Paris and the month of November are closely associated in my mind. Until last week that was for totally good reasons. In 1989 we spent the first couple of days our honeymoon there and it was was the perfect backdrop for that most happy time of my life. Last year we returned at the same time of year as we celebrated our 25th wedding anniversary.
I have probably been to Paris more often than any other city other than those I have actually lived in. I have always loved its elegance and character with the chance, in more recent years, to broaden my acquaintance from beyond the well-known sites to discover some lesser known corners of the city. However many times I have visited it never disappoints. It is one of the great cities of the world, not just because it is beautiful but because of its deep culture and the values of it represents of freedom, joie de vivre, intellectual curiosity and tolerance.
From today November and Paris have a different association as I try to get my head round understanding the terrible nature of last week’s attacks on the city and the death of so many innocent people going about their business on a Friday night.
We live in difficult times in which the regular intrusions of terrorist acts have become a reminder of how fragile, at times, the civilisation we take for granted can be. As well as the individual tragedy for those who have lost their lives or the life of a loved one there is a sense of affront to the lives and values of many more. The object of terrorism lies in its name and it succeeds in that aim to no greater extent than when it makes us feel that the places we know and love are no longer safe and spreads mistrust in the midst of our communities and neighbourhoods.
I do not begrudge all the hard talking and promises of retaliation which have come out of the lips of politicians and others over the last week. I would not want to sit in their shoes and try to offer reassurance in the wake of such horrific events. Such acts can only be condemned in the strongest language but at the same time something much deeper and more thoughtful is required if we are to find an effective response to the monstrous events which have been unleashed in our midst. The Archbishop of Canterbury, Justin Welby, was much closer to the mark in describing how the extent to which his faith had been shaken to its roots by what had happened in Paris. Certainty in the light of such events can only be a superficial state of mind.
So how can we can get to the bottom of what the Paris attacks really mean? History offers some lessons. Paris has seen similar events before, whether the St Bartholomew Day’s Massacre of Protestants in 1572, the Revolutionary terror of 1793-4, when human life has been recklessly sacrificed in the name of a religious or political cause. However ideology is rarely the cause but rather the container of human wickedness. The Paris massacres were no more about Islam than the Robespierrian Terror was about liberty, equality and fraternity. However it suits the terrorists for us to see their actions as the clash of cultures and for the bonds of trust between different groups in our communities to be undermined.
What is most worrying for me is to see the deep sense of alienation at the heart of our societies. To some extent this is nothing new but there is something very frightening in the scale and depth to which young people from a range of communities feel totally cut off from western societies whether they act as terrorists in Europe or lone gunmen in the US. While the last thing I would wish to do is to pigeonhole such a phenomenon as mental illness there is no doubt there is a deep level of unexplored trauma and mental distress which leads what in many cases are quite ordinary young people to play out such extreme roles.
I can accept that there has to be a response. Sad though it is these attacks, just like those of the IRA and 9/11 will lead to restrictions in freedom of movement and civil liberties. As we know, once lost, they can take a long time to recover. Some kind of war must be fought against IS but before we go too far we must be clear about what are tactics and objectives are and whether we can be sure of achieving them. Even if we can be sure of winning the war we must think carefully about whether we can win the peace. Recent events in the Middle East and elsewhere are not promising.
On a different scale we were shocked four years ago when the streets of London erupted into riots and indiscriminate violence. A sense of alienation amongst the young and tensions between communities were again a strong factor in what happened. My organisation was involved in responding in one of the communities affected, Tottenham. Through the Thinking Space initiative we were involved in creating a facilitated opportunity for communities to come together and explore their experiences. I am not claiming that it was a panacea but it appears to have done some good in opening dialogue in that community and building trust.
So my plea after Paris is for thinking space. To recognise that however shocked we rightly are by the atrocities that have happened we need not just retaliation but actions which respond to the deeper cause of the horrific events we have seen. For the present though “nous sommes Paris.”
One of the aspects of the spending settlement announced to be announced by the Chancellor on 25th November which I will be most interested to scrutinise will be that relating to social care. I have both a professional and personal interest in doing so.
