Russia update

Still going through Russian Accelerator and asking odd question to kind Russian friends / friend of friends on FB.

Very excited to be going to St Petersburg with a friend for 5 days in May – the Russian tourist office in London have been completely fab about everything. Will be great opportunity to practice Russian and what a beautiful place to see first. 

After 10 months of following various Russia accounts on twitter, blogs am still shocked by some of the hostility but I live in a country that is more hostile than previously thought and I have campaigned at grassroots.

Off tangent but I was campaigning in Rotherham with a candidate on NHS issues. He is Asian and a lovely man. There has been a lot of press in Rotherham about child grooming by an Asian gang. We walked into a pub and it was a bunch of white blokes who stared at us. My friend was temporarily uncomfortable but I walked  up to first table and introduced us. One of the men said this is a National Front pub and we chatted a bit more. I explained that my friend had founded and continued to self-fund Rotherham learning disabilities network and after that tension eased.

I haven’t done this level of preparation before visiting a country but keen to find out more. I understand very little about Russian politics so keep reminding myself daily not to rush to snap judgements about the way things are. I have found Irrussianality blog and Rethinking Russia useful for this and Kremlinstooge and Odessa blog for further commentary on Ukraine and other topics.

Maybe none of us would be where we are if it wasn’t for the kindness and compassion of others – this is certainly true of the last ten months on all things Russia.

H5P and course menus in Moodle / Totara

We wanted to create a menu – initially left-hand side of main H5P but could be right-hand side if wanted.

I searched to see if others have embedded H5P content into other Moodle resources such as books / pages / labels but I didn’t want to go down the embed route as the overall goal was to create a better flow between different H5P activities rather than tweak an existing Moodle format if possible.

So I used 5 steps to make a menu block which would have a similar look and feel to Moodle book and use similar navigation.

1. Go to course and press Turn Editing On button / link.

2. Add an HTML block from the Add a block dropdown menu

addblock moodle menu screenshot

3.Press Configure HTML block (the little grey cog) and add hyperlinks to the relevant activities. Make sure the HTML block is set to appear on all course pages so when a learner is in an H5P activity it still appears. It can also be set to appear at the top of the screen:


4. Add in the H5P activities.


5. Open the HTML block again (I left mine open in an existing tab so I didn’t have to keep re-opening) and paste in the H5P activity hyperlinks, ensuring they are set to open in new window


Keep adding any other H5P activities until it is finished. This is how an example looks to a learner in our learning hub, they can still navigate using the menu without having to leave this page / activity.







Oxford and political reading

I did a quick wander around some of Oxford new and second hand bookshops yesterday whilst there. 

In the politics / global / international relations sections, there are some textbooks and various views on Russia and Vladimir Putin – including people who say they are his number one enemy or something similar.

I couldn’t find any alternative perspectives on Russia which may have been in the more general books or maybe not. So anyone’s first impression just by looking at the shelves – even in 2017 – will be a classic bad Russia, oligarchs and Marxist-Lenin thought. And that’s it. That is what is attracting people’s attention.

A couple came in,  one of whom studying art history and politics and they looked at the shelves and said – well of course these are popular political books. They were looking for something very specific and prepared to go further.

There were also entire shelves of books which were anti EU. 

The bookshops are a reflection of media and social media today. Do Oxford political students actually dig deeper (I know some Oxford lecturers think critically) or is it just rather convenient to display these ‘feathers’ to the outside world?

Is that what they want to impress on visitors because of Oxford’s reputation and just be a continual echo chamber?

Multiple choice questions and online learning in a hospital

I revisited this earlier this year in a couple of work projects. The staff I work with have science and/or medical degrees and in some cases PhDs too. We do use some as part of an assessment whilst being aware of limitations and also distracting cognitive issues around the question design which affect outcome. I don’t have a definitive opinion on whether MCQs should disappear for good now in 2017 or not. We’re having several discussions about practical applications of some quite specific learning where recall may help or not. What we are trying to do is document what we have done and work out whether we can review it to inform any further course development.

Cathy Moore’s post has great examples of these common issues: and there’s a nice summary in BMJ about why these are issues.

Perspectives /  research from

Safeguarding resources

I’ve added some links to a range of free resources – mostly videos – about safeguarding and being safe online

Job update

I am leaving The Royal Marsden at the end of February and will be joining Roehampton University as an elearning Adviser.

I will continue to volunteer with People’s University and also colleagues at the Royal Marsden who are keen to develop and license their knowledge using elearning projects and Creative Commons licensing (also downloadable copies via the NHS elearning repository). The first one is likely to be about cancer pain. 

Political Twitter activity will reduce by end of February, have removed from FB already and will continue to explore open source alternatives and online communities wisdom. 

Peace in a troubled world

This is partly where I was trying to get to in previous post only this is more eloquent and comprehensive.

I read Mahatma Gandhi’s autobiography recently and meeting soon with PeopleUni co-founder who whilst attempting to semi-retire is on a quest for some kind of enlightenment whilst spending most of the year in India.

