I have transferred this blog to Wordpress; new entries, including coverage of social security issues, appear regularly at the new site. I have left this file in place to make sure that no-one gets stranded.
I'm not a constitutional specialist, but I think I can see how enhanced devolution, or "devo-max", might work for Scotland. Currently there are about 240,000 people who are not governed from Westminster or the devolved governments; they live in the Channel Islands and Isle of Man. The governments of these islands are responsible for its own economic, social and domestic policies; treaties are made by the UK in its behalf, but it is not part of the European Union. I served as a consultant for the States of Guernsey for four years; my work was based on corporate planning for health, housing, education, social work, social security and policing. Effectively, each government has its own negotiated status. In some cases, the policies are very similar to those of the UK (I am not sure why Guernsey residents should want to pay a TV Licence to support the BBC, but that's up to them), in others they are distinctively different. Devo-max is neither unfeasible nor untried.
There is however a potential problem with the two-question referendum. People would vote yes or no for independence, and yes or no for devo-max. Imagine that 22% vote "yes-yes", 22% vote "yes-no", 22% vote "no-yes" and 33% vote "no-no". The result would be that both questions would be defeated, 55-44 - despite 66% of voters voting for increased powers. It's critically important what the questions are and how they're put.
posted 2nd November 2011 E-mail your comments
The Commission on the Future Delivery on Public Services in Scotland has reported. In a time of major cuts in public services, the Commission's reponse is an unreflective recitation of all the things that Scottish public services have been trying to do for the last few years anyway: partnership working, holistic responses, personalisation and early intervention. And, just because we have been doing them for years, we know what is wrong with all of them. Partnership working is all very well, but services need a division of labour to work effectively. The main impact of partnership has been to refocus attention on the boundaries - often issues of that affect the interfaces between services (such as the environment or community safety) rather than the things which most matter (like health, education and housing). The problem with everyone trying to be holistic is that is means that everyone is responsible for everything; services duplicate effort and spend time dancing on each other's feet. One of the silliest proposals in the report is that public agencies should all have the power of welfare: so the local NHS trust will have legal power to build a railway? Be serious. Personalisation is administratively cumbersome and wasteful; it depends on there being choices and options, which are drying up; it individualises responses (like employment provision) which should be generalised. And early intervention, which has been tried repeatedly for nearly fifty years, is fuelled by a myth of integenerational continuity, something that doesn't happen; depends on us having effective models of development, which we don't have; and assumes that early gains are maintained, which they're not. The fundamental problem is not continuity, but long-term insecurity; and the route to a secure social framework is not focused early intervention, but a continuing framework of access to the services and support people need.
posted 4th July 2011 E-mail your comments
I am puzzled by the repeated mantra that government in general, and the Scottish Government in particular, cannot create jobs. Of course they can; for example, every job in Parliament is created. Nor is it true that public jobs are not "real" jobs. Real jobs we need more of include, for example, police, cleaners, teachers, janitors, carers, street and park wardens, or guards. If we invested more in builders, plumbers, painters, gardeners or people to mend roads, it would do a power of good. Part of the argument was made by Keynes: it makes more sense to pay people for doing something than it makes to pay them for doing nothing, and the economic benefits of engaging people in paid employment will be considerable. But there is also a social benefit in ensuring that people are integrated into the economic structures and have the basic entitlements that work brings. If we judge certain activities only by the standards of costs, then it will often seem cheaper to use heavy machinery to repair holes in the road than it is to get human beings to do it - but we cannot afford the machines, and we have labour to spare. (I do not understand the case that CCTV is more cost effective than a street warden; CCTV is very expensive, and a camera cannot actively intervene during an incident.) Creating jobs is often worth doing in its own right. We need to start thinking about costs and benefits across the wider economy.
posted 4th July 2011 E-mail your comments
This is, admittedly, just a little out of my usual field. However, I cover issues relating to human rights as part of work on principles in social policy, and privacy is also a vexed issue in social research, so the recent furore about privacy injunctions has piqued my interest. The central issue concerns a footballer who had obtained a "superinjunction" preventing a girl from revealing secrets about an affair, or even the name of the footballer from being revealed. There are two striking issues. The first is the issue of secret justice, which is no justice at all; the prospect of anonymous, unreported enforcement and legal sanction is repellent, and John Hemming MP was absolutely right to raise it in Parliament. The other issue is the interpretation of privacy by the courts.
Privacy is usually understood in one of two senses. The first, which is the
interpretation given to privacy in legal cases in the USA, is that people have
an intimate sphere of life which other people are not able legitimately to intrude
on. The second, which is more prominent in social science, gives people control
over information that relates to them. In the context of social research, the
Australian National Health and Medical Research Council explains:
"Individuals have a sphere of life from which they should be able to exclude any intrusion ... A major application of the concept of privacy is information privacy: the interest of a person in controlling access to and use of any information personal to that person."
The idea of consent in research is based on the idea that information is private, and that it needs the consent of the person who reveals it - the research participant. It's not usually the case, however, that researchers are asked to get the consent of everyone mentioned in research. That, by contrast, is what journalists are now being asked to do.
Let me offer a little scenario: a man's girlfriend goes to his wife and says, "I am having an affair with your husband". If the husband has an intimate sphere which no-one can impose on without permission, the girlfriend has breached it - admitting the girlfriend to intimacies is not a licence to reveal those intimacies later. If he has a human right to control the information, the girlfriend has breached it. I find it hard to believe that either outcome is what the advocates of privacy laws intend; privacy may be a right, but it does not follow that secrecy is. An individual may retain control over information only in so far as that information relates solely to his private actions. A couple, a group, an association, may control aspects of information that relate to that couple - but they exercise that control jointly, not severally, and if they do not agree, neither retains the right. If one partner in a couple wishes to reveal all, the right does not pass to the control of the other person. The attempt to curb revelations by those who want to "kiss and tell" may be many unpleasant things, but it is not a breach of human rights. The courts have got it wrong.
posted 30th May 2011 E-mail your comments
Several entries on this blog refer to cuts, austerity measures and pressure to transfer public services to the private sector. The rationale for doing this is very weak.