Social care has been an area which has already suffered as a result of austerity. Over the last 5 years budgets have been cut substantially and this had an inevitable impact on services and the people using them. As someone running a NHS organisation it is clear that this has had a significant effect on the numbers and acuity of cases presenting to our services. Most NHS leaders would, and do now regularly, say the same.
Social care is an elusive concept in the public consciousness (that is part of its problem) but in essence it exists to support individuals who, whether because of disability, age or other issues of vulnerability, need additional help with aspects of daily living. It includes (rightly or wrongly) those who need care in a nursing or residential care home and it also embraces safeguarding and the crucial role of the state in protecting children at risk of harm. My personal interest relates to the position of my ageing parents and disabled brother whose need for support from social care is likely to become critical in the next couple of years.
The social care system has suffered from a number of disadvantages. It is a child of the traditions of the Poor Law and it has been means tested while health care has been free at the point of delivery. It does not have the glamour of health care and the powerful voice of the medical and scientific establishment to help argue the case for resources. Finally it has been connected with issues such as frailty, disability, family breakdown which can at times be issues which we struggle to talk about as a society in a comfortable way.
Yet despite all of this social care in this country has done much in the last 70 years it can be proud of. It has helped to support many of the most vulnerable and disadvantaged people in our society enjoy a better quality of life. It has increasingly promoted a philosophy of respect and independence for disabled people and it has made much more progress than the NHS in involving people in decisions about their care and support. It has done this for growing numbers of people as a result of the success of the NHS in enabling growing numbers of us, and in particular growing numbers of people with disabilities, to live for longer.
Since 2009 the social care systems has been under unprecedented financial pressure. Social care, unlike the NHS, has not been ringfenced and has spending has fallen by an average of 2.2% each year since then. This is despite substantial transfer of resources from the NHS recognising the absolute interdependence of the two systems. Without this the drop in spending would have been as much as 3.6% each year. Given the news, this week, that the Department of Communities and Local Government had settled its position already in the Spending Review, accepting a 30% cut in its budget over the next 4 years, it is only to be supposed that spending will continue to fall at least this rate for the foreseeable future. Whatever Local Government can do to rationalise back office and other administrative functions reductions on this scale cannot be made without substantial cuts to front line services. To what extent the NHS, with its own financial pressures, will be able to help, as it has done for the last 5 years will have to be seen. I am not hopeful.
If we continue to decimate social care budgets in this way there will inevitably be consequences.
A first consequence will be for families and carers. The nature of social care is that, to some extent, it can be substituted by informal care. Indeed the vast majority of social care is indeed, already provided by 6 million family members and other carers (including more than 160,000 young carers), an effort valued a couple of years ago, as equivalent to £110 billion per year. But the formal social care system can make a crucial difference to the lives of those informal carers by providing help with difficult tasks such as personal care, providing periods of respite and when, needs become too great, offering access to long term care. When formal care is limited already in many places to those with the greatest needs it is hard to imagine how much more can be absorbed by informal carers without significance consequences for their health and where younger, their ability to participate in economic activity.
A second consequence will be for disabled people. We have, as a society, made important steps forward, in changing attitudes to people with disabilities and in enabling them to participate as full members of society. Social care plays a key role in providing the support which enables that independence. As services and support are cut back there is an undoubted impact in narrowing the opportunities and choices available to those people.
A third consequence will be for the NHS. As is already clear reductions in social care impact directly onto the NHS when the services and help which allow a frail elderly person to stay in or return to their own home are not available or take much longer than should be the case to arrange. Similarly cut backs in the resources available to work with looked after children and at risk families will impact on the demands for CAMHS services. Of all the assumptions which underpin a vision of a sustainable NHS the level of social funding is key. While there is some hope of making progress through better integration of budgets there is a limit to what can be achieved unless social funding receives some level of protection.
Finally there will be a consequence for society. How we look after older people, people with disabilities and vulnerable children are fundamental to the values of civilised society. If we cannot, as a society, afford to sustain a decent level of social care provision we run the risk of seeing many more distressing cases of neglect and abuse amongst those groups which as a society we should be doing the most to protect.
The saddest part of the story about social care cuts has been the lack of political debate about the value we place on social care. I hope it doesn’t become the case that we only really value social care once it’s disappeared.
