The Somalia Option for Brexit

Everyone is curious to see what our intrepid team of brexiteers will come up with. Will they go for the Norway option, with free market access, but free movement of people budget contributions and no input into regulations (not so much take back control, but give up control). That doesn’t sound like it is what people voted for.

Maybe we want the Switzerland option, with free movement of people and a lack of access for the banking sector and services — well that could screw London quite badly and it isn’t what people voted for.

How about the Canada option? Well CETA was on the way as a comprehensive trade agreement with the EU, but it isn’t in force yet, and it needs completely rewriting because if we leave we would probably want to take our portion of the tonnage of potted shrimp and suchlike with us (this is what the Article 50 negotiations are going to be about, carving out the UK portion of existing trade agreements). CETA doesn’t include services and took years to put together, and now it is all wrong. It isn’t a good template to use to draw up a UK/EU trade agreement.

How about the default, full Brexit to WTO rules? Well that means tariffs and it means the EU must impose tariffs on us or they can’t impose tariffs on other WTO members because they have to give all WTO members the status of their most favoured nation. We can’t be more favoured than Singapore for example or any external tariffs the EU is imposing on Singapore become illegal.

You might think that we have run out of options at this point, but no! There is one left. With the Unilateral Continuity option we just leave the EU but say we want to have informal tariff free trade with the EU, whilst reserving the right to impose tariffs elsewhere if we want to. This is completely contrary to the principals of global trade since the 1948 General Agreement on Tariffs and Trade, and puts us in an extremely exclusive group of countries. I call this the Somalia option.

A second Brexit referendum won’t work

The referendum on the membership of the EU was non binding, it had no significance in law. It is an advisory instruction to the government, the legal significance is the invocation of article 50. If we have a second referendum then there will be two, non-binding advisory instructions to the government. This does not move us any further forward, even if the second referendum is to remain and not tear up the Good Friday agreement (which really should have been the text on the ballot paper). There is a petition for a second referendum, I signed it because, well, why not, but it won’t work. It doesn’t ask enough.

David Cameron fell on his sword to give us a few months time before invocation of article 50. His resignation wasn’t the important bit, kicking the can down the road a bit was the important part of that speech. As a Financial Times journalist put it, the shock resignation of the Prime Minister was the third most important story of the day. David Cameron is still our Prime Minister and he still can do one last thing to help our country. He can recall parliament and propose a motion “That there shall be an early parliamentary general election.” as set out in the fixed term parliament act 2011 http://www.legislation.gov.uk/ukpga/2011/14/section/2/enacted this needs a 2/3 majority of the house including vacant seats — and lets all take a minute to think about why there is a vacant seat and whether Farage won a victory without a shot being fired.

I call upon David Cameron to propose a three line whipped motion that there shall be an early parliamentary general election.

Leaving this to the next prime minister is insufficient, Boris wants to be Winston Churchill — just watch him lower his voice like Jim Hacker on Yes Minister when saying something that he things is statesmanlike. Europe want us to invoke article 50 soon, the only way we can fail to do that is if we have no government. The government needs to collectively fall on it’s sword. After that we get a snap election, where a party can stand on a platform of setting aside the referendum result and never activating Article 50 and attempting to put this basket case of a country back together. We need to accept the reality that this party of national unity might be the SNP standing in every UK constituency.

The other paths to peace that I see are very narrow. We could invoke article 50 and as part of the exit negotiation Scotland gets the remnants of our membership, they join the Euro and Shengen, and they take Northern Ireland with it’s current borders and redraft the Good Friday agreement as close as they can to the status quo. That way the border does not change (if it changes at all it will need to be re-militarised), free movement does not change and with the Euro trade over the border is a bit smoother. England goes it’s own way in an isolated economic spiral over 15 years with external borders north and south until it is annexed by Scotland. Argentina gets shared sovereignty over the Falklands, Spain gets shared sovereignty over Gibraltar. We accept the end of the Le Touquet agreement and set up a refugee camp in Dover (I do expect the Jungle to disperse and net migration to go negative as England is a deeply unattractive destination). England and Wales is done, stick a fork in it.

The current personality based movements in the shadow cabinet are a pointless distraction. The priority is preventing article 50 being invoked by the government.

None of this can happen this week, because too many people who voted leave don’t realise the consequences of what they did yet. We are going to have to wait a few weeks until opinions change and the baseless optimism is fully exposed. Specifically, it will be after George Osborne comes out from his cave and tells us how HS2 is gone, how Trident renewal is off the table (good, and Trident scares me right now) how we have no new schools or hospitals, road maintenance and building has gone and wages are frozen in education and the NHS.

Brexit and the tampon tax

The #Brexit campaign has got one argument that I can’t refute. They don’t talk about it much, but they should because it is, as far as I can see, pretty solid.

There has been for some time a campaign to zero rate VAT on feminine hygiene products in the UK, on the quite reasonable basis that tampons are not a luxury item, they are a necessity and paying VAT on them is a bit of an affront. As a member of the EU we can’t do that, there are very specific rules on minimum VAT rates (we have some historic exemptions that other countries don’t like us having) and VAT is deeply tied in to our membership (for example, the rebate we get that means we don’t pay £350 million per week is based on a complicated formula involving VAT and GDP https://en.wikipedia.org/wiki/UK_rebate). We can negotiate some stuff around VAT, and occasionally ignore bits (HMRC decided to officially not bother with enforcing the place of supply change on digital VAT for non-registered small businesses) but adding a new class of zero rated products just isn’t going to happen, the other members of the club won’t let us. VAT was dropped on tampons from 17.5% to 5% back in 2000, but getting it to zero is for the moment a step too far. George Osborne’s compromise, or acknowledgement of the issue, was to use the VAT raised to fund women’s charities and shelters to the tune of about £12 million a year — not very satisfactory to some. They are still lobbying the commission over the issue, but it would take a proposal backed by all 28 members to get it through, not impossible but very hard indeed.

