Why we should redirect public health funding to social care

"3-5% of people are responsible for 39% of our spending."

This is your NHS folks. The statistic comes from Bradford's three Clinical Commissioning Groups at a meeting today. Dwell on that statement for a second or two - here in Bradford just 15,000 or so people use up 40% of the money we spend on health care. Out of a population of 500,000.

There are lots of reasons for this situation and for the continuing pressures created by expensive treatment. Most of those 15,000 are elderly and in that stressful and traumatic end-of-life situation. Nobody is saying that we shouldn't spend the money we spend on that treatment.

What bothers me is that, time and time again, I'm told that the answer to this concentration of costs is to shift money from acute care into 'prevention' (or 'Tier 1' in the jargon). This is lots of jolly and cuddly stuff like fat clubs and smoking cessation clinics plus a whole panoply of annoying fussbucketry wrapped up in a thing called public health.

Think about this for a second and you'll realise one of two things:

1. This fussbucketry and huggery doesn't make a blind bit of difference. The money is wasted but also loads of people are irritated, businesses are shut down and products banned.

2. The fat clubs and advertising bans do work and people live longer. The money wasn't wasted but we still have to spend loads of cash on that end-of-life stuff. We just do it at 85 instead of 75.

For what it's worth (and this being the NHS it's worth a fortune) there is pretty much no evidence at all that tells us 'Tier 1' investment works (except in the economic sense of price hikes, bans and other restrictions impacting consumption). Yet we continue to spend millions on this - something like £10 million in Bradford alone - while moaning about bed-blocking, shortfalls in social care funding and hospital overspends.

Scrapping this sort of public health spending wouldn't solve the problem of funding care and the NHS. But it would be a damned good start.

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"We need safe spaces..." - how the NHS ducks the big questions

I can't remember the precise moment or why the subject came up but some point in 2016, in a meeting with NHS folk, something along these lines was said: "we need safe spaces to discuss the real challenges facing the health and care system". What they really meant was that some subjects are just to difficult to discuss other than in a carefully protected space - protected, that is, from the public. This answer is a reminder that our populist, planned health system is facing something of a crisis.

Before we go on to talk about the challenges we can't discuss in public we have first to talk about money. I had a Twitter exchange with someone recently where I asked what she meant by 'adequately resourced' in the context of the NHS. The answer, as these things often are, was something of a cop out but was at least better than the more usual response to such questions - a response typified by this piece of populist cant from Tim Farron:

Farron said voters had reached the stage of not believing the NHS’s problems could be solved through efficiency savings and might be willing to pay more if they were convinced it would go to the health service.

He said he did not want to pre-empt the conclusions of an independent panel formed by the Lib Dems, which will look at possible taxes to help the NHS.

In varying forms this is the default response to concerns about our health system - more taxes, more resources. The problem is that, for all that sticking a ring-fenced penny on income tax sounds good, it goes nowhere to making the NHS more sustainable. Bear in mind that, despite the claims of its founders, the NHS has required above inflation increases in funding throughout its existence meaning that it now spends approaching £120 billion out of those taxes.

In one respect our health system needs that extra cash - as Jonathan Portes pointed out recently the proportion of GDP spent on health has fallen and we do spend less per capita than other places (significantly so than the USA). But when you open the NHS up, every single element within the system will tell you that with a little extra cash they can solve this or that problem. Indeed most of those individual bits of healthcare systems - the non-clinical as well as clinical - will tell you that right now they are starved of cash meaning that people might die.

So maybe we do need more cash. But first we need to huddle in that safe space and discuss some more fundamental things about the NHS. By way of example, West Yorkshire has eight or nine general hospitals (I forget the precise number but it doesn't matter for this discussion). All of them are seen by their local community as "their" hospital and the popular expectation is that the general means they do everything that community needs. The question we need to ask in that safe space isn't how do we get more cash for those hospitals or what services do we cut to stop them overspending. No the questions are more fundamental - does West Yorkshire need all those hospitals, are they in the right places, do the facilities meet modern needs or public expectations?

We might ask, for example, why Leeds has two huge general hospitals with real access issues right bang in the city centre? Should we be finding a greenfield site somewhere more convenient and building a new large hospital? And do all those hospitals need to have high support accident units, heart care centres and cancer wards or would it be a better service to have specialised units?

I don't know the answer to these questions - or indeed to thousands of other questions about health and care provision - but I do know (because I've been given a privileged peep inside the system) that the NHS simply isn't discussing these issues at all. Mostly for fear of adverse public reaction but also because the planners within the health system are driven by issues of sustaining what's already there rather than by more fundamental questions about structure and organisation.

