Faith in the free market is unshakeable in this government, as has been demonstrated by Covid19 and the huge number of tenders given to private companies to provide key services required to save thousands of lives, such as test, trace and track. However, the re-branding of any aspect of public health care as a commodity over the last 40 years has all but ignored some simple truths pointed out by the economist Adam Smith several hundred years ago; the purpose of the free market is to generate wealth for those who own the means of production, or the ‘masters of mankind’ as Smith christened them, it is not a charitable endeavour but a single minded system driven by cash not compassion, who Smith suggested had a ‘vile maxim‘ of “all for ourselves”. The ‘masters of mankind’ in Smiths time were the merchants and manufacturers who supported policy that enabled them to make more profit, they were not concerned with how such policy and their actions might impact on others. Today the ‘masters of mankind’ appear to be financial institutions; banks, insurance companies, private healthcare providers and international management consultants, such as McKinsey and Company who wrote many of the proposals contained within the Heath and Social Care Act and made several millions from there implementation.
The provision of care related products and services by the private sector clearly leaves individuals vulnerable in a variety of ways, from the treatment of vulnerable adults in Winterbourne View see review, to Serco and their disastrous handling of test, trace and track provision.
Successive governments have been keen to point to the failure of ‘state’ provision as an argument for the introduction of more private sector provision. True there have been problems, however, rather than addressing these issues government seeks to displace them into the private sector, an under regulated private sector, where problems can conveniently disappear from view and politicians spout an empty rhetoric of disgust when an issue is exposed, whilst pointing their finger at faceless corporations exclaiming “its not my fault…s/he did it”.
Government appears to believe not only is the private sector to big to fail, but more worryingly, to big to jail.
In essence some major private providers seem to operate with impunity to wrong doing. If they are not held accountable and government is not held accountable, who is? Oh of course, the ‘consumer/taxpayer’ who paid for the product will have to bare the brunt of failure.
The truth is the ‘free market’ is anything but ‘free’. A favourite of Mrs Thatcher, economist Friedrich Hayek compared the free market to a ‘game’ where there are winners and losers suggesting trying to regulate the market in the name of social justice was a waste of time, there are winners and losers and it is not governments place to even the odds because we are all free to make choices, and should live with the consequences of those choices and not try to displace them onto others, such as government or other taxpayers. Which in many ways I support, however, the market is not free and is comparable to a casino where the ‘house’ always wins.
Lets reflect on the global economic crisis brought about by the same old economic neoliberal ‘masters of mankind’ and the displacement of said crisis on the public sector, and consequently those who use the public sector, to see how a system premised on the free market is neither free nor fair, and the biggest losers are those most vulnerable.
The current government appear to believe there is only one game in town when it comes to the future of our health and social care sector, they are wrong. Call me old fashioned but for me an active State should be about taking a lead, collective action and solidarity, setting a high bench mark for all in society, not running away and hiding behind the financial sector and an outdated mantra of ‘private sector good, public sector bad’ where ‘money is the anthem of success’ like some National Anthem (Lana Del Rey).
Category Archives: Conservatives
Older people still dominate Safeguarding practice, will this ever change?
Has there ever been a ‘golden age’ where older people were consistently valued, respected cared for and protected by family and the institutions that make up wider society?
Latest figures in respect of Safeguarding referrals under s42 of the Care Act 2014 found for the 2016-17 reporting year there were 109,145 individuals that were the subject to a safeguarding enquiry, an increase of 6 per cent on 2015-16. Of these individuals at risk, 63 per cent were aged 65 or over and two thirds of these were over 74 yrs of age.
This will come as no surprise to many within the health and social care professions, and indeed many feel the numbers could possibly be an underestimate given previous statistics. For example a House of Commons report on elder abuse published in 2004 stated
Other witnesses also commented on the estimate of “half a million” older people abused at any one time. Both Bill McClimont, Chair of the UK Home Care Association, and Sue Fiennes, National Lead for Older Peoples Services of ADSS, suggested that the figure was an under-estimate. Mr McClimont commented that it was likely that there was greater reporting in the part of the care sector that was currently regulated. As regulation spread to other parts of care, detection and reporting were likely to rise.
This may well be accurate when we consider the abuse of older people is a global issue.