Knuckles update

Managing about 10 pressups minimum now daily – not completely down to normal pressups but getting there.

A colleague at work has started too – he did martial arts years ago so is really good with the hand grippers. Trying to do batches of 10 throughout day.

Another colleague who used to do kung fu and has that presence & total sense of peace that long time kung fu practitioners have – used to do knuckles and apparently 10 x fingertips too.

Rice all good. Yoga going ok. No longer seeing physio now unless sometjing changes – have some more suggestions which are apparently classic start of ashtanga – most of these

Some thoughts on force and resistance 

I started martial arts due to self confidence at a very low point, am not going into details of why, but the rest is not very exciting history. At my black belt grading I was mildly reprimanded by a 9th Dan for using too much force in one of sparring bouts. So haven’t learnt that much so far.
At the moment I don’t see a male/female distinction in my own practice, either using more direct force or less direct force – some see that as male/female mostly related to Asian philosophy and traditional societal rules.

Unnecessary force is not better or worse physically if it’s man2woman, man2man, woman2man, woman2woman we all have anatomy which is affected.

Spiritually, psychologically, socially more complex of course and what leads myself and others to lose self-control. I didn’t start tkd to go and beat up (physically, emotionally) men, women or children but not going to pretend fighting doesn’t evoke reactions and there are many people who don’t do martial arts who will beat up others anyway. Don’t know where this will all end up but I’m going to play my tiny role in consciously sorting myself out because others more senior than me have been kind enough to help. Time to pay back.



Using this yoga app daily – without trainer it’s not ideal but simple to use and better than nothing


Taped up, tried again and increased crack but it’s not happening yet re brick breaking and I’m not using first knuckle properly so going for different conditioning including some from

2nd Dan preparation

I don’t need to learn the next Dan poomsae but as I’ve not trained properly in a few years will be 

a) hopefully returning to live in town near club so I can train & coach several times a week and return to being a martial artist instead of a semi excuse for one.

Cook Ding’s Lenten Challenge in Spring will be a good moment to shake off more dust.

b) do yoga exercises daily, my physio who used to do tkd recommended in place of pilates for now and said use a yoga app so I’ve started this wkd/week.

c) probably start another martial art at least once a week (depending on location).

d) possibly start zen meditation again – I briefly went to classes in Leeds so may do very short sessions at home. 

e) learn the next Dan poomsae anyway 🙂 

All of the above will eat into all personal time so will reduce the size and frequency of online portions. Existing online commitments will continue and I have offered to help some other NHS staff so not quite sure how it will pan out but that’s the plan.

Our NHS and why it matters in 2017

A friend who is older than the NHS wrote this in response to a national plan:

Social change is now so rapid that it is hard to make sense of it let alone learn from it. The opening sentence of the FYFV report is a measure of that. The first words, while seeming to assert the value of the NHS, fail to reflect its full significance. 

Our pride in it is beyond doubt – no ‘may be’ about it.  It is impossible to overstate the importance of the NHS: It needs to be spelled out that the NHS is an evolutionary social development which has changed the lives of everyone in this country (our country) and peacefully effected change in (our) society so profound that we do not recognise it, or fully remember the circumstances in which it arose.

For example, optimism in 1945 was less important than the clear-eyed determination to eradicate pre-war squalor, ignorance and fear: of sickness, of the cost of medical treatment and of the loss of livelihood that it entailed.

Only those people now well into their 70s can remember that the sacrifices of war had not been left behind in 1945: despite rationing, food and fuel shortages were critical and the scars of the blitz still dominated urban landscapes. The pre-war housing crisis had been exacerbated by the devastation of the air raids. The country (our country) was bankrupt.

It is against that background that the present condition of the NHS should be considered. It faces new problems and challenges, of course, but its condition cannot be described as critical, still less insupportable, considering that we have recently managed to meet the costs of two long-drawn-out wars (supported by both major political parties), and the bail-out of irresponsible bankers – all money down the drain. 

By contrast, the relatively small amounts needed to maintain and develop the NHS have beneficial effects, now as in the past, not just on the nation’s health, but on its prosperity, as the post-war experience shows. The NHS creates employment and expertise in many fields as well as health. It increases the disposable income of the general population by removing the burden of personally financed health care. (c.f. the USA health system). A healthier, longer-lived population is almost the least of the benefits of the NHS. We cannot afford to waver in our commitment to universal health care – publicly funded and provided. 

“Our values haven’t changed, but our world has”. The two cannot be separated. Our values have changed, not in relation to the almost universally beloved NHS, but in response to changes in the world. The new challenges of longer life have still to be fully addressed at all levels. As for health problems “of our own making”, once problems reach the proportions cited in this report (60% of adults are obese, 30% misuse alcohol, 20% still smoke) they can no longer be seen solely as personal, but as public issues. (C. Wright Mills).   

It is beyond the remit of the NHS to deal with such complexity: it derives from the unchallenged pressures and persuasions of a commercialism and consumerism so insidious and pervasive that they fail to attract the critical analysis and counter measures that are needed even in relation to life-threatening issues like obesity and alcohol misuse.