There's a further problem, one stemming from the very top of the NHS (indeed from the World Health Organisation), which is the belief that the drivers of rising costs are lifestyle factors especially smoking and obesity. Even when the health systems own statisticians point out that longevity is the problem, we still get strategies founded on the idea that being fat and liking a fag is the problem. This is where the proposals for limiting access to surgery come from (like this one from York) - they don't really address the problem, they're usually overturned and they make it look like the Clinical Commissioning Group (CCG) is doing something.

It seems to me that the NHS, for all the "Our NHS" and "Save the NHS" rhetoric, isn't really all that good. OK, I'll grant that it's better than a system such as that in the USA which manages to be both very expensive and to leave out great chunks of the population from effective care, but there are other approaches - Sweden, France, Holland, Singapore - that might offer some ideas about how we might improve our health outcomes. The UK has a very centralised system that is painted to look like a dispersed and localised system. As the recent round of reorganisation - called Sustainability and Transformation Plans in that jargonistic NHS way - has shown, the idea of local control or direction is anathema to the system's bureaucracy.

The Tim Farron solution - whack up a few taxes - sticks a slightly bigger plaster over the wound but doesn't address the fundamental problems (just as allowing councils to stick up council tax a bit more does solve the care crisis) in the health system. We have a health estate that was mostly designed by Victorians (to which we've added a lot of prefabs) and a structure that would do the Soviet Union proud - right down to the endlessly revisited five-year plans. Until we actually use that safe space we mentioned to discuss the real problems of the health system the NHS will carry on lurching from self-generated crisis to self-generated crisis. And worse, populist politicians like Tim Farron will go on waving the NHS's problems about as a cheap source of votes.

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We shouldn't be surprised when right-wing politicians stop funding left-wing academics

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The Japanese government isn't all that keen on social science and humanities - preferring what it calls socially useful subjects:

A recent survey of Japanese university presidents found that 26 of 60 national universities with social science and humanities programmes intend to close those departments during the 2016 academic year or after. The closures are a direct response to an extraordinary request from the Japanese government that the universities take “active steps to abolish [social science and humanities departments] or to convert them to serve areas that better meet society’s needs.”

Now I'm not here to defend what the Japanese government has done but rather to ask why, given the nature of these courses, we have got to the place where a national government can deem them less able to meet society's needs. All that sociology, social psychology, political science, literature and history is to be sidelined - I'm guessing for science and engineering, business and languages.

This comes on the back of the decision by the US Congress to pull funding for social sciences from the National Science Foundation:

First, in April the House passed a reauthorization of the National Science Foundation — the America Competes Act (H.R. 1806) — that cuts funding to the social sciences by 45 percent, even as it increases funding to the NSF overall.

The question here is again - why? It's easy for the establishment of social science academia to cry political foul - after all these are political decisions made on partisan grounds - but what they fail to appreciate is just how utterly loathed and detested much of their output is outside their narrow milieu. Frankly you can't expect the political right to support a set of academic disciplines that make it their business to argue that all conservatives are thick or that neoliberalism, capitalism or free markets are at the heart of all society's problems. The reason for this problem is simple - and I would support 'defunding' UK universities on this basis: the academic disciplines concerned are completely dominated by a left-wing, anti-conservative agenda.

While the authors’ political motivations for publishing the paper were obvious, it was the lax attitude on behalf of peer reviewers – Jussim suggested – that was at the heart of the problems within social psychology. The field had become a community in which political values and moral aims were shared, leading to an asymmetry in which studies that reinforced left-wing narratives had come to be disproportionately represented in the literature.

This example isn't a one off - the literature in sociology, political science, regional studies, and psychology is entirely dominated by a set of left-wing ideological certainties. And researchers cannot - if they want to get published, secure funding or advance an academic career - step beyond this narrowly defined world. It's easier to be a Stalinist communist in most social sciences than a moderate conservative. Until this imbalance - this sustained bias - is addressed, I see absolutely no reason why a conservative would want to support funding social science 'research'. What is remarkable is that Conservatives and conservative-led governments have continued to fund academics who both despise those conservatives and have the means to promote an anti-conservative ideology through their academic discipline.

If social science faculties want to protect themselves better, they should look to their own central failing - an almost complete capture by the ideological left. Until this happens the value of the disciplines within those faculties will continue to decline in the eyes of everyone but those immersed in that part of academia or else entirely wedded to illiberal, anti-democratic and oppressive left-wing ideologies.

