Friday, 20 November 2020

Bye-bye, mein lieber Kier (and G4S, Serco and the others)

Outsourcing and privatisation died at 1518 on Wednesday 4 November 2020. Or thereabouts.

That was of course a misquotation of the great architectural critic Charles Jencks. It was also when the Guardian published the news that Randox, the company involved in a testing failure during the summer had just been handed another government contract worth £347m. Though it could perfectly well refer to the bankruptcy of Carillion on 15 January 2018.

It is strange when you think about it, but the more they have held on to life, the more that privatised utilities and outsourcers have become a byword for incompetence – rather as, once upon a time, it used to be with nationalised industries.

Ironically, this is both for similar reasons – both were far too big to be responsive.

In my new pamphlet for the New Weather thinktank, The End of Privatisation, I tell the strange story of privatisation, from its beginnings with Peter Drucker and Keith Joseph in the 1970s and the triumphant sell-off of British Telecom in 1984 – and the ideas at the heart of it: more entrepreneurial efficiency, less cost.

Nearly four decades have passed since then and those promises have turned to dust, and for similar reasons: most of the outsourcers are too big to operate effectively.

As Drucker wrote himself: “The most entrepreneurial, innovative people behave like the worst time-serving bureaucrat or power-hungry politician six months after they have taken over the management of a public service institution." And so it proved.

Even the outsourcers add another layer of costs during an unaffordable austerity years and their only expertise turns out to be provide the KPI and target data that ministers crave, and which only they believe.

They represent rule by tickbox – which, as we know – tends to spray costs elsewhere in the system by narrowing the definitions of success to what they can easily achieve.

That explains why this final hurrah of outsourcing to government friends during covid has put the final nail in the coffin of what was once a big idea.

So why does the body of privatised outsourcing still twitch? There is no practical or intellectual justification left for it. The only explanation is that this is all that ministers and officials in the Johnson administration – never the most thoughtful of people – know about. And possibly the only people they know remain the only remaining advocates of tickbox in the whole wide world.

So farewell then Serco, G4S and all the others, as E. J. Thribb used to say in the days when privatisation seemed like a pretty neat idea. It was a fine affair, but now it’s over – or it soon will be.

This first appeared on the New Weather blog

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Sunday, 1 November 2020

What do they know of science who only science know?

What do they know of the England who only England know,” wrote the much-derided poet Rudyard Kipling more than a century ago. After listening to the excellent debate on science and politics last night, which Radix organised, I wondered whether we should say the same of scientists.

Or indeed anyone whose narrow field of expertise gets in the way of understanding the world. Should we also for example say: What do they know of epidemiology who only epidemiology know? I don’t know.

Some of the debate goes back to C. P. Snow’s famous paper on the Two Cultures. The critic F. R. Leavis condemned it without reading it - “To read it would be to condone it,” he said. And I have some sympathy with that on the grounds that Leavis was objecting, I think, to the idea that arts and science were somehow equal, with the same complexity and moral validity. Which they are not.

Still, everyone – however little they may think about molecules – has something to learn from scientific method, as mediated through the two great 20th century philosophers of science, Popper and Kuhn. Mere knowledge of human or bureaucratic processes is not expertise, for example. Nor is it science.

What seems to me to be, in the long run, unfair to scientists and their reputations is the way that the media use them to fight what are essentially political battles.

Take the Great Barrington declaration, for example, which has barely been reported at all in the UK, where the three top epidemiologists in the world denied that lockdowns were the most effective way forward - on the grounds that they killed as many people as they saved. They were immediately condemned in the American press for "advocating mass murder”.

The day Radix published their declaration in the UK – on the grounds that somebody should – they were the subjects of a hatchet job in the Guardian, in the grounds that one of them had been interviewed on a dodgy US radio programme and that some of the people who had signed their declaration turned out to be (shock horror!) homeopaths.

Now let us leave aside the fraught issue of homeopathy. It seems to that when nobody reports the three top epidemiologists, and when a former law lord like Jonathan Sumption can say (thank you Charlotte!): “This is how freedom dies. When societies lose their liberty, it is not usually because some despot has crushed it under his boot. It is because people voluntarily surrendered their liberty out of fear of some external threat” – then we have a problem.

We have not yet had the lockdown riots that are beginning to emerge in continental Europe. But if most of those who dare step forward and doubt the establishment consensus are right-wing nutcases, then we will be at their mercy for some time to come.

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Friday, 2 October 2020

Robots in care homes? No thanks!

This post first apppeared on the Radix UK blog...

I am one of the few people in theUK to have written at any length about the need for authenticity. As such, it ought perhaps to be me who points out what a thoroughly bad idea it is to use robots in care homes to counteract loneliness.

