people with the thought. Yet men and women struggling with the miseries of looking after old people with dementia at home can surely be forgiven for wishing, sometimes, that they would die. And some people, facing dementia, might indeed feel it would be better if they did die before the misery – or some other horror – set in.

I think they should have the right to die, with help if necessary. But it can never be a duty, and to use the word “duty” suggests to anyone who hadn’t already come to the same conclusion that Warnock is unfit for purpose and indeed something of a burden on the public mind and purse.

Fortunately for her, and despite her efforts, it is not her duty to hasten to join the choirs invisible; nor is it anyone’s right to send her there, whatever the temptation.

The harmful mistakes of sex education in school

Those who can, do, according to the old saying, and those who can’t, teach. That has always seemed to me unfair. However, I have come to think that those who can’t teach, teach sex education.

Judged by its results – not a bad way of judging – sex education has been an utter failure. The increase in sex education here in recent years has coincided with an explosion of unwanted pregnancies and sexually transmitted disease (STD) far worse than anywhere else in Europe. Since the government’s teenage pregnancy strategy was introduced in 1999, the number of girls having abortions has soared. You might well be tempted to argue that sex education causes sexual delinquency.

Only two months ago the Health Protection Agency reported that a culture of promiscuity among the young had driven the rate of STDs to a record. Almost 400,000 people – half of them under 25 – were newly diagnosed, 6% more than in 2006.

When something fails, the usual procedure is to drop it and try something else. With sex education, the worse it gets, the more people cry out for more of it and earlier. Ministers are considering whether to make schools offer more sex education, offer it earlier and deny parents the right to withdraw their children from it.

Last week the Family Planning Association – now calling itself the fpa, having joined other charities in a mad rush to reduce themselves to a couple of lower-case letters – published a comic-style sex education booklet for six-year-olds to be marketed in primary schools for use in sex and relationships lessons. It has printed 50,000 copies of Let’s Grow with Nisha and Joe, and tried it out in more than 50 primary schools; it hopes to encourage schools that have shied away from sex lessons to take them on with Nisha and Joe. Oh dear.

There’s nothing wrong with the pamphlet itself. Admittedly it’s more of a dreary workbook than a “fun” comic, but there’s nothing that would startle a child or should upset even the most conservative of “family campaigners”. The rudest thing is a drawing of two children, naked, with instructions to draw lines connecting interesting bits of their bodies with the appropriate words. This is all to promote discussion of sex and relationships when children are young enough not to feel self-conscious.

It seems to me highly unrealistic (given that 25% of children leave primary school struggling to read and write) to assume that many six-year-olds could begin to read the labels “testicles” or “vagina”. And it is infuriating, given that medical-style euphemism has triumphed over plain English, that the authors have chosen one that’s wrong. “Vagina” does not mean the external genital organs, commonly referred to as “front bottom”. It comes from the Latin for sheath or scabbard and means what that suggests. The correct word would be “vulva”, but the ill-educated educationists blithely impose inaccuracy on our tiny children. However, that is not what I most object to.

What I object to about the book is what I object to about sex education as a whole (quite apart from its failures). Sex education – particularly compulsory and standardised sex education – is based on mistaken assumptions. The first is the pervasive assumption of equality – that is, that all six-year-olds or all 11-year-olds or 15-year-olds can discuss the complexities of sex in the same form in the same way. That’s nonsense. Children vary in intelligence and progress. Some young children can easily decipher words such as “urethra”; others may never be able to read them.

More importantly, children and teenagers mature at different ages and come from different backgrounds with different family expectations. You cannot talk the same way to a shy 13-year-old who hasn’t had her first period to another who is well acquainted with the darker recesses of the school bike shed. Some boys are men at 11 and 12, physically; others are children until much later. Some children’s parents find it acceptable that their sons and daughters are having sex at 13, while others would be shocked: you cannot talk to all these children together. It would puzzle and offend them and might do them serious damage. And it undermines the authority of those parents who do not share the values of the teacher, or of the majority of the other pupils. It is wrong to assume that people want equality in such matters. They want differences.

