Less of the Same
In November 2008, the Chief of Staff for President Elect, Barak Obama, one Rahm Emanuel, uttered words that have entered into the political lexicon: 'You never want a serious crisis to go to waste'. But with this week's Comprehensive Spending Review (CSR), it's possible that the coalition government did exactly that.
A selection of the facts: at the end of September, public sector net debt was 64.6 percent (£952.0 billion) of GDP, compared with 58.5 percent (£821.5 billion) at the same time last year. We currently spend £120 million per day simply servicing that debt. In the last ten years, public spending has grown by 53 percent - a mix of genuine (if not always effective) investment in public services, the bank bailouts and the fiscal stimulus package. In only four years since 1967 have real terms annual declines in public spending been achieved (the coalition is now proposing three in a row), a demonstration of the fact that no government has been able to keep a lid on public spending.
The brutal CSR is a product of this almost irresistible upward pressure on public spending, and the immovable object of the public deficit. What this should have occasioned, especially in the light of the 'new' politics of the coalition, is a fundamental reconsideration of the business of the state. Who, according to the terms of justice, must we commit, as a community, to provide for? How? What can a state do most effectively to ensure that people can live well?
There are good liberal (in the old sense) and conservative answers to these questions. Many might disagree with them, but they are respectable, defensible, adult positions to maintain. The capacities of the state are strictly limited, and it would be better for us if we did not expect it to do the things that it can't. The family and wider community should take more of the welfare strain. The state falsely and wrongly allows us to outsource our moral responsibilities. The fiscal crisis has created the conditions where those arguments could have been made and heard.
But the CSR is neither bold nor visionary. In Philip Blond's words, it makes 'orthodox' cuts - similar to previous attempts to rein in public spending - while doing nothing to resolve the inherent pressures for public spending growth. Take the NHS, which needs an annual three percent above inflation budget rise just to stand still, and after the most sustained and substantial period of investment in generations is still in a fairly parlous state. By 2015, the NHS may account for around one in every three pounds spent by the government. In ring-fencing its budget, the coalition balked at the key public spending challenge of the next 20 years.
No one would question the fact that the deficit represented an incredibly difficult challenge for the incoming government - a fiscal crisis in fact - or claim that there was a substantially different package on the table from the Labour Party. But there's no narrative behind the CSR, no logic, no principle - except the bland and indefinite value of 'fairness' - no fundamental reconsideration of the role of the state in economically straightened times, no reflection on what the good society looks like; just less of the same.
Paul Bickley
Comments
Thanks for your reflections, Tim. We’ll pass them on to Paul Bickley (who works with Theos, not LICC, as it happens). All the best – Antony Billington (Head of Theology, LICC)
I agree with everything Tim Goodacre says. Let's hear Christian commentators who actually have to depend on state services (whether that is health, education, welfare...) rather than those who can choose to go elsewhere. When I hear Christians calling for less state resources and the community to take that place, I can't help suspecting that those who make the suggestion have the resources and funds to go private and to salve their conscience require that fellow christians step up to the mark to cater for everyone else. As someone who depends on healthcare on thrice-weekly hospital treatment simply to stay alive, I've come to see the NHS as a very CHRISTIAN service. Available to all at the point of need. There's God in that, isn't there?
I believe we should welcome both of these comments. They show that there is a need for a different kind of debate - around consumption, relative earnings, the role of the state and community, and so on. Wouldn't it be interesting if Christian communities were able to host and conduct these debates in a way which really engaged thinking both within and out with the churches?
