QUESTION; WHY IS THE PUB ON THE CORNER, THE CORNERSTONE OF LIFE IN GENERAL?

We review the revival of the Puccini opera “La Boheme”, at ENO in London just a few days ago,  and ask – is this a simple story, a view from a distance so to say, where you and I are looking on almost against our will, through some window  – or a classic love story, that has stood the test of time?

Perhaps it is both. 

I never thought during this performance, that I was in the grip of a serious romantic affair, as say I have been in Madame Butterfly, or Carmen. But I did feel that I was a voyeur, and unable to change any of the outcome.  I knew Mimi would die. And the facts are these:

If you are looking for an Opera that mirrors life in all its seediness and lack of hope – then the Puccini classic, “la Boheme” would not be a bad choice. Created just a few years after the Emile Zola equally classic novel “L’Assommoir” (the boozer…), if you want to get down and dirty amongst the very poor, well Paris in the late 19th century, is where it’s at.

The story is simple enough. Art for art’s sake does not pay the bills. Mimi, who by that time, is already freezing to death, finds love with Rodolfo – who then gets jealous, – and it doesn’t end happily ever after. It’s an opera, after all.

For once, the tension that we normally expect and associate with ENO production, did not readily surface until Act 3-  and yet all the classic ENO properties were there; very tight production, wonderful orchestra; great melodic delivery. For me, it took the arrival of Louise Alder, as Musetta, before things started to happen; her approach is almost Mozartian, very staccato and pin-point, it cuts through perhaps the saccharine lines of her colleagues.

And that’s unfair, because this production has stood the test of time. My graphic above shows the programme of La Boheme in 2010, and nothing has changed. 

This is an Opera and performance where you can take anybody who does not know about opera, but wants a classic music evening. Obviously, there is a new class of performers, if you like,  a new generation.  Ben Glassberg  excelled in the power of conducting the ENO orchestra. And there was great interplay, particularly Act1. If I was feeling distant in watching the story unfold, then it was also nice to be entertained, as opposed to be educated. 

The thing  is – the story, and its delivery, just works almost on autopilot. You sit back and let ENO deliver. And if there are questions, such as; “are Mimi and Rodolfo actually in love?” – well, could be….  And “why does Mimi have to die”? – well, that’s what happens, it’s the wrong part of  Paris at the end of the 19th century. It’s a story, and these are the facts.

IT’S HOLIDAY TIME – ON A BIG BOAT!

As gaps are starting to appear in the COVID stranglehold – we look at the background to getting back on the water, with a visit to the CRUISE SHIP INTERIORS EXPO in London Excel, – and what we can expect when we travel.


If you are going to have a Conference about Cruise Liners, then basing yourself by the side of the Thames, and just two tube stops down from the O2 Arena, is not a bad place to start. Adjacent also to City Airport, and equally close to Tower Bridge and some of the richest mooring spots in an already wealthy city financial area – it’s not hard to see why the organisers of this new Event, chose the Excel as their stopping off point.


They all had a party, the night before. If they say that every vertical market is like a small village – everybody knows everybody – then this was the ambience as you walk through the frankly deserted hallways of Excel until you come across Hall 3, and step inside the Trade Show area.


Perhaps the exhibitors and organisers, were expecting more? It didn’t help that just two days earlier, the UK went into a new series of COVID travel restrictions. More than one exhibitor confided that they had to fork out more than £100.00 on a sudden PCR test, that had not been made apparent before travel.


The chaotic travel scenario alas extended into the event itself. And this was a pity. Because CRUISE SHIP INTERIORS EXPO 21 – was actually rather good! There were some very, very inventive new products in the space-saving category, clever hospitality devices rubbed shoulders with travel agencies – and every Stand had at least one major decision-maker resident. Every conversation, was a productive experience.


I loved the Nautilus bedroom pod from Matalika; and the rather interesting invention from Icecooldesign, The nice lady at Franz Fertig showed me how to create a sofa-bed, without pretty much lifting a finger.


