Month: July 2011

Neoliberal shock medicine

The National Health Service is going through attempts at reorganization in the context of public sector debt, while the Royal College of Nursing is worried about ‘front line’ provision. Treatments and expectations continue to rise calling into question our ability to pay for them. The population ages putting further demand on health and social care while inequalities in health still reveal differences in a range of health indicators between socio economic groups. These are all elements of a social and health superstructure that rests upon a creaking economic base. The ‘social determinants of health’ approach require us to examine that base upon which we build social as well as individual health.


The links between health and the economy are thus worth examining, and a key feature of our economic base has been underpinned by a particular theory (neoliberalism) since the 1970’s. However, this approach to financing health and social welfare needs a radical rethink to address inequity in the system.


The neoliberal ‘project’ espouses values of:


Individual freedom.

Personal responsibility.



These are hooray words that we can all sign up to, and explains why neoliberal politics have been so successful, for who can be against liberty, individual freedom and personal responsibility? The economic policies to deliver these values include privatisation, free markets and free trade. Economic theorists, such as Hayek and Friedman, and their political followers Reagan and Thatcher (Clinton, Blair/Brown) have won the day.


However, much of the emphasis on freedom and liberty is espoused theory whereby freedom is applied much more forcefully for Capital while Labour is asked to exercise personal responsibility. Capital needs the freedom to go where the profits are and will invent new mechanisms to get around any barriers to this free movement. Labour is exhorted to take more and more individual responsibility for its own education, health and social welfare, and to keep pay demands down. The third sector and the ‘big society’ function to provide essential welfare needs within a framework of non state intervention as free organisations focused on individual liberties, the individual’s needs and wants which (it is argued) are best often expressed through the market. Freedom in this context is also freedom from state regulation on all market transactions. The Tea Party republicans in the United States best exemplify where this thinking may lead.


However, this is actually class politics dressed up as rational economic activity to encourage freedom and prosperity for all while in reality it impoverishes many.  Thus, this approach legitimises policies that have restored and consolidated capitalist class power since the 1970’s. It is ‘lipstick on a pig’.


Paradoxically, actual practice by global capital elites fly in face of their espoused theory. The theory argues for freedom from regulation and state intervention but not when it comes to the results of systemic financial risk. This has resulted in the perverse situation whereby support for the financial sector is based on privatising profit but socialising risk. Thus personal responsibility is not extended to actions at the macro level as finance capital is too big to fail and too big to be responsible to anyone. No one, not even the nation state can call the markets to account. Attempts to regulate and control new financial instruments such as negative credit default swaps have met with failure. Nations such as Italy and Greece have to bow down to the markets or face default and market exclusion. The United States faces a real risk (unusually) of defaulting on its debt, and if the political classes do not agree a lift on the debt ceiling, the bond markets will force measures on the US government by making credit more expensive imposing a cost to the US taxpayer. ‘Freedom’ also has a mixed meaning. It means freedom to make profit but not freedom from want, unemployment and insecurity.


The political ideology masking this process also ignores the driving mechanism underpinning the whole process, a mechanism which was overlooked (and continues to be overlooked) by most of the world’s leading economists who were then unable to spot the looming problem. This key mechanism is the capital surplus absorption problem – i.e.profits produce a capital surplus which has to recapitalize and be reinvested or face devaluation. New avenues for profit have to be found. If this does not happen then recession arises. This results in the failure to make a profit, and a rise in unemployment.


TheCapitalist class has been historically very successful in reinvesting the surplus. In recent times global GDP doubled between 2000 and 2008 going from $30 trillion to $60 trillion (not adjusted for inflation) dropping since the crash to $58 trillion in 2009 (see Global GDP ). Questions you may wish to ponder: who has benefited from this doubling? Who owns the wealth, who has the lion’s share of income? You may wish to ponder on the question of ‘affordability’ of pensions – this is not about quantity of capital it is about distribution and who controls that distribution.


