Category: Social Policy

This occasional blog discusses issues in Social Policy.

The British believe in contributions, apparently

An intriguing pamphlet from the Policy Network compares attitudes to benefits in Britain, France and Denmark. Their main point is that other countries have a greater commitment to ‘social investment’, but apart from that they also have material on social attitudes to benefits and services. Question 1 asks whether benefits hould be targeted at those in need, confined to those who have contributed or available to every citizen. In Britain, 48% of people said that pensions should be for those who contributed; 41%, social housing; 49%, unemployment benefits. Then question 2 asks what the main response of the government should be to financial problems: and only 24% say that benefits should be limited to people who have contributed. There is a fairly marked discrepancy here, which might be taken in three ways. One possibility, though I think it’s unlikely, is that people thought rapidly about counter-examples. A second explanation is that the responses defend what people suppose to be true at present – pensions are contributory, unemployment benefits used to be, and even if social housing has never been, some public authorities used to house people according to their ‘merits’, including contributions such as military service. The third explanation, which is most likely, is that the opinion is soft-centred, and there is something in the way the questions are worded that has led to an inconsistent response.

The Francis Report

Although the situations considered in the Francis report are shocking, the situation they describe is all too familiar. The scandalous ill-treatment of patients was a recurring problem of long-stay institutions – reflected for example in Sans Everything (1967) and a string of scandals in mental institutions, detailed at length in J Martin, Hospitals in Trouble (1984), a book cited in this inquiry report. Nearly thirty five years ago, as a student, I was given an advance copy of the Normansfield report by Brian Abel-Smith; it described how patients were restricted and neglected, and the upper echelons of NHS management did nothing about it. David Ennals explained, in Parliament: “… the report makes clear that there were many people who knew just what the position was. Some of them were in positions of authority with power to act but they failed.” In other words, we have been here before. The main difference is that this time it’s in acute care.

Unfortunately, the Francis report does not point to the way out of the problems. There are some hard-hitting passages – given the findings, there had to be – but there’s an awful lot of words in between. At nearly 1800 pages, the report is rather badly written – indiscriminate, repetitive, with some slushy, mystical twaddle about leadership (the stuff about it being a quality of the ‘spirit’ is in there twice) and an 125-page “Executive Summary” (someone should have taken the learned chairman into a corner and explained what that phrase is supposed to mean). The review of evidence in volume 1 is generally good; Volume 2 spends several hundred pages reviewing what regulatory and supervisory agencies did not do, and is interminable; the review of general issues in volume 3 is long, prescriptive and often preachy. The sheer number of words guarantees however that it won’t be read.

The stuff on leadership presents the most obvious problem. This report uses the word more than 800 times, referring to leadership haphazardly whenever it wants to think about the position of people in charge, senior management, ward management, roles in professional settings, personal qualities, motivation, or relationships with juniors. The poisonous cult of leadership, and the assumption that people in charge should energetically push others to share their values and aims, is part of what’s created this mess in the first place. What the report is really describing is systemic failure, and systemic failure cannot be responded to through on an individualistic basis without gaps being left.

Another way to pay for welfare

The veteran US journalist, George Will, has commented that there seems to be a new political consensus in the US: that “we should have a large, generous welfare state and not pay for it.” There is an uncomfortable truth in that observation, and it prompted me to think about whether there might not be ways to square the circle – to provide welfare without seeming to pay for it.

There are lots of ways of raising money besides taxation: they include mutualist contributions (many welfare systems are non-governmental), voluntary payments (e.g. lotteries), nationalisation and sequestration (governments can, and do, claim or confiscate resources), and raising other government revenue (e.g. returns on investment, profits on government enterprise, or the sale of resources). The last of these categories is possibly the most interesting: if governments can make a profit, for example out of banking, energy or telecommunications, the money can be used for the common good. The Alaska Permanent Fund – possibly a model for Scotland – has allowed the State of Alaska to save resources for the long-term benefit of its people. It appears to be a principle that even American Republicans can accept. But we seem in Europe to have set our face against the idea that a government can legitimately take profits in order to benefit its citizens.

A man for all seasons

This morning Radio Wales asked me to be up before six to be interviewed about the proposals in a report, Delivering Dilnot, edited by Paul Burstow MP. (My wife’s reaction to being woken at 5.45 this morning: “For Wales?”) Part of the proposal is to implement the Dilnot recommendations in England, limiting the amount that any person will have to pay for social care and increasing exemptions for capital on the means tests. (Scotland has ‘free personal care’, but the system is far from perfect. It has been shackled to a complex, selective process where needs are closely specified and nothing is delivered without prior assessment. In common with many other selective systems, that leads to confusion, complexity and inexorable increases in the budget.)

The report argues that the Dilnot proposals can largely be paid for by removing Winter Fuel Payment except for claimants of Pension Credit. The Conservatives have pledged to maintain WFP, but it has long been identified as a prime candidate for cuts. Pension Credit has many of the usual problems of means-tested benefits – complexity, low takeup (a third of those eligible don’t get it) and errors in calculation. The main justification for doing this seems to be that people don’t like better-off pensioners getting WFP. This seems to me a very weak argument – the same case could be used to reduce the state pension. If we’re not happy that a few older people have very large personal incomes, we can tax them on those incomes without complicating the pensions system for the rest of the population.