Ultimately, the only way out of a slump is through growth, not through retrenchment.
posted 16th June 2010 E-mail your comments
Thomas Malthus, at the end of the eighteenth century, argued that increasing population must inevitably lead to disaster. We were going to run out of food. Malthus was wrong, but that has not stopped generations of neo-Malthusians from claiming that it was going to be true next time. In the 1970s, The limits to growth claimed that the world was going to run out of energy. It isn't. What happens in an economic market is that as an item grows scarce, it becomes more expensive. As some sources of energy will become more expensive, we will be forced to switch to other sources. There is no point at which the last drop of petrol will ever be poured into the last car, while other drivers look on in fury. This is just not the way that the economy works.
The other side of the Malthusian argument is about population. Population does not grow exponentially: the birth rate falls as the economy develops. The reasons are complex. Part of the explanation is the changing role of women, who delay childbearing when they have options for education and employment. Some reduction may be attributed to contraception; some, perhaps, to the effect of urbanisation on the costs of raising a child. But a significant element must be the fall that most countries have seen in infant mortality over the course of the last forty years. The association is clear and strong: once parents see that children have a realistic chance of surviving to adulthood, the number of children they have drops markedly. The graph shown here, prepared by Google Labs, shows the relationship. As an Indian minister once commented, "The best contraceptive is development".
posted 16th June 2010 E-mail your comments
Now that cuts in public spending are on the agenda, a parade of experts has been in evidence, arguing for a new kind of welfare regime. However, what they are arguing for looks a great deal like the policies the same people have been pushing for over twenty years - a programme of privatisation, individualised services, diversity and a withdrawal of the state from direct provision.(1)
Precisely because these arguments have been running for more than twenty years, we can form a pretty clear picture of what happens when services are based on these principles. The policies may seem in principle take expenditure off the books of the public services, but that is largely illusory: the most expensive services are nearly always paid for ultimately by government, and the costs are still largely held within the accounts. The central argument is that the private sector is supposed to be more efficient than the public sector. That efficiency is largely achieved, however, by adverse selection - refusing to do things that the public services are bound to do; and the main way that private services have reduced cost is simply by reducing labour costs. Partial provision by the private sector still leaves the public services to provide residual services. The appropriate comparison to make is not between public and private services, but between the total cost of services where there are different patterns of service provision and delivery. Taken in the round, the combined effect of expenditure in the private sector, the development of regulatory mechanisms in the public sector and the maintenance of residual public services has been generally more expensive than services were when services were planned, delivered and strictly rationed by a sole provider.
Personalisation, diversity and consumer choice are not cheap options. There are no good grounds for believing that such policies save money.
(1) e.g. R Hewit, Public service reform is the only way to avoid cuts, Scotsman 1.3.2010
posted 17th March 2010 E-mail your comments
The Times tells us: "there are only two ways to ration the space on the
roads: by queue or by price" (Editorial, 31st October 2009). Rationing
is about how resources are allocated. There are many other ways to ration besides
queues or pricing. The standard approaches include service restriction, dilution,
filtering and reallocation. This might mean e.g. restricting the class of vehicles
or drivers able to use certain roads; redefining the use of the road space through
line markings; reserving space for certain purposes (e.g. breakdown lanes, bus
lanes, car sharing lanes); changing traffic flows (in the US they use gates
to open or close road sections at different times for traffic moving in different
directions); changing the rules of the road (should there be fast and slow lanes,
instead of all outside lanes being for overtaking?); and redefining the use
of existing roads (freight-only roads, motorways and ring roads are examples).
I'm a specialist in social administration rather than transport, and I cannot
tell which of the options is better; that needs evidence. Pricing may or may
not be better than the alternatives, but we should never assume it is the only
option.
posted 2nd November 2009 E-mail your comments
All the main political parties in the UK seem to have reached a consensus, that the economic situation must mean cuts in public spending. This is alarming. Governments must understand that they cannot cut their way out of an economic depression; they have to grow out of it. The way to bring in higher revenues is for people to earn more, not less. If they cut, the reduction in demand will lead to lower tax revenues, and increasing costs through higher unemployment.
The government finances are certainly bad. It is not because of high spending on public services; it is because the government has bailed out the banks. The main way to recover that money is going to be from the banks, as they repay their loans. The idea that this has to be paid from tax or public spending cuts is a false choice. Either might be true in time, but this is not the time.
posted 22nd September 2009 E-mail your comments
There may not be much to chuckle about in the current financial crisis, but complaints in the US about "financial socialism" (e.g. in Forbes magazine) offer Europeans some wry amusement. The US has never really understood what socialism is about; it seems to be some kind of infection, where exposure to a mild but toxic measure, like a publicly funded library or a school, turns people into brainwashed automata. Socialism, in most of Europe, refers to forms of social organisation for collective benefit. Socialists like Robert Owen, R H Tawney or Richard Titmuss stood for principled, moral intervention in social and economic organisation. (I have been puzzled by the number of commentators - like Matthew Paris in the Times - who seem to think that this has something to do with Marxism. Marxism had no time for principled idealism, or for collective groups working together to improve things, or for the idea that governments should intervene to make economies work better. The socialist parties in most European countries had very little to do with Marx - marxist parties in Europe were "communist", not "socialist".) The Parti Socialiste Europeen, the largest bloc in the European Parliament, is committed to "principles of freedom, equality, solidarity, democracy, respect of Human Rights and Fundamental Freedoms, and respect for the Rule of Law." In respect of financial markets, equality, solidarity and social justice implies much more than regulation for greater stability. Whatever one makes of the Paulson plan, "socialist" is not a word that springs to mind.
