On Wednesday 10th April, as the Conservative Party was granted use of both Houses of Parliament for a state sponsored party political rally , Channel 4 broadcast the first of a new series of “24 Hours in A & E“
As lesser and lesser light stood in Parliament to drone on about the greatness of Margaret Thatcher, the episode turned – entirely unintentionally – into a set of parables about the neoliberal project of which she was such an enthusiastic member.
On a London street, a migrant from Europe (one of those people so demonised by The Conservative and UKIP parties, and for whose presence the Labour Party is now forced to apologise) was assaulted randomly and brutally and left in the gutter.
A passer-by did not pass by, but tried to assist her and called for an emergency ambulance. His actions quite probably saved her life: but why did he do that? What was his economic gain? The answer is none: he acted out of a sense of empathy for a person in trouble and a sense of duty, of what was right. The young victim in the gutter was not a member of his family, but a member of his society.
There is such a thing as society.
In A&E a 90 year old man received care: in his own words he was always a strong man, but could not find the strength to pick himself up after a fall. It turned out this was a man who had lived a very individual life: but when his own strength was not enough, the National Health Service was there to pick him up and help him on his way.
There were no questions asked about patients arriving at this A&E other than questions relevant to necessary care. There was no worry about budgets or cost, as the patients were surrounded by staff and their bodies scanned with expensive, high-tech equipment. The only concerns were to save lives and deliver the best recovery. No hospital staff made moral judgments on the patients as they arrived, or worried about patients’ ability to pay bills.
There was no moral debate on responsibility when a child was brought in after a car accident. In a world of neoliberal individual responsibility, there is no such thing as misfortune: only failure. One doctor declared openly that he saw the purpose of A&E to manage the consequences of accidents in the literal sense: events unforeseen, unexpected, not caused by personal failure.
The National Health Service is fundamental, central to the British concept of society and consequently anathema to the neoliberal concepts of humans as individually responsible economic units. The NHS stands as a reminder of the courage of the postwar governments which, despite all the challenges, delivered the welfare state as a bulwark against the pre-war evils of ill-health, unemployment, and poverty.
The neoliberal project, the reactionary ideology developed and embedded into the UK democracy by the bonds forged between rightwing thinktanks, craven politicians, the greedy rich, and the corporate lobbyists (so frequently the same people) sees the NHS – correctly, from its perspective – as the ultimate prize in its war to destroy the society which it demands not so much does not, but must not exist.
For society to survive in the UK, the NHS must survive according to its founding principles. The alternative is for us all to exist as muggers, riding dark streets looking for the next victim, denying their rights and our obligations to them.
I first came across a personal service contract in the early 1980s when I was employed by a local manufacturing company in the IT department. One of the programmers set himself apart. His working day was not altered by the cycles of activity in the company. He would arrive after us, leave before the rest of us, sit and code; and avoid office conversation except very occasionally to contribute – and then only briefly – to technical discussions. I remember being astonished to learn he was a subcontractor, and to get a hint of how much my employer was paying (for) him.
From the mid-1980s until the dot-com bubble burst, contracting boomed in the IT sector. I’m not saying we all subcontracted, but large numbers of us did so for some or all of that period. There was a business logic – it was said – that for the project work which made up a significant proportion of IT activity it was more efficient to hire contractors for fixed periods and retain permanent staff to work on the underlying service. For programmers and analysts contracting rates were higher – sometimes much higher – than salary rates, and there were always contracts available; particularly in the finance sector which never had problems funding new projects. The challenge for subcontractors was to get the work, the challenge for businesses – at least so it was commonly agreed – to manage so many individual subcontracts.
This interface between IT subcontractors and companies was immediately occupied by agencies, who agreed a contract with a company for the supply of IT subcontractors and a contract with the limited company set up by each and every IT subcontractor who sought work through an agency whenever they could place the subcontractor with a company. For this and for passing on the payment from the hiring company (less the agency commission) through invoicing the agencies made their profits. The IT subcontractor very typically worked through a series of personal service contracts.
