My friend Dr Christopher Tame died last week, an inspiration to us all right to the end. His email last week still contained a message of determination and hope, along with sharp comments on the political scene. He was looked after to the very last few days by Tim and Helen Evans in their own home and Helen and Dr Sean Gabb, his literary executor, were with him in hospital in his final hours. Such courage and compassion are rare.

Chris was a PhD, not a medical doctor, but he could well have had a degree in any subject whatever. He told me once that he read a book a day. He had an incredible appetite for knowledge. He was also keen to spread it rather than to keep it to himself. He established the Libertarian Bookshop and the Libertarian Alliance, an informal think-tank, and was for many years their guiding light. His influence was immense. I recall with amazement two evenings that he put on at the bookshop, one addressed by Friedrich Hayek and the other by Milton Friedman. To count two Nobel prize-winners among his friends is quite something.

Three months ago, with his knowledge, Meg and I established The PROMIS Chris Tame Prize of £1,000 to be awarded annually for an essay on a Libertarian theme, preferably with reference to the works of Ayn Rand. The prize will be administered by Dr Sean Gabb and details are available on his website (sean@liberterian.co.uk). For us the opportunity to keep the memory of Chris and his ideas alive and flourishing is a privilege. He gave so much to others from his generous spirit even though his pocket was empty. He earned his friendships. He deserves to be remembered.

Three pairs of gay patients of my medical practice have recently had civil ceremonies to formalise legally their long term partnerships. I am delighted for them. It’s nice for them and it’s nice for Meg and me to feel that our friends can be as honest in their relationships as we are in ours.

As the Labour government digs itself progressively deeper into the mire, I have an increasing fear that the Conservatives might win the next general election. I have come to believe that it is vital that they should not. The National Health Service and the state education system have got to fall apart at the peak of socialist control and financial investment. I am not sure that three years is time enough for that. It’s going to happen inevitably but it is the ideas, not simply the practicalities, that have to be seen to fail.

When Phoebe comes back from Desperate Dan, who bathes and trims her every couple of weeks, she looks a right little princess – and she knows it.

Quite rightly, I have to review my policies and procedures annually. New ideas and methods have to be incorporated into clinical practice. None the less I do find some of the demands of the Healthcare Commission rather comical. I work in single-handed practice but I have to sign each document three times, to say that I have originated the policies, distributed them and read them. The Healthcare Commission needs to be absolutely sure to have someone to blame if anything goes wrong. That’s the way bureaucrats think.

We’ve broken through one thousand hits on the blog in this month but we don’t know by how much. The programmer, he of little faith, had not imagined that we could reach that level. For my part, I recognise how small a number of hits that is in comparison with some sites that are into the hundreds of thousands and even into the millions of hits. I count each hit on our own blog as a spur to write more – but I don’t get carried away.

This evening Meg was out with her sister to the Royal Ballet. I spent part of the time talking with a Green Party activist. He knows things that I don’t know and he offered to buy me a book. He asked if I would read it. Of course I shall: I am a book person. The evening chat was at the expense of all sorts of thing that I knew I should be doing. My internal driver cracked the whip – but I ignored him.

This afternoon at the University of London, South Bank, I demonstrated group therapy techniques and processes to our MSc students. I worked with an inner group while an outer group observed and then they swapped around. Periodically I would stand up to explain my over-all observations and strategy. I illustrated the various phases of a group therapy session, moving from level one interchanges (warming up the participants and getting everyone involved) to level two (looking at the deeper level of emotional attachments) and then to level three (taking the whole group into their hopes and fears and reasons for living) and finally helping them gradually to re-surface back into the day-to-day world so that they would be comfortable and safe to return to it.

I gave away my crown jewels, my trade secrets, but in truth I don’t see it that way. My ideas, if they are any good, are my immortality and they need to take root in as wide a field as possible. Leaving that self-centred concept aside, however, I consider myself privileged to challenge and stimulate people who want to learn. Anyway, I find that the process is always mutual. I learn a great deal from students because they challenge and stimulate my creativity as much as I do theirs.

I want it but I don’t need it. I can make out a case to justify it: I always can. I am very good at convincing myself of the correctness of my rationalisations. Fortunately I have a wife, a level headed one, not a kill-joy but not a dreamer either. Two dreamers would spell disaster.

