Tag Archives: monopoly

104. The wolves of Wimpole Street.

The Monopoly Board Game is an increasingly valid metaphor for British society. Railway stations, water and electricity utilities can be bought cheaply so that jail is the only service left publicly owned.

Ironically, Monopoly was invented by a Lefty as an educational tool to illustrate the downside of capitalism. Ownership of property slowly but surely polarises the players into haves and have nots, leaving one person super rich and the others destitute. Sure, there is an intermediate stage where a notional middle class can own a few houses, but this is an illusory phase, like Derby County’s sojourns in the premier league. Sooner or later the market will prevail, typically after significant alcohol consumption, leaving family relationships in tatters and one giant corporate entity in control.  

The original idea for Monopoly was stolen by one of the inventor’s dinner party guests, patented and sold to a large games corporation. The inventor did get $500 though, enough nowadays to buy Liverpool Street and Kings Cross stations, given the current exchange rate. The monetary values in Monopoly are pleasingly anachronistic – £200 seems cheap for the whole of Kings Cross. I like anachronisms. Shakespeare in space suits for instance, or the bit in ‘A Knight’s Tale’ where the medieval dance morphs into Golden Years. It was fairly anachronistic when British Home Stores was sold for £1, though it should be remembered the pound was worth a lot more in 2015.

What’s surprising about Monopoly is that there is no hospital on the board nor any other health or social services related property. Players can only build houses or hotels on their streets, not Walk-In or Sure Start Centres. 

Getting out of jail costs £50, maybe even less if you can buy a card off a competitor or throw a double. In real life, the super rich don’t go to jail very often, but may still need to go to hospital. Even the richest individual occasionally crashes a Bentley or has a heart attack during a special massage. 

Which is the moment when, if they have the misfortune to be in the UK – where there is no private A and E – that person realises the paramedics won’t be there for 90 minutes, there are no beds in A and E and their money is suddenly useless to them.

If only there was a card called ‘Get into Hospital Free’, it would trade at many multiples of its face value. Even more valuable would be a ‘Get into Hospital Fast’ card, with a picture of an ambucopter flown by Prince William.

There are two ways into A and E – via reception or ambulance. The reception route collects all those who have been dealt a card called ‘Go directly to hospital, do not pass Go’ and who are well enough to stagger up to reception. 

There are pros and cons both ways. In recent years I have spent a few nights in A and E as an aspiring patient. On the most recent occasion I was walking wounded rather than stretchered, so I went in via reception and I had time – 13 hours or so – for some light blog fieldwork. Staying up all night to get lucky, as Daft Punk (feat. Pharell Williams) would put it. 

During the night the receptionist, who was wearing tight leather trousers and a leopard skin print top, spent a lot of time sticking labels onto case files and filing notes away, carefully ignoring prospective customers. Towards the end of her shift she retreated further and further back from the glass screen into her dark receptionist-cave.

A tall man, probably concussed, with his gashed head bleeding into a towel turban, waited for quite a while before getting booked in. Finally he was asked his details: for occupation he replied ‘international sex symbol’. That was met with a frown. ‘OK, sales executive then’ he tried instead. He reluctantly gave his wife’s name as next of kin. When asked whether he wanted her to be informed, he said, ‘no, that would only make things a hell of a lot worse’.

He took his seat with the rest of us, on the non – covid side of the waiting room. 

Unfortunately the vending machine was on the covid side, necessitating occasional masked guerrilla raids across the imaginary germ frontier. 

Luckily there was a portacabin called The Pod, which was a medium term waiting room, like Purgatory. No-one seemed to use The Pod, probably in case they lost their place in the queue. It was hard to be confident that the staff would come and find you once your turn came up. The pod had a TV, but it was set to a shopping channel and there was no sound and no remote. Don’t tell the Care Quality Commission (they insist on Sky Arts). It was quiet in the Pod. 

Monopoly does pay attention to the random vicissitudes that can affect people, rich or poor, using ‘Chance’ and ‘Community Chest’ cards. The cards do include a £50 doctors fee and a £100 hospital fee, but nothing financially ruinous, like crashing into Gwyneth Paltrow on skis. Chance cards include a range of life events, both positive and negative. According to monopolyland.com the Chance cards are more luck-based and Community Chest cards are more likely to reward the player with money. The worst thing that can happen is the need for property repairs.

Why the game excludes a dimension related to health care is unknown, but my speculation is that the designers were reluctant to admit that accidents and emergencies really happened to property owning people. If they did, they would be treated by insurance based private health providers. The original version of the game, after all, was set in the Atlantic City of the 1930s, a time when Night Nurse was a person rather than a drug of abuse.  In translating the UK version to the streets of London the makers should have gone a bit more Ralph McTell.   

