Up in the air – the election and the NHS

Healthcare Manager 25 cover, Spring 2015.It’s already become a cliché to describe the 2015 general election as the “NHS election”. But clichés are often just things that are true. Polls show the NHS is the most important issue for voters, ahead of the economy, immigration or Europe. The papers are full of NHS stories – at the time of writing, there has been one on the front page of at least one national for eight days. Which party gets the first go at forming a government on 8 May may well depend on who voters mistrust the least on the NHS. [Read the rest...]


Because they’re worth it

Don’t be put off by the bowler hat on the cover of Owen Jones’s The Establishment. Top civil servants are barely mentioned. There’s little about aristocrats, only passing references to Oxbridge, and nothing at all about fagging.

For Jones, author of the bestselling Chavs, it’s not the old school tie but ideas that bind the “new Establishment” together: free markets, a minimal state, hyper-individualism and a sense of limitless entitlement. This amounts to a “common mentality which holds that those at the top deserve their power”. If the Establishment had a motto, says Jones, it would be L’Oréal’s slogan: “Because I’m worth it.”

The right-wing blogger “Guido Fawkes” (AKA Paul Staines) calls this what it is: plutocracy. In a slightly creepy, moustache-twirling contribution, he tells Jones that undermining politicians is about undermining democracy itself. “It suits my ideological game plan,” he says. “Democracy always leads to… those who don’t have [taking] from those who do have.”

Fawkes, says Jones, is one of the Establishment “outriders” – people who pose as dissidents while working to shift mainstream thinking towards Establishment ideology. Jones traces their origins back to Mont Pèlerin in Switzerland in 1947, where a group of right-wing thinkers and economists (my distinction is deliberate) met to plot the ideological fightback against post-war social democracy.

Jones’s assault on this ideology is clear, well-argued and passionate, but it’s not clear why he needs to shoehorn it into an awkward, institutional concept like “the Establishment” – especially as trying to pin down who’s in and who’s out causes him so much trouble.

The book abounds with people from Establishment institutions – economists, senior police officers, journalists, even some Tory MPs and bankers – who are critical of this dominant ideology. Often the evidence Jones uses to expose how it has corrupted British public life comes from the same institutions supposedly in its merciless grip. And he can’t decide whether the “libertarian” ideas espoused by many working-class Tories and UKIP supporters constitutes Establishment thinking or not.

For example, Jones says that allegations of left-wing bias are “a way of controlling the BBC”. But that would be unnecessary if the corporation was the “consistent platform for Establishment perspectives” that he describes. In fact, there is plenty on the BBC – comedy, drama and current affairs – which challenges free-market ideology, as well as plenty that doesn’t. Jones’s claims about a uniform BBC political ideology are simply wrong.

Jones is excellent how corporate interests have manipulated the state for their own ends, sucking up lucrative government contracts while simultaneously avoiding tax. His account, for example, of how A4e milked taxpayers for hundreds of millions of pounds, hugely enriching its founder Emma Harrison in the process (staff even nicknamed the firm “All for Emma”), while providing an abysmal service to jobseekers, is devastating even if not exactly news.

Ferocious attacks from Amazon users and some right-wing hacks ludicrously cite Jones’s left-wing politics – and Oxford education – as reasons not to read a left-wing book. But few put up much defence against the facts as he lays them out. More balanced critics point out that what Jones describes is not an establishment but a consensus. But that doesn’t mean it isn’t a rotten one. Or that it cannot be changed.

Amédy Coulibaly described himself as a "soldier of the caliphate" in a short video made just before his killing spree in the Hyper Cacher supermarket in eastern Paris on 9 January.

It’s complicated

LONDON, MONDAY: People often feel the most profound question they can ask after a senseless killing is “why”? It speaks not only to bafflement faced with the apparent meaningless of the particular act, but also to our more existential need to find explanations for the things that happen to us and around us, and ultimately our search for a meaning for life (and death) itself.

On Saturday afternoon, someone unfurled a huge banner in Paris’s Place de la République saying, “Pourquoi?” Perhaps the literal translation, “for what”, is better here than “why”. Because “why” doesn’t seem a particularly useful question to ask about something like the Charlie Hebdo massacre. The killers would have no difficultly answering it, and we know more or less what they would say. “For what?” or “to what end?” would be a more difficult question and a truthful answer would be revealing. What these people wanted could range from the utterly delusional (a global Islamic caliphate), through the implausible (civil war in France) to the much more terrifyingly possible (permanent alienation between the Muslim and non-Muslim communities in Europe). My gut feeling is that jihadist “leaders” will tend towards the more realistic (and dangerous) end of that spectrum; the actual killers are more likely to be delusional in their motives. But who knows?

