Not So Great Expectations

Recently I was struck by a quote from geographer Danny Dorling on the fact that, in 2020, the UK recorded the highest number of excess deaths since the Second World War.

“All these excess death calculations that are being made, we’re comparing ourselves in 2020 with five truly awful years,” said Dorling last month, “whereas other countries are comparing themselves with the best years they’ve ever had.”

Excess deaths are defined as deaths above what could be expected based on an average of the previous five years. Because of Covid-19, there were nearly 85,000 excess deaths last year. In the first three months of 2021, there were over 32,000 excess deaths.

However, the problem in using excess deaths in the UK as an indicator of the unprecedented nature of the Covid pandemic is that, because of the political choice of austerity, between 2014 and 2019 – the previous five years – excess deaths were already rising. There were, for example, over 32,000 excess deaths in 2015, over 20,000 excess deaths in 2016 and 2017 and over 22,000 excess deaths in 2018.

In other words, because of the preceding “five truly awful years”, the huge rise in excess deaths in 2020 and 2021 was less pronounced than it would otherwise have been. In yet other words, the true extent of the present human catastrophe overseen Conservatives has been masked by the previous human catastrophe overseen by the Conservatives. You might call that ironic.

Lifting the veil

This can happen because a veil of denialism still surrounds austerity. With Covid, the bare facts are generally accepted even if the reasons for the enormous death toll – at the time of writing the sixth highest in the world – are blotted out. Austerity does not even have that chink of light. A cheer-leading consensus has blinded a rational acceptance of its effects. The entire political class was in cahoots – though austerity was carried out by the Conservative-Lib Dem coalition, the pre-Corbyn Labour opposition voiced its support from the sidelines.

Austerity was largely implemented through swingeing cuts to benefits and central government funding to local authorities. A combination of the popular and the invisible.

The ground for the former was prepared by a massive, and effective, propaganda campaign, portraying benefit claimants – especially allegedly sick claimants – as scroungers living off the naive generosity of the taxpayer. In addition to direct cuts in benefits – the benefits cap and freeze – there was a huge increase in the sanctioning (the withdrawal of all financial support) of claimants. Over a million sanctions were imposed in 2013, a 345% rise on their 2001-2008 average (they had been introduced by the previous Labour government).

Local authorities, however, bore the brunt. The central government grant to local councils was cut by 49%. Given that most local government spending (around 60%) goes on social care, this is where the axe fell, with palpable consequences for mortality rates. In 2014, there were a million fewer social care visits to the elderly than there had been five years before.

There is nothing painless about cuts; they don’t just eradicate ‘waste’. “ … the more cuts there have been to public health, social services and benefits – particularly for people in old age – the more earlier deaths there have been in the UK,” says Dorling. “Cuts that prevent visits by social workers to elderly people reduce their chances of being found after a fall. Cuts that make it harder to rehouse someone who is currently in a hospital bed back into the community result in hospital beds not being available for others.”

All this was compounded by what was happening to the NHS. Though formally “protected” from austerity, between 2010 and 2015 health spending rose by an average of 0.5% compared to an annual uprating of 4% since 1950.

In 2017, a study published in the British Medical Journal found that the post-2010 squeeze on public finances was linked to around 120,000 excess deaths in England alone, with the over 60s and care home residents most affected. The researchers estimated there were more than 45,000 excess deaths between 2010 and 2014 and over 152,000 people could die between 2015 and 2020 unless the “mortality gap” was closed by more funding.

Mind the gap

But such was the size of the mortality gap, it was starting to eat into life expectancy. In autumn 2017, the Office for National Statistics (ONS) revised its predictions for life expectancy for both women and men, cutting the estimate for both by about a year – an estimate that had been made just two years previously. Life expectancy was flatlining. After rising consistently for decade after decade, it was now barely creeping upwards. During David Cameron’s time in office it rose by a month a year for men and by just two weeks for women. By contrast, in the 1940s and early 1950s life expectancy rose by a year every three years and accelerated again in the 1970s and ‘80s.

This means, explains Dorling, “that 110 years of improving life expectancy in the UK are now officially over. The implications for this are huge and the reasons the statistics were revised is a tragedy on an enormous scale.”