There is a different word for pragmatic intervention intended to achieve order and stability: that word is "conservatism". The standard view in conservative thought was powerfully expressed by Edmund Burke (incidentally, as much a supporter of the American revolution as he was a critic of the French one). "Government", Burke wrote, "is a contrivance of human wisdom to provide for human wants." The idea that government should take action as needed to regulate, balance and protect people is fundamentally conservative, and it has been a cornerstone of the "christian democracy" of central Europe for sixty years.
posted 25th September 2008 E-mail your comments
Another day sees another panic about the loss of "private" data. Today's problem comes from the sale of a second-hand laptop containing data for a million banking customers; yesterday's concerned the details of 33,000 people in prison. The personal details of millions of people can be copied to a hand-held device in less than ten minutes.. The usual response in these cases is to cluck concernedly and say, "we have to keep personal data much more secure." Every attempt to make things more complex - requiring more data, drawing on a range of data - can be compromised by error, omission or duplication. For example, biometric data may be difficult to reproduce; but the digital information which is used to represent them is not. There are no procedures which can guarantee the privacy of the data or protect data from loss.
It seems obvious that we can't stop this kind of data from escaping. What is less obvious is the argument that we shouldn't. What is so private about our personal data? Identities are not private: they are public. That is part of what having an identity means. Our names, addresses and ages are generally speaking a matter of public record. Birthdates are hardly confidential information: they are publicly celebrated, people advertise major ceremonies, and celebrities have them posted in newspapers). Criminal records are public, in their very nature; no democratic regime conducts its justice in camera. Our identities announce who we are to the world; that is what they are there for.
Something rather strange has happened. Because, in a cashless society, some people are able to defraud the banks, the banks have been attempting to shift the responsibility to their customers - telling them that their identity has been stolen. And increasingly, it seems, people have come to accept that this is true - that somehow, if they admit publicly to their name, their birthday or the details of their bank account, the subsequent confusion of financial institutions are their fault. We have all been told, for example, not to share details of our bank account, because it can be used fraudulently. But anyone who has ever issued a cheque has given at least as much information - the name of the account holder, the number of the account, the bank's sort code, a copy of the signature and in all probability, because it was common practice until about five years ago, a personal address. The banks routinely use the mother's maiden name: in many communities, this is a matter of public knowledge, and many public announcements of births, marriages and deaths include them.
For members of the public, there is an argument for ending the presumption of confidentiality on many details. Telephone numbers, addresses and dates of birth are widely available; some details (like credit card numbers and bank details) have traditionally been fully accessible to traders, though that practice has recently been circumscribed with the introduction of chip and pin technology; and there is an argument for saying that some issues, like criminal convictions and tax records, should also be fully public (as they are in some countries). The question that remains is how far there should be a presumption of confidentiality relating to collective data - the compilations of millions of names on electoral registers, benefit and pensions records or lists of customers. The problems that arise here are not so much about the existence of the data, as the uses to which people put them - mass mailings, farming names for marketing, or fraud. Those are the issues that really upset people, and those are the issues we should really be trying to deal with.
posted 22nd August 2008 E-mail your comments
Is “rural Scotland” the right focus for policy? The OECD report on rural Scotland (10) lumps three different parts of Scotland together. Part is the urban hinterland, described as “accessible” rural space. Part – the smallest part, in terms of the population – is the kind of area that is most often represented as “rural”, rooted in agriculture and the activities associated with the countryside. But in terms of the distribution of population and communities, the largest part of what the OECD is treating as “rural” is not agricultural, but coastal. Scotland’s coastal areas face a complex set of economic and environmental issues, that have little to do with conventional understandings of the rural environment. They take in issues like energy, mineral extraction, tourism, cultural activity, military activity and the ports. The largest single industry is the distribution network.
The key problems relate to isolation. The services and facilities in many coastal areas are often desperately inadequate. Communities need enough population to support basic services. People want access to shops, banks, post offices, schools and medical facilities; these facilities can only survive if there are enough people to keep them going.
However, development, which is difficult enough in isolated areas for practical reasons, is locked by a combination of opposition from landowners, exclusionary communities and planners. Much of Scotland is radically underdeveloped. The high cost of housing reflects a market in scarce supply – and where supply will always be scarce unless we take the fetters off. Where there is not enough housing, there are not enough people. We all want sustainable communities, but no community is sustainable if it is not also viable. If the coast is not built up, the communities will die.
10. OECD, 2008, OECD Rural Policy Reviews: Scotland, UK: Assessment and Recommendations
posted 22nd August 2008 E-mail your comments
David Cameron, the leader of the Conservative party, is reported this week as saying: “We talk about people being at risk of poverty, or social exclusion: it’s as if these things — obesity, alcohol abuse, drug addiction — are purely external events like a plague or bad weather. Of course, circumstances — where you are born, your neighbourhood, your school and the choices your parents make — have a huge impact. But social problems are often the consequence of the choices people make.” In one sense, this has to be true. However, the sentiment Cameron is expressing invites condemnation of the poor, and for that reason it should be treated with great caution. Poor people do not have the choice of avoiding poverty; the nature of poverty is that it limits choices. Condemning people with very little choice for making the wrong decisions seems peculiarly callous.