UPDATE: Another article setting out the egregious bias and misrepresentation in social psychology concluded:

I think reform is urgently needed because I think there’s a significant risk that the field will be defunded within the next few years. I urge social psychologists to take this risk seriously. In the US, we have a funding monoculture that is largely dependent on a couple of US government agencies. If most of our findings are false, I think policymakers will question why taxpayers should fund our work. There is also strong evidence (PDF) that the field discriminates against non-leftists and conservatives — this alone may prove disastrous for us, especially since the field has taken no action to prevent such discrimination.

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It's time that NHS management started earning those big bucks they get paid

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It's a couple of weeks before the latest 'comprehensive spending review' so we can all understand the explosion of shroud waving, sorry tales of budget cuts and screams of 'crisis, crisis'. Indeed I've indulged (I think rightly) in a little bit of this myself.

However, we need to think very carefully about what we mean by 'crisis' - as in 'the NHS is facing financial ruin':

By next year, hospitals’ deficits may have escalated to such a degree that the NHS could face widespread financial collapse.

Now it's true that hospitals (and the writer is Chief Executive of a hospital trust) are facing something of a problem. We saw recently that the total deficit has reached over £800m and that most of them report continuing pressures on delivery. But Christopher Smallwood, the writer here, is just scaremongering as part of a timely lobby.

The inference in these arguments is in two parts - first that hospitals are the NHS and second that the problem is a consequence of cuts to the NHS budget. Neither of these two suggestions are right - hospitals are responsible for just about half of NHS spending and expenditure on the NHS is programmed to rise (funnily enough by the £8 billion the NHS said it needed and the government promised).

The problem here is that while the Department of Health has a specific amount of cash allocated though the national budget, this doesn't apply to hospitals - NHS Providers in the jargon - which operate on a tariff system and mostly get paid according to how many operations (or whatever) they undertake. As one consultant put it to me - 'each time a new patient arrives in hospital for an elective procedure it's "kerching, kerching".

The problems with this system are many and varied but the most egregious is the widespread belief in hospital management that fewer patients means less money for the NHS. The managers (who really should know better) think that because their hospital gets less money this means that the whole system has less money. And this gives rise to one of the more pernicious criticisms of extending the choice of providers in the health system - 'cherry-picking':

Around half of all NHS-funded hospital care – about £40bn a year – is paid for through a national tariff, where hospitals are paid a set rate for each patient, depending on the treatment given. As private hospitals generally do not treat complex or emergency patients, critics claim private contractors can profit by “cherry picking” easier patients.

What you need to understand here is that we're being told (by those same people complaining of inadequate funding) that the NHS should commission more expensive provision through general hospitals because otherwise those hospitals, in some way, would be less viable. Instead of purchasing elective surgery from the lowest cost provider meeting the necessary high standards, we are commissioning from general hospitals on the false premise that the more cost-efficient approach would cost the NHS more money.

The central issue for the NHS - and one of the reasons it has failed to meet (or even tried to meet, in truth) its efficiency targets - is that the dominance of general hospitals over the system has made it nigh on impossible to develop a market of specialised providers or to shift low-risk procedures into primary care. The moment these systems start to reach the point where their impact on the system is positive (ie releases more money for other NHS activity) the result is NHS Trust deficits giving the impression that there is some sort of crisis. This may or may not be the case but so long as the hospitals' budgets assume utter market dominance, we will continue to fail in making any meaningful efficiencies in the NHS. And there'll be this gun pointed at the government's head:

The choice is stark: more money every year or a sustained decline in the standards of healthcare and a financial collapse. How much more money? Even if the efficiency gains achieved in the next five years matched those of the past five, the government would need to increase annual budgets by £2bn-£3bn a year between now and 2020 to preserve standards. But since the NHS cannot continue to raise productivity at this rate, at least £4bn a year extra will be necessary, starting in April.

When I look at what local government - for all its faults and failings - has delivered over the past five or six years, I am forced to assume that these same opportunities exist in the NHS. But I - like the government and the public - would like the management of the NHS to make those changes without the blunt instrument of actual cash budget cuts. So far that management has avoided anything that requires structural changes and have resisted - to cries of "no privatisation" - any substantial attempts to use the private sector to help develop a significant and innovative delivery of high quality elective surgery and treatments.

I'm prepared to defend the high salaries of NHS management but that, I think, gives me the right to tell them that they need to up their game. If we're going to pay NHS Trust bosses £200,000 or more then those bosses need to start showing the creativity, innovation and invention those big bucks are paid to secure. And the message to people like Christopher Smallwood is to stop waving shrouds and start to make the case for a dynamic, flexible and responsive system - even if it means there are fewer huge general hospitals and more small, specialised and independent providers.