If we were to Brexit, we would absolutely be able to zero rate tampons as soon as we left (about 2 years). So there you go #brexit advocates, if you want a fact based economic argument for something that we could, should and would do after brexit that we probably can’t do from within the EU then you had best start talking about menstruation because that is all you have got.

Jeremy Hunt on #ipbill

I wrote to my MP, who happens to be the Health Secretary but you can write to your constituency MP about anything, best way to do it is through https://www.writetothem.com/. I tend to write about one specific actionable point, even if it isn’t the biggest issue on the subject. This time the subject was the return of the snoopers charter, the Investigatory Powers Bill.

Dear Jeremy Hunt,

I am concerned about the draft Investigatory Powers Bill.

"Section 51 Whilst everyone has a right to privacy, certain professions handle particularly sensitive or confidential information, which may attract additional protections. These professions include medical doctors, lawyers, journalists, Members of Parliament and the devolved legislatures, and Ministers of Religion."

One of these things is not like the others, one of these things does not belong. Ministers of Religion should not have a privileged status here, Abu Hamza, Anjem Chowdry, other radical clerics and the paedophile priests of all denominations do not deserve more hurdles protecting their privacy than I do.

Please work with your colleagues to remove Ministers of Religion from the list of sensitive professions.

I can't say I am a fan of the bill overall, it seems rather naïve about the nature of encryption.

Yours sincerely,

Alan Bell

and he wrote back, completely and utterly failing to address my point.

Dear Mr Bell

Thank you for contacting me about encryption.

The Government recognises the importance of encryption. I agree it is vital in keeping people's personal data and intellectual property secure and ensuring safe online commerce and communication. Current law requires that companies must be able to provide targeted access, subject to warrant, to the communications of those who seek to commit crimes or do serious harm in the UK or to its citizens.

It is true that the growing use of encryption does present a significant challenge. However the Government does not advocate or require the provision of a back-door key or support arbitrarily weakening the security of internet applications and services in such a way. Such tools threaten the integrity of the internet itself. The current legislation already requires that companies providing services to UK customers must be able to comply with a warrant and I am assured that the Government intends to preserve that position.

The draft Investigatory Powers Bill, which will be subject to scrutiny by a Joint Committee of both Houses of Parliament, will not introduce any new powers relating to encryption.

Best wishes

Jeremy Hunt
--------------------------------------------
Rt Hon Jeremy Hunt MP
Member of Parliament for South West Surrey

Well, that was quite unsatisfactory, so I wrote back.

thanks for replying, but it seems you didn’t address my specific and actionable point.
Section 51 of the draft investigatory powers bill gives radical clerics more protection over their privacy than I have for mine. Why is this? Why does the bill privilege radical clerics and other ministers of religion above anyone else? Can you please press for the removal of the privileged status of ministers of religion under this bill.
"Section 51 Whilst everyone has a right to privacy, certain professions handle particularly sensitive or confidential information, which may attract additional protections. These professions include medical doctors, lawyers, journalists, Members of Parliament and the devolved legislatures, and Ministers of Religion."
Alan Bell.

turns out if you are persistent you get results, this time it seems he read the mail.

Dear Mr Bell
Thank you for your further email. As you have mentioned, Section 51 includes Ministers of Religion as a profession that may attract additional protections as such people do tend to handle particularly sensitive or confidential information. Let me assure you that there are many measures in place to make sure extremist preachers cannot spread their message of hate. The new Counter-Extremism Strategy is a clear signal of the choice to take on the poisonous ideology of extremism with resolve, determination and the goal of a building a greater Britain. The strategy follows the 4 key pillars set out by the Prime Minister last July: to counter extremist ideology; to support mainstream voices, especially in our faith communities and in civil society; to disrupt extremists, aggressively pursuing key radicalisers; and to build more cohesive communities, tackling segregation and feelings of alienation.
Thank you again for taking the time to contact me.
Best wishes
Jeremy Hunt
 — — — — — — — — — — — — — — — — — — — — — — 
Rt Hon Jeremy Hunt MP
Member of Parliament for South West Surrey

so, second part of that is a bit of a brush off, but I think the point got through. Radical preachers are on the same level as politicians, journalists, doctors and lawyers under this bill, so either the protections for all of these are meaningless, or the bill really misses the very people it is allegedly aimed at.

How I compute a convex hull

I have a bunch of points defined by their x and y position, in my real world scenario these are points on the ground where a van will go and deliver some stuff, the x and y positions are actually latitude and longitudes. I want to draw on a map a polygon showing the area containing the dots. There are actually different sets of dots where different vans go, so I will be putting lots of these polygons on a map and I want to show the areas covered by each van, but we can focus on the way to do just one van at a time. I don’t want the polygon to be all spikey, I want it to be what you would get if you put a rubber band around the points and it turns out this is called a convex hull.