Children and families and moral values are not equal, neither within schools nor outside them. They simply aren’t the same.A sensitive teacher will try to make allowances, but there is a shortage in this country of good and sensitive teachers – hence the crisis in education.

Another mistaken assumption is that sex education ought, necessarily, to be entrusted to teachers, given how wildly they vary in ability and in moral attitudes. The thought that the government is considering making sex and relationship education compulsory in schools is terrifying. I can hardly imagine anything worse than subjecting a sensitive child to guidance on such matters from an inexperienced and politically correct teacher, who is neither well informed nor self-critical.

The relationships between sex, love, babies, crime and disease are too explosive to be left primarily to such a person, or to any person apart from the parents. Of course where parents can’t, or won’t, guide their children on such matters, the duty falls on teachers. Some may do a good job, although the evidence isn’t encouraging. But none should take it on without parental consent.

It always amazes me when people complain that people don’t talk about sex and there’s not enough information about it. The truth is, you can hardly avoid it. Newspapers, magazines, chat shows, blogs, internet information sites, doctors’ surgeries and all the rest are groaning under the weight of information about sex, contraception and relationships. Some of it I think is good; some of it you might think is better. And that’s the point. Schools shouldn’t be required to impose sex education, still less a standard sex curriculum on us. We should be able to pick and choose for our children among the infinity of information out there.

Channel 4’s The Sex Education Show, for instance, strikes me as informative and helpful but depressingly vulgar. Others might find it tastefully frank. It’s up to us to choose. Teacher, leave that child alone.

Easy ways to cut immigration and still get the work done

It is a great relief to know that though the British Establishment may be unforgivably slow in recognising the obvious, it isn’t absolutely incapable of it. Last week the powers that be – the forces of conventional wisdom and political correctness – finally saw the light on immigration. They didn’t exactly admit it, of course. They merely stood by quietly and allowed others to tell the truth about immigration, without trying to shame them into silence. In its quiet way it was a remarkable cultural moment – a national tipping point.

On Monday a cross-parliamentary group led by Frank Field, the former Labour minister, called for a limit to immigration. There were no howls of outrage, merely a few squeaks. In a report called Balanced Migration, accompanied by a poll by YouGov, the parliamentary campaigners made the obvious point, accompanied by painstakingly gathered facts, that immigration cannot continue at its present uncontrolled rate. The country cannot stand it. At current levels, (mostly immigration from outside the European Union) 7m people will come to live here by 2031; that is the equivalent of seven cities the size of Birmingham. By now only bigots against the truth deny the pressure that recent immigration imposes on schools, hospitals, prisons, housing and infrastructure.

All this ought to have been obvious long ago. It’s what the vast majority here think. What’s new is that it’s possible to say so without being accused of playing the race card or the numbers game; I’m not sure why, but it must have something to do with the fact that many ethnic minority people now think so too. The YouGov poll showed that 85% of all people think immigration is putting too much pressure on public services, 76% that Britain is overcrowded and 81% that the government should greatly reduce immigration to Britain. Sixty per cent of Asians and 45% of blacks think the same, so such thoughts are not necessarily racist; ironically, it is their agreement that has made discussion possible.

The Balanced Migration group is calling for a stop to net immigration: it proposes that the number of immigrants (from outside the EU) who are given permission to settle here should be kept to roughly the same as the number of British citizens who are emigrating. This wouldn’t affect temporary work permits or family reunion, but it would significantly cut the population explosion here.

Part of the point of this launch is the usual invitation to a national debate. I have a couple of suggestions to offer. One of the many standard arguments in favour of immigration is that we need the workers. Even if immigrants make a net contribution of only a few pounds a year (62p a week, according to the exhaustive House of Lords economics committee investigation this year into the economic impact of immigration) or even if they are a large net cost, we’d be lost without them because they do essential work. They do all the care work, the unskilled work and the seasonal work. Who else would do it?