I’m very pleased that Michael Gove has come back from the USA full of ideas for the reform of the justice system and enthused by using the justice system not just to punish but, where possible, tackle the underlying issues which have brought people into court in the first place.
The good news for Mr Gove is that he doesn’t have to go too far to find successful examples of this model in operation. My own Trust, the Tavistock and Portman, working in partnership with the childrens’ charity Coram has been delivering, for a number of years, the Family Drug and Alcohol Court (FDAC) service which uses a problem solving approach to work with parents who have come to court at risk of losing their children on account of alcohol or drug misuse issues.
This is a serious issue. Parental substance misuse is a factor in two thirds of care cases and is a major risk factor for child maltreatment, family separation and offending behaviour. For the children it is frequently associated with poor educational attainment and other poor life experiences. Often it has an inter-generational character with histories of trauma and substance misuse destructively repeating themselves.
The FDAC model is based on a multi-disciplinary team of therapists, social workers and other professionals working alongside specially trained judges to provide tailored support which help parents address their substance misuse issues and, if appropriate, keep or be reunited with their children. Further support is provided by a team of parent mentors.
An evaluation of the service was published in 2011 by Brunel University. It demonstrated not only that this was an intervention which delivered much better outcomes for parents and children, it also saved money for local authorities and the judicial system.
So 48% of FDAC mother were no longer using substances at the end of the intervention compared to 39% of comparison mothers and the same was true of 36% of the FDAC fathers while none of the comparison group had done so. 39% of FDAC mothers were with their children at the end of the intervention compared with 21% in the case of those mothers who had not received the FDAC service.
At the same time the service can offer savings to local authorities of £1200 per family on the cost of expert evidence and £4000 on the cost of out of home placements. The service also shows a saving of £682 per family on the cost of court hearings.
This has not been my first experience of problem solving justice. While I was at Rethink Mental Illness we were involved in the delivery of CAS a problem solving and signposting service operating in magistrates’ courts in Plymouth and Cornwall. It was equally effective in demonstrating better outcomes for those at risk of custodial sentences.
These interventions demonstrate a number of key features which together underpin their effectiveness.
The first is the way in which judiciary and health and social care practitioners are able to work together as a single team. Judges have prompt access to expert opinion and support. In response judges and the court process provide structure and, in some cases, some persuasive impetus for parents in engaging with the issues they are facing and the treatment which is on offer. A key feature of the service is an element of continuity in the involvement of judges in particular cases.
The second is the broad range of interventions on offer. FDAC is able to offer not just access to substance misuse services but also a range of therapeutic interventions and practical support to sort out issues such as housing which can so often underpin the vicious cocktail of life problems which makes it hard for people to change their behaviour. The involvement of peer mentors also provides the shared voice of experience which at times can be even more powerful than that of professionals in helping people to change.
The third feature is a non-judgemental approach, from both judges and practitioners. We heard recently at the Trust’s AGM from four parents who had used the service. They spoke eloquently of how surprised they had been with how judges and practitioners in FDAC had actually listened to and taken them seriously when all they had been used to, from other services, was being criticised for their actions.
The fourth and related point is the ability of this service to help parents make their own realisation of the need for change in their lives. From hearing their stories there is undoubtedly a role which court proceedings can play in this but almost more powerful, I would judge, is the recognition by the service of the complex stories of individual’s own lives, and the trauma those individuals themselves have experienced, that can unlock the motivation to change.
In my experience such stories are so often prevalent in the lives of those who end up in the criminal justice system and yet we often pay so little attention to addressing those deep psychological factors and helping people to cope with their consequences. We have in this country been tough on crime but we have failed, in the same way, to be tough on the causes of crime.
In the last year we have been very excited to have the opportunity to work with a range of stakeholders in others parts of the country to develop FDAC services in four other areas. There is enormous interest in and demand for this new and different approach to one of the most difficult and intractable of social problems. However, even as we develop plans to extend the service in new areas, there are difficult conversations about the existing service with local authorities, who despite their support for the services, are under such financial pressure that they are having to review the level of their commitment.