Related to this mechanism is that a healthy rate of growth is 3%, anything less is seen as sluggish and once below 1% recession looms. Throughout history, and evening out the highs and lows, the actual rate has been about 2.25%. Barriers exist to this mechanism which periodically produce a crisis for capital. These barriers include material and labour shortages (for example based on restrictive labour practices or ageing populations).  Growth at 3% faces environmental, spatial, market and profitability constraints which have to resolved, or got around, to continue the growth.


The current crisis is a result of the world being awash with surplus liquidity needing a home for 3% compound growth.  Capital’s move to financialisation was a way of solving the 3% compound growth problem but meant obfuscation of capital movements and the construction of complex financial products that few could understand. Thus the answer (finance capital) to the driving mechanism resulted in systemic risk which was solved (temporarily) by the bad boys of neoliberal theory: the state.


Social democratic states have not been immune to this process. When they were in power, parties of the centre left kept in check the outcomes of neoliberalism  but they failed to address this underlying logic of capital accumulation. The defeat of social democracy (e.g. Labour becoming (neoliberal) New Labour) merely paved the way for neoliberalism to be given its head, freeing up finance capital even more.


Now, asking for morality to be brought into the market or for tougher regulation will not address the underlying mechanism at play. Surplus capital is still in the financial game, still trading in complex products bringing huge profits for finance capitalists while austerity measures and ‘structural readjustment’ is called for everyone else. Surplus capital has to have a home for at least 3% growth, and is therefore still driving financial innovations giving fantastic returns but not to those who need it.


Why should nurses give a damn about any of this? Their job is to promote health, help heal the sick and assist with dignity in death. These issues may be a world away from the hospital bed and treating a patient who has septic shock involves a completely different skill set and knowledge base. However, nurses are citizens and as citizens they will be affected by wider social and economic processes that will impact on them, their workplace and their clients/patients. As a potential powerful and numerous semi-professional group they have a moral obligation to lay bare the social determinants of health and to hold power to account for the health and welfare of populations.


While we have a political system that refuses to address this structural mechanism we will not be able to come up with an answer that provides an economy that works for all of us. The lack of even a debate or a discussion on this question does not bode well.


Anyway, this may well be wrong but it is worth examining as so far no current solution is even coming close.


See David Harvey: View his full lecture at the RSA.


Harvey, D. (2011) The Enigma of Capital and the crises of capitalism. Profile. London

Flowers and chains 2

Flowers and chains 2

We have been lied to and have lied to ourselves. We have let class politics in by the back door and given succour to the entrenchment of class power without realising it. How has this happened ? We have focused on the (illusory) differences between parties of liberal democracy rather than on the (real) differences of class politics. The collapse of communism and the continuing success of neoliberal hegemony has led us to believe that class is no longer relevant. We have been told that class no longer applies and that voting along class lines is less important than it was two decades ago. Both are fallacies.

Let’s be very clear, the differences between left and right parties in western liberal democracy are differences mainly about the role of the state in managing advanced consumer capitalism and not about whether consumer capitalism itself is the issue.

Arguments about whether the state’s role is to only provide a framework for entrepreneurship or that the state should intervene in regulating markets more forcefully is like a family argument around the dinner table. Consensus exists around that table that the family exists, the argument is only about who should have the say over serving up the peas. Neoliberal theory and practice is now so entrenched in liberal democracy that there is now a state-finance nexus whose separate voices differ only on the best management practices.

Greece, Italy, and the crisis in the euro zone, the UK and US deficits have produced a great deal of debate about how best to deal with it. One thing is clear. The people being asked to take pay cuts and lose pension rights are not the people responsible for the crisis in the first place. That much we know. Even the most ardent of neoliberal hawks must accept that, and arguments about states indulging in overspend, poor inflexible employment practices and lack of entrepreneurship (e.g Italy) should not distract us from the real reasons liberal democracies are in a fix. Italy may well be a basket case who ignored the rules set down by the family, but it is the family’s rules themselves that are at fault. Even if Italy played ball and acted as the US and UK did over the last decade or two would that have prevented their problems? The US and The UK are no role models and are supposedly bastions of neoliberal economics, however they underestimated the role of systemic risk that is a central feature of global capital flows. China et al will not escape the system risks as they grow either, but in the short to medium term they have other ways of dealing with the various crises of capital (for example they have huge armies of reserve labour to call upon).