The locations of the points are held in a mysql database and the latitude and longitude columns are indexed, this means I can do very fast queries that involve sorting or comparing these values. I know there is a computational cost for sorting and comparing things, but I don’t care about it, it is probably O(log n) in terms of complexity and it is fast and easy. I don’t really want to calculate angles at all because that involves doing more trigonometry than I can be bothered to remember.

Start at the most northerly point

select * from points order by lat desc limit 1;

From the points to the west choose the most northern one. — repeat this step until you are on the most western point.

select * from points where lng < ? order by lat desc limit 1;

From the points south of this one, select the most western — repeat until on the most southern point

select * from points where lat < ? order by lng asc limit 1;

From the points to the east of this one, select the most southerly — repeat until on the most eastern point

select * from points where lng > ? order by lat asc limit 1;

From the points to the north of this, select the most eastern point — repeat until back at the most northerly point that you started from.

select * from points where lat > ? order by lng desc limit 1;

This doesn’t necessarily give you a strictly convex hull, but it does give you a shape that water would run off even if rotated 90/180/270 degrees. This is actually good enough for my purposes but you can then do a second pass around the path you have calculated and check for convexness without doing any angles by taking three points at a time and checking to see if the middle point is left or right of the line connecting the first and last point, this can be done with simple maths and no angles with a function somewhat like this:

function convex(p1,p2,p3){ return (p2.lat-p1.lat)*(p3.lng-p1.lng)-(p2.lng-p1.lng)*(p3.lat-p1.lat)
}

If that returns a negative value then discard the middle point from the polygon (I may have that the wrong way round). This test could be done as you go along as part of the first walk around the path.

Here is what it looks like for my data, without doing the second pass for strict convex shapes.


May You Live in Interesting VAT Times

Accountancy is not very exciting in general. If you arranged all the subjects within the topic of accountancy in order of excitingness, VAT would not be at the more thrilling end of the scale. This will remain the case until the end of the month, when on January 1st 2015 the European Union will introduce some changes to perk up VAT and make it much more exciting! Yay!

So, what is VAT anyway and who has to care about it? Well, VAT is short for Value Added Tax, from a consumer standpoint this name makes no sense, it just looks like a tax on the sale price, what is the “value added” bit all about? Well it starts to make a bit of sense when you think about a VAT registered business that buys things, does something to them and sells them again for more than they paid in the first place.

The VAT the business pays for the goods is “input tax” and they can claim that back from HMRC. If a business buys a widget for £12, then HMRC owes the business £2 for the VAT they paid out. The business will then typically do something to the product, which might be a manufacturing process using it in a component of a bigger product, or it might be splitting a big pack into little packs, or simply putting the product in a shop. Whatever the in between bit is, lets say this product ends up being sold on for £15+VAT. Someone walks into the shop and pays £18 and walks out with their widget. Now the business just collected £3 in VAT from the consumer, so the business owes HMRC £3, and they can offset the £2 that HMRC owe them. The net result is the business owes HMRC £1, which is a 20% tax on the £5 improvement or “value added” to the product as it passed from input to output. The chain from raw materials to consumer can be quite complicated, and HMRC collects 20% of the value added from each business in the chain, ultimately this is paid by the consumer in the purchase price, but it is shared back along the supply chain in proportion to the amount of improvement each element of the chain made to the product in terms of it’s price. You might wonder how this applies to digital goods, where there are no clear raw materials or an obvious supply chain but as VAT looks at your total inputs and total outputs, it does kind of work. If you buy a computer and a desk and a chair, these are allowable expenses for your ebook business, they are the raw materials. They each have a supply chain behind them, so the VAT you pay to HMRC is the amount you collect on the ebooks, less the amount of VAT you paid on the computer/desk/chair. You pay to HMRC a proportion of the value you added to the equipment by sitting at it and writing an ebook.

It is quite a clever system and only really gets complicated when you have international trades involved. If that happens when you are buying stuff as a business you have to do a “reverse charge supply” this means you pay the tax on things you buy at UK VAT rates to HMRC (instead of the supplier paying them out of the gross price), and then claim it straight back again as input tax. It is a paper transaction, no money changes hands, just some boxes to fill in for the VAT return. It is just like buying goods from a UK supplier except the VAT portion doesn’t get paid to the supplier, it gets paid to HMRC. If you are selling to a business overseas you sell it and don’t put VAT on it. They then have to do the reverse charge thing and pay their local VAT to their local VAT office and claim it back as input tax. The UK business then needs to fill in an EC Sales list with the VAT numbers of the customers so that it can be audited and someone can check that the customers are in fact paying and reclaiming the VAT.

Now, this is all fine, bit odd perhaps, but it works. A UK business can sell stuff with 20% VAT and pay that over to HMRC, this is always a safe thing to do. They don’t need to know who the customer is, or where they are, it is always safe to sell for one price including the VAT and hand over the collected VAT to HMRC. If the customer happens to be in Europe that is fine. If they are a business in Europe then they are paying 20% too much, and that is still fine. Slightly too much VAT is collected and nobody cares. Perhaps if a Europe VAT registered business wants to not pay UK VAT in addition to their local VAT then they can arrange to get a zero VAT invoice for the goods, but if they don’t do that, they can pay the VAT inclusive price and nothing bad happens.

“Nothing bad happens” is what we want in business. From January 1st, this position evaporates. Bad things can happen. Really bad things. There are very few ways to avoid bad things happening. The change is small, the consequences drastic. They are changing the place of supply. This means that instead of charging VAT according to where the seller is, VAT is charged according to where the purchaser is. Simples!

