In a series of essays that CentreForum will be releasing over the next few months in anticipation of the book, The Challenges Facing Contemporary Liberalism: 2015 -2025, the liberal think tank has today released “How to save public service choice for liberalism?” by David Boyle, which can be read here.
It is the fourth in the series; the first, On Blasphemy by Maajid Nawaz, can be read here; the second, an essay by Tim Farron, Neil Stockley and Duncan Brack on green growth and climate change, can be read here; the third, “Bold liberal tax reforms for a stronger economy and fairer society” by Adam Corlett, can be read here.
David begins by stating that never has one word caused as many problems as “choice”. The word has become nebulous, and different political parties use it in very different ways. What the paper focuses on is what the word means for liberals.
It looks at choice and its meaning through the prism of public service provision. David asserts that neither the Right’s response to poor choice in regards to public services (let bad providers go bust) nor the Left’s (grin and bear bad services for the overall common good) is really good enough. “Quality” is another word that has lost a great deal of meaning dependent on which political party stripes it’s being uttered under. What counts as quality in public service provision will inevitably cover a huge number of factors.
Flexibility is singled out in the paper in terms of importance when looking at public services within a liberal framework. David tells of a muscular dystrophy patient who saw her consultant every six months, always to simply tell her doctor she was doing fine. What she really needed was the ability to call him on the occasions when she was not fine. In other words, the Left’s guarantee of provision being available should be combined with the Right’s sense of choice being provided.
A more flexible system would mean less certainty but more human connection. This would not come without problems: up-front investment would be required, and there is the very real possibility that some patients may very well choose their care poorly. But as liberals, we should want the system that works the best, regardless of ideological hang-ups; we should also trust in individuals to know what’s best for them.
* Nick Tyrone is a liberal writer. He blogs at nicktyrone.com and is an associate director at CentreForum.
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“As liberals, we should want the system that works the best…”
The thing is, most people want this, not just “as liberals” but as Conservatives, Labourites and the much larger contingent of the public who are not affiliated to any political party. The disagreement is over the means to achieve this uncontroversial end; it is not primarily a matter of motives, as many Lib Dems seem to imagine (having higher or more altruistic motives than other parties), but of instinct and analysis and interpretation.
I recall that under Charles Kennedy Lib Dems were apt to say things like “people don’t want choice, they want every school to be a good school/hospital etc”. The problem with such bromides is that they entirely begged the question of how that worthy goal was to be achieved, and offered no insight on why large sustained increases in inputs (ie expenditure and public sector employment) were showing disappointing results and running into sharply diminishing returns.
David Boyle at least recognises that some more imaginative thinking is required if we are to have public services which actually respond and are shaped by the people they are supposed to serve.
Notwithstanding the UK’s over-centralised state, the answer cannot simply consist of shifting power between different tiers of government – as David Laws argued in 2007, devolving power from national politicians to local politicians is often important, but by itself it amounts to municipal socialism, not liberalism. The users of public services pay the piper and it is high time they called the tune.
“…devolving power from national politicians to local politicians is often important, but by itself it amounts to municipal socialism, not liberalism. ”
What a bizarre statement. I am not sure if it is because you misunderstand Socialism or because you misunderstand Liberalism. Maybe you misunderstand both. Maybe you misunderstand democracy?
Or maybe you just assume that everything would be better if power was handed over to hedge-fund spivs ?
“..The users of public services pay the piper and it is high time they called the tune.”?
So how does that work in practice ?
Alex
“The disagreement is over the means to achieve this uncontroversial end”
Such a simple point but so often missed in these discussions, so much time is spent labelling people holding different views to try and suggest nefarious intentions as opposed to a genuine disagreement on achieving the uncontroversial ends.
“I recall that under Charles Kennedy Lib Dems were apt to say things like “people don’t want choice, they want every school to be a good school/hospital etc”. The problem with such bromides is that they entirely begged the question of how that worthy goal was to be achieved”
This was a particularly embarrassing message. It actually works effectively when you intend to be an opposition party but comes unstuck when you are going to deliver something.
Everyone wants somethign to be “good” but what is “good?” there are basic standards to be achieved (to make something satisfactory) but after that it then comes down to what areas should be prioritised when trade offs have to be made. Lots of people who say they want a “good” school/hospital don’t think the same as the next person about characteristics that make the school/hospital “good” as opposed to “satisfactory.”
JohnTilley: Obviously I am not saying the act of devolving power from central to local government is municipal socialism. That would be silly. By itself it is an act of decentralisation. Conversely, giving LEAs powers over things which currently reside with schools (irrespective of whether it might be desirable or necessary) is an act of centralisation.
And a mentality that the town hall knows best, that power should be hoarded by local or regional government and not devolved further down to communities and individuals, is simply a municipal version of Douglas Jay’s ‘the gentleman in Whitehall really does know best’.
To the average voter the local council is just as remote and unresponsive, and just as capable of high-handed decision-making, as central government or franchised private sector providers. Local democracy might be part of the solution but it is far from being a panacea. (In any case it often strikes me that the Lib Dem enthusiasm for local democracy is skin-deep: they seem to be keen on it only in so far as it dosn’t disrupt national uniform standards of provision, national pay bargaining and the like…)
Nick Clegg once seemed to understand this: when he was elected Lib Dem leader – long before the coalition – he said public service reform should mean ‘real daily empowerment’ of the service users; electing a bunch of councillors or MPs every few years should not be a substitute for this, but a means of holding accountable those responsible for the design and oversight of the system.
He cited as a potential model the ‘personal health budgets’ being planned (and since introduced by the NHS) enabling people with long-term conditions to tailor their own care according to their needs and choices. This was a good example, but the concept needs to be developed further and could have a wider application.
My second paragraph in the above comment was meant to begin “But a mentality that…”
Alex Sabine
Any chance of you addressing my question ?
Your assertion was that — “..The users of public services pay the piper and it is high time they called the tune.”?
So how does that work in practice ?
JohnTilley: I addressed your criticism of my ‘bizarre statement’ directly. I gave the example of personal health budgets. I would favour extending this approach to other aspects of public service provision. I agree with Alan Milburn, for example, that we should consider a system of school vouchers – although I don’t think this would have to be a national scheme. It could take the form of giving parents a legal right to control their share of LEA funding. There are a number of possible versions, including ones that tie extra funding to pupils from disadvantaged backgrounds (like the pupil premium, except the full amount spent on that child’s education would ‘follow the pupil’ not just an add-on element.)
However, I don’t claim to have all the solutions. I do contend that merely defending the status quo, or indeed advocating a more monolithic model of national or local monopoly provision, is a depressingly conservative reflex from supposedly progressive parties.
David Boyle asks many of the right questions. The task for Lib Dems should be to develop an approach to public service reform that holds providers directly accountable and gives greater voice and, yes, choice (which will often imply the power of exit) to the users of public services – instead of treating these as things which only the users of private health and education services can be trusted with.
My experience of talking to many nurses and doctors are that perhaps 30-50% of people at A and E are wasting NHS resources. Basically it comes down to responsibility. The Welfare Stat e envisaged by Beveridge required mature adults taking responsibility for their lives and not wasting resources. In 1948 , ill health related to diet was due to malnutrition , now it is obesity. When J Kennedy said ” D not ask what the country can do for you but ask what you can do for your country ” was the last time any politician told voters that they needed a sense of responsibility for democracy to work.
A major problem for most comprehensives , is the percentage of parents who take no responsibility for the education of their children at best, and at worst are antagonistic to scholarship.
Much work undertaken by councils in public space is clearing up rubbish left by people, graffiti and vandalism.
I would suggest a threat to democracy is the narcicistic attitude of people who do not take responsibility for their actions , especially their failures. Consequently, those people who believe in an all powerful state or corporations are quite happy to run their lives for them , at a price. The price is either overly high taxation or paying for goods and services which people want for narcicistic reasons, but do not actually need. I would argue the greatest beneficiaries in the increase in taxation and public spending since 1945 and white collar administrators . I would argue that a person would far more benefit from taking up boxing or the martial arts , than pay vast amounts for playing violent computer games.
