Author: Paul Spicker

‘Shaping future support’: more on the obsession with work-testing people who are ill

The ‘health and disability’ Green Paper, Shaping Future Support, is nominally addressed to benefits for people with disabilities and ‘health conditions’.  It promises a review of three broad areas – ‘enabling independent living’, support into employment and  experience of the services, but in the wash this mainly comes out as a review of two issues, assessment and employment.

On the topic of assessment, the paper has little to offer.  People find the assessments are repetitive and inaccurate; the main responses are ‘triage’ and developing more telephone and video assessments.  On the first point, I defy anyone to develop a triage process that doesn’t lead to people being asked some of the same questions twice – unless, of course, the purpose of the triage is to block some people from going futher. As for inaccuracy, the central problem is that the DWP is still holding to the idea that their assessors can garner more information in an hour than professionals in continuing care can collect over several months.  There will be a problem for as long as the DWP continues to disregard medical evidence.

The other issue, and the issue which gets the most coverage in the Green Paper, is about employment. I apologise for repeating myself, but it stands repetition. Two million people who receive Employment and Support Allowance have been receiving it because they are too sick to work, and it is not reasonable to ask them to.  I can say that with reasonable confidence, because they have been subjected to a government-set assessment that was designed to establish precisely that point.  I am sure that there will be those in government who will say, ‘ah yes, but they are still capable of work-related activity’.  They may be, or may not, but there has been no assessment of that; there should have been, there was going to be some relevant test, but the DWP decided not to introduce one.  At present the only criterion for being deemed capable of work-related activity is an assumption, that by default people who need less support must be capable of such activity.  So they are set to do things like writing a CV and invited to have their confidence built. Just what people with bowel cancer need.

One other point about the Green Paper is worth noting.  Late on, in paras 300-303, it floats, for no obvious reason, the possibility of combining ESA/UC with Personal Independence Payment – despite acknowledging that the criteria for eligibility, and the assessments, are  quite different.   I suspect, but do not know, that this may herald an attempt to restrict disability benefits to people on low incomes.

The government embraces the Equality Act – in a way

While preparing to ease lockdown, the Prime Minister’s office has issued this threat, reported in the Guardian: ‘Businesses that chose to enforce mask-wearing would need to take legal advice on their responsibilities under the Equality Act, Downing Street said.’ It appears that ‘equality’ consists of exposing vulnerable people equally to the kinds of risk otherwise experienced by football supporters and anti-lockdown protests, and firms that decline to do this have to take legal advice to defend their actions.

Unemployment is not about to triple – is it?

I was idly poring through the most recent edition of the DWP’s Benefit Expenditure and Caseload Tables – I know, it’s sad – when I came across this striking sequence of data, in the table headed “Unemployment benefits”.

2019/20 2020/21 2021/22 2022/23 2023/24 2024/25 2025/26
Outturn Forecast Forecast Forecast Forecast Forecast Forecast
Expenditure, £m (real terms)
20,119 38,564 41,873 42,680 45,298 50,373 57,990
Caseload, 000s
2,330 4,284 4,509 4,544 4,714 5,192 5,953

By that reckoning, both caseload and expenditure will increase to two and a half times their current level.  There will be nearly six million people unemployed.

There are two possible explanations for this.  One, which I think implausible, is that the government is anticipating a massive and prolonged surge in unemployment as a result of the pandemic and Brexit.  The scenario is not beyond imagination, but I don’t think it at all likely,  even if it was true, that the government would build it into their medium-term forecasts.

The second, which is much more likely, is that the figures represent the anticipated caseload of Universal Credit, currently being counted without any distinction between people who are unemployed and the rest. At the moment, Universal Credit is mainly performing two functions: payments to people who are unemployed, and payments to people on low earnings.  As time goes on, it will also be taking in more and more people on ‘legacy benefits’, and the largest group of people in that category  are nearly two million people currently receiving Employment and Support Allowance. There may well be some people on ESA who are really unemployed, but all of them are  sick or incapacitated.  Bear in mind that the basic, central criterion for receipt of the benefit is that these people are sick, and cannot be expected to work.  That’s not just me saying that. This is the text of the 2012 Welfare Reform Act:

37 Capability for work or work-related activity
(1) For the purposes of this Part a claimant has limited capability for work if—
(a) the claimant’s capability for work is limited by their physical or mental
condition, and
(b) the limitation is such that it is not reasonable to require the claimant to
work.     