I should explain the title of this comment, for the enlightenment of those who haven't had the benefit of a merciless British education. "Musical chairs" is a children's game. There are fewer chairs than children, the children run round the chairs in a circle, and when the music stops, they have to try to sit down. Those who do not sit down in time are out. Now of course it is true that those children who sit down tend to be those who are faster, bigger or quicker. The children who hesitate tend to have made the wrong choice, and they have probably reacted more slowly. But it would be ridiculous to blame the children who lose; the game has been designed that way. The same is true of poverty. People who lose out are often less well qualified, less connected, or slower. They may have flaws of character; they may not have responded to opportunities; they may have made the wrong choices. It does not follow that their poverty is their fault. It is more important to ask whether society shouldn't provide a few more chairs for people to sit on.
posted 15th July 2008 E-mail your comments
I have submitted a response to the Government Economic Strategy: a copy is available here, in PDF format. Clicking on the link will open a new page.
posted 15th July 2008 E-mail your comments
The European Union claims that the newly agreed treaty is not a revival of the abortive proposal to establish a constitution. A House of Commons Select Committee has complained that the new treaty has most of the same elements as the old, rejected one. They are both right.
The abortive attempt to establish a European constitution might be seen as a fundamental criticism of the character of the EU. I suspect the reasons for the treaty's rejection in referenda is more pedestrian. The responsible committee, chaired by Valery Giscard d'Estaing, made a thoroughgoing hash of it, being unable to select the principles that mattered, and trying to include every aspect of EU policy. Even for those who (like myself) support the principles of the European Union, it was a thoroughly uninspiring document. The procedures for the French referendum made made the full document available to everyone - and the document, which is as hard to read as a telephone book, was unlikely to win any friends.
A constitution is a foundational statement. It needs to be communicative, transparent, and justiciable. Every constitution needs to set out the basic institutional framework. It needs to state primary legal rules - rules of recognition, change and adjudication. It should probably state fundamental principles, like the Bill of Rights in the US constitution. But it should not include policy. Instead of confining itself to constitutional issues, the "constitutional treaty" sought both to consolidate the content of previous treaties and to include substantial elements of previously agreed policy - issues like the environment, agriculture and fisheries, and commercial rules. However important these may be, they are not constitutional principles; and whatever the merits of the policies may be, it is very questionable whether the policy which is appropriate now should be expected to be appropriate a hundred years from now. More than nine-tenths of the constitutional treaty was clutter - although it may have contained important policy decisions, it should not have been in a proposed constitution at all.
At the same time, the constitutional treaty included many issues on which there were new agreements. Some of those agreements were fundamental, like agreements on the principle qualified majority voting. Some were not, such as the specific designation of voting arrangements in respect of different policy fields. The member states and the Commission are reluctant to lose sight of the areas they agreed; and so the proposals have been revived in the new treaty. In other words, the new treaty is largely made up of the clutter that should never have been in the proposed constitution. The new treaty does duplicate the constitutional proposals - but it is not a constitution.
Europe still needs a constitution - the specification of institutions, primary rules and basic principles. This treaty is not it. One has to hope that eventually, proposals will be made for a genuine, effective constitution - but it has to be done without elevating every policy area in the EU to the level of fundamental principle. As a modest proposal, there needs to be a word limit. The constitution should not be longer than ten pages; there should not be more than about seventy five clauses. It needs to be served up in plain language. Then, perhaps, it might be worth voting for.
posted 30th October 2007 E-mail your comments
Recent political debate in the UK has been seized by an abstruse discussion of the merits of inheritance tax. Politicians have been wrong-footed; no-one, it seems, can remember what the tax is for, which makes it rather difficult to justify.
There are four main arguments for taxing people on legacies.
The case against inheritance tax is that
Only the final criticism has major substance - but none of the current proposals attempts to deal with it.
posted 10th October 2007 E-mail your comments
The Scottish Government have announced legislative proposals to reform the law of rape. In particular, they intend to make it inadmissible in court to raise the issue of whether a women was drunk. The problem with rape trials is that they often become trials of the victims rather than of the perpetrators; this proposal is a small step to help with that problem.
It is only, however, a very small step. The central problem with the law of rape is that the definition of the offence depends on the issue of consent, and so on the state of mind of the victim, rather than the actions of the perpetrator. As long as that remains true, it is inevitable that the victims will be put on trial. And the recent proposals to investigate rape as if it was murder will only make things worse: a more extended, detailed, thoroughgoing investigation and legal process will bend most victims until they crack.
There is an alternative. Rape is only part of a general class of serious sexual assaults. Many are at least as bad as rape. (This comment is likely to surprise people who think that rape means "very bad", but some of these other actions are much worse, even if they typically carry a lesser sentence than rape itself. Unfortunately, I cannot explain the comment fully in a public forum - they are so appalling that I am not prepared to describe them explicitly. I can only suggest that people consult a law book and see what sort of thing is classed as "indecent assault".) If the nature of the offence was redefined in terms of the general class of assaults, the issue to be considered in court should be whether or not the actions of the perpetrator (male or female) fell into that class - and, regardless of consent, physical evidence of force would stand as evidence of such assault.
posted 6th September 2007 E-mail your comments
The NHS in Scotland has been blighted by creeping centralisation. Hospital services have been progressively been sucked into the large, university-based hospitals in the major cities. The result has been growing problems with accessibility and equity, and a sense of alienation from the population that these hospitals serve. People do not simply want the best medical care possible - especially not if if means they have to travel away from their communities and their families in order to receive it. There are now many parts of Scotland where there is no cover on evenings and weekends, and over an hour's travelling is needed to get help. Health care is all about social protection, and the first, basic rule is to make sure that people are covered when they need it. The resistance to the closure of Accident and Emergency (A&E) facilities in Monklands and Ayr is symptomatic of this. The understandable fear that people have is that the services will not be there when they need them, and they will have to travel long distances to get essential cover. One of the first actions of the new SNP executive has been to refer the issue back to the health boards for reconsideration.