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"The bigger the number the better" - public health campaigners' cavalier attitude to evidence

An entirely gratuitous picture of cake

I've felt for a long time that single issue campaigners of various kinds - poverty, public health and so forth - have a tendency to choose statistics that maximise the scale of the problem they are campaigning about. From the perspective of campaigning as a business, this makes a lot of sense - if we can demonstrate there are huge numbers 'living in poverty' or some sort of booze or food related crisis then the need for our campaign is all the greater. And we can present the stats to compliant - and media-scared - governments who will carry on providing the funds to pay us so we can carry on campaigning.

This hyping up of a problem does however have a downside - by making the numbers ever larger and the problem greater and greater we feed scepticism and cynicism in the population. If your recommended alcohol limits boil down to a glass of dry sherry twice a week the drinking public (and that's most of us) are going to think something like "that probably a load of nonsense, isn't it", And that public will carry on behaving just as they were before.

So the campaign is sustained because government is given scary figures by the campaigners. And the unwillingness of the population to change its behaviour (because it doesn't believe those scary figures) further reinforces the view of campaigners that "something must be done".

And now we have some evidence to support this theory:

People who think they are overweight or obese are more likely to pile on the pounds than those who are unaware that they may be heavier than doctors would advise, according to research.

The researchers show that telling people that they are fat is unlikely to work because of the stress associated with the stigma of fatness. Yet the obesity industry is utterly predicated on two interpretations of statistics - firstly the conflating of 'overweight and obese' into on number and secondly the narrowing of the definition of 'normal' weight. We're repeatedly told that two thirds of more of adults are 'overweight or obese' and in doing so extend the stigma of being a bit chubby from body image alone to body image plus health. This is despite there being no evidence at all showing that being overweight is unhealthy.

"Our results are similar to those from other recent studies, confirming that underweight and obesity class II+ (BMI > 35) are clear risk factors for mortality, and showing that when compared to the acceptable BMI category, overweight appears to be protective against mortality."

This is a pretty consistent finding - far from being chubby shortening our lives, the reality is that is probably extends them. If we were - given what the evidence tells us - to redefine healthy and unhealthy weights so as to direct appropriate interventions, a better definition would focus 'obesity' on people with a BMI in excess of 35. But were we to do this the numbers might fall from 'two thirds of adults and a third of children' to '5% of adults and 1% of children' - still a lot of people but not exactly a crisis. Such a change would challenge the huge sums being spent on anti-obesity campaigns and would call into question the ongoing campaigns against sugar, fat and the working class diet.

I am repeatedly told by public health folk that their work is 'evidence-based'. And they are very quick to point out studies that support their position. But when the evidence - as we see here with obesity - challenges the preferred position (and funding - Bradford spends over £2 million on its obesity team) it is simply ignored. By not fitting the narrative - 'global obesity crisis' - the pesky evidence undermines the strategies of public health and brings into question its programmes of work. This cannot be allowed.

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Everything that's wrong with lottery funding - in one quotation

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The quote is from a chap called Henry Kippin who works for an organisation called Collaborate CIC (who do something very important around" creative thinking, policy development, and a ‘shared space’ for insight, debate and problem-solving"). It's in the house magazine of professional urban nonsense, New Start:

A proactive navigating of sector boundaries has precipitated more creative, iterative and diffuse ways of reaching scale – blending public funding with social finance and a more proactive role for the private sector. Far from protecting a sense of safe isolation, funders celebrate confident interdependence and regularly take collective risks on path-breaking initiatives to build social capacity and resilience. The impact on funding beneficiaries feels profound; offering the possibility of new routes to impact, and an alternative to the increasingly fraught relationship between social action and the local state.

I'm pretty sure that Henry knew what he meant when he wrote that paragraph - it's a picture of the 'social funding' environment in 2025 if we all do what Collaborate thinks we should do. The problem is - and I know you've spotted it - that the prediction does actually say anything of substance. Roughly translated it says that 'social funders' (that's the lottery, charitable trusts and other formal philanthropy) will be most effective if they work in partnership with the public sector in their funding decisions. You could call it 'collaboration' but in truth its the alignment of private initiative with the policies and priorities of the state.

Such an arrangement suits the public sector and, since that is the pond in which they swim, also meets the needs of those who work for the big social funders. But for that social funding to be most effective it should be challenging the state - investing in things that government can't or won't do. This isn't about plugging perceived gaps in provision but rather is a route to new ideas and new activities. What Henry and his pals are proposing isn't a beautiful collaborative future but rather the de facto nationalisation of social funding - the further submission of charity to to objectives of big government.