The evidence kept accruing. In February 2020, the Marmot Review, an investigation into health inequalities originally commissioned by the Brown government, found that overall life expectancy had failed to increase for a decade and had actually declined for the poorest 10% of women. The author, Michael Marmot, blamed austerity for taking a “significant toll” on the nation’s health and being responsible for “flatlining life expectancy”.

And the pension industry believes life expectancy is actually falling. In 2018, The Institute and Faculty of Actuaries cut adult life expectancy by six months in what it said was “a trend as opposed to a blip”. In March 2019, Continuous Mortality Investigation, a company owned by the Institute and Faculty of Actuaries, found that the life expectancy of men and women aged 65 had fallen by five months from 2017. According to one group of analysts, the main reason was that deaths in 2018 were “particularly high”.

However, there is a silver lining. In 2017 the Financial Times had reported that the “sharp slowdown” in life expectancy could wipe £310 billion from the deficits of large companies’ final salary pension schemes.

In an irony typical of this economic system, deteriorating public health is actually good for the financial health of big firms.

At present, official life expectancy is stalling, as opposed to actually declining as it is in the US, but further revisions are not unlikely.

For whom the bell tolls

Changes in life expectancy such as these are momentous. Besides the human cost, they signal that something very significant is happening to an economic and social system. The collapse of the Soviet Union was preceded by rising mortality and declining health spending. In 1976, a French demographer – widely ignored at the time – correctly predicted the demise of the Soviet system on the basis of rising infant mortality figures. Coincidentally, since 2014 infant mortality has started increasing in England.

But despite our free institutions and allegedly adversarial media, stagnating life expectancy here and now has created nothing more than a faint murmur. The ONS’s downward revisions referred to earlier were buried in an appendix to a press release. The BBC can claim that Covid “has undone the progress made in the last decade or so” and ignore the pre-Covid rise in excess deaths (that its own graphs show!). Matt Hancock can pontificate about adding five years to life expectancy through healthy eating.

Nothing is being suppressed. All the information contradicting official complacency can be readily collated (I just have). But in the absence of mass exposure and repetition – the secret of news becoming received wisdom – the truth about austerity and life expectancy reaches, at best, a minority who want to hear about it.

And far from the damage being repaired, austerity – as enshrined by Rishi Sunak’s last budget – will continue. With the evidence about the effect of austerity in 2010s now clear, the government is responding by upping the dose.

Meanwhile, the land of make believe strides on, brimming with absolutely unwarranted self-confidence.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Johnson and Cameron: A Tale of Two Extremes

We are, we are told, suffering under the yoke of one of the most right-wing governments Britain has ever had. Before coming to power, Boris Johnson chewed over tactics with white supremacist Steve Bannon. Upon achieving it, he has suspended Parliament, appointed a Home Secretary who has registered her support for capital punishment and wants criminals to “literally feel terror” and dog-whistled to racists, the far right and empire nostalgists that he is on their side.

Indeed, the person who first came up with the idea of proroguing Parliament is a former Conservative special adviser, now Brexit party supporter, who convinced himself that ex-PM David Cameron was leading a “homesexualist movement” and infecting Britain with ‘cultural Marxism’ lifted straight out of the Frankfurt School.

So it’s plausible – for those of us who inhabit Planet Earth – to believe that Britain is now led by a hard right nationalist party that has brutally severed its ties (by expelling 22 MPs for example) with the saner, moderate, liberal conservatism that preceded it. Plausible, indeed believed in by many people, but not correct.

In fact, we are confronted by two extremes – undoubtedly different in certain ways – but united by a dogmatic, ideological conviction that the damage they inflict is justified and necessary.

It’s hard for people not of the Conservative persuasion – and not under the age of 60 – to understand how David Cameron upset traditional conservatives. Commitments to equal marriage, to disowning Section 28 and to prioritising more female and ethnic minority candidates, which appeared to successfully‘detoxify’ the Conservative brand, were anathema to many Conservative members who think wearing ties should be de rigueur and that Christianity should lie at the heart of public policy. Such people are economically Thatcherite but culturally traditionalist, which might appear contradictory, although not to them. They are also invariably anti-EU. Cameron was tolerated while he won elections and referendums, which all came to juddering halt in June 2016.