An example of an argument that completely misses the point is the current struggle between defenders of the public sector and those who believe the state should be whittled away to leave room for business to do it’s thing freely. Notwithstanding ‘race to the bottom’ arguments on pay and conditions or that the two sectors are not comparable in any case, this argument is one about the character of the superstructure itself rather than focusing on the economic infrastructure. Both social democrats (arguing for the application of regulation and morality to markets) and free Market conservatives (arguing for less regulation and less state intervention) are not discussing the core problem of the economic infrastructure which if not addressed results in systemic risk manifesting itself at the weak points in the global capital system.

The issue? The problem is of surplus capital accumulation at a compound growth rate of around 3%. That is to say that a driving mechanism of capital flow is the need to invest/spend surplus capital that results in a 3% rate of growth. Capital has to flow freely to achieve this end, if it does not then the system collapses. This is what David Harvey calls the enigma of capital.

This is a technical economic argument that needs much more explaining, suffice to say at this point that this is the reason class politics is under the radar because few are paying any attention to capital flow and it’s concomitant affects on labour.

The flowers are the political debates between leftist and rightist parties of western liberal democracies. The chain is surplus capital accumulation and the requirement for labour to act as wage slaves to provide this surplus value.

For a very good cartoon on this see

Plucking Imaginary Flowers

“Criticism has plucked the imaginary flowers on the chain not in order that man shall continue to bear that chain without fantasy or consolation, but so that he shall throw off the chain and pluck the living flower. The criticism of religion disillusions man, so that he will think, act, and fashion his reality like a man who has discarded his illusions and regained his senses, so that he will move around himself as his own true Sun. Religion is only the illusory Sun which revolves around man as long as he does not revolve around himself.” (Marx Critique of Hegel’s Philosophy of Right)

This quote from Marx has always been a favourite of mine because it clarifies a fundamental truth: that many social practices obscure the actual nature of social relationships resulting in imbalances of power and exploitation which because of self delusion are not challenged. The subject here may be religion as an obfuscatory belief system but it equally applies to the tenets of consumer capitalism as an obfuscatory belief system.

Religion says “I am the way, the truth and the life, no one comes to the father but through me” (John 3:16). Without going into too much interpretation the message here is that Christ is the only path to enlightenment and knowledge of God, of course accepting that there is a God to know in the first place. Thus is established the first hierachy which was then extended into the human realm by such notions as the Divine Right of kings and the established practices of organised christianity. “Rich man at his castle, poor man at his gate, God made them high and lowly and ordered their estate”.

The flower: Believe in God (and his ordained ministers on earth) and your reward will be in heaven. The chain: your lowly social position.

The apologists for consumer capitalism use the public sector deficit as an ideological cover for their brand of neoliberalism. They say “We are all in this together” and that there is no alternative to slashing public spending to head off becoming Greece. Public sector pensions are also “unaffordable”:

The flower: Cut public spending and we will prosper. The chain: the inability of labour to break free from wage slavery and to organise an alternative relationship to wealth creation, distribution and exchange.

Illusions abound: It is argued that governments do not make money, they only spend it, and that it is the private sector, and importantly, global corporations that provide jobs and wealth. Note the words ‘government’ ‘private sector’ and ‘corporation’. These are illusory abstractions (flowers). They exist in discourse only to explain how a system works. In concrete reality there are human beings engaged in productive processes arranged in particular social relationships (chains).

