Lottery of NHS drugs punishes the dying

Thousands of patients denied life-extending treatments approved by health watchdog

Despite certain drugs approved by the NHS rationing body, at least 14,000 patients a year are not receiving them Photo: ALAMY

By Laura Donnelly, Health Correspondent

7:42PM GMT 21 Jan 2014

154 Comments

Thousands of patients suffering from cancer and other serious illnesses are being denied the drugs they need from the NHS, according to a report.

Even though the treatments have been approved by the health service rationing body, at least 14,000 patients a year are not receiving them.

As many as one in three of those suffering from some types of cancer are going without medication that could extend their lives, the figures show.

Experts said the report, from the Health and Social Care Information Centre, a government quango that provides NHS statistics and analysis of trends in health and social care, exposed an “endemic and disastrous postcode lottery” of care within the health service.

Charities said the findings were “alarming” and meant patients were being condemned to an early death because local NHS bodies were failing to fund drugs even though they had been proven to work. 

When the National Institute for Health and Care Excellence (Nice) was created by the last Labour government, officials promised to end the variation in medical treatment across the country and ensure that if a drug was found to be effective, patients should not have to fight to get it.

However, the findings show that thousands of patients suffering from cancer, motor neurone disease and an eye condition which is the most common cause of blindness, are not being given the best medication.

The research examined 10 common treatments which have been backed by Nice, meaning they should be given to all patients who require them.

It found that in three of the groups, there was a gulf between the number of patients who should have been given the drugs and the numbers who were actually prescribed them.

The worst findings were for kidney cancer, which affects more than 8,000 patients a year, and for a form of motor neurone disease which affects almost 3,000 people.

One in three patients who could have benefited from sunitinib (which has the brand name Sutent) and pazopanib (brand name Votrient), life-extending drugs for kidney cancer, or from riluzole (brand name Rilutek), the only treatment for motor neurone disease, did not receive them.

More than 12,000 patients were denied injections for wet age-related macular degeneration (AMD), the most common cause of vision loss and blindness.

Nice makes rulings on whether drugs are effective and good value, but has been criticised for refusing to support drugs in the face of evidence that they can extend lives by months or even years, and for delaying decisions.

But the findings suggest that even when Nice says NHS bodies must fund the drugs, thousands of patients are still denied medication.

Charities said too many terminally-ill patients ended up fighting bureaucratic procedures in an attempt to secure NHS funding for treatment.

In other cases, they were never told about drugs such as Sutent, which can double life expectancy with kidney cancer to 28 months, and was approved by Nice more than four years ago.

Andrew Wilson, the chief executive of the Rarer Cancers Foundation, said patients were suffering from “an endemic postcode lottery in access to Nice-approved medicines”.

“It is extremely worrying that the NHS does not seem to be making available cancer treatments to all patients who could benefit, even when the drug is approved by Nice,” he said.

Nick Turkentine, the chief operating officer of the James Whale Fund for Kidney Cancer, said the failure to follow national guidance was “a disaster” for patients with aggressive cancers. He said: “Sutent was one of the first drugs to be approved for kidney cancer — it is really disastrous that patients are still having to battle for a drug which we know can give several extra years of life.”

Duleep Allirajah, the head of policy at Macmillan Cancer Support, said: “Patients do not choose which cancer they get. Every patient deserves equal access to treatment no matter who they are, where they are from, or which cancer they have.”

A spokesman for Nice said the organisation hoped the report would help ensure that guidance was followed more widely, and that local NHS groups needed to be able to justify variations from it.

A spokesman for the Department of Health said: “Patients have a right to drugs and treatments that have been approved by Nice and we expect the NHS to provide them if they are needed.

“That is why the chief executive of the NHS has written to the local NHS requiring them to publish which NHS organisations are funding and using drugs and treatments approved by Nice, and which are not.”

Drugs whose use was lower than expected:

• Riluzole (Rilutek) - the only treatment for motor neurone disease - 35 per cent of patients who would have been expected to receive the drugs did not.

• Sunitnib (Sutent) and pazopanib (Votrient) for kidney cancer - 32 per cent of patients who would have been expected to receive the drugs did not.

• Ranibizumab (Lucentis) - the most effective treatment for wet age-related macular degeneration, which can cause blindness - 5 per cent of patients who would have been expected to receive the drugs did not.