Problem solving justice is an effective response to dealing with issues where a costly punitive approach has been the only previous option open. Government, at the national and local level, and the judiciary should be embracing it with open arms. In the long term it save a lot of money and a lot of misery. It would be a great shame if acute short term pressures prevent us from seizing that opportunity.
Last Wednesday marked the 30th anniversary of my first day in work. I can remember it vividly, sitting anxiously in a café in Elephant and Castle just before reporting for duty at what was then the Department of Health and Social Security, a new set of colleagues and day of meetings, which I was asked to take a note of, full of acronyms which I was unable to translate.
Looking back it’s staggering how much change there has been in the world since I started. No computers, no email, everything written out in long hand and then typed up by “the pool”, no open plan offices, regular Friday lunchtime trips to the pub with the obvious consequences for productivity on Friday afternoons.
I joined the civil service in 1985 with the clear expectation that it would be my career for life just like many others starting careers at that time. Things have moved on and it’s much easier to change organisations and paths than it was in the past. Although I have stayed in area of health my own career has spanned central Government, the NHS and the voluntary sector.
Work has been very important for me and I have been lucky to have a broadly successful career and the opportunity to work on issues which matter to me intellectually and morally. Many are not so lucky. One of my grandfathers was out of work for 15 years after the 1926 Miners Strike in the Rhondda Valley. The experience destroyed his self-esteem and left his family in poverty. Others spend a life trapped in jobs from which there is little satisfaction to be gained and, from which, economic necessity means there is no escape.
At the end of the day for the majority of us most work is better than no work, in particular in times of austerity. That truth, however, can distract attention from an important debate about the quality of work and the essence of what gives us satisfaction in activities which occupy a large proportion of our waking hours.
For me there are four things in which satisfaction at work is grounded.
The first and most important are the people you work with. Good colleagues are a crucial part of why good tasks are enjoyable and a significant compensation for those situations which are otherwise difficult. Ever since prehistoric times we have organised ourselves in groups to carry out tasks and effective teamwork is a crucial ingredient in performance at work. Having good colleagues is not just a question of people you like or are happy having a pint with. It reflects qualities of reliability and mutual commitment and of respect for complementary skills and attributes. Most central to good work is the relationships you have with those you work for or who work to you. Second to being a good parent being a good boss is one of the hardest things to do well in life. It is crucial, though, to good work. Much misery is caused when it is done badly.
The second feature of good work is the ability to feel that what you are doing is worthwhile and that you are, in some way, able to make a difference. In general, I have been lucky in my career that has been true most of the time, as it should be for a career spent in health and social care. But even in the NHS it is all too possible to lose sight of the purpose of the endeavour and to be ground down by the day to day difficulties which you are trying to manage. Celebration of purpose and achievement are important ingredients in refreshing perspective and renewing one’s commitment.
Thirdly it is also important to have a sense of self-worth at work and to have some pride in what you do and the skills you bring. External recognition for that is a key factor whether through the formal systems of promotion or reward, hard to deliver when money is tight and organisation shrinking, or informally. Thank you and well done or two of the most important words at work, their currency never diminished if they are delivered with genuine sincerity.
The fourth element is the element of discretion one has in how is allowed to carry out one’s work. There is some good research evidence here which associates poorer health outcomes with groups of workers with less explicit discretion over their jobs. Technology has changed some of the parameters of the debate. Email and mobile technology can create some flexibility in where and when we work and releases us, at times, from the tyranny of being “in the office”. At the same time we can be at risk of never being free from work with the insidious temptation to look at our emails. The importance of taking holidays and having a break from work is vital if work is to remain good.
So in reflecting on 30 years at work I am drawn to remind myself that the issues which matter are fundamentally about people and that, as an individual and a manager, it is how I think about people and their motivations and their interactions which makes the profoundest difference to whether work is something good or something harmful.
It also makes one think about the wider changes in the workplace. In many respects work is a less hierarchical and more empowering experience than it was when I started. However a constant desire for change has made the world of work much more unsettled and uncertain. Some of that brings opportunity but constant restructuring takes its toll.
The next decade of my career may see as much change as the last three and certainly I fear for the world of work which my children will join. It is an issue which is worth thinking about.
