Month: May 2014

Election.

I make no apologies for overt politicking this week. Social media is the only tool ordinary people have to discuss issues, the Tory dominated right wing press being sycophantic and running to the rules of the established political class. The TV media are more interested in entertainment and seems incapable of analysis beyond spectacle.

Russell Brand may be correct on analysis but wrong on strategy. Yes, don’t vote necessarily for the neoliberal hegemony of New Labour and the ConDems. But do vote, if you don’t, the fascist and the scared xenophobic populist right will be doing so. Remember, that many current fascist and neo nazi parties in Europe have been voted in ! Twentieth century politics clearly showed how disillusioned and frightened populations voted in ‘strong charismatic men’ with tragic consequences. Look to Afghanistan to see what voting means to a population. It is the only thing we have in what is left of our tattered ‘democracy’.

Values:

Planetary health is the basis for all human health and well being.
An NHS free at the point of delivery, functioning to provide care not profit.
Education and Transport as a public good affordable for all paid for by us all.
Houses as something to live in rather than speculative investments.
Taxes as investments for the public good.
International and national control over unelected plutocrats.
The media frenzy focus on UKIP is based more on novelty and attempts to address their views are counterproductive. It cedes the ground to them and forces us to use their frame to counter argue. People vote according to their values and no amount of facts will sway them. UKIP have very successfully frightened people into the ‘fear of the other’ when in fact it is class politics being played out…low wages and ‘flexible’ labour policies favour the interests of capital and employers and not the workforce. The wealthy are not job creators or wealth creators – even Henry Ford realised that fact when he acknowledged that his workers needed enough pay to buy the cars they were making, without demand he had no business. Employers only take on staff as a last resort – if there is a demand for their business – workers are both employees and consumers, squeeze that sector of society and and demand drops off to be filled by credit. Sound familiar?

Therefore green values need shouting as I think they are in accord with many people’s values, focusing on what is positive rather than trading on fear. We should be extolling the values of community, empathetic understanding allied to individual and social responsibility, restructuring the economy so that it works for all not just the elite and the lucky, we should be shouting about the critical need to instigate international and national global governance that challenges the neo-feudal plutocracy and the hegemony of the ‘market’ (which is paraded about as if it is devoid of vested interests, manipulation, criminal practice and unethical behaviour).

Vote green.

Strict father or nurturing parent? Family metaphors and socio-political values

Ever wonder why Tories like Ian Duncan Smith are focusing on ‘welfare dependency‘ ? Smith argued:

We must be here to help people improve their lives, not just park them on long-term benefits. Aspiration, it seems, is in danger of becoming the preserve of the wealthy.

Do you wonder why politicians such as Congressman Paul Ryan talk about  “cultures of poverty” ? Ryan stated:

We have got this tailspin of culture, in our inner cities in particular, of men not working and just generations of men not even thinking about working or learning the value and the culture of work, and so there is a real culture problem here that has to be dealt with.

Do you know why the ‘strivers v skivers‘ metaphor is being used?

David Cameron has said his party:

“…cares about the strivers, the battlers, the family-raisers, the community-builders”.

It might seem incomprehensible to those who are of the ‘progressive left’ who might feel that the the poor are being stigmatised while the 1% are wrongly lauded as ‘job and wealth’ creators?

An answer is that our much of this political positioning is down to our values rather than as a result of rational fact and argument. Tories state these things because they truly believe them and that they arise out of their values. This of course also applies to progressives. So where do these values come from and what are they?

George Lakoff in ‘Don’t think of an Elephant‘ and ‘The Political Mind’ attempts to describe the link between our values, what they are based in, and our political views.

To do that we have to go back to the beginning of our experiences as human beings and that means our experiences in a ‘Family’.

Every single one of us experienced early life in a family.  That family might be the ‘ideal type’ of the nuclear family beloved of advertisers,  or it might be a ‘reconstituted family’ including second wives/husbands. Sadly, a few grow up in social services care experiencing a ‘family’ of a very different type. The family is an ‘agent of primary socialisation’ in sociological terms – this means we learn social norms, values, behaviours and attitudes as well as a host of other things such as language and modes of dress. The family then is a foundational social experience and our experiences of families provide us with ways of thinking about how we should live together as couples, families and within wider society.