The truth is we are all living on Benefits Street

Everyone is on the take, and whole industries are on white-collar subsidies. Some of us are just smarter at concealing it

• 
• • Simon Jenkins
  • The Guardian, Tuesday 21 January 2014 19.00 GMT

‘Child benefits, agriculture subsidies, wind-farm subsidies, house-buying subsidies, arts subsidies and tax avoidance schemes may satisfy the political and electoral goals of passing ministries, but then so do subsidies to the poor.’ Photograph: Alamy/DPA

Let's face it, we all live on Benefits Street. The Channel 4 series may be raising hackles to left and right, but I doubt if there is a person reading this column who is not "on the take" in some sense. We may work a bit, mostly obey the law and not look a total mess, but then we are not really poor. We can still be "on benefit", and some of us are rich because of it.

I was once driving down a country lane with a diplomat friend when we slowed to a crawl behind a tractor. My friend finally lost patience and blurted out that he could count "seven different subsidies" holding us up ahead. He listed them in a rage.

I proceeded to ask after his relocation allowances, subsidised school fees and index-linked pension. He retorted with my heating grants, tax deductions and charity reliefs. I asked which state-funded arts consultancy employed his daughter and which awareness-raising quango kept his son from occupying the family nest. We were about to deflect to the banker in a nearby Cotswold manor, snorting his quantitative easing, when the tractor turned off into a higher-level stewardship meadow to plan a subsidised wind farm. We bowled on down our own benefits lane.

We are all on the game: some of us are just smarter at concealing it. I have a book on my shelf by the Americans Mark Zepezauer and Arthur Naiman called Take the Rich Off Welfare. It glares down at me whenever I think of writing about poverty. It shows how well-heeled Americans, starting in the Reagan years, cornered the lion's share of public spending. They had capital depreciations, fiscal reliefs, muni bonds, fuel subsidies, bailouts, price supports, cultivated waste and tax frauds. It was called "wealthfare".

This was no leftwing tract. It merely pointed out that "wealthfare costs the American taxpayer some three-and-a-half times the cost of welfare for the poor". The relentlessness of the rich lobbying Congress for tax breaks and subsidies meant "the US government today functions mostly as a huge Robin Hood in reverse". If there is money going begging, those who beg loudest get most.

By this book lay other revelations of fiscal outrage. There was The Sacred Cow (agriculture), Putting Patients Last (the NHS), The Terrible Truth about Lawyers (law), A Dinosaur in Whitehall (defence) and Plundering the Public Sector (consultants). The loftier the profession, the wilder the scams. Looming over them was JK Galbraith's pre-crash diatribe, The Economics of Innocent Fraud. After skimming this lot, I thought Benefits Street was like a meeting of the Mothers' Union.

Of course, many of these beneficiaries do serious jobs and rarely break the law. But then, they can get their hands on other people's money without stealing it. One in five British employees now works for the state. In addition to their pay, they have negotiated index-linked pensions that cost the taxpayer £9bn a year, beyond the dreams of those working for themselves.

This is merely the tip of the iceberg. Child benefits, agriculture subsidies, wind-farm subsidies, house-buying subsidies, arts subsidies and tax avoidance schemes may satisfy the political and electoral goals of passing ministries, but then so do subsidies to the poor. Benefits Street's denizens may do drugs, door-to-door selling, odd jobs and pilfering. At least I know them. Running down the Guardian's interactive guide, Visualising Whitehall, I am not sure what is meant by "corporate development, change delivery, compliance strategy". They sound like upmarket benefits scrounging to me. I am sure Benefits Street's White Dee would say she was in human resources strategic delivery if she realised it held the key to George Osborne's wallet.

Whole industries are on white-collar Benefits Street. Higher education, despite fees, is a cross-subsidy from taxpayers (including the poor) to mostly middle-class students and professors, now to the tune of billions of pounds a year. The construction industry is a monument of public plutocracy. Having pocketed £9bn from the Olympics, it is now building Crossrail and hopes to win HS2 and Heathrow Three. Its housebuilders are eating their way through Osborne's soaring subsidies. These projects are essentially tax transfers from poor to relatively (or very) rich.