It’s easy to forget how immature the IT sector was in the 1980s. IT skills – analysis and programming skills particularly – were in short supply as businesses implemented and built their IT systems and radically changed ways of working. As with all bubbles, IT subcontracting seemed like it would make everyone a winner: companies were more likely to get access to skilled resources as and when needed, IT professionals could get well-remunerated work as they wanted it, and agencies also made handsome profits. This was surely the exemplar of ‘flexible working’ which every other industry should copy.
For a business owner or manager – particularly of a small business – seeking skilled and experienced IT people outside of the finance sector, or outside of the south-east – even outside London – this may not have seemed so wonderful as those people were overwhelmingly attracted to the rewards in the banking sector, which meant the City. If you owned or managed a business seeking to appoint and retain skilled IT professionals to develop – and develop with – your business, the loss of staff to subcontracting was a risk that was difficult to manage. The seemingly perfect model of permanent staff supporting service while contractors came for projects and left again was difficult to maintain, and many permanent staff left companies to subcontract with competitors, supporting their services. From a business perspective, this simply couldn’t continue.
Many IT subcontractors believed – possibly still do – that the bubble was burst by Chancellor of the Exchequer Gordon Brown and the legislation which became commonly known as IR35. More probably it was the rapid maturation of the IT industry. Large and efficient IT services companies simply replaced the individual subcontractors because they could provide not just outsourcing but large and complex programmes. Meanwhile the numbers of people with IT skills rose dramatically, and the shortages in skills and competencies moved to areas such as IT project and programme management. The Internet permitted global competition from low-cost IT companies in Russia or India and from services provided by IT giants such as Microsoft and Amazon. IT subcontracting in the IT sector rapidly transformed into low-reward, contingent freelancing.
Originally formed to fight against IR35, the PCG still lobbies on behalf of freelancers (in any business sector). It argues that personal service companies are a consequence of the ‘flexible employment’ which governments and employers have been trying to achieve, and that government should create alternative arrangements for self-employed to use. Richard Murphy argues consistently that tax avoidance can be identified whenever an accounting or business arrangement is put in place that has no business purpose other than to reduce tax liability, that there already exist alternatives for the self-employed to use, and that the limited company is too easy to form and too open to abuse.
The use of personal service companies sits at the convergence of what appear initially to be two complementary ideas, and which turn out to be a very tight positive feedback loop. One is the ideological drive by employers to have the use of employees without any responsibility as an employer; the other is the ideological trope of ‘individual responsibility’, where persons seek employment without any responsibility towards an employer. The personal service company enables both parties to achieve this, with the added ‘benefit’ (to the two parties, not to anyone else or to society in general) that both reduce their tax liability. Denial of responsibility to others and to the state; ‘individual responsibility’; tax avoidance: neoliberalism.
In response to a report that the BBC has 25,000 people on such “off-payroll contracts” (13,000 of whom are on air) Margaret Hodge MP, Chair of the Commons Public Accounts Committee, argues strongly that avoiding paying tax and national insurance in the public services is “not fair”. That seems a very kind statement. Many who are struggling to retain the National Health Service might well challenge the very notion that the BBC provides a service to the ‘public’. The recent history of the BBC as part of the UK TV and Films sector does clearly demonstrate that the consequences of ‘flexible employment’ are more destructive even than loss of revenue. It serves as a dire warning.
In her recent study Irena Gugulis, Professor of Employment Studies at Durham University, analysed the impact of the last two decades on employment practices in the UK media. She argues that at the end of the 1980s, the BBC began to change with the media industry from a monolithic body with defined managerial and career structures to one which commissioned rather than produced, and replaced careers with self-employment. During the next decade, the media sector became a sector of many small companies using the self-employed on short-term contracts (sometimes production by production or even more temporary). Professor Gugulis found that in an industry where self-employment predominates, career structures break down. For the self-employed, moving from one role to another – even similar or closely associated roles – within the same industry requires that you start again at the (very) bottom. This was a problem faced by the IT subcontractors in the 90s, forced to retrain themselves on new technology and systems as the industry changed. But for the self-employed in the media industry, the bottom is now a lot lower.