Free Parking? Hard to believe that still exists, any more than Free Lunch. I would call that square ‘Clamping Zone’ and have a picture of a menacing man with a Pitbull. Or instead of Free Parking, on the corner diagonally opposite Go, a square called Stop, a disused BHS shop doorway with a picture of a comatose homeless person under an old duvet. 

Monopoly does not have anything the district council would call ‘high quality public spaces’, so I would suggest they include the Southbank Skate Space, with a picture of Melvyn Bragg, in the background, spraying graffiti. And what about including a square for Tufton Street, where the right wing think tanks are located? Pay a large penalty if you land there, dark money preferred. 

There are versions of Monopoly depicting many different cities around the world. Although there are monopoly situations existing in health care, both government-run and private, the board game itself remains silent on health provision ownership.

I’d like to think this proves that capitalism and medicine just don’t mix well, at least in board games. 

The longest ever Monopoly game lasted 70 straight days, which is about the time it takes to get an urgent eye appointment. It will take a while to find out whether we are getting richer or poorer, but like Derby County, I’m guessing the prognosis for the NHS is Game Over.

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20. Choosing Love, Zero, or the Egg.

Image

Trying to see the big picture.

Does it make any sense at all to go to the National Gallery, look at Turner’s The Fighting Temeraire for a few moments, and state, ‘I’ll give it a 7’?

This week we read that the NHS has produced a series of 8 commandments. Some of them are a bit basic, like patients having the right to food and drink. It also seems they have to be given ‘the right amount of  medication, when they need it’, which is an excellent idea, rather than using random number tables.

Whether the commandments will be on stone tablets or not depends on Health Secretary Jeremy Hunt. If he spends too long carving them, NHS staff might make a golden effigy of his predecessor, Andrew Lansley, and pray to that instead.

My first thoughts are that eight is an unusual number. Did they start with 10 and drop two of them? Which two didn’t make it? Consultants should wear top hats? The layer of butter on toast should be exactly one molecule in depth?

Nevertheless I see the makings of a scoring system with a maximum of 8.0, maybe more if there are sub-scales for each commandment.

Does it really help to measure everything? Today we were urged to catch ladybirds in a net and report them using a special app. At school, children dig up one square metre, to count the number of earthworms. On the main road, other children wait with clipboards, counting the number of cars that go by, so the distribution of car makers can be made into a bar chart.

I’m forced to conclude there is something in the human mind that likes to assign numbers to concepts. Perhaps its a desire to bring order to the universe.

People love scoring systems, often far more than the activity that is being scored. The ultimate ‘scorathon’ is the Eurovision Song Contest, where the scores are luxuriously accumulated over a half hour period, layer after layer of numbers added to a chart.

The shipping forecast gives scores for both wind speed and visibility, for exotic parts of the North Sea, which are given a name and a number, like ‘forties variable four’. Its incredibly atmospheric.

As far back as 1964 Eric Berne wrote ‘Games people play’, introducing his theory of Transactional Analysis. The book contained nothing about Monopoly or Risk, let alone Cribbage or  Texas Hold’em, which were games people played at the time, making it something of a swizz to my mind, but nevertheless it became a best seller.

Unfortunately Eric’s games were relatively light on scoring, mainly win or lose, comprising self defeating scenarios like, ‘why don’t you yes but’.

Psychologists had been using numerical scores since the early 1900s, when IQ tests were invented. Psychometric testing spread like plague in schools, more so than in clinical psychology or psychiatry. Most of the summer term in schools and universities is taken up with exams. You don’t grow onions by weighing them, as they say in Yorkshire.

Nevertheless, around the time Bob Dylan ‘went electric’ (psychologists and psychiatrists had gone electric in different ways many years prior to this), Max Hamilton introduced his Depression Rating Scale, the HDRS. In Yorkshire.

Everyone has their own scoring favourites. I like the ones where stern-looking judges from Eastern Europe hold up cards with numbers between 5 and 6. For some reason our exams at medical school used a similar system, where everyone scored between 50 and 60. All those numbers, above and below, just wasted.

The scoring system for football is reassuringly simple, being based merely on goals scored. There are no subscales for creativity or artistic interpretation, gentlemanly behaviour, nor even hairstyle. Tennis has an unusual non-linear scoring system: Love, 15, 30, 40, etc. ‘Love’ is probably the odd one out in this list, especially if translated from French to mean ‘the egg’. For some reason the French say ‘zero’ instead of ‘love’, and ‘egalite’ instead of ‘deuce’. Social historians, please discuss why.

