Meikle's Blog

The framework within which policy-makers and decision makers have been operating over the past decades in Britain and most Western countries has been dominated by ‘managerialism’. This is a focus on the best way of managing and implementing policies in the socio-economic and political spheres which transcend, indeed almost dismiss, ideological considerations of left and right, in favour of optimum solutions to achieve policy goals: a “managed consensus”.

The most obvious results of managerialism have been a plethora of policy programmes and initiatives, usually time-limited and subject to rapid changes in all areas of public life in the UK. The city of Glasgow, Scotland’s largest city, is particularly instructive for what the outcomes have been.

This city has undergone a veritable economic renaissance in the last twenty years, including radically changing its image and profile, from an old ‘smokestack’ industrial city to that of a vibrant town specialising in financial services, retail and leisure. And the city has not stood still in terms of trying to combat poverty and deprivation. Since the 1980s a succession of programmes such as Urban Aid, Areas of Priority Treatment (APT), Social Inclusion Partnerships (SIPs) and more recently Community Planning Partnerships (CPP) and Community Health and Care Partnerships (CHCPs) have been tasked with tackling poverty, deprivation and health inequalities.

Hundreds of millions of pounds have been poured into areas of deprivation including urban regeneration programmes and high profile campaigns to change unhealthy lifestyles and getting people back into employment. Despite this, levels of poverty, deprivation, unemployment and adherence to an unhealthy lifestyle remain high and stubbornly resistant to change while levels of alcohol and drug misuse are very high (Glasgow has one of the highest injecting drug rates per capita of the population in the world and 15,000 people, or 2.5% of the population, are on methadone maintenance prescribing programmes.

A report from Dr Chick Collins of Glasgow University published in 2008 graphically illustrated this. As reported by BBC News, “He cited the Ferguslie Park area in Renfrewshire, which despite having had £150m of investment, still has Scotland’s worst record on health, employment, crime and education. More than 20 years ago, the Garden Festival in Glasgow was designed to revitalise Govan, but Dr Collins said unemployment was four times the Scottish average. And he pointed out that the GEAR (Glasgow Eastern Area Renewal) project, which spent £315m in the East End of Glasgow in the 1980s, had created a net total of 39 jobs”.

And Glasgow’s experience has probably not been untypical in terms of the UK’s approach to tackling poverty and deprivation. So why have so many programmes and initiatives delivered such meagre returns?

These projects have inevitably focused almost exclusively on managing individuals and lifestyles while simultaneously attempting to achieve grand aims such as eliminating homelessness or reducing health inequalities with little resources (trying to achieve macro solutions with micro means) and result in having either no or only marginal effects. In a sense then decision-makers and policy makers in health and social care services, which have mushroomed in the past decades and who have committed themselves to this managerialist framework, can only experience a sense of frustration that so much has been expended for so little return.

The result has been a recent tendency to explain the stubborn persistence of poverty and inequality in terms of some distinctly cultural factors (Glasgow, being a prime example of this and where the concentration and longevity of poverty and associated factors such as violence is being attributed to a mysterious “Glasgow factor”) when the reality is that grand, overarching policies indissolubly linked to fragmented short-term funded programmes focused on individuals are inevitably doomed to failure.

Recession and the electoral defeat of New Labour have helped to expose the threadbare limitations of managerialism (the last government were purveyors of managerialism par excellence), but we’re not quite out of its aura yet. The ‘Big Society” with all of its hype and contradictions (see past Meikle’s Blogs) has all the classic ingredients of macro solutions to be met with micro means.

The combination of managerialism and grand solutions which has dominated our politics and culture for nearly thirty years has exhausted itself (with its probable final swansong being the aforementioned ‘Big Society’). What we need to get back to is pragmatic policies based on common sense and yes messy compromises, that leads to real sustainable differences.

Prince William and Kate Middleton appear to be a personable, attractive young couple, and as with the news of anyone’s wedding, no reasonable person can wish them anything but health and happiness for the future.

The problem is, that unless you’re closeted on Mars or sequestered in some isolated Buddhist monastery in the Himalayas, every detail of this couples’ forthcoming nuptials (or at least the anodyne and heavily edited version of them that will be served up for public consumption this side of the Wedding) will be blasted at us in an orgy of publicity from almost every media outlet. Of course, to state the obvious, this is not an ordinary couple: one half is a future heir to the throne of the United Kingdom.

Because of this, what has started this past week and what we will now have to endure until the Wedding actually takes place will be an exercise in gushing sycophancy. The notion that we are a mature, healthy early 21^st century democracy which has transcended the class based, deferential, forelock tugging norms of such periods as the Victorian era, are instantly belied by the infantile, reverential tones that the British public will be subjected to in relation to William and Kate, aka the “Royal Couple”.