Anyone who applies for ESA has to show that they have limited capability for work, tested not (as it once was, and should be) by doctors who know their patients,  but by an elaborate points scheme.  The whole point of providing a long term sickness benefit is to make provision that does not depend on people seeking work.

What the forecasts tell us is that the government currently intends to make no distinction between people who are unemployed and people who cannot reasonably be expected to work.  They will all be counted as receiving unemployment benefits.

The Resolution Foundation proposes a rethink of benefits

The Resolution Foundation has published a short report – they call it a ‘briefing note’ – to consider lessons from the crisis for the system of benefits.  They make several key points, most of which I’d endorse:

  • Earnings-replacement is a critically important role of benefits
  • The current system of sick pay is inadequate, and forces sick people to go to work when they shouldn’t
  • The distinction between employees and self-employed people makes no sense
  • The general level of benefits is too low
  • The safety net needs to reflect housing costs and family size
  • Big reforms will inevitably generate problems
  • There is going to be an increased demand for support for long-term sickness.

I’d depart from their arguments in two ways  First, I don’t think the response of the benefit system, and particularly Universal Credit, has been adequate even within its limited sphere of operation.  Half the applicants have found the process difficult, delays have been marked, it’s full of arbitrary hurdles, and it’s riddled with errors.

Second, the report  seems to me to think of universal benefits, earnings replacement and safety net benefits as being alternatives.  It’s in the nature of cash benefits that they can be combined from different sources, in different ways  – what matters is the final ‘income package’.

Some reflections on ‘ethnic disparities’

The report of the Commission on Race and Ethnic Disparities is a long, dull read, and it’s taken me three goes to force myself to the end of it. They argue:

“Put simply we no longer see a Britain where the system is deliberately rigged against ethnic minorities. The impediments and disparities do exist, they are varied, and ironically very few of them are directly to do with racism.”

Lots of public comment has beaten me to the punch, and I’m not going to try to give an account of everywhere it goes wrong.  There are four key problems with the line they take.  The first, quickly identified by Jonathan Portes, is the extraordinary definition of ‘racism’.

The Commission … proposes the following framework to distinguish between different forms of racial disparity and racism:
1. Explained racial disparities: this term should be used when there are persistent ethnic differential outcomes that can demonstrably be shown to be as a result of other factors such as geography, class or sex.
2. Unexplained racial disparities: persistent differential outcomes for ethnic groups with no conclusive evidence about the causes. This applies to situations where a disparate outcome is identified, but there is no evidence as to what is causing it.

There are only two kinds of racial disparity: those which can be explained by other means, and those where there is no conclusive evidence.

The second point was nailed by Tom Newton-Dunne, who obviously got through the report quicker than I did.  He identifies one early comment as central:  “As our investigations proceeded, we increasingly felt that an unexplored approach to closing disparity gaps was to examine the extent individuals and their communities could help themselves through their own
agency, rather than wait for invisible external forces to assemble to do the job.”  That is the report’s approach in a nutshell – it is only when one moves on to later sections that its importance becomes clear.  As I read through, with growing disbelief, the Commission’s readiness to condone stop and search by the police  – it’s not racist, apparently, but the poor police have become “society’s punching bag” (p.190)  – I had the strong sense that the message to minority groups had become: stop whingeing and behave  yourselves.

The third point rests in the definition of ‘institutional racism’, a term which is

applicable to an institution that is racist or discriminatory processes, policies, attitudes or behaviours in a single institution.

Some discrimination is direct. If people within an organisation are empowered and able to behave in a racist manner, there’s something wrong with the processes that allow them to do that.  The vetting of tenants, GP removal of list patients and adverse selection of job applicants are examples.   And if those processes are permitted to continue despite the evidence that they are working in a racist way, there is clearly an institutional problem.