It’s exciting to be involved in a project which can offer some new hope for those affected by severe and enduring mental health problems. So Friday was a good day when the Today Programme covered the results of the Tavistock Adult Depression Study which over a period of 10 years has been evaluating the impact of long term psychoanalytical psychotherapy at the Tavistock Clinic for people affected by treatment resistant depression. This is the first randomised controlled trial in the NHS for this kind of intervention and its results were encouraging.
The study showed that 44% of the patients receiving an 18 month programme of weekly psychoanalytical psychotherapy no longer met the criteria for a major depressive disorder when followed up after 2 years. This compares to 10% of the control group receiving treatment as usual. 14% of the group receiving treatment had fully recovered compared to 4% from the control group.
Not everybody with this condition will benefit from this treatment but it is very promising news for a group of patients with a serious condition who otherwise have had little on offer. Those who have been affected by long term, recurrent depression know its awfulness. A condition which robs life of all pleasure and meaning, so much so that in too many cases ending that life is preferable to carrying on in suffering.
In times of austerity there will be no easy path to making this treatment more readily available to patients who could benefit from it. There is a case for more research to confirm the results of this trial and to help better understand why some patients can benefit from this approach and why others do not. I hope that NICE will take serious note of these new findings and consider how they should be reflected in their guideline on Depression in Adults. There should be for patients and GPs to argue for this treatment using patient choice but, despite some clear policy statements under the Coalition Government, the mechanism of choice in mental health remains obscure and underutilised.
The study has also made me think again about the battle we still need to fight to get a genuine parity of esteem for mental health. It remains a scandal that in overall terms while over 90% of people with a physical condition such as diabetes will receive treatment there is a treatment gap for depression of over 50%. More people with the condition do not receive treatment as do and for those who receive treatment the options remain limited.
For many years the only option available to people presenting in primary care was the prescription of anti-depressants. The Improving Access to Psychological Therapies (IAPT) programme has broadened access to short term CBT and has been beneficial for many patients. Neither intervention, however, is a panacea and there are many patients who need an alternative approach. IAPT, in particular, has been an enormously important initiative in quickly and relatively cost effectively broadening access to psychological treatment but it has undoubtedly taken a lion share of any additional investment in mental health services and there is a real danger that policy makers overestimate the scope of what it can achieve.
In the case of cancer it would be inconceivable to contemplate the debate about services being limited to a simple set of medication or a time limited course of treatment. The Cancer Drugs Funds shows a willingness to invest in new treatments with an unproven economic case but which offer some hope of extending life. Are we ready to bring the same arguments to mental health in respect of longer term treatments, where the arguments in terms of the relief of suffering are equally strong and for which there is probably a better economic case given the chance of longer term benefits relating to improved social functioning and reduced care costs?
The study is, for me, another reminder of the importance, in particular in times of scarcity, of the value of improving the evidence base in the effectiveness of different interventions. Parts of the psychological and psychotherapeutic community have not always heeded this advice and found themselves at a disadvantage when arguing for resources in difficult times. Evidence based medicine does not reach to all aspects of understanding the value of different kinds of clinical work but without evidence there is unlikely to be any new investment and even what is currently in the system may, increasingly, be at threat.
The purpose of the NHS, in my view, is the alleviation of human suffering. I hope that our study has been able to offer a ray of hope that there may be more we can do to relieve the suffering of people who experience long term depression. If we are able to make a reality of that then perhaps we are on the road to parity of esteem.
I have had Sicily on my list of places to go to for quite some time so it’s been of those special trips, this summer, to get the chance of going there. My wife, Catherine was less keen, but Saturday evenings watching Inspector Montalbano, with all those shots of the Sicilian coast and leisurely lunches, have helped win her round.
It didn’t disappoint.
Sicily is the biggest island in the Mediterranean and is bigger than Wales. While, at the closest point, only a few miles away from the Italian mainland, it is very much its own place with a distinctive and often sad history.
To add to the sense of adventure we decided to go the long way – by train. This involves an overnight sleeper from Rome which they actually put on the ferry to cross the Straits of Messina. As a result, our first sight of the island was as we pulled out of Messina on our journey down the Ionian coast to Catania. There is something always so captivating for a northern European in seeing the Mediterranean and it is particularly so seeing it from the top bunk of sleeper.