But all the while, and despite protestations from esteemed academics that he was a one-nation Conservative at heart, Cameron deepened Thatcherism. Austerity took public sector cuts to places Thatcher could only dream about, privatisation was driven as far as it could go and the NHS was starved of funding like never before while being opened up to the private sector. Anti-trade union laws were extended, while protection against unfair dismissal was diluted. And for the poor and disabled, Cameroonian Conservatism made the Thatcher era look positively compassionate by comparison. The Con/Lib Dem coalition government – followed by a year of ‘pure’ brand Cameron – left a trail of ruined lives, deaths, suicides, destitution, homelessness even self-immolation.

This was, by any fair assessment, an extreme and intensely ideological government but its leading lights presented themselves as centrists, modernisers and “liberal internationalists”. That they were taken seriously by large swathes of the media can be explained in part by the fact that their amplifiers had no personal experience of the depredations the Tories and Lib Dems inflicted. Those that did – though they number in the millions – were largely silent in public debate. Hence, Brexit, which was rooted in deprived areas hardest hit by austerity, appeared to many commentators to come out of the wild blue.

This political mind-set has been described, by Tariq Ali for example, as emanating from the ‘extreme or far centre’. Its manifestation certainly wasn’t limited to Britain. The EU imposed savage austerity on countries such as Ireland, Portugal, Greece and Italy and in order to get its way was quite prepared to overthrow governments and override the will of national Parliaments – in fact proroguing the House of Commons seems almost quaint by comparison. But neither this, nor the pursuing of secretive trade deals with the United States, has dented its reputation as a bastion of enlightened liberalism surrounded by populist sharks.

In Britain, the transition from David Cameron to Boris Johnson – in which the failures of the first flow inexorably into the predominance of the second – reveals several things. One is that the liberal conservatism Johnson is determined to expunge from the Tory party is very selective in the principles it is willing to stand up for. It is pro-EU and against overt bigotry. But, as shown by the voting records of Tory dissidents such as Dominic Grieve and Anna Soubry, strangely unmoved by the social callousness of the Cameron-Lib Dem government. Hence, contemporary liberal conservatism should not be mistaken for a rebirth of the Tory Wets of the 1980s. They – Ian Gilmour for example – would have been outraged, primarily, by Cameron’s inherently Thatcherite approach to social and economic policy and the human damage it inflicted. Unfortunately, they no longer exist.

Another is the strange sight of strict austerians reneging on their previous iron commitments to reducing public spending and controlling the deficit, obsessions which have defined politics for the past eight years. The chancellor, Sajid Javid, noted The Economist, “is a fan of Ayn Rand and hangs pictures of Margaret Thatcher his office. Yet on Mr Johnson’s instructions he announced an extra £13.8bn in election-friendly giveaways, paid for with extra borrowing.”

However, as highlighted by this blog last year, such flexibility is simply what happens when the Right realises that patience with austerity is at breaking point and the consequences of persevering with it are worse than performing an intellectual volte-face.

Undoubtedly Britain now has a ‘hard Right’ government under Boris Johnson. But it has already experienced one for the past eight years, although one whose sheen was that of modernising conservatism. Now some of the elite are getting a taste of the ruthlessness that Cameron routinely meted out to ordinary citizens. But don’t worry too much – they won’t starve.

The illusion of independence

I think it’s an unspoken rule of politics that the person who claims to be unideological is the most ideological of all. Thus one of the central assertions of the newly formed “Independent Group” (IG) of British MPs is that while the blinkered automatons to their Right and Left see everything through an ideological prism, they, by contrast, do not pre-judge but look at every issue dispassionately and according to the evidence.

Thus when asked by Andrew Marr last Sunday whether the IG would support the renationalisation of the railways and the water industry, former Tory MP Heidi Allen replied: “My gut instinct is no but it needs to be based on evidence and, rather than just choosing ideological solutions, what will work and what we can learn from other countries.”