Some discrimination, however is indirect – a term which exists in our laws, but doesn’t feature in this report at all.  If the system is not ‘deliberately rigged’, they seem to be arguing, it’s not racist.  Some processes can appear to be neutral while repeatedly producing disadvantage.  Processes such as exclusion, stop and search and the operation of the criminal justice system do that.  And that is  waved aside in a report that is determined to locate the source of problems in the action of individuals.

The fourth problem lies in their emphasis on finding ’causes’. If causes are complex, addressing them one by one is not an effective way of changing the pattern. If they are unknown, that’s no excuse for inaction.  The way into a problem is rarely the way out of it.

Lastly, a minor irritation.  This is a personal blog, and it’s hard to pass over a report like this without riding a personal hobby-horse.  Students, we read, “should be taught about all famous and important people in the society” (p.91)  Paupers, peasants, prisoners, soldiers and slaves aren’t typically famous.   I think it would do this country a power of good if students learned less about kings and queens and rather more about the lives of the people who came before them.

‘Greed is good’, revisited

Boris Johnson’s claim that the vaccine programme is a triumph of self-interested ‘capitalism’ has been roundly condemned; I don’t think I need to explain why it’s simply not true in this context.  It has spurred me, however, to come back to the broader argument, that we owe our prosperity and living standards to private enterprise.  That argument has been vigorously restated in support of Johson, for example by Rod Liddle in the Sun: “this is what brings about progress in society”.

It’s an argument that goes back at least to Mandeville – private vice leads to public benefit – but it’s most often cited from Adam Smith:

“It is not from the benevolence of the butcher, the brewer, or the baker that we expect our dinner, but from their regard to their own self-interest. We address ourselves not to their humanity but to their self-love, and never talk to them of our own necessities, but of their advantages”

That much is clearly true, as far as it goes; I do not want to take anything away from it. However, it’s only one aspect of our current standard of living in the UK.

If we look back at the things that have made our lives better than it was in Adam Smith’s time,  there are a few other things to consider besides butchers and bakers.  First, there’s the fabric of public space: roads, drains, pavements, street lights. Second, there are the standards and services that govern our private space: housing standards, sanitation,  sewerage, waste disposal, water supplies, and energy supply.  Third, there are the services and facilities which shape our daily lives: education, health, social security, and housing.   (The last one on the list deserves a reminder: we built six million council homes, and most of them are still standing even if they’ve been privatised or transferred to new management.)

It’s become commonplace for the advocates of free markets to claim that we owe everything to private enterprise.  That claim is false.  In some cases, governments paid private enterprise to provide goods and services; in some cases, such as agriculture or energy supply, they kept services going that would have collapsed otherwise; in some cases, they produced the goods directly.  All of the examples I have given were, at least to some degree and in some cases predominantly, the result of collective social action.  Not private enterprise, not self-interest, but government.

Is it time for a stimulus package?

I write this, not knowing the answer.  One view is that as the pandemic quietens, the economy will spring back into life – not, perhaps, the ‘V’ shaped recovery that the Bank was hoping for last summer, but at least a climb out of the canyon.   Another possibility is that those people who’ve been saving during the lockdowns will have pent-up demand to release as soon as the opportunity arises, and that this will translate into inflationary pressure, for example in housing.  In either of those scenarios, we don’t actually need to inject resources into the economy.

On the other hand, there are some disquieting economic trends.  The pandemic has already closed some businesses, and there will be more.  The continuing lockdown in other countries will reduce demand in Britain further.  Brexit  means that some existing trades selling to Europe (and some to Northern Ireland) will not be viable – for example, small shipments of agricultural produce have become prohibitively expensive and tied up in bureaucracy.    And people have incurred debt, serious deprivation and in some cases destitution.

The case for a stimulus package, of the sort that Biden is introducing in the USA, is that it is only by increasing demand that the economy will get moving again.  But the British economy is not like the US; it’s much less self-contained, much more dependent on trade, services  and complex international supply chains.   I can’t tell, then, whether a major increase in expenditure is actually justified.

