Month: February 2016

Homage to Andalucia

On the edge of the sea where the mountains touch the sky, and the warmth of the sun rises over Africa, a white village slowly awakens from its sleep. The mountain cradles and shelters the ‘una pueblo blanca’ from any harsh easterly, should it blow. Rising from the coast, the reclining dragon shaped hills, nose first into the sea, in mimicry of the ridged spine of a fire breathed but now sleeping giant, are outlined against the blue and the fluffy white. Steeply the land falls away, down 5 miles to the coast where the bright lights of ‘Funky Town’ sparkle, soon to fade as dawn strikes in golden red light across the scattering of buildings. Dragon mountain arcs around the village whose streets are scoured into its side in parallel. Grey limestone cliffs, cloaked with olive, pine and ‘other trees’ rise up defiantly against the erosion seeking rain. That is our morning view from the window on the first day in Andalucia.

Mijas clings to the slopes by its Rioja stained fingernails a thousand feet above the sea. Fuengirola looks like a tiny model city from up here. Funky Town it shall remain, as that is where all the action probably is. Mijas, however, sits aloof, offering a better class of shenanigans or so it might think but shenanigans all the same. If wine flows, then so shall excited talk, followed by hints of debauchery. This occurs regardless of social positioning or upbringing. Whether clad in Prada or Primark, wine facilitates the lowering of inhibitions, judgment and modesty. Twas ever thus.

We arrived last night on a late afternoon flight. Malaga airport has developed hugely from the one grass runway and biplane affair of 10 years ago. It is a beneficiary of the Spanish construction boom fueled by the optimism of a tipsy wine soaked Matador armed with a machete and braggadocio, facing a pink ribboned kitten who thinks its mummy has come to feed it warm milk. Turns out the machete was made in Taiwan and is as blunt as a witch’s tit, and thus only half as useful, while the kitten is a banker from Frankfurt demanding his money back with menaces and a panzer tank to support his claim. The Matador gets to keep his shiny suit, for so is the airport, and outward appearances are thus sustained. His dignity and future prospects however cling precariously to hope like a virgin in a brothel knowing that payment is due by being screwed by a scruple free, morally incontinent, fat, sweaty Bavarian with halitosis on holiday. All the vaseline in Andalucia is not going to be enough of an emollient.

There is a nice train though.

It runs from the new airport terminal into Malaga and Fuengirola. One only needs to follow the (badly) signposted walk from baggage reclaim and in 5 minutes the train slides into the station. It is quiet, clean and efficient. And cheap. There is no need for a quiet carriage. It is night by the time we arrive and can only then guess at the scenery as the train hums through Malaga Centro, Torremolinos, Benalmadena, Torreblanca, Los Colinos….. You get the picture. A short taxi ride from Fuengirola 5 miles up the road, and I mean ‘up’, and we arrived in Mijas.

I like stereotypes for they say as much about the stereotype user as they do the stereotyped. I like it better when the need for stereotypes becomes redundant because reality is actually better. And joy of joys within an hour I’m presented with four glorious examples of the stereotyper’s art. A Spanish taxi driver, an English owner of a bar, ex-pat bar fly and weed smoking old hippy from Holland. Honestly, this shit writes itself.

The road from Fuengirola to Mijas has to snake and weave up and around the mountain. Hairpin bends are a speciality. As are the ditches, just a wheel width away from death or a headache. The balding, portly taxi driver has done this journey a thousand times, blindfold and drunk no doubt. How else to explain gunning the engine and skimming the edge of the ditch with only millimeters to spare. I don’t think it was to impress us with his impression of Spanish F1 hero, Fernando Alonso. I think this is just the way he drives, probably with one eye on the road and the other on the Senoras he once woo’ed. In any case, fifteen minutes later and fifteen euros lighter, we arrive at Casa San Pablo, the home of Henri and Mary and our place of rest for the week.

Henri is a very, well there is only one word and that is sprightly, 76 year old. A retiree cinematographer who moved from Singapore to Mijas in 2000. His wife Mary is originally from Ireland and Coventry. How one can hail from the Emerald Isle and the armpit of England is another story no doubt. After scouring the earth for somewhere to settle, Andalucia worked its magic and here they are. The apartment is on the top of the main house with glorious views to Dragon mountain and the sea. Just. Breathtaking. Above the apartment which has to own terrazza del sol is another terrace with a 360 view over Mijas. We arrive in the dark and are treated to a brief electric storm over the Mediterranean and the briefest of rain storms over our heads. Time is not our friend at this hour as the bars and restaurants will soon be closing for food. So Henri bids us hurry into town.