Otherwise sober, normally impartial broadcasters such as the BBC and broadsheet newspapers will adopt the same pose of honeyed phrases and breathless commentary on the most obscure minutiae in relation to the build-up to the “wedding”. All striving to project an idealised vision, to which the word “fairytale” can really only be the most appropriate description.

When it comes to coverage of Royalty, the British media loses it for long periods. Any scintilla of objectivity, far less the merest hint of sceptism is swept aside in favour of this fantasy, fairytale construction in the belief that this is want readers and viewers want served up to them. Probably, up to the wedding of Charles and Diana in 1981, the media were on to something. But now after thirty-odd years of martial breakdowns, infidelity and scandal after scandal, the glitter and aura of Royalty looks decidedly tarnished in the eyes of a substantial proportion of the British people. In spite of all the trappings and regalia, they are merely mortals subject to the same weaknesses and failings as the rest of us and most of us want them to be treated that way: neither worse nor better than anyone else, with some degree of fairness and balance.

And that, I regret to say, is the problem for the young couple. Sycophancy knows no balance or indeed objectivity. Like all celebrities, the coverage of Royalty veers from sickening adulation to derisive, merciless mockery and intrusion as, surprise, surprise our royal heroes are revealed to have feet of clay witness the relentless coverage of Diana (though to be fair, she was no innocent when it came to self-publicity). All that gushing praise currently being heaped upon Kate and William, can easily turn into its vicious opposite.

As for most of the rest of us I suspect it’s a case of selective use of the remote control and avoiding the worst excesses of the press coverage until it’s all over, while the real world of austerity and cutbacks has to be confronted.

Of course, this could all so easily be avoided or at least toned down, if only the media, particularly the broadcasters such as the BBC, when covering Royalty, started to talk to us as ADULTS!

The Coalition Government’s public spending cutbacks have provoked much outrage. A lot of that has been directed at the economic case for the cutbacks with observers arguing that reductions on this scale are unjustified and run counter to the imperative to stimulate an economy through deficit finance at a time of recession; on the contrary, these commentators insist, reducing public spending is likely to provoke a further “double-dip” recession.

State spending in Britain has increased dramatically over the past decade and it is salutary to remind oneself that the present level of spending cutbacks will actually only reduce public spending to what it was in 2005/06. Governments of all parties since the 1980s have presided over a precipitous decline in manufacturing industry, which has effectively de-industrialised whole areas of the UK rendering dependence on the public sector for jobs, services and economic wellbeing all the more critical. Indeed, in most large UK cities such as Birmingham and Glasgow the public sector accounts for a third of the economically active workforce.

But that third of the workforce doesn’t explain the whole story. Large numbers of firms, jobs and contracts in the private sector are dependent on the public sector as are leisure and retail outlets. And, while there has been a huge growth in the voluntary or ‘independent’ charitable sector with many hitherto statutory services privatised or outsourced to it particularly in the field of social care, the reality is that through a combination of regulation and funding, the voluntary sector is heavily dependent financially on the state sector. Consequently, public spending cutbacks can have serious impacts on the entire economy if entered into too hastily and abruptly. Proponents of alternatives to public spending, such as the Governments much vaunted Big Society concept, have thus far been unable to satisfactorily explain where the money for this and further privatisation or outsourcing of statutory services to the community is to come from?

The reasons for the growth in the public sector over the past few decades are varied. Apart from the huge sums spent since 2007 bailing out the banks, the numbers of older people requiring care and attention have soared, while spending on welfare benefits has risen remorselessly exemplified by the sustained increase in the housing benefit bill. But a crucial factor has also been the substantial increase in the levels of regulation, compliance and accompanying legislation to enforce and monitor it which has pervaded every aspect of life in the UK.

In their book The Gods that Failed*, authors Larry Elliot and Dan Atkinson quote the centre-right think tank Reform that “only 45 per cent of the growth in public sector employment would consist of ‘front-line jobs’” implying that the remainder would consist of either managerial or compliance/regulatory posts or in areas to do with interventions in lifestyles, attitudes and behaviour which have proliferated in recent years. Issues hitherto considered to be of concern only to the individual have now become ‘public’ issues that are the concerns of all and require ‘interventions’ in the individual’s life. There has been a massive expansion in positions such as outreach workers, development officers, healthy living strategists etc, posts virtually unheard of except over the last thirty years.

The real issue in dealing with public spending cuts, apart from the severe economic impact they can have on local communities and the economy at large, is achieving a balance between getting rid of, frankly, unnecessary quangos and the plethora of regulatory/compliance bodies that pepper our public life and the multitude of superfluous posts that go with them, while retaining and sustaining important front-line services which are essential to deal with health, alleviating distress, poverty, deprivation and meeting real social needs.