If I were to attack someone for being black, or attack all black people, there is nothing they can change in order to alter my opinion. The fault would be mine for being prejudicial. They would be blameless and would be right to be angry with me.

If I say that I believe someone to be an addict, or say that Celts have a higher incidence of addiction that Anglo Saxons, I would be giving a clinical opinion and would have to support it with evidence. In my mind there would be no question of a personal or general attack because I do not see addiction in pejorative terms; I believe an addictive tendency to be genetically inherited and therefore blameless (although addicts are responsible for their behaviour as it affects other people). However, the person or people on the receiving end of my observation might be angry with me because they themselves may see addiction as a disgrace or a depravity and would say that I am being judgmental, irrespective of my intention or evidence. In such a case there is nothing I can do about that other than to repeat my case and hope that I might be better understood. It would be wrong for me to be brow-beaten out of my clinical opinion.

If I say that I should like to see independence for the Scots, Welsh and Northern Irish so that the English could also be independent, this says nothing about the people. Through my mother’s father I am one quarter Scots myself. I am saying no more than many of these people (other than Unionists) would themselves say. We are each expressing a political opinion. The common ground for all of us separatists is a wish for political and financial independence. If we are all part of the European Union, there would seem to me to be little point in the United Kingdom maintaining boundaries that have little residual significance. If I go on to say that I should rather that England was not part of the European Union, I am expressing a political viewpoint that has nothing to do with my love of various European countries or respect (or otherwise) for their people, individually or corporately. I can appreciate them while still opposing the political concept of a European super-state.

If I say that Liverpool is the whingeing capital of England, I am throwing down a challenge that has been made before in an article in The Spectator. I am not arguing that everyone in Liverpool is a whinger. I would anticipate that there are many hard working people in Liverpool who would be very angry with the whingers in their midst just as there are many moderate Muslims in Finsbury who are very angry with fundamentalists who support Al Qaeda. However, Boris Johnson, a Conservative MP at the same time as being editor of The Spectator, was made by Michael Howard, the Conservative Party leader at that time, to go to Liverpool to apologise. I am not sure that Michael Howard necessarily disagreed with the opinion. He may, as a politician, have been merely afraid of losing votes.

I am not a politician but I have political views, just like all other people have theirs. In this instance I am not making an observation on all Liverpudlians (I have quoted Bill Shankly, a former manager of Liverpool Football Club, in this blog with appreciation for his sense of humour) but I am simply returning in kind the type of attack that is frequently made by northerners on southerners. I see no reason why this should be a one-way process. That, in my mind, has gone on for too long. Southerners in general and Londoners in particular, should not be reticent in pointing out that our financial enterprise supports the rest of the country and it is time for us to be appreciated for this. Liverpool is a particular representative (clearly a special one in the view of the writer of that article in The Spectator) of a common general behaviour in some northern cities as perceived from the south. In this respect all is fair in love and war and politics – except, as I have previously emphasised many times in this blog, for attacks on individuals.

I do not consider myself to be personally attacked when someone attacks Londoners or the English. I fight back and try to produce evidence to counter the opinion. If Liverpudlians are offended by Liverpool being referred to as the whingeing capital of England, they can fight back by proving that the accusation is untrue or they can rise above it and make no comment. That’s up to them. I see no reason to apologise for my comment and I think Michael Howard made a political mistake: he magnified rather than diminished the issue in the public mind. Also I see no reason why the writer of the article (Boris Johnson honourably took responsibility as editor at that time but I understand that he didn’t write it) should apologise for making the original observation.

All of us bandy about political view points all the time. Some people may not realise that they are doing so. We all need to be thick-skinned when the spotlight is turned on us. If we dish it out we have also to take it. That applies to me as well as to anyone else. Challenge me any time on k.stclair@promis.co.uk. My secretary will hand on copies of emails to me so that I can read them at a time convenient for me (usually at night) and not disturb my wife, as a computer screen or keyboard would do. I can take it. As a private doctor I am used to being abused day after day, personally and as a representative, by people who oppose private medicine. But, as this blog shows, I fight my corner. I respect those who fight theirs. After all, my attackers, rather than acolytes, are the people who help me to change my opinions and thereby stay alive and grow. Without the stimulus (sometimes a bolshy stimulus) to change our ideas or behaviour there is little point to life.