"Austerity Osborne" claims to be cutting back on public sector jobs to boost private ones. He is shortening Benefits Street to lengthen Enterprise Alley. Public sector employment is falling overall, but the fall is in lower-paid local government jobs outside Osborne's control. His personal Benefits Street, known as Whitehall, actually grew last year by 50,000 jobs. Austerity is always for the other guy.

Eight years ago, David Craig's Plundering the Public Sector calculated that 10 years of New Labour had seen £70bn vanish from taxes into management consultancy, PFI and IT fees, to no noticeable public gain. Most Whitehall IT projects had been fiascos, and there is a new one each week. The beneficiaries have been the rich: firms such as KPMG, Deloitte, PwC, Capita, Serco, McKinsey and others. Today's public accounts committee may howl about waste, but the stable is bare and the horses are over the horizon laden with gold.

None of this approaches the greatest benefits scam of all, the accumulation of public and private debt incurred by today's citizens at the expense of future taxpayers and interest payers. Britain's public and private debt together runs to some 500% of GDP, by far the highest ratio in history. Such benefits to today's citizens – in pensions, housing, travel, lifestyle – are at the expense of tomorrow.

As Niall Ferguson said in The Great Degeneration, his 2012 Reith lectures revised in book form, equitable finances have long relied on trust between one generation and the next. He concludes: "The enormous inter-generational transfers implied by current fiscal policies [are] a shocking and perhaps unparalleled breach" in that trust. The young are entitled to see parents and grandparents as all on benefits at their expense. The pensions time-bomb is real.

Like all journalism, Benefits Street tells a partial truth. Its lesson is banal, that any group of people will live according to their means. At least Iain Duncan Smith is making the first ever serious effort at reform – crippled by computer failure by another sub-contractor beneficiary. But in fairness, Channel 4 should now go for somewhere far harder. It should move from Benefits Street to Subsidy Row and dig out the serious scroungers.

Trickle-down economics is the greatest broken promise of our lifetime

The richest 85 people in the world have as much wealth as the poorest 3.5bn. That should be a wake-up call to the deepest sleepers

• 
• • Alex Andreou
  • theguardian.com, Monday 20 January 2014 17.06 GMT

'The realisation must dawn soon – one hopes – that this model is unsustainable because its effects are uncontrollable.' Illustration: Matt Kenyon

The richest 85 people in the world have as much wealth as the poorest 3.5 billion – or half the world's entire population – put together. This is the stark headline of a report from Oxfam ahead of the World Economic Forum at Davos. Is there a reason why the world's powerful, gathering at the exclusive resort to sip cognac and eat blinis, should care? Well, yes.

If one subscribes to the charitable view that neoliberal philosophy was simply naive or misguided in thinking that "trickle down" would work infinitely, then evidence that it doesn't, should be cause for concern. It is a fundamental building block of supply-side economic theory – the tool of choice these past few decades for those in charge to make adjustments. The realisation that governments have been pulling at economic levers which, for some time, have been attached to nothing, should be a wake-up call to the deepest sleepers.

Even if one subscribes to the cynical view that the elite knew what they were doing all along, observing that the "rising tide" is lifting fewer and fewer boats and leaving more and more to rot in the sediment – both at a personal and national level – must make most wonder "am I in the right boat and is it big enough?" Concentration is rampant. Credit Suisse estimates that the world will have 11 trillionaires within two generations.

It is not so much that the supply-side principle "if you build it, they will come" is no longer true. It is more that we appear to have passed a tipping point, where so much wealth has been concentrated at the top, they no longer need bother to "build" anything. In short, it has become more economically efficient to buy countries' economic policy than to create value in order to sell it on. If one can control government to favour the richest, while raising barriers for new entrants, thus increasing their share of the pie exponentially, what is the incentive to grow the pie?

This applies to both companies and individuals. Small business gets clobbered by taxes and business rates, while big business turns around and says to the state: "This is how much tax I fancy paying this year, take it or leave it". The rich no longer create jobs, through a process of consolidation, takeover and merger, they actually destroy them.Zero-hours contracts are the way of the future; in a society that is hungry, desperate and devoid of political engagement or unionism, why would anyone offer terms and conditions that give individual workers any standing?