The reality is that the haste and extent of the present cutbacks will inevitably be indiscriminate and hit front-line services as much as if not more than, the bureaucratic empires that have been created over the past decades. Worse, as the cuts percolate down to local authorities, entire areas of public funding and provision will cease or be severely reduced, in spite of commitments to protect front-line services, which will be impossible to maintain, given the extent of council budget reductions.

A real opportunity has been missed here by the Coalition. One of the reasons why Labour was rejected by the electorate last May was undoubtedly widespread discontent with the extent of bureaucracy, regulation and the intrusion of the state into everyday lives. The new government could have taken the initiative and won widespread support by conducting a proper and balanced evaluation-come-audit of what was really necessary to combat waste in the public sector rather than the hell-for-leather rush to cut which is likely to cause suffering and damage to really necessary public and social services. That would have taken time. Instead, to use the old adage, the Coalition has cutback in haste and will repent at the consequences of their actions at leisure.

 *Larry Elliot and Dan Atkinson: Fantasy Island, Constable, 2007.

Glasgow, Scotland’s largest city is a health promotion and social care professional’s nightmare. In spite of hundreds of millions of pounds spent on programmes and a plethora of initiatives targeted at poor health and lifestyle, the city stubbornly remains at the bottom of the table when it comes to bad health, atrocious diet, dreadful levels of violent crime not to speak of appalling instances of domestic violence and prevalence levels for drugs and alcohol which are shocking and world-beating.

At the same time it has become almost a cliché to speak of Glasgow as a veritable schizophrenic city. The city has reinvented itself as a cultural centre teaming with good shops, nightlife and restaurants; a buzzing and vibrant place. Yet it contains large areas of multi-deprivation, high concentrations of unemployment and destitution with life expectancy for adult males in some parts amongst the lowest in Europe.

This apparent paradox and the persistence of chronically bad health and lifestyle indicators, in spite of resources expended, has led some to speak of an inherent Glasgow ‘dynamic’; a blend of cultural, socio-economic, political and psychological factors which predispose Glaswegians to poor health and wellbeing. This dynamic, it is claimed obviously affects the poor and deprived most, but it also has a corrosive impact across the board and impacts on the population of the city at large in terms of confidence and positive outlooks on life.

Carol Craig’s book, The Tears that made the Clyde attempts to synthesise the evidence for this thesis. Glasgow has dreadful levels of poverty, deprivation and inequality, but they are no worse or better than other cities in the UK, yet in terms of health, crime and addictions amongst others, Glasgow appears to score persistently worse. In other words the source of Glasgow’s continuing problems, according to Craig, cannot exclusively be attributed to external economic factors, important though these are.

Instead, rejecting a reductionist approach, she develops a picture of a historical set of multi-dynamic factors and influences that have crucially shaped the city’s cultural horizon. These factors encompass alcohol, work, education, class, relationships amongst others. Combined they have produced a very materialist culture, premised on traditional hierarchical relationships at work, a macho mindset where men effectively turn their backs on family life, a strong tendency to addiction and a very negative, insensitive cynical outlook on life, all of which interact with each other and provide the framework within which ill-health and inequality can have consequences far deeper than elsewhere: the so-called ‘Glasgow factor’.

To combat the Glasgow factor will require more than just material resources. Carol Craig contends that the negative and damaging culture prevalent in the city has to be replaced  with a more positive outlook which would also incorporate ‘transcendental’ and ‘spiritual’ values.

How valid is this thesis? Glasgow’s experience has been that of very rapid industrialisation accompanied by all the problems associated with unplanned urbanism: high population density, crime, infant mortality, massive inequality and squalor. Equally, the city has de-industrialised rapidly and Glasgow is now heavily dependent on (vulnerable) public sector, finance and service jobs. Both have produced huge levels of dislocation and blight.

In other words Glasgow has gone through massive processes of change and transformation to a far greater extent than most other post-industrial cities. Its traditional heavy industrial base has been effectively wiped out, leaving a legacy of chronic long-term inter and intra-generational unemployment. It has had to re-house vast numbers of people and demolish most if it’s unfit housing stock in a short period of time; a task which would have challenged any authority. The response to chronic overcrowding and terrible housing conditions was the creation of huge housing schemes and a frenzy of multi-storey tower-block construction. These have produced their own problems, not least in creating pockets of concentrated multi-deprivation. Yet, we should not succumb to the temptations of the historian’s fallacy of viewing the past exclusively from the perspective of the present. In their time housing schemes and tower-blocks (“villages in the sky”) were viewed as an optimum and humane solution to rat-infested, grossly overcrowded, soot begrimed tenements, which met with universal approval.