However, there is another option.  The position of the people who have suffered most can and should be protected; that implies redistribution and transfer payments, which are the other side of the Biden plan.   If we take resources from people who have been able to save and move the same resources to those who have little, that would probably have a marginal stimulus effect, without running any serious risk either of overheating the economy or of inflation. It’s possible that some sectors would suffer ill-effects, but as great as my respect is for the people running foodbanks, I could stand to see them being put out of business.

The one-number census is not a good way to chart what is happening

It’s census time again.  I’ve made several criticisms of the process in the past, at first in an e-mail list and subsequently in two of my books, and I hate repeating myself.  Checking my previous posts, however, I find that I haven’t made any of those comments on the blog, so it makes sense to cycle through them now.

The first thing is to acknowledge that something like a census is essential.  The census gives us the denominators – the numbers that go below the dividing line.  Without those numbers, we can’t tell how big a problem is, or how evenly it’s distributed.

‘Something like’ a census, however, doesn’t mean it has to be this  census.  There are major problems with the UK census, and most of them are avoidable. I’ve heard Ian Diamond, who’s now the head of the Office for National Statistics, lecturing on this, and he emphasises the importance of  arriving at ‘one number’.  The  preservation of the census in this form is its greatest weakness.

If we look around the world, we’ll find that Britain’s reliance on a one-number census is increasingly unusual.    They’re used in southern Europe, but in other countries they use different techniques.  The USA has the American Community Survey, a large geographic sample of about 3% of the population, to get the fine detail.  Germany has a 1% micro-census and a range of information from administrative sources.  The Nordic countries are using registers of information.  France has a rolling census, allowing for regular updates.

The British census is too long, too complex, too unwieldy, and too slow.  If we go back to the historic archives, we can see what the census used to be: a literal count of the persons in each household, comprising names, ages and addresses.  That, frankly, is all we need from a single census – and as much as we can handle.  The English census has 51 questions. Every added question is another hole in the ship.

The first problem is time.  It generally takes two years to get the first results from the census, and, because it’s such a massive exercise, it has to last us for 10 years after that.  (We last had a mid-term census in 1976.)   That means, simply enough, that the census is always out of date – by at least two, and up to twelve, years.  If we want, for practical purposes, to do something useful, like setting up a primary school, the census is at best a rough, rusty guide.  Rolling data would be much better for the purpose.

The second problem is accuracy.  Statisticians have probably learned that as the numbers get bigger, they become more reliable – that we can be ‘more ‘confident’ about the findings.  This is just not true, at least not in the real world.   What happens with big numbers is that mistakes and biases are amplified, and we are liable to invest the numbers with meaning when they may have none.  I think people will remember, for example, the large number of write-ins claiming to be members of the Jedi religion; at least we can tell that’s bogus.  It’s more difficult to pick holes in other responses, but we should be able to acknowledge at least that we couldn’t rely on previous censuses to get the numbers of young men right.  If this census gives us an accurate, reliable count of people who are disabled or those whose gender is non-binary, I for one will be astonished.

If we really want to know about these topics, the census won’t give us the information.  That is going to rely on much more detailed work, probably with a qualitative  component to clarify what the answers actually mean.  That leads me on to social science, and finding better ways to do things.  Numbers about society are indicators – that is, signposts or pointers. We do not need accurate counts of everything; we need to have enough to prepare samples, which we can look at in more depth.  The census provides us with the sort of information we need to work out how to make a sample.  The great mistake is to suppose it can do more than that.

 

 

The problems with behavioural genetics are far from being resolved

An article about behavioural genetics has attracted a certain amount of attention from people who believe this sort of thing.  The article, by Paige Harden, is trying to rehabilitate this research, which has an appalling record.  The study has been tainted by fabrication and fraud.  And, of course by mass murder.  (There’s a good history in Carlson, 2001, The Unfit.)

