Alpha Males, Psychopaths and Greedy Bastards,

Alpha Males, Psychopaths, Greedy Bastards.

In October 2016, during the United States presidential campaign, the Washington Post released a recording of Donald Trump made in 2005. Trump was heard to be making comments about women:

“I moved on her and I failed, I admit it. I did try and f*ck her, she was married…I moved on her like a bitch…you know I’m automatically attracted to beautiful – I just start kissing them…its like a magnet…grab them by the pussy. You can do anything” (BBC 2016).

Nigel Farage told Fox news that the remarks were ‘ugly’ but something “if we are honest that men do… this is alpha male boasting”. (BBC 2016).

The alpha male trope, its behaviours and traits, might be widespread (Ludeman and Erlandson 2006) especially among ‘alpha males’, those in the 1% and the plutocracy. Teller (2017) critiqued a Fox news article which argued that women’s success in the Boardroom are dooming their marriages, because they are “groomed to be leaders rather than wives…they become too much like men…too competitive…too masculine…too alpha”. Teller criticised the piece for its uncritical acceptance of an American trope – the leader as alpha male, which has ‘wormed its way’ deeply into the American subconscious. It is part of the American mythos in which great men accomplish great deeds with little help from anyone else and draws from a rich vein of rugged individualism as expressed by such as Ayn Rand (1957, 1964). It is in line with the ‘Great Man’ theory of leadership in which leaders are born not made, and great leaders will arise when there is great need, “Cometh the Hour, cometh the man”. Thomas Carlyle (1840) was an early exponent of ‘Great Man Theory’ in the 1840s stating: “The history of the world is but the biography of great men”.

In 2004, Ludeman and Erlandson painted a positive picture of Alpha males, arguing that the modern corporation is characterised by their presence, that indeed it would be difficult to think of the corporation without them. They also devised an instrument to develop ‘alpha profiles’, based on 1,507 individuals all of whom worked full time in the business world, 64% were male with an average age of 41 in 106 countries and in various industries. A significant finding was that alpha risks are closely related to alpha strengths, in general the greater the strengths, the greater the risks, see table below (Ludeman and Erlandson 2006).

The stereotype, or trope, exists probably not as result of biologically determined characteristics or superior innate traits. Rather it is probably the case that the ‘innate traits’ of ‘Great Man Theory’ are used as justification for aggressive, competitive, loud, selfish and often sexually dominant male behaviour. This justification harks back to Thomas Carlyle’s description; draws upon quasi pseudo-scientific principles of evolutionary biology’s ‘survival of the fittest’, and the individualistic rhetoric of neoliberal political economy (Goodman 2017) which is based on an erroneous utility maximising rational actor theory, i.e. ‘homo economicus’ (Persky 1995). It also has roots in the ‘objectivist epistemology’ of Ayn Rand (2007a, 2007b) whose 1947 and 1954 novels have gained current popularity among some of the most powerful people in the United States, and those who aspire to be the most powerful in the United Kingdom (Freedland 2017). Rand’s emphasis on, and the neoliberal rhetoric of, ‘freedom’ is a rallying cry used to mask the reality of exploitation (Monbiot 2017).

Not only is it a myth used by the erstwhile ‘masters of the universe’ in the City of London to justify their dominance, it is sexist and misogynist as it is ignorant of socially constructed gender roles; it is unscientific without any grounding in the natural sciences, it is anthropomorphic of animal behaviour, and it is simplistically individualistic as it shifts the explanations for status and power differentials away from issues of social structure onto biological inevitability and individual psychological characteristics. It is uncritically reflexive in its adoption of the ‘liberal human self’ ontology. It does so to avoid discussing, acknowledging and unmasking unequal social relationships based on class, gender or ethnicity.

Alpha male behaviour is a choice exercised by ‘those who can’ based on their privileged backgrounds and attributes, which are often white, male, heteronormative, educated and so called ‘elite’, over ‘those who have not been able to’. The latter have to overcome class, ethnic and gender barriers not faced by their privately educated competitors. The alpha male also ignores or dismisses our capacity for empathy, without which it truly is an alpha dog eat beta dog world. This alpha male ideology and actual behaviour assumes selfishness and self-interest are main driving forces for successful capitalist societies. The inequality it helps to sustain are, in this world view, necessary for success. Alpha males may also share some characteristics attributed to psychopaths.

What are ‘Alpha Males’?

The term comes from studies of animal behaviour (ethology), e.g. in chimps (de Waal 1982) and wolves (Mech 1999). It denotes the animal of the highest rank who achieves this status often through physical prowess. They often get to eat first and mate first, and in some species they are the only one allowed to mate. Sexual conquest is thus an important aspect of alpha behaviour. Animal behaviour, for some, provides models and explanations for human behaviour on the basis that we are evolved animals only differing from, say, primates because of our higher cognitive functions. It is thus tempting to extrapolate from primate behaviour to human behaviour on the basis that behaviour in human social groups are affected by evolutionary, and genetic, processes. We watch animal behaviour and are tempted to anthropomorphise and apply to humans. E.O Wilson’s ‘Sociobiology’ was term akin to ethology in that it was an attempt to explain social behaviour in humans such as altruism, nurturance, aggression,  by appealing to underlying evolutionary mechanisms and thus the theory has more than a whiff of biological determinism about it.

In humans, we label alpha behaviour often as that which is about ‘getting the girl’ due to confidence, charisma and competitiveness. Women are supposed to like this display and ‘swoon’ in the presence of an alpha. Whether this is true in sexual politics I leave to women to decide. However alpha characteristics, if seen as the basis for sexual success, can also be seen to be the basis of success in business and politics.

Ludeman and Erlandson (2004) describe the Alpha as ‘highly intelligent, confident, and successful (who) represent about 70% of all senior executives in the United States’. They are not happy unless they are the ‘top dogs’ – they are supposedly natural leaders, they get stressed when tough decisions don’t rest in their hands; they get a thrill when in charge. Ludeman and Erlandson also identify four breeds of Alpha: commanders, executors, strategists and visionaries. Alphas have ‘unique strengths as well as destructive ‘flip sides’.

Strengths and Weaknesses of Alpha leadership style.

It might be an interesting exercise to compare the traits with descriptions of psychopathy/sociopathy which according to Hirstein (2013) are:

  • Uncaring, Shallow Emotions, Overconfidence, Narrowing of Attention.
  • Irresponsibility, Insincere speech, Selfishness, Inability to plan for the future and Violence.
Alpha Attribute Value to Organisation Risk to Organisation
Self-Confident and Opinionated. Overconfident Acts decisively has good intuition Is closed minded, domineering and intimidating.
Highly Intelligent Sees beyond the obvious, takes creative leaps Dismisses or demeans colleagues who disagree with him. Uncaring
Action orientated Produces results Is impatient, resists process changes that might improve results. Narrowing of attention.
High performance expectations for himself and others. Uncaring Sets and achieves high goals Is constantly dissatisfied, fails to appreciate and motivate others. Uncaring
Direct communication Style.

Uncaring.

Moves people to action Generates fear and gossip filled culture of compliance. Uncaring
Highly disciplined. Is extraordinarily productive, finds time and energy for a high level of work and fitness Has unreasonable expectations of self and others, misses signs of burnout
Unemotional. Shallow emotions. Is laser focused and objective. Narrowing of attention Is difficult to connect with, doesn’t inspire teams..

(Ludeman and Erlandson 2004).  Words in italics are from Hirstein’s description of psychopathy.

Juni (2010) suggests 3 major types of psychopathy: Superego deficit, aggression driven and sadism while also acknowledging controversy over definition (Scott 2014). He does suggest that people with psychopathy have ‘pro social’ values who often pragmatically get by through complying with social rules and norms. They are able to manage relationships at an adequate, though superficial level. Interestingly they are able to advance in their careers through their interpersonal skills. In discussing ‘superego deficit’ Juni suggests that due to extreme emotional hurt or deprivation in childhood, ‘superego internalization’ is lacking. This means children fail to develop their own checks on what is acceptable and how they should treat others, and then rely on external repercussions to govern behaviour. They have a basic learned incapacity for interpersonal trust, meaning they never really learn to appreciate others and will essentially be ‘users’ as they exploit relationships for their own good. Others are expendable and exchangeable. Another aspect of this is ‘blunted affect’ in which the child has learned to distance itself from all forms of emotion. Past experiences of emotion were painful they learn to choke off feelings. There is a superficial veneer of emotion but internally they have renounced affect. These might be useful traits to have in leading certain corporations.

What would a Venn diagram look like?

Silvio Berlusconi displayed, or thought he did, alpha traits bringing Italian politics into the bordello by treating Italian voters like paying customers being screwed by the puttana of politics. Trump’s ‘pussy grabbing’ comments similarly betray a sense of unearned entitlement, objectifying women merely as playthings for his own narcissistic amusement. His dismissal of this as ‘locker room banter’ was an insult to many ‘locker rooms’ and in doing so he tried to use a veil of ‘irony’ to cover actual misogyny.

Those that consider themselves as alphas may earn more, compete more or attain higher social status than their beta brothers; they think of themselves perhaps as ‘Heroes, Rogues and Lovers’ (Dabbs 2000). Dabbs used this as a book title and discussed the role of testosterone, a hormone linked with alpha theory, further giving justification within our biology. He also linked it with violent crime and sexual assaults!


 

Justifications

Alpha males may conceive of their actions as originating in and being determined by and thus excused by evolution, often implicitly invoking the reptilian brain and the force of genes upon behaviour and traits. Many alphas from the world of politics, business and economics are not steeped in ethology or would be aware of its origins. However an appeal to evolution is nonetheless often present. Thus they have an essentialist understanding of the human. What is missed is that evolution has further acted upon the human brain and we now have the limbic brain and the neocortex which together, it is argued, constructs the ‘Triune Brain’ (MacLean 1990). In other words the reptilian territorial selfish brain has the empathic, communitarian brain and higher cognitive functioning brain to balance any primordial tendencies. Alpha also misses what epigenetics tells us, i.e. that it is the interplay between environment and genes and cultural life that influence behaviour. We are not as genetically predisposed to do anything, as much as we like to think we do. Appeals to some form of biological determinism for behaviour, is just stupid.

A modern exponent of essentialist determinist nonsense in the field of psychology is John Grey. His book ‘Men are from Mars, Women are from Venus’ exaggerates the differences and lends credence to theories based solely on biology. He recently explained the behaviour of ‘alpha males’ as resulting from testosterone. Men, he suggests, are hard wired for violence and polygamy. This relates to the workings of the reptilian brain. However, as already noted we also have the capacity to be ‘soft wired’ to be empathic and communitarian. Susan Gerhardt (2011) argues it is culture and child rearing practices that results on changes in brain function towards or away from empathy, violence and selfishness. This is based on neuro-scientific research, such as that carried out by Baron Cohen (2011). Hard wiring is a misleading term as it suggests a form of determinacy, reducing the possibilities for change.

Research now suggests that we are soft wired with ‘mirror neurons’, which results in our ability to experience another’s plight as if we were experiencing it ourselves (Rifkin 2009), we can then empathise with others. We are not hard wired for aggression, violence, utility maximisation and self-interest but soft wired for sociability, acceptance, affection and companionship. However, we have built up social institutions and economic structures as if the former were true. These selfish structures are going global. These structures are also designed and run by alpha males for alpha males and justified by appeals to human nature and the inevitability of violence, aggression, utility maximisation and self-interest as the engines for creative social development that capitalism has wrought.

Self Interest?

 

Alpha’s justifications imply an ‘essential’, often selfish human nature.  The idea of an essential human nature has a long track record. However, an essentialist view of human nature, if human nature indeed exists, does not necessarily mean that it includes a drive for naked self-interest and aggressive competition.  The modern confusion can be traced to some Enlightenment philosophers (e.g.  John Stuart Mill 1836,  Adam Smith 1776) and their modern interpreters, overplaying the selfishness and utility maximising aspect of behaviour. Thomas Hobbes in Leviathan placed self-interest on the throne of human motivation. Adam Smith’s utility maximising rational actor merely reflected what was emerging under industrial capitalism rather than what could be in other more empathic civilizations (Rifkin 2009).

Human nature to Alphas, is ‘naturally selfish’. We were naturally rational actors seeking our own self-interest to maximise our utility in the market. This we now know to be nonsense. Economics cannot be seen to work in isolation from society, culture, politics and power. Its mathematical models have proved to be false by the Great Financial crash of 2008 and by everyday experience.

Self-interest has not been seen as the only drive for humanity. Alongside this drive is the ‘Will to Power’ associated with Friedrich Nietzsche, the ‘Pleasure Principle’ associated with EpicurusJeremy Bentham and with Sigmund Freud (Snyder, Lopez and Pedrotti 2007) and the ‘Will to Meaning’ associated with Frankl (1946/2006). Thus the quests for Power, Pleasure and Meaning are alternatives to economic self-interest as drivers for human action. Erich Fromm and Manfred Max Neef have also discussed fundamental human needs which could be thought of as drivers for human action. Self-interest for material gain does not feature anywhere near as prominent in their theories.

 

Miller (1999) argues that a different view of human agency acknowledges the power of other motives, such as public spiritedness, empathy, commitment, and justice.

 

Yet given this, somewhat admittedly white, colonialist and patriarchal divergence of views on what motivates us in contemporary societies, it could be argued that hegemonic neoliberal imaginary (Hall 2011) especially in the United States and the United kingdom since the 1970’s, rests on the idea of the rational actor, the ‘free, possessive, individual’, using his economic self-interest for ‘life liberty and the pursuit of happiness’.

 

One aspect of rational self-interest is that of “principal-agent” theory: agents will perform best under high-powered financial incentives to align their interests with those of the principal (a business school thesis – Layard 2009). For example employees and managers (agents) will work for the same goals of employers and shareholders (principals) and not in their own self interest, if the goals are aligned, e.g. profits are shared. However, Daniel Pink argues that above a certain level of material reward, what motivates us is Mastery, Autonomy and Purpose. Financial rewards start to become hindrances rather than benefits. Not that this insight affects the level of, and justification for, the ‘High Pay’ of many ‘fat cat’ CEOs.

 

John Stuart Mill (1836) argued:

[Political economy] does not treat the whole of man’s nature as modified by the social state, nor of the whole conduct of man in society. It is concerned with him solely as a being who desires to possess wealth, and who is capable of judging the comparative efficacy of means for obtaining that end.