Beginning in the early 1980s new globalised heroin markets and sources of supply began to infiltrate inner-city areas and housing schemes reeling from economic recession and youth unemployment and found fertile ground to spread rapidly. In addition, the erosion of the traditional family unit along with urban relocation and displacement allied to the proliferation of fast food outlets, the extensive use of alcohol as a sedative and most people getting little or no exercise in a damp, cold climate has led to the perpetuation of a tradition of ill-health.

But, critically, none of this gives credence to the notion of a special “Glasgow factor” because all of these factors are replicated in virtually every city that has gone through the trauma of post-industrial transformation. There are pockets of inner city London as well as entire districts of Liverpool, Newcastle and Belfast that can rival anything Glasgow can offer in the way of concentrated deprivation. This is definitely not to downplay or be complacent of the city’s manifold problems but to assert that Glasgow’s problems may be huge, but they are differences of degree, not of kind. 

Yes, Glasgow has a cynical, negative side to it, exemplified by its sardonic humour, but this is no different in essence from typical working-class humour elsewhere, and the city’s humour, blunt though it may be, is often its saving grace.

Carol Craig’s book is well-written and accessible and mercifully avoids jargon. It is an excellent compendium of most aspects of Glasgow’s politics, culture and history. But in trying to avoid reductionism it tends to fall into the opposite trap of trying to cover and do too much, with sometimes meagre evidence. There is also some confusion with the central thesis. Material deprivation alone, it is asserted, cannot explain the extent of Glasgow’s problems because they are no worse than elsewhere, and yet one of those factors, inequality, is meant to be a prime causal factor for those same problems? 

Surprisingly, one important area that is paid scant attention to, despite providing a continuous backdrop in the narrative, is the religious divide in Glasgow and its profound effects on employment, politics, education and not least culture and which still exerts an admittedly fading residual influence today. Glasgow was never Belfast, but at times, particularly in the 1920s and 1930s, it became alarmingly close to it. This is a serious omission for any work that seeks to address the major factors that have affected Glasgow’s history, culture and dynamic.

The effects of unplanned rapid de-industrialisation on cities like Glasgow have wreaked havoc. The major response to this has been short-term health related and social care programmes and initiatives. These mainly focus exclusively on individuals and lifestyles while simultaneously attempting to achieve grand aims such as eliminating homelessness or reducing health inequalities with little resources (trying to achieve macro solutions with micro means) and result in having either no or only marginal effects. In a sense then decision-makers and policy makers in health and social care services, which have mushroomed in the past decades and who have committed themselves to this managerialist framework, can only experience a sense of frustration that so much has been expended for so little return. Inadvertently, The Tears that made the Clyde echoes that frustration by seeking to attribute deep causes to what are, yes complex but actually quite transparent historical, regional, national and international forces which have produced Glasgow’s current situation.

 One other deficit that can occur when working in social care and associated fields and is reflected in the book, is that the world can come to be seen solely through the prism of people experiencing problems and issues, in this case around deprivation. It ignores the fact that most Glaswegians enjoy standards of living, health and wellbeing and opportunities unprecedented in human history and which would have been unthinkable to their predecessors only a couple of generations ago. Yes, Glasgow has tremendous problems, which will require concerted effort and real resources to tackle, but it’s not the full story.

Most people in Glasgow lead a reasonable life, certainly compared to previous generations and people in other parts of the world. They and their families, experience ups and downs, but make every effort and mostly succeed in achieving a decent life for themselves and their children. In that they are no different from people in any other city in the world and, by and large, are not concerned with, nor are they in any need of an infusion of transcendental or spiritual values. What that sizable minority of Glaswegians who do not have a decent life need is to partake of the same opportunities and chances the rest do, and that again is no different from anywhere else.

Tears did make a contribution to making the Clyde, but so did laughter and no small amount of pride.

Imagine a man aged over 50 who is grossly overweight and eating a salt and vinegar saturated fried take-away fish supper, washed down with a sugary, high calorie soft drink. Having vociferously consumed the fish supper our man proceeds to open a can of strong lager and accompanies this by lighting up one of 60 cigarettes he consumes per day. Fruit and exercise, amongst others, are foreign to this man. In short he epitomises everything that defines the expression: ‘unhealthy lifestyle’.

Now take a lean man, also in his 50s. He exercises vigorously every day, cycles everywhere, eats at a minimum 5 portions of fruit and vegetables daily as part of a balanced diet, rarely drinks alcohol but when he does will never stray beyond the guidelines for daily consumption. In every respect this man adheres firmly to the precepts of a healthy lifestyle, almost, if you could envisage such a thing, a veritable pin-up for health promotion professionals. He is the antithesis of our obese, beer guzzling man.