Some of us are for capital punishment, capping welfare and social security, a strong military and intervention,  using force if necessary, to secure the nation’s interests abroad. We might also consider that those who use the railways, or universities,  should be the ones to pay for them rather than taxpayers. The same goes for health in that we should learn to take responsibility and pay for services when we need them. The nanny state should be made redundant and that taxes should be ‘relieved’ or cut to the bone.

The link between our family experiences and our politics is not very clear. We may even think there is no link at all,  and that our social and political views are arrived at after some due consideration and the application of rational thought.

Lakoff however argues that the family provides us with at least two experiences which then act as unconscious metaphors for life:

1. The Strict Father.

2. The Nurturing Parent.

These two models of family life provide us with ‘frames’  – ‘mental structures that shape the way we see the world‘ (Lakoff 2004 p xv). Frames provide us with language and values, they shape our policies, the organisations we devise, what we consider is good bad, moral or immoral. Lakoff’s work follows on from Ervin Goffman who discussed our use of frames in ‘Frame Analysis: An Essay on the Organization of Experience (1974)’.

To over simplify perhaps, this is to say that we all hold both frames, strict father – nurturing parent, in our heads but one may be more dominant than the other. We then approach political and social life and use these frames to explain and give meaning to what we are experiencing and to what we value.

Right wing conservatives tend to have a ‘strict father’ frame while those on the progressive left tend to have a ‘nurturing parent’ frame.  Thus, issues such as social security will be seen by referring back to those frames, and in so doing  we will use particular language  such as ‘striver v skiver’ and invoke values that accord with those frames to explain and gain meaning for issues such as  ‘social security’.

Lakoff’s point is that over the past three decades or so the conservative right have been able to get their frame accepted in the media, by political parties and even in the general population while those of the progressive left have been unable to articulate their frame – ‘the nurturing parent’.  The right has done so by spending billions of $ in think tanks, universities, books, articles, research grants, professorships…..

So what are the features of the ‘strict father’ ?

This frame is based on a set of assumptions:

1. The world is a dangerous place and always will be, because evil exists.

2. The world is hard and difficult because it is competitive.

3. There will always be winners and losers.

4. There are absolute right and wrongs.

5. Children are born bad, in that they only want to do that which feels good rather than that which is right.

6. Children therefore have to be made to do the right thing.

7. This world therefore needs a strong strict father who can: protect the family in a dangerous world; support the family in a dangerous world and teach children right from wrong.

These assumptions draw upon centuries of religious teaching from patriarchal Abrahamic faiths – Judaism, Christianity and Islam – that puts ‘God the (strict) Father’ at the top of the social and universal hierarchy. Early capitalist development in Europe and in the United States was founded upon these principles and found expression in the laws enacted at the time, for example the poor law in England.

Children are required to be obedient, because the strict father has moral authority – originally derived from God – as the head of the house: patriarchy. The only way to teach obedience is through punishment for wrong doing until the child can internalise discipline to do what is right.  A striver has this internal discipline while a skiver does not. Without punishment, there would be no moral authority and the social order would collapse. Moral hazard is invoked as a justification for imposing strict social policies and for not introducing supportive systems. Moral hazard arises when individuals (skivers) or institutions (e.g. trade unions) do not take on the full consequences and responsibilities of their actions. In doing so they have a tendency to act less carefully than they otherwise would.  This might result in someone else bearing responsibility for the consequences of those actions.

This idea was invoked at the inception of the NHS. It was argued that if people no longer had to pay for health care then they might take less responsibility for their health. Free at the point of delivery means people will not then take responsibility, because they don’t pay,  and the NHS i.e. taxpayers, would have to pick up the bill.

The morality of internal discipline has another affect. Discipline is required to be successful in a competitive difficult world; discipline results in self reliance and prosperity. Wealth is a result. Therefore wealth is a marker of discipline and therefore wealth and morality become linked. Those who are wealthy  – the 1% – deserve to be because of their internal discipline and self reliance. Those who are on benefits deserve their poverty because of their lack of discipline and self reliance.