People come to Trade Fairs, to do business. There were far more European vendors, than British, and they had travelled there for a reason. There were more conversations in Italian – than English. Everybody was happy to have a chat.


The comparative lack of people created an intimacy – you could progress in a conversation beyond the usual “meet and greet”.


For that reason, although the Fair was not large in size, by comparison to others at Excel – this was a more worthwhile experience.


There was enough space not to need absolutely a mask, all the time. Just to be on the safe side, I put mine on, when re-emerging onto the Excel hallway. I think we are in for the long haul with COVID into 2022, but hopefully long gone by the time we all get back for the same event in 2022. I’ll be among friends.

CAN WAGNER OPÊRA REACH OUT TO THE COMMON MAN?

We review the latest brand new production of the Wagner Opêra “the Valkyrie”, at London’s ENO English National Opera, and ask – what is it about this performance, that is so special that we want to come see it?

I am seated at a nice seat, somewhere. I txt my wife. “I’m excited”, I say. “Did you bring your mask?”, she asks. “Yes. And it is very crowded” . “Then make sure you wear your mask”. The line goes dead. The man sitting next to me is not wearing a mask. He is talking with his friends.

It is not that ENO produces safe opera. You could almost say that English National Opera carries a health warning. It is risky. You don’t come to ENO because you necessarily want to sing the tunes on the way home. You come for the journey. You could almost say that ENO Members and Supporters are addicts.

So, when Annilese Miskimmon steps in advance onto the stage prior to curtain up, and says something like: “look guys, we’ve got just one or two little issues… there’s no big fire at the end… and oh -forget COVID – two of the leading singers are down with bad colds, and one of them can’t even sing a note, for God’s sake!”- seasoned supporters are used to this. It is not relevant.

How so?

Because the driving force of this “Valkyrie”. Is not the individual singer, but the communication of the emotion, the human relationship, as much as the storyline itself. It is the synergy of the parts of orchestra, the subtlety, the ambience, that support the protagonists on stage, that keep all of our attention, for the full five hours. ENO has been perfecting this approach for a very long time. Even from my very first opera, Wagner’s “Mastersingers” at Rosebery Avenue, as a 12 year old kid hitch-hiking across London to see something called an opera – looking back at my top five all-time best performances at ENO – Wagner would fill three of the spaces – and I am not even a Wagner aficionado.

This production is brand new, it brings to the table some of the best Direction and Performers. With minimalist scenery and graphic intervention -its secret is that it lets the performers “do their thing”. It treats this Wagner project as a modern opera in style and approach, and lets the singers and their relationships with each other, keep us guessing and spellbound.

The programme notes describe this new staging as “narratively gripping and emotionally poignant”, and I think that for the most part – they get there.

The standout Act, perhaps surprisingly, was Act 1 – the performance of Emma Bell as Sieglinde, is phenomenal, and her chemistry dramatically and vocally with Nicky Spence as Siegmund. Is the driving force of the opera. There is a noticeable tension when they re-emerge later in Act 2.

This is a long opera, with a deep multi-level message. You and I will not get all of this, in one sitting. But that is not the point. We go for the total experience, and pick up what we can, and then perhaps go again.

But there is also a point that might have been overlooked by so many of us, and that is one of the key objectives for both this performance, and production – and that was briefly alluded to by Annilese Miskimmon in her opening prelude – that is the giving away of free tickets, to a younger audience. There was a round of applause when she made that statement.

The inclusion of a new non-opera audience, and showing its relevance, and its ability to change lives for perhaps more than just one or two – is a key mandate at ENO. And I should know. All those years ago, I was one of them.

SATYAGRAHA – A STORY OF OUR TIME

At a time of resurgence from COVID restrictions, we look at the relaunch of the Satyagraha Opera by Philip Glass, by the ENO English National Opera, on their first day back at their home London Coliseum after 19 months – and look at why this is both an Opera and performance for the moment.

It is a full twenty minutes before I fully understand why it is that people of all ages, aims, backgrounds, ambitions, love being part of the ENO Family, and what is the single thing that draws us all together.

