Author: Paul Spicker

‘Low value’ degrees

The government (and, apparently, Rishi Sunak in particular) thinks it can distinguish ‘low value’ degrees from others by what happens to students shortly afterwards.  The test of a higher value degree, it seems, is whether students obtain a professional job, go into postgraduate study or start a business.

Very few undergraduate degrees lead directly to a professional qualification; students will commonly have to go through an intermediate, professional stage in order to qualify for jobs.  What, then, are universities teaching when they offer courses in various sorts of ‘studies’ ? The answer is much the same as it would be for traditional degrees in English Literature, History or Philosophy.  Universities aren’t, for the most part, in the business of training; they’re engaged in higher education.   Students are being guided how to absorb information, select it, order it, evaluate it, and communicate it, and (increasingly) they are learning how to do that independently, without much further guidance.  Their future employers  are interested in the skills that graduates have, not in the specific knowledge they have gained during their studies.

If we ask why some courses have worse ‘outcomes’, the answer is unlikely to be found lurking in the specific knowledge area that the course has covered.  It’s much more likely to be a question of respect for the institution, status, and the background of the students.

My own first degree, for what it’s worth, was in Politics, Philosophy and Economics – the same low-value, airy-fairy course done by the likes of Rishi Sunak.  My parents disapproved.

Social Policy: a subject still in trouble

I’ve just read a review of the state of Social Policy teaching in UK universities.  Twenty years ago, I made the case that the subject was in ‘deep trouble’.  At the beginning, this report cites me saying that,  but the tone of the report is more positive, claiming that Social Policy is still threaded through a wide range of courses.  I’d hold to my initial position.  It isn’t just that ‘social sciences’ are ‘under attack’: Social Policy has fared particularly badly.  There are only 18 single honours courses in the UK, and 25 institutions offering joint honours.   A sizeable clutch of universities have closed their courses.

There are two points of particular concern.  The first is the hopelessly inadequate description of Social Policy, taken from the Higher Education Statistics Authority,  as “the study of the policies of institutions which are designed to modify the balance of sociological factors”.  There is a common confusion in the idea that Social Policy is about policy for society.  Some social policies are – Ferge called them ‘societal’ or ‘structural’ policies.  Many are not; they’re about economics, or politics, or service delivery.    If the description had only talked about ‘the balance of economic, social and political factors’, I probably wouldn’t have kicked about it, but it still doesn’t cover the ground. The assumption, that Social Policy is about issues in Sociology, is quite misleading.  Yes, Social Policy does draw on Sociology – but it draws on much, much more.  That ‘more’ includes Economics,  Law, History, Psychology, Management, Philosophy and Politics – and if it doesn’t, it’s not being taught very well.

The second big problem is the relegation of practical and professional issues to the sidelines.  Students of Social Policy need to know about policy analysis and social administration – issues such as planning, partnerships, voice, empowerment,  quasi-markets, incentives, targeting, access to services and so on.  And I was disturbed to see, in a long list of cognate subjects in Table 2.3, no reference to Housing Policy, Social Care or Social Work.

 

A comment from Stewart Lansley:

I really agree with this. I have two concerns about social science teaching and research today – one is the failure to incorporate an economic perspective in examining on social policy. The other, in part because of this, social scientists have effectively lost much of the influence they enjoyed in the post-war era ( all in the case of the Tories ).

There’s some discussion of this in Policy Press | The Richer, The Poorer – How Britain Enriched the Few and Failed the Poor. A 200-Year History, By Stewart Lansley (bristoluniversitypress.co.uk) which is in part an attempt to merge economic and social analysis.

75 years of the NHS

The NHS – and the British Welfare State -are 75 years old today.  I’m not going to try to cover all the issues here, but I did offer a potted summary in my book, How to Fix the Welfare State (Policy Press, 2022).  Here are two of the summaries from that book, for the chapters on the NHS and Social Care.

 

 

The NHS
Key points  

  • The NHS offers a form of insurance, providing medical care to anyone.
  • Despite the dominance of hospitals, general practice is at the heart of what the NHS does.
  • The need for public health has been highlighted by recent experience.
Positive developments  

  • The NHS has moved away from long-stay institutions and focused on medical care.
  • General practice has been greatly improved.
Where policy has gone wrong  

  • Private markets cannot fill the gaps. They depend on producers having choices, and that leads to exclusion.
  • Health is public as well as individual. Reducing everything to the personal level compromises the aims of health services.
What to do instead The health service has to provide different levels of service: decentralised general services, more specialised work for larger areas, and highly specialised centralised provision.