This tiny little change has ramifications and unintended side-effects. What they wanted was to stop multi-nationals like Amazon and Google from incorporating in Luxembourg as a flag of convenience and selling around Europe from there at the lower Luxembourg VAT rate. Nice for the Luxembourg exchequer, but really a bit unfair to everyone else. These companies manage to undercut domestic UK businesses and all the VAT paid by the UK consumer was whisked out of our economy. This change of the place of supply means that the UK taxpayer is better off, tax on stuff we buy here stays here. The huge companies have to stop hiding in Luxembourg and register in the places they actually trade and pay their taxes.

Trading with the EU is completely optional, see https://www.gov.uk/trading-in-the-eu the founding point of the EU is to make it easier to trade across the borders you decide to trade across. The internet makes it easier to trade without caring where the borders are, which goes somewhat further. This move brings things back to a requirement to have a deliberate intention of operating in a market, and then it is as easy as the EU designed it to be, but not as easy as the internet makes it. Accidental trades across borders could now shut your business down, you could get penalties from 27 separate VAT regimes.

There are in fact 75 potentially different VAT rates across the EU. Different countries have different rates for various classifications of items. (Jaffa cakes are not biscuits in the UK, for example, but they might be different elsewhere). You now need to care about all of this. Did you know about the VAT rate on ebooks in Italy? Are you preparing to change your store for the Polish VAT cut in 2016? No? Do you want to have to care about that?

In this new world order with the changing place of supply companies are supposed to capture two bits of non conflicting evidence to suggest where a customer is located, and then charge the relevant VAT. This means you need to know what the relevant VAT would be, and you need to know where the customer is prior to the payment happening. If you were hoping that you would use the paypal billing country you get after payment then you are kinda late, you have charged them the wrong price. It is a big problem and other people have written about how big a problem it is in more detail than I want to. EU VAT Action has a great list of articles expanding on the problem.

Don’t bring me problems, bring me solutions!

So yes, that is a big old mess, lots of people are very worried about the implications and practicalities of finding out where your customers are and accounting for the VAT, but is there a simple solution? Well yes, there is, and it is perhaps a bit surprising.

I propose we introduce, very soon, a new special rate of VAT. The Default EU VAT. This would be set at 30% for all member states, and would be legal (but optional) to collect on all transactions and remit to a VATMOSS. This VAT fund would then be distributed to all the member states in proportion to population (or GDP or whatever other distribution methodology they negotiate). Businesses can safely list prices and sell goods to anyone including this rate of VAT, but if a customer wants to get a lower price then the customer can provide two bits of evidence to support their claim to be in a particular member state, they will then be shown the prices including their local VAT rate and can buy things for less money. This way we retain the freedom of anonymous trades, but customers have a financial incentive to give up some of that anonymity for lower prices and a more accurate allocation of tax. Nobody need ever pay this 30% rate, it’s sole purpose is to remove the risk of collecting too little VAT when the place of supply hasn’t been established. It also means that completely anonymous trading is legal (but a bit more expensive). I belive this is a proposal that all 28 countries could agree on very quickly. Thresholds simply are not going to happen, but this could be politically agreed and implemented across Europe without delay.

Why 30%? Well it is higher than any standard VAT rate, and it is exactly double the EU statutory minimum standard VAT rate of 15% that all countries have to comply with. Setting it at double the 15% means it will automatically change if the minimum statutory rate changes.

Shouldn’t HMRC/UK Government do something?

Well they have been trying. The thing is they can’t just unilaterally fix this for us. People have been saying that HMRC should allow a de minimis threshold on it, like the £81k threshold for UK VAT. The problem that many people don’t seem to grasp is that HMRC can’t give us a threshold or exemption on German or French or any other member state’s VAT. It isn’t for HMRC to do that. Like my other proposal, this one may come as a surprise.

I propose that HMRC go on an enforcement rampage. Go out, have fun, make sure everyone complies to the letter and send as many penalty notices as possible. Just not to UK companies . . . HMRC should make sure that anyone selling a knitting pattern or a recipe pdf or a wordpress extension module anywhere in Europe that might be purchased by someone in the UK is correctly registered with their local VATMOSS and is accounting for the VAT. All of the rest of the EU owes our exchequer VAT money for the digital services stuff we buy from them. This mess won’t get fixed if the rest of Europe ignores the problem and the law abiding UK businesses close.

Ways To Remove Stuff That Doesn’t Belong in Brains

There has been a lot of news about young Ashya King recently, he had something in his brain that didn’t belong there. So did my daughter a few years ago, I haven’t written about that much, however the recent events have brought a lot of stuff back to mind and maybe it is time to write about it a bit. I happen to know a bit about some laws and court procedures, and a little about hospitals and brains and a reasonable amount about particle physics. This episode maps onto a sweet spot of intersecting topics I don’t really need to know about and things I never wanted to know about. I am not qualified, nothing is advice, but I will try and explain a few things to the best of my understanding. There has been a lot of misinformation and misunderstanding floating about on the interwebs, it has been very much an everyone on the internet is wrong kind of time. I may try and update this as things get clearer, it might be a bit rambling and unordered, bouncing about between medical and legal stuff interspersed with the events of the week and the past. I will try to start out with a bit of a story.