The reform of A&E is not, however, just another example of centralisation. On the contrary, the development of A&E is itself an example of over-centralisation - formed in the belief that a unit can only function adequately if it has a critical mass, and all the bells and whistles that might be needed. The current arrangements don't work - it's not very long since A&E in Lanarkshire was virtually overwhelmed by the number of people reporting with a respiratory virus.
The Kerr report (9) argues that the problems of A&E can be dealt with by more decentralised, local services. The report makes a crucial distinction between Casualty and Emergency services. Kerr proposes a network of casualty units, each with the capacity to deal with lesser injuries and to stabilise life-threatening conditions. Kerr suggested that "as a rule of thumb, each current hospital offering A&E services should be able to sustain services for urgent care." Emergency services, by contrast, will be more specialised, typically serving about a quarter of those who currently come into A&E.
The NHS boards in Lanarkshire and Ayrshire and Arran proposed, in line with the Kerr report, to replace A&E with a split between Casualty and Emergency units. In Lanarkshire, the plan would have increased the number of units dealing with casualities from three to five, with new units in Cumbernauld and Lanark. These 5 units were to cover 70%-80% of the load currently done in three places. Each, then, wouldl have only half the load of current A&E provision. Two further Emergency units, at Hairmyres and Wishaw, were to act as specialised backup. A&E in Monklands was to be downgraded - not closed - as part of a process which would have redistributed staff and facilities across seven units in five locations. The same pattern was proposed by NHS Ayrshire and Arran. Instead of two A&E departments there were to be five causalty departments and one emergency unit. A&E in Ayr would therefore be downgraded.
The purpose of these plans was to make services more local, less centralised, more accessible and much less overburdened. That is what people are now opposing. An attempt to decentralise is at risk of unravelling because of a demand to keep things as they are.
Note 9. NHS Scotland, 2005, Building
a health service fit for the future.
posted 7th May 2007 E-mail your comments
I have responded to proposals for a boycott by accepting the nominal position of Affiliated Professor of the University of Haifa.
posted 30th July 2007 E-mail your comments
First things first. If I ask a cobbler to repair my shoes, and he goes bankrupt while my shoes are in the shop, the bailiffs have no right to take my shoes away. They are still my shoes, and I can l get them back. If I give money to a lawyer to pay for a house, it does not become the lawyer's money; it will sit in a separate account. If I give money to a bank to safeguard, the bank does not become the owner of my money. I am their customer for the service I am receiving, and may be liable for charges or a charge against the interest, but it is still my money.
The Farepak scandal happened when a saving club went bankrupt. About £40m in savings were lost. Farepak's bank, HBOS (Halifax Bank of Scotland), was able to recover about £35m of debts owed to it by Farepak. The "customers" have lost everything.
Something is seriously wrong here. The people who saved money with Farepak might be regarded either as depositors, or as customers. If they are depositors, the money recovered by HBOS still belongs to them. Irrespective of how Farepak ordered its accounts, the bank has actually recovered its losses from their money, and the bank is liable to restore it. If, by contrast, they are customers, and their "saving" was in fact payment by instalment for a service to be rendered, the situation is legally different - they become creditors, like others including the bank. The bank has acted legitimately, even if it might be thought to have taken advantage of the situation to recover assets before others could act.
This situation is still questionable, however. One has to ask whether the position of the unfortunate customer is morally equivalent to that of a lender or an investor, both of whom offer capital on the basis that there will be a return on their risk. Lenders and investors knowingly take a chance, and gauge the rate of return in that light. The customer, by contrast, is not engaged in risk-taking. That seems to me to imply, in the settlement of debts, an order of priority. The restoration of bailed goods and money should have priority over the repayment of loans. The "customers" should receive the £35m recovered by the bank. If the law does not say so, the law should be changed.
posted 15th November 2006 E-mail your comments
The problem of obesity is seen largely as a problem of nutrition and exercise. (There may be other contributory causes, such as sleep deprivation or the controlled temperature in heating systems, but this is still a reasonable generalisation.) Whenever exercise is mentioned, however, it is likely to be transmuted into "sport" in general, and competitive sports in particular. In several cases, absurdly, this has even been cited in support of Britain's Olympic aspirations, as if sitting watching the Olympics with a pack of lager cans was going to inspire our transformation into leaner, fitter citizens. The sports lobby has kidnapped the idea of exercise, which is being held prisoner in a suburban room somewhere while an impostor takes its place. "Sport" is not the same thing as "exercise", and even if sports are a way of exercising, they are not usually the best way.
An active lifestyle should mean that people are active across a wide range of ages, personal and social circumstances. Most people who have active lives do so through a variety of physical activities. The Scottish Health Survey classifies exercise for children in four categories - sport and exercise, walking, active play, and gardening and housework. Exercise for adults is mainly classified as home activity (including gardening, housework and DIY), work activity, and sport and exercise. (2) In relation to all categories, "sports and exercise" is at best a contributory factor - not the main one.
Within the category of "sport and exercise", the role of "sport" itself is limited. Exercise includes walking and non-sporting activity such as dancing. "Sport" is fairly generally defined, including e.,g. swimming and jogging. Competitive sport and games are a residual part of exercise within the category of "sport", and a tiny part of exercise overall. Engagement in sport is highest among young males; it is much less important for females, and it declines rapidly in importance with age, Team games are largely beside the point. If we want a fit, active lifestyle, encouraging walking and gardening are much more relevant than getting people to play football or rugby. Whether or not schools need a football pitch, they do need a garden more.