We were staying just outside Acireale, a town about 15 miles north of Catania and on the slopes of Mount Etna. While Etna is a less malevolent neighbour than Vesuvius, nonetheless Sicily has suffered a lot, over the years, from the consequences of seismic activity which has destroyed a number of its cities. However Etna has also brought some benefits and its fertile slopes support acres of lemon trees, whose fruit were just reaching ripeness while we were there. Etna brooding summit was equated with the single eye of the Cyclops, Polyphemus, who was tricked by Odysseus in the Odyssey. A couple of miles down the coast at the town of Aci Trezze, a strange set of volcanic rocks in the sea are known as the “scogli dei Ciclopi”, the rocks of the Cyclops (in the picture) and represent the rocks supposedly thrown blindly by Polyphemus after the fleeing Odysseus.
The Sicilian coast is stunning and inviting. Brought up with summer holidays on the North Wales coast, I have always had an ambivalent attitude to swimming in the sea but I probably swum more in a fortnight in Sicily than I have in the last 30 years. And afterwards there are restaurants like they show in Inspector Montalbano, ones where you chose your fish, at the start of the meal, out of the catch of the day and which you can you enjoy half an hour later, beautifully fried, with a lovely glass of Sicilian white wine.
It was, however, the history which brought me to Sicily so that’s what I should move on to. This is the place that’s been held by virtually everyone but at the same time never totally belonged to any of them. The Greeks were the first to bring Sicily under their wings and the island was a major point for Greek colonisation in the West. Cities such as Syracuse and Agrigento were major hubs of Greek political power and culture and have left a stunning architectural legacy, still very much visible today. For a while the Greeks had to fight successfully with the Carthaginians for control of the island but it was the Romans who were the eventually the winners and who incorporated Sicily into their empire by the end of the second century BC. The Romans built on the civic legacy established by the Greeks, rebuilding temples and theatres and leaving their own mark, for instance in the stunning mosaics of the imperial villa at Villa del Casale.
The fall of the Western Roman Empire saw brief incursions by the barbarian Vandals, the return of the Byzantine Greeks of the Eastern Roman Empire and by the middle of the 9th century by the Arabs. The survival of many ancient treasures such as the wonderful temple of Agrigento is often a product of their reuse as churches and mosques, a sign of a wider tendency in Sicilian history to look to respect rather than destroy the past.
The Arabs in their turn were superseded by the Normans, who spread to their acquisitive wings to other shores besides ours but who proved cultured and respectful rulers of the island, showing tolerance, in particular to their Muslim predecessors and making Sicily for a while the meeting place of eastern and western cultures in the Mediterranean. Normans in their turn were replaced by the Spanish although the island continued to be fought over intensely by the French and Austrians to name but a few. Finally the celebrated actions of Garabaldi and the Thousand in 1860 led to the overthrow of the Bourbon Kings of Naples and the Two Scillies and the incorporation of Sicily into the newly unified nation of Italy.
One of the more sinister associations of Sicily is of course, with the Mafia. Not necessarily visible to the naked eye of the tourist, the Mafia remain a major force on the Island. The first named reference to the Mafiosi dates to just after Italian reunification but the tradition of banditry on the island is much older, reflecting its troubled history and the unwillingness of the aristocracy to recognise central and foreign authority. As elsewhere long periods of weak Government and lawlessness leave a vacuum which is easily filled and which once established are difficult to eradicate. Mussolini tried and failed.
For all its beautiful landscapes and fantastic cultural legacy Sicily has a harsher side. There is much poverty and very visibly the island is in the forefront of dealing with the consequences of large scale migration from North Africa. In Sicily the ugly and beautiful can sit cheek by jowl and the most stunning views and the most elegant of buildings can be juxtaposed with ugly half-finished apartment blocks.
Sicilians, apart, perhaps, from when they are on the road, are down to earth and welcoming. It is very much, though, a place apart. As the garage attendant who I chatted with briefly about national idemntity said with feeling “Io non sono italiano, io sono siciliano” – “I’m no Italian, I am Sicilian”. However given the complex history of the island one might be tempted to ask and what exactly does that mean. I can’t wait to go back to find out more.