Ashya King had something in his brain that shouldn’t be there. An expanding lump of tissue at the back that wasn’t brain. That isn’t good. It is pretty much exactly where the lump of not good stuff was in my daughter’s brain. The surgeon described the operation to us as being like cracking an egg on the table and then picking up the yolk with a knife and fork and not breaking the yolk or damaging the white. It is important to cleanly remove the lump, so you hope it has nice well defined edges and the bit that isn’t brain doesn’t blend into the bit that is brain. My daughter had a large, but well defined lump of stuff that turned out to be not cancerous when they tested the removed stuff. Ashya was more unfortunate. Ashya had the initial operation to remove the tumor then a further operation of some kind which might have been a very small op in theatre to remove a shunt (tube through the skull that drains excess fluid and maintains the correct pressure in the skull). The operation and biopsy would have revealed that it was a nasty lump. Grade 4 level of nasty on a scale of 1 to 4. That is bad, it is a spreading cancer rather than something that just grows. With that kind of situation just removing the great big lump is not enough. You have to kill the little bits that are left, burn the edges of the hole and poison anything you can’t find. This is therapy. It is poisoning and blasting cancer. Cancer is alive, just like the patient and can be killed, just like the patient. The idea is you poison both the cancer and the patient and blast the cancer and the patient with radiation, but you do it carefully so that you try and kill the cancer a bit quicker than you kill the patient. Once the cancer is properly dead, you can stop trying to kill the patient and hope they recover. You don’t want to start this with a patient who is weaker than the cancer is, because it is a race that you want the patient to win. After the surgical operation there is a period of recovery for the patient to build up strength before the poisoning starts. My daughter didn’t need therapy, but I found out quite a lot about it at the time by doing my own research. Right now Ashya is at the end of that recovery period and is about to start therapy. His dad did a lot of research too. Brett King found out about Proton Beam therapy (which I didn’t find out about in my research, it was even rarer at that time).

Proton Beam therapy is pretty cool, you will see pictures of a shiny clean room with what is quite clearly a Stargate in it all looking high tech.


Why can’t they get one of these cool things installed in every hospital? Well there is a reason for that. The shiny room has got a great big cyclotron particle accelerator in the room behind it (and above and below it). These pictures and diagrams from Penn Medicine might give you a sense of the scale. Unlike in Oz, looking behind the curtain reveals something surprisingly impressive.



Regular radio therapy blasts x-rays through your head (or wherever might need irradiating) These go straight through and burn stuff, kind of like a penetrating laser beam, but way more energetic. They try and focus it on the bad stuff and miss as much of the good stuff as possible, and it works. Really quite well. Radio therapy is very effective. Combined with chemotherapy (that is the chemical poisons that poison the cancer a bit more than the patient) it is even more effective. Proton Beam therapy uses particles rather than photons, if you remember school stuff, x-rays are basically gamma radiation (low energy end of gamma radiation), so we know about them. Alpha radiation is helium without the electrons (a bundle of 2 protons and 2 neutrons). Beta radiation is just electrons. So what on earth is a proton beam? Well that isn’t in the school books, it is hydrogen with the electron stripped off, so just single protons. These are charged particles so they can be pushed by magnetism. Stick them in a vacuum tube and push them a lot and they go fast. Let them out and point them at a person they will go clean through the first few cm and then hit something with a bit of a thump and stop, scattering the energy that it had and doing damage. This allows fairly good targeting, you can focus it in x, y and z directions. The photons don’t stop, you point them in x and y but the depth is less controllable. So protons and photons both do a bit of useful targeted internal damage. Sometimes the extra accuracy of protons that stop might give a better clinical outcome. Sometimes it might make no difference. There isn’t really a lot of solid evidence either way. We figure out if something is a good treatment by doing clinical trials, you can do retrospective trials (look at people who have had it) or the gold standard of trials, the randomised clinical trial, where you take people who are going to have treatment and randomly assign them to a treatment. Unfortunately there are pesky medical ethics getting in the way of the science as it would be ethically unacceptable to randomly pick a therapy for an individual when it is something so serious, which is a bit of a shame, because it would also be good to do better science on something so serious. Bottom line is that it is a good treatment, arguably better than radio therapy (xrays) for some situations. It is certainly not a cheap therapy though, is any added benefit cost effective? Nobody knows. Would it be a better treatment for Ashya King? The oncologists in Southampton didn’t think so, and they might be right (they know a lot about the patient in front of them). The oncologists in Prague think it would be good, they might be right (they know a lot about what their Stargate can do). It is a reasonable difference of opinion, we are not in the situation of comparing a real treatment against urine therapy or theta healing or any other form of cancer curing woo.

Brain surgery is complicated stuff (it isn’t rocket science though) and people react to it in odd ways and recover from it in odd ways. You probably saw the video of Ashya and Brett King, Ashya was a bit unresponsive, and using a feeding tube. That isn’t uncommon and isn’t necessarily permanent. After a traumatic brain event (and someone breaking and entering the skull and then scooping out the yolk without damaging the white is pretty traumatic) it takes a while to recover, but stuff does come back. Maybe a little, maybe a lot. You don’t know what will come back until it does, and then you never know what might have been different. Personality, behavior, ability in music, maths, sports etc. Is it what it would have been anyway, or better or worse? Is any particular change recovery or is it just growing up? You don’t know for certain, and neither do the doctors. It is a bit clearer on an adult as you have a baseline to compare against, changes can be attributed to the intervention and recovery. Children are expected to change dramatically over time anyway, so attributing cause to the effect is harder.