Social care
Key points  

  • The shift from health care has left services that are fragmentary, insecure and often expensive.
  • Residential care has grown because it is an effective way of providing intensive services, but not all residents need that.
  • Domiciliary care has been based in a flawed model of ‘personalisation’ – and a catastrophic assumption that it won’t be sustainable.
  • Care in any setting depends on continuing personal relationships.
Positive developments  

  • This service did not exist when the welfare state was founded.
  • It was created as part of the movement away from long-stay institutions. It has its failings, but at least it has made it possible for some people to continue to live in their own homes.
Where policy has gone wrong  

  • Personalisation has never lived up to its promise; it only works for some.
  • Creating something like a market in social care is no guarantee of choice.
  • Markets offer commodities; people who need care need something different.
What to do instead The clients of social care need people with time and skills, not a shopping list of the tasks that workers will fulfil. Both residential and domiciliary care will need teams of carers who can offer a personal service to clients.

A place for anti-poverty strategies

One of the difficulties faced by old-timers in the field of social policy – and I have reluctantly to admit that that description applies to me – is that the same ideas, good or bad, will always come round again.  I was mildly intrigued then, rather than deeply excited, to see a report from LSE about local anti-poverty strategies.  It’s nearly 25 years since I prepared an anti-poverty strategy for Dundee Council, their first.  Some of the lessons that the LSE report draws were evident in that exercise: the importance of ensuring that local actors buy in to the strategy, the need for an action plan, and the necessity of having some means of monitoring implementation and outcomes.

There are, however, some other lessons that it’s important not to lose sight of.  The first was to produce a plan for everyone in poverty, not just those living in deprived areas.  The second was the need to be inclusive – to let people with different ideas about needs and priorities have their say – and not to impose my own definitions or understandings on people.  The third was to allow people in poverty to identify their own priorities.  Before I did this work, for example, I hadn’t understood how important pets were to people’s lives.  That’s the great advantage of open-ended, qualitative research – it gives people scope to say what matters most to them.

I also found, in three successive focus group interviews,  although I’d come to talk about poverty, they all wanted (quite independently of each other!) to talk about deafness.  It wasn’t right for me to tell them that they were off the subject – far too many people in poverty have their concerns overridden by well-meaning academics.  Poverty is a much broader topic than managing on low incomes. The first thing any researcher or planner needs to do is to listen.

 

 

The welfare state: a communitarian perspective

Today I gave a plenary paper to a conference of  the Wales Institute of Social and Economic Research and Data, under the title of The welfare state: a communitarian perspective.  The conference brought together Welsh academics and researchers with practitioners from the voluntary sector.  Here is the abstract:

Communitarianism is not, as some critics imagine, an argument for the dominance of the community over the individual. It begins from the view that our rights, responsibilities and moral understandings are rooted in the society of which we are part; these phenomena are socially constructed, relative, contingent and particular. A society is not a single ‘thing’: it is a network of networks, depending on a mesh of interactions, exchanges and obligations. Welfare provision has developed from the networks, duties and conventions which bind a society together.
       The welfare state is commonly understood in three ways: as provision by government, as a complex set of systems for social protection, and as a normative ideal. This presentation will argue for a fourth understanding. The welfare state is a way of describing a set of normative aspirations. These aspirations are sometimes thought of as universal, but all welfare states apply principles of ‘bounded solidarity’; the terms of the welfare state depend, like ideas of equality, social justice, or democracy, on the context of the society in which they are applied. The ‘welfare state’ is a direction of travel, not a destination.

The paper is online here, on my access page.

Misunderstanding socialism (again)

An article in the Daily Telegraph by Priti Patel, a former Home Secretary, has been given a preposterous headline: Britain can still escape the OECD’s radical plan for permanent worldwide socialism.  What she’s actually writing about is a proposal for to level the playing field in relation to Corporation Tax.  I think it’s likely that the identification of this proposal with ‘socialism’ has been made by a Telegraph sub-editor – I’m sure that Patel would be more eager to get us to engage with her argument. I’m not going to do that, but I am concerned about the lazy insult, and I want to clarify two things about the terminology.

The first is the supposition that state regulation or ‘intervention’ is a form of socialism, implicitly opposed to the operation of free markets.  By this test, just about every country in the world would be ‘socialist’.  There isn’t a government anywhere that doesn’t have some form of expenditure on health education.  Nearly all (just not quite all) spend on education.  Something like three quarters of all countries now have some kind of national scheme for cash benefits.  This isn’t  worldwide socialism – it’s just what contemporary states do.  Grown-up politics needs to be concerned with how policies like this work.