When it comes to any organisation producing quality it relies on the attitude of the staff. The Royal Navy and The Indian Civil Service required the highest levels of professional ability, integrity and courage and that is why they were respected . The reality is that very little of Britain reaches the standards of the Royal Navy and Indian Civil Service at their height of their abilities. In both organisation failure was punished: Admiral Byng was shot on the deck of his ship!
CentreForum is supposedly a liberal think tank (is that ‘Liberal’ or ‘liberal’?)
David Boyle hails from CF and tells us that we should anticipate the book, “The Challenges Facing Contemporary Liberalism:”
And yet, in no part of this post “How to save public service choice for liberalism?” does he make an attempt to connect the great tradition of Liberal thought with his views.
We are back again at the level of “LibDems – What’s the point?”
Our great opportunity now is to use our rep for being able to engage in sound government with a raison d’etre which differentiates our Liberal approach from that of the other two.
Can I take it as read that the Labour Party is now an ideology-free zone – and that for years now no Labour spokesman dares mention the toxic ‘S’ word? It went far too far down the discredited road of Marxist – Leninism, class-based conflict, ‘the means are justified by the ends’ and such leftist claptrap and New Labour merely reached for empty page pragmatism leaving, even now, Miliband still casting around for an ideology to lean upon.
The one advantage now for us is to shout from the heavens about our great Liberal thinkers, and how relevant they are in today’s society with today’s problems, and show our differences.
Regretfully, this post, and much from similar sources ignores this wonderful chance to grab the imagination of that section of the idealist youth who, over the last century, were previously suborned by trendy lefties.
I am so disappointed that the social democratic section of our great Liberal Party are still introducing their pale pink into what should be our primary coloured philosophy.
Alex Sabine
Nick Clegg once seemed to understand this: when he was elected Lib Dem leader – long before the coalition – he said public service reform should mean ‘real daily empowerment’ of the service users; electing a bunch of councillors or MPs every few years should not be a substitute for this, but a means of holding accountable those responsible for the design and oversight of the system.
But what do you mean by “real daily empowerment”? I’m a busy person, I don’t want to have to spend my life exercising “empowerment” over whole loads of things. Mostly I just want to turn up to the place where the service is provided, get the service, go away. I want the job of ensuring the service is a good one to be done by someone else, someone I can trust will make sure it is what I want.
That is surely the case with health services, for example. It’s not like buying clothes or food where I might enjoy looking around at the options, decide whether I want to go for something cheap and functional or more luxurious and expensive and so on. It’s not something where I might necessarily know what is the cheap functional option and what is not. I want reliable experts who I can trust will provide me with the best option to be making the right choice for me, not to have to have to play wheeler-dealers or do huge amounts of research to find out.
I find already that the impositions made on me where I am supposed to play wheeler-dealer with various basic services such as energy supplies to be a burden, not liberty. Why should I have forever to be playing the market, switching from one provider to another, having to do the research and going through administrative procedures to do that? I have more enjoyable things I could be doing with my time.
So, no Alex, I don’t think I am finding the sort of “freedom” you seem to be proposing here to be much of a freedom. There are many other things which would do a lot more to enhance my freedom than this.
“In no part of this post “How to save public service choice for liberalism?” does he make an attempt to connect the great tradition of Liberal thought with his views.”
“The one advantage now for us is to shout from the heavens about our great Liberal thinkers, and how relevant they are in today’s society with today’s problems, and show our differences.”
“… Regretfully, this post, and much from similar sources ignores this wonderful chance to grab the imagination of that section of the idealist youth who, over the last century, were previously suborned by trendy lefties.”
James Murray – your first eroror is that this isn’t a post by David Boyle; its a post _about_ David Boyle’s book by someone else and (however worthy it is) amounts to little more than a press release.
You may or not like David Boyle, but if you read his blog (and doubtless his book, but I haven’t read it, so can’t make that claim), you will see that he does indeed spend a lot of time connecitng his thoughts to the great tradition of Liberal thought.
Stop straw-manning.
I am not convinced that whoever it is you think is the one true philosophical touchstone of Liberalism (I think you’re going to say John Stuart Mill but I could be wrong) is going to lead to a LibDem youthquake if we focuse o ourselves on disseminating their ideas. Politics is relational and communal as well as conceptual – or are we not Democrats?
You are of course right to say that there is relevance in the plurality of thinkers who have inspired Liberal and LibDems, but the party exist to be more than a philosophical-ideological catechising machine. No party is capable of unified ideologial purity. People are too messy for that.
Matthew Huntbach 9th Mar ’15 – 9:16am
Matthew, you sum it up perfectly. “…Why should I have forever to be playing the market, switching from one provider to another, having to do the research and going through administrative procedures to do that? I have more enjoyable things I could be doing with my time.”
All of this stuff is a diversion. Ed Davey appears in the media frequently telling us that we could save £100 by switching from one of the rip-off energy povider to another. He could have saved us all a great deal more every year by making those energy providers clean up their own radioactive mess.
Why do people who got elected as Liberal Democrats spend their time and political capital imposing Conservative policies under a pretence that this is a Coalition Government?
Matthew Huntbach
“I want the job of ensuring the service is a good one to be done by someone else”
I think what you are doing is confusing good with satisfactory. If you go to a hospital you don’t want it to kill you with an unrelated condition to the one you went there with. Good is a matter of the one that most suits your preferences. If you are indifferent to the service you receive you should be able to turn up anywhere and be treated to a minimum standard.
“someone I can trust will make sure it is what I want”
I would ask who is it that you can trust to know your exact preferences, other than the extreme basics (not likely to kill you if you go to see the Dr about an enflamed knee)? So if you are arguing for a minimum standard that is not an argument against choice.
“I’m a busy person, I don’t want to have to spend my life exercising “empowerment” over whole loads of things. Mostly I just want to turn up to the place where the service is provided, get the service, go away.”
This is the most common argument against “choice” but I do wonder if it is true. Everyone I know who has been diagnosed with Cancer has taken time to take advice (when it wasn’t emergency surgery time) and do some research. This covers both the location and also the choice of treatment. I imagine this is not the situation you have in mind?
Also when choosing a school, most parent actually put effort in, this predates “choice” being the big political buzz word. A parent may want a school where children are taught in a safe environment but they may have a preference between a huge school over seen by a “superstar” executive head and a much smaller school that doesn’t offer the same range of subjects 14-16 and 16-18 but has a more personal feel.
For the small “transactional” interactions with public services which are repeated over and over you quickly get to decide if the nearest one is not what you want and go to the next closest.
For the big decisions like which of an array of complicated medical approaches (and where to receive them) to take to a life threatening condition most people done say “I’m a busy person, I don’t want to have to spend my life exercising ‘empowerment’” everyone I know put in time and effort on the big calls.
On the choices like power supplier (or your bank current account provider) there are steps being made to make switching easier so when you decide you do want to look at how good your deal is you can do so and change easily but if you want to stick they you are free to do so. The fact you have a choice is not an argument that you have to exercise it. If you don’t want to change you don’t have to.
People preferences are revealed by their actions most people care about what treatment they receive for a life threatening illness or where they send their children to school, they care less about who they get energy from or who they bank with. Restricting your own choice is fairly easy.
Psi 9th Mar ’15 – 1:08pm
All this stuff about choice and preference is a diversion. The free market does not work in medicine and so those devoted to free market Voodoo cover their tracks by going about the illusions of “choice” and “preference”.
It is expensive and dangerous Eyewash.
Excellent medical treatment (as provided in the UK by the NHS) is NOT a matter of preference, it is a matter of medical science.
Unless of course you are like the lunatic Conservative MP who thinks Astrology is a valid form of medical treatment.