The World Health Organisation suggests the abuse of older people occurs in many parts of the world with little recognition or response. This serious social problem is often downplayed or hidden from the public view, and considered mostly a private matter. Even today, the abuse of older people continues to be a taboo, mostly underestimated and ignored by societies across the world. However, evidence has accumulated to indicate that the abuse of older people in the UK is an important public health and societal problem.
The full extent of abuse is unknown, however, its social and moral significance is obvious. As such, it demands an active response, one which focuses on protecting the rights of older persons, and a change in our perspective on whom, and what, we value in society.
Although representations of old age and societal responses to older people have differed over time it could be argued old age has always been viewed as negative.
In ancient Greece old age was portrayed as sad, with the Greeks love of beauty marginalising the old. Although some commentators suggest the reality was more complex with the portrayal of older people in the classics as ‘both pejorative and complimentary’ (Thane, p.32). For Plato reverence toward old people was a guarantee of social and political stability, whereas Aristotle disagreed with such positive images. Cicero’s work De Senectute, written in 44 BC, points to the variety in individual experiences of ageing, acknowledging that for those who are poor and without mental capacity ageing is miserable, however, suggesting older people need to strive throughout their life to remain intellectually and physically able.
Arguably this belief still underpins social care legislation and policy today in respect of older people.
It has been suggested older people’s status in society is linked to their ability to participate in society from an economic perspective, especially in terms of activity in paid employment. Historically where older people have been unable to participate in paid employment, help and support has been provided through a mixture of family and state support, with an emphasis by government on the former rather than the latter. However, commentators suggest, post industrial revolution, another victim of change were older people. The old did not merely lose power, they also lost respect. The rise of the alms-houses, and institutionalised poor-relief, may indicate their children were increasingly shedding responsibility for their support and transferring it to the community.
Although Thane argues, this may have been due to families own depths of poverty, rather than lack of care or a shedding of responsibility.
The abuse of older people was not something government identified as a problem throughout this period, although, self-neglect was identified as an issue which government sought to address in the 1948 National Assistance Act.
This is not to say it did not occur, for example, the 1942 Exceptional Needs Enquiry found most older people living with families were there under sufferance. They were often less well off than those who lived with strangers, and lacked essential items of clothing, bedding or household equipment as families used any provision, such as clothing coupons, for personal use. Whether this constituted abuse is not clear as many families who cared for older relatives were often living in poverty themselves and older people often willingly gave their families any support they could, even if this meant going without themselves. Of course, records do not exist to either confirm or deny whether such relationships were abusive or mutually supportive, however, it might suggest in terms of individual worth and personal identity, a cultural norm existed where the welfare of the younger generation was prioritised over that of the old by both young and old.
However, Peter Townsend’s landmark study of long-stay institutional care for older people in 1950’s Britain, provides a little more insight into the experiences of older people receiving care. One of the interviews he recorded was with a matron of a small private residential home in Greater London, which Townsend suggested was by far the worst home he had visited, was clearly describing abuse, as defined in legislation today.
This suggests the abuse of older people has been going on for a long time, both nationally and internationally.
How will we ever change this I wonder?
To deliver good, safe, sustainable care, leaders need to think beyond traditional boundaries ……
‘Our care system is at breaking point. People are struggling to find a good care home when they desperately need it. With demand for beds set to rise, the time for action is now. Help us convince the regulator to confront the care crisis before it’s too late.’ (Which?)
CQC have confirmed in their State of Social Care report the problems many requiring social care already know, the system needs reform.
As Which? and CQC yet again bring to government and wider societies attention to the problems and poor levels of care some older people experience, one wonders will we ever get to grips with this issue? The transformation of ‘care’ into a commodity that can be bought by families and those who use services, like any other product, dominates current health and social care reform, however, discussion on what ethical principles underpin the delivery of such care has not emerged. This raises the question for me, is it wise to continue to build a system of care provision with no clear ethical foundation outside of that of the free market? Arguably, we need greater ambition in developing great care for older people and a more strategic approach to make real improvements. But how?
Developing ethically sustainable care for older people
Drawing on the ecology movement sustainable development is defined as “development that meets the needs of current generations without compromising the ability of future generations to meet their needs”. This captures two relevant issues; the need to support those older people currently requiring care, without compromising the future of the care system.