 

Similarly, Adam Smith (1776) wrote:

It is not from the benevolence of the butcher, the brewer, or the baker that we expect our dinner, but from their regard to their own interest.

 

Smith (1759) however does express in ‘The Theory of Moral Sentiments’ that self interest alone is not the sole motivator, men can act out of regard for others:

“How selfish soever man may be supposed, there are evidently some principles in his nature, which interest him in the fortunes of others, and render their happiness necessary to him, though he derives nothing from it, except the pleasure of seeing it. Of this kind is pity or compassion, the emotion we feel for the misery of others, when we either see it, or are made to conceive it in a very lively manner. That we often derive sorrow from the sorrows of others, is a matter of fact too obvious to require any instances to prove it; for this sentiment, like all the other original passions of human nature, is by no means confined to the virtuous or the humane, though they perhaps may feel it with the most exquisite sensibility. The greatest ruffian, the most hardened violator of the laws of society, is not altogether without it” .

 

This exposition of rational self-interest demonstrates that Smith accepted that what makes us human is not only based on unrestrained self-interest.

 

Ayn Rand (1943, 1957) in her novels and lectures taught ‘objectivism’ based on a belief that:

 

man exists for his own sake, that the pursuit of his own happiness is his highest moral purpose, that he must not sacrifice himself to others, nor sacrifice others to himself”.

 

Rand insisted on the ‘virtue of selfishness’ and the ‘morality of rational self-interest’ which is congruent with the neoliberal creed of individual responsibility. This sounds close to Adam Smith’s rational self-interest of the market, whereas Smith described the invisible hand, Rand moralises it.

 

Yet Becker (2007) argues that moral leadership is exercised not solely based on rational self-interest, that business decisions are not made only on the economic conditions of the market. The World Business Council for Sustainable Development (WBCSD) is also an example of business principles being enunciated which go beyond the simple search for maximum profit.

 

However, the theory of self-interest allied to material reward remains strong as a description of ‘natural’ human behaviour. If it is ‘natural’ then human happiness is gained if self-interest is given its head. Self interest as ‘human nature’ can be seen therefore as the major drive which should be harnessed both for prosperity and happiness.

 

 

Alphas as Self-Interested Greedy Bastards

 

Graham Scambler, following on from Margaret Archer’s theory of ‘modes of reflexivity’, argues that we have entered an era where plutocrats and oligarchs (Alphas) have captured the levers of the State to rule as ‘Greedy Bastards’.

 

He constructed an ideal-typical sub-type of Archer’s ‘autonomous reflexive’ called the focused autonomous reflexive. Those who make up the ruling oligarchy, or the ‘greedy bastards’, are also ‘focused autonomous reflexives’. Scambler argues they have the following characteristics:

 

“Total commitment:  The focused autonomous reflexive exhibits an overriding engagement with accumulating capital and personal wealth/income. Nothing less will suffice: that is, any deficit in commitment will result in absolute or relative failure.

 

NIETZSCHIAN Instinct: Born of a Hobbesian notion of the natural human state, they betray a ruthless determination to cut whatever corners are necessary to gain an advantage over rivals. they are the ‘blond beasts’ of ‘noble morality’ whose values are constructed by themselves to serve their own interests.

 

Fundamentalist ideology: Commitment is not only total and Nietzschian but fundamentalist: it does not admit of compromise. It is an ideology – that is, a standpoint emerging from a coherent set of vested interests – that brooks no alternative.

 

Cognitive Insurance: While cognitive dissonance is a state to which none of us is immune, they are  able to take out sufficient insurance to draw its sting. Thus accusations of greed and responsibility for others’ suffering are rarely internalized. Such epistemological and ontological security is the exception rather than the rule in this era of financial capitalism.

 

Tunnel Vision: A concomitant of a total, Nietzschian and fundamentalist commitment is the sidelining of other matters and a reflex and frequently gendered delegation of these to others.

 

Lifeworld Detachment There is simply no time for the ordinary business of day-to-day decision-making. In this way focused autonomous reflexives rely on and reproduce structures not only of gender but of class, ethnicity, ageing and so on. Their Lifeworld detachment presupposes others’ non-detachment, i.e. other people service the everyday requirements of life”.

Graham Scambler’s typology requires empirical verification and is not meant to describe any one person in totality. Without studying the lives of the 0.01% and their ‘players’ (often to be found in the 1%), this cannot be verified. However, may we see indicators of their world views in their speeches and writings?

 

Societies have ‘myths’ – stories to explain phenomena and to bind the people together. Self Interest in free markets is an old story, an ‘anti-myth’, as it divides peoples based on negativity, rather than binds. It sorts a people into ‘winners and losers’, ‘top cornflakes‘, ‘skivers or strivers‘ and the ‘left behind‘. It is not based in the actuality of human experience or within philosophy over history, but has been imposed in the West as a guiding ideology especially since the Reagan-Thatcher Duopoly. The Autonomous Reflexives both in the political class and the corporate class of the 0.01%, have imposed: “there is no alternative” and ridden roughshod over other values and stories. Facts, evidence and reason have not worked against their neoliberalism to date. However we may be witnessing the challenge of Authoritarian Populism, which will either destroy or appropriate neoliberalism, as a new ‘anti-myth’. What we need now is a new story, to bridge this ‘myth gap’ (Evans 2017).

 

A poor ‘quality of mind’ 

Alpha males lack a sociological imagination, a quality of mind that links biography and history and the relationship between the two in society. They are unable to link their personal stories to the structures of society at the time they live in. For them, continuing unemployment is simply a personal failure not a result of changing labour market structures; obesity is a personal and moral weakness unrelated to increasing fossil fuel dependence (car use) and the availability of cheap calorie rich foods and our ‘lock in’ to high carbon systems; the lack of female representation at the top is down to female unsuitability to leadership in market employment conditions rather than market conditions being designed by alpha males for alpha males; black people are poor because they lack a work ethic not because of institutional and cultural racism; countries are underdeveloped because they lack a capitalist ethic rather than as a result of past and current imperialism.

They seek always to blame the individual, emphasise personal responsibility and ignore power relationships and structures, which are rigged in one’s favour. Once one accepts the notion that success may be down to a combination of luck, individual effort and abilities, privileges and certain socio-economic conditions, then it becomes untenable to justify huge disparities in reward as being solely based on one’s work ethic and abilities. Empathy is a luxury for the weak in this context, for to empathise would mean examining the real reasons for success and failure in one’s ‘peers’ and the need to gain an understanding of the hopes and ambitions and the barriers to fulfilling such in an unjust world.


 

Freedom!

Alpha males behave in that way because we let them do so and because they have the power to do so. It is often a self-justificatory myth for boorishness and exploitation of the weak members of society. It has no scientific basis. It is theoretically vacuous, empirically wrong and philosophically infantile. We are not ruled by our hormones, our genes or our reptilian brains. However, alpha males have big sticks and they make the rules, but they can be forced to put the sticks down.  We can refashion society in a way that reflects more communitarian ethics and behaviour when we first counter their propaganda based on a singular value ‘freedom’. Freedom is a word that powerful people use to shut down thought (Monbiot 2017). What they mean of course is freedom to do what they please, what they count , free from red tape, regulations of market stultifying laws.

Freedom from: Trade Unions; paying Tax; environmental protection legislation.

Freedom to: design sophisticated financial products that crashed the system in 2008; to buy and develop property that only plutocrats can own; lobby and receive from the state for a hand out on land they own; to ignore and bypass democracy….

Do Alphas exist?

Now it may be that the alpha male is a straw man, that in reality powerful men do not exhibit traits of dog eat dog über competitive, devil take the hindmost, who dares wins mentality. Step forward Donald Trump, Steve Bannon, Rex Tillerson, Alan Greenspan, Senator Rand Paul, Uber’s Travis Kalenick, Facebook’s Peter Thiel, Boris ‘Top Cornflake’ Johnson, Sajid Javid MP,  Alan Sugar… Kim Jong Un, Putin, Assad, Modi, Orban, Erdogan, Duterte….

Do alphas exist in real life? If an alpha is a highly rewarded individual, at the top of the social stratum and who justifies that position by reference to their own individual endeavour then we may suggest that the erstwhile masters of the universe may qualify as alphas.  Toynbee and Walker (2008) interviewed City ‘High Fliers’ in an attempt to understand their justifications for their salaries and bonuses. Their responses certainly indicate their attitudes as alphas, they objectively are high status and they control the reward structure. No doubt their access to females is unlimited. Competition and charisma would be prized characteristics among this group. It was clear from their responses that they saw that their success was down to them and their individual effort. Initially the reasons given for success was globalisation (a structural reason) but as Toynbee and Walker continued it became clear that personal moral reasons were the basis for success. They thought of themselves as ‘better’: “we work harder and aspire the most”, fairness is not a valid question, “it’s a fact of modern life that there is a disparity…people say its unfair when they don’t do anything to change their circumstances”, “people don’t want to achieve”, “you won’t find a teacher who works as hard as we do” (p27).

Empathy at the socio-political or corporate level is hard to find. Aspects of neoliberal capitalism and globalisation is pitting all against all as nations try to out compete each other in a race to the bottom in terms of wage reductions, pension reductions, flexible working (i.e. rotational unemployment) and extensions of working lives. Somehow we have accepted that working longer for less in a less certain world is a good thing because not to do so risks losing jobs to India and China (Jones 2011). The structures of globalisation are such that competition not cooperation rules social lives. We are now working for the economy rather than for the community. It is not the alpha males in Greece who have to bend the knee to austerity, they still have their yachts and villas. The existence of the odd rich alpha victim to globalised capitalism only serves to show that the system they operate takes no prisoners. Many of those who go down keep the riches they earned when in power.

The lack of an empathic civilisation and the rule by global elites is not natural or inevitable but we somehow believe it to be so. Meanwhile the alpha looks on, secure on his yacht or in his gated community in ‘Richistan’ (Frank 2007), laughing at the poor people while justifying his ‘right’ by ‘might’.

Because he can.     Because he’s ‘worth it’.

 

 

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Neoliberalism: Rhetoric and Reality.

This paper was prepared as background to the 4th edition of ‘Communication and Interpersonal skills in nursing (Grant, A. and Goodman, B. forthcoming). In that book discourses of neoliberalism and their effects on health and health service delivery as well as the interpersonal communications nurses have with people will be explored and critiqued. An example is the discourse on ‘individual responsibility for health’ and ‘lifestyle drift’ responses to public health which draw upon the concept of ‘sovereign individual’ of neoliberal philosophy. This paper explores what neoliberalism might be to argue that it is more a discursive practice than a political action.

 

Neoliberalism is at once everywhere and nowhere. There is ‘appearance’ and ‘reality’, there is reification and fetishisation. Its name is spoken in certain circles and vilified (Springer 2016), it is an ‘imprecise exhortation’ (Thorsen and Lie 2007, Thorsen 2009), in others there is denial that it even exists (Talbot 2016). It might be best to understand neoliberalism as a ‘discourse’ (Foucault 1969) rather than an actuality of political practice, as a “rather radical set of ideas which nevertheless have had a certain influence on society and politics in recent times” (Thorsen 2009 p20).  It is a word used by the progressive and critical left, e.g. Saad-Filho and Johnson (2005), to counter what the right call the ‘free market’ in the context of the breakdown of the post war consensus around the social welfare democratic state.

 

I suggest that the discourse of the ‘Free Market’ was, and is, used to reshape the State, and civil relationships, away from ownership and control of the means of production, away from Keynesian state intervention in the economy and away from providing all social security (including housing, health, education, and transport). Free market rhetoric is used to mask the reshaping of State apparatus towards State intervention for wealthy landowners and corporates (financial and industrial). This is a bid by a capitalist class to (re)capture the State’s support for capital and property accumulation in their favour. This ‘support’ is referred to as a ‘framework’ in which ‘free’ markets are to operate. I also argue that there is nothing ‘neo’ or ‘new’ about the practical reality of this form of liberalism, tied as it is to the capitalist State.

 

The term ‘Free market’ is often preferred to ‘neoliberal’ by its supporters according to Talbot (2016) and Thorsen (2009) who argues that the term neoliberal is now most often used in a pejorative way by the left. We say ‘Neoliberal’ you say ‘Free Market’. ‘Free market’ or ‘neoliberal discourse’ is used as part of the Ideological State apparatus backed up by the Repressive State apparatus of the judicial system, police and ultimately, if needs be, the military.

 

An important idea of ‘Free Market/Neoliberalism’ is the espoused theory of a minimalist State. The theory in action is a State becoming minimal for social security but otherwise continuing the facilitation of capital accumulation and the ownership of wealth especially by the 0.01%. The ‘Nightwatchman’ minimal state of the 19th century is a goal of free market (or liberal) ideology, but this has not been achieved for all of the talk of the Reagan/Thatcher years of the 1980’s. This is possibly because the reduction of State spending down to 10% of GDP from the current 40% of GDP (per year, see figure 1 in the appendix) would be as disruptive for the capitalist class and the political power elites as it would for everyone else. This is also because key sectors of the economy such as agriculture, the military-industrial complex, and the nuclear power and fossil fuel industries, rely on government funds and subsidies without which their business models would have to be radically altered. Capitalism’s ‘creative destruction’ is a lauded dynamic feature, as long as its not your industry or business model that goes bust or, in the jargon; is ‘disrupted’.  It is also because in theory, liberalism is not a monolithic philosophy, ‘classic’ and ‘modern’ Liberalism (Ryan 1993) have different views of the State’s role.

 

The minimalist state (‘Nightwatchman’) ‘classic liberal’ solution to questions of political economy might still be the goal of some current thinking. This may include the Tea Party in the US, kicked into life by Rick Santelli’s comments on President Obama’s mortgage bail out plan (Pallasch 2010),  and perhaps in the UK by the Adam Smith Institute. Yet in current practice many of the Conservative capitalist class, and their political voices in the Tory party, seem as wedded to state intervention as they claim socialists to be.

 

Neoliberalism as a discursive practice, embedded and supported by an ideologically driven, highly funded ‘intellectual’ infrastructure, can also be linked to around 1,000 self conscious neoliberal intellectuals organised in the Mont Pelerin Society (Plewhe et al 2007). Its proponents fight for hegemony in research and development, and engage in political and communication efforts with well funded, well coordinated and highly effective new types of knowledge organisations: partisan think tanks such as the Cato Institute and the Heritage Foundation in the US, the Institute for Economic Affairs (IEA) and the Centre for Policy Studies (CPS) in the UK and the Institute of Public Affairs in Australia (IPA) (Beder 2001).