If it were just a question of not recognising what most exercise is like, there would be a case for doing sport as well as exercise. But that's not the only issue. The culture of sport in schools, and particularly of team games, is profoundly alienating. Most schools in Scotland suffer from the dominance of football in the playground, where a few more competent boys participate, and the rest of the children are relegated to the corners of the open space. The obsession with competitive games leads to people avoiding physical activity. Sport, then, is part of the problem rather than part of the solution.
Note 2. Scottish Health Survey 1998, www.show.scot.nhs.uk/Scottishhealthsurvey/sh8-00.html.
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The announcement that Herceptin (the brand name of trastuzumab) has been approved for early stage breast cancer has also been accompanied by fears that it will cost the NHS about £100 million, on the assumption that it will be routinely prescribed in cases where women have early stage breast cancer. On a recent court case, a women took her health authority to court for refusing to prescribe the drug prior to its approval by NICE, the National Institute for Clinical Excellence. She was convinced that not receiving the drug was tantamount to a death sentence, and she made several emotive appeals to the press. The Secretary of State for Health intervene to direct that she should receive the drug.
This has been seen as an argument about rationing, finance and costs. I'm not convinced that it is about rationing at all. The first issue it raises concerns the process of approval. In some countries, doctors are able to prescribe drugs fairly freely. In France, prescriptions or licensed drugs are permitted unless the drug has been entered on a list of "références medicales opposables". In the UK, the opposite is true; doctors are unable to prescribe drugs on the NHS until they have been approved for use. The rationale for limiting prescriptions reflects fears that the information available to doctors is partial, and unduly influenced by the pharmaceutical companies.
In the case of Herceptin, there have been some disturbingly misleading reports - including one in the New England Journal of Medicine, which really ought to know better. The article examining the use of the drug (3) suggested that using it in the early stages had reduced the recurrence of breast cancer by "approximately 50%", and the journal editorial took that on trust. The numbers in the article are not clearly stated, and they seem to be different in different tables, but nearly 1700 women received trastuzumab for a year, and a roughly equal number did not. 127 women receiving the drug had a recurrence of their cancer, and 220 in the other group had recurring cancer - an improvement, on the face of the matter, for 42% of the treatment group, not "approximately 50%". Crudely put, 93 people, or less than one person in 18, seemed to benefit. What also needs to be mentioned is that 84 patients receiving the medication were taken off it or withdrew because of ill effects, and that 29 people suffered symptomatic congestive heart failure. What we seem to have, then, is a drug which is potentially beneficial for a few people, potentially harmful for a few others, and makes little difference to most. This kind of profile is not particularly exceptional.
The key problem for the NHS rests in the finding that some people are significantly worse off as a result of receiving the drug. When the NHS approves a drug, it doesn't just go to one person; it goes to hundreds, and sometimes thousands. What risk is acceptable to improve the circumstances of some people, at the cost of danger to others? This is not a simple question of mathematics, and there is no numerical answer. The moral responsibility of the NHS is to do as much as it can to ensure that the benefits go to the people who need it, and that the dangers for others are minimized. There are more people who benefit that who suffer, which is encouraging, but not good enough. The normal procedure would be to use the results of successive tests gradually to refine the definition of the potential recipient group, so that it is used most appropriately for people who stand to benefit, and avoided for those who are most at risk. That is what the procedures for testing and trial are supposed to do; and that is what the political intervention has stopped. The first duty of any medical service lies in he principle primum non nocere, "first do no harm". This, not the money, is what is at risk.
Note 3. M Piccart-Gebhart et al, Trastuzumab after adjuvant chemotherapy in HER2- Positive Breast Cancer, new England Journal of Medicine 2005 353:1659-1672
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The Stern review on the economics of climate change (4) presents an argument for preventative action, intended to stop the world from getting warmer. I don't have the scientific background to judge whether or not the arguments about global warming are justified, or whether the predictions in the report are accurate. But I can tell that the proposals in the Stern report don't follow from the analysis of the problems.
Assuming that Stern is right about the problems, the first question to ask is whether mitigation will work. The analysis in the report depends on the idea that there is a critical range of carbon emissions. If carbon emissions continue at more than that level, the situation will continue to worsen. If they reach that range, they might stop. I say "might", because that is as far as Stern is ready to go. The estimates he cites suggest a probability of up to one in five that even if the reduction falls well below that range, the global temperature will still increase by 3 degrees - enough, according to the report, to displace 150 million people, and to put up to 500 million people at risk of starvation. What we are being offered, then, is a preventative approach that may not have any effect at all.
The second problem is that even if prevention is possible, it requires the cooperation of every nation. Stern is clear that any measure that fails to engage most of the world's economies will fail to mitigate global warming. To justify any major investment on the part of a single country, we need to know that that nation's contribution would make a difference proportionate to its expenditure, or at least some difference. There is no indication that it would.
The third problem is that the solution that Stern proposes - a global market for carbon emissions - could make things worse. Countries in the process of development will be fettered; they can develop under constraints, or they can sell their rights, which offers a short-term return but traps them in dependency. The main way out of the dilemma will be to develop nuclear power - a paradigmatic case of the West willing the end while denying developing countries the means. Stern's world will be underdeveloped, unjust, and dangerously unstable.