That was the story on the front page of a recent Guardian, and it seems to me to suffer from the whole corrosive technocratic worldview which brought us exam grades by algorithm and government by tickbox.

It reminds me horribly of the ideas put about by Americans in the early 2000s about the non-existent difference between real and virtual. Why is it that Americans are so susceptible to this kind of nonsense?

“Once your house can talk to you, you may never feel alone again,” said The Futurist magazine.  I’m not so sure.  Nor was I convinced by Machines That Think author Pamela McCorduck about the geriatric minder robot that looks after people by saying “tell me again” to their stories – “and means it”.

Those interviewed in the Guardian article were at pains to point out that they were not suggesting that robots take over from human beings entirely. But that really isn't the point. The idea is that care home staff, run off their feet, might get a bit of a break by plugging their charges into one of these. As if there was any chance of going back to the human beings if that was ever to happen.

So, no doubt you are wondering why the older people in the experiment had 'improved mental health' as a result. That is simple for anyone who knows about the famous Hawthorne experiments in the 1920s and 30s.

It is because of all the attention paid to them by the researchers, not the ersatz attention paid to them by the machines.

It is an elementary mistake, and one that those schooled in the delusions of tickbox should be able to recognise.

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Friday, 25 September 2020

Once more, the rise of local money...

This post first appeared on the Radix blog...

Charles Zylstra was the man who first introduced Stamp Scrip – the negative interest local currency – to the USA around 1932/3. He used to tell this story:

“A travelling salesman stopped at a hotel and handed the clerk a hundred dollar bill to be put in the safe, saying he would call for it in twenty-four hours. The clerk, whose name was A, owed $100 to B and clandestinely he used this bill for the liquidation of his debt, thinking that before the expiration of 24 hours he could collect $100 from his own debtor, whose name was Z. So this 100 dollar bill went to B, who, greatly surprised, used it to pay his own 100 dollar debt to one C, who (equally surprised) . . . and so on, and so on, all the way down to Z, who, with much pleasure, returned the bill to A, the clerk, who, in the morning, restored it to the salesman. And then did A, the clerk, stand petrified with horror to see the salesman light a cigar with it. ‘Counterfeit,’ said the salesman, ‘a fake gift from a crazy friend, Abner; but he didn't put it over, did he?’”

“Let us now look at the collective result,” wrote the economist Irving Fisher, whose book this story was in. “At the end of the year, the town has a new street, paid for with scrip which (through the stamps) was paid for by the citizens who used the scrip - and will use the street too.

“The scrip cost the citizens perhaps one third of 1 per cent on mostly new business, while the street cost the city (in the sense of the city treasury) nothing at all. But, of course, the city is the citizens; so that these various statements boil down to this: The citizens have bought a new street out of a self imposed tax on mostly new business, and it was a tax less heavy and more spread out than any other tax they ever paid.

“The chief objection to Stamp Scrip which I have thus far encountered is that it will not work because people will refuse it - it will not catch hold. But the man who said this, said later, ‘I guess I must be like the Englishman a hundred years ago, who said that the steam-locomotive couldn't work because smooth wheels could not catch on to smooth rails. While he was saying this in London, Stephenson was successfully running his locomotive in Scotland’.”

The fact that an economist of the calibre and reputation of Fisher could intervene with a book called Stamp Scrip was partly a measure of the depth of the Great Depression and partly related to the importance of the great alternative to Roosevelt’s new deal.

Stamp Scrip was an idea that began in Austria, and reached the USA at the moment when so many communities were running out of cash. So many places were issuing their own notes, which required you to buy a stamp representing one per cent of its value every month – if you failed to spend it on. This was negative interest money, after all.

Senator Bankhead, the uncle of Tallulah, managed to get a bill drafted in Congress which would have authorised $1 billion of stamp scrip to be issued the following year. The Bankhead-Pettengill bill was introduced in February 1933.

But when Roosevelt was unaugurated as president in March 1933, a month later, a quarter of US banks had shut their doors, and he believed that stamp scrip was undermining belief in the banks and were therefore part of the problem.

When I used to kcture on these two decades ago, having written Funny Money about their experimental successors, I used to emphasise the wooden currency of Tenino in Washington state as particularly unusual.

Every time, we have run short of money again, experimental DIY currencies come back, from Ithaca hours in 1992 to the Bristol pound in 2012. But we have experienced nothing on the same scale as stamp scrip.

But amazingly, Tenino’s wooden currency is back. It convinces me that – this time – as the money begins to dwindle around the world, we will know how to create the money we need to live.