Right now most of the social funding out there goes to a very limited pool of recipients. Funding is most likely to go to organisations with full time workers where the focus is on capacity, social infrastructure and campaigning rather than on what most of us normal folk think of as charity. Most of the social action taking place today isn't being done by these organisations but rather by a host of little groups doing things they think important. Nine out of ten charities and community groups don't employ anyone yet to read what organisations like Collaborate say you'd think this was the exception not the norm.

If social funders want to make a real difference they need to change what they do and how the fund. Not by getting more cuddly with the state or even holding hands with private business, but by widening their net and supporting the small battalions of volunteers that really do make a difference in all our communities. Sadly though, people like Henry with their jargon-ridden wibble will win the day meaning that the distance between real voluntary work and the activity of the "third sector" gets ever larger.

Thousands of organisations simply don't bother approaching those big social funders. Not because they don't need support and aren't doing great work. Rather it's because they take one look at the information provided by the funder and decide they have no chance of getting support. "No point in us applying for funding, they never give money to organisations like us round here" - I've heard this dozens of times and, however much Henry and his pals want to say it ain't so, I know it's the truth.

So if Henry wants to change things - wants a better future for 'social funding' - he should start arguing that support should be directed to real social action being done by ordinary people in every community rather than for some sort of grand unified theory of collaborative funding that's really just code for doing what the government wants.

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How political parties get paid isn't the concern of government...it's the concern of members

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I know you'll all start talking about corruption and the buying of influence but, let's be honest about that problem, it's not a consequence of political parties but rather the result of how government's willingness to fix markets makes bribing politicians an effective marketing strategy.

No, dear reader, how private organisations fund themselves isn't the concern of government - assuming that they're not doing so by doing things we've decided are illegal (drug dealing, running protection rackets, intimidation - all the things Sinn Fein used to use). Yet the Electoral Reform Society has decided - from its pinnacle of righteous knowledge on these matters - that action is needed:

The public are sick to death of party funding scandals. Over the last two weeks we have been exposed to yet more findings about the suspect dealings of party donors. It brings our democracy into disrepute, and we have to do something about it.

I'm not concerned here with the question of whether those donors are good or bad people. I take the view that, regardless of the political debate, they are mostly good people who care about politics. Care enough about politics to donate large sums of money to political parties and political campaigns rather than pouring it into the bottomless pits of football, sea-going yachts and opera.

What I'm concerned with is whether there's any justification for the Electoral Reform Society's campaign:

We propose three solutions, all of which have been recommended by previous committees looking into party funding and have been shown by ERS polling and focus group research to command support from the public. These are:

• A cap on the amount that anyone can donate to a party, to end the big-donor culture that has led to scandal after scandal
• An increased element of public funding for parties, to bring the UK into line with other advanced democracies
• A cap on the amount that parties are allowed to spend, to end the arms race between parties at election time

There is huge public support for doing what it takes to get big money out of politics, so whichever party takes a lead on this could stand to benefit at the polls.

To understand why the ERS are wrong we need to appreciate a few things. The first is just how cheaply we get our politics and democracy, the second is the lack of evidence supporting a link between political donations and party policies, and the third is that (as the Americans - after decades of campaign finance reform - have discovered) there's always a get around. I also take the view that there's a matter of principle here - in a free society people should be free to use their money to campaign for the things they think are important (including, of course, their own self-interest).

British politics and democracy is pretty cheap. Really it is. Over the six years from 2008-2013, the two main political parties had a total income of £386 million (split more or less equally - Labour raised about £5 million more that the Tories). I appreciate that this isn't all the money spent on politics - other parties raise funds, there are plenty of campaign groups (some very well funded) and there's the unquantified value of all that volunteer effort we see a glimpse of on Twitter.

To provide some context here, the annual player wage bills at Manchester City, Manchester United and Chelsea are all higher, at around £200 million, than the income of either the Conservative or Labour Party for the entire period of the current government. We get all our politics paid for for less than the wages at a football club. Yes, I know you think footballers are overpaid, but this still tells us that our democracy is, relatively speaking, cheap as chips.

Generally speaking giving money to political parties isn't a great way to influence policy. It's true that there's some reliable evidence from the USA that campaign contributions and policy outcomes are linked. Moreover there's some research suggesting a link between contributions and public contracts (although mostly the contributions come after the contract not before). There's also some evidence suggesting that the more 'professional' the legislature and the higher paid the legislators, the more likely it is that campaign contributions will influence decision-making.

The evidence from the UK is more limited and mostly anecdotal. Transparency International reviewed 'Corruption and the funding of UK political parties' in 2006. This report didn't record a single identified example of 'corruption' or evidence of undue influence and opted to fall back on the same argument as the ERS:

The recent ‘Power’enquiry into the state of Britain’s democracy found that “there is a widespread perception that donations to parties can buy influence or position. It is clear that a system of party funding that relies increasingly on very sizeable donations from a handful of wealthy individuals or organisations creates an environment in which the perception spreads that democracy can be bought.”