The first two bars/restaurants are indeed closing for food as we arrive at their doors. It is nearly ten at night and in winter this is late enough for the locals. The third bar is thus our rest as we settle for a glass of wine. Or two as it turned out. The bar is called ‘The Village Bistro’, not you may note ‘El Bistro del Pueblo’ or something else suitably Spanish such as ‘Paella Plaza’ or ‘Cojones del Toro’. The name should have been a clue, for just as I was winding myself up to employ my refined in Asturias Spanish, the owner spoke in fluent Northern. I don’t mean northern Spain, but North as in Macclesfield for such was the town from whence she hailed. Food had just ceased being served and I, rather ponce like, asked for a ‘Ribera del Duero’. This is a rather fine Spanish wine. I soon realised that this was like asking for a Chateaunuef du Pape in the Spoons in Camborne, they hear the words but you might as well have asked for sausage in a synagogue in Arabic.

House Rioja it is then. Fair enough, and a damn fine glass or two they were. As for nibbles, on offer was Walker’s (yes Walker’s, we are in Spain) cheese and onion crisps. The restaurant side still had customers finishing their meals while we collapsed into a comfy sofa and soon tuned in to the gaggle of English voices all around us. The owner, a middle aged woman dressing like she was fifteen, was all tits and tattooes. Classy tattooes mind you, there was a butterfly trying to wing free from between her very well endowed cleavage. I had to take a second look to ensure I was just seeing things. Ann had not noticed the petite papillon in purple nestling between the underwired orbs of delight. A nicotine patch was stuck fast to her upper arm. I don’t know why I noticed that or what it means. you decide.

As we stood at the bar ready to pay up I noted a TV on the wall. Match of the day. Leicester v Norwich City. The BBC. A small group of ex pats, one guesses, stood around it no doubt discussing the up coming EU referendum and the butterfly. I made the mistake in engaging a gentleman at the bar in conversation regarding the match. Now this chap has been in Mijas for over 10 years, originally from East London, Wanstead. I guess he was over 60 now and had been practicing to be the poster boy for UKIP, representing England in a foreign country. Within 5 minutes the old cliches started about the ‘old country’.

He’ll never go back.

“It’s all changed”

“London is not the same” (has it ever been?).

“I want my country back” (so why are you here?).

There are too many of them over here (there, in England he means).

“You can’t even call them Paki’s any more” (So, I suppose ‘nig nog’ is right out as well).

“They don’t mix, they stick to themselves and they don’t speak the language”.

The bastards. Coming over there and working on minimum wage at jobs such as ‘shit poking with broken sticks’, ‘pea threading’ and ‘talking to people’.

I’m surprised he did not call for a wall to be built.

“I’d send them back” (…and where would you go?)

So this poured out without a trace of irony, in an English bar, owned and staffed by English people, surrounded by English people, watching English football on an English TV station, talking English. I doubt if he could spell Paella, let alone shit one. His grasp of Spanish is probably on a par with that of whizzed up Scotsman at a rave. Oh, and tomorrow the bar serves its speciality: a roast dinner. Reservations had been pouring in all day. Don’t get me wrong, it is a nice place for a late night glass of red, but it’s as Iberian as my ringpiece is open for business to a red hot poker.

So, hearts of oak can’t stand foreigners invading their country and mucking it up with their funny ways, so they have to move to another country, moan about it, and end up mixing in with the native Andalucians about as well as vindaloo and Guinness fueled fart at a funeral. So, come June 23rd will they be queuing up to move back once we leave the EU? Don’t mention the war.

Luckily ex pats don’t get to vote in the referendum. That would be like vegans voting for veal.

The missing two C’s – commodity and critique   This is the link to the published article in the Journal of Research in Nursing.