And yet, the realisation must dawn soon – one hopes – that this model is unsustainable because its effects are uncontrollable. The more unequal we become as a society, the faster the top's earnings diverge from the bottom's. "When so much of the purchasing power, so much of the economic gain, goes to the very top," Bill Clinton's former labour secretary Robert Reich explains in the film Inequality For All. "There's simply not enough purchasing power in the rest of the economy." At the same time, there is far too much loose cash sloshing around at the top, leading to unwise risks and toxic investments. Wealth inequality in the US was at its highest levels, historically, in 1928 and 2007, one year before its two biggest financial crises, notes Reich. The base of the pyramid atrophies and begins to crumble.

Then why are most governments continuing to fiddle with supply-side levers in order to revive the economy, when it is abundantly clear it does not work? The simple answer is in two parts. First part: habit. The second was perfectly expressed by the creator of The Wire, David Simon: "That may be the ultimate tragedy of capitalism in our time, that it has achieved its dominance without regard to a social compact, without being connected to any other metric for human progress."

We have come to measure, to an increasing extent, individuals' success by their wealth, spending power and other assorted trappings. We do the same with the economic success of governments; measure it by an aggregated data set that fails to take into account wealth distribution, educational achievement, innovation, or even the welfare and health of the population they claim to represent. We must shift this perspective. It will be the hardest, simplest thing we have ever had to do as a species.

The challenge of leaving a faith - From Islam to Atheism

Sarah Morrison in The Independent

Amal Farah, a 32-year-old banking executive, is laughing about a contestant singing off-key in the last series of The X Factor. For a woman who was not allowed to listen to music when she was growing up, this is a delight. After years of turmoil, she is in control of her own life.

On the face of it, she is a product of modern Britain. Born in Somalia to Muslim parents, she grew up in Yemen and came to the UK in her late teens. After questioning her faith, she became an atheist and married a Jewish lawyer. But this has come at a cost. When she turned her back on her religion, she was disowned by her family and received death threats. She has not seen her mother or her siblings for eight years. None of them have met her husband or daughter.

“It was the hardest thing I’ve ever done – telling my observant family that I was having doubts. My mum was shocked; she began to cry. It was very painful for her. When she realised I actually meant it, she cut communication with me,” said Ms Farah. “She was suspicious of me being in contact with my brothers and sisters. She didn’t want me to poison their heads in any way. I felt like a leper and I lived in fear. As long as they knew where I was, I wasn’t safe.”

This is the first time Ms Farah has spoken publicly about her experience of leaving her faith, after realising that she did not want to keep a low profile for ever. She is an extreme case – her mother, now back in Somalia, has become increasingly radical in her religious views. But Ms Farah is not alone in wanting to speak out.

It can be difficult to leave any religion, and those that do can face stigma and even threats of violence. But there is a growing movement, led by former Muslims, to recognise their existence. Last week, an Afghan man is believed to have become the first atheist to have received asylum in Britain on religious grounds. He was brought up as a Muslim but became an atheist, according to his lawyers, who said he would face persecution and possibly death if he returned to Afghanistan.

In more than a dozen countries people who espouse atheism or reject the official state religion of Islam can be executed under the law, according to a recent report by the International Humanist and Ethical Union. But there is an ongoing debate about the “Islamic” way to deal with apostates. Broadcaster Mohammed Ansar says the idea that apostates should be put to death is “not applicable” in Islam today because the act was traditionally conflated with state treason.

Some scholars point out that it is against the teachings of Islam to force anyone to stay within the faith. “The position of many a scholar I have discussed the issue with is if people want to leave, they can leave,” said Shaykh Ibrahim Mogra, the assistant secretary general of the Muslim Council of Britain. “I don’t believe they should be discriminated against or harmed in any way whatsoever. There is no compulsion in religion.”

Baroness Warsi, the Minister of State for Faith and Communities, agreed. “One of the things I’ve done is put freedom of religion and belief as top priority at the Foreign Office,” she said. “I’ve been vocal that it’s about the freedom to manifest your faith, practise your faith and change your faith. We couldn’t be any clearer. Mutual respect and tolerance are what is required for people to live alongside each other.”

Yet, even in Britain, where the freedom to change faiths is recognised, there is a growing number of people who choose to define themselves by the religion they left behind. The Ex-Muslim Forum, a group of former Muslims, was set up seven years ago. Then, about 15 people were involved; now they have more than 3,000 members around the world. Membership has reportedly doubled in the past two years. Another branch, the Ex-Muslims of North America, was launched last year.