I am usually enthusiastic about the stimulating comment I read week by week in this column; thank you for the continuous supply of provocative thought. However, this week's leaves me deeply unhappy. I agree that the crises of the past 2-3 years have presented a compelling case for radical changes in our economic system - if not the whole social paradigm that governs policy making in post war democratic societies. This column pleads for a 'fundamental reconsideration of the role of the state in straightened times' and 'reflection on what the good society looks like'... following a thinly veiled attack on the current level of provision of state resources across society. I take issue with almost every aspect of the critique of current spending, but the slight on the NHS is simply too much. '...it is still in a fairly parlous state'... Let me assure the author that there are few countries in the world that offer such value for money as the NHS does at present. The stratospheric cost of the new 'biologics' (monoclonal antibody derived treatments for a diverse range of conditions that can cost over £40K / year to treat an individual) which have transformed the well being of certain patient groups with breast cancer, other cancers, ankylosing spondylitis, severe psoriasis, rheumatoid arthritis and so forth have been available to almost all who would truly benefit from them, completely free on the NHS. No private system of insurance could ever conceivably bear this cost, and neither could any but the most rich in society afford them. Our caring system has bent over backwards to eek out the resources available to it in the most fair system possible. It doesn't always get it right, and it is extremely difficult to manage, but let me assure you it is a whole lot better than in just about every other system which people are tempted to view as having greener grass ... Just show me where else every citizen of a nation has access to such treatments for the level of contribution we make in the United Kingdom? Yes, the NHS can do better, and efficiency in such massive organisations can always be improved and refined. But the %GDP it consumes still looks very favourable compared with continental Europe let alone Stateside ... where many seme very content to live in a society where £48 million have access to utterly unacceptable levels of health care. I agree that 'what constitutes a good society' needs a thorough look at - on constant rolling review. But how would the author begin to propose that we stop 'outsourcing our moral responsibilities' or making families and communities 'take more of the welfare strain' ...? Philip Blond was one of the most uninspiring speakers I can recall when he addressed a Church meeting in London in December last year; he comes across as yet another Tory (supposedly 'Red' from his group I believe) who consistently attack the role of the state without having the courage to live within it without the support of their privileged background of good education, good health, birth, and (usually) financial inheritance to fall back on if things go bad. I welcome Christian involvement in the political debate, but it ought to be progressive and creative, rather than airing the sort of retrogressive and critical comments that I have read today. I would welcome a broader description of what this author constructively offers as an alternative society and spending plan than the one which he has so roundly condemned. I believe the analysis of those economists who feel the current CSR was too harsh and too quick; it would appear that the author would like things to have been even more radical. How, and where, and when and to who ...? Perhaps more to the point, 'what would Jesus do ...or what would his society look like ...'? Would the 'good society' have high earners on multiples of thousands more than the lowest earners in employment ... or should I see that my hospital porter's salary of a barely living wage for his week even with overtime is entirely good alongside the 7 figure sums that several church members earn per annum as a manifestation of a Christlike kingdom? I think not ...
I work for the NHS. I earn a good wage, many of my colleagues do not, particularly considering the amount of responsibility they carry. The vast majority of us are working hard for the good of our patients, to deliver the worldclass service they deserve, and we are all already facing cuts in staff (my own head of department has recently retired and has not been replaced) and funds for staff training and new equipment. And that's before the government gets started on its proposed restructuring... Outside of the workplace, we are facing cuts in benefits (including housing benefit, which is certain to exacerbate recruitment problems in the southwest) and cuts of 30% in council budgets that will mean free playgroups for our children, respite care for our elderly relatives, community liaison officers on our streets and the small pleasures like flowers in the park will all disappear. It's fair enough to say that if people looked after each other more, then the state would have to do less. The role of the state certainly needs to be debated, and we in the NHS need to ask some hard questions about whether we should be funding homeopathy and reiki if we can't "afford" universal access to the imaging necessary to accurately diagnose cancer (spot my personal bugbear). But the role of the public will always be limited and the role of the state will always be necessary. The general public cannot select the correct diagnostic tests to order from the vast array now available, interpret the results of those tests to reach a diagnosis, correct disorders through surgery, rehabilitation or complex cocktails of drugs, and monitor response to treatment and act accordingly. Neither can society at large be relied upon to do a whole host of other things that most people in this country are not able to do for themselves for a whole host of reasons. If we value all people equally, we need to ensure that they get what they need - that's why I pay my taxes.
Date:
2010-11-01 14:52:18
Author:
Heather Williams