The media industry is marked by unpaid work and unpaid internships. Employers who want employees without having any responsibility toward them will see no logic in employment benefits, and ultimately feel no need to pay them for their work. Someone wishing to change career role within the industry must be prepared for perhaps years of unpaid or very low-paid work. Moreover, unpaid work and unpaid internships act as barriers to entry into work and into the sector by those who cannot afford to work without pay. Unpaid work introduces a bias against anyone without wealth, or with family responsibilities, or with dependencies such as disability.
The breakdown of a career structure removes value from a curriculum vitae, and the meaning from job titles. Within a large organisation where permanent employment is the norm, career levels are apparent to all employees. Career progression can be planned and attained, and the job titles, achievements and competencies held have a meaning to other potential employers in the sector. This is destroyed when employment is replaced by self-employment. The income of the self-employed is always determined by the current piece of work: the market replaces personal development. When CVs are effectively meaningless and work is piece-work, the self-employed have to find an alternative route to secure their next piece of work. The consequence is that selection based on experience and achievement no longer functions, and work is instead gained through personal networks.
What makes someone employable is not being available and having the appropriate skills and experience, it is being known to be available by someone they have worked for or with previously. What gets them employed is not their skills and experience, or talent: but, Professor Gugulis asserts, whether they they will fit in. To get employment, you have to fit in. To fit in, you have to be like everyone else. The sector is populated overwhelmingly by people from the upper-middle class: but not just occupied, it has also been secured. If you do not ‘fit in’; if you are not part of this social background and milieu: even if you do not dress like everyone else, you are locked out. By creating a ‘flexible workforce’, the sector has been rigidly secured and protected from incursion by people from other classes or other ethnic groups.
Not only has entry to the sector been blocked: Professor Gugulis interprets her research to show that within the industry, gender roles have been re-enforced; with women assigned to clerical and administration, and barred from the creative areas of the sector. This is not her conclusion, but it seems the ‘flexible workforce’ is part of the war on women.
It is outside the scope of Professor Gugulis’ work, but it is necessary to speculate on how the occupation of roles in the BBC by a self-serving elite formed of self-employed members of the upper-middle class effects the ethos and output of the BBC. In a piece I wrote earlier this year for Open Democracy’s ‘Our Beeb’ work, I posited the view that the BBC was lacking in self-awareness, particularly of its failure to question right-wing views, and especially of its complete failure to inform the public about the Health and Social Care Bill. I charged it with demonstrating the Dunning-Krueger effect. Perhaps it’s because it has been turned into a gravy train for a small clique of public schoolkids.
If the public perception of the BBC is that it remains the stuffy Reithian preserve of people named Dimbleby or Attenborough when it is clearly nothing like this any more, then public perception of “civil servants” as a bunch of Sir Humphreys is possibly even wider of the mark. The Commons Accounts Commitee’s request for information was prompted by the knowledge that the head of the Student Loans agency was on a personal service contract. It seems this is common across the civil service. This undermines democracy. A civil servant who accepts a personal service contract effectively undermines the very state he or she is intended to serve, and erodes their credibility and authority.
The journey to a ‘flexible workforce’ is a dismal one. On the journey, revenue will be diminished, careers will be lost, organisations disorganised, employment made insecure, earnings reduced, the majority blocked from whole sectors of employment, gender roles re-established, ethnic groups discriminated against, the disabled further penalised, businesses made unable to plan long-term, skills lost, public service destroyed, and the state itself undermined. Are these unintended consequences of pursuing a ‘flexible workforce’? Quite probably not.
Between October 27th and November 11th 2012, Occupy will be celebrating the anniversary with a series of events, some in St Mary’s church in Putney, inspired by the original discussions. The emphasis will be on public participation.
A strong line-up of contributors includes Richard Wilkinson (co-author of The Spirit Level, Natalie Bennett (Green Party), Michael Mansfield QC, George Monbiot, Kate Pickett, and others.