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Saturday, 29 August 2020

My mission to slay tickbox to save the NHS

The tickbox phenomenon, which I have been writing about for most of this year, seems finally to have reached its apotheosis with the appointment of the queen of tickbox, Dido Harding, to run the government’s test and trace service.

Now I have never met her, I’m afraid – I’m sure she is delightful -  but as a former chief executive of one of the most useless phone companies known to mankind, she personifies tickbox: the fantasy, shared mainly by the richest and most powerful people in the world, that data and algorithms can describe the world accurately.

Because of this mistaken idea – that we can hand over human decisions to machines, programmed by our philosopher-kings – explains why, at the heart of so many centralised and technocratic organisations, you have this remarkably widespread fantasy that the data and the ticked boxes that pour in from the front lines represent exactly what they purport to.

That is a working definition of tickbox – the gap between official rhetoric and numbers and the reality.

If you want to know why our test and trace system has failed to work, it is this – over-centralised privatised outsource contractors, whose only skill is providing the ticked box figures that ministers crave, have been put in charge of an enterprise that simple must be made to work and they just can’t do it.

Other examples of tickbox may vary. You might for example find tickbox demanding impossible information, impossible in the real world. As it did via Home Office computer system to Anthony Bryan, caught in a kafka-esque world, managed by immigration software and deaf algorithms. The Windrush generation former painter and decorator (whose story was recently dramatised) provided huge amounts of evidence to the Home Office, as they prepared to deport him from the UK, which the system studiously ignored.

Second, tickbox works because the centre really wants to wash their hands by automating decisions, for example over the cladding used on Grenfell Tower and other blocks.

Third, it tries to automate tough decisions to insulate the handful of people in charge, as it did with the recent exams fiasco – damaging lives which failed to fit into its neat formulae.

That is why I have helped start a petition to lift the tickbox curse from one of the most centralised organisations in the UK, the NHS – where so many resources get eaten up ticking boxes which don’t really relate to reality, for all those three reasons (and others too). All of them because the centre believes they can control everything on the front line, and has faith that the numbers they receive from there are real.

I don’t mean checklists here: they provide a means to save lives – as long as they are controlled by individual surgeons and their teams. Tickbox seems to provide an answer to the problem of accountability in huge, centralised organisations. Sir Keith Joseph, once Health Secretary, used to complain that he had struggled his whole life to get his hands on the levers of power, only to find they weren’t attached to anything.

But tickbox and the automation of accountability only works if the flow of information is at all accurate, and tickbox information rarely is – because of Goodhart’s Law (any numbers used to control people will always be inaccurate).

When the chips were down to fight covid, NHS managers lifted the tickbox yoke because – as they told staff in one north east trust – because “we are all grown-ups”.

Of course that was right, but they were before and they still are. It is time to lift that tickbox burden and restore the trust in the UK between top and bottom, so that – once more – the only thing that matters is what individual patients need…

So go on, please sign!

This post first appeared on the New Weather blog.

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Thursday, 6 August 2020

How to untickbox the NHS

It is a strange divide in society. Some people furrowed their brows when I told them I was publishing a book called Tickbox, and really seemed to struggle to understand what I was on about – while some people grasped it immediately. Among those who got it, I couldn’t help noticing that many of them worked in the NHS.
It maybe that the NHS is not the most boneheaded user of tickboxes but – as a huge over-centralised operation, managing people looking after people’s very individual needs, somehow the gap between appearance and reality (which is for me the heart of tickbox) – the NHS has seemed to involve more tickbox-inspired sclerosis than most.
Yet, what did they do when the NHS was absolutely the front line? They rolled it back, the whole amalgam of online tickboxes, KPIs, targets and centralised controls that NHS managers rely on to monitor performance.

“Decisions that used to take months or even years because of endless, pointless form-filling and meetings are now made in less time than it takes to boil a kettle.” This is the new NHS under COVID-19 according to Dr Max Pemberton. One doctor we know was told by managers that sudden freedom was because NHS staff are “adults” and can be trusted to make the right decisions on the spot.

And of course that was right. They were adults yet they still are as the whole tickbox thing wafts back across the NHS. That is why we started our Radix petition to stop it in its tracks.

And what their managers want is often to make the best impact on the company hierarchy. Which in the NHS means saving money – or appearing to. Then the argument shifts, almost imperceptibly, away from ‘Is this the best thing for this patient?’ – to ‘Are we meeting our KPIs?’

It provides a fake, simplified and mechanistic view of what is undoubtedly a complex system – but complex in a different way. Anyone who thinks differently looks as if they are missing the point, but it is actually the system that misses the point.