Or unless you agree with Prince Charles that Homeopathy is something more than Snake Oil.
Excellent medical treatment and care provided by The NHS out of general taxation has served the people of this country fantastically well for more than 60 years.
The only people who say otherwise are ideologues or people who have been fooled by the enormously powerful Lobby which is hell-bent on breaking up The NHS so that Privateers can get their hands on the resources for their own private profits.
We were fed all this nonsense when the pubically owned Water Utilities were flogged off to the highest bidders.
Since then the monopolies for privatised Water Companies have boosted private profits at the expense of the general public in the form of higher prices.
The only choice I have is between the private water company which has a monopoly, buying Perrier by the bottle or harvesting rainwater from my roof. The latter two were of course available before.
Privatisation has not resulted in better water, or choice of water or anything at all which is to the benefit of the people who pay.
JohnTilley
Does any one claim there is a competative water market?
Do you think that there is currently no choice in the NHS?
Quality of treatment and how it is delivered are not the same thing. It is less obvious to those living in London and the south east but the more remote people live and the more restricted they are (transport, support networks etc) the more obvious that becomes.
Psi
You seem to be unaware of Coalition Government policy on competition in the water market.
You might want to check this out – the Government not only believes that there is a competitive water market they passed The Water Act 2014 in a stated attempt to “improve” competition.
Here is the link —
” Government Policy — Reforming the water industry to increase competition and protect the environment ”
https://www.gov.uk/government/policies/reforming-the-water-industry-to-increase-competition-and-protect-the-environment
Psi
This is what the ludicrously named “Ofwat” says on the subject —
“. Ofwat > Markets
Effective competition has the potential to bring benefits in a range of water and sewerage services.
It is a key driver of efficiency and innovation, which will enable the water and sewerage sectors meet future challenges.
It can help deliver the Governments strategy, as set out in, ‘Future water’, for sustainable and secure water supplies and improving the water environment.
It has brought benefits in other utility sectors, including improved service and more choice for customers.
Regulation can be gradually withdrawn as markets become more competitive.
While most customers currently receive water and sewerage services from monopoly companies, there are increasing opportunities for companies to compete for customers in these sectors.”
The temptation to insert a letter “t” after the “f” in Ofwat is almost too tempting.
Wow that OfWat quote sounds like a quote from another decade (the 1990’s to be exact).
“Regulation can be gradually withdrawn as markets become more competitive”
This applies in certain markets but not others (I can’t see how it applies in the water market as currently constituted), I haven’t got time to look in to it now but that sounds like they haven’t moved with the times.
Giving people choice is fundamentally Liberal, but the choice must be meaningful and people must be able to use it equally. If you’re offered a choice of Doctors Smith, Jones and Brown for your consultation this is likely to leave you underwhelmed because you can’t assess who might be the best. A choice of hospitals, though, will be meaningful for most people: for me when I had this choice it meant I could walk up from work rather than taking a lot of time off work to go to the hospital near where I lived. But unless public agencies are prepared to fund information and advocacy for vulnerable people making choices about how money is spent on their home care, for example, the choice will exacerbate inequalities because the best-informed people, who will generally not be the poorest, will get the best out of it.
Matthew: Sometimes choice, like freedom, can indeed be a burden, though much more often it is a blessing. To take a rather trivial and light-hearted example – since just now I am addressing the point about the psychology of choice not its applicability to public services – when I see the length of the menus at some restaurants, I sometimes wish to have less choice. Sometimes I like to go to my local steak house where literally the only choice is between different cuts and portions of steak! Vegetarians would not share that opinion, however; and all in all I would not trade the cornucopia of culinary options in today’s Britain any day for the monochrome yet undemanding British culinary scene of (say) the 1970s.
Now I know what you are going to say, since it is the standard retort at this point, which is that choice is appropriate for what we think of as consumer goods but not for public services. Up to the 1980s it was assumed that things like telephones were not appropriate candidates for choice or competition, and the result of monopoly provision and primitive tchnology (which were not unrelated, of course) was often a long wait to be connectd to the phone system.
There are problems like (in economic jargon) the ‘asymmetry of information’ which makes health a more complex area in which to extend choice, but there are sensible and practical ways of doing so which do not deny the need for expert medical guidance, but which enable patients to have substantial input and control over how, where and when they are treated for non-emergency conditions and elective surgery.
The claim that choice is not appropriate in areas like health and education but it is in choosing what make of TV we want strikes me as a strange ordering of priorities. The implication seems to be that people can be trusted with choice when nothing important is at stake, for the trivialities of life, but when it comes to the truly important things it is safer to keep them out of the picture and they should accept what they are given. I remember Vince Cable arguing that this attitude by councils in relation to public housing was one of the things that made him leave the Labour party in the 1970s.
Of course, the fact is that choice is and has always been exercised in these areas by those who are able to afford to go private, whether in housing, health or education. I don’t see why a supposedly progressive party should be comfortable with this, yet determined to deny the same choice to those who do not have the means to pay for it. It reminds me of the Yes, Prime Minister sketch in which Sit Humphrey is trying to shoot down a proposal by Hacker’s political adviser to allow greater parental choice in the state system:
“It’s preposterous. You can’t expect parents to make these choices. How on earth would parents know which schools are best?”
“”Which school did you go to, Humphrey?”
“Winchester.”
“Was it good?”
“Oh, excellent, of course.
“Who chose it?”
“My parents, naturally… Now, that’s different, Prime Minister. My parents were discerning people. You can’t expect ordinary people to know where to send their children.”
“…Parents are not qualified to make these choices. Teachers are the professionals. In fact, parents are the worst people to bring up children, they have no qualifications for it.”
And later: “The only people who will like this idea are the parents and the children. Everyone who counts will be against it. Teachers’ unions. Local authorities. Educational press. And, of course, the Department.”
Psi gives some excellent examples of where people are, in fact, keen to exercise choice in public services. The idea that parents, for example, aren’t interested in exercising choice where it is available and practical is completely contradicted by experience. In fact they go to great lengths to do so, including to the extent of moving house or discovering new-found religious convictions. I gave the example of personal health budgets for those with chronic health conditions, which enable people to tailor their own care.
Whether and in what circumstances the appetite for choice can be accommodated by the public sector is a separate question. Clearly, in remote rural areas for example, choice of school has less relevance than in inner-city London. But the fact that it has limitations (I’m not arguing that it is a panacea) is a very weak argument for opposing it where it is both desirable and practical.
And just to be clear, John, in health provision there exists a multitude of options between a state monopoly service entirely funded by taxation and delivered by public sector agencies with zero private sector involvement and no patient choice – at one extreme – and the mythical “free market in medicine” of which you talk, and which exists in no developed country in the world that I am aware of. A disinclination towards the former does not mean advocacy of the latter. In reality there is currently, and will continue to be, a mixed economy in healthcare, which includes a large element of public financing, public provision but also elements of co-payment (as with prescriptions) and private sector involvement. Once we accept that, the discussion can focus on how the service might be improved, be made more responsive to the patients it is supposed to serve, and be properly and sustainably funded to meet rising demand and expectations.
As it happens I don’t support the particular model put forward by David Laws in the Orange Book. I think he asked many of the right questions, but his proposed solution was flawed and created some additional problems. However, the caricature of his scheme – and indeed almost any reform proposals – as a ‘US-style private insurance system’ was misleading hand-waving by those who are so insular and narrow-minded as to believe that we in Britain have all the answers. The NHS is “the envy of the world”, we are told: yet, strangely, other countries are not so envious that they have been moved to imitate it. The reality is that healthcare is a complex issue and its financing and delivery poses problems for every country. The tendency in British political debate to treat the NHS as a quasi-religious issue rather than a practical, technological and financial challenge is not the best way of ensuring its long-term viability.