The strict father frame is often supported by referring to the economic theory of Adam Smith in the ‘Wealth of Nations’ and can be seen in its modern incarnation in such conservative think tanks such as the Adam Smith Institute and the Institute of Economic Affairs.

This frame is unconscious, part of our brain structure, and is not invoked explicity in political discussions. When using the language that arise from this frame,  the frame is invoked and reinforced. Conservatives know this,  and hence do not rely on reason or facts to make their case – they invoke the language of the frame and talk about their values. In so doing, they reinforce the strict father frame.

When Andrew Lansley talked about the ‘responsibility’ deal he was invoking the requirement for all of us to exercise internal discipline towards our health, reinforcing the idea that children should learn to act in ways that are healthy and should learn to avoid ‘feel good’ but unhealthy lifestyles. If they fail to do so they should be punished by experiencing the consequences of their actions. The father’s (State’s) job is not to pick up the pieces afterwards. Corporations should be encouraged to support us in our actions but not forced to do so because in the end it is in our own hands to choose the right path.

Let’s revisit those ‘strict father’ assumptions as they apply to health:

1. The world is a dangerous place and always will be, because evil exists. ‘Evil’ in this sense is the existence of dangerous substances such as alcohol, tobacco or illegal drugs; or is sexual desire, lust and promiscuity resulting in STI’s; or high sugar, high calorie foodstuffs.  These things are ‘evil’ and pose a threat to our health.

2. The world is hard and difficult because it is competitive. Living healthily is tough, requires discipline and application above the norm of ‘soft’ living. If we don’t work hard we will not get the rewards of, for example, access to gyms, or good expensive healthy food.

3. There will always be winners and losers. In health terms, this may be that that we are born with good or bad genes that map out for us from birth our health pathways.

4. There are absolute right and wrongs. Smoking is wrong, drinking to excess is wrong, unprotected, teenage sex is wrong, illegal drug taking is wrong…we know all of this this. ‘Just say No’.

5. Children are born bad, in that they only want to do that which feels good rather than that which is right. Adults act like children when they overindulge on fatty sweet foods that they know are bad for them, when they smoke knowing it kills and when they get drunk.  they have not learned to discipline themselves and are acting out on ‘feel good’ emotions.

6. Children therefore have to be made to do the right thing. Adults however, who have not learned to do the right thing, have no internal discipline and should therefore bear the consequences of their actions. The Obese are lazy, morally weak who should just eat less and exercise more. They were not made to do the right thing and have learned unhealthy behaviours. Adults are not children, it is too late and if they are protected from the consequences of their own actions what sort of example is that to give to children? Smokers, drinkers and drug takers should just take responsbility for their actions. Ill health that arises not from behaviour but from “genes” or “chance” invokes  no moral approbrium or blame and therefore health services should be provided. Illness that arises from poor choices and behaviours should really be addressed and paid for by those who make those wrong choices. Why should society pay for bad choices? Alcoholism, drug addiction, STI’s and to a lesser extent diabetes as a result of obesity, or lung cancer and vascular disease from continued smoking,  attract moral judgment and justified stigma.

The strict father knows that adults must bear responsibility, and are no longer entitled to his protection as they should have learned right from wrong.

Reflect on your view of health…what values is it based on…to what extent do you agree with the strict father assumptions?

As for IDS and Congressman Ryan, consider that they are invoking the ‘Strict Father’ frame. In focusing on the ‘parking on benefits’ he is reinforcing the idea that the State should not bail out people through overly generous benefits, this invokes ‘moral hazard’, instead people should be experiencing the discipline of the ‘real world’ – the strict father would be considering that they are adults that need to learn inner discipline which benefits rob them of so doing. Benefits robs people of aspiration, of the inner discipline to do better for themselves because they can receive enough to get by without having to work hard for it. Similarly Ryan is saying that inner city men are learning that work is not for them, they have not learned the inner discipline  to achieve. Further their poverty is proof of their lack of moral worth, they have not learned self reliance. If they act like children by not working  – and by arguing that they have a culture of poverty he invokes a lack of moral will to work – then they need punishing, not a soft cushion.

The personal is political; care in an age of spectacle.

Are we really surprised that the BBC’s  Panorama has again uncovered  poor quality care and abuse in a home for older people?