The spectacle of Greece, over the last weeks, at the mercy of its creditors and fellow European Governments has been profoundly depressing. It has been a picture which, even for a professed Europhile as I am, does the image of Europe no favours. Whoever is to blame for this situation, and as in most human activities, blames sits in more than one place, there ought to be a better way of resolving the issue. As many other episodes in European history demonstrate, humiliation is a toxic ingredient in international affairs and humiliation has been dealt out in this situation in spades.
The events in Greece have been especially saddening for anyone, like me, who has been educated in or has any knowledge or love for the classical tradition. Through that tradition one is reminded of how completely central Greece, Greek language and Greek thought are to the history and identity of European and indeed western civilisation. Europe without Greece is inconceivable.
The story of Greece is that of the brilliant young man of history who has fallen on hard times in later life. Even when you have been immersed in it, it is totally staggering to reflect just how brilliant the golden age of Greek thought and civilisation was. In a couple of centuries in the middle of the first millennium BC the Greeks laid the foundations of western literature, drama, political thought, science and medicine. Little else of note happened until the rediscovery of Greek thought in the Renaissance rekindled western intellectual development almost 2 millennia later.
Even after the Greeks were conquered by the Romans in the second century BC they remained the intellectual powerhouse of the Roman Empire, providing the lingua franca for the Eastern half of the Empire and in the West providing many of the leading figures of intellectual and administrative life. Much Roman literature, philosophy and other intellectual products drew heavily from Greek traditions.The Romans weren’t known for inferiority complexes but they had a big one in relation to the intellectual superiority of the Greeks.
Greek thinking has reached modern times in other ways. What we know as Christianity owes a heavy debt to the Greeks. Starting with St Paul, Greeks and Greek speakers were crucial to the development of Christianity and Christian theology, incorporating into the Christian canon the traditions of Greek neo-Platonist philosophy. Islam too engaged with Greek thought as it took over the Greek speaking areas of the Roman Empire, embracing the Greek, and particularly Aristotelian traditions of thinking in science and medicine. As a result it was from Arabic sources from which many of these ideas made their gradual way back into western consciousness in the later Middle Ages.
So what was it about ancient Greece which led to this explosion of intellectual activity, the like of which is virtually unprecedented in human history? I am not sure if anybody precisely knows but a number of factors are important.
First in the period in question the Greeks were not limited solely to the country we know as modern Greece. A maritime people, often driven by the poverty of their own land, they spread themselves across the Mediterranean in search of opportunity and in many cases new ideas. Greeks were well established in the Ionian coast of modern Turkey (something which lasted until the struggles between Greece and Attaturk’s emerging modern state of Turkey in the early 1920s) and elsewhere in the Levant. In the west they colonised Sicily and Southern Italy (by the 5th century there were 500 Greek cities in this area). Marseille was a Greek foundation and there is some evidence that Greek explorers may have even reached Britain. Greek travellers and thinkers collected ideas and in particular acted as powerful bridge with intellectual developments of eastern civilisations in Syria, Anatolia and Egypt.
The second phenomenon which was special about ancient Greece was the creation and proliferation of city states. Fiercely competitive and often at war with each other, they provided a real focus for cultural and political developments. Their separate identities and rivalry fostered cultural developments and creativity allowing intellectuals such as Aristotle, Archimedes and many others to move between different centres of patronage which were, nonetheless, unified by a common lingua franca and cultural traditions.
Finally may be there was something about the Greek character, the love of argument and cleverness which for a number of centuries fuelled an intellectual revolution without precedent. The Greek intellectual revolution was not a silent one but one which was fought out through private and, often,public discourse. As the story of Socrates shows sometimes such intellectual struggles had a tragic conclusion
So what does all of this mean in 2015? A brilliant intellectual past does not mean that Greece should be, in some way, let off the consequences of the actions which have left it in its current economic plight. It should, however, make us reflect on what are the values which lie at the heart of the European project and consider whether we need a bolder and more generous spirit in how we approach the consequences of the economic difficulties which have traumatised the continent. As civilised Europeans we owe an awful lot to the legacy of the Greek intellectual revolution, perhaps even more than the Greek state owes to the European banks. Greek debts will one day be paid, we will remain, for ever, in debt to what Greece gave to western thought.