It is not necessarily the music. True, this performance, its direction and delivery, is brilliant, stunning, mesmerising. My two colleagues next to me, the young lady with her teenage daughter are spellbound – they described it as “resonant” – and the introduction itself had rich luscious vocal lines, even though this was no Verdi. But it was the moment when the full chorus, from somewhere in the shadows suddenly came alive and you got this fabulous wall of sound. It was as if we had all been waiting for this, and it did not disappoint.

The depth and intensity of the desire to communicate – the continual hypnotic orchestral themes and continual variations of time signature – left me uncertain, and the hesitating steps of the protagonists on stage, as each carried their own line of music and text, was confusing.

But that did not matter. This was ENO saying; “look, we are here for a reason. Nobody smiles in this ‘Satyagraha’. We are taking a solemn story and winding it around new dimensions and images in ways that you might not have seen before. And we know how to do it.”

The girl in the interval, told me that there have been some preparatory sessions, to explain the thinking behind the staging, the strange larger than life puppet characters, etc. And I can understand the need for that. I spent the first two Acts unsure of what was going on, sitting on the edge of my seat, sometimes – particularly in act 2 – actually scared. Did I really come to the Opera to be scared? And simultaneously intrigued, drawn in.

They say that “Satyagraha” is what they call a “marmite” opera; you either love it or hate it. And talking with members of the audience generally, that division is still there, The complicated story line and topics it is trying to explain, create a sort of Bach on steroids musical structure, or a Big Burger with nineteen different layers, there is just so much going on.

And there are so many clever aspects to communicate. The key points are brilliantly highlighted by the very clever use of Newspapers from the time, that assemble and re-assemble to form impromptu screens that display key words on stage as we go. The symbolism of frankly everything is just too much for one evening alone, for an average opera goer who just wants a night out with some music.

But that itself misses the point. To deliver this sort of cohesion and perfection requires absolute singing and musical quality and I am not going to single out any particular artist or group. It just all works.

Or maybe it doesn’t. Maybe this is simply the formula, perhaps redolent of when I first saw “Two Boys” with Mary Bevan, that I first understood ENOs prowess with modern opera. But that too is unfair.

This “Satyagraha” is an opera that reflects a different age of how we communicate themes that are as relevant today as they have always been. Did I like it? No, I don’t think so. Did I love it?. Absolutely!

NEW LAWYERS. TRANSFORMATION OF A PROFESSION

The subtle movement and shift of emphasis from today’s lawyers into Business Partners and strategic advisers – has changed the view that we have of them – and them of us. The question is; is this a difficult sell?

Nora Teuwsen is looking at me across the screen. She is dressed in Swiss minimalist chic, dark grey modern clothes, long auburn hair. As former General Counsel for Swiss Railways, and surrounded by the financial areas of Zurich, she is well placed to make a perceptive judgement.

“It used to be”, she says. “But now, Corporates are waking up to the fact that their in-house Lawyer is also a modern facilitator”.

Like so many young lawyers starting out, Nora had little clue of what a legal profession entailed. Her motivation had been more a belief in justice, integrity, that she still regards as valuable of all skills to have. What she was not prepared for in those early days – was the lack of client contact, and to work out and discover an understanding, that her preferred role was one of explanation, to explain the “why” things need to be so.

She is calm but animated in her delivery, you can see the entrepreneurial spirit that is driving her responsibility to take her client on a journey. The legal background has no longer become the prime reason for being retained, it is the structure of thought that can open other commercial discussions.

It is no surprise that after 15 years with Swiss Railways, it was obvious that the next step was to create a vehicle that could embrace all of these attributes and competences, into one, that could be offered as a package so to say.

What she says is; “companies are underestimating the value of their legal department”, and in many ways that department needs to be courageous in pushing for creative and pragmatic solutions which are taking into account the company’s strategy and focussing on longterm value.

Nora continues: “The role of the legal department is expanding. Areas of sustainability, social responsibility, are becoming the go to areas of importance for corporates of all sizes, and the legal department can assist in handling that interest.”