One of the most comforting rituals of Saturday afternoon is the ‘full classified’ football scores, which is very similar to a long prayer, such as the Rosary, but without beads. How many families gather together to find out how Hamilton Academicals have done? (Is there also a non-academic Hamilton team, such as ‘the pragmatics’?) The trick is, you know who has won, before the second score is stated, from the intonation of the first score. Its the one job that could not be done by Robert Peston, or King George the Sixth, for that matter.

The academicals were not named after Max Hamilton, who was not even Scottish, although he was an academic – a medical statistician as well as a psychiatrist. Hamilton invented the HDRS for Depression in 1960. It is still the gold standard today, despite many alternatives. Its freely available, so you can use it on someone in your kitchen to see if they are depressed. If you want to use one on yourself you need a self report scale such as the Beck Depression Inventory.

They don’t work on pets by the way.

Its hard to believe that as recently as 1960 people already had electric guitars and long playing records, but didn’t use rating scales for everyday decision making. The notable exception to this was the Michelin star rating scale for restaurants, which had been around since 1936.

Rating scales for mental health problems were born out of the need to establish whether treatments were effective or not. Antidepressants for instance, started to come out in the sixties. To do this, some kind of yardstick was required that allowed people to compare treatment A with treatment B. The Hamilton scale was more ambitious than the Michelin guide, using 17 items instead of 0 to 3 stars. It was made in Leeds, instead of France, so it did not contain any items about truffles or vintage champagne. (It was before they had Harvey Nichols).

Now we have rating scales for all kinds of everyday activities, such as Trip Advisor, so we can know whether hotels cook sausages properly or choose tasteful enough wallpaper. This is presumably the way the NHS is going, with the commandments system.

Perhaps the major religions missed an opportunity for developing rating scales for the actual ten commandments. It seems likely it would not have been as simple as just a mark out of 10. It looks as though some of the commandments are more important than others, for instance not killing should be allocated more marks than not coveting your neighbour’s donkey.

Then there is the problem of setting the time frame for making judgements. Is it at the end of the person’s life, or at the end of time, or at a cross sectional point, such as age 34, when you are just old enough to know right from wrong? Or could it be a random point in time, like in musical chairs, when the music happens to stop?

There are other problems with a whole of life scorecard. One of these is whether a handicapping system is needed, as used in golf. People dealt a poor hand by nature or circumstance ought to get some kind of start over people who were born rich and brainy.

The system for football clubs seems a bit unkind. If the club goes into administration a further 15 points are deducted, something that co-incidentally also happened in Leeds. If that’s not kicking someone when they’re down, I don’t know what is.

I stayed at a hotel last week, where a rating of 8.2 was proudly displayed at reception. How would the rating be affected by price? I paid half the ‘proper’ price, so that should put the rating up somehow, but surely not to 16.4?

No-one states these scales are linear, and in fact the distributions they relate to are probably bell shaped or skewed in some way, like the people who invented them. Many of them are called Likert scales, which typically offer a five point scale, from strongly disagree to strongly agree, or from nought to stupid, as Spinal Tap would say. The more abstract and subjective the concept, the more people try and impose a number scale. Ten out of ten for irony.

The most interesting thing about Likert was his first name, Rensis, which is in the top 12 ‘most unusual real names’ according to the experts at Nancy’s baby names. Five point Likert scales are everywhere now, from Amazon to Army Generals.

Should we use a scorecard to measure our life? We’d have to set the goals and the scoring system as early as possible. Strokeplay, matchplay, Queensbury rules, tiebreakers and sudden death play offs all need factoring in. I’ve a feeling the goalposts might get moved at times, certainly widened.

The ten commandments seem like a starting point. The deadly sins and corresponding heavenly virtues could form the basis for a seven item linear analogue or Likert scale. But that might be overly religious for many people.

We may have to stick with our old friends, the annual appraisal and the personal development plan.

Or we could use the 360 degree appraisal, as in the NHS, where we give feedback questionnaires to family members and neighbours on a regular basis.

I’d give one to hotels and shops so they could get their own back on me. (I really regret asking why one hotel had attempted to cook the breakfast with a hairdryer. But sarcasm doesn’t seem to be a deadly sin, so I haven’t lost any points, technically.)

To my knowledge, no sports have brought in a feedback based scoring system, not even cricket.

As they say in golf, and at the National Gallery, and now in the NHS, there are no diagrams on the scorecard, only numbers