Currently, all our health promotion material strongly exalts the second man and equally firmly disparages the first. Our first man is a lifestyle disaster and a walking time-bomb, very likely to die a premature death as a consequence. Yet, for all the health and other benefits likely to accrue by adopting the lifestyle of the second man relatively few people manage to do so.

These two men are at opposite ends of a spectrum. The issue, though is that the overwhelming majority of people are somewhere in the middle of this spectrum. They will try to keep their weight down, exercise occasionally, try to eat healthily and so on. But they will also take the occasional fry-up, have a booze-up every so often and laze about the house for long periods, without any adverse impact on their health and wellbeing.

At one time, and not so long ago, most health promotion advice and information reflected this reality. They enjoined people to try to pursue healthy living, but accepted that, being mere mortals, folk would occasionally break-out and have a fish supper and a good bevy. But as long as this wasn’t everyday, disaster wouldn’t befall.

Now the entire tenor of health messages is that you MUST effectively live your life like our hypothetical healthy man or face dire consequences. There is no middle ground, no brook with compromise; instead there is a stream of didactic stern injunctions to adhere to an ideal lifestyle which most people will not or don’t want to live up to. And because of that, most people end up switching off.

Health promotion messages in our contemporary society have morphed into propaganda, and as with all such messages in non-authoritarian societies, effectively turn their intended target audience off: People don’t like being shouted at and hence ignore or avoid them. 

But health promotion messages are merely symptomatic of entire series of public service policy campaigns and promotions which seek to assert ideal ways of living and acting. From anti-discrimination to the promotion of equalities, from health and safety to the avoidance of causing ‘offence’, from risk minimisation to the endorsement of ‘positive messages’ to boost self-esteem we are being shouted at to adopt ideal ways and modes of behaviour.

 What is missing from all this is the notion of messy compromises; the promotion of pragmatic common sense ways of living which allow people to lead their lives with an element of risk, experimentation and, yes, vicarious pleasure without going to excess. Messy compromise is the handmaiden of a pragmatic liberal politics that was the Hallmark of the British political system until the last thirty years. It avoided extreme positions while extolling the middle ground and worked effectively.

Didactic, uncompromising messages and campaigns, by contrast, easily accompany ideology.  Ideology seeks to mould reality to a preconceived ideal form which inevitably ends up distorting it. Messy compromises do the opposite; they reflect the real situation on the ground and are consequently much more effective at promoting incremental social change.

This is no mere abstract argument. Possibly billions of pounds of public money has been spend on health improvement and public service initiatives, within the last twenty years, with no tangible benefits or improvements apparent. Concentrating on individual’s lifestyles and behaviour, which has been the focus of much public service campaigning while ignoring the wider socio-economic conditions people find themselves in, and which often gives rise to health and other social problems is flawed and easily perceived as such. Shouting at people is no substitute for effective social action. Meanwhile governments of both parties advocate radical changes in lifestyle and behaviour while offering few resources short of funding for ‘compliance’ and ‘monitoring’ posts to do so: A classic instance of trying to achieve macro solutions with micro resources, which gives the impression of sustained activity while achieving very little.

The looming draconian cutbacks in public spending might have one positive outcome. That is to persuade governments and others to eschew striving for ideal type lifestyles or grand total solutions, which are unattainable, and instead refocus on pragmatic, feasible solutions which don’t alienate people. This will necessarily involve messy compromises. And to realise that some of our current crop of health promotion and public service ideologues will have to loosen up or give way to more practically minded people.

According to a report in the Observer, almost one person in five in the UK has consulted a counsellor or psychotherapist (Observer 1^st August 2010). This is a remarkable transformation in a country which until very recently was renowned for it’s stoical bearing characterised by the stiff upper lip and disavowal of emotions.

How did this transformation happen? The last thirty years has been an era where a concern with individualism, consumerism and the self as the focus of all needs and concerns has triumphed over collectivism. It cannot be stressed too much how novel the present emphasis on individualism is. For almost all of human history, except the present, virtually all religious, political, social and economic ideas and philosophies were based on concepts and notions of human collective action. Change for the individual could only come about through change in the wider society. 

Now the terms have changed. Political ideologies mobilised to effect change in the wider society have been eclipsed by a gray managerialism about the best way to run the economy, where differences between political parties are largely marginal. At the same time collective and informal support networks at community and family level have largely disappeared and with it a marked rise in social isolation. Accordingly, the hitherto predominant focus on collective reforms and transformation have been replaced by an emphasis on individual happiness, self-worth and, above all, self-esteem.

Viewed from within this framework, the route to enhanced well-being, peace, stability and happiness is not “out there” but “in you”. Terms such as the “real you”, the “inner person” attest to some vague notion of an ideal type personality lying latent within people. All that’s required is therapeutic intervention to get rid of the facade of neurosis, fears and inhibitions that prevents individuals from dealing positively with issues and problems. Once these have been overcome, they will be free to become a “real person”, magically balanced and emotionally mature and empowered to cope with all situations.