Now there's some truth that a widespread view that money buys political power runs counter to the idea of a free democracy but the evidence of actual corruption or undue influence on policy is negligible (and yes I include the Bernie Ecclestone donation to New Labour in this conclusion). And there's not even all that much evidence closely linking donations and electoral outcome! Here's an expert on campaign finance effects talking:

For example, large shocks to campaign spending from changes in campaign finance regulations do not produce concomitant impacts on electoral success, nor do candidates with vast personal wealth to spend on their campaigns fare better than other candidates.

These findings may be surprising at first blush, but the intuition isn’t that hard to grasp. After all, how many people do you know who ever change their minds on something important like their political beliefs (well, other than liberal Republicans who find themselves running for national office)? People just aren’t that malleable; and for that reason, campaign spending is far less important in determining election outcomes than many people believe (or fear).

Our worry that somehow a shadowy bunch of hedge fund owners are somehow buying the election makes for good politics but there's precious little evidence supporting the contention that big donors - whether corporate or individual - either get what they "want" or influence the outcome of elections.

There is no case for legislation to regulate the funding of political parties any more than the degree of control needed for any private organisation be it a company, a charity or a campaign group. When the ERS refers to "scandal after scandal" it uses deliberately unspecific language - we've read the scandals in the newspapers and, if we're honest, they don't amount to any real threat to our democracy.

The losers in this dominance of party funding - including the access that can go with it - are not the voters or even the operation of government. The losers - and that's why the numbers have dwindled - are the ordinary party members. Our ability to have an influence over our party is what gives when big donors - whether institutional or individual - play such an important role. And this is the reason why I've argued for ages that the Conservative Party should simply impose an unilateral cap on the level of donations. The Conservative Club in Cullingworth will give £1,000 to the Party this year - and that club considers this to be a significant contribution. Because the Party - at a national level - is chasing those million pound plus donors, the emphasis on member recruitment, local events and the idea of the Party as a social movement as well as a vehicle for getting Tories elected has been lost. A voluntary cap on donations would force us back into doing just that - working to get ordinary folk to help us, in whatever way they can, get the sort of decent, efficient and effective government we need.

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We propose three solutions, all of which have been recommended by previous committees looking into party funding and have been shown by ERS polling and focus group research to command support from the public. These are:

• A cap on the amount that anyone can donate to a party, to end the big-donor culture that has led to scandal after scandal
• An increased element of public funding for parties, to bring the UK into line with other advanced democracies
• A cap on the amount that parties are allowed to spend, to end the arms race between parties at election time

There is huge public support for doing what it takes to get big money out of politics, so whichever party takes a lead on this could stand to benefit at the polls.
- See more at: http://www.electoral-reform.org.uk/blog/deal-or-no-deal#sthash.pLfWMR8L.dpuf

The public are sick to death of party funding scandals. Over the last two weeks we have been exposed to yet more findings about the suspect dealings of party donors. It brings our democracy into disrepute, and we have to do something about it. - See more at: http://www.electoral-reform.org.uk/blog/deal-or-no-deal#sthash.pLfWMR8L.dpuf

The public are sick to death of party funding scandals. Over the last two weeks we have been exposed to yet more findings about the suspect dealings of party donors. It brings our democracy into disrepute, and we have to do something about it. - See more at: http://www.electoral-reform.org.uk/blog/deal-or-no-deal#sthash.pLfWMR8L.dpuf

Quote of the day: on the Arts Council

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From Lloyd Evans in the Spectator:

The Arts Council, of course, is not an artistic organisation. It distributes bribes. And as a vassal of the state, it unconsciously mimics its political masters who have no faith in the people.

And those bribes - for all the talk of 'diversity' - are overwhelmingly directed to the grand institutions of high culture rather than towards the promotion of creativity. Probably because it's not really about art at all.

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The real voluntary sector - or the Big Society the sector's leaders want to kill off...

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The Community Development Foundation has published a report looking at what it calls the 'community sector'. This is the myriad of small local groups and charities - CDF estimate between 600,000 and 900,000 of these groups up and down the country. It is the real voluntary sector because, as CDF point out these groups mostly have an income below £2,000 per year and rely entirely on the efforts of enthusiastic volunteers. Nor have those volunteers been 'recruited', 'checked' and 'trained' in the manner of volunteers for big charities and 'voluntary' organisations.