Full details and dates of events are available at The New Putney Debates. http://thenewputneydebates.wordpress.com/
I am currently reading The Patient Paradox, by Margaret McCartney. I highly recommend it. The author considers how
“our obsession with screening swallows up the time of NHS staff and the money of healthy people who pay thousands to private companies for tests they don’t need. Meanwhile, the truly sick are left to wrestle with disjointed services and confusing options.”
That synopsis alone prompts two thoughts:
- This describes an approach to healthcare which is inefficient and ineffective. The two terms are not synonymous: the former describes how well the service is delivered (which can be measured by the efficiency of the processes, the unit costs for resources); the latter describes the service from the perspective of the recipient, in this case the patient. It is undermining the NHS.
- By altering a few words this can describe the approach, or policy towards, many other things in our society.
For example, welfare:
“our obsession with scrounging swallows up the time of welfare staff and the public money paid in millions to private companies for tests they don’t need. Meanwhile, the truly needy are left to wrestle with disjointed services and confusing options.”
“our obsession with crime prevention swallows up the time of police and the public money paid in millions to private companies for cameras they don’t need. Meanwhile, the victims of crime are left to wrestle with disjointed services and confusing options.”
The obsession with screening is clearly visible in the area of “national security”.
Consider, for example, the Coalition Governments resuscitation of the previous administration’s plans for communications surveillance. This is a proposal to store and analyse electronic communications such as emails and internet traffic to support criminal and terrorist investigations. We are to be persuaded that this will make us safer and is a price to be paid for our safety and security. But, to draw on Dr McCartney’s warnings about health tests, what of the false positives and false negatives that will undoubtedly be thrown up by any such screening? With so much data and with far from perfect algorithms for analysing it, the results will be that some criminals or terrorists will escape the surveillance while many more innocent individuals will be wrongly implicated.
What is described for healthcare in the The Patient Paradox seems to have commonality with the panoptic approach towards at least welfare, crime, and security. The neoliberal urge to create reality rather than to live with and manage it proclaimed by the arrogant neocons who devised the invasion of Iraq is permeating our consciousness. Consider the following correspondences between the screening approach to health, crime, and security:
- Fear of an unknown or unseen enemy which is about to attack. This might be an aneurysm, coronary disease or a cancer; it might be a predatory pedophile or identity thief; it may be a terrorist planning a bomb attack. The common factors are that the attack be imminent, will be deadly, and you are currently unaware.
- Threat which can be visualised easily. It will be a threat which can be used to stimulate the fear in 1, above. It will be a threat which you can be made to respond to readily by people practised in manipulation: the marketing specialists in healthcare or security firms, their advertising companies, the right-wing thinktanks and media, or political spin-doctors, or governments using all of the previous resources.
- Risk which you can be exploited by those who know how fallible people are at understanding and assessing risk, such as those same marketing specialists, salesmen, advertisers, and spin doctors.
- High-tech presented as infallible solutions such as MRI and CAT scanners; sophisticated policing and military hardware; or computer programmes, database mining, and IT systems.
- Private providers of screening and medical treatment, or monitoring and video systems, or military hardware, or security services.
- Pre-emptive action such as medical treatment, control orders, or remote-controlled weaponry. However, the pre-emptive action must be taken immediately.
- Semblance of choice, but a choice prescribed by specific options represented by technical or scientific solutions which are presented as “clean-cut” and infallible - providing a resolution by completely removing the threat. There is no information or discussion about the risk of the solutions.
- Semblance of personal control. The action of being screened or of using screening appears voluntary and decisive, but is actually driven by the manipulation through fear, poor assessment of risk, and misinformation.
- Absence of evidence that the screening or the consequent resolution will actually work – or work permanently. The screening approach is the opposite of evidence-based policy or action and a terrible misdirection from the real problems, and finding solutions to real problems.
- Simple problems, simple solutions. Who was it said that for every problem there is a single, neat, elegant solution: which is entirely wrong? The screening approach seems sensible only to those whose critical thinking has been dulled, or who have not been provided with critical-thinking skills.