Need, capabilities and the ‘good life’
A first step in developing ethically sustainable care involves reframing our understanding of ‘need’. Need in a health and social care context is often used to refer to a function to be fulfilled, i.e. nutrition, physical care. Such needs are viewed as a necessary condition for survival. However, we should also view older peoples’ needs in terms of security, respect, love and justice.
The failure to distinguish between different types of need has led to limiting our understanding of how to care for older people, and has subsequently influenced how service provision has developed. Amartya Sens’ concept of ‘capabilities’ provides an alternative approach Sen is concerned in this model with identifying what individuals require to flourish and live a ‘good life’. In this model it is recognised older people require different capabilities to flourish, depending on their personal circumstances and the community they live in, whether that community is within an in-patient/residential setting or in the wider community. Successive governments’ appear to believe an expansion in a consumer culture within health and social care provision is the only route to a ‘good life’ for older people, as it enables individuals to increase choice and control by becoming consumers of care, rather than receivers of care.
Yet many older people are clearly not flourishing in a culture that defines the good life in terms of their ability to engage as a ‘customer of care’. A more useful way of thinking about this, from an ethical perspective, links Sen’s idea of capabilities and Aristotle’s vision of the ‘good life’. From this perspective achieving quality of life is central, rather than just meeting physical needs. In other words it is not just about achieving an ‘average’ notion of well-being but about the opportunities available to the individual which will enable them to develop their full potential, whatever that might mean for that individual.
This approach moves beyond ensuring older people have the ability to flourish to consider whether they are actually flourishing. Commentators suggest there are five areas in which older people need to flourish to live a good life, regardless of where they live. These are: belonging to a family; belonging to a community; having access to material goods for sustenance, adornment and play; living in a healthy environment; and having a spiritual dimension to life. Arguably the commissioning and delivery of service provision based on achieving these five areas might enable older people to receive care that is both compassionate and dignified.
The way forward
Conceptions of what constitutes a good life are varied, however, within health and social care provision it is prudent to assume a good life involves at a minimum care provision that is not abusive to older people.
Within the public sector the organisation and delivery of care is structured to focus on the meeting of targets rather than enabling an individual to flourish. The health and social care sector is arguably over managed and under led. In the private sector it could be argued a free market economy contains structural incentives for business to pursue a notion of the good life that supports the sale of a narrow range of care ‘products’, whilst there are not mechanisms in place to ensure the market operates within a clear ethical framework outside of the profit ethos.
By not actively endorsing care provision from an ethical stand point the government and regulatory bodies may actually be unwittingly aiding the abuse of the most vulnerable within the care system. A shift in focus from human need to human flourishing has already begun with the development of the personalisation agenda and emphasis on voice, choice and control however, this agenda has been overshadowed by a managerial approach to consumerism and consumption in a low paid, low status care system and this is undermining the ability of the care system to develop ethically.
Markets versus Values
Michael Sandel argues markets are not a mere mechanism designed to deliver goods, they also embody certain values, and the problem is these values ‘crowd’ out non market values like compassion and dignified care. Where values and ethics are weak we need a strong and active state to intervene, where both are weak those most vulnerable in society will continue to be exploited and abused. This begs the question can we afford not to have an ethical care system?
Our neoliberal care system trades on the marginalised and vulnerable… it’s time for change
Michael Sandel argues the free market is not just a mere mechanism designed to deliver goods, it also embodies certain values, and the problem is these values ‘crowd’ out non market values which are really worth caring about and preserving, such as compassion’.
Increasingly ‘neo-liberalism’ is up for debate. Whilst well known to economists, politicians, Guardian readers and academics (like me!) it is rarely thought about in wider society. Yet its impact on our society over the last 40 years is immense, many would say for the good, others are not so sure.
For example a report published by Lancaster University entitled ‘A Trade in People’ clearly expresses the failure of a neoliberal care system. The report states
‘it is clear to us that the way in which the healthcare economy has been encouraged to develop by recent governments turns people into commodities and liabilities. For local authorities and CCGs they are liabilities that they have often sought to export to other areas and for independent hospitals they are a commodity and source of millions of pounds of income and profit.’