The answer is simple. There are already plenty of British citizens here to do it. I don’t mean the unemployed Britons here, though some of them might be suitable as well. I mean two other groups. One consists of state sector workers. The Labour government, while in office, has created well over 800,000 public sector jobs, most of them unnecessary. Not only is this make-work, it is make-waste. All those functionaries do not merely sit at desks, consuming heat and light and waiting for their pension. They create other costs and other work. Such is the mindless power of bureaucracy that one outreach worker with an absurd brief such as advising Irish people in Birmingham about sex (I didn’t make that one up) can call upon new initiatives, new meetings, new groups, new funding, new employees and more expense. Meanwhile the old and the lonely are neglected, unless a Filipino or a Somali immigrant can be found for them.

This vast army of state sector workers should be redeployed. They should be allowed to keep their job security, salaries and pensions, but they should become social care workers. They should, in person, look after the old, the sick, the mentally ill and the displaced; we are all capable of social care – looking after a bedridden pensioner, or feeding a sick child in hospital, giving a worn-out carer a respite break, working in a women’s shelter, or advising a desperate family about debt. We don’t have enough citizens doing this. It is supremely valuable work, far more so than checking the ethnicity of people parking cars.

This important work is not exactly skilled, but it is responsible and demanding. It is not right to give this work to low-paid, poorly educated immigrants who speak little English, when we have plenty of people here already who could do it.

Similarly with work that is more obviously unskilled, or low-skilled, like looking after parks and streets and countless other essential jobs, we need not depend so heavily on immigrants when we have huge numbers of citizens who could do it, yet they are often denied the opportunity. I mean people with learning disabilities.

Learning disability is an awkward term. It has nothing to do with mental illness. It means a significant intellectual impairment, or – crudely – a low IQ. Clearly a person with a mild or moderate learning disability couldn’t usually expect to do a skilled job. But for many doing an unskilled job can be a great joy, a source of pride and independence, as well as useful to all concerned, whether it’s stacking shelves in a friendly supermarket, assisting a park keeper, working on a building site, in a hotel laundry or picking strawberries. And according to government estimates, between 580,000 and 1.75m people here have mild to moderate learning disabilities; that is a huge source of willing workers. Yet despite the known wishes of people with such disabilities, despite the pressure of various lobby groups on their behalf, they find it difficult to get jobs.

Immigrants have brought great things to this country. One of them, rather oddly and recently, is the opportunity at last to talk more openly as a society about the costs and benefits of immigration, without being denounced as a heartless xenophobe or closet racist. Enoch Powell is at last being proved wrong.

This cynical choice has left McCain’s honour in shreds

I’m an American, California born. It’s true my mother was English and that I was brought up here from early childhood and think myself exceptionally lucky to belong here; I feel as English as I think anyone possibly can. Yet all the same, America is the land of my forebears on my late father’s side. I would even qualify to be a Daughter of the American Revolution, since one of my ancestors in North Carolina fought in the American war of independence. My grandmother travelled as a little girl in a covered wagon in the Wild West with my great-grandfather, who was an army officer. I have close family living in America still, and I have the right to vote there.

So I have always felt a strong sentimental attachment to the United States. I’ve felt proud of American achievements and generosity, and resented the unthinking antiAmericanism everywhere in Europe, ever since the first child in the playground of my first school shouted at me “Yanks go home”. Admittedly the spectacle of electioneering is a painful test of anyone’s respect for the United States. In their ghastly harrumphing electoral extravaganzas the Americans show themselves at their worst – vulgar, venal, naive, dishonest, stupid, wasteful, tasteless and vicious. Priggish though it may sound, I prefer to ignore these periods of national hysteria; after all, politics is nasty everywhere, it’s just that America does everything in extremes.

But last week everything changed. John McCain’s choice of Governor Sarah Palin was the last straw. It makes American politics look like a sick comedy. My faith in my native country had already been shaken by other elections and by other wrongs, such as the Iraq war (which I at first supported, to my shame). But the moose-hunting pitbull with lipstick is too much. I have never used my vote in the past, but if I had, I would usually have voted Republican. Today no rational conservative can vote for the Palin and McCain ticket. It makes America an international laughing stock. The fact that there has been a Palin bounce, after her charismatic speech, fills me with dismay.

This has little to do with Palin’s views. I disagree passionately with some of them, but the Republicans are entitled to present any views they choose to the electorate. Nor do I share the objections to Sarah Barracuda of the liberal sisterhood; unlike them I don’t in the least object to an ambitious woman being right-wing. I am rather right-wing myself, and Margaret Thatcher is one of my heroines.