This discussion paper argues for understanding nursing care as a commodity within capitalist relations of production, ultimately as a product of labour, whose use value far exceeds its exchange value and price. This under recognised commodification of care work obscures the social relationships involved in the contribution to the social reproduction of labour and to capital accumulation by nursing care work. This matters, because many care workers give of themselves and their unpaid overtime to provide care as if in a ‘gift economy’, but in doing so find themselves in subordinate subject positions as a part the social reproduction of labour in a ‘commodity economy’. Thus they are caught in the contradiction between the ‘appearance’ and reality. A focus on the individual moral character of nurses  (e.g. the UK’s 6Cs), may operate as a screen deflecting understanding of the reality of the lived experiences of thousands of care workers and supports the discourse of ‘care as a gift’. The commodification of care work also undermines social reproduction itself. Many nurses will not have tools of analysis to critique their subject positioning by power elites and have thus been largely ineffectual in creating change to the neoliberalist and managerialist context that characterise many healthcare and other public sector organisations. The implications of this analysis for health care policy and nursing practice is the need for a critical praxis (an ‘action nursing’) by nurses and nursing bodies, along with their allies which may include patient groups, to put care in all its guises and consequences central to the political agenda.


NHS Dissatisfaction levels are perhaps not yet high enough to embolden the political power elite to further uncouple NHS principles from actual delivery, but they might be going in the right direction.

How satisfied with the NHS are we? The British Social Attitudes Survey has been tracking satisfaction levels since 1983. In 2011 it reached the highest it had been (64%), much higher than the 39% recorded in 2001. In 2000 there was a large rise in funding and according to John Appleby (Kings’ Fund) the change upwards might reflect that extra funding. In 2010 the rate had hit 70%, while in 2015, 65% stated they were quite or very satisfied, with dissatisfaction at a low of 15%. Now, in 2016, dissatisfaction rates have hit a 23% ‘actively dissatisfied’.


For trends see the graph at:



So, should we read anything into these figures? The “NHS’ is a complex set of organisations and services, and is affected by such external factors such as social care. It is probably foolish to peg changes in attitudes to any one factor (such as funding or waiting times). The survey does provide some information as to why those who are dissatisfied say so:


The stand out reason is taking too long to see a GP (60%). Interestingly only less than 5% state ‘stories on TV or radio’. However, 6 reasons above that are also gained by reading the press, watching TV as well as being supplemented by actual experience of friends and family.

See reasons at


The figures cannot be directly tracked to funding or political party. The background of the Health and Social Care Act 2012 has not on the face of it made a difference to people’s attitudes. The high rate of satisfaction in 2010 of 70% has dropped to around 60% since, while dissatisfaction has only just started to rise again from the 2011 level.


If you want to change the way the NHS is funded, this survey is still an issue. Too many people like it the way it is, “free at the point of delivery” is a possible reason. Social Care (means tested) ranks the lowest on these satisfaction scores and might indicate that funding is a real issue for people.



The context for this includes 4 assumptions held by governments over the past 25 years: Neena Modi in the Guardian writes:


  • Personal responsibility for health supersedes government responsibility.
  • Markets drive efficiency.
  • Universal healthcare is unaffordable.
  • Healthcare is a business.


For example, Christopher Smallwood wrote ‘Free at the point of use’ has had its day and argues for private health insurance.


Each one of these assumptions are questionable and draw upon a certain view of the role of the state vis a vis the private individual (neoliberalism). Alongside that there are profit making health care organisations looking for new business opportunities that the relatively closed NHS used to block. Graham Scambler’s ‘Greedy Bastards Hypothesis’ suggests that health inequalities are the unintended consequences of the actions of a core cabal of the ‘capitalist executive’ who, aided by the ‘political power elite’ engage in business activities aimed at capital accumulation which includes commercialisation of health services for profit. The Health and Social Care Act 2012 provided an opportunity for just such private sector involvement. A problem for the private sector is that much demand for services comes from an increasingly ageing population whose needs are difficult to make a profit from.



There are very real discussions to be had about the sort of health service we want and the principles that should underpin it. There is now increasing argument for a rolling back on its founding principles of universal access, comprehensive coverage, equity of service and free at the point of delivery all in the name of ‘affordability’ underpinned by an ideology that deplores public sector provision. Dissatisfaction levels are perhaps not yet high enough to embolden the political power elite to further uncouple NHS principles from actual delivery, but they might be going in the right direction.




For discussion on health services globally see:


  1. Which country has the best healthcare system?
  2. Britnall, M (2015) In Search of the Perfect Health System. Palgrave macmillan .






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