Rather than (metaphorically) asking the killers why they did it, we might more usefully ask ourselves why these people think so differently to us. Why do they not recognise and respect free speech? Why do they not see religious observance as a private matter and not something to be imposed on other people? Why do they see ISIL’s statelet in Syria and Iraq, where life is indeed “nasty, brutish and short”, as preferable to free, prosperous and cultured France? Why do they believe evident fantasies? Why do they believe them with such fervour that they are prepared to kill for them? And why do they hold their own lives so cheap?

This has nothing to do with responsibility for the killings, which rest squarely with the gunmen and those who aided, abetted and encouraged them. But when we start to look at why they thought they way they did, it ought to be clear that the responsibility for that is much wider.

We might look at the characteristics and training of imams in French mosques, at the responsibilities of parents and the care system involved in their upbringing, at the way radical Islamism functions as a nihilist death cult, with a particular appeal to alienated and psychologically disturbed youth. We might also look at the French prison system (two of the Paris gunmen were apparently further “radicalised” at the notorious Fleury-Mérogis prison south of Paris, though it didn’t start there), at the way “ordinary” Muslim criminals are rehabilitated, at the culture of the banlieus (the often-desolate suburban zones that ring most large French cities), at youth unemployment, ghettoisation on housing estates, even mental health services. The list could go on and on, but we can’t simply walk away from this and pretend that having people who are primarily and viscerally motivated by a hatred for the society they live in has nothing to do with the way that society works.

If we hadn’t realised it before, the Charlie Hebdo and Hyper Casher attacks have revealed that violent jihadism, particularly in Western countries, is an extremely complex problem with many, many causes. There are religious and geopolitical aspects, of course, but also personal and psychological ones. Many of the jihadist terrorists who have perpetrated atrocities in Western countries seem to show signs of psychological disturbance. A 2002 court psychiatric report on the Hyper Casher gunman, Amédy Coulibaly, found an “immature and psychopathic personality” (and one thing jihadist terrorists seem to have in common is an enormous capacity for self-delusion). It could be that this, combined with a sense of racial and religious grievance, instruction from manipulative and “hate-filled” preachers (such as the Kouachi brothers’ “guru” Faris Benyettou), connections with “ordinary” criminal gangs into drugs and petty theft, and a sense of nihilism and alienation to set against the perverted glamour of killing and dying for a cause, produces this murderous cocktail. Or it could be even more complicated than that.

It’s not good enough to pin everything on mass immigration or the impossibility of different traditions living side by side. It’s not good enough to put it all down to handful of “radical imams” and internet “hate preachers”. Still less to common criminality. But neither is it good enough to blame it all on George Bush’s invasion of Iraq and poverty and unemployment on bleak housing estates.

All these factors and more need to be carefully unpicked and dealt with, both ruthlessly and sensitively (a difficult but not impossible balancing act). Are we up to it? We will have to be.


How to keep the United Kingdom (sort of) together

Okay, panic over, here’s the answer to the West Lothian Question.

England is going to get its own parliament one way or another, so let’s have a proper parliament and not a rump group of Westminster MPs doing a spot of English legislating in their spare time. That means an English prime minister and cabinet, accountable to an English House of Commons – an English government in name as well as practice.

The governments of England, Scotland, Wales and Northern Ireland would have power over the same things – basically everything except those powers they agree to share through the UK (pretty similar to the “Devo Max” deal offered to Scotland at the last minute, as the union seemed to be slipping away).

For the UK, we directy elect the UK “prime minister” (best not say “president” while my fellow citizens retain their sentimental attachment to the House of Windsor – but how about “President of the Council” for those who, like me, enjoy finding new uses for old things?). He or she would head a small cabinet dealing with UK-wide matters, which we could call the Council of State (or even the Privy Council if you like – sorry, can’t stop myself).

I’m not convinced we would even need a UK parliament. We would have four perfectly good parliaments already, and how many parliaments does one small archipelago need? There wouldn’t be much UK legislation – most laws would be domestic matters – so what there is would have to be ratified by all four parliaments (and hence, in practice, negotiated first – what a novelty!). A less stringent alternative would be to have all four parliaments “meeting together” as the UK parliament (they don’t have to be physically in the same place – we have the technology for that). You could have some sort of weighting system, so that England gets more say than the smaller nations, but not 85% of the say.