Of course it helps to get outside help to assist this process and find this magical balance. And just as informal networks of support and action to deal with everything from collective action to family breakdowns or recovering from a traumatic incident have collapsed or been frowned upon so there has been the rise of the professional therapists and counsellors ready to step in with individually focused ‘interventions’.

The new framework, therefore, is one that is crucially defined by outside agencies, whether by the state in the form of social and health services or state supported voluntary sector agencies. Accordingly we are witnessing the effective professionalization of people’s inner thoughts, concerns and worries: their private space so to speak.

There is not a shred of evidence that people have magically balanced inner personalities which are emotionally mature and just waiting to be shorn of essentially superficial problems. Humans are dynamic, interactive creatures intensively shaped by external circumstances. People constantly change and develop, for better or for worse, in response to this. Under the guise of liberating people from problems and concerns, therapeutic society actually strives to persuade people to adjust and confirm to their present circumstances; a profoundly conservative influence.

 Moreover, when people are willing to invest the solution to their fears, hopes and concerns, their private space, to others, they can leave themselves open to abuse, manipulation and even authoritarian control.

There is nothing wrong with talking about problems or getting counselled. But that is no elixir that can transform people’s circumstances or make them conform to them. A healthy society is one which balances the collective with the personal. A therapeutic society places the emphasis on the latter and leads to hopes, desires and expectations which can never be fulfilled. We need to break out of our growing dependence on therapy and re-assert our aspirations for collective action.

There is a growing impetus to reform and liberalise the UK and international drug laws; these being widely regarded as ineffectual in terms of combating drug use. Those arguing for reform make several points.

The first is that the existing drug laws are grossly hypocritical in that tobacco which kills a minimum of a quarter-of-a-million people per year, and alcohol which causes widespread misery and harm in our communities, are freely available. Alcohol does cause immense problems and a significant minority of people who use it become dependent on it, with dreadful consequences. However, throughout the long history of its use, the vast majority of people using alcohol have encountered no problems with it. This cannot be said for some substances such as heroin which, throughout its relatively short history by comparison has caused serious problems, including death, for the vast majority of people who have used it for non-medical purposes. As for tobacco it was only from the mid twentieth century that it was discovered to be such a dangerous drug and measures adopted against it.

The second point put forward by pro-reform advocates or those wishing to legalise drugs is that the serious problems caused by  heroin and, to a certain extent, cocaine are not intrinsic to these drugs but stem from the fact that they are illegal and, therefore, impure and cut with all sorts of adulterants. There is some mileage in this; there is no quality control with illicit drugs witness the current spate of heroin deaths in Scotland caused by anthrax spores mixed in with street heroin. But heroin and cocaine are very powerful drugs and the risks attached to them: overdose, heart problems, collapsed veins, blood-borne viruses and a host of other serious health problems are likely to continue even if they were sound quality control procedures in place.

It is also very important to note that the numbers of people in countries such as the UK, who use substances like heroin or cocaine, are a fraction of those who use alcohol and tobacco. If the number of people who use the former were to increase to that of the latter it is very possible that there would be a substantial rise in the numbers of people overdosing or coming into harm through using them, precisely because of their inherent lethality.

The third and most consistent argument put forward for decriminalisation or legalisation of drugs is that it would lead to a decrease in overall rates of crime and lawlessness. This is an assumption however based on the contention that the illicit drug market would effectively disappear with some form of decriminalisation or controlled regulation. It takes no account of the ‘gray’ market that already exists with controlled substances such as methadone or diazepam (valium) at street level, or the widespread black market in tobacco or, to a lesser extent alcohol, which would likely to continue with drugs such as heroin. It also assumes a one-to-one correlation between crime and drug use.

The fact is that a large number of people who have been caught using, possessing or dealing in heroin or cocaine, have also been involved in criminal activities prior to or alongside their drug use or dealing. Moreover, drugs, are just one of a number of activities, albeit currently the most lucrative, that criminal networks are involved with; in other words if drugs became legal these networks would turn their hand to something else. Despite this, even if crime rates were to reduce, the negative health consequences, spiralling addiction rates and overall impact on society resulting from legalising or decriminalising heroin and cocaine, would more than outweigh any transient benefit from reduced crime, alongside the already existing problems caused by alcohol, including binge drinking, and tobacco use.