Unlike the lily-livered liberal intelligentsia, I admire Palin for being a good shot and a good fisherwoman, and capable of butchering large wild animals in her basement, though I do not share her rather unsporting enthusiasm for shooting wolves out of small aircraft. I admire her for her determination, for her energy and her self-possession. I admire the virtues of small-town and frontier America. As for her grooming and her cunningly chosen glasses, if I don’t admire the results, I do admire the self-discipline and self-respect behind them.

All the same, her selection was a shock. What horrified me was not so much the woman herself, though she is clearly entirely unfit to be vice-president or president. It was McCain’s cynical and sudden choice of her. Would you give power of attorney over your entire life to someone you had only met once, or possibly twice? Of course not. You would give the matter and the person very serious consideration. Yet McCain in effect is offering power of attorney over all the affairs of the United States and over all Americans, including me, to a woman he had barely met. I myself wouldn’t hire a house-sitter on such scant acquaintance.

Palin herself may not know what a vice-president is for, but McCain surely must. He must know that a vice-president needs to be someone the president can trust and rely on and work with. Such a person is not easy to find, even when highly qualified in other ways. It takes time. It’s a personal matter, a question of psychological fit and mutual understanding.

Obviously McCain’s public relations people have been scouring the country for libertarian babes. But politics is not painting by numbers. McCain doesn’t know Palin at all, nor it seems did his vetting people; revelations keep emerging about her all the time. But he showed himself willing to hand the free world over to a stranger because his people think she is a psephological paragon.

I had thought that McCain was, for a politician, an honourable man. Certainly honour is one of his top selling points. But who can think so now? In choosing a woman he doesn’t know or understand, purely for electoral advantage, he reveals a dishonourable lust for office, a disrespect for women generally and a dishonourable indifference to the future of his country. After all, if this known unknown woman does become president, it will almost certainly be because he himself is dead – quite possible given his age and health – and past caring.

Though he didn’t know Palin personally, he must have known a few facts about her. He must have known that she compares feebly with previous vice-presidential candidates. Her education is minimal, her real political and managerial experience very slight. The only previous woman candidate for vice-president, the Democrat Geraldine Ferraro, was well qualified, well educated and experienced; Palin can’t hold a candle to her. Palin’s experience is as nothing compared to that of Dick Cheney (congressman, secretary of defence and White House chief of staff), Al Gore (senator and congressman) or George Bush Sr (congressman, ambassador to the United Nations and China, head of the CIA). Being a vice-president is not just a matter of PR and homespun rhetoric, or used not to be.

Even a brief consideration of Palin might suggest that she is not the straightforward redneck hockey mom she claims to be. It’s not possible to be much of a mom to five children, including a baby with Down’s syndrome, if you have a more than full-time job. Like other people with working responsibilities, you have to hand your children over to someone else to bring up. There’s nothing wrong with that, but it denies you the right to exploit your image as a yummy downhome mummy.

In short Palin is an ill-educated, inexperienced hypocrite. The Republicans are trying to sell her to the voters as something she isn’t, and McCain hardly cares what she is. It’s a bad day for my native land.

Leave the fat alone – state bullying won’t curb obesity

Fat is not a feminist issue, despite what feminists used to say. It is a class issue. Well-to-do, well educated people are rarely fat, still less obese. You see few fat children in private schools. Fatness and obesity are directly related to low income and low education.

A fat map was published last week by Dr Foster Intelligence, showing the areas with the fattest populations, and sure enough the poorest industrial areas in the north of England and in Wales produce the most obese people. The problem seems to be getting worse, fast.

You hardly need expert medical data analysis to understand that. You need only to go to a few supermarkets. At a Tesco in western Scotland this summer I was astonished by the number of horribly obese shoppers waddling round the aisles with their elephantine children, who could not possibly have squashed themselves into an ordinary one-person chair. Young women, with eyes reduced to slits by the pressure of the fat on their faces, laughed grimly with each other as they scanned the shelves. And this is a rich country.