Thus Marx calls for an examination of actual social relationships as they exist in concrete reality to reveal that it is labour creating surplus value for capital as the basis for wealth creation. Bright, ambitious individuals prosper partly through their own efforts but also because the system they prosper in has been constructed to reward certain types of effort disproportionately. This is now happening to the extent that a financial global elite are making sums of money most ordinary mortals cannot even concieve of for creating things like Credit default swaps ( which are basically bets on firms or countries failing in a market worth an estimate $45 trillion. That is to say people are working on abstractions in financial markets (which are numbers in a computer software programme) which bear little relationship to actual houses, food and energy. Let’s return to ‘affordability’ – read that number above again. That is in trillions (1 trillion = 1,000 billion). How much is the financial sector worth in trade each year? How much money sloshes around the global sytem, who earns it,  who keeps it? Affordability is another abstraction. These questions need concret answers before we talk about affordability.

The flowers include buying your own home, owning a new car, a holiday in the sun, a new kitchen…the chains were the loans you have to take out to get these things and the length of time you need to spend in work to pay it all back. You (labour) work in a system which promises you illusory heaven now to cover the the actual hell experienced while capital reaps the rewards. The system is just not sustainable. 


If the law is an ass, drugs control law is a lobotomised mule

“The International Drug Policy Consortium (IDPC) calls on the international community not to oppose Bolivia’s move to denounce and re-accede to the 1961 Single Convention on Narcotic Drugs with a reservation on coca leaf chewing”. 

The international drug control system is based on a series of UN conventions which have prohibition at their core. These conventions can be seen to rest on assumptions drawn from a particularly Western interpretation on the use of certain substances that is morally rather than evidenced based. 

Cracks are appearing in the global ‘consensus’ on drug laws, policy changes are being called for and seem to be accepted by just about everyone except elected politicians and those of a morally puritan persuasion (the ‘Daily Mail’ tendency), i.e. those who fear change regardless of its effects.  

There are innumerable victims of the ‘war on drugs’ – not the least are indigenous peoples whose way of life  practiced for centuries is threatened by, frankly, an imperial mind set that imposes its own moralisng on a cultural practice it cannot understand.

I am not a cultural relativist, this is not about accepting all cultural practices as sacrosanct. Female genital mutilation (FGM) is just wrong (sorry, that is not true…all wrongs ought to have a rationale for why they are wrong, I don’t believe in some ‘natural law’). However chewing coca leaves is a harmless cultural practice that international law should just accept.

Why? Why accept chewing coca leaves and not genital mutilation?

I guess this is where Mills’ libertarian ethic of harm applies. If a cultural practice does not involve social harms then we have little right in banning it. The individual ought to be free to chew coca leaves regardless of its effects. The society in which that practice is located should have a view but should also appeal to some form of universal human right.  The difference between the two practices is that the individual can choose to indulge in chewing leaves but cannot choose FGM.

Bolivia should be allowed to accede from the 1961 convention to protect the rights of its peoples in this respect.   

For a discussion on FGM see Michelle Goldberg on relativism and FGM on the excellent   website


No, not dark chocolate. The Bike. The Bike. The sort of Bike that winds into country roads in Devon, sticking to the tarmac like its been glued there (well of course moveable glue, otherwise it would not go forward…you get the picture). Ah, yes freedom of the english highway, freedom to dodge the “sorry mate i didn’t see you”, freedom to skid through the admixture of cowshit, oil and blood (from the previous biker’s death), and freedom to scare the living bejeesus out of little old ladies in Totnes when you wind up the baffle free ‘not for road use’ exhaust pipes. Not very carbon friendly of course and hitting a car coming out of a junction takes the shine off the day somewhat (1977 and I still bear the scars) but hey i am old and I am going to die. Might as well be screaming maniacally while high on K and horlicks as I slam into a carthorse in Penwith.

happy days.