Their increasing visibility is controversial. There are those who question why anyone needs to define themselves as an “ex-Muslim”; others accuse the group of having an  anti-Muslim agenda (a claim that the group denies).

Maryam Namazie, a spokeswoman for the forum – which is affiliated with the Council of Ex-Muslims of Britain (CEMB) – said: “The idea behind coming out in public is to show we exist and that we’re not going anywhere. A lot of people feel crazy [when they leave their faith]; they think they’re not normal. The forum is a place to meet like-minded people; to feel safe and secure.”

Sulaiman (who does not want to reveal his surname), a Kenyan-born 32-year-old software engineer living in East Northamptonshire, lost his faith six years ago. His family disowned him. “I knew they would have to shun me,” he said. “They are a religious family from a [close] community in Leicester. If anyone [finds out] their son is not a Muslim, it looks bad for them.” He added that people “find it strange” that he meets up with ex-Muslims, but he said it is important to know “there is a community out there who care about you and understand your issues”.

Another former Muslim in her late twenties, who does not want to be named, said the “ex-Muslim” identity was particularly important to her. “Within Islam, leaving [the religion] is inconceivable. [The term] atheist doesn’t capture my struggle,” she said, adding that her family does not know the truth about how she feels.

Pakistani-born Sayed (not his real name), 51, who lives in Leeds, lost his faith decades ago. He left home at 23 and moved between bedsits to avoid family members who were looking for him. He told his family about his atheism only two years ago. “I was brought up a strict Muslim, but one day, I realised there was no God,” he said. He told his mother and sister by letter that he was an atheist but they found it difficult to comprehend.

“Whenever I tell my sister or my mum that I am depressed, stressed or paranoid, they say it’s because I don’t pray or read the Koran enough,” he said, adding that he will not go to his mother’s funeral when she dies. “I won’t be able to cope with the stress or the religious prayers. There’s quite a lot of stigma around.”

Iranian-born Maryam Namazie, 47, said that it does not have to be this way. Her religious parents supported her decision to leave their faith in her late teens. “After I left, they still used to whisper verses in my ear for safety, but then I asked them not to. There was no pressure involved and they never threatened me,” she said. “If we want to belong to a political party, or religious group, we should be able to make such choices.”

Zaheer Rayasat, 26, from London, has not yet told his parents that he is an atheist. Born into a traditional Pakistani family, he said he knew he didn’t believe in God from the age of 15.

“Most people transition out of faith, but I would say I crashed out. It was sudden and it left a big black hole. I found it hard to reconcile hell with the idea that God was beneficent and merciful.

“I’m sort of worried what will happen when [my parents] find out. For a lot of older Muslims, to be a Muslim is an identity, whereas, for me, it’s a theological, philosophical position. They might feel they have failed as parents; some malicious people might call them up, gloating about it. Some would see it as an act of betrayal. My hope is that they will eventually forgive me for it.”

The hijacking of cricket, once again!

Tell the administrators you're watching them

International cricket's top three seem to be planning a hostile takeover of the game. Do you want to stop them?

Jarrod Kimber

January 18, 2014

 

	If the draft proposal is passed, India will have more power in world cricket than they already enjoy © AFP  Enlarge

The fact that Australia, England and India have formed a cabal to choke the game of cricket is not exactly new. Like a bum with a sandwich board, myself and others have been walking the streets of cricket shouting this message for a long time. During the Champions Trophy I wrote that only the top threein cricket matter. Before that I started making a documentary on the death of Test cricket. And during this Boxing Day Test at the MCG, I was chatting toABC Grandstand about it.

If you follow cricket politicking at all (and I do, so you don't have too), you could see this coming. So it was nice that Sharda Ugra showed that it was not just a conspiracy theory by a few nut jobs. That it was a real takeover of cricket by the greedy and wealthy.

But what does this leaked draft actually mean, and is the ICC financial and commercial committee actually run by giant lizards? I tried to answer a few questions that people had.

In a word, good or bad for Test cricket?
Bad, not just for Tests, but for all international cricket.

If there is promotion and relegation in Test cricket, but Australia, England and India can't be relegated, isn't that cheating?
It's not just cheating, it's organised fixing. Any individual who signs off on a regulation like this is corrupting the game, and should be banned by the ICC for their action. They are ensuring the result of the competition before a game is played. The integrity of the game is corrupted as much as by any huge no-ball. They might as well only let other teams use five batsmen, bowl with beach balls and field with sponsored flippers on. As long as the sponsorship money is split unfairly, favouring the stronger nation.