 

A Discursive Project.

 

This is an ongoing rhetorical project in the UK because as Desai (2007) argues, the values and principles of Thatcherism, which did not call itself neoliberal but did emphasis similar ‘free market, small state’ principles mixed with ‘Victorian values’,  were not wholly accepted by the British public. This is evidenced in surveys of public opinion in the 1980’s and 90’s and arguably even today if support for the socialist inspired NHS is an indicator.

 

Support in elections since 1979 have not won over majorities of the electorate, and it is only thanks to first past the post that Tories and clause 4 ditching ‘Tory lite’ New Labour, were able to win. See figure 1 (appendix) which shows what % of the electorate actually voted for the government of the day.

 

These figures show that at its peak only 33% of voters could be bothered to put an x next to free market rhetoric. This was down to 24% by 2015. Neoliberals/Thatcherites/ Conservatives have not won the hearts and minds of the British Electorate and neither has the goal of a small state in terms of GDP spend been achieved. Their success in the US and the UK, is to be measured not by the popular vote, but by their assaults on Trade Unions, by Privatisations, Tax breaks and Labour market and Financial deregulations.  And by the increasing share of wealth and high pay going to the 1% and 0.01% (Saez and Zucman 2014, Dorling 2014, Moshinsky 2016).

 

I argue here in accordance with Desai (2007) that:

 

“Market dogma may well be entrenched in capitals around the world, but its intellectual vacuity and practical failures have been documented in a vast literature. It would be truer to say that neoliberalism’s intellectual pretensions are designed to provide a fig leaf of intellectual respectability to the most naked pursuit of the interests of capital and property (my emphasis) than that neoliberalism has motivated this pursuit by intellectual force and political influence” (Desai 2007 p220).

 

In other words, powerful and rich individuals have used talk of free markets (and neoliberalism) to justify their ongoing grab of global wealth through using the levers of State power, rather than it being the case that the intellectual case motivates their actions.

 

Graham Scambler (2012) also points in this direction in his exposition of the ‘Greedy Bastards Hypothesis’ which is underpinned by the strategic actions of ‘focused autonomous reflexives’ in the capitalist class executive and the political power elite.

 

 

 

 

Discourse

 

 

In common understanding a ‘discourse’ is an exchange, perhaps of ideas, between two people involving language as the medium of transmission. This can be seen as a neutral exercise between two people of equal power and status using certain phrases, words, jargon and syntax to share understanding or to question the other’s statements. Consider the situation when two Tory MPs are talking to each other about a ‘flexible labour market’  or the need for people to be ‘taking responsibility for one’s health’. The first is an example of the neoliberal/free market discourse that favours weak labour regulations to make it easy to hire and fire staff making them ‘flexible’. The second brings in and joins the ‘Moral Underclass discourse’ (Carlisle 2001) to the free market’s central idea of ‘free sovereign individuals’ in charge of their own destiny in order to shift responsibility fully onto the shoulders of individuals. This discourse can then blame individuals for being obese, for smoking or for any other ‘moral failing’ such as catching an STI or binge drinking.

 

Discourse as a critical concept is associated with Michel Foucault. For Foucault (1969) discourses are institutionalised patterns of speech and knowledge seen and felt in ‘disciplinary’ structures, e.g. in the medical clinic or in the prison (Foucault 1963, 1975). Discourses connect knowledge to power. Knowledge is power. To oversimplify, the concept refers to the idea that a discourse shapes, or constructs what we know, what we can say and also reflects differences in power between people. Becoming a Tory MP introduces one to the institutionalised patterns of speech which might be very familiar to that experienced in public schools (e.g. Eton) and certain Oxbridge clubs (e.g. Bullingdon).

 

 

 

 

Discourses are more than mere words.  A discourse, Foucault (1969) suggested, actually brings into being that of which they speak.

 

“…discourses…are nota mere intersection of things and words….

 

The task of analysing discourses is to show that they are not just:

 

groups of signsbut as practices that systematically form the objects of which they speak.discourses are composed of signs; but what they do is more than use signs to designate things. It is this more that renders them irreducible to language and to speech. It is this morethat we must reveal and describe (1969 p 54)” (my emphasis).

 

By continually repeating the discourse, and getting it accepted by enough people, that “There is no money” or “There is no Alternative” or “Labour caused the public debt” or “Banks are too big to fail” or “Top cornflakes rise to the top” or “high pay rewards hard work and intelligence” or “Inequality is good for competition” or “Skivers v Strivers” or “In this together” or “we must balance the books and bring down the deficit” these things are brought into being. They are part of a larger, taken for granted, understanding of the ‘proper’ role of the state, the individual and the corporation.

 

 

What then is ‘Neoliberalism’ and what is formed by that of which it speaks?

 

 

Traditional Enlightenment ‘classical liberalism’ (Ryan 1993) emphasises:

 

  1. Individual Freedom (liberty) through limiting government and maximising capitalist market forces.
  2. Civil liberties under the rule of law and laissez faire economics.
  3. Free markets, utilitarianism, natural law (inherent rights which are universal, uncovered by reason) and progress.

 

Key thinkers: Adam Smith, John Locke, Thomas Hobbes, David Ricardo. Alexis de Tocqueville

 

Modern liberalism accepts a greater role for the State in the economy, manifested in regulation and the State supplying of goods and services (Ryan 1993). Laissez faire economics cannot in this interpretation meet the goals and purposes of liberalism. Thorsen (2009) argues that liberalism has many facets and has become in effect a contested concept particularly over the role of the State.

 

 

Neoliberalism is associated with ‘Austrian’ economists Ludwig Von Mises (1881-1973), Friedrich Hayek (1899-1992) and the American economist Milton Friedman (1912-2006). Around 1950, the classic liberal state had grown into, for some, a social democratic monster driven by Keynesian economic theory and the growth of Welfare States. In both the US and the UK, governments were beginning to spend more and more of GDP and intervening in many areas of the economy including social security programmes. Von Mises, Hayek and Friedman would have noted that the share of GDP spent by the State on welfare and public services had grown from about 10% in the middle of the 19th Century (figure 2 in the appendix) to around 40% by the 1970’s.  Today the share of GDP spent by the government in the UK is about 41% (figure 3 in the appendix).

 

In the context of the centrally planned Soviet Union and Hitler’s Germany, Hayek (1944) argued that any government control of economic decision making through central planning leads to tyranny and that civilisation requires liberty as a prerequisite for wealth and growth (1960). Hayek and Freidman (in the 1950’s) referred back to classical liberalism rather than ‘neoliberalism’ in their reaction to the amount of state intervention in the economy.  Yet, they accepted some aspects of welfare provision by the State although this provision in their view should be greatly reduced. Their status as fringe economists  in the 50’s was altered when their economic theory and political philosophy was then taken up by Reagan in the US and Thatcher in the UK around the late 1970’s. At this point there had been a sort of post WW2 consensus between Conservatives and Labour regarding the level of state intervention in the economy.

 

 

 

Margaret Thatcher was to change that cosy relationship.

 

At a Conservative Party policy meeting in the late 1970’s, Thatcher made it clear upon what her approach to the economy was based:

 

Another colleague had also prepared a paper arguing that the middle way was the pragmatic path for the Conservative party to take…the new Party Leader [Margaret Thatcher] reached into her briefcase and took out a book.  It was Friedrich von Hayek’s The Constitution of Liberty…..she held the book up for all of us to see.  ‘This’, she said sternly, ‘is what we believe’, and banged Hayek down on the table.” (Ranelagh 1991).

 

Neo simply means ‘new’ and refers us back to the earlier liberal small state. The ‘Nightwatchman’ state in the 19th century provided for property rights, contracts, markets and personal/national security. That was about it. No provision for schools, health, transport or subsidies for industries. Hence the relatively small % of GDP being spent by the government. Talbot (2016) argues that the 1950’s Neoliberalism was new in that it also embraced social as well as economic and political rights. Social protection, workers rights and public health would actually help the capitalist society, however following the Chilean coup of 1972 a theoretical inversion took place in which it now meant a reversion to 19th century free market liberalism.

 

Four Definitions

 

Stuart Hall (2011) argued that:

 

The term ‘neo-liberalism’ is not a satisfactory one. Intellectual critics say the term lumps together too many things to merit a single identity; it is reductive, sacrificing attention to internal complexities and geo-historical specificity. However, I think there are enough common features to warrant giving it a provisional conceptual identity, provided this is understood as a first approximation…..What, then, are the leading ideas of the neo-liberal model? ….neo-liberalism is grounded in the idea of the free, possessive individual. It sees the state as tyrannical and oppressive. The state must never govern society, dictate to free individuals how to dispose of their property, regulate a free-market economy or interfere with the God-given right to make profits and amass personal wealth”.

 

A ‘tyrannical and oppressive’ State was of course Hayek’s view.

 

George Monbiot (2016) outlined its main principles in this way:

 

“Neoliberalism sees competition as the defining characteristic of human relations. It redefines citizens as consumers, whose democratic choices are best exercised by buying and selling, a process that rewards merit and punishes inefficiency. It maintains that the marketdelivers benefits that could never be achieved by planning. Attempts to limit competition are treated as inimical to liberty. Tax and regulation should be minimised, public services should be privatised. The organisation of labour and collective bargaining by trade unions are portrayed as market distortions, that impede the formation of a natural hierarchy of winners and losers. Inequality is recast as virtuous: a reward for utility and a generator of wealth, which trickles down to enrich everyone. Efforts to create a more equal society are both counter-productive and morally corrosive. The market ensures that everyone gets what they deserve”.

 

David Harvey (2005) defines it thus:

 

Neoliberalism is in the first instance a theory of political economic practices that proposes that human well-being can best be advanced by liberating individual entrepreneurial freedoms and skills within an institutional framework characterized by strong private property rights, free markets, and free trade. The role of the state is to create and preserve an institutional framework appropriate to such practices. The state has to guarantee, for example, the quality and integrity of money. It must also set up those military, defence, police, and legal structures and function required to secure private property rights and to guarantee, by force if need be, the proper functioning of markets. Furthermore, if markets do not exist (in areas such as land, water, education, health care, social security, or environmental pollution) then they must be created, by state action if necessary. But beyond these tasks the state should not venture. State interventions in markets (once created) must be kept to a bare minimum because, according to the theory, the state cannot possibly possess enough information to second-guess market signals (prices) and because powerful interest groups will inevitably distort and bias state interventions (particularly in democracies) for their own benefit.

 

 

Thorsen (2009) after an examination of literature on liberalism including the critical literature argues:

 

“Neoliberalism is…a loosely demarcated set of political beliefs which most prominently and prototypically include the conviction that the only legitimate purpose of the state is to safeguard individual liberty, understood as a sort of mercantile liberty for individuals and corporations. This conviction usually issues, in turn, in a belief that the state ought to be minimal or at least drastically reduced in strength and size, and that any transgression by the state beyond its sole legitimate raison d’etre is unacceptable (cf, especially Mises 1962; Nozick 1974; Hayek 1979).

 

This latter two descriptions  are that of the ‘Nightwatchman State’. Remember at this time in the 19th century less than 10% of GDP was spent by the government on public activities. Is this the goal of current Conservatives? Or is neoliberal/free market discourse an ideological mask for something else?

 

A minimal state safeguarding individual mercantile liberty and that is it?

 

We have to question whether in action Tory ministers believe this and wish to cut public spending from around 40% to 10%. To see what that would mean, we would need to look at the current 2017 budget (approximately £800 billion which is 40% of GDP) and note that to get down to 10% of GDP the budget would have to be £200 billion. See the appendix figure 4 for the 2017 budget. This is not 10% of GDP. Social Protection (pensions in the main) is over 10% on its own.

 

This is not a ‘Nightwatchman’. Is it a socialist utopia? The State is spending a lot of money still. However, what is actually happening is that in each sector, privatisation means that more and more government money (taxpayer’s money) is subsiding private provision. This is an explicit aim of the Adam Smith Institute who explicitly call for private provision but public funding for health. In Rail the government is subsiding private train operating companies and in housing the government is subsidising landlords through housing benefit.  In employment the government is subsidising employers through tax credits.  Figure 5 in the appendix shows where the revenue comes from.

 

The UK government spending accounts for about 40% of GDP, leaving 60% going elsewhere. Spending on health, social care and social protection (pensions) accounts for £426 billion, that is over 50% of the total spend. Add £102 billion for education (total now is £528 Billion).

 

Who pays for that? Well, whoever pays Income Tax, National Insurance, VAT, Council Tax and excise duties. All of this accounts for £628 billion.

 

What we have is redistribution from the 99.9% to the 99%.

 

‘Neoliberalism’ as rhetoric actually works for 0.01% – the plutocrats, the global capitalist executive. Henry (2012) argues that anything between $21 to £31 trillion as of 2010, has been invested tax free in about 80 ‘offshore’ secrecy jurisdictions. That is trillion not billion.

 

What we don’t have is a minimal state focused solely on safeguarding liberties for markets.

 

This idea of a small state free market economy is of course patent nonsense as it has just not happened. The reduction of public spending and deficit reduction are two current policy goals (i.e. Austerity) but this is hardly neoliberalism.  Neoliberal purists have failed to get the Tory party to reduce spending to these ‘classic liberal state’ levels. So what was all that Thatcherite talk for?

 

The reduction of state spending down to 10%, I suggest is either a complete failure of the neoliberal project or it is deliberate policy failure in that this is not the neoliberal goal at all.

 

It could be the case that the free market discursive practice is a cover for capital and property accumulation through curbing what is seen as labour power but more importantly by capturing the levers of the State. Cutting state spending to 10% would be seen by the capitalist executive and the political power elite to be socially and politically dangerous to capital accumulation.

 

Marx once remarked in the Communist Manifesto:

 

the executive of the modern state is but a committee for managing the common affairs of the whole bourgeoisie”.

 

One does not have to be a communist to begin to see how executive power is being used to the advantage of Capital (deregulations, subsidies and offshore tax breaks) while at the same time weakening labour through strict union laws, wage freezes and labour market ‘flexibility’.

 

Prior to 1900, no state spent more than 3% of GDP on ‘social programmes’. Around 1870 the average public spending level of ‘advanced economies’ was 10% (Talbot 2016). The 1914-1918 war saw an increase to 20%, followed by a steady growth to the 40% of today. This leads Talbot to argue that the neoliberal state of the 1970’s with 40% spending is actually little different from liberal market/social democratic states. Therefore it is all talk and no action since that level of spending has not been reigned back to 19th century levels.