If you have that strange feeling of déjà vu, that’s because an insistence on ‘what works,’ as opposed to ideological prescriptions, was a staple of the New Labour years. Ministers could get way with claiming they judged everything according to the evidence because the evidence they relied on was produced by people whose ideological biases were so ‘baked in’ they thought they didn’t exist.

You’re only ill because you think you are

This can be seen most clearly in the story of the Work Capability Assessment (WCA), the tick box questionnaire that determines whether sick and disabled people can receive benefit and, if so, what conditions are attached. Judged in terms of the amount of misery it has generated – it was revealed in 2017 that the number of disabled claimants attempting suicide had doubled over the lifespan of the WCA – I think the assessment has no equal among post-war domestic government policies.

But its introduction was surrounded by mountains of evidence that it was the correct policy, medically and socially. In fact that it would be grossly unfair, it was claimed, to leave disabled people ‘parked’ on benefits and shut out from the health-giving qualities of work. In 2005, for example, the DWP commissioned a report called the Scientific and Conceptual Basis for Incapacity Benefit. Co-written by the department’s Chief Medical Officer, Dr Mansel Aylward, the paper recommended something called the biopsychosocial (BPS) model. This assumes that disability is caused in part by the disabled person’s attitudes. Illness was a belief, said the authors, and people could think themselves well.

They recommended, therefore, a “functional” non-medical assessment for all claimants on Incapacity Benefit, one that ignored diagnosis, prognosis and medical history. This became the WCA. The opinions of doctors weren’t mysteriously overlooked when the WCA came into being in 2008, they were deliberately ignored.

A year after the ‘Scientific and Conceptual Basis’ for the WCA was established, the DWP started funding a group of academics to run something known as the PACE trial, which compared the effectiveness of different treatments for Chronic Fatigue Syndrome or ME. The results from the trial were published in 2011 and were presented as demonstrating the visible success of BPS interventions such as Cognitive Behavioural Therapy. The then Conservative-Lib Dem government was miraculously bowled over by the evidence, with minister David Freud telling the House of Lords that “we have gone for the biopsychosocial model” which had “garnered very significant academic support”.

In fact, the research was very seriously flawed. An analysis by the Centre for Welfare Reform revealed that the supposedly “strict” standard for recovery was so loose that you could actually deteriorate and still be classed as having recovered. Another analysis of the whole BPS model concluded that it was “riddled with inconsistencies, misleading statements and ‘unevidenced’ claims”.

But so entrenched is the government’s faith in the ‘evidence’, that even Mansel Aylward, the man responsible for the adoption of the BPS model, admitting in 2012 that he now found it “unsatisfactory” and incapable of meeting the needs of disabled people, had no effect. The WCA steamroller, now over 10 years old, just continues on, oblivious of the collateral damage it causes.

I’m a banker so listen to me

But the WCA needed more than BPS philosophy – the idea that claimants were divided between real sufferers and malingerers – behind it to really fly. It also needed the evidence that there were legions of claimants who were ‘work ready’ and in fact, unjustly, left to rot on benefits. This was provided by David Freud, a millionaire and former investment banker, who despite admitting he knew nothing about welfare, produced the independent 2007 report Reducing Welfare, Increasing Opportunity: options for the future of welfare to work’, commissioned by Tony Blair just before he left office.

The ‘Freud Report’ was hugely influential – New Labour accepted its recommendations as did the Cameron government that followed. In fact, Cameron was so impressed he ennobled Freud and made him a junior minister in his government. The Freud Report achieved a ‘cross-party’ consensus. As a former Labour DWP minister put it in July 2010, “the Labour government’s regulations are now being tabled by a Tory minister who inspired them when he was a Labour adviser”.

Not only did Freud advocate using the private sector to conduct the assessments required to receive sickness benefit, and introducing sanctions, he also asserted that the 2.68 million people on Incapacity Benefit could and should be reduced by 1 million.

This number was subsequently cited endlessly ministers but, as geographer Danny Dorling pointed out, it was based on fiction. Freud “got his numbers” wrong by claiming the remarkable success of government ‘Pathways’ projects in getting Incapacity Benefit claimants into work could be replicated nationally. In fact, the success of the pathways projects was based on recent claimants only, not long-term ones.