Whilst this report is referring to learning disability services from my experience I think it could also easily apply to a broad range individuals who require care; older people, those with mental health difficulties, substance misuse, physical and cognitive disabilities, child care, indeed just about any care need you can think of has been turned into a commodity to be traded and profited from.
This is why I think it is important to be aware of the influence neoliberalism has in shaping our daily lives because it has provided successive governments with a framework to deliver its ideas, ideals, values and beliefs about the world and provides a guide on how life should be lived, how society should be structured and our role in society , along with that of government and the free market. Most controversially for me has been its wholesale export into the realm of health and social care, where ‘care’ has become a commodity to be profited from.
In short it determines the nature and limits of that state, what matters and whom.
There are a number of strands to neoliberalism. In recent years, from a political perspective, successive governments have used this ideology as a vehicle firstly, to stigmatising those who require support, just look at the reforms to welfare, and then to disinvest in the public sector that provides their support, instead promoting open unregulated markets and the transfer public services into the free market.
This has resulted not only in the deregulation and privatisation of publicly owned assets, such as housing, but also the transfer of responsibility for those requiring public services away from government, so when there is a failure in the system, i.e. Grenfell Tower; Winterbourne View; Mid-Staffs, holding someone to account is almost impossible due to a diffused chain of responsibility government has put between it, and the individual, by creating a host of intermediary layers of officials and organisations , such as management companies, contractors and sub-contractors.
A key tenet of neoliberalism is the role of free market in delivering everything from baked beans to iPhones’ and cancer care. The free market is highly valued in neoliberal ideology because it is viewed as a more efficient system in providing goods and services, and promotes individual liberty by empowering society through consumer choice.
Whilst neoliberal ideology has indeed empowered us to upgrade our iPhone at will and purchase cheap clothing and chemically enhanced food, what has this meant for those most vulnerable in society who might require quality care rather than consumerism?
Whilst an economic and political system premised on the commodification of people and neoliberal theory maybe a reliable form of wealth generation for some, it is also associated with little compassion for those who require support, as well as structural inequality and poverty for many.
Nobel prize winning economist Joseph Stiglitz is clear, we are now engaged in a battle which is ideological, describing free market neo-liberalism as a stifling economic ideology which has run it course.
Neoliberalism has an insidious presence in our lives, much like the air that we breathe, everywhere, yet unseen. George Monbiot provides a compelling argument against this ideology, which values the free market as the place in which citizens can exercise their democratic choices through consumer choice and the private provision of goods and services. Supporters of neoliberalism maintain “the market” delivers benefits that could never be achieved by government, and that the more unregulated the market, the better the efficiency. Within this framework everything we do, and every person is a potential commodity that can bought, sold and traded for profit.
However, for me, the free market is associated with a loss of compassion, dignity and respect for one another as an inactive state projects structural failure onto the individual, along with an outdated mantra of ‘private sector good, public sector bad’.
One need not dig too deep to see the flaws within the current system. The research by Lancaster University adds to a plethora of reports, all stating the same thing. This system is broken!
Just consider housing and the care of older people to establish the limits of the free market.
Shelter’s report on the barriers low-income households face in private renting exposes the private housing market’s limitations, clearly arguing significant government intervention is needed if it is to play an expanded role in preventing homelessness and housing people on low incomes.
The same issues arises in the care of older people, where significant market failure is a continuing problem.
Over two years ago the King’s Fund highlighted what many in the sector already know, the free market is failing stating
‘Social Care is now a complex and sprawling sector – more than 12,000 independent organisations, ranging from big corporate chains to small family-run businesses, charities and social enterprises, which makes the NHS provider landscape look like a sea of organisational tranquillity. Less than 10 per cent of social care is actually provided by councils or the NHS – their retreat from long term care provision is virtually complete. But unlike the NHS, when a social care provider hits the financial rocks, bankruptcy not bail-out is the more likely scenario. But a deeper problem is the failure to think through the consequences of shifting the bulk of our care provision to a private business model’.
This is supported by Andrew Dilnot , former drector of the Institute of Fiscal Studies, who suggests social care is is a classic example of a market failure where the private sector cannot do what’s needed.
However, the effect of the failure of the free market and neoliberal ideology extends beyond money, the real effect of failing markets rests upon the poorest and most marginalised in society, like the residents of Grenfell Tower and those with social care needs in private institutions, the frail and vulnerable who require support.