Stern's central argument rests on the idea that prevention, or "mitigation", of climate change is possible, and cheaper than "adaptation", or trying to deal with the consequences. The cost of mitigation is about 1% of GDP per annum over fifty years. There is no real attempt to assess the cost of adaptation, and because Stern says very little about the process, it is difficult to know what the comparison is based on. Two criticisms have been made of Stern. One is that he does not discount adequately - he gives far too much weight to an uncertain future, counting future generations as worth nearly the same as present generations. Because future generations always outnumber the present, this kind of argument can always be used to show that prevention of unpredictable, remote events is worthwhile. The second problem is that he gives far too little weight to the poor, both now and in the future. Stern does accept that the poorest people will be hit first, and hit hardest. If Stern is right, there are major issues looming relating to water supply, agricultural production and the migration of 200 million deprived people. I do not know how much they will cost either, but a forty or fifty year programme of development, resettlement and relief could do a great deal to reduce the harm that the report foresees, and if the numbers of people are those outlined in the report, the money earmarked by Stern for "mitigation" should be more than enough to lift those people out of poverty. It might be prudent to start paying a little more attention to those issues now.
Note 4. HM Treasury, The Stern Review: Economics of climate change, 2006, http://www.hm-treasury.gov.uk/independent_reviews/stern_review_economics_climate_change/sternreview_index.cfm
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Somehow or other, people in the US seem to have convinced themselves that they are individualists. Everyone is out for themselves, people have no responsibility to each other, and everything that is social is immoral. Like many myths, this view of the world has the capacity to become self-fulfilling. The quality of public life in the US - the physical structure of towns, the condition of public roads, the absence of transport - is appalling. The world looked on with horror when, after Hurricane Katrina, the world's richest nation abandoned its poor, its disadvantaged and dispossessed and blamed them for not making their own arrangements.
There is, though, another USA. There is a USA where people live in families and neighborhoods, where people go to school with other people, where they worship collectively and give to charity. The word for this kind of behaviour, in Europe, is "solidarity". People are in relationships of solidarity when they accept responsibility for each other. There are many Americans who are not part of patterns of solidarity - who are excluded. But most are not. The US seem torn between an image of its itself as a frontier populated by isolated individuals, and the reality that people experience day to day.
Most of the people I have talked to from the US seem to fall immediately into talking about state action. People are either "liberal", by which critics seem to mean "interventionist" (the term in the UK means the opposite), or "conservative". These positions are mainly defined in terms of how much state intervention there should be. The test for America is not how to build a welfare state, or even how to develop social welfare by other means. It is how to use the solidarities which exist effectively, for the benefit of its citizens.
The European social model has grown as a way of developing the links between disparate communities and traditions, and it might just be extendable to another rich, highly complex, culturally diverse, nation. The model is based on three core elements. The first is the development of solidarity - developing the things that tie people together, like family, community and culture. The second is the extension of solidarity, making sure that people have the opportunity to be part of solidaristic networks. And the third is the process of social inclusion, making sure that people who are excluded are brought into the net through a combination of obligation and rights. The idea of an "inclusive America" - a phrase once used by Pope John Paul II - has been raised by some religious and racial groups; but if anyone, either Democrat or Republican, was talking about this in the recent elections, I missed it.
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What is a parent? Is it a biological relationship? Or is it someone who raises and nurtures a child? In the UK, we have tended to assume that the two things mean much the same.
There is nothing inevitable about the idea that parenthood is biological. In France, parenthood is understood in social, rather than biological terms. When a child is born, it can have no parents, one parent, or two. If the mother or father do not accept the child, the child will have only one parent. If both of them withdraw, the child is treated as having no parents, and may be adopted.
One of the central assumptions behind the structure of family law in the UK is that children have two parents. The norm is both an expectation, and a rule. Where it does not apply, it is treated as if it ought to apply. So,
The assumptions behind these policies are increasingly questionable in practice. The first, and most obvious thing, to say about them is that many children do not have two parents. In a society where many children are born to unmarried couples, and many marriages end in divorce, they tend to have a relationship with one carer, rather than two. About 40% of all children do not see the absent partner at all two years after a divorce. The preoccupation with biology, the insistence that children must have two parents, and the under-estimation of social relationships, is at odds with experience. More importantly, they are often at odds with the interests of the children.
There is little prospect of bringing about a fundamental cultural change, and no prospect at all that a law modelled on the French idea could be implemented directly in the UK. But there are several principles we ought to consider. They would include
We need also to balance the position of children who have more than two people in parental roles - mainly through step families. The law has been gradually amended to recognise the importance of these relationships, and partners may have rights of access; but we should not be confusing those rights with the rights of parenthood.
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This was written in reply to Compass's review of energy policy in the UK (5), which emphasised domestic fuel economy as a way of protecting supplies for the future.
Britain's plan for energy is based as much in fuel efficiency as in increased production. Fuel efficiency has a role to play in improving economic performance, but there is little scope for making a major difference - and the idea that we can do much worthwhile by focusing on lightbulbs and larger car engines is risible. Much of the debate has more to do with the appearance of virtue than with practical policies. Some of the policies may be damaging. All systems for reducing consumption based on the price mechanism penalise people on low incomes to some degree, but schemes based on domestic consumption penalise them the most. We need to protect the poorest from the effects of changes in supply, not to increase their vulnerability.
Realistically, we are all going to use more energy as the economy grows - everything we buy requires energy for production and distribution. Britain's estimated 30% shortfall in capacity should not be seen in isolation; every country in the world is going to increase its consumption. We have to plan on that basis.
We are not actually going to run out of energy. What happens, as some sources become scarcer, is that their relative price changes; options which seemed too expensive in the past become economically more viable. We do not need actively to conserve coal, gas or oil; they will simply become relatively more expensive. But we need to be aware that this means that other options - such as nuclear and renewables - are likely to become primary sources of energy in the future.