Health, Education and buying shoes

Now,  this f**king (excuse my Cornish) Tory gov’t cannot see beyond its own ideology and its disappointing that ‘two brains’ Willets is caught up in this. Let’s be clear: students are not customers, ill people are not customers, health is not a commodity, Education is not a commodity. They are not shoes. Creating markets in health and education is not a good idea. The Economist recently argued similarly for health: see and see this for what is happening in education  Now here is the point about markets in health and education:



“Most people aren’t qualified to determine which medical procedure/product is the optimal product to treat their ailment”. (from a comment by Heimdall) . In the same vein most students are not qualified to determine which University or course is the optimal product to further their careers. In  addition markets cannot serve health protection, education or the social determinants of health.

When you buy a car, you know roughly how much power you want, how much storage, etc. You can look to Consumer Reports to gather reliability data and dealer cost. You can negotiate with the dealer based on this information. Similar story with most consumer goods.

When you have a dread disease (one of a bazillion maladies, not a few dozen as with most purchasing decisions), there might be uncertainty among doctors whether it is indeed disease X, or maybe Y or Z.

Once you (kinda maybe) know what the problem is, which treatment is best? Even among doctors who agree on the disease, they may think that treatment A, B, or C is most effective based on their research, year of graduation, etc.

Thus, even if all doctors and practitioners were equally adept, you would still need to navigate the diagnosis/treatment thicket. But they’re not equally adept, and there’s no Consumer Reports to provide data on reliability, outcomes per thousand operations with doctor X in hospital Y.

In short, consumers are ill-equipped to treat medical care as if it was any “normal” market. We just don’t have the expertise to do it. And thus we are even more susceptible to the recommendations of the “experts” as to what to do than we are with a pair of sneakers.


“its interesting to be young and famous…”

“…and I want to be young and famous!” So says an interviewee on the streets of LA when asked about the visit of Wills and Kate to the USA. Well, to be young does not take much talent, just ensure you get born and stick around for a short while. But not too long eh? Otherwise you may make the transition to ‘not young’ and then ‘old’ and then, ‘heaven forfend’ you will be boring. Also make sure you are born (preferably white and to well off parents) in the Rich developed world, Beverly Hills, Los Angeles for example. Not in, say Africa, where the Disasters Emergency Commitee (DEC) has just issued an appeal ( 10 million, yes count them, people are at risk due to a combination of the worse drought for 60 years (climate change?) and war.

Maybe it is churlish of me to expect anything other than vacuousness from a Valley Girl, after all, she lives in a town that makes a living out of dressing up and make believe. If asked about the Horn of Africa she would probably giggle thinking you were making reference to a porn film. Context is all and so what else could she say when asked about British Royalty? Wills and Kate, fresh from bear trapping, moose shooting and patronising native american indians in the North, have arrived in Tinsel Town to meet other royalty (The Beckhams). This has created a flutter of excitement among those who already have difficulty differentiating between reality and illusion, further stoking dreams of being ‘like them’ by buying stuff from whatever designer Kate chooses to use for her breakfast cereal.

I did ‘young’ once, it was…ok. Too much testosterone without a valid release valve or the wit to use it. It was also easy and only started getting difficult around 30 years of age. Famous? Famous for what? Dressing nicely and marrying a very rich bloke who is going to inherit even more riches and having sister who has a nice arse? That’s interesting is it? (ok, from a bloke’s perspective the latter must be).

A valley girl with nice teeth is an easy target, the poor lass did not go out that morning expecting to pronounce on global poverty, the surplus capital accumulation problem or the political struggle in Libya. Brought up on a diet of fashion, sparkle and a world view so one dimensional that it would disappear if seen from the side, how else can she answer when confronted by a moron with a microphone who thinks that the Americans must love Wills and Kate as much as we do.

Well, a child in drought stricken Africa is young and I guess living in a war zone is nothing if not ‘interesting’. And now, thanks to the DEC appeal they are famous (I have seen them on the telly!)