The problem in government today is that many of those who govern this country are woefully out of touch and too quick to blame individuals for their descent into a commodified system of care, and those who provide care, rather than look at their own role in creating a a system of care that has no space for compassion, whilst those on the frontline still fight to demonstrate, and deliver, care with compassion, dignity and respect in an increasingly brutal system .
Michael Sandel argues the free market is not just a mere mechanism designed to deliver goods, it also embodies certain values, and the problem is these values ‘crowd’ out non market values which are really worth caring about and preserving, such as compassion’.
Where values and ethics are weak in any system which seeks to support those in need, we need a strong and active state to intervene, where both are weak those most vulnerable in society will continue to be denigrated and exploited.
What is the point of ‘choice’ if your choice is between poor or inadequate care?
As CQC finds 32% of facilities in England inadequate or in need of improvement and says social care in ‘precarious’ state one wonders will we ever get to grips with this issue?
This latest report suggests
“social care is in a “precarious” state – and according to Age UK the results leave elderly people and their families “playing Russian roulette” when they choose a nursing home or other care service. Inspectors making unannounced visits to care homes found medicines being administered unsafely, alarm calls going unanswered and residents not getting help to eat or use the toilet. Some residents were found to have been woken up by night-shift care workers, washed and then put back to bed, apparently to make life easier for staff”
This is not just poor care but adult abuse.
Governments response is to promise more money for social care, however, I feel we would be foolish to rely on the same old political rhetoric. This amounts to no more than economic deception as successive governments continue to adhere to the neoliberal principles of the quality and responsiveness of free market provision and consumer choice. The current approach is failing to deliver either of these fundamental neoliberal principles as the care ‘market’ flounders. According to research, carried out for BBC Panorama by Opus Restructuring and Company Watch, the care ‘industry is in crisis with 69 home care companies having closed in the last six months and one in four of the UK’s 2,500 home care companies is at risk of insolvency.
Anyone reading this who has sought to purchase care for their relatives can attest to the lack of ‘choice’ the current system provides. Indeed most would forfeit ‘choice’ to just have one provider who we can trust to provide decent care for our loved one’s.
What is the point of choice if your choice is between an inadequate care provider or one requiring improvement?
The primary issue, for me, is that care should never be treated as an ‘industry’ because the conflation of care and profit should never ever have occurred because marker values have altered our understanding of the value of humanity in care. Arguably, the discussion needs to go beyond financial issues to consider the greater deception of successive governments who have consistently ignored their failure to develop an ethically sustainable approach to the care and support of those requiring care, especially older people.
Let’s be honest, growing old in the UK is not for the faint hearted when we consider research and inquiries over the last decade. Action on Elder Abuse have consistently highlighted the prevalence of abuse older people experience in the community, leading in 2016 to the publishing of a ‘dosier of shame’ which outlined how the abuse of older people frequently go unpunished.
From a European perspective research findings suggest older people’s experience of ageing in the UK falls behind that of many of its European counterparts, with the UK performing most poorly on indicators such as income, poverty and age discrimination (WRVS,210). The report states the UK faces multiple challenges in providing older people with a positive experience of ageing, scoring poorly (although not always the worst) across every theme of the matrix (WRVS, 2012, p.8).
This all provides a troubling vision of older people’s experience of ageing in the UK.
Successive Governments in the UK tend to address issues associated with care and an ageing population in individual ‘silos’. Research from Europe suggests those countries taking a joined up approach, where government consider how factors such as income, health, age discrimination and inclusion interact develop more successful policy approaches, which improve our care provision and the experience of ageing.
However, any action needs first to move away from the dogma of neoliberalism and take a long term approach with a strong ethical, rather than financial, foundation. This needs to be founded on a commitment to promoting care as a humane act rather than promoting the care of those most vulnerable as a product to be bought, sold and profited from.
Should care be a commodity to be profited from?
Arguably, the ‘free market’ is anything but ‘free’ with the cost to many in society excessive in terms of compassion and inequality.