Back to that feeding tube for a minute. It is a tube that goes through the nose and into the stomach. It has a machine with a rotating part in it that kind of squeezes the tube and slowly pushes the food along, it pumps it from outside the tube. The one Ashya is using is a Nutricia Flocare Infinity it takes a 5vDC supply, pretty standard stuff, you could get a generic power supply for it at any electrical store, if you don’t already have a drawer full of the things at home. A power supply for it is not hard to come by. It has an internal rechargeable power pack, there is no “spare batteries” about it. Any media report you see that talks about spare batteries is just lazy journalism. It has an internal lithium ion battery that is good for 24 hours at a flow rate of 125ml/hour. Now what happens after that? You don’t drop dead, any more than you drop dead when you finish eating a meal. It isn’t a breathing tube, it is an eating tube. If it stops then after a few hours you might start to get hungry. After a day or so you would be quite distressed about it. After that you start to suffer starvation, it takes a surprisingly long time to die from it, and it would be hard to watch. Being in a weak state would speed things up, being in an inactive state would slow it down. I have no idea what that adds up to, but it certainly isn’t an instant catastrophe when the batteries run out. The initial reports given by the hospital to the police and media were very much stressing the battery life and strongly implying that time was running out, and that it would be fatal after 24 hours. Some people had other concerns. Would they be able to keep it sterile? Well it needs to be clean, not sterile (some bits probably get sterilised in hospitals). It needs to be clean as a plate that you would eat off, because that is what it is. A delivery system for food. Some kids have these long term and they are designed to be portable, there are backpacks for them, search for tubie backpacks and you will find lots. There are real risks with feeding tubes. Reinserting them can go wrong, put it in the lung rather than stomach and that is dangerous, best not done without training. Vomiting would be a risk without a swallow or cough reflex as it would be harder than normal to clear. Seasickness and carsickness would be a bit of a worry, batteries, not so much.

On Thursday 28th August at 2:15pm Ashya Kings parents left the Southampton General Hospital. Brett King was pushing Ashya in a buggy. They had decided to leave, travel to Spain, sell their apartment and spend the cash on Proton Beam therapy in Prague.

Six hours later, at around 8:35pm the hospital alerted the police, by this time the King family were getting off a ferry in Cherbourg. The police went into full child protection emergency mode, applied for an arrest warrant at some time on Friday and upgraded it to a European arrest warrant. The hospital separately asked Portsmouth Council to apply to the high court to have Ashya made a ward of court on the Friday, the police would not be involved in that to any great extent. The court approved the ward of court order, which meant that from the moment it was raised (not approved, it is effective from the time of raising though this doesn’t matter much in this instance, just a legal oddity) the high court took on parental responsibility for Ashya. On Saturday night, they were found in Spain, Brett King recorded a video which was posted to YouTube showing that Ashya was fine, the feeding machine was plugged in and working and they had plenty of food and they had a plan to obtain treatment. They were then arrested, handcuffed, moved to Madrid, appeared in court on Monday and were remanded in custody pending a bail decision. Bit harsh really.

Some people were a bit surprised and shocked that a family would walk out of a hospital like that. Was it reckless? Was it a risk? Well yes, but you calculate risks and benefits and consequences a bit differently in that situation. You are perfectly rational, but consequences that don’t get in the way of your immediate objectives are utterly irrelevant to your decision making process. It is a bit hard to explain to people who haven’t been in that situation, but imagine you are in the middle of nowhere, no phone, no means of raising the alarm, you are with a child who suddenly needs to get to a hospital fast (make up your own reason here). In front of you is a car with the keys left in the ignition, you don’t know who it belongs to. You take the car and achieve your immediate objective. Taking the car was wrong, there will be consequences. They could be quite severe, but as you get to face them later, after you have achieved your objective, the consequences don’t matter much. You don’t want to avoid the consequences, just face up to them on your own terms afterwards.

Under those circumstances, selling the apartment and spending £100,000 falls into the easy instant decision category of things to do. Walking out of the hospital without filling in the self discharge against medical advice form was always likely to have consequences at some stage. Remember who pushed the buggy out of the door? I am guessing that wasn’t an accident, that was taking ownership for the decision and the eventual consequences. As it happens the consequences of that caught up with them a lot faster than expected and were a lot more severe than expected. Big miscalculation there. The rest of the plan was meticulous.

The overall effect of the response was an epic failure. Everyone knew on Saturday night that it should no longer be a police matter. It was appropriate to find them, it was appropriate that the police were involved in doing that. The ward of court bit isn’t as harmful as some people make out, but it contributed to a further error later. It was appropriate that Ashya was taken to a hospital. It then should not have been a policing matter. It was downright horrific that they were in custody until Tuesday night.

The problem was that the UK police had no jurisdiction in Spain (obviously) and thought they had no way to ask the Spanish police to lift a finger without the European Arrest Warrant so they asked the Crown Prosecution Service to upgrade an arrest warrant to European Arrest Warrant. The EAW is only for situations where a prosecution is intended, they are designed to be only for serious matters, created in 2002 as a response to the threat from international terrorism. They can only be used for offences that can have at least a 12 month prison sentence and can’t be used to investigate something, only for an offence where there is an intent to prosecute.