Alternative to the White Paper – Putting the Vision Back into Higher Education by John Holmwood

I cant really better this so in full:

? British Sociological Association: Response to White Paper
Alternative to the White Paper – Putting the Vision Back into Higher Education by John Holmwood

Academic staff and students from across the sector and in a variety of campaigning groups – Campaign for the Public University, Oxford University Campaign for Higher Education, Sussex University Defends Higher Education, Warwick University Campaign for Higher Education, Humanities Matter, No Confidence Campaign, Cambridge Academic Campaign for Higher Education – have written a trenchant response to the Government’s White Paper.

This document – Putting the Vision Back into Higher Education is a call  to colleagues and their subject associations and other groups to contribute to an Alternative White Paper to be published at the end of the Government’s consultation period in September. This will be presented to the Department of Business, Innovation and Skills, together with the weight of opinion in its support.

The response to the White Paper argues that:

It threatens the excellence of higher education in England. It does not put the student at the ‘heart of the system’, but the market.

It cuts direct public support for undergraduate degrees by 80%, and by transferring costs to students via higher fees it succeeds in providing fewer resources for most degrees while requiring students to pay more.

It is a reckless gamble, a dangerous experiment in university funding with no precedent in British experience. Its different elements are incoherent.

While the Browne Review advocated a new funding model because of uncertainty over public funding, the present proposals will not produce stability. The uncertainty is switched to the ballooning student support arrangements necessary to maintain a fee-based system of loans and the Government’s overriding interest is now to reduce their cost.

It has parallels to the privatisation wrecking the financial solvency of high-quality public universities in the US (such as the University of California, where net private revenues have not covered the public funding lost through cuts despite upwardly spiralling tuition costs).

It had no vision for higher education, only a narrow emphasis on employment and education as an individual investment in human capital.

It is necessary for higher education to “sustain a culture which demands disciplined thinking, encourages curiosity, challenges existing ideas and generates new ones; [and to] be part of the conscience of a democratic society, founded on respect for the rights of the individual and the responsibilities of the individual to society as a whole” (Dearing Report, 1997).

There is no government mandate for the privatisation of higher education and for the despoiling of the social and cultural value of universities.

John Holmwood University of Nottingham, Chair of Heads and Professors of Sociology Group/Campaign for the Public University

‘Students at the heart of the system’

The recent gov’t white paper ( of course contains some sentiments that on the face of it few would find hard to disagree with and it seems churlish to knee jerk with negativity. Given that the view is now firmly entrenched (by many in HE it must be said) that HE’s role is primarily to produce a workforce that can compete in a global market, and that students are now consumers of a product, the statements make sense in that context. However, and you knew this would come, this does nothing to address the challenges faced by critical disciplines in the humanities and social sciences whose raison d’etre, as disciplines, does not fit this intrumentalist model of HE. I really fear that only the very well off will now spend £27,000 + to study what may be seen as esoteric subjects that are not immediately aligned to well paid employment. And don’t give me the guff about not paying that back until a threshold of earnings has been reached, as students will clearly see this as investment they have to make for payback in a career.

This is the continuing triumph of neoliberal philosophy applied to HE, my only hope is that students may see through this and that I am worrying needlessly because of an ideological position I am taking. As an afterthought, how did C Wright Mills gain employment in Columbia given the instrumentalist and often private nature of US HE? Anyone know? His ‘star status’ now may gain him entry into Grayling et al’s New College?

Wimbledon and Scotland

I wish I had a view on this, I really do. Beyond being mesmerised by Sharapova’s ability to swing the bat while driving gloriously to the covers, I just can’t see why the need for a british/scots win is so important. At the risk of offence (oh go on then…) the most interesting thing I have read is this from Kevin Hambridge:

“ For sale: Andy Murray Wimbledon towel. Smells of sweat, failure and disappointment. Or in other words, Scotland”

Nice one kevin, that should give Alex Salmond even more ammunition to cry freedom with.

ps he did win in end .

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