The other thing about this real voluntary sector is where it gets its money from:

Figures from registered micro-groups suggest that community groups receive the largest portion of their funding from individual donations (65%). Other sources include investment (17%), other voluntary sector organisations (12%), government (4%) and the private sector (2%).

The important figure to note here is the 4% from government. Contrast this with the grand charities - Oxfam got £159.8m from various statutory sources in 2012, over 55% of its income and the same story can be told for Barnardos, for The Children's Society and many other big charities. Without grants and fees from government the 'voluntary' sector would be a whole lot smaller.

The government in its various guises provides around 35% of the income for the voluntary sector and, as we can see here, this overwhelmingly goes to large organisations. Partly this reflects the way in which the sector has developed over the years and especially the changes that took place after the election of the 1997 Labour government. That government set about transforming the role of the voluntary sector - or at least the larger organisations within that sector - from independent charities to agents of government policy.

So when the idea of the Big Society arrived the leadership of the voluntary sector saw immediately that the idea of voluntary social action threatened their control of the idea of 'voluntarism'. Rather than voluntary action being seen as the initiative of the volunteers, the sector's leadership preferred to see voluntary action as something to be managed by paid professionals. And this leadership sought out allies within the organisations that fund the big voluntary sector organisations - local councils, the agencies of the lottery, the Arts Council and elements in Whitehall and academia. A coalition of resistance to new voluntary initiatives was created and this set about demonising the idea of Big Society - 'just a cover for cuts', 'neoliberalism' was the cry as the paid professionals in the voluntary sector protected their interests.

The continued existence and success of the 'community' sector is a reminder of how out-of-touch that voluntary sector leadership has become - by focusing almost entirely on protecting state income and advocacy for the larger organisations that dominate the sectors lobbying the professional leadership of the voluntary sector has, in effect, allowed smaller organisations that make up most of the sector to sink or swim. These groups and organisations don't know about the conferences, the workshops and the action groups, they aren't connected to the networks of consultants, managers and directors that dominate the discussion about the work of voluntary action and their voice is lost in special pleading or calls for more funding.

The Big Society was the chance to put these groups centre stage, to celebrate the everyday voluntary action that sticks communities together. It may be that recession and the struggle to make the national budget's sums add up rather meant government took its eye off the ball but, at the same time, the professional leadership of the voluntary sector chose to be agents of the state rather than champions of the volunteer. In short that leadership failed the sector by campaigning to kill the Big Society.

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6

How Third Sector Professionals killed Big Society...and the idea of voluntary initiative

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A few years ago I attended an event organised by Julian Dobson and others that was, or rather purported to be, connected in some way with the government's Big Society idea. And, as a fan of the idea, I toddled along in what turned out to be a vain expectation of enthusiasm for thinking about civil society and the way in which voluntary social action plays a part in transforming society for the better.

What I experienced (and this was repeated again and again in my peregrinations round the voluntary sector) was quite different. Instead of people engaged in voluntary social action what we have in this visible part of the 'voluntary' sector are two sorts of people - political activists (almost exclusively from the left of politics) and what we might call 'sector professionals'. I was struck, as I am always struck at these sorts of occasion, by the almost complete absence of any genuine volunteers - people who have got up off their backside and done something for their community.

Today, various of the 'usual culprits' in "The Sector" have rounded on the Big Lottery and Cabinet Office over the manner in which they have funded a couple of organisations closely linked to the Big Society agenda. It is, we are told by these people who made it their mission to distance "The Sector" from Big Society, a terrible scandal requiring investigations and probably executions.

Yet these people - so self-righteous in their condemnation - are the very same people that spent the first year of this government undermining the idea of Big Society. They came up with different versions of it - one's untainted by the dread association. With the result that the winners in the game were new organisations - bright-eyed and bushy-tailed for sure but inexperienced and with ideas that needed work. But where were the experts? All those people from NCVO and ACEVO, all the parasitical consultants upon the multi-billion pound state funding of the 'voluntary' sector?

These self-appointed sector leaders set out to make sure Big Society failed. And they did so for one reason alone - it was an initiative from a Conservative prime minister. To these "sector professionals" (a surprising number having close links with the Labour Party) no Tory could possibly understand "The Sector" and therefore the initiative was either a smokescreen to cover up the evil neoliberal agenda of the Coalition or else a trojan horse aimed at smuggling in cackling Tory businessmen to take over voluntary action.

What these "sector professionals" and their new found activist friends fail to appreciate is that they are the problem rather than Big Society, the Coalition government or evil Tory neoliberals. It is the transforming of voluntary organisations of all sorts - whether working with a particular group people, in a particular place or on a particular issue - from organisations doing voluntary work into sub-contractors to the state that represents the single greatest wound to our civil society.