 

Does this mean that Thatcherism was not neoliberal in action? Yes, if by that we define a neoliberal state as that in which only 10% of GDP is spent. Was Thatcherism even ‘free market’ in action given the continuing level of state intervention in many sectors of society and economy? Both Thatcher and Reagan promised to ‘roll back the frontiers of the state’ or that ‘government was not the answer, it was the problem’. This was ‘New Right’ talk to distinguish it from post WW2 Conservatives who accepted the post war social democratic consensus based on around 40% GDP spending and intervention.

 

Talbot (2016) argues that neoliberalism exists only as a ‘bogeyman’ created on the left to oppose various conservative attempts to ‘rebalance’ government-market relations. Bruff (2017) however argues that ‘neoliberalism’ is not about a return to free markets and 10% spending levels but is an ideology to mask a coercive, non-democratic and unequal reorganisation of society. There is seeming agreement that this is not about cutting government spending per se down to 10% but about reshaping democratic social and political relationships in favour of Capital. To repeat Desai (2007):

 

neoliberalism’s intellectual pretensions are designed to provide a fig leaf of intellectual respectability to the most naked pursuit of the interests of capital and property”.

 

Bruff (2017) points out that many current governments are not neoliberal in that they actually oppose free markets in practice and instead are engaged in protectionist rhetoric and practice. A 40% GDP spend does not indicate much in the way of ‘cutting back the state’ except for the working classes as a result of austerity politics and social security spending decisions.

 

This results in socialism for the rich (state spending) and neoliberalism for the poor (welfare cuts).

 

If neoliberalism is narrowly defined as a political programme valorising free markets then indeed leaders such as Trump, Modi, Erdogan and Abi are not neoliberal. Instead ‘free market’ rhetoric is just that: rhetoric. Bruff goes on to suggest that actually Hayek et al constantly invoke ‘free markets’ as an abstract principle but then they have a preference for certain types of markets to prevail in actuality. Neoliberalism in this definition is the use of the State in a central role to maintain a certain kind of market:

 

“neoliberalism has nothing to do with markets as commonly conceived, and everything to do with the orchestration of social relations in the name of markets…it is about the coercive, non democratic and unequal reorganisation of society along particular lines…intensification and extensification of the differences, inequalities, hierarchies and divisions that pervade capitalist society as delivered by authoritarian states and global corporations…neoliberalism is a way of seeing the world that is carved from the empty words ‘free’ and ‘markets’ ”. Bruff calls this ‘Authoritarian Neoliberalism’

 


 

Some Free Market advocates get this too.

 

Jamie Whyte is a free market advocate and in the BBC radio programme Analysis ‘Keeping the Free Market faith’ (8th October 2012) thinks Conservatives are now losing that faith in the free market, implying neoliberalism has lost its grip. Of course, as figure 1 to 5 show, it never had one.

 

Three Conservatives said this about the state of politics in 2012:

 

An Unholy alliance between a free market ideology which took over a government and a process of social change in which fair dealing and trust were ditched in favour of get rich quick economic libertarianism”

 

“We have to challenge the assumptions of laissez faire economics…”

 

“…the left wing account (of a conspiracy of the rich against poor people) is much more believable (since the credit crunch) than in 1990, although I don’t believe it”.

 

(Jessie Norman, Matthew Hancock (Tory MPs) and journalist Charles Moore).

 

In the ‘Free Enterprise Group’ in the Tory party, Andrea Leadsom argued deregulation in the banking sector had caused major problems. Ferdinand Mount also queried deregulation and the big bang which ‘had its downside’. Matthew Hancock (Tory Minister for Skills) also of the Free Enterprise Group, argued free markets need strong frameworks. He argued we should not muddle up laissez faire economics with free markets, and that the banking sector is special, it is an exception where free market principles should not hold! The State also should have a view of what are sustainable business models for many industries.

 

Jamie Whyte interviewed Ferdinand Mount, who helped write Thatcher’s manifesto in 1983, argued in the radio programme that ‘bankers are the worse kind of oligarchs, immune to old standards of corporate governance, paying themselves whatever they like. Shareholders are sleeping and are not taking them to account’. Qualms about high pay, argued Mount, is about social justice and economic efficiency (rewards gained despite performance). He argues against total deregulation and against withdrawal of state support for the ‘too big to fail’ banks.

 

Whyte interviewed Lord Griffiths (advisor to Thatcher in 1986) who dents Thatcher’s image as a neoliberal or free market ideologue. He argues that Thatcher believed in a ‘moral market’ and the value of enterprise but was never a total free marketeer. Free markets yes, but within a boundary of social justice, including consumer protection. Thatcher he suggests was not a purist Hayekian. Despite the earlier Hayekian gesture in the 197o’s, Griffiths argued that Thatcher believed that the market economy had a moral basis in a Judeo-Christian ethic; a ‘moral market’ and this was the underpinning of the economy. Thatcher was free market enough to let the UK coal mines close and railed against support for ‘lame duck’ industries. She also began the wave of privatisation of nationalised industries.

 

What then now of Theresa May’s reintroduction of industrial policy, of explicit talk of government involvement in various sectors of the economy? Since 2010, there has been the  setting up of a British Business bank and the rebalancing of the economy as policy goals. Government should now have a view over the structure of the economy (Matthew Hancock MP), and support for successful business is a legitimate role. ‘Active and thoughtful’ government should support successful companies, and not be neutral between sectors. Hancock argued that there needs to be a strong framework around a market supporting successful industries, i.e. those that work well. An industry strategy must allow new challengers, but there must not be a planned economy. This must be done through looking at regulation and providing industry with the skills it needs.

 

Pro-Business rather than Free markets?

 

However, businesses are good at lobbying government (Zingales 2012), they ask for and get support rather than just asking for arm’s length regulation.  Zingales (2012) also argues that the US risks deteriorating into a pro-business rather than pro-market system. Jamie Whyte calls the relationship between business and government  ‘cosy and corrupt’.

 

Trump’s election and his appointees and advisors might indicate or vindicate Zingales’ point. His first big meeting in January 2017 (Feloni 2017) was with 12 CEO’s of the United States’ largest companies and he told them that he would ‘prioritize corporate tax cuts and decrease regulation’ (free market talk) and impose a ‘border tax’ on companies that move production outside the US (state interventionist).

 

Key appointments include:

 

Rex Tillerson (ex CEO of ExxonMobil), Steven Mnuchin (Goldman Sachs, Hedge Funder), Robert Lighthizer (Corporate and Trade Lawyer), Andrew Puzder (CEO of restaurant chains) and Wilbur Ross (Billionaire Investor). Well, who else would you want to run the capitalist executive but capitalist executives?  Smith (2016) suggests that ‘Trump’s billionaire cabinet could be the wealthiest administration ever’:

 

Todd Ricketts ($5.3 bn), Betsy DeVos ($5.1 bn), Wilbur Ross ($2.9 bn), and Steve Mnuchin ($46 m).

 

In the UK, May’s cabinet are pretty rich but look like paupers compared to Trump’s (Saner 2017).

 

As for business connections, in the UK, there are 50 official ministerial ‘business buddies’ for large firms in the Business Council. Glaxo Smith Kline had David Willetts while Vince Cable worked with Oil and Gas. Hancock in the Whyte radio programme argued they ‘listen’ to their companies and the government then does what they would like. This is not only a UK phenomenon. Angresano (2016) argues there is a ‘Corporate Welfare Economy’ in which the US government has increasingly been influenced by corporate lobbyists with regulation skewed in order to suit the interests of the privileged.

 

Other examples include the United States Department of Agriculture’s plan to buy 11 million pounds of cheese worth $20 million (USDA 2016) to support US dairy farmers. The Overseas Development Institute (ODI) and Oil Change International found that as a whole, G20 nations are responsible for $452bn (£297bn) a year in subsidies for fossil fuel production. Bergin (2016) reported that compensating carmakers in Britain for any post-Brexit tariffs on exports to Europe could see the government hand the companies more money than they need to pay the salaries of all their British workers. For decades British farmers have received subsidies under the EU’s Common Agricultural Policy (CAP). Full Fact (2016) report that the average farmer made £28,300 in subsidies in 2015 and £2,100 from agriculture. Wealthy land owners, such as the Daily Mail’s Paul Dacre, the Queen, a Saudi Prince, the Dukes of Westminster and Northumberland, the Earl of Moray also received subsidies from the CAP (Press Association 2016). Hinkley nuclear power station will have a subsidy worth £30 billion (Ward 2016). George Monbiot (2011) wrote:

 

the Guardian revealed that the government’s subsidy system for gas-burning power stations is being designed by an executive from the Dublin-based company ESB International, who has been seconded into the Department of Energy. What does ESB do? Oh, it builds gas-burning power stations. On the same day we learned that a government minister, Nick Boles, has privately assured the gambling company Ladbrokes that it needn’t worry about attempts by local authorities to stop the spread of betting shops. His new law will prevent councils from taking action”.

 

The Economist (2012), a free market paper, also reports on the US Chamber of Commerce and its lobbying and influence in US politics:

 

“Small firms can get a lot out of the Chamber—its annual small-business summit is well-regarded, for instance. But some feel under-represented: most of the firms represented on the board are large. Others worry that they are being used as pawns. In a letter to a Philip Morris executive just after he took over, Mr Donohue said that small firms provide the foot soldiers, and often the political cover, for issues big companies want pursued, because Congress listens more to them than to big business”.

 

Traynor et al (2014) similarly reported on corporate lobbying in the EU, claiming that there are over 30,000 lobbyists operating in Brussels while Drutman (2015) argues US lobbying is ‘America’s Business’ leading to ‘politics becoming more corporate’.

 

Jamie Whyte argues for a genuine free market, unregulated and free from government, even in the banking sector whereas Ferdinand Mount argued that it would be a ‘brave thing to do’, and it is  “rather terrifying”. Whyte argues however that the market is a mechanism for experiment and trial and thus there is no place for state regulation and subsidy. Banks should be allowed to fail. However, not bailing out the banks in 2008 would have been a brave thing to do, argued Mount, but he thinks ‘free market’ ideology will return.  Luigi Zingales (2012) supports Whyte in arguing that too much intervention creates perverse incentives. The State’s involvement in protecting money lent by the banks, means we have socialised the losses and privatised the gains. Free markets should apply to banks, they should not be bailed out, and government protection of their lending, subsidises the bank’s risks.

 

Neoliberalism, if defined as ‘small state’ and free markets, does not exist. If however ‘neoliberalism’ is understood as a discourse including ideas around individual liberty within free markets with minimal state intervention including cutting welfare programmes  aimed at the ordinary people, then it does. Its function is to reshape society by using the rhetoric of free markets while at the same time controlling certain markets though state intervention. Neoliberalism for the poor, socialism for the rich.

 

We have the data on wealth and income distribution, land ownership, offshore tax wealth, derivative values, corporate subsidies and the connections between the capitalist class executive and the political power elites which includes the military-industrial complex.  We know what money is, that it is not a physical commodity or has material existence in any form whatsoever (Harvey 2008, Pettifor 2017) and is therefore not in short supply. We know that it is now nothing more than a set of social relationships, ‘promises’, and thus is in infinite supply, but it is backed by judicial and ultimately military power. One reason we perhaps do not join the dots is too many of us have swallowed neoliberal ideology that argues ‘free markets and individual effort brings success’ while ignorant of its real effect to cover the actions of Capital which operate in rigged markets.

 

 

What should current neoliberalism look like?

 

The Adam Smith Institute (ASI) (https://www.adamsmith.org) is a free market think tank. It calls itself, “independent, non-profit and non-partisan…(to) promote neoliberal and free market ideas through research, publishing, media commentary and educational programmes”. Their priorities:

 

…are driven by a desire to rid the system of rent-seeking and inefficiencies that destroy wealth, and to create public services that are both innovative and in the hands of the people who use them, not the people who run them”.

 

The use of the word ‘neoliberal’ is interesting because it is not easily clear at first from the website that the ASI wants actually to be as neoliberal as Talbot’s ‘Nightwatchman’ state. It is not immediately obvious at first glance that they would wish to reduce public spending from 40% to 10% of GDP. However, the ASI published a blog on the level of public spending (as a % of GDP) that states that we are stuck with current levels “much as we ourselves would prefer the Hong Kong option”. Hong Kong’s spending ranges from 5.7% in 1960 to 10.9% and in 2015 was 9.15%. Therefore, buried in a blog an aim would be levels of spending equal to the ‘Nightwatchman’. The ASI believes in ‘market efficiency’:

 

  1. Low, simple, flat taxes that encourage investment and innovation, and hence economic growth (OK, need to read upon on that).

 

  1. A voucher-based education system that gives parents and schools complete freedom over how and where children are educated. (Hang on, vouchers, who is paying for that?)

 

  1. A privately-provided, publicly-funded healthcare system where patient outcomes, not NHS wages, are the focus. (what, publicly funded?)

 

  1. Freedom of trade with the world, and a liberal immigration system that is designed to work for migrants and natives alike.(open borders and requires ‘flexible’ labour markets?)

 

  1. A liberalised planning system that lets many more houses be built, so everyone can afford to own their own home. (so, environmental protection to go?)

 

  1. A simple welfare system based around a Negative Income Tax or Basic Income that tops up the wages of the poor and guarantees that work always pays. (basic Income…that’s more like it…something Marx would approve of)

 

  1. Free market money and an end to bailouts of private banks, in all their forms (Yes, nothing for a Marxist to disagree with).

 

 

 

 

The need to ‘rid the system of rent seeking’ echoes Thomas Picketty’s (2014) analysis of current capitalism and Marxist critiques of rentier forms of capitalism. The importance of wealth in attracting rent, is once again asserting itself as wealth grows faster than economic output. The ASI is sounding a bit marxist here.