It is also a focus on use of Data. Surprisingly, Nora is not convinced by use cases in Artificial Intelligence in the legal industry. There is a great transformation going on, but so far, results are limited. So far, it has not come up on her radar as a priority.

The “BeyondLegal” Boutique Firm, Nora’s brainchild – from a single Zurich base – is already international clients. “What we are trying to do, is build a network of like-minded legal professionals. We live in an international world”.

I turn off my screen and take a moment of reflection. In a technology driven marketplace, human values are still the bedrock of our corporate growth, which we always had but somehow had been forgotten. Some things remain the same.

IS DIGITALISATION THE SUICIDE NOTE OF BUSINESS?

We look at SEO and the epidemic of digital solutions in Biz Dev, and ask; are we missing the point here?

I have a colleague, who is Head of Procurement for some large areas of Scandinavia. And what he says is this; “Richard” – he says – “ I have deliberately stopped answering any emails, or any calls, from anybody I do not recognise. If you want me to talk to any of your people, just let me know in advance and I will put their number in my personal contacts.”

In the same way that the freedom of the internet has given us multiple information choices that should have given us a broader outlook – and the reverse has been true – that we only focus on those news feeds that say the things we already believe, – and made worse by algorithms that proactively feed us those restrictive views. So – the same is with SEO and all things digital.

We can now reach out to anybody on this planet. But so can everybody else. Which means that the people that we need and want to talk to – for our business growth, our customer service, etc – have long since made the decision not to be available, at all.

What that means is that, far from being simple to grow a business by finding a person who we do not know, and just giving them a call, has now become more than four times as long and four times as expensive, and now involves, pre-sales people, post-sales people, all manner of IT support and analysis, to do what used to be the straightforward and simple task of just phoning a friend of a friend.

But what is worse, is that this has given acceptance and justification, to being proactive in not making human contact possible at all. Woe betide any receptionist who passes on yours or mine contact details!

This means that both sides are the losers. Vendors of great solutions give up, because they cannot support the increasing drain open their marketing spend. And Corporates or our Public Services continue with their outdated practices because nobody has been able to show them otherwise.

If COVID restrictions have taught us anything, it is that human nature needs human involvement, and yet we seem to be travelling at warp speed in the opposite direction. It is as if we are scared about the whole process of actually talking together in a business environment, or being”sold to”. How terrible.

In our own business here at Profomedia, we research a lot and are continually building personal relationships. Whenever we want to find out something, we reach out and phone someone we already know, – who then introduces us to someone who we don’t.

There. It wasn’t so difficult, was it.

DIABETES MANAGEMENT FOR ALL PEOPLE WITH DIABETES

As part of our series of Case Studies for The HETT Show (www.hettshow.co.Uk) – we look at the rise of the Nipro Diagnostics company in Diabetes healthcare and ask, – from a standing start (with the new 4SURE portfolio), in just a few years, has their time come to be a major UK player?

For many people like you and I, the realisation that many people with diabetes do not have their condition out of choice, is a hard one to accept.  And yet its management requires a complex understanding.  

Let’s try and set the scene. In the last 10 years, the cost of treating Diabetes in the UK, has almost doubled. Looking at it another way – some 13% of all the NHS spending, is diabetes related. It is the largest slice of spending in the NHS cake.  And for type 2 diabetes there is no shortage of blame. Everything from the UK government’s lack of practical steps – through to you and I for eating the wrong food and an ever increasing sedentary lifestyle . 

Or maybe, there is no blame? Maybe, despite the fact that 10 years is a long time, and long enough to change both personal and NHS day-to-day processes, is it only now that we need to take a deeper look?

Is it therefore time? Time to reassess, and look again at what do we really need, now, to bring the diabetes epidemic under control and into the 21st century with technological advancements?

10 years ago, and with a Nipro global headcount of some 29,000 people – the NiproDIAGNOSTICS company was not a known player in the UK. Two years ago, they set out to furtherfocus their attention to help people living with Type 1 diabetes, by launching the 4SURE range of glucose meters and partnered with the revolutionary Diabetes:M App. With the aim of being the single one stop shop for every person requiring blood glucose monitoring, Nipro set about bringing into a needy market, a combined process that was affordable for the NHS, and easy to understand for you and I.