If the policy in Burstow’s report was to be implemented, it would imply a transfer of resources from most pensioners to the children of better off pensioners, who would inherit more. There’s no good reason, however, to suppose that this redistribution is what would happen – if government wants to implement Dilnot, it can afford it, and if it is trying to raise money, it is likely to cut WFP regardless. The two policies seem to me quite separate.

Safe in their hands

The release of Cabinet papers from 1982 has led to headlines about the revelation of a secret plan to dismantle the welfare state. It was hardly the best kept secret of its day. Nicholas Timmins, in his 1995 book The Five Giants, writes (pp 392-3):

“The headline options included: ending even price protection for all social security benefits and ending state funding of higher education. Market fees … could be charged for courses. … Replacing the NHS with private health insurance … This was dismantling the welfare state by anyone’s standards. … The wets for once combined, producing in the the words of Nigel Lawson, then Energy Secretary, ‘the nearest thing to a Cabinet riot in the history of the Thatcher administration.’ They forced the paper off the agenda … and for good measure someone … leaked it to the Economist.”

This was the background to Mrs Thatcher’s famous statement that the NHS was ‘safe with us’. The NHS has not been replaced with private insurance, but the other main measures in this agenda – charging for university tuition and stopping benefit upratings – have now been introduced.

Can we afford to support older people?

The Herald asked me yesterday to comment on whether we could afford universal services for older people; here is my response, as it appears. (The Herald website allows direct access to first-time users; after five views you have to register.)

The debate on free services for older people lumps three questions together. The first is whether we can afford to support services for growing numbers of older people. That question has been reviewed in many reports; the answer comes out, consistently, that the commitments are sustainable, but they will have to be paid for in higher taxes or contributions. Many people imagine that when they pay for pensions, that the money is being saved for their old age. In most cases, it isn’t. Contributions now largely pay for pensions now; the current generation of workers is relying on the next generation to pay for them in turn. The real test, then, is whether we’re willing to pay for pensioners now.

The second question is whether help should be free. The critical judgment is about what should be provided, and what should not. Some essential items we expect pensioners to pay for (food and telephones), some we don’t (personal care and prescriptions) and for some the signals are mixed (cleaning). The arguments for free services are partly about solidarity – services we want people to have and have a duty to provide – and partly self-interest, whether we’d want ourselves or our families to be charged in the same circumstances. Few people in Scotland would want everything to be paid for: it’s difficult to make the case that help with incontinence – an important component of health care as well as personal care – should not be free.

The third question is about universalism, whether benefits and services should go to everyone, or only those in most need. Services that test people’s needs are complex, difficult to provide fairly and can be expensive. Tests are often intrusive, burdensome, demeaning and many are put off from asking for help. Universal services use simple eligibility criteria, such as age, so are cheap to run. The basic argument for bus passes, for example, is that many older people need help, extending it generally allows those who need it to get help, and people who have alternative transport don’t use the buses. When money is short, simple generalised provision is often the way to go.

Stigma and benefits

A new report by Ben Baumberg, Kate Bell and Declan Gaffney highlights the problem of stigma in benefits. I’m not going to say much about this report, because I’ve had some involvement with its production; I discussed the issues with Elizabeth Finn Care before the research was commissioned and I was on the advisory group. The book I wrote on stigma nearly thirty years ago is free downloadable here.

The report has also prompted a useful short piece on representations of welfare in the press on the Guardian website.

The consultation on child poverty

The DWP and Department for Education are consulting on “better measures” of child poverty that will include a range of considerations – deprivation, parenting skills, worklessness, debt, housing, education, parental health, and family stability.

There are three fundamental muddles here. The first is the confusion between definition and correlation. We know that some people are more likely than others to be poor, such as families headed by women or people in lower social classes, which are not on the list. Even if all the things in the consultation were associated with poverty, it would not mean that they defined poverty.

Second, an association – an increased likelihood – is not the same thing as a characteristic. Poor families are more likely to have children at risk – but that does not mean that most, or even many children are at risk because they are in poor families. Poor families where children are at risk are a very small minority.

Third, the model in the consultation is based in an unjustifiable, stereotypical identification here of poverty and family problems. Many people – on low income figures, most – have been poor at some point in their lives, and all of us are vulnerable to poverty. Family problems are something quite different.

Football is broken

Football bores me personally, but it’s hard to live in Scotland and not to be aware of the passion and commitment it arouses in Scottish communities. A tiny nation has been trying to accommodate a finance structure which belongs to an international entertainment industry, and has made local clubs the playthings of rich entrepreneurs. It doesn’t work. We’ve just had the announcement that a second major club faces imminent bankruptcy, and it’s the fans and supporters who have been asked to save it.

This posting, then, is flying a kite. Communal activities, which rely on communal support, don’t have to be organised communally, but they can be. Public organisations which promote “participation in sport”, recreation and culture are now able to register as charities in Scotland – provided they are not for profit, they offer substantial benefits to the broader community, and they are properly governed. (There’s no intrinsic bar to a professional sport. The English Charity Commission’s guidance is directed only at amateur sport, but that’s not the distinction here; other charities employ professionals, and some such as theatres put on professional shows.) The full list of criteria for charitable status is laid out at OSCR’s website. A football club could qualify. But it is going to call for a rethink of what football clubs do, and how they do it.