I would point you to some sensible words on this subject by Vince Cable Mark I (as I call him) in the Orange Book. He noted with some evident frustration: “The one area where plurality of provision is being most strenuously resisted is in the NHS, where the vast majority of hospitals remain part of a centralised system of state-managed institutions. The government’s foundation hospitals were an attempt to break away from this model but are still far too tightly controlled to have meaningful independence. Liberal Democrats have championed mutuality in this sector, but it would need to be recognised that the most successful mutuals (from BUPA to the Nationwide Building Society to Linux computer systems) are disciplined commercial operations with a strong customer service ethos backed by tight financial control and strong management; mutuality is not a soft option.”
Psi
I would ask who is it that you can trust to know your exact preferences, other than the extreme basics (not likely to kill you if you go to see the Dr about an enflamed knee)? So if you are arguing for a minimum standard that is not an argument against choice.
How do I know what’s best for me? I’m not a health expert, that’s why I would want the decision to be made on my behalf by someone who is. I know, however, that I DON’T want the decision to be made by someone who has a financial interest in one outcome or another. If I was paying for health care, there’s two ways it can be delivered, and problems both ways. If I’m paying on an “as delivered” basis, how can I trust advice that I need a certain procedure if it’s given by someone who gets money for doing that procedure? If I’m paying on an insurance basis, then how can I trust advice that I don’t need a procedure if it comes from someone who saves money when it’s not provided?
“I’m a busy person, I don’t want to have to spend my life exercising “empowerment” over whole loads of things. Mostly I just want to turn up to the place where the service is provided, get the service, go away.”
This is the most common argument against “choice” but I do wonder if it is true. Everyone I know who has been diagnosed with Cancer has taken time to take advice (when it wasn’t emergency surgery time) and do some research. This covers both the location and also the choice of treatment. I imagine this is not the situation you have in mind?
It most certainly is, because people with cancer are very vulnerable to “snake oil” salesmen who convince them that there’s some sort of magic solution they can pay for, and use the usual anti-elitist lines to make them think the real experts who are telling them the snake oil is expensive nonsense are hiding something.
Not just cancer, but I know of several cases where vulnerable people have been conned into parting with huge amounts of money for very dubious services.
Also when choosing a school, most parent actually put effort in, this predates “choice” being the big political buzz word
Yes, but it always seems to end up as the “choice” being the higher up the league tables the better, which has the feedback effect the higher you are up the league tables, the more you get children from the keener or more able or more influential parents, so the better you do, regardless of REAL quality.
Now, I know a fair amount about the related issue of university choice because I have been involved with admissions to my own university department for many years. This has done a lot to make me sceptical about the “choice” argument. In doing this role, I have been surprised, actually shocked, at how LITTLE applicants know about what they are applying for, and how therefore the choice they make is based on utterly trivial things, but mostly on “University X is higher up the league table than University Y, so University X is better”. It rarely even goes beyond this as far as looking at the ratings of individual departments rather than the universities as a whole. The consequence is that the pressure from management is on whatever artificial things will push us up the league tables rather than on what we from our own expertise know would be real quality.
I’m not saying in all of this that I’m opposed to choice, but I am sceptical about claims that it’s the be-all-and-end-all to freedom, and even more sceptical about claims that the more there is of it, the more it will “drive up quality”.
In a similar way, when I was young and naive, I used to believe that everything could be run by co-operatives, a sort of massive decentralisation, everyone turning up to meetings to vote for what they wanted, and this would be “empowerment”. In those days, we used to think “radical liberalism” meant that sort of thing, as opposed to the centralisation of socialism.
Now I am older and wiser, of course I can see that most people have better things to do with their time than attend endless meetings. Gosh, even when I WAS involved in that sort of meeting, when I was a councillor, it was hard to drag up enthusiasm to go to all of them, and the endless paperwork you had to get through in order to be able to make sense of what was happening …
This doesn’t mean that I’ve turned against democracy, or against decentralisation, just that I have a better sense of balance in these things, and more of a feel for how real people work, and just more life experience, which leads me to be cautious about idealistic solutions.
Matthew: Your disillusionment about the practicality of running everything through workers’ cooperatives brings to mind Oscar Wilde’s phrase that “the trouble with socialism is that it would take up too many evenings”…
The irony of your complaint about the implications of choice is that is a planned central bureaucracy – where the investment and all the inputs have to be marshalled by some central agency based on huge amounts of information collated months or years before, and where scarce resources are allocated through rationing with price signals and competition abolished – that the capacity of those responsible for running the system to respond is really overloaded.
That’s why we have these decentralised systems called markets to process the information and allocate the resources in a more timely manner, guided by people’s preferences rather than a bureaucrat’s whim.
I’m not arguing – heaven forbid – for the price mechanism to be extended wholesale across the NHS. I’m simply pointing out that the challenge of allocating resources is greater, not smaller, when there are no market forces to guide the process and Gosplan-type targets are substituted. It’s just that this task is handed to a central agency (and its local satellites, eg NHS trusts) rather than being done by thousands of businesses as in conventional markets.
And just because we have choice about (say) which watch to buy, doesn’t mean we need all need to be amateur watchmakers. We do our research, yes, but we rely on things like buying from a manufacturer we trust, from a shop that has a good reputation, advice from someone who is more expert anout watches than us, etc. Then we make a decision.
Now I am fully aware that there are important differences between health and education on the one hand and things like watches on the other, which makes the exercise of choice more subtle and in some respects more challenging. But that doesn’t make it impossible, as those who pay for private healthcare and education demonstrate quite clearly. It would seem to be feasible. Perhaps those who see the obstacles to choice in public services as insuperable are really saying that it is undesirable, not that it isn’t feasible or practical? That is a different argument, but one that smacks rather of the attitude exhibited by Sir Humphrey in the passage I quoted above.
And of course no one here is saying that choice is a panacea, in the NHS, education or elsewhere. Merely that we should see if there are ways it can be brought to bear on services which are really important to our lives as well as things like buying watches. As David Boyle suggests, liberals should have an instinctive preference for seeking to do so. If they don’t like the versions of choice being put forward in other parts of the political spectrum, then why not seek better ways rather than dismissing the whole enterprise?
“That’s why we have these decentralised systems called markets to process the information and allocate the resources in a more timely manner, guided by people’s preferences rather than a bureaucrat’s whim.”
This is only true of the idealised, non-existent market that is found only in economics textbooks. The late Lady Thatcher was infamous for saying that society did not exist. One may argue that, but if one follows her logic, one must agree that there is no such thing as the market either. Rather, there are various entities, some very powerful, others less powerful, who act to set prices and allocate resources without the slightest regard for “people’s preferences.” Items that are popular and sell well are withdrawn from the market all the time. Unpopular items are relentlessly pushed upon people with every trick marketing can devise. Successful companies are brought down and bought out by market tricks, and their products replaced by something inferior or by nothing at all. Money-losing strategies are employed whose purpose is politics, not profit. Both the rational consumer and the rational producer, in the economic sense, are figments of the imagination. Markets do not “process information” but obliterate it. They do not “allocate resources” but mandate certain patterns of consumption. The companies that make up the market are quite as capable of tyranny as any bureaucrat. Why worship at the altar of this chimæra?
Alex Sabine 10th Mar ’15 – 8:13pm
Alex
In reply to Matthew you say –.
“…That’s why we have these decentralised systems called markets to process the information and allocate the resources in a more timely manner, guided by people’s preferences rather than a bureaucrat’s whim.”
That does not seem to describe the operation of IKEA or Primark or EDF or Tesco or Ford to me.
Whatever kind of markets they operate in they are certainly not “decentralised”.
There are bureaucrats in capitalism just as there are in socialism and they have just as many whims.
Did you notice how Tesco have decided not to bother even to open some of the mega supermarket buildings they have been plonking all over the country, often in the teeth of opposition from local people? How were they responding to people’s preferences? It looks more like something from a Soviet five year plan.
Am I being harsh in suggesting that your view of “markets” is so dreamy and idealised that you make a utopian socialist seem like a down to earth realist?