There you have it: no cumbersome regional assemblies in England that no one wants; no asymmetric distribution of powers storing up trouble and sowing instability for the future; no Barnett formula; no ridiculous “double-hatting” by the UK prime minister dabbling as England’s PM two days a week (what happens if the UK prime minister is a Scottish or Welsh MP?); no paralysis in England when the UK government lacks an English majority; no need for increasingly meaningless Westminster elections (with ever dwindling turnouts) in Scotland, Wales and Northern Ireland. And no need for any resentment – it’s a voluntary union and everyone has the same powers over their own affairs.

Of course there are a lot of detail to be worked out, but I can’t see any serious problems. My biggest headache is where to stick the UK prime minster, assuming the English PM bagsies the keys to Number Ten… You know, there must be a lot of room in that big grey building at the end of the Mall.

Machiavelli and his half-blood Prince

niccolo_machiavelli_statue-2I’ve just caught up with Alan Yentob’s BBC documentary on Machiavelli and The Prince, broadcast (I think) around Christmas. Old Nick is going through something of a rehabilitation at the moment (Jonathan Powell has recently published a sympathetic “updating”, for example) at the hands of our plutocratic elite, who are increasingly confident and willing to openly flaunt their Machiavellianism. Boris Johnson’s remarks last year about greed being good and rich and poor deserving their lot was another example of this tendency.

Taken on its own, The Prince is a horrible book, but one perfectly in tune again with the age. One of Yentob’s contributors made the point that we’re living through times remarkably similar to those Niccolò Machiavelli lived through at the beginning of the Renaissance: intense but futile competition for power, instability, a collapse of old certainties, widespread fear about security, and a bunch of unscrupulous rulers of dubious competence.

It’s an age of turbulence and Machiavelli’s harsh message strikes a chord with many. Not least those in power, to whom it offers a virtual carte blanche to behave as they see fit if they can get away with it.  “The common people,” Machiavelli wrote, “are only interested in appearances and results.” But what are these “results” and why should a Machiavellian ruler care?

Machiavelli’s fans — always most plentiful among the rich and powerful — contend that he is “only telling it the way it is”. Like it or lump it, people really do only care about themselves, and experience shows it is better to be feared as a leader than loved (obviously no one told that to Nelson Mandela). But for me it’s never been really clear what all this Machaivellianism is for. Often boiled down to “the ends justify the means”, Machiavelli’s thinking in The Prince seems to lack any concept of the common good. What are the ends exactly? Sometimes he talks (in striking echo to today’s leaders in the US and UK) about the “security of the state”, but this often means little more than the leaders own personal interests.

Machiavelli’s is an impoverished view of human nature. Even if it’s true to some extent of all of us, it’s not all that we are. Yes, we all want power and control over our own destiny, not everyone wants the same destiny, or sees the means of pursuing it as irrelevant to the value of acquiring it. He assumes everyone wants to live in a perpetual state of competition. This may suit the story of hyper global capitalism, but I don’t think it’s how most people want to live their lives.

The Prince is a book born of despair, written by a desperate man just released from prison trying to ingratiate himself with the new Mr Big in Florence, Lorenzo di Piero de’ Medici. It leaves no room for love or kindness, or for the idea that the people might want to collaborate (or any other “idea” for that matter). Machiavelli knew a lot about one aspect of human nature and one aspect of power, but he either knew nothing about the other half, or chose not to express it in The Prince. Probably, every politician needs a bit of Machiavelli. But Machiavelli’s Prince, and Powell’s “new Machiavelli”, would be half a politician and, worse still, a bloodless half of a human being.

(Incidentally, Machiavelli emphatically did not take his own advice. Shortly after writing The Prince, he retired to his vineyard outside Florence and lived a quiet life writing books and plays. You can still buy his wine – I imagine it leaves a bitter taste.)

Andrew Rawnsley wrote on Nelson Mandela: ‘His ego was pressed into the service of an idea, not self’. Machiavelli has nothing to say about ideas and, for him, self-interest is the only thing that a prince should concern himself with. But there is low scheming and there is scheming in pursuit of an idea, what Rawnsley called Mandela’s ‘classy cunning’. Ultimately, what’s wrong with the Machiavelli of The Prince is not that he thinks the means don’t matter (although they do a bit, because bad means can tarnish good ends), but that he doesn’t think the ends matter much either.