A report published by Lancaster University entitled ‘A Trade in People’ expresses the failure of the free market in providing services to those most vulnerable in society when it writes
‘it is clear to us that the way in which the healthcare economy has been encouraged to develop by recent governments turns people into commodities and liabilities. For local authorities and CCGs they are liabilities that they have often sought to export to other areas and for independent hospitals they are a commodity and source of millions of pounds of income and profit.’
Whilst an economic and political system premised on the commodification of people and neoliberal theory maybe a reliable form of wealth generation for some, it is also associated with little compassion for those who require support, as well as structural inequality and poverty for many.
Nobel prize winning economist Joseph Stiglitz is clear, we are now engaged in a battle which is ideological, describing free market neo-liberalism as a stifling economic ideology which has run it course.
Neoliberalism has an insidious presence in our lives, much like the air that we breathe, everywhere, yet made invisible by the taken for grantedness of its’ core premise ‘public sector bad, private sector good’. George Monbiot provides a compelling argument against this ideology, which values the free market as the place in which citizens can exercise their democratic choices through consumer choice and the private provision of goods and services. Supporters of neoliberalism maintain “the market” delivers benefits that could never be achieved by government, and that the more unregulated the market, the better the efficiency. Within this framework everything we do, and every person is a potential commodity that can bought, sold and traded for profit.
However, for me, the free market is associated with a loss of compassion, dignity and respect for one another as an inactive state projects structural failure onto the individual, along with an outdated mantra of ‘private sector good, public sector bad’.
One need not dig too deep to see the flaws within the current system. The research by Lancaster University adds to a plethora of reports, all stating the same thing. This system is broken!
Just consider housing and the care of older people to establish the limits of the free market.
Shelter’s report on the barriers low-income households face in private renting exposes the private housing market’s limitations, clearly arguing significant government intervention is needed if it is to play an expanded role in preventing homelessness and housing people on low incomes.
The same issues arises in the care of older people, where significant market failure is a continuing problem.
The King’s Fund has highlighted what many in the sector already know, the free market is failing stating
‘Social Care is now a complex and sprawling sector – more than 12,000 independent organisations, ranging from big corporate chains to small family-run businesses, charities and social enterprises, which makes the NHS provider landscape look like a sea of organisational tranquillity. Less than 10 per cent of social care is actually provided by councils or the NHS – their retreat from long term care provision is virtually complete. But unlike the NHS, when a social care provider hits the financial rocks, bankruptcy not bail-out is the more likely scenario. But a deeper problem is the failure to think through the consequences of shifting the bulk of our care provision to a private business model’.
This is supported by Andrew Dilnot , former drector of the Institute of Fiscal Studies, who suggests social care is is a classic example of a market failure where the private sector cannot do what’s needed.
However, the effect of the failure of the free market and neoliberal ideology extends beyond money, the real effect of failing markets rests upon the poorest and most marginalised in society, like the residents of Grenfell Tower and now those older people who have lost their lives due to Covid19, abandoned by government in private care homes.
The problem in government today is that many of those who govern this country are woefully out of touch and too quick to blame individuals for their descent into a commodified system of care, rather than look at their own role in the rising tide of compassionless care which threatens us all.
Michael Sandel argues the free market is not just a mere mechanism designed to deliver goods, it also embodies certain values, and the problem is these values ‘crowd’ out non market values which are really worth caring about and preserving, such as compassion’.
Where values and ethics are weak in any system which seeks to support those in need, we need a strong and active state to intervene, where both are weak those most vulnerable in society will continue to be denigrated and exploited.
Grenfell Tower represents the culmination of Thatcher and all who follow in her neoliberal footsteps ….. Time for change
Commentator, after commentator have made political links to the manmade tragedy that befell the innocent residents of Grenfell Tower. Within such commentaries the authors refer to the ideology of ‘neoliberalism’, which whilst well known to economists, politicians, Guardian readers and academics (like me!) is rarely thought about in wider society. Yet its impact on society over the last 40 years is immense, and for me Grenfell Tower represents all that is wrong with this insidious ideology that does more harm than good.
But, what it is?
Firstly, I think it is important to be aware of the power of ideology, and neoliberalism, because it provides government with a framework which shapes its ideas, ideals, values and beliefs about the world, what motivates individuals, and provides a guide on how life should be lived, how society should be structured and our role in society.
In short it determines the nature and limits of that state, what matters and whom.