HSBC — decentralised local market responding to customers’ needs ? Well maybe the needs of those customers in their Swiss Branch but not the hundreds of thousands of customers from Hereford and Shropshire to Hong Kong and Shanghai.
The people lobbying hardest to privatise The NHS are mega international healthcare giants mostly from the USA. You may think that their board of directors in Chicago or Nevada will respond to the needs of customers. It would not be a view shared by many US patients or would be patients who simply cannot afford treatment in the over- bureaucratised private health system in many of the States in America. The cost of bureaucracy in the private American hospital system is legendary. They look at our cheaper, better, more advanced NHS with envy.
I am a fan of much of what David Boyle writes. Not this time.
A cynic might say that “he who pays the writer calls the tune” and David has been commissioned to write this article by the market-loving Centre Forum .
See my exchange with Psi earlier in this thread about the “market in water” for an example of the imracical unwordy nonsense that an organisation like Ofwat pubishes on their website.
John Tilley
That does not seem to describe the operation of IKEA or Primark or EDF or Tesco or Ford to me.
Whatever kind of markets they operate in they are certainly not “decentralised”.
There are bureaucrats in capitalism just as there are in socialism and they have just as many whims.
Indeed. If what Alex said bore some sort of resemblance to the truth, wouldn’t big companies all operate with market forces internally? If Alex wanted to discuss this in a way that suggests he was looking at it neutrally and rationally, why does he use wording like “guided by people’s preferences rather than a bureaucrat’s whim” which takes the most optimistic stance towards one way of doing things and the most pessimistic towards the others? That is as biased language as we might have in the other direction coming from old USSR-style socialists defending their ideal in the face of its evident failure in reality.
All I am suggesting is that one needs to look on these things with the ability to see both sides of the arguments, the strengths and weaknesses. It seems to me we’ve had this “markets are the answer to everything” line pushed very energetically for decades now, so isn’t it perhaps time to look at it a bit more sceptically and ask do they really provide the freedom that is claimed for them? In just the same way that in the 1940s and 1950s it was very much the right thing to do to question whether state control was really giving what it claimed to give and was really the inevitable way forward for everything. Hayek’s The Road to Serfdom published at that time was a much needed counter to lazy assumptions of the time, a bit polemical maybe, but it was needed to put the other side. But now that side’s become dominant and lazy, we need the equivalent of Hayek in the other direction to question its assumptions.
Alex Sabine
these decentralised systems
Decentralised? When it’s all in the hands of a tiny number of people in the City of London (or Monaco or whatever tax have they live in) who operate a dense network so that they all sit on each others boards and so on? No, it’s long become an aristocracy. The benefits of scale mean the smaller local operators long ago got pushed out.
Matthew: Do you imagine that the majority of goods and services in the global economy are provided on the basis that you describe? In any event, where there is collusive behaviour that is an argument to sharpen competition not soften it. I have some sympathy for the argument that there are serious problems with the way pay packages have been structured, and pay levels set, in industries like banking – but the problems are those of rent-seeking not of competition.
David-1 and JohnTilley: My last comment was really intended as a counterpoint to the idea that choice and markets take too much time, and that planning and bureaucratic decision-making are so much easier and tidier because we are not burdened with choice. Hence my reference to the Oscar Wilde quip about socialism. That’s all. It wasn’t an argument for open heart surgery on the living body of the NHS!
You seem to think the authors of economics textbooks are either utopians or else paid stooges of evil multinational corporations bent on world domination. The reality is more prosaic. They are typically earnest academics, like those in partly publicly funded research institutes like the IFS, and they describe simplified versions of the real economy in order to aid understanding and clarify the concepts.
The model of perfect competition is just that, a model. No one imagines that in the real world markets are ‘perfectly’ competitive, such that no firm is a price-maker and they are all price-takers. Fortunately it is not necessary that they should be perfectly competitive for them to be preferable to monopolies. Likewise the concept of the circular flow of income (one person’s expenditure determines someone else’s income) – which is the theoretical basis for Keynesian fiscal policy for example – is only a model. It is subject to much empirical qualification and challenge, but it is a useful working assumption.
Often these critiques of how big companies supposedly work in today’s economy make no distinction between corporate power and the market mechanism, which are very different things and in some ways opposites: it is stronger competition, not the absence of competition and markets, that offers the best prospect of taming corporate power and harnessing it to the public good.
Being in favour of some definition of capitalism (which many on the left are nowadays not ashamed to say they are) but distrustful of competition and markets gets things completely the wrong way round. It is when the state co-opts corporate interests through statist industrial policies, subsidies and tax breaks – and shielding them from competition – that the consumer and taxpayer should be wary.
Returning to the issue of public services and healthcare in particular, I have never advocated the American model or anything like it. But whatever else it is, and it has many defects as well as some positive features, the American model is not the free-market that left-wingers and others in Britain like to imagine. Believe it or not, there are other healthcare systems in the world other than the American system and our system, and there is much to learn from some of them, including the social insurance systems on the Continent. It’s odd that the EU enthusiasts in the Lib Dem ranks are so keen on French and Scandinavian tax levels but so resistant to their pluralistic provision of public services.
While plenty of Americans are all too aware of the shortcomings of their system, I am not convinced (and I have lived in various parts of America for extended periods) that they “envy” our NHS. It is one of the stories we in Britain like to tell ourselves, that the NHS is “the envy of the world” – yet in that case it does seem surprising that these envious foreign countries never get round to copying it…
As for John’s cynicism about David Boyle’s motives for writing his essay, I very much doubt that either David, or Centre Forum, would be as respected as they are if they did not have high standards of scholarship and independent-mindedness. To draw a parallel, I am a member (though not a staff member) of the IFS, which means I contribute an annual membership fee. Part of the reason I do so is that I think thy have high standards of impartiality and research. If I were to offer them a large donation and in return they said I would be allowed a veto over what they publish, I would reject the offer. In reality they wouldn’t make it in the first place, because they trade on their reputation. Not all think-tanks are as fastidious, or as well-respected as a result: and there is a place for the more polemical and less research-heavy outfits, even if their findings have to be treated with greater caution. But as it happens Centre Forum, like the IPPR (who I am not in ideological sympathy with) and a handful of others, is one of the more rigorous think-tanks and produces well-substantiated arguments. David himself has of course done the same in plenty of other forums, including his very interesting book Broke: Who Killd the Middle Classes?.
‘Killed’, even (mis-spelling)
Matthew: I agree with you about the ned to recognise the limitations, as well as the advantages, of markets and ‘choice’. If you look you will find that I have often stressed that there are no panaceas in economics or politics; there is no single philosopher’s stone which we can rely on; and miracles are for the gods.
But in my years conversing with Lib Dems on this site I have rarely found they have had any difficulty acknowledging the limitations; it is the advantages they have been reluctant to recognise. Often there has been outright hostility to the idea that either choice or competition could have a role to play in public services, which to me strikes a discordant note in a liberal party.
And while they are forever finding market failures and broken markets and imperfect competition and market fundamentalism, they are so busy slaying these dragons that they don’t pause to consider the defects of the political market place, and the corporate state that it nurtures. If your premise is that we are currently living in a laissez-faire free-market society with a ‘nightwatchman state’, then it is not surprising that you will be led astray in seeking remedies for the problems that do actually exist.
I’m glad you feel that Hayek’s Road to Serfdom served a transient purpose, although I’m not sure its lessons were much heeded. The idea that rent-seeking banks and ‘too big to fail’ are his legacy is a travesty. In fact I think arguably Hayek’s most valuable and distinctive contribution was not so much his warning about the incompatibility of centrally planned economies and personal liberty – valid and important though that was – or the slippery slope from state intervention to collectivist socialism, but his exposition of the advantages of the market as an information-signalling process, and his explanation of why it would not be possible for socialist enterprises simply to copy private enterprise principles, while remitting their profits to the state.