 

Conclusion

 

If it is serious about a minimalist state and protection only for market transactions then free market/neoliberal ideology ought to be seeking to get private corporate and wealthy landowning snouts out of the State trough. In that, Marxists would agree. A free market should be just that. No bank bail outs, no subsidies for private schools in the form of charitable status; Oil, Gas and Nuclear power to stand on their own two feet; Farmers to earn from agriculture not government handouts; Aristocratic grouse moor owners likewise; Employers should pay what the market bears and not rely on working tax credits; Private health care companies should rely on what private individuals are willing to pay; Train operating companies should pay the full price of running the network and keep all of the profits from passengers while receiving no state funding; social care to be provided by charity, families or private individuals buying from care companies; private citizens should insure themselves for ill health and old age; Schools and Universities should compete in a market for students paid for by their parents or themselves with no state funding or through loans at market rates of interest; the road network sold off and motorists to pay to access; no housing benefit, no unemployment benefit, no sickness benefit, no pension unless paid for by private schemes, no business rates, no corporation tax; Free trade across borders with no tariffs, free movement of people, capital and services.  With the state off your back: “no income tax, no VAT, no money back, no guarantee…Good Bless Hooky Street” in a ‘Del Boy’ economy.  Libertarianism for all. Freedom from the State! Let the market decide!

 

A bit much?

 

The problem with neoliberalism and free market ideology is indeed a Hobbesian one: life could be ‘nasty, brutish and short’ as we compete one with another in a dog eat dog ‘ubermensch take the hindmost’ world.  And there’s the rub. Do they really mean it, or have they not only accepted a role for the state but embraced it for their own ends under the guise of ‘market efficiency’?

Appendix

 

  winning % Turn Out Total who did not vote

at all

Total Electorate

Who voted for

Thatcher 1979 44% 76% 24% 33%
1983 42% 72% 28% 30%
1987 42% 75% 25% 31%
Major 1992 42% 77% 23% 32%
Blair 1997 43% 71% 29% 30%
2001 41% 60% 40% 25%
2005 35% 61% 39% 21%
Cameron 2010 36% 65% 35% 23%
2015 37% 66% 34% 24%

 

 
Figure 1. Voter support for free market discourse. Increasingly it is the case that nearly a third (range 23% to 40%) or more of voters were either apathetic, disillusioned, disengaged or too distracted to bother to give their support for any political party.

 

 

Figure 2.     1900-2010 spending  as % of GDP

http://www.ukpublicspending.co.uk/past_spending

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Figure 3. 1996-2017 spending as % of GDP.

 

 

The following two figures illustrates the degree of State involvement in the economy. The spending accounts for about 40% of GDP, leaving 60% going elsewhere. Spending on health, social care and social protection (pensions) accounts for £426 billion, that is over 50% of the total spend. Add £102 billion for education (total now is £528 Billion).

 

Who pays for that? Well, whoever pays Income tax, National Insurance, VAT, Council Tax and excise duties, accounts for £628 billion. What we have is redistribution from the 99.9% to the 99%.

 

‘Neoliberalism’ as rhetoric actually works for 0.01% – the plutocrats, the global capitalist executive, as Henry (2012) argues that anything between $21 to £31 trillion as of 2010 has been invested tax free in about 80 ‘offshore’ secrecy jurisdictions.

 

 

 

 

Figure 4. 2017 UK budget. Spending £802 billion

 

 

 

Figure 5 Revenues. £744 billion.

 

UK Budget:  https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/597467/spring_budget_2017_web.pdf accessed 22 march 2017

 

 

References

 

 

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Environmental Politics, 10(2), Summer 2001, 128-133.

 

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Bruff, I, (2017) Authoritarian Neoliberalism and the Myth of Free Markets.

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Carlisle, S. (2001) ‘Inequalities in health: Contested explanations, shifting discourses and ambiguous policies’, Critical Public Health, 11: 3, 267 — 281

 

 

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Dorling, D. (2014) Inequality and the 1%. London. Verso

 

Drutman, L .(2015) The Business of America is Lobbying: How Corporations became Politicised and Politics became more corporate. Oxford University Press. Oxford.

 

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Harvey, D. (2005) A brief history of Neoliberalism. Oxford. Blackwell

 

Harvey, D. (2008) Reading Marx’s Capital vol 1. Class 3 Chapter 3. Money, or the circulation of commodities

http://davidharvey.org/2008/06/marxs-capital-class-03/ accessed 20 march 2017

 

Hayek, F. (1944) The Road to Serfdom. London. Routledge.

 

Hayek, F. (1960) The Constitution of Liberty. University of Chicago Press. Chicago.

 

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Monbiot, G. (2011) Its business that really rules us now. The Guardian 11 November.

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Moshinsky, B. (2016) The global wealth pyramid is still topped by the 1% who own almost half of the world’s wealth. World Economic Forum. Online available at https://www.weforum.org/agenda/2016/11/the-distribution-of-global-wealth-has-stayed-just-as-skewed-as-last-year accessed 22 march 2017

 

Office for National Statistics (2015) The Effects of taxes and benefits on household income : financial year ending 2015. https://www.ons.gov.uk/peoplepopulationandcommunity/personalandhouseholdfinances/incomeandwealth/bulletins/theeffectsoftaxesandbenefitsonhouseholdincome/financialyearending2015 accessed 20 march 2017

 

Pallasch, A. (2010) ‘Best 5 Minutes of my life; His ’09 CNBC rant against mortgage bail outs for ‘losers’ ignited the Tea Party movement’ Chicago Sun-Times.

 

Pettifor, A. (2017) The Production of Money; how to break the power of the banks. Verso. London

 

Picketty, T. (2014) Capital in the Twenty-First century. Harvard. United States

 

Press Association (2016) The Queen, aristocrats, and Saudi prince among recipients of EU farm subsidies.

https://www.theguardian.com/environment/2016/sep/29/the-queen-aristocrats-and-saudi-prince-among-recipients-of-eu-farm-subsidies accessed 20 march 2017

 

Ranelagh, R. (1991) Thatcher’s People:  An Insider’s Account of the Politics, the Power, and the Personalities.  London:  HarperCollins.

 

Ryan, A. (1993) ‘Liberalism’ pp 291-311 in Goodin, R and Pettit, P. (eds) A companion to Contemporary Political Philosophy. Oxford. Blackwell.

 

Saad-Filho, A. and Johnson, D. (2005). Neoliberalism – a critical reader. London. Pluto Press

 

 

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Saner, E. (2017) ‘Theresa May’s cabinet: pretty rich, but nothing on Trump’s’. The Guardian online. Available at https://www.theguardian.com/business/shortcuts/2017/jan/17/theresa-mays-cabinet-pretty-rich-but-nothing-on-trumps accessed 22 march 2017

 

 

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There is a critical need for Socio-Political awareness among undergraduate student nurses.

There is a need for Critical Socio-Political awareness among undergraduate student nurses.

“For the remainder of this century, the most worthy goal that nurses can select is that of arousing their passion for a kind of political activism that will make a difference in their own lives and in the life of our society.” (Peggy Chinn).

When I read this I almost literally fist pumped (I’m British, so we don’t actually do that – a bit too flamboyant!). I’m a lecturer in the UK teaching mainly from a public health/sociological perspective. I’ve noted that various writers have suggested or implied that politics and political awareness and knowledge is, or ought to be, a component of nursing knowledge and advocacy, if a rather neglected one. Nancy Roper referred to it as one of the 5 factors influencing the Activities of Living, while also lamenting its lack of application. Jill White developed Barbara Carper’s patterns of knowing to include it, Jane Salvage argued that it needs to be understood and acted upon. Celia Davies had written about the gendered nature of nursing and its ‘professional predicament’ and Micheal Traynor has written a whole book on politics and the profession.

Other writers include Adeline Falk Rafael, and Kath Melia long ago illustrated the contextualised pressures on student nurses while more recently Alexandra Hillman and colleagues have described how patient care can be compromised by the systems nurses work within. Alec Grant suggests politics is implicit in some qualitative research methods such as autoethnography. I have argued it is explicitly part of the sustainability agenda for nursing, while the social determinants/political determinants of health approach are predicated upon it. Other health concepts such as Barton and Grant’s health map, Lang and Rayner’s ecological public health domain and Ottersen et al’s focus on ‘global governance for health’ centre it for health care delivery and outcomes. The inequalities in health literature, for example “Fair society Healthy Lives” refer to health being a matter for social justice and fairness. Some authors have highlighted the health policy role for nurses, although advocating for nurse involvement in public policy making does so probably within accepted frames of reference devoid of critical concepts such as Foucault’s ‘governmentality’ or deeper analyses of, for example, managerialism, neoliberalism and the ‘capitalist class-command dynamic’.

In the education and curriculum development literature writers such as Stephen Sterling and David Orr suggest that teaching and learning should go beyond skills teaching in an instrumental fashion to address personal growth and social transformation. Others discuss ‘emancipatory pedagogy’ in nurse education which accords with aspects of ‘provocative pedagogy’ as advocated by Peter Morrall. The sociological literature, for example critical social theory, marxism and feminism of course, are wholly socio-political in nature. For nursing, each has also something to say about the interplay between health, illness, society and gender.

It is my contention that undergraduate nursing education is one in which politics is largely absent in nursing curricula and fails to equip student nurses with tools of analysis that renders them blind to social and political systems that are often unfair, unjust and oppressive. It also fails to politically socialise them. It is a self marginalised education denuded of any critical importance and largely ignores the vast sociological literature on health and illness. Nurse educators themselves, beyond a few ‘individual enthusiasts’ lack the requisite skills or concepts to engage, resulting in the lack of politics or health policy in nurse education. This is not to say nursing education, as it currently is, lacks importance as the requirement for clean, kind and compassionate care will be emphasised daily in seminars, lectures and tutorials.

This assertion might be supported if it can be shown that student nurses lack a critical understanding of the socio-political context in which they work. This is not to say however that student nurses are not political or are not interested in politics. Rather that their interest and understanding especially in relation to health (power, social justice, indigenous rights, post-colonialism, funding, inequalities, access, outcomes and determinants) may be lacking and only slightly better than their peer groups. Further, that any student nurse who is active, interested and knowledgeable is so despite not because of nursing education. I take it as self evident that this matters and not merely for the reason that it suits the capitalist executive and political power elites to have a huge number of health workers (600,000 registrants in the UK alone) ignorant, confused, uninterested and inactive in regards to the eco, social and political determinants of health. We have nurses schooled in the biomedical aspects of health delivery (or rather disease treatment), but rather less in the EcoPoliticoPsychoSocial (EPPS) approach to health. Student nurses are introduced to a BioPsychoSocial (BPS) model to health however, the curriculum process and learning experiences may often dilute this, emphasizing the Bio at the expense of the Psycho-Social while ignoring the Ecological. BPS becomes Bps.

Politics can be defined simply as ‘the process of influencing the scarce allocation of resources’. The Royal College of Nursing’s ‘Frontline First‘, while laudable, is also a very narrowly focused campaign which is about resource (staff) allocation. However, this does not go far enough as it fails to engage with more critical analyses of power and the legitimacy of the exercise of power, concerning itself with more ‘mundane’ issues of resource allocation within uncritically accepted frames of reference.

Politics is much more than knowing the manifestos of political parties or the internal machinations at Westminster/Washington. Political action is much more than the 5 year placing of crosses on ballot papers. Engaging in politics requires at least a critical understanding of power. Tony Benn, a UK Labour party stalwart now no longer with us, outlined questions to ask the powerful: We should know who has power, what power they have, where did they get it from, in whose interest do they wield it, to whom are they accountable and how do we get rid of them? This does not apply only to Westminster and the Whitehouse, but in every organisation including a hospital.

To test the hypothesis that student nurses lack a critical understanding of an EPPS approach to health, a survey of student nurses in two or three HEIs in the UK could be undertaken. There is a handy online tool called ‘political compass’ (https://www.politicalcompass.org) which is a self test indicating where one sits across two axes: Authoritarian left/right and Libertarian left/right.

Siobhan Mccullough undertook a survey in Northern Ireland in which 81% of nursing students claimed ‘not much knowledge’ of politics and 60% claimed either never or less than once week to follow politics in the media. Of course a caveat in this must be that politics in this context may mean ‘party/Westminster/Stormont politics rather than political issues. Bear in mind that Northern Ireland had been a highly politicised society suffering the ‘troubles’ since the 1960’s in which the Irish Republican Army fought a guerrilla/terrorist/resistance war against the British.

If Russell Brand’s  website, The Trews, is any guide, many people are very interested in politics, just not the dominant media fed variety of political talking heads, and the representatives of mainstream political parties. If we widen the definition of politics to include social movements around health, climate change and human rights, then according to Paul Hawken there is a global ‘Blessed Unrest’ involving millions of people, a global ‘environmental and social justice movement’ that does not appear in the mainstream media.

This will be a disparate group politically, nurses are not to be treated as an homogenous group for political purposes. For example, the free market nurse think tank Nurses for Reform (NFR):

“….long argued that the NHS is an essentially Stalinist, nationalised abhorrence and that Britain can do much better without its so called principles“.

Whether this group actually has a huge number of nurses supporting it, has been questioned. Nonetheless the point remains that nurses probably voted for all parties, and none, at the last 2015 election in the UK. I was recently informed by a colleague that while in the United States he visited a Nursing Faculty and discovered that many nurses in the Faculty voted for Donald Trump. If my memory is correct the figure was over 50%. He put it down to ‘localism’ and ‘regionalism’ – a distaste for the remote Washington elite. That, I can understand.

The close vote for Brexit in the UK is a paradox, given the reliance by the NHS on EU citizens for the day to day delivery of health care. We have no idea how many nurses voted leave, all we do know is that the leave voter is more likely to be older (55+), living in rural environments and in the smaller towns and cities outside the major metropolitan cities such as London, and white. The leave vote crossed party lines. They were affluent Eurosceptics, the older working class and a smaller group of disadvantaged anti-immigration voters.

The current context of rising ethno-nationalism, if not fascism, isolationism, nativism and tribalism within a world threatened by climate change requires an urgent response by everyone. We cannot be anything other than political. Stating ‘neutrality’ is still a political position. Disinterest, disengagement and disillusionment are political positions by default. However they are not viable positions for student nurses to take given the social, ecological and commercial determinants of health.

To what degree nurses are part of the Paul Hawken’s ‘blessed unrest’ is unknown, Siobhan Mcculloghs small survey does not answer that question. Perhaps we should start asking?

The case of the Trump regime: The need for resistance in international nurse education

In July 2016 doctors and nurses protested against Candidate Trump in Cleveland, Ohio (Cleveland.com), and currently the US Facebook group ‘Nurses Resisting Trump’ is building up its members. Why should this trouble or be of interest to nurses and nurse academics in the rest of the world? If the answer is not immediately obvious, this signals a problem. The issue is not a conventional one of political differences between health care professionals based on old differences between republican and democrats, or conservatives versus progressives. The fact that nurses in the US protested against a candidate and now against the President, his Republican Administration and what this stands for internationally, is pivotal.