The second misconception concerns the nature of socialism.   Wikipedia  reflects a common confusion when it writes that ‘socialism refers to economic and social systems which are characterised by social ownership of the means of production … social ownership is the one common element’.  This is plainly wrong. Social ownership is not necessarily socialist (roads? parks?) and many socialists are concerned less with ownership than with public welfare.

The terminology used in the Wikpedia article is marxist, once dominant but now at best a minor branch of socialism. Marxists  like to claim that their beliefs are the only real and true form of socialism, ignoring the simple fact that socialism developed some time before marxism and the political movements parted company about a hundred years ago.  Right-wingers (such as Kristian Niemitz, writing for the IEA) also like to think that ‘socialism’ means the same thing as ‘communism’.   It doesn’t: that’s why we have different words for the two.

Socialism is complicated, but here is a short summary from my website:

There are many forms of socialism. The main models, which can be found in various permutations, include representations of socialism as

  • a movement for the improvement of society by collective action (for example, in Fabianism)
  • a set of methods and approaches linked with collective action, such as cooperatives, mutual aid, planning and social welfare services (e.g. the co-operative movement);
  • a set of arguments for social and economic organisation based on ownership and control by the community (e.g. in syndicalism, guild socialism and anarchism)
  • an ideal model of society based on cooperation and equality (e.g. Owenism and utopian socialism);
  • a critique of industrial society, opposing selfish individualism (e.g. Christian socialism), and
  • a range of values, rather than a particular view of how society works (e.g. the position of the Parti Socialiste Européen in the European Union).

 

A just society? Rawls is not the way

An article in today’s Guardian argues that the philosophy of John Rawls offers “a “realistic utopia” that provides the basis for a broad-based and genuinely transformative progressive politics.”  I don’t share that view.  Rawls makes a case for some of the key values dominant in American liberal politics, but falls far short of encapsulating progressive values.

The first weak point in Rawls’ approach rests in his appeal to the idea of a social contract – that what reasonable, moral people will agree to offers us a model of fairness and justice.  Reasonable people may well agree to lots of things.  Sometimes they will opt for things that have good consequences – what is good.  Sometimes they will choose what is right. He thinks they will agree to principles of individual freedom and a degree of useful inequality. Perhaps they will, perhaps they won’t; but whatever they do agree to, ‘justice’ is not the same thing.

This might come over as a quibble about language, but it’s been fatal to most attempts to form a picture of a ‘just’ society.  Consider, for example, the fate of the Commission on Social Justice in the 1990s.  They ended up with a political manifesto covering everything they could.  If justice means everything, it means nothing.

The second weak point concerns Rawls’ ‘difference principle’: that people should accept a degree of inequality on the basis that it leads to more for everyone.  This reflects the influence of the ‘Pareto principle’ adopted by many economists.  That approach fails to understand that inequality is intrinsically exclusive: that where inequalities occur, people with resources are able to outbid and so to exclude others from the benefits that they claim with those resources.

The third weakness lies in the construction of ‘justice’ and ‘fairness’.  These are not end-states, and cannot be understood in those terms: they are principles, and the pursuit of either is a continuing process.   The point, I have argued in other work, is ‘not to eliminate every conceivable injustice at one blow, but to ensure that each step makes the situation more just than it was before.’

That leads me to one of the strongest objections to Rawls’ vision: that there is no route from where we are to where he wants us to be.  The plea for a ‘realistic utopia’ is not just an oxymoron: it is an impossibility.  In The future of socialism, Tony Crosland made a devastating critique of utopian politics.  Every change we make alters the picture; it means, it must mean, that the conditions which have to be addressed will no longer be the same as they were before.

My submission to the Work and Pensions Committee on the adequacy of benefits

The Work and Pensions Committee has issued a call for evidence about benefit levels in the UK.  My response to that call is here in a PDF or on the Committee’s website here.

There are some common confusions in the discussion of adequacy, which this submission seeks to clarify.

  • The purposes and functions of benefits are complex.
  • The adequacy of benefits depends on how they work in combination with each other, and with other sources of income.
  • Benefits have not been set at a level that reflects the costs of subsistence.
    Universal Credit in particular is not designed to provide a basic minimum
    income and does not do so.
  • Most benefits are designed to be delivered regardless of work status. The
    emphasis on the centrality of work is a major distortion of their role and
    purpose.
  • The operation of the benefits system is frequently penal and fails to provide
    adequate avenues of redress.
  • Assessments of people’s  financial position which attempt to identify all possible income streams and household circumstances are unavoidably complex, difficult to administer and liable to error. The alternative is to offer a range of less comprehensive benefits which can be combined in different ways.

The proposed abolition of benefits for long-term sickness is staggeringly stupid.