His writings made the case for general rules rather than the discretionary authority of the executive. They exposed the misleading identification of liberal democracy with the divine right of temporary majorities to impose their will (what Lord Hailsham later famously dubbed ‘elective dictatorship’). They demonstrated the connection between economic and personal freedoms. They showed that the domination of both the economic and political market place by interest group struggles is a baleful influence leading to the concentration rather than dispersal of power. And they explained why pecuniary rewards neither can, nor should, reflect merit. Overall, I concur with Sam Brittan’s judgement that “Hayek, like Keynes or Friedman or the American philosopher John Rawls or other such seminal figures, is best treated as an intellectual iconoclast rather than a pundit with all the answers.
In the spirit of reciprocity, I also have plenty of time for Keynes, although less for his latter-day followers. Indeed I often draw attention to his insights and I was quoting just the other day from the 1944 Employment Policy White Paper which was based on his ideas, to make the point that Keynesianism properly understood does not provide a pretext for routine deficit financing (whether for current or capital spending). Such justifications, if they are to be found, must be sought elsewhere.
You might be interested to know that Keynes sent Hayek a letter following the publication of The Road to Serfdom in which he said that “morally and philosophically” he was “in deeply moved agreement” with the thrust of that book. That is not to say he went all the way with Hayek, but it shows that he found much to commend in it, which is not an attitude I have detected very often on today’s left.
Perhaps indicative of the underlying disagreement between Keynes and Hayek was Keynes’s observation (and this had particular relevance to the British context, with its rule of law, parliamentary tradition, independent institutions and strong civil society) that: “Dangerous acts can be done safely in a community which thinks and feels rightly, which would be the way to hell if they were executed by those who think wrongly”.
Alex Sabine
I was not owning up to being a cynic myself. 🙂
What I said was —
“…A cynic might say that “he who pays the writer calls the tune” and David has been commissioned to write this article by the market-loving Centre Forum .
See my exchange with Psi earlier in this thread about the “market in water” for an example of the imracical unwordy nonsense that an organisation like Ofwat pubishes on their website.”
It was a reference back to an earlier part of this thread. I was not impuning David Boyle’s motives, I was just having a dig at the concept of “empowerment” flowing from “he who pays the piper “.
As for the authors of text books on economics — I have not picked up a text book on economics since 1970 when I collected my A-level certificate in the subject. I think I am a better human being as a result. 🙂
John Tilley: Fair enough, you are acquitted of cynicism 😉
I’m not terribly keen on the word ’empowerment’ myself, mainly for semantic reasons*. It was a Cleggism (though it, and other buzzwords like ‘social mobility’, ‘stakeholding’ and ‘the enabling state’ are in vogue more generally across the political spectrum). Some of these ideas have value but the ugly or anodyne words do them a disservice. All of them require more precise definition, but are selected (it often seems to me) in order to escape it.
Empowerment sounds like a euphemism for more politically controversial words like choice and competition, which Nick Clegg perhaps regarded as too combustible for Lib Dem audiences. But the argument he was making back then (in his early ‘Orange’ phase, pre-coalition Rose Garden and coalition differentiation) was that it was necessary but not sufficient for public services to be accountable to their users through the ballot box; this needed to be supplemented with more direct forms of engagement than the opportunity to cast a ballot on a whole menu of policies at four- or five-yearly intervals.
The objective was a good one, though stating an objective and formulating practical policies are rather different things. One problem in doing so is that those who are hostile to the objective will not seek ways of achieving it. They might seek refuge in any practical difficulties they can discover when their fundamental grievance is with the concept itself.
The converse is also true. To illustrate this point, David Boyle’s concept of choice is in some respects different from mine, but I am open to it and see a fair amount of common ground. I wouldn’t like to see a worthwhile enterprise given a bad name by exaggerating the differences of execution and emphasis. He is also surely right to think strategically about what we might want public services to look like, to begin by seeking some ‘design principles’ for reform rather than a laundry list of policies. In reality there is a mixture of collaboration and competition in all systems – including public services – and the task is to get the balance right between these elements so that, for example in the schools system, collaboration/coordination exists where necessary but there is as much autonomy as possible for individual schools within a pluralistic system of providers (maintained schools, academies, free schools, voluntary aided schools etc).
And while neither my ideas nor David’s are a comprehensive blueprint for public service reform, more of a rough sketch, it is a pity that much of the criticism here has focused on denigrating or downgrading the very concept of choice in this arena rather than seeking better ways to give effect to it.
* Talking of semantics, your words ‘reference back’ remind me of the special lexicon of party conference debates. Reference backs, amendments, composite resolutions… As L. P. Hartley wrote of the past, they are “a foreign country: they do things differently there” 😉
Alex, Thank you. Good to start my day with an acquittal. 🙂
@ Alex – “Empowerment sounds like a euphemism for more politically controversial words like choice and competition”
I’d like to submit “fairness”, which sounds like a euphemism for more linguistically substantial words like equity and justice
Interesting Econimist piece on the impact of Obamacare on health provision and payment by results.
http://www.economist.com/news/business/21645741-wasteful-and-inefficient-industry-throes-great-disruption-shock-treatment?frsc=dg%7Cd
What I find odd about this thread is the assumption that those of us who had control or influence in local authorities were in effect municipal socialists who were not interested in reforming services based on citizen involvement.
Most of the innovation in public service provision had their origins in Liberal and then Liberal Democrat ‘experiments’.
Best remark above was from matt(Bristol), “people are messy” anD that is why work deriving from the thinking of Mary Douglas, around ‘clumsy solutions’ is potentially very important. It is good to see that after years of this being a minority ‘sport’ it has recently been taken up by Mathew Taylor at the RSA.
A clumsy solution would mingle market based, hierarchical and egalitarian approaches.
That is one reason why it is interesting to see how Obamacare is evolving.
Dare I suggest that Good Liberal Democrat governance would now be experimenting in working through clumsy solutions. Works on this are available and so too are some lectures by Taylor I think at the RSA site.
Bill Le Breton 12th Mar ’15 – 10:22am
“…What I find odd about this thread is the assumption that those of us who had control or influence in local authorities were in effect municipal socialists…”
Quite right, Bill, very odd indeed!
I am always amused when I am accused of being any kind of socialist or communist. I sometimes point people to Kingston Town Centre – a busy and successful shopping centre which is nothing if not an example of well-regulated capitalism. During a couple of decades when other shopping centres got boarded up and redeveloped having capitulated to the loathsome ‘out of town centre’ Kingston thrived.
This coincided with extended periods of Liberal Democrat majorities on Kingston Council and the building of a brand new Theatre — who would have thought it? a new municipal theatre and not a socialist in sight. 🙂
Jedi – Agreed.
Bill – Yours is the kind of positive and constructive contribution to a debate about public service reform that I felt was lacking earlier. I’m afraid I find Matthew Taylor incomprehensible sometimes (that other Third Way guru Anthony Giddens was the same) but I’m sure he has something to say.
I see the fact that “people are messy” – as indeed are many, if not most, social institutions that work – as an argument for, not against, choice, diversity and experimentation. It is also an argument for ‘piloting’ solutions rather than imposing uniform central blueprints and targets – and sometimes local councils can be the best vehicle for this.
I don’t regard those who work in local authorities as municipal socialists. At least not necessarily. My point was that the concept of accountability through local government delivery of services is too limited by itself. If those running the local services – or indeed national politicians – can devise ways of devolving power further downwards, so much the better. The mere process of devolving power from one tier of government to another is not likely to satisfy the appetite for more responsive and effective public services.
My other point was that statements like “people just want every school to be a good school” or “prople just want a good school in their local neighbourhood” are true, but so bland as to be close to useless for practical purposes. They entirely beg the question of how that is to be achieved (and indeed why there is a large variation in school performance even after you ‘control’ for the socio-economic profile of the pupil intake, parental circumstances etc).