The inauguration of Donald Trump was greeted with mass citizen protest throughout the world. Yet, despite losing the popular vote, he gained office because enough American citizens believed the narrative he voiced. Clearly, those citizens are not all racists, homophobes, misogynists, or climate change deniers, and this has to be remembered when we critique and call for international resistance of nurse educators to the Trump regime.

Trump repeatedly stated very clearly what many politicians are conspicuously silent about: ‘wealth buys influence’ (Ornitz and Struyk, 2015). In this context, he asserted time and again that there are losers as well as winners in the globalisation game. This narrative resonates disturbingly with the many on the left, and should do so with all nurses and their educators internationally who subscribe to supporting and valuing cultural diversity and difference (Bach and Grant, 2015 ;  Grant and Goodman, 2017).

It will of course be argued that there are of course always legitimate political differences and values in the world of international politics, and these do not ordinarily overspill into the lifeworlds of nurses and their educators. But the case of the current Republican Administration is crucially different. The magnitude of global issues, such as climate change and its implications for health, and continuing inequalities in health, require far more intelligent and human responses than those associated with Trump and other authoritarian populists internationally, such as Putin, Erdoğan, Modi and their associates (Garton Ash, 2017 ;  Varoufakis, 2016).

The full Article can be found here: http://dx.doi.org/10.1016/j.nedt.2017.02.013.

Black Swan future?

Rowland Atkinson and Don Mitchell in ‘Fracturing Societies‘ paint a rather bleak picture:

The world feels like it is falling apart, and maybe it really is. Maybe the weight of human misery, the collapse of civil societies, ethno-national tensions and divisions, political exits and polarization and the accelerating ecological crisis, maybe all of this make things different this time” .

…I personally struggle to see the positive: Rockstrom et al on the Anthropocene, ‘safe operating space for humanity’; Jared Diamond in ‘Collapse’; Wolfgang Streeck….

Of course, and acknowledging confirmation bias, there are many pessimistic voices. One might say that ever since the rise of capitalism in its various guises there have been jeremiads – we know who they are – and the optimist (Indur Goklany, Daniel ben -Ami, Martin Wolf) can say ‘they were proved wrong’. This depends on inductive logic and a certain time frame.

Martin Wolf for example, in his review of Wolfgang Streeck, argues that we will not descend into a new ‘Dark Ages’ due to the progress we have already made, and points to the benefits of globalisation accrued to China and India. He also makes the (bourgeois) argument regarding democracy and capitalism:

“…the relationship between democracy and capitalism is not, as Streeck seems to believe, unnatural. On the contrary, both systems derive from a belief in the role of people as active citizens and economic agents. In the former role, they make decisions together; in the latter, they make decisions for themselves….both are essential. Moreover, democracy cannot function without a market economy”. 

Does it though? Does a market economy always defend democracy? ‘Active citizens and economic agents‘ are bourgeois myths, they are ‘abstracted ideal types’ rooted in neoclassical economics. It might be correct to say ‘democracy cannot function without a market economy’ but what is the evidence? We might want to consider that right now in 2017 liberal democracy has died, or is at least in critical care, right at the time when we tried to establish (neoliberal) market economies in the US and the UK.

Tell me the critics, like Streeck, were wrong in another 100 years. Progress enjoyed by Europeans and Americans might be easily swept aside by an event we are currently not aware of. Globalisation already has inner contradictions (viz Rust Belt and Silicon Valley America) playing out and manifest as authoritarian populism.  Some of us think we can just see perhaps a Black Swan (or a flock!).

“A black swan is a highly improbable event with three principal characteristics: It is unpredictable; it carries a massive impact; and, after the fact, we concoct an explanation that makes it appear less random, and more predictable, than it was”.

So, we should be on the look out for what seems impossible, what we don’t know. Large events continue to surprise us because we are looking in the wrong directions. In 2015 both Brexit and the Trump Presidency were Black Swans that few predicted or took seriously. Now, after the event everyone is an expert.

So what were we doing in Universities? Were we so wrapped up in trying to solve technical questions and academic navel gazing as we compete in a market for customers?

Not everyone. I count the likes of Zygmund Bauman, David Harvey, Slavoj Žižek and of course Nicolas Taleb, as some engaged with the bigger picture.

The role of the academy is to support and encourage Gramsci’s organic intellectual and not weigh them down with nonsensical Research Exercise Frameworks or Teaching Exercise Frameworks (or whatever neoliberal metrics your University uses).

C Wright Mills argued:

“It is the political task of the social scientist — as of any liberal educator — continually to translate personal troubles into public issues, and public issues into the terms of their human meaning for a variety of individuals”. (1959 p187).

If we accept this task, as social scientists, liberal educators, can we translate the personal troubles of people into public issues and then act upon this interrogation of cultural, social and political forms; can we reveal both the structural transformations currently taking place and the personal stories as experienced?

Following on from Antonio Gramsci’s notion of the organic activist v the traditionalist academic and Noam Chomsky’s entreaty that it is the responsibility of intellectuals to speak the truth and expose lies, Brock argued the role of the social movement academic is to “to debunk the knowledge on which the powerful rest”. Although written many decades ago, Gramsci’s archetype may well be seen within the corporate university (Bill Readings) which supports and encourages the traditional and ignores the activist, and in which, too many are far too obedient to the established order of the corporate university.

Graham Scambler argues that academics can be but are generally not intellectuals, the distinction is important because the latter are so because:

1) They possess an academically credible vision and pathway for a better state of affairs.
2) This is argued in public.
3) They are unwilling to compromise except in the ‘face of a better argument’.
4) They reject sophistry and demagoguery in pursuit of their ends.

Basing his analysis on Burawoy’s ‘four sociologies’ – professional (the scholar), policy (the reformer), critical (the radical) and public (the democrat)’, Scambler adds a fifth: action (the activist) sociology, but suggests that intellectuals may operate across all 5, but there are few engaged in public and action sociology. To what degree we are academics or intellectuals perhaps is a moot point but is worth some critical reflection. It is suggested here that the structures in which they operate discourages debunking, overlooking its funding while focusing in high impact publishing and research grants.

To engage in the debunking Brock suggests, may require ‘intellectual craftsmanship’, ‘critical practice’ as critical analysis/action/reflexivity important for critical enquiry in the ‘paraversity’. This assumes that academics see themselves as a) intellectuals or b) engaged in critical transformative pedagogy with their students and communities, as much as some sociologists do. This latter is problematic as education may be overly reliant, in practice if not in espoused theory, on transmissive, competency, instrumentally based pedagogies.

If the University cannot rise to the challenge by having an impact of political decision making, we may the first civilization to scientifically document our own demise.

 

See: https://ca.finance.yahoo.com/news/nassim-taleb-donald-trumps-election-win-was-no-black-swan-191857463.html

Climate change is an unsolvable wicked social problem?

Climate change is an unsolvable wicked social problem?

 

 

The following outline of climate change as a wicked problem (Rittel and Weber 1973) is based on a reading of Reinar Grundmann’s (2016) ‘Focus on Climate change and the social sciences’. The work of Jurgen Habermas (1984, 1987) and Wolfgang Streeck (2016) contextualises the exposition of climate change as a wicked social problem and this paper agrees with Grundmann’s analysis that there are no easy answers for the short or medium term, here defined as within 50 years, and adds that perhaps there might not ever be. Thus we are adopting Gramscian ‘pessimism of the intellect’ which requires urgent work on adaptation for a very different and perhaps dystopian world by the end of the century.

 

Regardless of its genesis, whether that be human induced or natural cycles, climate change requires human responses. Mitigation is now probably too late, as we’ve in all likelihood passed 400 ppm of carbon dioxide permanently. This means we are locked into temperature rises above the 2 degree ‘safe’ level. This is taking us into a new era, the Anthropocene, beyond a ‘safe operating space for humanity (Rockstrom et al 2009). Therefore we will have to plan for, and more urgently talk about, adaptation, disaster management and conflict resolution. However and in what manner we come together, or not, to address the fact of climate change and all of the other ecological challenges, this a ‘wicked social problem’ exacerbated by contemporary changes in the geopolitical, social and technological order (Streeck 2016, Harari 2016). The Anthropocene may well be characterised as a period of insecurity, indeterminancy and dissipation of the social order into a miasma of dystopia. Human societies are experiencing the dialectic between risks arising from modernity and the solutions put forward to manage those risks (Beck 1986).

 

A wicked problem is the sort of problem that is inherently different from the sort of ‘tame’ problems that natural scientists and engineers grapple with.

 

First of all, ‘wicked social problems’ are never solved once and for all. They can only be better managed. Each ‘solution’ invokes another problem to address. Take, for example, crime. To achieve a society with a 0% crime rate involves either redefining what crime is, leaving unsolved the social problems certain activities previously defined as ‘crime’ invokes, or it requires an enormous and deep level of surveillance and loss of liberty that would have unintended consequences for human relationships and politics. Like a game of ‘whack a mole’ other social, political and philosophical problems would arise from such an answer.

 

A ‘tame’ problem would be an equation to solve, analysing a chemical compound, designing a bridge or checkmate in 5 moves (Grundmann 2016). Tame problems allow us to know what the measure of success is when they are solved, and success criteria are known beforehand. They have a ‘stopping rule’. The success criteria of wicked problems like crime are inherently political and often underpinned by cultural values within a power matrix of vested interests.

 

‘Wicked’ here means resistance to solution rather than evil. The problem is difficult to solve because of incomplete, contradictory and changing elements to them that are also difficult to recognise. The elements making up a wicked problem may be interdependent within a complex system and thus solving one element may exacerbate another aspect of the system and/or reveal another problem.

 

For climate change what are the ‘success criteria’? What indicators, metrics, outcomes or empirical observations can we make that allows us to claim success? This may depend on how we define climate change. Do we use the United Nations Framework Convention on Climate Change (UNFCCC) or the Intergovernmental Panel on Climate Change (IPCC) definitions (Grundmann 2016)?

 

The UNFCCC define it as “a change of climate that is attributed directly or indirectly to human activity, that alters the composition of the global atmosphere, and that is in addition to natural climate variability over comparable time periods”.

 

The IPCC define it as “any change in climate over time whether due to natural variability or as a result of human activity”.

 

The UNFCCC focuses on human activity driving climate change, while leaving to one side natural variability. The IPCC encompasses both. Therefore climate policy would address anthropogenesis (UNFCCC) or everything (IPCC). In each case we would still need to construct measures of ‘success’.

 

If we could agree and state that the measure is ppm of C02 in the atmosphere then action would naturally be channelled towards addressing that figure. It is by no means clear that this would or could ‘solve’ the social problem of climate change such actions might entail. Climate change does not have a ‘stopping rule’ characteristic of tame problems. Atmospheric Carbon Dioxide might look like one but there are other measures such as carbon budgets, global average warming temperatures or heat content in the oceans. There is also fierce resistance to curbing carbon emissions and environmental regulation in some quarters based on free market and libertarian arguments (e.g. Cato Institute 2016), despite the agreement signed at COP21 in Paris in 2015.

 

 

The wider context in which climate change solutions operate.

 

The expression of climate change as a problem, and climate change solutions, interact with the social, cultural and political power context in which they operate. They are not ontologically separate from the social or the material and they operate within complex adaptive systems. Knowledge/power discourses frame their expression, their feasibility and their acceptability within often hegemonic, though not unchallenged, frames of reference.

 

That context is variously called late modernity, post modernity, post industrial, disorganised, financial, rentier, or neoliberal capitalism. Wolfgang Streeck (2016) pace Antonio Gramsci, suggests this context is actually a post-capitalist interregnum in which the old system is dying but a new social order cannot yet be born. Streeck calls the current order one of multi-morbidity, climate change being one of many frailties as we head towards social entropy, radical uncertainty and indeterminancy. Streeck argues that the current context is anchored in a variety of interconnected developments:

 

  1. Intensification of distributional (capital v labour) conflict due to declining growth
  2. Rising social inequality
  3. Vanishing macroeconomic manageability
  4. Steadily increasing indebtedness (private and sovereign)
  5. Pumped up money supply (from quantitative easing)
  6. Possibility of another financial crisis as per 2008
  7. The suspension of democracy
  8. Slowdown of social progress
  9. Rising Oligarchy and Plutocracy
  10. Governments’ inability to limit the commodification of labour, money or nature
  11. Omnipresence of corruption
  12. Intensified competition in winner takes all markets
  13. Unlimited opportunities for self enrichment (for the 1%)
  14. Erosion of public goods and infrastructure
  15. The failure of the US to establish a stable global order
  16. Public cynicism towards economics and politics.
  17. Rising populist nationalism and the spectre of fascism and isolationism in the US
  18. Fracturing political blocs and alliances
  19. Erosion of Democratic legitimacy ad thus a democratic deficit

 

 

To that:

 

  1. Health Inequalities.
  2. Potential Ecosystem collapse.
  3. Disruptive technologies: Automation, Artificial Intelligence and digitalisation.

 

 

There are countervailing voices. There are those who see a better future for humanity, placing belief in progress (Norberg 2016), reducing global violence (Pinker 2011), the ability of growth based capitalism to solve problems (Ben-Ami 2010, Goklany 2007, 2009) and the citing of improvements in key indicators such as reductions in infant mortality (see Hans Rosling’s ‘gapminder’ 2016). Added to this are of course the voices of politicians who promise to either “make America great again” , “A country that works for everyone” or “Russia as a Normal Great Power”. Extrapolating from the past into the future is of course inductive logic and is thus open to its critique. This also applies to the negative descriptions of the current state of affairs. The task remains to consider which view will prove correct? Not an easy question partly due to many issues being wicked problems.

 

These latter political narratives may be examples of ‘systematic distorted communication’, i.e. voices and discourses aimed at achieving very particular political ends inimicable to that aimed towards mutual understanding and social integration. This form of communication, according to Habermas (1984, 1987), involves one party being self deceived, it is a form of communication in which power differentials operate and are invisible.