When I posted about the reform of the Work Capacity Assessment before, I had no idea that what was being contemplated was an abolition of benefit for  long-term sickness.  That, however, appears to be what the government actually intends to do.  They are so fixated on disability that they have forgotten what sickness benefits are supposed to do.

The Beveridge reform included, initially, only a Sickness Benefit.  This wasn’t enough, and in 1971 a longer-term benefit called Invalidity Benefit was introduced, largely to cope with people who otherwise would have to make demands of the system for unemployment.  Subsequent changes gave us Incapacity Benefit, then Employment and Support Allowance, now being swallowed by Universal Credit.  It’s already the case that benefits for people who are ill are now set at the same level as benefits for people who are unemployed.  The difference rests in the situation of people who have ‘limited capacity for work related activity’ or LCWRA – people who (in the terms of the 2012 Welfare Reform Act) it is not reasonable to expect to work. Those people are largely exempt from the requirement to be actively seeking work.

Transforming Support, the White Paper on Health and Disability, has been published at the same time as the 2023 Budget.   The bulk of the White Paper is taken up, unexceptionably, with the situation of people with disabilities, and how they might be supported into work.  The problem is, straightforwardly, that sickness benefits are supposed to do something quite different.  They are there to support people who are sick.  The government, it seems, is incapable of making the distinction. Most people who are sick are not disabled.  Many people who live with disabilities are not ill.  There are conditions which overlap, but these are different circumstances calling for a different approach.  I’ve explained the difference between sickness and disability benefits in my previous work; here is a quick summary.

Benefits for people with disabilities people are given on a number of principles.

  1. Compensation for disability. Industrial disablement or action in the courts assume that people should be paid if something unpleasant happens to them. This does not extend to those who simply become ill or to those born with disabilities.
  2. Special needs. Allowances can be made for example for personal care, transport, and medical goods.
  3. Desert. In some cases compensation depends on a moral evaluation of the
    reason for disability. War pensions are the obvious example.
  4. The protection of carers. People caring for a disabled person may be limited in their capacity to seek work and to earn.
  5. Rehabilitation. Benefits may be concerned to change the status of the disabled person – for example, through training or the provision of special equipment.
  6. Promoting employment. A number of benefits are geared specifically to the promotion of employment for disabled people, as a desirable end in itself. They do so principally by altering the calculation of costs and benefits made by disabled people or by employers.
  7. Improving low income. Low income may reflect incapacity or disadvantage in the labour market. Many disabled people on low incomes rely on forms of social assistance benefits, for others who are poor. Support for disabled people on low earnings is another example.
  8. Equal opportunity. Rehabilitation and the promotion of employment can both be seen as means to further equality of opportunity for people with disabilities.
  9. Participation in society. This encompasses rehabilitation, employment and income support; it is also a justification for a range of benefits in kind intended to promote social inclusion for people with disabilities, including housing, transport, leisure, cultural and educational benefits.
  10. Market-based and voluntary provision. With the exception of insurance-based social protection, the role of non-governmental organisations (NGOs) in this field is overwhelmingly geared to disability, not to incapacity. The voluntary sector has a wide range of objectives, including humanitarian, religious, mutualist and commercial aims. State intervention which is based on support of the voluntary sector necessarily reflects those principles to some degree.

Benefits provided to deal with sickness are based on different criteria.

  1.  Social protection. The principle of social insurance is intended to cover changes of circumstance and needs which might arise. This extends to cover for medical care, the incurring of unexpected costs and income maintenance.
  2.  Income maintenance. People wish to protect themselves from circumstances in which their income might be interrupted. This is sometimes done through social assistance but more typically it affects people who have previously been earning.
  3. Economic efficiency. Part of the rationale for incapacity benefits is based, not in the circumstances of the incapacitated worker, but in economic processes. Employers wish to maximise the productivity of the workforce. Rules relating to short-term incapacity allow for restoration of full capacity; rules relating to long-term incapacity allow for removal of less productive workers from the labour market. (Note that there is a potential tension between this principle and the desire, in relation to people with disabilities, to promote increased participation in the labour market.)
  4. Early retirement. A scheme for incapacity benefits may become in effect a
    surrogate scheme for early retirement. Because it legitimates withdrawal from the labour market, it makes it possible for those who hope to retire a means of doing so.
  5. The functioning of medical services. The balancing of medical priorities has
    been an important element in the administration of incapacity benefits: part of the purpose of sickness benefits has been to facilitate and encourage medical consultations, but the routine certification of sickness has proved burdensome and (in some systems) ineffective as a means of prioritisation.