The search for evidence that genes determine behaviour has lasted about 150 years, and still has a long way to go.  No-one has been able to establish any real proof that any of our behaviour is genetically determined.  However, that last point is  disputed by the keepers of the faith.  Harden writes:

“A meta-analysis of results from 50 years of twin studies … concluded in 2015 that genes do, in fact, make a difference for these types of social and behavioural outcomes – for people’s cognitive ability, personality, sexual behaviour, educational attainment and income. In fact, this finding is so consistent that it’s long been enshrined as the ‘first law of behavioural genetics’: everything is heritable. That is, variation in every aspect of human psychology and behaviour, and variation in every social outcome that’s influenced by one’s behaviour, is influenced by the genetic differences among us. Despite making different assumptions from twin studies, GWAS [genome-wide association study] results converge on the same answer: which genes you happen to inherit from your parents makes a difference for socially valued life outcomes, such as how far you go in school.”

Let’s take this apart.  The first thing to note is the claim that genes ‘make a difference’.  That is plausible enough, but it slides into a different argument as the article goes on: that “genes have causal power for people’s lives.”   That’s rather more than making a difference.  In the study she cites, the authors claim to demonstrate that genetics account for up to 13% of the variance in educational attainment.  Put that another way: at least 87% of the variance is not associated with the genomics.

The central problem with the claim that this has ‘causal power’ is that genes don’t actually determine development; they only establish a pattern.  The article that the author cites on the ‘laws’ of behavioural genetics comments:  “ Development is fundamentally nonlinear, interactive, and difficult to control experimentally.”  Just so – but it’s development that really matters.  Take, for example, the case of height.  That, according to Harden, is down to “the environmental and genetic accidents of one’s birth.”  Well, not quite.   Height is not set at birth. It’s the product of a phenotype – the cumulative development of a human body, conditioned by its genome, in its interaction with the environment.   There are exceptions, at the extremes – but they are exceptions. We know that people have been getting taller in every generation; that would not be possible if height were fixed by the genes.  We also know that people who are not well fed are liable to be stunted; that would be impossible, too.  Height is influenced by genes but is not determined by them.    And we should expect nothing more than that to be true of any developmental factor – such as weight, language development, sporting prowess or academic attainment.

The second problem lies in the idea of ‘heritability’.   In animal breeding, heritability is generally put down to genes, because the main differences between animals that matter to breeders are probably those conditioned at birth.  We don’t breed humans for their physical attributes, and there are a few other differences.  Human behaviour isn’t hard-wired – humans have fewer genes than most complex animals, and we should expect (and can observe) fewer inborn, instinctive behaviours.  The relative lack of fixed, instinctive behaviour is compensated for by a different mechanism: socialisation, mainly in families.  Families share a great deal, including a more or less common environment, language, cultural practice, leisure activities and diet.  Estimates for the heritability of obesity vary between 40% and 70%.  That does not mean obesity is genetically caused, only that it runs in families.  We cannot be certain for any individual whether their obesity is generated by a genetic blueprint, but there is a clue: obesity has been rising rapidly.   As the gene pool changes only very slowly over time, we can take it that the change is social.

Third, there is the reliance on twin studies.  For more than 50 years, twin studies have been an unfailing source of bad science.  The central assumption behind twin studies is that twins who are identical (monozygotic, or MZ) will manifest the same behaviours on that account; twins who are not identical will share 50% of genes, making them more like each other than ordinary siblings would be.  There are several problems with this.

  • Any similarities within families may well reflect similar environmental factors. That point is acknowledged by Harden.  Identical twins generally have social environments which are very similar indeed, 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.
  • Twins are not representative of general experience.  All twins have a different experience from other babies, and an experience which is similar to each other. They are typically born prematurely; they have to share the divided attention of parents, in a  different way to siblings; and because they have been born at the same time their environment and experience will be more alike than other siblings.
  • There is the common assumption of genetic similarity.  In most studies that is based not on hard genetic evidence but (believe it or not) on the impressions of the parent.  It should be no surprise that parents who think their children are more alike treat them as more alike.
  • Nearly all studies discard information about twins where one is disabled – a not uncommon issue – even though that disability means that children with the same genes clearly have different experiences.