 

For example, the Cato Institute argues on environmental regulation:

 

“Science can inform individual preferences but cannot resolve environmental conflicts. Environmental goods and services, to the greatest extent possible, should be treated like other goods and services in the marketplace. People should be free to secure their preferences about the consumption of environmental goods such as clean air or clean water regardless of whether some scientists think such preferences are legitimate or not. Likewise, people should be free, to the greatest extent possible, to make decisions consistent with their own risk tolerances regardless of scientific or even public opinion”.

 

On the face of it who would argue against freedom to decide one’s own risk tolerance? ‘Freedom’ is a public good is it not? What this statement ignores is the fact that some very powerful and well resourced ‘others’ are more ‘free’ to exercise risk tolerance, they are also more ‘free’ to engage in activities that involve ‘externalities’ – pushing the cost of one’s exercise of freedom onto others. How free were the victims of Union Carbide’s Bhopal ‘death by negligence’ of 1984 where at least 2000 died as a result of the plant’s gas leak? Union Carbide’s freedom to operate involved a power imbalance that denied the citizens from exercising their ‘risk tolerance’. How free are Londoners in exercising their ‘risk tolerance’ to nitrous oxide pollution from vehicle exhausts responsible for 9,500 deaths per year (Vaughan 2015)?

 

The Cato Institute argues it is a research organisation conducting independent non partisan research on a range of policy issues. It clearly states however that principles of individual liberty, limited government, free markets and peace underpin its work. Apart from the nebulous ‘peace’ (who is not for peace?), those principles are very clearly part of the neoliberal imaginary and are thus as ideological and partisan as many other organisations. On funding, Cato states on its home page that it receives ‘no government funding’. What it fails to clarify is who exactly funds it. On page 41 of its 2016 annual report there are only numbers of $ donated while preferring to refer to individuals, corporate and foundations as funding streams. However, Cato was founded by the Koch brothers, billionaire owners of Koch industries, who reportedly believe in lowering corporate and personal taxes, minimal social security and less oversight of industry (Mayer 2010). Hardly a non partisan viewpoint.

 

 

Habermas’ theory suggests that communicative action serves to transmit and renew cultural knowledge, in a process of achieving mutual understandings. It then coordinates action towards social integration and solidarity. Communicative action is also the process through which people form their identities. The current context suggests that communicative action, orientated towards the requirement for social integration for action on climate change, is extremely fragile.

 

Gross (2010) gave three examples of systematic distorted communication:

 

  1. The pervasive employment of Nazi language in Europe in the 1930’s in Europe.
  2. The everyday, routine use of sexist language.
  3. The prescription languages and practices of Physicians influenced by drug company promotions.

 

We may consider also:

 

  1. The narrative on individual responsibility for health
  2. The absolute requirement for deficit and debt reduction as a goal of policy
  3. Free market liberalism in the US and the UK
  4. An unaffordable NHS in the UK
  5. Immigration, asylum and refugee control
  6. Fossil fuel subsidies and continued extraction.
  7. The hegemonic Nuclear Deterrence Theory
  8. Koch brothers support for the Cato Institute on liberty, small government and free markets.

 

 

Climate change solutions arise and operate within this context. Today we have no easy solutions or even signposts that indicate success on progress to either mitigation or adaptation. It may even be the case that we are actually chasing rainbows. If we are entering a period where social institutions are breaking down, where system integration disappears leaving a mass of individuals to find individual solutions to the myriad problems they face, without grand integrative narratives to provide guidance, then social cohesion breaks down and Habermasian ‘communicative action’ dissipates in the face of the onslaught from the systematic distorted communication of power interests.

 

 

Beck U (1986) Risk Society. Towards a new Modernity. London Sage. (1992 edition)

 

Ben-Ami, D. (2010) Ferrari’s for All – In defence of economic progress. University of Bristol. Policy Press.

 

Cato Institute (2016) Environmental Regulation (online) http://www.cato.org/research/environmental-law-regulation accessed 13th October 2016

 

Goklany I (2007) The Improving State of the World: Why we are living longer, healthier, more comfortable lives on a cleaner Planet. Washington. Cato Institute

 

Goklany I. (2009) Is climate change the “defining challenge of our age”? Energy Environment, 20:279-302.

 

Gross A (2010) Systematically Distorted Communication: An Impediment to Social and Political Change. Informal Logic 30 (4): 335-360

 

Grundmann R (2016) ‘Focus on Climate change and the social sciences’ . http://discoversociety.org/2016/10/04/focus-climate-change-and-the-social-sciences/

 

Habermas J (1984) Theory of Communicative Action. Vol 1. Reason and the Rationality of Society. Cambridge. Polity Press

 

Habermas J (1987) Theory of Communicative Action Vol 2. Lifeworld and System. A critique of Functionalist Reason. Cambridge. Polity Press.

 

Harari Y (2016) Homo Deus. A brief History of Tomorrow. London Vintage.

 

Mayer J (2010) Covert Operations. The billionaire brothers waging a war against Obama. New Yorker. August 30th. Online http://www.newyorker.com/magazine/2010/08/30/covert-operations accessed 13th October 2016

 

Norberg J (2016) Progress. Ten reasons to look forward to the future. London Oneworld.

 

Pinker S (2011) The better angels of our nature. A history of violence and humanity. London. Penguin.

 

Rittell,H. and Weber, M. (1973) Dilemmas in a General Theory of Planning, pp. 155–169, Policy Sciences, Vol. 4, Elsevier Scientific Publishing Company, Amsterdam

 

Rockstrom, J., Steffen, W., Noone, K., Persson, A., Chapin, F. S., III, Lambin, E. F., Lenton, T. M., Scheffer, M., Folke, C., Schellnhuber, H. J., Nykvist, B., de Wit, C. A., Hughes, T., van der Leeuw, S., Rodhe, H., Sorlin, S., Snyder, P. K., Costanza, R., Svedin, U., Falkenmark, M., Karlberg, L., Corell, R. W., Fabry, V. J., Hansen, J., Walker, B., Liverman, D., Richardson, K., Crutzen, P. & Foley, J. A. (2009) ‘A safe operating space for humanity’. Nature, 461 (7263). pp 472.

Rosling H (2016) MDG 4 Reducing Child Mortality available at https://www.gapminder.org/downloads/mdg-4-reducing-child-mortality/ accessed 13th October 2016

 

Streeck W (2016) The post-capitalist interregnum: the old system is dying, but a new social order cannot yet be born. Juncture 23 (2): 68-77

 

Vaughan A (2015) Nearly 9,500 people die each year in London because of air pollution. The Guardian (online) 15th July https://www.theguardian.com/environment/2015/jul/15/nearly-9500-people-die-each-year-in-london-because-of-air-pollution-study accessed 13th october 2016

Antonio Gramsci on intellectual thought – challenging nursing.

Antonio Gramsci on intellectual thought – challenging nursing.

 

 

Antonio Gramsci (1891-1937), leader of the Italian Communist party, was arrested and imprisoned by the fascist regime in 1926 and died in the Quisisana clinic in Rome in 1937, aged 47. His pre prison work and his ‘prison notebooks’ have hugely contributed to the examination and development of political philosophy and intellectual thought. Among the ideas he developed are the role of the intellectual in culture and politics and the concept of hegemony. The prosecutor at his trial was acutely aware of his intellectual abilities, and thus threat, and stated:

 

“We must prevent this brain from functioning for twenty years.”

 

(Buttigeig 2011 p16).

 

Gramsci found himself in a concrete prison not of his own choosing. Nurses find themselves in an abstract prison of the mind put there by their own reason, their lifeworld colonised by the systematic distorted communication of the strategic action of powerful others.

 

This is all a world away from the daily work of nursing, and so at first pass may appear of interest only to the likes of critical social scientists or historians of political thought. Reading Gramsci opens up a discussion on what being an intellectual might mean and of how power is exercised and maintained. Nurses going about their clinical work will not be vexed by such questions and it might be the case that academic nurses will not be either. That could be a mistake given the current context outlined by Streek (2016) of global challenges to social order which have current and future impacts on health and health care delivery.

 

That context is variously called late modernity, post modernity, post industrial, disorganised, financial, rentier, or neoliberal capitalism. Wolfgang Streeck (2016) echoing Gramsci, suggests this context is actually a post-capitalist interregnum in which the old system is dying but a new social order cannot yet be born. Streeck calls the current order one of multi-morbidity, climate change being one of many frailties as we head towards social entropy, radical uncertainty and indeterminancy. Streeck argues that the current context is anchored in a variety of interconnected developments:

 

  1. Intensification of distributional (capital v labour) conflict due to declining growth.
  2. Rising social inequality.
  3. Vanishing macroeconomic manageability.
  4. Steadily increasing indebtedness (private and sovereign).
  5. Pumped up money supply (from quantitative easing).
  6. Possibility of another financial crisis as per 2008.
  7. The suspension of democracy.
  8. Slowdown of social progress.
  9. Rising Oligarchy and Plutocracy.
  10. Governments’ inability to limit the commodification of labour, money or nature.
  11. Omnipresence of corruption.
  12. Intensified competition in winner takes all markets.
  13. Unlimited opportunities for self enrichment (for the 1%).
  14. Erosion of public goods and infrastructure.
  15. The failure of the US to establish a stable global order.
  16. Public cynicism towards economics and politics.
  17. Rising populist nationalism and the spectre of fascism and isolationism in the US.
  18. Fracturing political blocs and alliances.
  19. Erosion of Democratic legitimacy and thus a democratic deficit.

 

 

To that:

 

  1. Health Inequalities.
  2. Potential Ecosystem collapse.
  3. Disruptive technologies: Automation, Artificial Intelligence and digitalisation.

 

 

Streeck seems to suggest that it is the very success of neoliberal capitalism, its defeat of social democracy and forces that would otherwise tame its destructive tendencies, that has paved the way for such developments that characterise its internal contradictions. There is nothing left to save capitalism from itself.

 

There are countervailing voices such as Joseph Norberg (on the possibility and actuality of progress), Daniel Ben-Ami (on growth based capitalism to solve ecological problems) and Stephen Pinker (on reducing levels of global violence) who paint more positive pictures. Add of course the voices of politicians who promise to ‘Make America Great Again’, to create “A country that works for everyone’ or establish ‘Russia as a Normal Great Power’ or to regain ‘primacy in South East Asia after a century of humiliation’. The picture now is one of complexity, tension, dynamics and unpredictability.

 

None of this bothers most UK nurses who work with individuals who are ill, distressed, living with long term conditions, or dying in hospital and at home. They are also involved in public health basing their approaches in general health management, health education and health promotion. Their training and education focuses on instrumental competency based knowledge and skill acquisition but it lacks critical enquiry into the context in which they work. Gramsci’s approach to intellectual enquiry could provide a blueprint for alternative or complementary critical nurse education that has to consider wider socio-political determinants of health, the sort of developments that Streeck outlines.

 

 

 

Gramsci’s thinking

 

We get an insight into how Gramsci’s brain functioned from a letter he wrote in 1929 to the wife of a comrade who also was in prison for ‘anti-fascist’ activity. The context is that of how to study while in prison. The prison referred to, of course, had concrete existence. However, if we consider that today nurses may imprison themselves within the conceptual walls of stultifying paradigms that block freedom of critical thought, for example biomedical empiricism, his thoughts on reflection and analysis might be useful. The letter predates Wright Mills’ 1959 chapter on intellectual craftsmanship, a reading of which shows some commonality in approach and is an alternative to the metrics used today in our research excellence framework assessments. One wonders if Gramsci was writing today, would he secure tenure in some contemporary Universities.

 

He wrote in the letter that one must abandon, in the prison context, the ‘scholastic mentality’ and banish the thought of pursuing a regular and in depth course of study. Along with Wright Mills who later wrote about avoiding empirical work if he could help it as it was merely about sorting out facts and disagreements about facts, this statement appears to be counter intuitive until one considers that a goal of intellectual life could be about criticality, understanding philosophy, self, culture, history, politics and society. Again put this way, many nurses may well eschew intellectual enquiry as irrelevant.

 

Gramsci urged language learning as rewarding, but more interestingly is his outlook on the relative paucity of texts in prison libraries. He argued that a political prisoner must extract “blood from stones” (Buttigeig 2011 p15). The paucity of books in prison was of course a function of the external constraints imposed by the regime. The ‘paucity of books’ available to students today may be a result not of external concrete constraints but of internal self imposed constraints as to what counts as proper reading for a degree in Nursing. Gramsci experienced a concrete prison of walls imposed by the fascist regime. We might experience a ‘prison of the mind’ constructed by dominant cultural ideas (hegemony) imposed by ourselves upon ourselves through the process of normative governmentality. Gramsci argued for ‘extracting blood from stones’, the stones being whatever he could get.

 

To get the most of the books available to him, often popular novels, Gramsci adopted the following viewpoint:

 

“Why is this always the most read and most published literature?”

“What needs does it satisfy?”

 

“What aspirations does it respond to?”

 

“What sentiments and views are represented in these awful books that have such broad appeal?”

 

For student nurses, these questions could be applied to many of the texts, for example the professional body’s literature, that they read to assist with the development of critical thinking. Critique could be emancipatory but in actuality reading ends up in uncritical acceptance. I’m not talking about appraising and critiquing research evidence or engaging in critical analysis of for example leadership theories in nursing. Criticality is lacking in the socio-political and power domain.

An example of the lack of such criticality is the almost universal acceptance of the UK’s Nursing and Midwifery Council’s revalidation process. The requirement is for nurses to renew their registration every three years by following the process outlined by the NMC. The surface reason for revalidation is that it ‘promotes greater professionalism among nurses and midwives and also improves the quality of care that patients receive by encouraging reflection on practice against the revised code’. If we apply Gramsci’s questions above to the texts on revalidation put out by the NMC, a possibility arises that we just might make alternative and critical analyses of just such banal statements in official publications.

 

“Why is the NMC always the most read and most published literature on professional behaviour?” Because of its statutory position as the regulator to protect the public. Because Nurse educators use it as the basis for their teaching. Because the NMC has the power to discipline nurses…..

“What needs does it satisfy?” Neophyte nurses, especially, need guidance on professional behaviour and standards and don’t have the time, or resources or educational preparation to consider this in an in depth way. NMC guidance provides the generally widely accepted standard……

 

“What aspirations does it respond to?” To keep one’s registration and to bolster one’s subject position as ‘safe practitioner’

 

“What sentiments and views are represented in these awful books that have such broad appeal?” The sentiment of nursing as ‘character based moral work’, of nurses as ‘caregivers’, as self sacrificial angels who always cope……

 

The answers to the 4 questions of course are myriad and those above are merely some examples requiring further reflection, reflexivity and criticism.