Even though the vast Oban Tesco is full of good food, the trolleys at the checkout were heaped with stuff that is either useless or positively bad to eat – crisps, snacks, swizzlers, twizzlers and guzzlers, cheesy dips and fatty whatsits, cakes puddings and pies, heavily dusted in additives. The obese seem to fill their carts regularly with several times their own weight in eatables that can make them only fatter, that they shouldn’t eat and that nobody should produce, as if they were determined to lay down yet more adipose tissue. Yet you rarely see such bloated people and trolleys in smart supermarkets in rich areas. These days you can easily tell people’s precise socioeconomic bracket and body weight by the contents of their trolleys.

Obesity seems to be the issue of the day, possibly because we are still in the silly season. Coincidentally last week, Andrew Lansley, the Tory health spokesman, spoke against obesity in a long speech to the Reform think tank. He was widely understood as saying that fatties have only themselves to blame; they must take responsibility for themselves and their weight because “we all have a choice”. And while that is a slightly unfair take on his speech, he does seem to mean something of the sort. Yet at the same time he offers what’s now called a whole raft of measures to stop people getting fat. This is awkward for Conservatives; either you interfere with people’s choices or you don’t. Empowerment, a word he used, is often just a weasel word for state intervention.

The question is why a Conservative government should interfere at all in people’s inalienable freedom to choke on deep-fried Mars bars if they choose to. The argument is that the fat and the obese (people with a body mass index over 30, which is something you could spot without a calculator) cost the country squillions in lost productivity and increased National Health Service costs. The obese tend to develop serious illness, particularly heart disease and diabetes, and are, generally speaking, crocked up and expensive to look after.

Somebody somewhere has come up with a figure for the cost of all this, which Lansley quotes – £7 billion a year, for what it’s worth. Last year’s Foresight report said this cost could go up by six times by 2050. And fat is getting fatter so fast. According to NHS figures, the proportion of obese men in the population rose during Labour’s time in office from 13.2% in 1993 to 23.1% in 2005. Among women it was even worse, from 16.4% to 24.8%. That is nearly a quarter of all women. If you consider people who are not obese but overweight (with a BMI of 25-30), 46% of men in England are overweight and 32% of women.

Fat is also an ethnic issue. According to NHS figures published in 2006, Irish and black Caribbean men had the highest incidence of obesity (25% each) and among women black Africans had 38%, black Caribbean 32% and Pakistani 28%. So, with migration trends and immigrant fertility, the costs of obesity are going to rise fast as well.

However, I wonder how much, if anyone knew the facts, the final cost of obesity would be to the taxpayer. For fat people die sooner and obese people die much sooner than others, thus relieving the NHS and the economy of their needs. It’s true that obese people need expensive treatment for diabetes and heart disease before they die, but that might easily be offset if they had significantly shorter lives – and they do. Current thinking seems to be that the obese die between five and seven years earlier than otherwise they would.

Few papers I’ve looked at on this subject discuss the possible cost-benefit of obesity, although one from an insurance company coyly mentioned the advantage to pension providers if a person died before he reached pensionable age. For years I used to argue that smokers were a net benefit, purely financially speaking, to the exchequer, because they died early. I still feel rather proud of being the first, I believe, to get a known expert (Professor Richard Peto in 1993) to agree publicly to this idea, now accepted. Might not the same be true of obesity? The real drain on the NHS is geriatric medicine; the obese might not reach old age.

If the only reason for interfering with what fat people eat is how much it costs the rest of us, perhaps we should leave them alone. It’s well known that obesity (and fatness) are associated with poor education, poor housing, poor employment or none, low expectations, low opportunities and all the rest. These are all social ills that this government has been trying to deal with for more than a decade. Yet little has improved and obesity – as an indicator of that fact – has swollen vastly while Labour has been in office. What prevents obesity is a good income, a good education, good opportunities and the kind of background that develops self-confidence. Prosperity, in short.

Obesity cannot be defeated by taskforces, better labelling on packets or investing in health accreditation schemes. This has all been tried and has failed. In the presence of a complex problem, and in the absence of a workable solution, perhaps it is better to leave people to their own devices. Nobody can pretend they don’t know what they’re doing. They should be left alone to do it.