People involved in the drug trade, whether by dealing or using or both are unlikely to be deterred by the drug laws and drug patterns and trends are largely influenced by factors that are most likely outwith the control of individual governments, politicians and laws. But the drug laws relating to ‘hard’ drugs, especially heroin, probably do act as a deterrent for whole groups in society not to get involved in serious drug use and incur a dependency on them. Take away that deterrent and any criminal sanction pertaining to the use of and dealing in such drugs as heroin and far greater numbers of people will get involved with them. Hard drug use is, despite the widespread and constant attention focused on it, confined to a small minority. Dismantling the drug laws whole-scale risks making hard drug use much more affordable, available and acceptable than it is now and turning a tiny minority into a significant minority.

But this is not unqualified approval of the current drug laws. There is probably scope, once more, for reclassifying cannabis to Class ‘C’ or even decriminalising it further as there is still no serious evidence that the drug is lethal. As for legal highs, it will be simply impossible to go on banning every single new substance that has been chemically manufactured by simple molecular tweaking, especially when the evidence base against them is anecdotal or sensationalised out of all proportion. But with cocaine and heroin, the current laws are about right and our society would be a hell of a lot worse off without them.

Over the next few months as public spending cuts really start to take effect expect to hear much about services currently being run by the public sector being ‘handed’ over to the voluntary or ‘third’ sector. This idea is also in line with the government’s current rhetoric about the “Big Society” in which people and communities are supposed to be empowered to run and take charge of delivering services instead of being controlled by faceless bureaucrats at local or national level.

Whilst laudable in principle, the notion of ‘people power’ running services in the form of voluntary services is called into question by three major factors.

Firstly, the logic behind out-sourcing and privatisation of statutory services, whether to the voluntary or private sectors is to reduce costs and save money, otherwise there would be no purpose behind it. Consequently, services could be tendered out at rates which would be less than that currently incurred by statutory services and this raises concerns about quality standards and delivering services “on the cheap”. One need only think of the pretty poor standards in cleaning and catering services in hospitals which resulted from wholesale privatisation of these services by health boards, so much so that almost all of them have been brought back in-house. This arose primarily from cost-cutting as the original tenders for these services were pitched too low. While not inevitable, the real danger in hiving off services mainly to save money is you end up with voluntary organisations or private companies delivering poor quality or sub-standard services.

Secondly, the notion that giving services over to the voluntary sector somehow equates to empowering people and communities does not really stand up to much scrutiny. Whilst there are numerous organisations that make up this sector, the reality is, as with the private sector, the field is dominated by a number of large agencies. These are controlled by Boards of Directors with day-to-day operations supervised by professional managers. Now in spite of much talk of service users and community members being appointed to the Board, the reality is the locus of control in such organisations resides with a small coterie of senior managers and office-holders from the Board; this is the real dynamic which controls the organisation.

Furthermore, the concept of a large, healthy independent voluntary sector, running a diverse range of services is belied by the fact that they are often dependent on statutory agencies to fund them. When one factors in the overweening regulatory environment the voluntary sector is subject to, then its independence, particularly around its campaigning role and its ability to scrutinise and criticise government policy can be seen to be severely compromised.

This combination of dependency on state sources for funding allied to extensive regulation and inspection has produced what some commentators have described as the effective nationalisation of the voluntary sector, albeit in the guise of freeing-up the state sector.

Finally, the idea that giving ‘control’ of services to the third sector means a greater variation of choice is often illusory. The overwhelming bulk of services provided by the voluntary sector are aimed at people who are poverty stricken, destitute, vulnerable or suffering from long-term limiting physical or mental health conditions where choice is largely cosmetic. Individuals in need of a service don’t really care too much about who provides what service whether  statutory, private or voluntary, so long as they provide a decent level of care, alleviate suffering and reduce distress. As such attempts to introduce ‘choice’ into such areas, where need predominates only brings about, at best pseudo-choice, disguising the fact that behind the façade of numerous voluntary sector providers the real power and the purse-strings lies elsewhere.

There is nothing intrinsically wrong with having services provided by the voluntary sector so long as they are sufficiently resourced to deliver a decent standard of service and care for the people and communities who use and rely on them. But we should also be aware that the reality of centrally managed, tightly controlled and regulated third sector organisations providing services will be a long way from the ‘people power’ envisaged by the Big Society advocates.