When the Crown Prosecution Service starts considering whether to do something about an offence they use one of two different tests, full code or the threshold test. To oversimplify things, the full code is for situations where they think they have an investigated case that could go to court, threshold is for situations where they think that they could go to court if more evidence arrives that they expect will arrive. They used the threshold test and issued the warrant. They can just do that for a domestic warrant, however the EAW is a bit different. That should normally be full code, in exceptional circumstances to use the threshold test they have to follow a procedure of getting approvals from people like the Chief Crown Prosecutor and the Head of the Special Crime and Counter Terrorism Division (kinda shows what the EAW was designed for). I have no idea if they did that, but if they did, they did it impressively quickly. Does it matter if they took a shortcut? Do they have Crown Immunity like they do for their decisions? Not if it is an administrative failing and they were not following their own procedures. Maybe they did get the exceptional process done, maybe not. I am sure we will find out in the fullness of time. Update: The CPS appear to be legally able to issue the warrant if “there are reasonable grounds for believing that the person has committed an extradition offence, and a domestic warrant has been issued in respect of the person.” http://www.legislation.gov.uk/ukpga/2003/41/section/142 but they still don’t appear to have followed their own procedures.

The start of the EAW process is a normal domestic arrest warrant. They have to get that first then upgrade it to EAW. The King family left the hospital at 2:15, there was a claimed 24 hour life on the battery and a claim that if the battery ran out this could constitute an offence of willful neglect, which is cruelty to a child and has a maximum sentence of 10 years (sentences can vary from nothing up to that maximum, people can be pretty cruel to a child, the EAW only looks at the max sentence for the offence, not the likely sentence for the alleged circumstances). Now the timing here is interesting to me. Based on what we think the complaint was, the willful negligence would not commence until 24 hours after leaving the hospital when the battery would ran out. (feed bags don’t last that long, but they were only talking about the battery). So, if the domestic warrant (first part of the long EAW process) was issued prior to 2:15 on the Friday then it was a warrant for an alleged offence that wasn’t alleged to have started yet! That would be kinda unusual to say the least, pre-crime belongs in Minority Report, not the UK justice system.

Once the EAW was passed around Europe The Spanish police reacted with all the vigour that is expected for the child abduction they were told it was, they didn’t do much wrong.

The CPS didn’t withdraw the warrant first thing on Monday morning and petition the extradition court for an immediate termination of proceedings. The Spanish court was confused and remanded in custody to consider bail. The Spanish hospital thought the ward of court order included a provision of no access, which is why initially the brothers and then the parents had difficulty with access. Maybe a ward of court does include no access by default in Spain, I guess eventually that was clarified to them, but it is unfortunate but understandable that the child protection administrator in the hospital was enforcing an order that the judge didn’t give.

There was further confusion about the ward of court, online. People thought that Portsmouth City Council had custody, they didn’t. Portsmouth requested the high court to take wardship. The court became the guardian, to make decisions for Ashya (not for the council or the parents, for Ashya). Once the court took wardship on Friday there was nothing that could vary it apart from an order from the judge. A wardship order can’t be overturned by the party that requested it, or the hospital even if they don’t want it any more. It can’t be overruled and instantly revoked by the Prime Minister, Prince Charles, The Queen, The Attorney General or anyone else (the list of suggestions made by people on twitter was longer and sillier than that). If the council and hospital lied through their teeth when they requested it that doesn’t mean it is invalid. Once in place, it is in place and it gets varied when and only when the judge orders it so, and that will be done when it is in the best interests of the child to do so. There were questions about jurisdiction, and this is legally weird (I am an armchair specialist in legal weirdness). Wardship is done in the inherent jurisdiction of the court. This is a slightly odd bit of English common law which a Spanish lawyer probably isn’t that familiar with, and wardship is a bit strange. If one of my kids was in Spain, and someone had to answer the question “who has parental responsibility for this child?” then half the answer would be me. Doesn’t matter that I am not there, doesn’t matter that I don’t have a local Spanish parenting relationship with the child. Doesn’t matter where in the world you ask that question, the answer is the same. Wardship works like that. The answer to the question “Who has parental responsibility for this child?” is “The Family Court Division of the High Court” (roughly speaking, but that is close enough to get the idea). It might not even matter that Ashya was born in Spain, if the minor is habitually resident then the high court thinks it has jurisdiction. Some might argue with that, but it probably isn’t a good idea to argue with a court that thinks it exercises unlimited power.

Some people were outraged that the parents were not represented at the application for wardship on Friday. This is not unusual. Parents often are not available or don’t turn up to such things, normally for bad reasons or very bad reasons, and occasionally for really really horrible reasons. Some people said that parents views should have much more weight in the family courts. This is misguided, do remember that this is a startlingly unusual case. Most of the time the courts need to protect a child from the parents. In this case the child needs to be protected from the applicant, that is fine, the court works just as well like that. The judge is on the side of the child and can work with the parents against wishes of the applicant just as well as working with the applicants against the wishes of the parents. That is what happened on the Friday, just over a week after it kicked off, the parents treatment plan was agreed by the court, ordered to be implemented and the wardship lifted (Some people were talking about the court giving them “permission” or being “allowed” to fly. Not quite the case. The court ordered that they have permission, which makes it a bit unstoppable, note that the wardship is lifted on arrival at the treatment centre in Prague, not before.) The hospital have given up all objections, but if they had continued objections they would have to take them up with the judge or be in contempt. The King’s treatment plan has now got the full force of a high court order behind it. I understand the hearing on Monday is still planned to go ahead so the judge can explain his decision. I think he might be a bit cross, I suggest bringing popcorn and not being a lawyer for the council.