An example of the power of ideology can be seen in religion. Religious values and beliefs shapes its organisation and provides motivation for the actions of its leaders and believers. As we know all to well religious ideology can lead to intolerable acts of violence, whether it be the Christianity of the Klu Klux Klan or the Islam of ISIS.
Just as religious ideology can be a strong motivator in shaping thoughts and actions, so to is the political ideology of neoliberalism.
There are a number of strands to neoliberalism which are, arguably, as relevant as the cladding on Grenfell Tower in understanding why so many lives have been destroyed. In political terms neoliberalism depends on, firstly, stigmatising those who require support and then disinvesting in the public services that provide their support to promote open unregulated markets and the transfer public services into the free market.
This has resulted not only in the deregulation and privatisation of publicly owned assets, such as housing, but also the transfer of responsibility for those requiring public services away from government, so that when, as in this case, there is a failure in the system, holding someone to account is almost impossible due to a diffused chain of responsibility government has put between it, and the individual, by creating a host of intermediary layers of officials and organisations , such as management companies, contractors and sub-contractors.
A key tenet of neoliberalism is the role of free market in delivering everything from baked beans to iPhone to cancer care. The free market is highly valued by neoliberals because it is viewed as a more efficient system in providing goods and services and promotes individual liberty by empowering society through consumer choice.
In the case of Grenfell Tower, the extremes and limitations of these beliefs are starkly revealed. Not least in Brandon Lewis’s comments regarding regulation to enforce the installation of sprinkler systems in tower blocks.
Mr Lewis, recently promoted to immigration minister by Theresa May, had declined in 2014 to force building developers to fit sprinklers. The coroner’s report into the 6 deaths after a fire in a block of flats at Lakanal House had recommended regulations be updated, and called for developers refurbishing high-rise blocks to be encouraged to install sprinkler systems. But five years later, Mr Lewis told MPs:
“We believe that it is the responsibility of the fire industry, rather than the Government, to market fire sprinkler systems effectively and to encourage their wider installation.”
He said the Tory government had committed to being the first to reduce regulations nationwide, pledging a one-in-two-out rule. He added:
“The cost of fitting a fire sprinkler system may affect house building – something we want to encourage – so we must wait to see what impact that regulation has.”
Even after the controversy when these comments were publicised Micheal Gove’ still held to the neoliberal ideological line when interviewed in respect of Grenfell Tower, suggesting that it is a matter for “debate” that government should regulate so that people could have safe housing conditions.
Whilst some might find such comments incredulous, these responses are wholly consistent with neoliberal ideology, which promotes the commodification of everything from housing to education to health, to social care and more worryingly clearly includes ‘risk’. This combined with limited regulation of the free market and an unshakable belief that all consumers can exercise free choice to control, or eliminate, risk is concerning.
Those in power do not seem able, or willing, to recognise there are flaws within the neoliberal ideology they so zealously adhere to, that authentic consumer choice is often a facade in important areas of life, such as housing and health and social care, that individuals cannot always eliminate risk because of the governments hand in creating structural inequality, which restricts the individual autonomy and consumer choice they purport to support, unless, of course you are very wealthy.
The powerlessness of the residents of Grenfell Tower to exercise autonomy and choice is seen in their inability to challenge decisions around whether a sprinkler system should have been installed and this exposes the interplay between the structural and personal realms of life. Peter Weatherby QC is one of Britains top lawyers, and he suggests a key action of government had been overlooked in this tragedy, the swingeing cuts to legal aid. Residents of Grenfell Tower had sought to challenge decisions being made, and residents did try to get a lawyer, however, they could not get a lawyer because of cuts to legal aid, according to campaigner Pilgrim Tucker, speaking on BBC Newsnight
“These are poor residents – or they’re ordinary residents. They’re not the wealthy. They’re not the Camerons. They can’t afford private schools, they can’t afford lawyers. They tried to get lawyers but, because of the legal aid cuts, they couldn’t get lawyers. ”
Other lawyers have also pointed out the role of legal aid cuts in this tragedy.
However, again, this is consistent with neoliberal ideology, why should the state fund legal aid?