What these "sector professionals" presided over, and it accelerated under the Blair/Brown Labour government, was the de facto nationalisation of voluntary action. We got to a situation where nothing was deemed possible without government funding and without the employing of these "sector professionals". And just as importantly those professionals were recruited on the basis of their ability to attract funds fron the Labour government, from QUANGOs led by Labour supporters and regional agencies padded with Labour councillors.

So organisations - just like their funders - got stuffed full with Labour supporters. And, when the change of government arrived and with it the Big Society idea, these people were faced with two options - suck up to the evil Tory neoliberals or do what the Labour Party wanted and undermine the policy. Sadly, for the idea of volunteering and of the voluntary society, the sector's leadership chose to dismiss Big Society and campaign instead for the continuation and extension of a role for "The Sector" as sub-contractors to state agencies.

The latest round of attacks on Big Society confirms to me everything that is wrong with those "sector professionals". I see a group of well-paid, middle-class folk protecting their interests and crafting a language of entitlement to do so. Links into government at professional or operational level - along with ministerial fear of upsetting "The Sector" - has maintained the current system of funding more or less intact. New places to broker influence arose - Clinical Commissioning Groups being a fine example - and the idea of people doing something simply because they care becomes ever more distant.

Thankfully there's a whole load of voluntary action still going on and plenty of people loving the place they live and the people who live there. But these people have absolutely no connection to or links with the entitled grant-farmers that dominate the national discourse about the voluntary sector.

It saddens me that an idea such as the Big Society was killed off by a self-interested group more concerned with protecting state-funding and state contracts than with the idea of promoting and encouraging voluntary action. The idea of the state stepping out of the way and letting people do it themselves has been sacrificed so a bunch of well-connected lefties can carry on lecturing us while living off government grants.

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On the proper use of public health funding...

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Public health funding is about improving environmental factors - things like making homes warmer, reducing air pollution and preventing trips and falls. Here's a good example of how the funding can be used:

A ‘Boiler on Prescription’ scheme to demonstrate the impact energy efficiency improvements can have on ill health has been launched by social business Gentoo Group.

The Sunderland pilot will create a framework for GPs to prescribe a range of free home improvements to help those who have medical conditions exacerbated by cold, damp homes.

This sort of spending isn't nannying but targeted, specific and intended to get the greatest impact from the funding. It's a shame that we're spending hundreds of millions on nannying fussbucketry really.

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I find it hard to fault this ambition...

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Although the Guardian appear to believe it it evil:

"Hopefully, it will push the English system towards one in which the state provides a generous amount of funding per pupil, which parents can spend in any school they wish, breaking down the barrier between private-state school, while the Department for Education does little more than some regulatory accountancy, and due diligence functions."

Sounds about right to me.

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Do they not get it? We don't pay taxes to fund politics...

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...and each time I hear someone suggesting that giving us politicians the ability to dip our fingers into the public purse to fund our political organisations - as a way of stopping corruption - I want to scream.

People don't get up every morning and go to work - often for not very much money - to pay taxes so political parties can run posh offices in Westminster. Nobody does this. If political parties want to run these offices but think that relying on millionaires or trades unions stinks of buying influence then they need to go out there and raise the money from ordinary people. From subscriptions, donations and fundraising events - just like they used to do before they decided that tapping up rich folk was easier (and meant that there were fewer of those pesky members to cause trouble for the leadership).

And what makes me even madder is the cavalier approach to public funds - 'oh, it's not very much' they say:

Nor are the sums large: Sir Christopher proposed a £10,000 donations cap and an increased state contribution of £23m a year over five years – the cost of a first-class stamp for every taxpayer. 

There are hundreds of better ways to spend £23million and, more to the point, there is a matter of principle involved here. It is not the purpose of government - the thing to which we pay our taxes- to fund the conduct of politics. Even more than with funding from the rich or from powerful institutions, the use of public funding for politics is wrong.

The problem political parties have is that nowadays only the ambitious and the anorak joins. The idea of joining a party (my party used to take any sum in return for a membership card - I recall collecting subs with my mum, 50p here, a pound there made for a large membership) to have your say and enjoy a bit of socialising has long gone. Today's Parties have largely given up on members - too much trouble.

If we allow state funding there will be no point or purpose of membership unless you want to be a politician. Is this really what we want for our politics? Where political parties look first to the state to pay their bills rather than make their case - for funding as well as votes - to the public at large? And where even more of our politicians emerge from the shallow, self-serving nomenklatura that populates Westminster. More and more nice posh boys and girls without the first clue about life in the real world but who sound good and know the right people.

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