David Laws rebuked the Lib Dems for this kind of lazy thinking when he told the party conference in 2007: “This is an excellent aspiration, but it is not a policy.”
Alluding to the fact that choice was in fact exercised by more affluent parents within the state system as well as outside it, Laws complained that “…only the poor have little or no choice; and if you were starting from scratch, it would hardly be possible to design a system which more effectively embeds inequality than this.
“But now, from the top comprehensive schools to the best new academies, schools are showing that you can break the link between social class and educational performance… The best schools in the toughest neighbourhoods are no longer accepting mediocrity as their fate, and nor should we.”
The department of education should be “cut back dramatically”, and some functions devolved to local government, but “in turn local authorities must embrace their new role as purchasers of education not merely providers. A blind eye can no longer be turned to failure or mediocrity, as it so often has been in the past in Labour’s rotten boroughs.”
He went on to implore the conference: “Let us be imaginative and liberal in the way we address educational failure. This party has never believed that the state has a monopoly of wisdom.
“Last year we voted the brilliant John Stuart Mill as our best ever liberal. Mill was a passionate advocate of free education, but he was also a passionate opponent of all monopolies, and in that great classic work ‘On Liberty’, he argued that improvement and progress in a free society could only be guaranteed by experimentation and diversity, not by central diktat.
“And I agree with Mill. If federations twinning with successful schools and other interventions can work – great. If universities, cooperatives, parents, independent schools, educational charities can help to turn around failing schools or establish better alternatives, they too deserve our support and encouragement.
“It is no longer good enough for schools with the best results to serve only the most affluent, and we must send out the message to the majority of our citizens, who do rely on public services, that the era of big government, top down, take-it-or-leave-it, monopoly supply is over.”
I accept the premise of Laws’s argument. The challenge (for both central and local government) is to put flesh on the bones and develop a policy agenda for public services that matches up to the rhetoric. I am not convinced that Lib Dems more widely share the vision, so it is not surprising they are quick to find fault in the architecture and the policies. That is their prerogative. But too often the critique appears to amount to a defence of either the status quo, or indeed a better yesterday of a pre-Thatcher and pre-Blair ‘secret garden’. As regards education, even Jim Callaghan (not a radical reformer by instinct) recognised that this approach had reached the end of the road with his Ruskin College speech in 1976.
Back in 2002, the always stimulating Jonathan Calder wrote an article in the Guardian in which he lamented the tendency of the Lib Dems, “while seeing themselves as radicals, to be remarkably conservative in their thinking… This conservatism has been evident in parliament, where for some years it has been difficult to tell Liberal Democrat education policy from that of the teachers’ unions. Nor has the traditional Liberal preference for local solutions been much in evidence: Liberal Democrats are as likely as anyone to complain of a ‘postcode lottery’ if provision varies from one area to another.”
The purpose of some of those who wrote the Orange Book seemed to be to change this state of affairs and challenge some of the comfortable party orthodoxies that had ossified into a mere defence of producer interests and the status quo. The positions taken by the anti-Orange brigade often look like a reactionary stand against this more than a positive agenda for reform.
Alex, I always enjoy your thoughtful and thorough pieces.
I was being sloppy (perhaps messy) using the municipal socialist jibe which was certainly not directed at you.
I happen to think that Mary Douglas was one of the most important thinkers of the C20th and her identification of four (or five) broad types of culture is a great insight. Her later work with Wildavsky (see for example Risk and Culture) and then the use made of Cultural Theory by Michael Thompson and the next generation (see Clumy Solutions for a Complex World) provide powerful insights into the creation of genuinely plural policies. To those of us who have ploughed a lone furrow, it is a great satisfaction to see someone with the profile and resources of Taylor take up the notion.
One has to understand the thought style of those we debate with and work with to design services. Douglas identified broadly, the hierarchist, the individualist, the egalitarian and the fatalist, Those advocating clumsy solutions believe that elements of the first three plus provisions for the fourth need to be part of any policy because of the plural nature of their styles of perception and their beliefs..
So, to me the *ultimate* choice is offered by providing ways in which all four ‘types’ can relate, support and exploit a policy. (This is not a Third Way).
Reading the above comments, the piece and David’s work, you can see these various ‘characters’ applying themselves to the ‘problem’ of choice. There are times and situations in which we may want someone up a hierarchy to make a decision for us. Next in the queue maybe someone who wants to make their own choice. When the third in the queue wants the same treatment as others as a matter of principle. Then there is the fourth who doesn’t believe anyone can help them and anyway always tosses a coin when they make any decision. They rather like lotteries.
Bill – I will have to learn more about Mary Douglas and the other thinkers you mention. I see exactly what you mean about different character types. Indeed I suspect that these are often contained within the same person: I certainly wrestle with those different impulses at different times and in different contexts myself. Politically, I have a strong prejudice in favour of allowing people to make choices and decisions for themselves; but psychologically I do not always welcome or take up the opportunity. My rejection of paternalism does not mean I have illusions about human nature, or that I equate a desire for autonomy with an atomistic view of society.
And let me return the compliment by saying that your contributions often prompt me to examine my own positions (however trenchantly I may express these sometimes!).
I see LDV has published a series of pieces on the central issue of public spending priorities and fiscal policy for the next parliament, which I have not got round to commenting on yet. I trust you will ensure that commentary on monetary policy is not neglected 😉 The ECB, in particular, could have benefited from your advice in the past few years…
As a quick follow-up to my first para, I suppose I might summarise it by saying that on occasions I am lazy enough to want others to exercise choice on my behalf and thereby (in many cases) improve the product or service that I receive without having to exert too much effort myself. I would just rather the choices were dispersed among millions of fellow citizens than a little group of fallible men (and they are still mostly men) in Whitehall or the town hall, or a cadre of managers. (I am sceptical of the cult of managerialism in both the private and public sectors, but that is another story.) One of the key reasons is not that mistakes won’t be made – they certainly will – but that they stand a better chance of being corrected or mitigated more quickly and more effectively.
I fully accept this is a personal prejudice, just as the more paternalist/hierarchical/technocratic attitude is. And it is a lodestar not a form of revealed truth. As some of my comments hopefully show, I am interested in the nitty-gritty of policy, and the empirical evidence about its results, as well as the lofty ideals.
Alex, “I suspect that these are often contained within the same person.”
Exactly so.
You are very kind.
B
Wow, I’m distracted by life for a but and the discussion moves on a lot.
Matthew
“How do I know what’s best for me? I’m not a health expert, that’s why I would want the decision to be made on my behalf by someone who is.”
This option is always open to you. You can just go to your GP and be referred to the normal person they refer you too, that person can just do what is required. At the end of day though I don’t think you will ever totally escape the choice issue as often for complicated medical questions there are a number of options such as how severe a treatment is a patient willing to undergo, so the length vs quality of life question when we are at the extreme end.
“I know, however, that I DON’T want the decision to be made by someone who has a financial interest in one outcome or another. If I was paying for health care, there’s two ways it can be delivered, and problems both ways. If I’m paying on an “as delivered” basis, how can I trust advice that I need a certain procedure if it’s given by someone who gets money for doing that procedure? If I’m paying on an insurance basis, then how can I trust advice that I don’t need a procedure if it comes from someone who saves money when it’s not provided?”
Interestingly you have missed one of the criticisms of the US system (much as I dislike that system being used as the “emotional” comparator in these discussions), which is one where insurance is used but there is a lot of “over testing” to avoid lawsuits/cover the costs of the infrastructure and it just feeds through in to the insurance costs. But that is another point and the US comparison is never helpful to these situations.
The point is choice can be delivered inside existing structure, or with additions, or with a totally different structure.
“It most certainly is, because people with cancer are very vulnerable to “snake oil” salesmen who convince them that there’s some sort of magic solution they can pay for, and use the usual anti-elitist lines to make them think the real experts who are telling them the snake oil is expensive nonsense are hiding something.”