Tom Atkinson, Country Manager of Nipro Diagnostics UK, looks corporate cool – with a fashionable soft northern accent, dressed in an open white shirt, he leans into his screen and talks fluidly about his Insulin Pharma background, and the wish to be part of a complete solution. 

“What we understood from day one, was that we have to work the same way as our patients. They don’t want a meter that the NHS cannot afford; they want one with Bluetooth connectivity.And they want an App, which has got to be their Dashboard – everybody wants an App. Our big plus is that access to our new innovative technology, is obviously free, along with the Starter Pack from their diabetes clinic – which includes their initial consumables.”

We talk about the pandemic. It is an irony that, at a time when the NHS and health service provision has been desperate for so many – the essential acceptance overnight of remote diagnostics and monitoring by NHS nurses, has been a game changer for the better, for Nipro. 

“Clearly, we had not forecast a pandemic”, continues Tom, “but it was obvious that it was only a matter of time before common acceptance and a desire for remote diabetes monitoring. What has helped, is that our meters have an accuracy rate of 99.3%, and we are the fastest growing provider of diabetes solutions”.

The corporate ethos of a sales pitch is creeping into the discussion, and I don’t have a problem with that. What is equally evident is the pride of helping the ordinary person with diabetes, just being available, at the end of a phone line if a patient needs help or advice.  But that does not address the basic issue of human behavior. A diabetes meter can only be reactive to a patient’s condition.

Not necessarily. By giving the patient an affordable, information-driven, platform to manage their condition, patients themselves can change their lifestyles armed with the facts and see the benefits of their condition improving by relating to their life choices.

Tom interrupts; “yes, this is true – we are “part” of the solution – but for the patient, we are the major part – as it’s our technology they are using every day and we are the link between them and their own clinic or doctor, as we are providing the vital remote monitoring bridge to keep a patient in touch with their HCP so they can monitor their glucose levels remotely in real time and change their medication and other variables, there and then, if needs be”.

The focus of the discussion goes back to that of patient-provider relationship. “We don’t want diabetes to be the affliction for everyone – but we do want to provide the all-embracing solution for those that need it”. Tom looks at his watch. We have been engaged in academic discussion for nearly an hour, and it is Friday afternoon, end of July. He is taking his family on holiday. 

I closed my screen and take a moment of reflection. Innovation is not necessarily about technology. The patient also has a role to play. The Innovation at Nipro is the approach, taking the fear-factor, the newness, and combining it to tech that simply delivers, and communicating that to the person in the street.

THE PURSUIT OF EXCELLENCE

We talk with Dr Minesh Patel, Partner at the Moatfield Surgey in the UK, and ask – how come they are so good at delivering healthcare for the common man?

Why is it in the UK NHS, that there are good surgeries, and not so good ones, and well, rank awful ones? Why are some standout – and others not so? If human nature is a common denominator, why are there not a set of standard rules, a sort of “go to guide for repairing a surgery”, a recipe book for getting it right, that we all can apply, and that’s job done? And if human nature is indeed the common linking factor, – does this explain why some surgeries are so terrified of change? And others embrace it.

At a time when “innovation”, and “digitalisation” are this year’s buzzwords, can these be imposed by some higher authority – “look, here’s some money, go and start this or that process?” – And if that is the case, then why do we not all have standout surgeries?

The answer is that my human nature, is not your human nature. In short, the success of a surgery, depends on the individual, and the mix of individuals, in each case. You’ve got to “want” to be innovative, to deliver excellence. The only question is whether this is nature at all – or nurture, can we “learn” to be innovative?

Minesh Patel hesitates as he answers this one. In his case, there was never much choice. His father was a doctor, his own daughter is a student doctor, so this is a family tradition so to say, The choice of working in a hospital, or running a surgery, was the freedom to improve and innovate given within a surgery, but it was a journey, taking in improving PCT performance, being Chair of a CCG, leading the clinical strategy development of a developing iCS, before settling and developing the Team at Moatfield, in East Grinstead.