Who are the people involved in this secret dossier for cricket's potential kidnapping?
The names of the people on the committee that the draft came from are Giles Clarke (chairman, ECB), Alan Isaac (ICC president), Dave Richardson (chief executive), N Srinivasan (BCCI), Neil Speight (Associate and Affiliate member, Bermuda Cricket Board), Wally Edwards (CA), Dave Cameron (WICB), Campbell Jamieson (GM, commercial) and Faisal Hasnain (CFO).

But the big winners, if the draft was implemented, would be Clarke, Srinivasan and Edwards. It is they who will be taking over cricket officially on behalf of their boards. We don't have the details of who the architects of the plan are, but being that these men and their boards get the best deal, it's not a big stretch to believe they were behind it. I doubt the Bermuda chairman acted alone in this.

What did the FTP do? What does FTP stand for and why does it matter?
The FTP is (was?) the Future Tours Programme. It essentially meant that teams would have to play everyone, and not just who they wanted to play with. It was brought in to ensure that teams had a schedule to play each other and ICC tournaments. It helped sell TV rights and aided smaller nations financially by drawing them up against teams with larger markets and on the cricket field through experience against the best teams. It was a flawed but well-meaning system of sharing the wealth and making cricket fairer.

Wasn't the FTP ignored?
Occasionally. It was more a nagging aunty than a scary prison guard. I know Australia have played Bangladesh, I just can't remember when. And Bangladesh have never toured India. Things are moved around on a whim quite often, but it at least meant that if something did happen, like Sri Lanka and West Indies cancelling their Test series, they had to come out and say it, not just silently agree never to play again. No FTP makes it all a bit more covert and easier for board members to ruin things without us noticing.

	We have no vote in cricket. All we have is our passion, which is what makes the money that gives these men their power

Why does it matter if the big three countries make more money from ICC tournaments and share the ICC top jobs? Don't they already own and run cricket?
Yes, they do. But it matters because cricket isn't limited to three nations, or even ten. There are 106 member nations of the ICC. If this structural upheaval happens, less money and no power will escape this evil cricket cabal. These dirty three will be able to continue to rule cricket forever for their own good. And they'll have the backing of cricket's governing body, which will essentially be them in all but name.

Will cricket's best interests really be looked after by these three nations?
One recently got involved with a fraudulent crook; the second stopped players picking who they wanted to represent them at the ICC level; and the final one wanted all the other nations locked out of the World Cup.

Isn't the current ICC set-up terrible anyway?
If by that you mean there are no votes at ICC boardrooms, that it's run by the ten Test-playing boards who are all out for their own good and that India have all the financial muscle, then yes. The Woolf Report, an independent evaluation of the ICC (that the boards never wanted, and of which they ignored all but the bits that helped them keep their stranglehold), suggested that cricket needed to be independently run, instead of by the member boards. But at least the current set-up, as pointless and ignored as it is, gave ten nations a say.

Sport is a business, and this is just a business decision, isn't it?
It is a business decision. A bad one. A short-term one. Like most decisions made by cricket officials, it follows the money where it is right now. It doesn't look ahead. It doesn't grow the game or improve it. It picks cricket up by its underwear and takes what is in its pocket.

Surprisingly, most billion-dollar businesses aren't run by unpaid men who face absolutely no consequence if they completely stuff up the business. Who would have thought a billion-dollar business run by amateurs with no independent management could be taken over so easily?

Should Bangladesh prepare for a five-Test match tour of Australia, England or India shortly?
No.

Which Full Members outside the trio will be playing Test cricket by 2020?
It is impossible to tell. But this is not a move to lock in the future of the current Test-playing nations. It is a move to lock in the future of three of them. The rest can go to hell, and by hell, I mean more Champions Trophy tournaments.

I'm from outside the cricket cabal but don't really like Test cricket. Why should I care?
Because the FTP and ICC restructuring isn't just about Tests. It's about stopping your country from getting money. It's about ensuring through financial means that while three countries will have every single advantage, the others will have to live on far less. Money doesn't guarantee success. But it certainly helps in sport.