Although there is some overlap between the two issues, it mainly happens in so far as disability implies incapacity, or incapacity includes disability. A person who is disabled does not need social protection or income maintenance solely on account of the disability; a person who is incapacitated without disability does need social protection, but is not necessarily disadvantaged in terms of equality of opportunity or participation in society.

What the government proposes is to confine health benefits solely to people who pass the assessment for Personal Independence Payment – that is, people with disabilities, who have a long-term, functional limitation in capacity.  The key proposal in the White Paper is this:

145. We are therefore proposing to replace the current UC LCWRA element with a new UC health element. The new element will be awarded to people who are receiving the UC Standard Allowance and any PIP element.

146. This new element will abolish the need to be found to have limited capability for work and work- related activity, as is the case with the current UC LCWRA element. This will remove barriers in the system that can prevent people who would like to, from entering or remaining in employment.

So – what happens to people who are not disabled, but sick?  The answer is that they will be treated simply as if they were unemployed.  The Institute for Fiscal Studies points out that “The 1 million people who are currently on incapacity but not disability benefits could potentially lose out from this change – with a typical health-related UC claimant losing £354 per month.”  They are going to be expected to engage in job-seeking for 35 hours a week.  They are going to have to report for meetings, and be sanctioned if they are too sick to get to them. People with conditions such as heart disease or cancer are going to have to undertake a PIP assessment on the off-chance, when they have no reasonable prospect of qualifying  – a situation that was recorded in some detail when in the past a million people who applied for Disability Living Allowance had to be rejected. This is going to be an administrative nightmare.  The CEO of the charity Mind has commented that the policy represents “a one-dimensional, overly-simplistic approach to a complex, systemic issue.”  The proposed reform  disregards everything we know about this sort of benefit.  It is staggeringly stupid.

 

 

Changing the Work Capability Assessment

It’s been announced, in various fora, that the government will propose in a forthcoming White Paper to abolish or reform the Work Capability Assessment.  This is the pro-forma points system used to determine whether or not a person has limited or no capability for work.

The  government’s priorities lie in ‘supporting’ people into work, rather than determining whether or not it is reasonable for people to work – which is supposed to be the legal test.  We can probably all agree that the WCA is not a good test.  It is slow, bureaucratic and rather bad at identifying what people’s circumstances actually are.  Torsten Bell has suggested, on Twitter, that the actual plan is to replace the WCA with the test for PIP – a different kind of test, but still one which has little to do with capacity.

Calling for reform doesn’t imply, as some might think, that the process of certification should go back to GPs, who have quite enough on their plate already.  In my 2017 book, What’s wrong with social security benefits?, I made a series of proposals about how the WCA could be refomed. Here’s an extract.

As things stand, nearly everyone who claims is being assessed.  …  Although repeated checks on people with long-term conditions have now been acknowledged to be ‘pointless’, most of the assessments that remain are little better.   They either confirm the obvious or they duplicate information that is already held.  Some assessments are necessary: many people with disabilities cannot say whether they are disabled or not, and have no idea whether or not their disability fits the criteria for benefits. Any general rule, no matter how sensitively it is administered, is going to have to deal with some grey areas.  But the same approach does not have to apply to everyone.
First, it is possible to identify certain conditions which should imply automatic entitlement, offering benefits on minimal or secondary evidence – either accepting on sight that the person has a qualifying disability (double amputation, severe disfigurement) or passporting benefits on the basis of provision by other agencies (congenital disability, blindness).
Second, there are conditions which will have led to prolonged long term contact with health services, and certification from a consultant is sufficient to establish that the condition is there without requiring further detailed examination of personal circumstances. Examples are terminal illness, multiple sclerosis, MND, malignant neoplasms or brittle bones.
Third, there are conditions where existing services in long-term contact with the individual are far better placed to judge the impact of a condition than an independent assessor could be, and it would be appropriate to accept medical certification. Examples are continued psychosis, epilepsy, dementia and learning disability.
Only after these three categories are considered is it appropriate to think in terms of further individual assessment. The points scheme currently used in a range of benefits was initially developed from work to establish the range and severity of disabilities in the UK. That research validated the approach through a range of tests, but it pointed to an important conclusion: that once the primary disabilities had been identified, it was very rare for further disabilities to make any notable difference to the findings, and that information served no useful purpose. It follows that it is neither appropriate nor necessary to ask most claimants whether they can go to the toilet unaided.  The question is embarrassing and the information obtained is for the most part irrelevant. The assessment process should begin by asking people to identify their most important disabilities, ask questions about those, and go further only in marginal or complex circumstances.
Finally, there will be a residual category of people who are not adequately dealt with by any of the four stages above, and who will require or ask for a more thorough comprehensive assessment. This category should be small.