Minesh readily admits that he cannot change or improve everything. Sometimes, the structures themselves do not lend themselves to change. And health inequality from one region to another, one person to another, is a life reality. Having said all that – is there a “process”, an attitude of mind, that is the difference , and what would be the roadmap for other surgeries to follow?

“The answer is little steps, all the time”, answers Minesh.

“At Moatfield, we have a daily huddle, we analyse all of our processes, and we act quickly. Our new website took just 4 days of re-tooling. We are not afraid to act if we believe in something” Minesh uses the word “innovative” a lot. 3 years ago, he became Chair of the National Association of Primary Care (NAPC), which he says has brought him into contact with a lot of like minded and talented people around the country, both within other surgeries and other providers, who are beacons of excellence, and who are learning from each other. It’s a case of seeing “what are the neighbours doing”. so to say. But it is also visionary.

Although we are talking about the daily routine, there is a focus also on the wider picture, why can’t we do things in a different way.

We are getting ahead of ourselves in the discussion.

As if on cue, I look at my watch – we have been talking for 29 minutes. “I’m really sorry!”, Minesh says…. “I have a patient call in a minute”

CAN MUSIC MAKE THE WORLD GO ROUND?

We talk with Andrew Given, Development Director of the English National Opera company in London, about the new ENO Breathe project that has taken both healthcare COVID support, and music markets by storm.

The answer to the above is yes, and no. It is not music per se but it is opera, and the deeper answer is; yes, – very possibly, and in ways that we could not have imagined.

Even more curious, is that – it is not like Opera is a household accepted musical item. It has that bourgeois middle class image which even ENO, the common man entry point for opera, inhabits. And yet here we have a project that is open for all and has to be so, regardless of musical ability or background.

ENO Breathe is a joint project that is a fully structured, thought-out, and managed collaboration, between the ENO, and Imperial College NHS Trust, that delivers a programme of breathing exercises, and participation in singing routines and soft lullabies – to help long term COVID suffers get over their condition.

It is a brilliant concept that astonishingly has no public funding – its initial pilot of 12 patients back in August was crowd-funded to the tune of £12K, by ENO Members, in just seven days. And Imperial College cover their own costs.

It is a marriage of expertise that can make, and is making such a difference already, across a divide that would not have been visible or noticed a year ago. You could say ENO Breathe was an accident, the result of perhaps an even more strange accident – where the seamstresses and costume teams at ENO – plus an increasing army of ENO staff and volunteers, produced the Scrubs for various hospitals, due to a national shortage of protective workwear.

From there, it is a short step to ask – “well, what else we can do?”

From those initial conceptual discussions in early June 2020 – ENO Breathe now has a network of regional NHS Hospitals all signed up to registering their COVID Patients into the scheme. Hospitals include all the main London hospitals, plus Liverpool Royal Infirmary, Manchester, Newcastle, and Oxford. Patient entry into the scheme has to be by referral only, from one of the above hospitals, or from a medical practitioner.

This is no singing group or roll-up choir practice. ENO Breathe is a medically based process that uses opera expertise at its highest level – for the good of patients who need help and who probably have never inhabited an opera house in their life.

And whilst Andrew would be supremely comfortable if patients in return, all became ENO Members, his more urgent need is to continue the funding process.

ENO is currently looking for corporate sponsors, who wish to be visible in their COVID support and also by implication, support for the Arts. It is a truism that every patient is somebody’s employee. You could argue there is a vested interest in corporates protecting their employees in a wider sense.

We finish our discussion. Andrew is sitting in white T-Shirt, in his pristine white lounge area at his home. He has other calls to make, One of the ENO mantras, is that opera is open to all – but I don’t think even he imagined how this would work out.
 
If you are interested in supporting ENO Breathe, please contact Andrew at agiven@eno.org and if you like to know more visit https://eno.org/eno-breathe/’