 But this didn’t affect the Freud Report from becoming the lynchpin of government efforts to ‘reform’ the welfare state. The reason was not his academic rigour but who he was. As Dorling explained:

David’s report is titled Independent but was commissioned and published by the DWP. Independent no longer means independent. The point of independent reports to government and ministers is that they are not written by people who are independent of government but by folk whose lives and connections are intimately wound up in the machinery of government and elite civil society.

The fallacy of independence

Ironically it was Heidi Allen who confessed that, on becoming an MP, she was “staggered” that minister were not , in fact, experts in their field and MPs were handed “bits of paper” indicating what they should say to the media. But the fact that, in truth, they don’t know very much just reveals how reliant on outside evidence they are.

And that evidence is never unideological despite fervent claims to the contrary. While in 2007, a former investment banker was hired to produce a report arguing that sick and disabled benefit claimants needed to be reassessed into work, two years later the government commissioned two reports – Bischoff and Wigley – insisting the competitiveness of London as a financial centre had to be maintained at all costs. Group members and expert witnesses came overwhelmingly from the City of London. Finance, as one outside analysis pointed out, was reporting on “finance by telling stories about finance”. But all three, in eyes of the Westminster bubble, constituted ‘evidence’.

In truth, nothing is unideological and there is no such thing as pure, neutral evidence. Pretending you’re above the fray just reveals how deeply ensconced you are in its web – so much so that you don’t even notice.

Feeling invisible is the least of working class problems

“If I was of colour or had a disability or a different sexuality I just wouldn’t even bother turning on the television, because you feel invisible,” Times columnist and author of How to be a woman, Caitlin Moran, told the Radio Times last week.

“The lack of working class people in culture at the moment is notable,” she went on. “And when they are represented … Take Benefits Street. It’s the only time I’ve seen people on benefits on television, but you didn’t get to hear them talking about their ideas on philosophy or politics, you didn’t get to see them being joyful – it was simply about surviving, and that made them look like animals. It didn’t show them as human beings.”

This is true but something jars. Representation of working class people is not the same as representation of other so-called minorities. It’s far more troublesome because the implications of genuine representation are far less containable. Put simply, it’s possible to have a resolutely capitalist society that is authentically diverse, and comfortable with multi-ethnicities, equal representation of women, fluid sexuality and disability. It’s not possible to have a resolutely capitalist society that pays more than lip service to working class lives and experiences.

Merely on a superficial level, working class representation in culture is different. The problem is not invisibility but abject distortion and hostility. When the working class is heard in popular culture, it’s invariably with the prefix ‘white’ as if working class views can only be amplified in racial terms. Benefits Street, Benefits Britain, On Benefits and Proud, Benefits by the Sea, On the Sick, Benefits Hotel, Benefits Cat* etc (it’s quite a long list) are all fixated on looking down at people whose lives, intelligence and moral scruples are presented at a qualitatively lower level than those of the viewer. People live in ‘benefits’ houses, have ‘benefits’ babies and smoke ‘benefits’ fags.

These portrayals are dripping with condescension, stereotypes and malice. Invisibility would be a major advance. You could compare this representation with the way homosexuality or ethnic minorities were depicted in the 1970s but even that was less spiteful. It’s like the venom that’s now not acceptable to vent on other racial groups or non-heterosexual people has been stored up to be spewed on targets few will defend.

What does working class mean?

However these depictions are not of the working class per se but people on out of work benefits. The closer people are materially to those at the bottom of the heap, the more they may well want to differentiate themselves. “I don’t think I would want to be in the same class as somebody who takes what they can and has the attitude of ‘Well, I’m better off not working,” Lorraine, a fork lift truck driver, is quoted as saying towards the end of the book, Social Class in the 21^st Century.

Just under half of society, if you credit official definitions, are now working class. 10.6 million people in Britain can be described as poor (in work poverty has now overtaken out of work poverty), as their income is below 60% of the median. A further 760,000 are claiming Jobseekers Allowance and 2.3 million are getting either Incapacity benefit, or its successor, Employment and Support Allowance. The term ‘working class’ can be applied to all of these groups, or just one, depending on your intention.