The urge to pre-emptive action against a perceived threat through inaccurate screening is leading to unnecessary and possibly risky treatment in healthcare. It is leading to the deaths of individuals, many entirely innocent, as a consequence of remote drone attacks by the USA in Pakistan and the Yemen.
Please read and consider the messages of The Patient Paradox. It may well be good for your health, and might provide insights not just into what is being done to healthcare but to other aspects of society by the propagation of neoliberal thought.
“I think we should go back to first principles and causes and ask what government should be doing and the answer is “not a whole lot”. It certainly does way too much and we could certainly get rid of a lot of it. We shouldn’t give people free money. You know, we should get rid of welfare programmes, we need to have purely private pensions and get rid of state sponsored pensions. We need private schools and private hospitals and private roads and private mail delivery and private transportation and private everything else. You know government shouldn’t be doing any of that stuff. And if it didn’t do any of that stuff it wouldn’t need all of that tax money so that’s the fundamental position and as long as you’re going to have government do all that stuff you’re going to have all those high taxes.” (Alvin Rabushka, the man who invented flat tax, quoted in Richard Murphy’s Blog)
The leader of the Liberal Democrat Party, the minor partner in the Coalition Government of the United Kingdom, asserts that his party has met its promise to ”remove many low earners from the income tax system altogether”. Setting aside whether this has actually been achieved, the more important point is why it should be the aim of a democratic government in the first place. One argument in favour of the change is that this stops government “taking money out of the pockets of those who don’t have much in the first place”. (Roy Meakin, writing for The Taxpayers Alliance)
The untruth which Roy Meakin’s statement includes, one which is reinforced all too frequently not just by his fellow anti-tax lobbyists but by BBC presenters such as Peter Allen and members of the public and politicians (many of whom actually know better) when they lazily speak of ”taxpayers’ money”, is that taxation is the practise by government of removing (and redistributing) other peoples’ property. As Richard Murphy cogently argues in The Courageous State and Nick Shaxon in Treasure Islands, taxation is intimately bound with the provision of property rights by legitimate governments and legitimate governments have a right to raise tax.
The Government is not taking money out of anyones’ pockets, because that money is the Government’s by right of its legitimacy. The Lib Dems have constructed a policy which is based on a lie. Moreover, it is based on a confidence-trick that is central to neoliberal thinking, which is that the way to utopia is to reduce taxation. By reducing taxation, the state can be reduced: by reducing the state, taxation can be reduced. This has nothing to do with efficiency and effectiveness, though these are frequently put up in pretence: the neoliberal denial of taxation is the neoliberal denial of the state. It is the re-assertion of the dogma that the state cannot provide services. Or must not.
For it is axiomatic that private enterprise, through “the market” is the only way to provide services, and the only way that services can be provided. In a recent speech to a right-wing thinktank, Policy Exchange, a Coalition Government minister made the government’s aim perfectly clear: the aim is to end once and for all the idea of any provision of public services by the state (David Hencke, Tribune Magazine) It is worth re-reading that aim. Sir Francis Maude states that the Coalition’s aim is not to reduce public services, or even to end them: it is to end once and for all the idea of them.
This aim is not in the Conservative election manifesto, and it is not in the Coalition agreement. Another lie is being perpetrated upon the electorate and the subjects and citizens of the United Kingdom by its government. But this is not the end: the next lie is a lie of omission: what should a state “do”, and how should that be funded?
Because only the most extreme of the extreme libertarians argue for no state at all. After all, most realise that if there were no state there would be no property except that protected by private armies in a lawless zone; and all argue for “free markets”. Yet it is not paradoxical that a “free market” could only exist if there were a state to create and protect its existence and its freedom. And how could a state raise the moneys to provide that protection without taxation or public debt? The neoliberals clearly desire a state that protects markets. Which brings us to the next lie, the fundamental lie of the “small state”.