It is the business of government to deal with this situation, not the NHS. The propaganda lessons of the Second World War need to be redeployed in improving national health. Clever merchandising skills cannot be left solely in the hands of those selling us stuff that does us no good, simply for profit. This may sound like a return of the ‘Nanny State’: in fact such measures would attack the infantilisation of everyone (by mass advertising and the mass media) which is breaking the back of the NHS. 

The task is too huge and important to be left to cash-strapped Local Government, elected mayors and an overburdened NHS: it is a major national issue for Central Government. If the NHS is to be able to cope with the challenges of longer life expectancy, a benefit for nearly all of us, the adult population needs to be enabled to behave like adults: the commercial interests profiting from unhealthy life-styles can only be challenged effectively by Central Government. It is now the case that local authorities have a statutory responsibility for improving health, but it is responsibility without power, the reverse of the case with the media.

As in the 19th century, preventive health measures are more important than medicine in improving the nation’s health; then it was sewage and water supply; now it is tackling the problem of over-consumption: problems of affluence not effluence : just as damaging.

The NHS is urged in the report to improve public health by promoting health in its workforce and making itself an exemplary employer. As well as setting a standard for all employers, it suggests that sickness absence would be reduced saving a great deal of money. But the report overlooks the unhealthy effects of long working hours and excessive shift work that are the result of 20,000 unfilled vacancies in the NHS. 

These cannot be unrelated to deteriorating pay and conditions of work as a result of pay freezes and cut-backs.  These government created conditions do not help to make the NHS an exemplary healthy employer. Better food on night duty etc. cannot solve the problem.

Parallel to this, while emphasising the central role of the care sector in future health care, the report ignores the plight of care workers in the private sector on less than the minimum wage (150,000 according to King’s College Care Workforce Research Unit) dependent on food banks for a healthy diet, while 370,000 are on zero hours contracts in the name of ‘productivity’. (Norman Lamb, Care Minister). (But has anyone ever met a ‘hard up’ private care home owner or shareholder?) The report does not consider these issues in urging a better integrated Health and Social Care system.

The five year forward plan is an evasion of the nub of the problems the NHS is valiantly facing. 

While generously recognising the successes it has achieved against the odds (e.g. quoting improved cancer and heart disease outcomes; the Commonwealth Fund report’s endorsement), the report fails to make explicit some of the main causes of the major funding challenges confronting it, e.g. the costs of PFI, the implementation of the 2012 H & SC Act and competitive tendering, still less to consider ways of dealing with those problems. The longer standing administrative costs of operating the ‘internal market’ within the NHS (the 1992 purchaser/provider split) are similarly ignored.

An issue nowhere addressed in recent reports including this one, is the costs the NHS has incurred as a result of out-sourcing ancillary services, the first wave of privatisation dating back to the ‘80s. In every area of Britain, there are people who have made private fortunes delivering services that were previously in-house (cleaning, supplies etc. etc.). It is arguable that causal links can be made between that process and infection in hospitals. Agency nursing is another hugely costly means of dealing with staffing shortages related to erosion of pay and conditions for full-time nursing staff. 

These key financial drains are ignored. They make an enormous contribution to the financial predicament of the NHS, and they mark only the tip of the iceberg of the costs of more recent privatisation. 

The 2012 Health and Social Care Act has unleashed unprecedented, hugely expensive, unnecessary and unpopular changes on our comprehensive and publicly funded NHS. This was done by a coalition government after the dominant partner had promised no top-down reorganisation in its election manifesto;  the junior partner had pledged commitment to the public NHS and its Party Conference voted against the Health and Social Care Act weeks before it colluded in passing that Act. No one outside Parliament voted for that legislation; the results go unmentioned in this Report. 

Health care, correctly delivered, is not and never can be a commercial undertaking. All diversion of tax funded resources (e.g. into profits, dividends, bonuses, etc) represents treatment denied and is directly harmful to patients and injurious to the common good. This is the basis of public support for the NHS.

When the NHS was founded, the average wage was roughly £5 a week.  Inflation takes care of most debt. We can afford the NHS, especially if more effort were to be made to retrieve unpaid taxes – another factor omitted from this text. We spend the least on healthcare as a proportion of GDP of all G7 countries (as Stevens acknowledges) and have the second lowest number of hospital beds per capita in Europe. Ring-fencing a budget that doesn’t meet our needs is meaningless.

The range of NHS activities is enormous: ‘from cradle to grave’ it attempts and largely succeeds in meeting the health needs of a large, complex, rapidly changing, post-industrial society as it invents and responds to new technology and evolving culture and life-styles. Depth analysis should encompass finance and economics, cultural factors, and management, especially of change and cross-boundary working, logistics ….the list is endless. Miraculously, the NHS deals with all these factors and it WORKS. 

The 5 year plan is unconvincing because it skims the surface of the issues it does address, and fails to raise the core questions.   

The NHS is now becoming a key election issue as the public begin to realize what is at stake, and the media can no longer afford to turn the other way.