We know the roots of this, and I have previously argued that this is a political game. This is also personal because, and this point has been made many times  before, I will be old one day and may well require care. Therefore I do not want to be treated like sh*t as a resident on the Panorama  film stated. It happens because the care sector is undervalued, invisible, ‘women’s work’ and it is thought by some  that it can be done by those with little training, poor supervision, risible pay, poor patient ratios, no professional development and inadequate management.

Individuals will of course be blamed and sacked citing ‘accountability’ as if it is the holy grail of quality care and patient safety.

What to do? The first is to recognise that this personal trouble is a political issue and nurses are front line staff in the trenches. In the UK for far too long nurses have been reluctant to use union power to address these fundamental issues. Yet, just when we need it, union membership across all employment sectors have dropped as workforces became more docile in the face of deregulated labour markets. Faced with the ‘flexibility’ requirements demanded by employers, resulting in the growth of zero hours contracts, part time working, minimum wages as targets rather than base lines, workers have become more pliable generally. Nursing, being a gendered occupation with its emphasis on self sacrifice and care, has historically shied away from exercising any worker power while simultaneously picking up the crumbs from the medics table (doing their ‘skilled’ tasks for nowhere near the pay) and now bowing to the control of their work as dictated by management.

In California, in the US, nurses are joining Unions and have a staffing ratio law of 5:1 for med/surg, 2:1 for ICU, and Psych 6:1 meaning five patients with 1 nurse. CA AB394 came about by the CA Nurses Association to implement their RN Staffing Ratio Law. William Whetstone (Professor of Nursing California State University)  states “Staff nurses were sick and tired of being abused, putting up with crappy workloads, incompetent nurse administrators and managers, and on and on. I can remember when I did staff nursing dealing with a patient load of 10 to 12 patients with no thought to their acuity. As a result, CA became the first state through the effort of the CA Nurses Association to establish RN-to-patient ratios. The law was successfully implemented January 1, 2004”.

Is this an increasing phenomenon? Are we finally seeing a backlash against the dominant political hegemony that does not want to pay for care? We can study this until forever, but that fact remains – care costs. It costs a lot, requires skill and adequate ratios.

In California it seems nurses have had enough, got organised and agitated for change. They have looked beyond the representations of nurses as caring angels and seen themselves as the exploited.  They have plucked the imaginary flowers from their chains and acted.

Consumer capitalism would not want this happen because care is seen, in this context, as a cost to be born not by society but by individuals and families. Consumer capitalism instead wants to fill our heads with distractions and representations using the ‘spectacle’.

News and other media constantly feed us representations of the world that actually do not exist; they are constructed for news and or as entertainment. Panorama falls into that trap because it represents poor care in a particular way and is unable to drill down to the root causes. The TV itself is a medium of the representation of actuality and can lull us in to classifying the poor care we see as almost entertainment; the lines between truth and  fantasy become blurred.

 

“In societies where modern conditions of production prevail, life is presented as an immense accumulation of spectacles. Everything that was directly lived has receded into a representation” (Debord 1967).

Consumer capitalism has ripped the citizen role from the heart of nursing and replaced it with consumerism in which we are presented daily with ‘the spectacle’ – representations of reality that are without form or substance but which service to make sacred the profane. The spectacle specifically aimed at women include the array of women’s magazines which preach that you can never too thin or that your breasts require surgical enhancement; thus are we distracted about what is truly real by a false representation, within care employment contexts that are precarious, undervalued and invisible. Feminists know this, critical theorists know this, those with a sociological imagination know this, many women actually feel the cognitive dissonace that this engenders. In California,  nurses have acted as citizens, able to see pass the distractions for long enough to see exploitation as it really is. In the UK those nurses who can see the reality, need to the support to take charge of care in this country.

Ordinary citizens need to organise their frustrations and anger over health and social care and cohere into a viable opposition. Unfortunately UKIP are currently presenting another false representation with the spectacle of Nigel Farage presented as an ‘ordinary bloke’ that nearly 30% of the electorate are falling for.

We saw a spectacle of poor care again last night, lets not allow it to become entertainment for its shock value, lets instead urge action by all of us to provide the care older people deserve.

 

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