I'm from inside the cabal. Why should I care about the other nations?
Maybe you shouldn't. You'll have all the IPL, Big Bash and Ashes you can eat. But if the other seven teams stop playing Test cricket, or don't play enough to make it relevant, you're going to get pretty damn bored pretty damn quickly. And while you may only watch for your own players, do you really want to live in a world that involves less Sri Lankan mystery spin, New Zealand pluckiness, Misbah-ul-Haq, and the current best Test team on earth?

What will happen to the non-Test playing nations?
Not much will actually change for them. Life wasn't exactly free beer and endless casual sexual encounters before. If anything, now they have seven new friends who also have no power.

Can saner people in the future undo this mess?
Yes, probably. Even the old veto was eventually taken away from the ICC. Things can change. If the chairmen of the three cricket boards were to change, it could change very quickly. There is also little doubt that at least one of Clarke, Srinivasan and Edwards wants to eventually run the ICC once the main job there is made more powerful. Which means this reign of bullying and grabbing for power may not end anytime soon.

Should these three men step down?
Yes. Anyone who agreed with this draft, whether it was their idea or not, should leave cricket immediately. They won't, obviously. But they should.

Is there any light at the end of the tunnel?
Someone leaked this draft. Someone who saw it realised that cricket fans wouldn't like this, and instead of it being announced through an ICC press release, it was blurted out before they had a chance to lock it in. In fact, there are many good people working in cricket all around the world. They don't like this situation any more than we do. Hopefully more of them will step forward with details. That gives us a chance.

What can I do?
Contact them. Don't be rude, don't abuse the people who are answering the emails, calls or letters, but contact them. Tell them what you think of all this. CA can be contacted here, the ECB here, the BCCI here. We have no vote in cricket. All we have is our passion, which is what makes the money that gives these men their power.

They are banking on you not knowing or caring about any of this. Giles Clarke regularly tells young cricket writers to stop writing about administration because it's boring and fans don't care about it. What this does is allow cricket's most important men to run the game while no one is watching. Show them you're watching.

If you have time to complain about a shocking DRS decision or a terrible cover drive, surely you have time to send an email to the men running the game. Show them you care. Tell them what you think. You have no vote in cricket's future. But you do have the contact pages.

England's reusable scapegoat

 

Andrew Hughes in Cricinfo

"Some day, if you play your cards right, you just might turn into a proper sacrificial lamb"  © AFP

Enlarge

Generally speaking, the Old Testament hasn't much to teach us about cricket. Yet as England continue to wander in a dry, harsh and unforgiving land in search of victory, it seems that certain members of that benighted tribe of outcasts have been taking advice from a passage in Leviticus: 

Then he is to take the two goats and present them before the Lord at the entrance to the tent of meeting. He is to cast lots for the two goats - one lot for the Lord and the other for the scapegoat. The goat chosen by lot as the scapegoat shall be presented alive before the Lord to be used for making atonement by sending it into the wilderness…

It's a simple idea. If you've done something you're not too proud of, perhaps pretending you hadn't hit a ball with your bat when really you had, eating too many shellfish fairy cakes or losing five Test matches in a row, then simply find yourself a tame quadruped, stick a piece of paper inscribed with the words "Sorry about all that" on its horns, and point it in the general direction of the countryside. Hey presto, all is forgiven.

Still, as splendid as this tradition is, these days people are less likely to be impressed by goat-based rituals of atonement than they were in Biblical times. A higher order of mammal altogether is required. Step forward Kevin Peter Pietersen.

That's the great thing about having a talented foreigner in your team. Not only can he win matches for you, but when the time comes to turf him out, no one really minds because he isn't English anyway. KP has been particularly valuable because he's a reusable scapegoat, an economy that the profligate men of the Bible clearly hadn't considered.

The ritual is already well underway. Journalists are clamouring for blood, Andy Flower has been spotted picking up his sacrificial robes from the dry cleaners, and Alastair Cook has refused to speculate on the identity of the tall South African-born goat they've got in mind.

But Kevin should not despair. He may not enjoy playing the role of the shunned ruminant, but he should remember that the scapegoat generally fared better than your average Biblical goat, not to mention your average Biblical sheep, ram, bull or fatted calf.