My Tickbox book argued that this is part of what might be described as the simplification – not to say vulgarisation – of the official mind. And it is already having serious consequences. We have already witnessed during the current crisis how inaccurate the figures will be for Covid-19 deaths or tests or people affected – and how officials intervene in the definitions (for example on safe protective equipment) the whole time.

I am also hoping the NHS increasingly understands that tickboxing may simply achieve the opposite of what was intended. It can be a real hindrance, not the great time saver it purports to be. Mere tickboxing enables a lack of accountability.

All the systemic failures enabled by tickbox – from Mid Staffs Hospital onwards – have to be measured against the extreme pressure on services brought about by the austerity policies of successive governments, which is why NHS managers are trying to tickbox compassion into the mix, fearful perhaps that the real thing is unaffordable.

That is what happens in large centralised organisations when tickbox takes control.

Part of the costs fall directly on NHS staff. “The Berkeley University psychologist Christina Maslach defined ‘burn-out’ as a combination of three feelings: ‘emotional exhaustion, depersonalisation (a cynical, instrumental attitude toward others), and a sense of personal ineffectiveness’, wrote Atul Gawande, the doctor and author of The Checklist Manifesto. These were his conclusions:

“Many fear that the advance of technology will replace us all with robots. Yet in fields like healthcare, the more imminent prospect is that it will make us all behave like robots. And the people we serve need something more than either robots or robot-like people can provide. They need human enterprises that can adapt to change.”

I am quite hopeful here because of Health Secretary Matt Hancock’s campaign against bureaucracy. He can see ow much it gets in the way. There are some self-help ideas we might encourage as a stopgap in the NHS. We could, for example, learn from the Dutch health service and their schrapsessies.

That is the name the new movement in the healthcare sector in the Netherlands has given to the ‘scrap sessions’ they hold at work to identify regulations, targets, tickbox rules it would be possible to get rid of completely. The idea emerged in 2018 from the Dutch thinktank (Ont) Regel de Zorg, but the movement now has a head of steam behind it, and the backing of ministers.

It is high time we spread it more enthusiastically over here. Hence our petition to demand the government to permanently remove their tickbox regulations on the NHS, partly to thank staff, partly to recognise their adulthood and partly to save money – which should be reinvested in the frontline.

We hope in the end that covid-19 could mark the moment we stop infantalising NHS staff, and also the moment we lift the threat of tickbox over all public service staff.

Because, decentralising the management of the NHS is the key to its survival and the most urgent element here is to stop the centre from their disastrous habit of micromanagement. So please sign the petition and pass it on if you feel as strongly as we do about this.

Thursday, 23 July 2020

'Good Germans' and the danger of othering

This post was first published on the New Weather blog...

Rupprecht Gerngross is not a household name, even among historians of World War II, though he led what may have been the only successful internal coup against Hitler's regime.

In the final weeks of the war, he led his small band of military translators to take control of Munich, the revered birthplace of Nazism. By doing so, he seems to have prevented the destruction of the city, and saved thousands of lives, including many thousands of Dachau prisoners who were to be killed by their Nazi captors.

He was an unlikely hero, a London-educated solicitor, brought up in China. But it was important to him that Germans should build the new Europe themselves by doing their part to liberate their own city.

Why isn't he well-known? Because after the war ended, few people believed or remembered what had happened there - and the story remains controversial in some circles. The BBC man sent to interview him was sacked shortly afterwards and his story was spiked by The Times on the advice of the Foreign Office that it would not be 'helpful' to circulate stories about 'good Germans'.

The amazing story is finally published in a new book, compellingly researched and thrillingly written by my friend Lesley Yarranton (Saving Munich 1945 - fuller transparency: my name is also on the cover urging people to read it!).

But it has made me think about how simple it is to 'other' your political opponents, and how unfair. How easy it would be if every wartime German had been a Nazi, if every demonstrator was a revolutionary (as Trump suggests) or every Briton born before 1830 had been an irresponsible slave-owner. But life is never quite as simple as that - nor is it possible to see the world accurately through those kind of paint-by-numbers, cliche eyeglasses.

We seem to be moving into a new world, which is a good deal more sensitive to people's needs and feelings. That has to be a good thing, as long as we remember that very few people will fit neatly into the new categories of good and evil - and not many more than they ever have.

Let me give the final thought to the Rev Eli Jenkins from Under Milk Wood:

"We are not wholly bad nor good,
We who live beneath Milk Wood..."

If we can remember that, it might steer us away from the puritanism that so often afflicts new elements of morality.

You can also find Saving Munich 1945 in paperback from Amazon and on kindle.

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