This is actually structural abuse, which is defined as ‘the process by which an individual is dealt with unfairly by a system of harm in ways that the person cannot protect themselves against, cannot deal with, cannot break out of, cannot mobilise against, cannot seek justice for, cannot redress, cannot avoid, cannot reverse and cannot change’
I think this sums up the plight of the residents of Grenfell Tower pre and post fire!
Albert Camus wrote “We must mend what has been torn apart, make justice imaginable again in a world so obviously unjust….. ”, going onto suggest mending a broken world is ‘steadfast, often unglamorous work – it is the work of choosing kindness over fear, again and again…’
To mend the broken in this society, those marginalised through poverty and homelessness, or through age and fragility, to ensure we never subject anyone to the horrors of those lives ruined in Grenfell Tower we all need to be more aware of the ideology that underpins our current system of government and decide if it is fit for purpose, and where we find it lacking, find new ways of governing.
Replacing Theresa May with Boris Johnson or Micheal Gove or A.N . Other will not mend our broken society because politicians all seem to adhere to the same ideology – neoliberalism. Nothing will change until this insidious ideology is revealed and challenged by us the people, and we hold our politicians to account for their actions.
Let the fate of the individuals of Grenfell Tower be a lesson to us all, and lets ensure their tragedy is never forgotten. We need real change for all our futures.
Covid19, Adam Smith and the future of health and social care
Faith in the free market is unshakeable in this government, as has been demonstrated by Covid19 and the huge number of tenders given to private companies to provide key services required to save thousands of lives, such as test, trace and track. However, the re-branding of any aspect of public health care as a commodity over the last 40 years has all but ignored some simple truths pointed out by the economist Adam Smith several hundred years ago; the purpose of the free market is to generate wealth for those who own the means of production, or the ‘masters of mankind’ as Smith christened them, it is not a charitable endeavour but a single minded system driven by cash not compassion, who Smith suggested had a ‘vile maxim‘ of “all for ourselves”. The ‘masters of mankind’ in Smiths time were the merchants and manufacturers who supported policy that enabled them to make more profit, they were not concerned with how such policy and their actions might impact on others. Today the ‘masters of mankind’ appear to be financial institutions; banks, insurance companies, private healthcare providers and international management consultants, such as McKinsey and Company who wrote many of the proposals contained within the Heath and Social Care Act and made several millions from there implementation.
The provision of care related products and services by the private sector clearly leaves individuals vulnerable in a variety of ways, from the treatment of vulnerable adults in Winterbourne View see review, to Serco and their disastrous handling of test, trace and track provision.
Successive governments have been keen to point to the failure of ‘state’ provision as an argument for the introduction of more private sector provision. True there have been problems, however, rather than addressing these issues government seeks to displace them into the private sector, an under regulated private sector, where problems can conveniently disappear from view and politicians spout an empty rhetoric of disgust when an issue is exposed, whilst pointing their finger at faceless corporations exclaiming “its not my fault…s/he did it”.
Government appears to believe not only is the private sector to big to fail, but more worryingly, to big to jail.
In essence some major private providers seem to operate with impunity to wrong doing. If they are not held accountable and government is not held accountable, who is? Oh of course, the ‘consumer/taxpayer’ who paid for the product will have to bare the brunt of failure.
The truth is the ‘free market’ is anything but ‘free’. A favourite of Mrs Thatcher, economist Friedrich Hayek compared the free market to a ‘game’ where there are winners and losers suggesting trying to regulate the market in the name of social justice was a waste of time, there are winners and losers and it is not governments place to even the odds because we are all free to make choices, and should live with the consequences of those choices and not try to displace them onto others, such as government or other taxpayers. Which in many ways I support, however, the market is not free and is comparable to a casino where the ‘house’ always wins.
Lets reflect on the global economic crisis brought about by the same old economic neoliberal ‘masters of mankind’ and the displacement of said crisis on the public sector, and consequently those who use the public sector, to see how a system premised on the free market is neither free nor fair, and the biggest losers are those most vulnerable.
The current government appear to believe there is only one game in town when it comes to the future of our health and social care sector, they are wrong. Call me old fashioned but for me an active State should be about taking a lead, collective action and solidarity, setting a high bench mark for all in society, not running away and hiding behind the financial sector and an outdated mantra of ‘private sector good, public sector bad’ where ‘money is the anthem of success’ like some National Anthem (Lana Del Rey).
Di Galpin 