Spending cutbacks are upon us. There is a debate as to the extent to what the level of the reduction in public spending should be, but reduced it will be. The question then is how do we best safeguard front-line services in heath, social care and other vital areas and still achieve a meaningful decrease in the deficit. The answer must be by cutting waste and bureaucracy, but how precisely is this to be done? Here are a few suggestions:

• Reduce the gap between public and private sector pay bill: The largest percentage of costs in the public sector is in wages. To be sure a significant number of public sector employees earn a pittance, but huge differentials have built up in a large number of areas between public, private and voluntary sector pay levels. For instance the difference in pay between middle-level managers in the public and voluntary sectors for comparable posts can be as high as £10,000. A level playing field is required both to attract good recruits into other sectors and put a cap on the public sector pay bill.
• Legislation: The cumulative effects of multiple items of legislation, particularly in relation to health and safety, equalities and diversity and employment have to be seriously assessed and discussed in order to strike a balance between protection and the imposition of a stifling regulatory regime. Measures to safeguard against highly improbable occurrences or to police conduct in the workplace against every perceived offence, to take two prominent examples, places an onerous burden on organisations, especially in the public sector, as well as raising costs and inhibiting creativity and initiative.
• Regulation should be appropriate and specifically targeted at ensuring services are being delivered to standard and not striving to ensure the public sector in areas such as health, education and social care are enforcing wider social aims and norms or unnecessarily intruding into people’s lives.
• There should be an immediate reduction of Quangos and national inspection bodies to that which is strictly necessary in order to avoid duplication, overzealous and unrealistic regulation and reduce costs. A rigorous audit should be carried out on each and every one of these creatures which have come to dominate public life.
• Government must learn to resist the temptation to succumb to the Regulatory Spiral whereby media, legal and political pressure surrounding an external event such as an accident or scandal prompts governments to pass more legislation and create further bureaucratic, regulatory and inspection agencies, again at considerable expense to the public purse.
• Over the past 30 years there has been an increasing tendency for governments, both Labour and Conservative, to attempt to achieve grand totalising solutions in social policy and people’s lifestyles which are unrealisable, but which divert resources, time and effort and add to public expense. In Scotland, three such policies: ending homelessness, eradicating prostitution and reducing problem drinking to zero are being pursued as part of national or local government policy: all three, noble as they are, are unattainable and unrealistic. Similar examples can be cited in other areas in the UK. Such unworkable aims, which place considerable stress on organisations and are ultimately wasteful, must be repudiated and services directed to what is achievable.

This list is not exhaustive by any means and there is no pretence here that these measures will by themselves reduce borrowing without having to incur cuts in front-line services. But they will make a dent in it and, perhaps more importantly, will break an almost institutionalised habit of setting up new regulatory bodies and resorting to legislation to progress any item of policy.

• Where at all, don’t create new legislation, use existing laws
• Don’t create further inspection or regulatory agencies, use existing bodies where possible

Over the past few decades a succession of governments in the UK have repeatedly spoken of the need to decentralise services and put them in the hands of voluntary groups and local communities in order to “empower people”; the latest manifestation of this being David Cameron’s “Big Society” pledge.

Yet, apart from considerations over where the funding from this is going to come from when those same voluntary and community based organisations are facing serious cuts from public sector funders, the fact remains that anyone trying to get a new initiative off the ground in Britain is hamstrung by regulation, planning controls, financial controls, laws and a thousand other obstacles that must be overcome/adhered to/met before any activity can begin. What this ensures is that only established organisations with access to good infrastructure and resources, the very wealthy or those fortunate enough to come into a sudden windfall, such as a substantial Lottery win, can establish anything new.

To be sure each individual part of these regulations, controls and laws can possibly be justified, as a need to protect or insure against some potentially invidious occurrence. But cumulatively it stifles innovation and creativity, inhibits risk-taking and cuts across if not blatantly contradicts common-sense. This is a potent brew that can severely constrain the development of organisations and restricts them to ensuring adherence to and compliance with regulation and legislation as a ceaseless process at the expense of other developments. This does not mean that there is a trade-off between regulation and community based innovations and initiatives. What is difficult if not impossible to achieve is to simultaneously attempt to maximise regulation and minimise risk as well as enhance community and voluntary initiatives involving innovation and risk taking. To do so is to pursue two contradictory, if not mutually exclusive goals

For instance, anyone wanting to start up a new community based initiative or charity in the UK has to go through the following milestones:

Establish governance and risk minimisation procedures,

Ensure you are in compliance with employment, equalities and diversities laws and regulations and you have proper human resources policies, procedures and protocols in place before you are ready to start recruiting staff or volunteers

Be subject to numerous compliance and monitoring regimes from different funders

Be prepared to be inspected regularly if you are providing services to ensure maintenance of quality standards.

And that’s just a sample.  For most small-scale organisations and community groups the present burden of regulations, laws and procedures are a huge obstacle course to anyone but large nationally based charities or private sector businesses running anything beyond a corner pub or local shop.

If the government is to be real about encouraging local innovation and the voluntary sector then it has to look at the balance between regulation, proper accountability and the need to empower local people to run services with the minimum of bureaucracy. At the moment it is trying to do both and the result is a guddle. What you may end up with is centralised local authority or other statutory services, being replaced with either large voluntary organisations or private sector companies running services to lower quality and service specification levels. The outcome will be the same: little or no genuine involvement of local people.