 

The lack of critique of the NMC on revalidation illustrates ‘normative governmentality’, in that nurses and midwives, and perhaps more interestingly nursing academics, have internalised certain norms, values and assumptions that prevent them from seeing anything other than the official line. This could be an example of what Furedi (2006) refers to as philistinism underpinned by instrumentalism in higher education, in which academics become educational technocrats rather than what Gramsci refers to as organic intellectuals.

 

Intellectuals are those with broad reading, vision and a concern for public issues. Graham Scambler argues intellectuals are not only engaged in the public sphere but do so around an identifiable moral or political position. A question arises about the degree nurses and midwives are, or wish to be, engaged in moral and political questions, the degree to which they can engage in communicative action free from systematic distorted communication.

 

The questioning of texts exemplifies the Gramscian notion of critical enquiry and action and allows us to consider such questions as, for example, what counts as research in contemporary nursing faculties. The answer to that is political in that it frames what nurse academics study, write about and publish, and it frames what students of nursing count as valid knowledge. If we apply those questions to the published outputs of contemporary nursing scholarship what answers would we get? For example, does a high h index always indicate intellectual rigour or criticality? Given the wider determinants of health, which include the social, political and ecological, it could be suggested that health care professionals would be aided in their understanding of health and illness, and hence what to do about it, by critical enquiry that goes beyond accepted epistemologies.

 

Nursing students have been told to be critical thinkers and many University curricula claim to foster such thought. Texts are not to be accepted at face value, and that we should examine assumptions and viewpoints of writers. This should go beyond for example appraising research literature for methodological rigour. Should we also appraise the metaparadigms and epistemological assumptions of ‘acceptable’ and ‘REFable’ nursing research? Should we ask what degree does contemporary scholarship in nursing reflect the sort of intellectual enquiry that Gramsci and Wright Mills advocate? In a world increasingly characterised by forces that threaten to disrupt stability and global order in ways that could be catastrophic to human health, are we preparing nurses to face that?

 

Gramsci died far too soon, and ‘without honour in his own country’. Whether he considered his life a failure in that fascism still held power, nonetheless he provides a template for thinking, studying and critique in difficult circumstances. He had a vision, he was an intellectual, he had a political purpose. Whether academic nurses in the 21st century find this inspiring or irrelevant may depend on what vision we have for nursing praxis for the future.

 

 

 

Buttigeig J (2011) in Gramsci A (1975) Prison Notebooks. Volume 1 Ed. Einaudi G. Columbia University Press. New York.

 

Furedi F (2006) Where have all the intellectuals gone? Confronting 21st Century Philistinism. Continuum.

 

Gramsci A. (1975) Prison Notebooks. Vos 1-3. Edited Einaudi G. Columbia University Books New York.

 

Scambler G (2013) What is an intellectual? http://www.grahamscambler.com/what-is-an-intellectual-2/

 

Streeck W (2016) The post-capitalist interregnum: the old system is dying, but a new social order cannot yet be born. Juncture 23 (2): 68-77

Manifesto

 

This manifesto calls for a social movement for political activism by nurses and other health professionals, to address inequalities in health and the social inequalities that highly structure, but do not determine, health outcomes. This action can operate at individual, clinical, organisational, national and international level.

Our aim is to respond to threats to health and socialised health service delivery from corporate, financial and political interests.

Our vision is for decreasing social and health inequalities in which the social gradient is greatly diminished.

Our goal is to create a networked social movement involving political and civic activism to bring critical understanding and action into the public sphere.

See:

A Manifesto for Action Nursing

Health and Social Care – the Tory Legacy

Health and Social Care – the Tory Legacy:

 

David Cameron appeared in jovial mood both in the commons and on the steps of number 10 when he recently left office. Cameron joked at his last prime minister’s questions in the House:

other than one meeting this afternoon with Her Majesty the Queen, my diary for the rest of the day is remarkably light“.

He listed his achievements in office and seemed not to be too bothered to be leaving.

It is not clear whether people, especially frail older people, will be so sanguine about his record.

When it comes to health and social care, ‘the nasty party’s’ record is appalling. Following largely on the heels of the Health and Social Care Act 2012 and Osborne’s deficit reduction targets for the public sector, and in the face of increasing demand, we have what Roy Lilley (2013) predicted, and called, ‘The big blue bit of doom’:

His diagram was prescient, as two reports below indicate. This is having an effect on staffing levels and thus on the quality of care people get.

 Jim Mackay, CEO of NHS Improvement, recently was reported in the Health Service Journal (July 2016):

“…Trusts exceeding the 1:8 nurse to patient ratio could be told “we can’t afford that”.  

Trusts, he suggested, should not automatically spend money on new staff or better facilities on the basis of a CQC report or in an attempt to meet Royal College standards.

Janet Davies CE of the RCN stated in reply

This gives completely the wrong message to trusts, whose boards are responsible for the care, treatment and safety of their patients, by suggesting that finances are more important than patient care”.

 I’m afraid in the current context that major decision makers do think finances are more important than the quality of patient care.

 

The King’s Fund (2016) reports:

 

  1. NHS providers and commissioners ended 2015/16 with a deficit of £1.85 billion – the largest aggregate deficit in NHS history
  2. The scale of the deficit signifies a system buckling under the strain of huge financial and operational pressures.
  3. The principal cause of the deficit is that funding has not kept pace with the increasing demand for services

 

The 2016 ADASS (Directors of Adult Social Services) budget survey report states:

 

  1. Funding doesn’t match increased needs for, and costs of, care for older and disabled people.
  2. More people’s lives are affected by reductions in social care funding. The quality of care is compromised: 82% of Directors report that more providers already face quality challenges as a result of the savings being made.
  3. Directors are increasingly unclear where the funding needed will come from.
  4. The continuity of the care market is under threat. Providers are increasingly selling up, closing homes or handing back the contract for the care they deliver to older or disabled people.
  5. Investment in prevention is being further squeezed.
  6. Reduction in funding for social care has wider impact. Directors feel that negative consequences due to budget cuts have already been felt right across health and social care and agreed particularly strongly with statements regarding issue faced by the wider sector:
  • 85% thought that the NHS is under increased pressure
  • 84% thought providers are facing financial difficulty
  • 85% thought providers face quality challenges

 

NICE produced the original safe staffing guidance, centred on the idea that 1:8 was acceptable, provided somebody could wave a ‘red-flag’ and additional staff summoned. The guidance was based on the work of Anne Marie Rafferty et-al, who never said 1:8 was safe, it will not be.

Roger Watson (editor of Journal of Advanced Nursing), wrote for The Conversation UK on a recent study:  https://theconversation.com/youre-more-likely-to-survive-hospital-if-your-nurse-has-a-degree-61838 and thus provides more evidence of the strong correlation between education and outcomes. My worry is that in the UK we have drifted into ‘policy’ based evidence rather than EBP. Safe staffing levels may well be decided by finance directors (what can we afford) rather than sound evidence. This reminds me of the climate change ‘debate’ of which Roger Pielke applies the ‘iron law of economics’:

When policies on emissions reductions collide with policies focused on economic growth, economic growth will win out every time. Climate policies should flow with the current of public opinion rather than against it, and efforts to sell the public on policies that will create short-term economic discomfort cannot succeed if that discomfort is perceived to be too great. Calls for asceticism and sacrifice are a nonstarter.”

So ‘when policies on nurse staffing collide with policies focused on deficit reduction, deficit reduction will win out every time. Staffing policies will flow with the current of finance directors/CEOs opinion, and efforts to sell them policies that may cost them cannot succeed if that cost is perceived to be too great’.

A question is that while there is a perception that degree nurses and lower nurse patient ratios will increase the wage bill, while not providing savings ‘on the bottom line’ then we have a political battle not an evidence battle. The externalities of FDs and CEOs decisions fall onto individuals, families and nurses rather than the organisations balance sheet. Do we have metrics that force the financial externalities back into the equation, or is there evidence that hospitals see this evidence and are changing staffing practice?

The Tory Legacy is that we are still chasing a target of deficit reduction within a wider ideology that is suspicious of public sector provision at best. The drift is towards more private provision with perhaps a base line that the tax payer pays and a system of tops ups and private insurance schemes. This will be sold as “we cannot afford the NHS as it is” to cover for much further privatisation, marketization and a return to individualising, rather than socialising, risk. Health and Social Care as we knew it is over. If you or your parents need caring for in older age, or if you need non urgent surgery, you will need to save more money to pay for it, take out private insurances, top up your pensions or pay more tax.

Poverty Privilege and Health

In two of the richest nations ever to have existed on planet earth we have a separation which allows affluent whites to exist in a bubble of privilege; a bubble of privilege which survives the shooting of police, deindustrialisation, poverty, precarity and the social gradient in health. Privilege understands and sees how radical losers exploit poverty and exclusion, but does not want to address social and economic structures; privilege understands that pain and anger can be turned both inward and outward but looks for solutions in the individual and ‘security’; privilege sees the transmission of poverty and exclusion only in the personal agency of the poor themselves.

Washington Heights is a suburb of the most segregated city in America. Charles lives in a part of Milwaukee where the residents are 99% white, yet a few blocks up are black neighbourhoods where shops are boarded up, many houses have repossession notices on their front doors, and the air is one of decay and poverty. The separation of black and white in Milwaukee is replicated in big cities right across the US, and separation breeds a lack of empathy.”

“Local authorities which report the highest rates of people facing severe and multiple disadvantage are mainly in the North of England, seaside towns and certain central London boroughs”

“Women who live in the least deprived parts of Kensington & Chelsea can expect almost a quarter of a century more of good health than their female counterparts in the most deprived part of the borough. For females at birth, the number of years an individual could expect to live in good health based on current rates – known as healthy life expectancy – differed by an average of 24.6 years between the most and least deprived parts of the borough” (ONS, 2015)

…and yet politicians like to focus on a ‘moral underclass’, blaming them for their behaviour that causes poverty. Drink and drugs are key factors in this regard:

“Ian Duncan Smith, Secretary of State for Work and Pensions, shocked readers of the Daily Mail with: ‘Addicts and alcoholics cost us £10billion a year, says Duncan Smith: Blitz launched to help people with drink drug problems find work’ “. (Glen Bramley LSE Blog)

There is a very old debate about whether poor people owe their circumstances to structural economic factors or to moral/behavioural failings. Sandra Carlisle in 2001 argued that there are ‘contested explanations, shifting discourses and ambiguous policies’  for health inequalities: there is the ‘Moral Underclass’ discourse, the ‘Social Integrationist’ Discourse and the ‘Redistrubutive’ discourse. Each has its own explanation as to why there are inequalities and then what to do about them.

Since Sandra Carlisle wrote her paper, there has been a a good deal of evidence to suggest that structural/economic forces are a major factor in people’s health and illness. There is some evidence also of ‘transmitted poverty‘ due to adverse childhood experiences. The misuse of Alcohol and Illegal substances (they are all drugs) are of course correlated:

“There is a huge overlap between the offender, substance misusing and homeless populations. For example, two thirds of people using homeless services are also either in the criminal justice system or in drug treatment in the same year”.

Many people faced with adverse social situations learn to cope, or they become fatalistic,  or they cling together in supportive communities or they become activists fighting for social justice.  Some self harm, some drink to excess, some go to University and become doctors or lawyers or politicians.  They exercise their personal agency and succeed or fail within structurally determined circumstances. They succeed, despite not because of, the activities and ideology of the privileged. A few of the successful however, then refuse to provide more ladders while shouting “I did it so can you”.

The lack of empathy, the total separation of lifeworlds, arises partly from moral intuitions that both blinds many politicians and commentators to alternative explanations pf poverty and binds them together in a bubble of privilege that prevents them from analysing the evidence. As we all do, they engage in post hoc rationalisations – in their case that that the poor are a moral underclass who are less intelligent, lazy, and hard working than the successful – to explain and justify their own positions.  This is almost a moral imperative, because not to blame the poor opens one up to the need to justify or critique the structural and economic privileges one has unequal access to. Placing the focus on the work, drinking and drug taking habits of a ‘moral underclass’ provides one with a sense of superiority and entitlement so much on show in both US and UK politics. No doubt the same occurs in Russia and China. To acknowledge that there are structural and economic conditions, for example the public school system or the service sector low wage economies,  or the inverse care law, opens up the middle class to accusations of champagne socialism.

This is a common tactic to deflect the argument away from an examination of causes to one of ‘ad hominem’.  Another tactic is to argue that the best way to address structural and economic factors is more of the same economic policies that have held sway especially in the US and UK. Indeed on a global scale the numbers of people living in absolute poverty is decreasing. Inequality is also decreasing with in the UK (gini coefficient). However these two factors are not the only issue.  Both the UK and the US are rich and other measures of inequality have increased, see for example the use of the Palma ratio. It matters greatly for very poor people to get incomes, and mortality rates, enjoyed by the poor in the UK and the US, but that is not enough as the social, health and political problems in both countries testify.

Privilege looks around and is satisfied knowing that the ‘have nots’ only have themselves to blame. They reach for the moral underclass theory and publish it relentlessly in their newspapers and commentary. They also have the wealth and political power to ensure this ideology is accepted by the poor themselves. However, many do not. In this context:

The losers get sick.

The losers get poor.

The losers get defeated.

The losers get mad.

The losers get even.

‘Many professions take losers as the object of their studies and as the basis for their existence. Social psychologists, social workers, nurses, doctors, social policy experts, criminologists, therapists and others who do not count themselves among the losers would be out of work without them. But with the best will in the world, their clients remains obscure to them: their empathy knows clearly-defined professional bounds’ (Enzensberger 2005). Enzensberger (2005) goes on to argue:

‘one thing is certain: the way humanity has organized itself – “capitalism”, “competition”, “empire”, “globalisation” – not only does the number of losers increase every day, but as in any large group, fragmentation soon sets in. In a chaotic, unfathomable process, the cohorts of the inferior, the defeated, the victims separate out. The loser may accept his fate and resign himself; the victim may demand satisfaction; the defeated may begin preparing for the next round. But the radical loser isolates himself, becomes invisible, guards his delusion, saves his energy, and waits for his hour to come’.

Shoots a Policeman, drives a truck through a crowd, blows himself up in an airport…..all the while privilege looks on in dumb uncomprehending horror calling for more security and economic crackdowns on the moral underclass upon whom the often middle class radical loser preys.