And this particular version of the old Bible story is likely to turn out rather well for the goat when he falls in with some other goats, travels to India to play in the Indian Goat League, becomes one of the richest goats on the planet and tweets photographs of himself sitting in a stretch limousine eating fresh grass out of a solid gold manger to his adoring fans, while Flower and Cook sit huddled in their ECB bunker, contemplating their 27th consecutive Test defeat and considering whether to abandon little Joe Root on a mountain top in the hope that it might bring them good luck.

Time to make leg slip a regular fielding position?

V Ramnarayan in Cricinfo

 

Most batsmen are rarely in control of the leg glance or flick off fast bowling  © Getty Images

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"What is unlucky about being caught behind down the leg side?" asked Samir Chopra in a recent blog post. He set me thinking about a cricket problem that has puzzled me for years.

Why is it that some of the greatest batsmen in the game fail to, or do not care to, keep the ball down while glancing or flicking it on the leg side? And why are such shots not considered poor except when the batsman is caught (and even then it may be regarded as a piece of bad luck or a fantastic catch by the keeper or both), when even a thick outside edge that goes for four is described as one? 

The answer is quite simple, in my opinion. You can get away with playing the ball in the air (actually, the batsman is rarely in control of the leg glance or flick off quick bowling, just as he is not with a poorly executed hook shot), because there is rarely a leg slip in position until after a missed opportunity, and the catch can often elude the wicketkeeper's grasp.

The leg slip or leg gully is rarely deployed because of the rule restricting the number of fielders behind the popping crease on the leg side to two. While that is normally understandable, especially when a bowler's stock delivery is an outswinger, I have often wondered why at the highest level of cricket, inswing bowlers tend to bowl to a three-slip, no-leg-slip field. At the college or junior level, a leg slip is quite a common sight when an inswing bowler is in operation, and that, to me, seems to make sense.

Madras batsmen of my vintage were advised by our coach KS Kannan to force short-of-length deliveries around the leg stump off the back foot rather than flick or glance them without foot movement, or with a tentative forward movement, as many of them were wont to do. This way they would also present the full face of the bat and watch the ball all the way on to it.

Kannan was then assisting the Derbyshire and England professional TS Worthington, whose approval he enjoyed. To the best of my knowledge, none of the boys in our camp followed Kannan's advice, and they merrily played the ball in the air between fine leg and midwicket whenever it landed in a sort of blind spot around the leg stump.

Two great batsmen of that era who were almost always in perfect control over such deliveries were GR Viswanath and Sunil Gavaskar. Vishy, whose wrists and forearms John Arlott once likened to those of an ironmonger, was perfectly capable of whipping short or long deliveries on the leg stump, or even the off stump, in a wide arc from mid-on to fine leg, keeping the ball down, unless he deliberately lofted it. Gavaskar was the complete master of anything on his legs, rarely missing a scoring opportunity in that region. Mohammad Azharuddin and VVS Laxman had the powerful wrists to roll firmly over the ball, virtually treating it with contempt. Sachin Tendulkar could, of course, make the ball do his bidding, rarely giving the diving wicketkeeper a hope on the leg side.

My question is, why should lesser mortals get away with edges and uncontrolled leg-side shots, instead of being punished in the same way as they are for flirting with deliveries outside the off stump? To enable a transformation, should there be a change in the laws of cricket so pace bowlers are encouraged to field leg slips?

In other words, to add yet another outrageous suggestion to ones I have already made in this column, why not raise the limit of two fielders behind the popping crease on the leg side to three? True, the rule came into being to prevent leg theory being used either to intimidate or hurt the batsman or as a negative ploy, but we now have the restriction on bouncers per over to prevent or reduce bodyline, and in any case, even under the present laws of cricket, negative leg theory is not an unusual sight in Test cricket, with left-arm spinners or legspinners sometimes resorting to it under the pretence of exploiting the rough caused by other bowlers' footmarks. Any such unfair tendency can also be countered by judicious declaration of deliveries deliberately aimed outside leg stump as wides.

While such an amendment of the rules can give the inswing bowler (and perhaps the offspinner) more teeth and another catching option in the deep off the bouncer, it will force batsmen and batting coaches to work on improving the techniques needed to negotiate well-directed inswing bowling or deliveries pitching on or around the leg stump.

In conclusion, I admit such a fundamental change will never even be considered, as it could make batting against top-quality fast bowling a nightmare. I am prepared to be proved to be absurdly wrong in my thinking by experts on the game.