Friday, 17 August 2012

Save us all from lazy politics

‘Law and sausage,’ said Otto von Bismarck, ‘are two things you do not want to see being made’.

Making law is by far the easier, which is why the lazy politicians I spoke about the week before last are constantly doing it. Here’s how it works.

Suppose a terrible crime is committed in Stamford, Lincolnshire. Or indeed Stamford, Connecticut. Perhaps a father killed his children, both under five, with a hacksaw.

There’s a massive scandal. In other words a few dozen journalists talk about next to nothing else for the best part of a week. The government feels bound to react.

What it should do is carry study the conditions in Stamford and other similar communities. It should find out whether this kind of crime is associated with particular economic or social circumstances. It should canvas informed opinion on how to deal with those problems, perhaps even looking at experience abroad on the most effective approaches.

Then it should adopt a sensible set of proposals and implement them. 

That takes time and costs money. The initial studies themselves are expensive enough and implementing the conclusions far more costly still. It might need more and better policing, better and more extensive social services support, tighter monitoring of children at risk, and so forth.

Meanwhile, once the initial furore has died down, the journalists who were demanding immediate action go back to their usual refrain, the need to cut costs. More police? More social workers? More support? Dream on.

So how does government square that circle? Easy. It passes new legislation. It receives the plaudits of campaigners by specifically targeting the killing of children with hacksaws. Pedantic lawyers point out that it wasn’t strictly legal to kill them before, but nobody listens. This terrible act has happened and it must be prohibited.

‘This must never happen again,’ they all chorus in unison, across politics, the media and the campaigning organisations.

The legislation provides for draconian penalties, including a minimum gaol sentence of 25 years, on which no judicial discretion can be exercised. Not that there was evidence of judges taking a particularly lenient view of infanticide with a carpenter’s tool before.

The opportunities for lawyers become immense. ‘Your honour,’ one will soon be pleading, ‘in common parlance a hacksaw has a blade not exceeding 20 mm in width and this one is at least 3 cm wide. It should be referred to more properly as an open-handled panel saw.’

There will also be gainful work for civil servants. Codes of application will have to be prepared for all the agencies affected: the police, the courts, social services. Consultants offering training courses will have a bonanza. Staff will be consulted and their comments fed back into new instructions and so on for at least as long as the full study would have taken.

That will about all the effect the new law will have. Its application requires effort and that requires manpower: more police and and social workers, for instance. But more police and social workers cost a lot more money, etc. etc.; see above for details.

One area where this kind of activity for its own sake is particularly prevalent, in Britain at least, is healthcare. We all really, really care about the National Health Service, so it’s almost a rite of passage for any new government to do something for, or at least to, the NHS.

The NHS. We love to love it.
And politicians love to muck it about
In the 27 years I’ve been working around the NHS, I’ve seen:
  • the old structure of governing boards, in which no one individual was responsible for the performance of a hospital, replaced by a bright new structure of General Managers who would be personally answerable 
  • control by the old geographically-based health authorities replaced by direct control of hospitals forming self-governing ‘NHS Trusts’ 
  • NHS Trusts, found not to be sufficiently powerful, gradually replaced by ‘Foundation Trusts’ with greater control of their affairs 
  • ‘General Practitioner Fundholding’ introduced so that GPs would contract for hospital services and negotiate the price to pay for them 
  • ‘Primary Care Groups’ to bury fundholding while still theoretically representing primary care physicians 
  • ‘Primary Care Trusts’ to beef up the powers of these organisations 
  • ...and now ‘Clinical Commissioning Groups’, smaller than Primary Care Trusts, to move power downwards once more towards GPs

Every one of these reforms has been announced with a fanfare, every of them has been found wanting and declared inadequate before being replaced by the next.

The Scots gave up on all this, and quickly went back to the geographically-based authorities (they call them health boards) to run their hospitals. There’s no evidence that Scotland does particularly less well than England.

What’s curious is that in among all these wonderful reorganisations, I’ve only really seen the English NHS improve markedly and visibly once: under the last government which increased funding by an impressive amount and cut waiting times – two years at their worst – to a statutorily backed maximum of eighteen weeks.

The current government intends to take £20 billion out of the English health service so it’s fairly obvious what kind of improvements we can expect in the next few years.

So what have all the reforms had in common? They’ve been dictated from above. They’ve required nothing more substantial than legislative effort. And they’ve given the impression that the government of the day was taking important matters seriously.

And one other thing: they all cost a fortune and spread massive demoralisation as the reorganisation axe fell.

Lazy men’s politics. Easy. Irrelevant. And massively damaging.

1 comment:

Mark Reynolds said...

I was going to quote Petronius Arbiter on reorganizations and the illusion they give of progress, only to discover when looking it up that he never said it. No one tell the government.