I would just say that it is not my experience that people often get ripped off by doctors trying to filter them to nonsense treatments, but I will accept that people can be vulnerable to snake oil sales men when under pressure but I don’t often see this from the medical profession (I am very happy to criticise them in many ways where there are problems but deliberately bad advice is not one I have seen). I suspect that occours more around things like nonsense homeopathy stuff which is just a matter of not allowing it to be funded from health budgets (unlike currently). You can never totally eliminate the snake oil though.
“it always seems to end up as the “choice” being the higher up the league tables the better, which has the feedback effect the higher you are up the league tables, the more you get children from the keener or more able or more influential parents, so the better you do, regardless of REAL quality.”
I know the situation where people look for a linear scale to choose from. It is a factor of the over centralised control that we have not had small and large schools develop as most governments like the “bigger is better” approach so people often don’t have the choice of a genuinely different ethos in terms of size, all the talk of choice has involved governments talking fo schools “taking over” other schools or “expanding” wells some times sticking to a set smaller size offers a different choice. It is a shame that in a country that has been described as the “nation od small shopkeepers” we aren’t able to learn the lesion that bigger is not necessarily better.
As to the example of Universities I have seen young people apply to courses which are then totally unsuited to them on the basis of a perceived linear scale, however I would say it is probably worse for large institutions in large metropolitan areas as compared with the sports of people who apply to places like Bangor, Aberystwyth, St Andrews, Royal College of Music, The Courtauld, The institute of Education. Much of the driver of applications is often make on the basis that may things are basically the same when they are clearly not so remote locations or specialist institutions are likely to have people who are expecting something different.
As with the example of the very out of date OfWat line I quote above, most regulated industries have moved away from the old plan of:
1- Impose regulation
2- Create competition
3- Remove regulation
Most of the time we now have regulators in telecoms and utilities trying to prevent the industry from using competition against the consumers, such as large players having very complex offerings so consumers are too confused to change, or too much admin to make a change.
Choice is not a panacea that solves all problems but public service without choice is a very dangerous place. Also when it comes to convenience (GP service vs walk-in centres in ploy-clinics) the choice can be within an existing structure but can tell you about changing preferences in different parts of the country.
David-1
You are correct that there is no such thing as “the market” in the sam e way as there is no such thing as “society” in terms of there is not a corporate body that controls either, there are influences on each and all of us who engage in either have a diffuse responsibility of the impact of both.
Markets have participants in the form of buyers and sellers, they have infrastructure which includes everything from the legal framework to facilitating service providers.
“there are various entities, some very powerful, others less powerful, who act to set prices and allocate resources without the slightest regard for ‘people’s preferences.’”
A supplier who has no regards for the preferences of their customers are not going to survive, think Woolworths, Blockbuster, currently the difficulty of the large supermarkets, etc..
“Items that are popular and sell well are withdrawn from the market all the time.”
Lets take examples from the motor trade, the Land Rover Defender is being pulled from production ant the end of the year, it is still popular and profitable, but it doesn’t meet the newer legal standards, that is the market infrastructure has changed to remove it from viability (for legal compliance reasons) that is not a failure, presumably we chose to implement the standards for a reason it is not a fault of the interaction of buyers and sellers but a decision by the people representatives to remove it. Or another car point, Lotus ended production (over the years) of the Lotus 7 and the Lotus Ellan. The Market response to the removal of popular and profitable and popular models being dropped by Lotus was Caterham 7 and the Mazda MX5, the market responded and provided.
Of course there will always be occasions where bizarre outcomes occur, but when compared with the “no market” approach of the soviet union I know which I prefer.
Perhaps you need to revisit your argument as you start by claiming “there is no market” which is the extent above true but then claim they “do not ‘process information’ but obliterate it. They do not ‘allocate resources’ but mandate certain patterns of consumption” the reality is there are drivers in the market and we may not like the outcome sometimes but it is not an inherent feature of buyers and sellers freely exchanging in a framework.
JohnTilley
“That does not seem to describe the operation of IKEA or Primark or EDF or Tesco or Ford to me.
Whatever kind of markets they operate in they are certainly not ‘decentralised’.”
I think you are applying a different definition of “market.”
Primark are a seller in the clothing market competing with all the various high street retailers, supermarkets and also the small independent local clothing shops, and even market stalls. That looks very “decentralised” to me. They don’t all get together and decide the allocation of clothing to be sold, they all take independent decisions about how much stock to buy and then try and sell it to consumers. Tesco similarly compete with the other supermarkets, the mid size stores (Aldi & Lidl), local shops, market stalls etc. Ikea compete with other furniture stores and people selling second hand furniture on ebay and Gumtree.
It would be very hard to have a centralised co-ordination of any of these markets.
EDF is a slightly different matter as Utilities are more concentrated and it would be possible for collusion. Some parts of Utilities (like Water as discussed above) are not competitive at all so it is fair to say it is barely a market. This is the reason for regulation of those industries.
The difference is between a market which is the sum of the buyers and sellers within a series of frameworks and the firms that act within the market. The firms are controlled (hopefully) to pursue a particular strategy e.g. to sell a very wide variety of products (Tesco) and hope it out performs it’s competition who are trying to sell cheaper more limited range (Aldi).
A market mechanism is intended to allow the actors within it to pursue their different strategies, the structures of the actors must be very different, focused on pursuing its strategy in the hope that it fulfils the requirements of the others. As Alex said the benefit of a market is the failure some suppliers, so if they find demand for their offering falling they know they have to change or close.
The Tesco example is one of market success, they were pursuing an expansion programme which was not what was wanted by customers, insufficient demand, and they lost money on these stores therefore stopped opening more.
In consumer products that is the price mechanism, in the health field it can be usage figures showing who is providing what is wanted, allowing those who are providing a service in a way that may be declining in popularity (e.g. one man band GPs) that they need to change what they are doing to survive.
Psi
I am still trying to digest your various comments.
But I am not sure about what you say about TESCO for example.
You see a Supermarket in competition with other retailers of food.
You seem to ignore the petrol sales by TESCO which are used as a loss leader and sourced and priced centrally.
You do not see , the special offers of TVs, radios and other electrical goods brought in at certain times of year and sold at less than cost, sourced and priced and advertised centrally.
You do not see the goods such as CDs ordered from TESCO over the nternet and posted to your door from a part of TESCO based in a tax haven in The Channel Islands. Sourced and priced centrally but more importantly without the nuisance of having to pay UK Tax.
I suppose “Every Little Helps” but this seems about as decentralised a structure as The Red Army.
JohnTilley
Sorry I wasn’t clear, My point was not that Tesco is decentralised they will be very centralised, I was saying that a market can be decentralised while the actors in it like those with large market share e.g. Tesco are very centralised. Tesco is not the market only one actor within it. Tesco’s actions are not coordinated in conjunction with its competitors actions, it will respond to actions of its competitors but the market is decentralised as there is no centralisation mechanism of the total market.
The comparator is an animal in an eco-system the market is the eco-system and the animal is a supplier/buyer. The ecosystem is not centralised and will fluctuate due to a number of factors the animal will not respond to in the same way, it will have an impact and be impacted upon by the eco system.
I agree Tesco also acts in other markets as well as food (as I mentioned the supermarkets compete with Primark) but food is a simple example to pick. In electronics they will compete with Curry’s, AO etc. but the same principle applies the firms made decisions in response to each other rather then in collusion (assuming everyone is acting legally).
@John Tilley : “You seem to ignore the petrol sales by TESCO which are used as a loss leader and sourced and priced centrally.
You do not see , the special offers of TVs, radios and other electrical goods brought in at certain times of year and sold at less than cost, sourced and priced and advertised centrally.”
This could explain ( if it was true which it isnt) a lot about Tesco’s recent dire results. But if they were foolish enough to see petrol and Tvs below cost why would that be a bad thing ?