The main issue in generation is not carbon emission, or pollution, but security of supply. The UK, like many other countries, needs to generate more. We cannot rely on undiscovered oil and gas, so the options are limited. This is the best argument for coal, but coal is not clean - and there's blood on it. By contrast, the cleanest forms of generation are nuclear, wind power and hydro-electric power. What they have in common is vociferous opposition from NIMBYs - people reciting "Not In My Back Yard". We have to remove the obstacles to development.
Note 5. www.compassonline.org.uk
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The maintenance of old people in their own homes for as long as possible has been an objective of community care policy since at least the 1960s. A Ministry of Health circular stated in 1962 that:
"Services for the elderly should be designed to help them remain in their own homes for as long as possible." (6)
There is, however, a concealed implication in the policy. The implication is that the time may well come when it is not possible. The idea of care in one's own home is based in a dichotomous model of care, in which people receive care either in their own homes or in some kind of institution. The effect has been to postpone relocation into residential care or purpose-built accommodation until the old person faces some kind of crisis, when it is difficult to adjust to changes in circumstances. For many old people, the effect is the reverse of promoting independence: they are forced into situations where they have no option but to become dependent. Half the people coming into residential care come from hospital, because they cannot return to their own homes; decisions to enter residential care are largely taken not by the old people themselves, but by professionals or carers.
There is a dilemma in the aim of promoting independence. Independence is generally taken to mean non-intervention and non-dependence; people are independent for as long as they do not depend on others for their care. People preserve independence, consequently, by refusing services until they can refuse them no more. There is something deeply wrong with this concept of independence, and it might be helpful to start using another, slightly less tainted word: the idea of autonomy. People act autonomously when three conditions are satisfied: they are able to make decisions for themselves, they are not constrained, and they have options to choose from.
We should not be looking, then, to keep people in their own homes for as long as possible, because that is the route to crisis. We need to be thinking, instead, about how people's autonomy can be maintained to the greatest possible extent. One option is not to offer care in someone's original home, but to think of more flexible and varied residential provision. Core and cluster units, or "very sheltered" housing, bring people close enough to services to make it feasible to deliver long-term continuing care without a further move. If old people are encouraged to relocate, not at the latest possible point, but at the earliest, they can settle, form relationships and communities, and have a reasonable chance of maintaining their situation without having to move on later. Moving as early as possible is the exact opposite of care in one's own home for as long as possible. It is not right for everyone - no policy ever is - but it has a great deal to commend it. Moving early increases independence, broadens choice and minimises disruption of the most vulnerable. Moving late reduces independence, denies options and puts people at risk. This policy is long overdue for a rethink.
Note 6. 2/62, Development of Local authority health and welfare services.
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This is drawn from arguments posted on the Radical Statistics mailing list.
Genes are not a blueprint for the way we live. Biologists distinguish between genotype - the underlying pattern - and phenotype, the observable outcomes stemming from the interaction of genes, environment and the combined process of development. The argument has been made that environmental factors can make genes more important. For example, myopia, a condition rooted in genetic makeup, has been exacerbated by the development of reading. Variation in height, which is clearly governed by genotype, is nevertheless largely produced by environmental factors (which is why height has increased in succeeding modern generations). To illustrate the point, we know that two centuries ago, even if they were drawn from the same genetic pool, people were much smaller and lighter than we are now. One French study records that 79% of male recruits in 1792-9 were below 1.5 metres tall. The difference between that range and the range of heights in contemporary society is large enough to move people with a similar genetic endowment from a relatively low position to a relatively high one, depending on the developmental environment (primarily, in the case of height, on nutrition). A similar comment can be made about obesity. Estimates for the hereditability of obesity vary between 40% and 70%; but anyone who imagines that recent increases in obesity are due to changes in genetics isn't living in the real world.
Despite nearly 150 years of trying, no-one has produced any good evidence that genes affect developed social behaviour in humans. With about 42,000 genes, it is easy to find statistical associations - at the conventional level where p<.05, there will probably be 2100 genes associated with any given character trait - but that does not demonstrate any causal link. Beyond that, however, most studies making claims about genetic origins of behaviour do not even try to show that there is a general association between the gene and the behaviour. They have simply relied on the occurrence of behaviour in specific families (7), and families have shared environments as well as shared genes. To the best of my knowledge, no study has ever shown that any social competence, personality trait or pattern of behaviour, of any kind, is shared by people with a common genotype or combination of genes while it is not present in others without that genotype. This is the minimum data that would be required to show that genes determine such issues.
Many studies rely, instead, on twin studies, in the belief that the similarity between identical twins must be genetic. This has three obvious problems. Firstly, any similarities within families may well reflect similar environmental factors. Second, identical twins generally have social environments which are very similar, and certainly more similar than fraternal twins. That's why past studies tried to concentrate on identical twins reared apart - the problem being that (a) not enough twins are reared apart to make for a valid study, and (b) that even when twins are reared apart, social services agencies try to match their environments to the greatest possible extent. Third, identical twins are only relevant if one begins from the proposition that their genetic endowment is crucial. In other words, the studies assume the phenomenon they set out to prove.
The argument is not just bad science, It was used at the end of the 19th Century to justify the isolation of "degenerates" from the rest of the community. It was the basis for eugenics. It was closely associated with fascism, because it is an argument that was made by fascists for political reasons and offered in justification of the extermination of inferior humans. (8) The argument is sinister, and it deserves to be treated with deep scepticism.
Note 7. S Jones, 1993, The language of the
genes, London: Flamingo, ch 12.
Note 8. See R Lerner, Final solutions, Pennsylvania State
University Press 1992.
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