The “small state” is only small for the elite (or the elect): for the most the neoliberal state is large, and it is brutal. Neoliberal regimes are characterised by assaults on workers’ pay and conditions, by the removal of welfare and imposition of workfare, by the mistreatment of the disabled, by prejudice and violence against women, by panoptic supervision of public spaces and workplaces, by overflowing prisons and harsh legal regimes aimed at the victims of neoliberal policies, by bureaucratic means-testing for benefits, by lack of access to education and healthcare. The neoliberal state is not a small state: its function of forcing everyone into the “markets” is as brutal as any repressive regime. The violence of neoliberal regimes in the reduction of public services and the suppression of dissent is well documented in Loic Wacquant’s Punishing the Poor and Naomi Klein’s Shock Doctrine. It’s near to final form is most probably suggested by the horrifically violent free market dystopia which is Amexica.
The ethical response to the compound lie about the evil of taxation is to make the case for the state, and to therefore make the case for public services, and to make the case for the benefits of taxation. The worst legacy which we can leave our children is not public debt as Nick Clegg and the neoliberals would have it: it is the end of democracy; it is the fished-out, dead oceans; it is the wholesale reduction in the quality of human life in the unequal world that will result from the loss of state-provided welfare, healthcare and education. And we know, as the Government hands out contracts to private companies and pays them from taxation, that there is yet another lie in here: that privatisation will reduce government spending. How can it, when governments pay private companies and purchase vast quantities of armaments?
We need a real Clause IV moment: a realisation and acknowledgment that there are limits to the markets, and limits to what private enterprise can achieve without the regulation, order, and services provided by the state. Tony Blair’s Clause IV moment was just another lie, that by its elimination he made Labour electable: by deleting Clause IV, the Blairites and New Labour announced their commitment to the neoliberal project.
From 1972 until 1994 (when it was killed off by Speaker Newt Gingrich and the first Republican majority in the House of Representatives for four decades), the Office of Technology Assessment played a significant role by providing disinterested and detailed analyses of technological change to the US government.
“The Office of Technology Assessment occupied a unique role among the Congressional information agencies. … Through eleven Congressional sessions, OTA became a key resource for Congressional members and staff confronting technological issues in crafting public policy. Its existence brought a healthy balance to the analytical resources available to the executive and legislative branches of government.”
The dismantling of the OTA was “a crucial turning away from the idea of valuing, promoting and relying on the power of critical thought as a key ingredient in the process of self-governing”
In order to restore critical thinking and evidence to the heart of UK government, we should create an “Office of Policy Assessment” derived from the purpose of the OTA. The original US legislation could be borrowed with a few amendments (such as striking out the term technology. Something like this …
“The basic function of the Office shall be to provide early indications of the probable beneficial and adverse impacts of the Government policies and to develop other coordinate information which may assist Parliament and the public. In carrying out such function, the Office shall:
1.identify existing or probable impacts of government policy;
2.where possible, ascertain cause-and-effect relationships;
3.identify alternative methods of implementing specific programs;
4.identify alternative programs for achieving requisite goals;
5. make estimates and comparisons of the impacts of alternative methods and programs;
6.present findings of completed analyses to the appropriate legislative authorities and to the public;
7. identify areas where additional research or data collection is required to provide adequate support for the assessments and estimates described in paragraph (1) through (5) of this subsection; and
8. undertake such additional associated activities as the appropriate authorities specified  may direct.”
The Office of Policy Assessment would be an independent, publicly accountable body working closely with a reinvigorated Office for National Statistics to rigorously analyse, test, evaluate, and report on all government policy and proposed legislation; and to prevent legislation proceeding which did not meet its agreed objectives. It could perhaps replace the House of Lords, so demonstrably ineffective and in large part corruptible – as the passage of the Health and Social Care Act 2012 proved.
The mission statement of this new Office would be to protect the public from inefficient or ineffective legislation, and to force governments to produce legislation which would – at a minimum – meet SMART objectives. Because it made all data public, it would discourage Minister’s answers as a set of fictional or badly-framed data.
The new Office would challenge all government objectives and demand measurable precision. It would oversee pilots and tests, and analyse realisation of benefits.
We urgently need information, evidence, and critical thinking to select and support government policy; and a complete change from dogma to practical application. Policies based uncritically upon false assumptions (such as any derived from neoclassical economics) would be revealed and would be easier to block.