Questions will be asked about that wardship hearing on Monday, the parents were not represented and information was not presented by the council that could have been, specifically relating to the funding options for the treatment. I was quite surprised to hear that the applicants told the judge in court that they had absolutely no idea how the treatment might be funded. They didn’t tell the judge about the plan to sell the apartment, they didn’t tell the judge about any online fundraising, they didn’t tell the judge about the offer from Prague to get on with it and sort the money out later. At the very least I think they failed to give the judge information that they had access to, whilst the parents were unrepresented and still in custody. I think the judge had a pretty good idea how wrong the wardship was at that time, however with the parents still in custody and the applicants not telling him the full story he couldn’t do anything but hang on to it for a while until he could talk to the parents. Here are the orders made that day.

Someone should totally do something!!!

This was an epic fail, and after every epic fail we implement knee jerk legislation that fixes the problem and never has any side effects. Oh wait no, it is the other thing. There are improvements or changes that could be made, some are minor tweaks, some are observing existing rules, some might be new. We should remember that this situation is really rare, any reaction to fix this (such as boosting parental power in the family courts) that has a side effect that impacts the more common situations will probably only be known for the side effect. Here are my suggestions.

The CPS should use full code on the EAW. No shortcuts to threshold test, it is meant to be hard to use threshold, keep it hard.

There might be a need for an EAW-lite, a cross-border request for police in another country to find, stop and question someone. Maybe the Interpol yellow notice would already do that perfectly well and they shouldn’t have gone for the EAW (and the CPS shouldn’t have issued it under current rules requiring full code). There is something on the way called European Investigation Orders which might be it. They are highly controversial, but the legislation was adopted in Europe in March and national governments have 3 years to implement it (that is how EU laws work, they get adopted in the middle but have no force, then the nations must copy and paste into their own actual legislation within a time limit). These investigation orders would allow the UK police to ask the Spanish police to stop a car and check that everything was fine. The Spanish police would then have the discretion to decide that it wasn’t a police matter, or to take whatever action they wanted. With the EAW they must arrest, detain and extradite. No discretion. On the downside this investigation order thing would allow any EU country to request the UK police to investigate any citizen. That sounds a bit bad.

The CPS needs to be one heck of a lot faster at getting an EAW withdrawn, they can raise it in an afternoon, 3 days to get rid of it is far far too long. They need a really fast “oops” process.

The CPS should be at the initial hearing of the extradition, ready to throw in the towel and stop things if the situation is manifestly not as expected.

Doctors should never ever discuss protection orders with parents before actually getting one (and probably not even then). As Yoda said, “Do or do not, there is no try”.

Doctors when reporting a missing child to the police should stick to the facts and give all the facts, regardless of how long it takes to get them across. Don’t sex up a report like a dodgy dossier to make it sound more dramatic than it is. The feeding tube battery panic was not grounded in reality (though they could have gone strong on the choking risk). They knew what the plan was. They knew the plan in enough detail to tell the family court on Friday that they might need to look in France, Spain, Germany, the Netherlands, and the Czech Republic. Look on a map, the alternative route would be ferry to the Netherlands, straight to Prague, leave the family there and go on to Spain to sort out the apartment. The hospital knew there was a plan, they knew it didn’t constitute neglect, distorting it into neglect with the objective of getting the police to take action didn’t help anyone.

Journalists, and in fact everyone saying stuff online, should fact check. Really properly fact check. If someone is telling you something that sounds a bit implausible then check it out. Even the trivial stuff, if you are saying that two parents, plus Ashya and his six siblings are driving in a Hyundai I800 that has 8 seats, you might want to contemplate whether that works, or whether Ashya might be one of six siblings (I don’t actually know the answer to that one, but as reported it doesn’t add up). If you are making the implication that someone is refusing medical treatment on the basis of the irrational dictates of a religion, you should check what medical treatment that religion objects to, and whether it is plausible that it is in any way relevant (brain surgery isn’t very bloody). A journalist should have found out more about feed tubes and figured out that the battery hype was bogus. I had no idea about the things until I heard this story and it just didn’t add up, so I looked up the specifications of the devices. It isn’t much harder to be right than it is to be wrong and it feels much better.

What happens next?

Well Ashya is off to Prague now, nobody can mess with that. He will get therapy, which will make him worse and kill the cancer. After that he will get better. How much better is unknown. A full recovery would be very optimistic, there is no reason not to be optimistic, but be aware that there are realistic and pessimistic outcomes also. There is going to be legal action. Possibly several cases. (Hampshire Police possibly making a complaint against the hospital would be an interesting one). If the treatment is successful it might lead to pressure for more proton beam therapy centres being built and consequently massive extra costs being put on the NHS, for possibly no scientific benefit. It might lead to people being irrationally scared of radio therapy and resorting to less scary sounding stuff that does nothing.

Hopefully the thousands of uninvolved spectators like me have learned more about cancer, brain surgery, particle physics, law, wardship, extradition, procedures, the determination of stressed parents, jurisdiction and child protection over the last week. If all that we can really learn from this is in fact actually learning stuff then that is not a bad outcome.


First Published 8th September 2014. Please direct any comments or corrections to @alanbell_libsol on twitter. This article may be reproduced verbatim, but please let me know so I can tweet about it. If you want to reproduce it with edits then check with me first, I am likely to be cool with it.