What, we might reasonably ask, can twin studies prove?  The standard scientific approach is not to prove a hypothesis; it is to disprove it.  Identical twins cannot show us that something is genetically caused, because of confounding factors that cannot be controlled for.  What identical twins might be able to show us are the circumstances which are not genetic in origin, because if MZ  twins were to act differently we would know that the difference between them could not be attributed to their genes. There is  some presumptive evidence, for what it’s worth, that MZ twins can and do have different sexualities – the same in two thirds of cases, different in one-third.  If that happens at all, it isn’t genetically determined – though, being of a sceptical bent, I do wonder about the sampling and the lack of specific genetics which lie behind that finding.  I don’t expect behavioural geneticists to do the work to test this properly, because of course they are already convinced that everything is driven by genes.  Unfortunately, that presumption undermines the studies they make.

Fourth, there is the use of big data.  If we were serious about identifying genetic effects, we should be able to identify behaviours which exist only when a gene or set of genes is present, and which do not exist when those genes are not present.  We can do this with current genetic medicine – the same approach which last year saved my life; I know exactly which set of genes has malfunctioned, what it has done and what the best treatment is.  The GWAS research referred to might, in principle, be able to show something of the kind about behaviour – but the signs are not good.  Take the major study of genes and educational attainment cited above.  It processed data for 1.1 million adults and identified 1271 relevant gene clusters, that is ‘genome-wide significant SNPs’ .  A previous study, done on 294,000 adults, had found that they were able to explain only 3.2% of the variance.  In this study, the authors report that “A joint (multi-phenotype) analysis of educational attainment and three related cognitive phenotypes generates polygenic scores that explain 11–13% of the variance in educational attainment and 7–10% of the variance in cognitive performance.”

Taking that result at face value, what does it tell us? The most striking finding, which I’ve already pointed to, is that genetic analysis does not explain at least 87% of the variance, and in the worst case it did not explain 96%.  Genes may have an influence, along with lots of other things, but – if we trust the figures – it’s not a big one.

Now, let’s be a bit rougher on this research.  The first objection is straightforward:  association is not causation.  Even if the association was higher, it wouldn’t actually prove a causal link.  There has to be a specific generative mechanism, and that’s never been established.

Second, the stats weren’t developed to deal with numbers this big.  People often suppose that associations in bigger data sets are more reliable than associations in smaller ones. That’s not necessarily true; the larger the number, the more systemic imbalances can be amplified.

Third, this is a fishing expedition.  Whenever you deal with massive numbers of observations, there are going to be associations arising by chance.  The bigger the numbers, the more apparently significant associations there are going to be.  The claims in this study might, I think, be compared to the work on astrology, seeking to prove that people born under particular star-signs move into certain occupations.  Austin et al report, in the Journal of Clinical Epidemiology, no less (2006 59 pp 964-969) that people born under Gemini and Libra had increased mortality after infarcts treated by aspirin.  Make the sample big enough, and you’ll find some pattern.  Just don’t try to invest it with meaning.

Last, and not least, these associations might simply mask the real influences.   There are lots of other reasons why people might have higher or lower educational attainment – class, poverty, family background, language – and a comparison of educational attainment with selected elements of the genome doesn’t bother controlling for them.

Economically, France has not fared badly; maybe we could learn something from them

Looking over a digest of recent news, a comment from last week’s Sunday Telegraph caught my eye. The government, they argued,”must begin a root and branch overhaul of public spending to cut billions. It cannot keep assuming that grands projets and government direction will propel Britain upwards: if it were that simple, France would have enjoyed a multi-decade economic boom.”

There are two parts to that.  First, there is the proposal to cut billions off public spending during a major slump.  There’s not much to say about this, beyond the obvious comment that it’s economically illiterate.  Taking demand out of a depressed economy is a recipe for a major slump.  The second part, which is rather more interesting, is the idea that the French approach doesn’t deliver.  France did, of course, have a ‘multi-decade economic boom’ after 1944, which they call the trente glorieuses.  Then they were hit, as we were, by the oil crisis.  The graph below, which I hope will show up on your screens, compares GDP per capita in Britain and France since 1980.  There’s not much to distinguish them: Britain did gain a marginal advantage in income per capita from 1997 to 2008, but that apart, the two economies are a lot like each other. The French approach doesn’t have a clear advantage over the British, but it doesn’t have a clear disadvantage either.  And at least France has had the benefits of major  infrastructure projects, which Britain could have done with.