It’s possible to react to working class stereotypes in the same way as racial stereotypes or homophobia. Just as there is sexism and racism, so there is classism. The solution is to fight an attritional battle on sexist, racist, homophobic or classist attitudes so that eventually society is free of them. In this ideal world, working class people have their voice heard equally in culture in the same way that women, ethnic minorities, non-heterosexual and transgender people do. The working class are not looked down on or stereotyped.

But this would be a false utopia. Being working class is not a collection of attitudes to be respected, or the spur behind an ambition to colonise the commanding heights of society, but a state of being that should not exist. The aim should be a classless society. The working class should be abolished. And that is a truly transgressive aspiration.

Diversity

It’s easier to see the distinction if you examine society’s acceptable and seemingly unstoppable radical edge, the push for diversity. Since 2010’s Equality Act it has been illegal to discriminate against job applicants on the basis of, not just sex or race, but sexual orientation, transgender status or disability. Discrimination obviously does happen but officially it shouldn’t. Government departments have been at the forefront of this drive. The Home Office has been recognised as one of the UK’s Top 50 Employers for Women and offers guaranteed interviews to qualified people with disabilities.  Secret service agency MI5 been has named ‘employer of the year’ by LGBT rights charity Stonewall. In the US, since the time of George W Bush, the US federal government has declared itself in favour of ‘workplace diversity’.

Allied to this, there has been constant pressure to make corporate boardrooms and the upper echelons of public sector bodies more reflective of society. The 30% Club campaigns for greater gender balance at board level in the UK. Groups such as OUTstanding claim business can benefit from greater productivity by enhancing representation of LGBT people at executive level.

It is, without question, a good thing that society, and its cultural expressions, reflect its actual diversity. Gay and transgender people, in particular, have suffered terribly from bullying and worse. The current stigmatising tone of coverage of benefit claimants prepares the ground for sanctions and cuts to sickness benefit. So a more realistic, and, gulp, sympathetic portrait may have tangible effects.

But cultural diversity and equal treatment by employers are profoundly inadequate tools for dealing with the inescapable inequality and autocracy of the capitalist organisation of society. This becomes apparent when you consider how the working class fits into the diversity agenda. The short answer is, it doesn't.

If an employer doesn’t want to discriminate, for example, against working class people, how are they to proceed? They could aim to ensure that people with working class backgrounds aren’t excluded. That would be difficult to define and enforce, but beyond these surface difficulties, whether a working class person even gets to the application or interview stage, is dependent upon innumerable factors. These elements, such as education, childhood experiences, parental wealth, ownership of assets, or cultural capital are produced by entrenched political and economic forces, and not within the gift of enlightened employers to bestow.

The result is that, despite the ostensible backing of Left and Right for greater social mobility and equal opportunity, the reality either gets worse or remains static. Two decades ago, Conservative Prime Minister John Major promised a ‘classless society’.  With impeccable amnesia David Cameron now claims the Conservatives as the ‘party of equality’. But class cannot be undiscriminated away.

A cooperative economy

However the incongruity goes far deeper. Genuine representation of working class opinions and experiences cuts against the grain of organisations built on hierarchy and career progression. For a telesales worker, a front-line nurse, a fork lift driver, a cleaner or a receptionist to have an equal say in the management of the organisations they work for presupposes an end to the arbitrary power of management, and the reaping of profits by senior management and shareholders. This simply cannot be allowed to happen. Power should steadily accrue to those who ascend career ladder. So working class experiences and opinions are necessarily suppressed in favour of those of the upper middle class.

If, however, you wish society to genuinely listen to the experiences of working class people, you have to move towards a cooperative economy, in which the distinction between employer and employee is abolished. This doesn’t mean that a division of labour is no longer needed or that management disappears as a function. But it does mean that enterprises and public sector organisations become classless and democratic. The huge cooperative enterprise at Mondragon in Spain, which contains over 250 businesses, indicates this is quite feasible.

The implications of such a change are massive for a society increasingly defined in terms of status, seniority and inequality. But, like a basic income heralding a post-work future, a cooperative economy could be just as liberating for those convinced they benefit from the current make-up of society, as for everyone else.

*This one is made up but I’m hopeful Channel 5 will commission it