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Will no one take an axe to this garbology culture?
Watching the prime minister wriggle out of almost any awkward question with the mysterious skill of a fakir’s snake, once so mesmerising, has become boring. However, last Thursday he was for once well and truly pinned down with a forked stick by a member of the public on Question Time.
She was not asking about Iraq; she was merely expressing her fury that GPs will not allow patients to make appointments much in advance. Surgeries will accept them only 48 hours beforehand, to meet the government target that nobody must wait more than two days to see a GP.
Tony Blair’s blue eyes opened in what looked like genuine surprise; at first he couldn’t grasp the problem. Members of the audience angrily explained.
You cannot make an appointment in good time, say a week ahead. Instead, 48 hours before a consultation “you have to sit on the phone for three hours in the morning trying to get an appointment because you are not allowed to ask for the appointment before that because by making it 48 hours beforehand they are meeting the government’s target”. Then when you get through there may be no appointments left.
When this absurdity finally became clear to the prime minister he said with embarrassment that it was news to him and he would do something about it.
The obvious thing to do, however, is the one thing he won’t do, and that is to abolish this target and hundreds like it in the National Health Service and across the public services. He won’t and Gordon Brown won’t either when his day comes because they are both statists, particularly Brown.
They simply don’t understand what is wrong with state interference (or in Blair’s case he may have given up trying to change it). They don’t understand that their bossy, statist micromanagement is bound and determined to have perverse consequences.
The man in Whitehall does not always know best. Any doctor or nurse or teacher or police officer will tell you so in despair. This 48-hour appointment nonsense is a perfect example of it.
It is state interference that the election should have been fought over. It is much to the Conservatives’ discredit that they have not done so. In this election if the Conservatives are speaking up for a radical attempt to roll back the state they are talking in an almost inaudible voice — dog whistling at the wrong pitch.
It must be a deliberate failure — they are supremely conscious now of messaging and packaging. It is a failure of nerve and a failure of conviction, due apparently to a belief that the voters won’t buy a truly anti-statist manifesto. Perhaps that is true for now but since the Conservatives’ electoral position has been near to desperate for some time, they could at least have indulged themselves in the luxury of conviction politics.
At one time, when the Conservatives commissioned the James review, I thought they were going to be truly bold. It’s obviously true that any real reform in public services means real cuts — not cuts in medical care or teaching, but deep cuts in the astonishingly, shockingly wasteful culture that has grown up around them.
I don’t mean only cutting target setters, target inspectors, target auditors, target trainers and so on. I mean cutting most of the extra posts created by the state sector ideology to do work that is at best a secondary priority.
There are countless examples of this loss of a sense of priorities. Suffolk county council, for instance, advertised late last year for a garbology officer at £20,000-£23,000 a year.
The successful applicant would “show children in school how to explore their heritage through the study of waste”, “use techniques of archeology to involve communities in an understanding of changing waste patterns”, “work with older people using retrieved objects as a focus for reminiscence” and “organise training programmes and workshops for people from a diverse range of backgrounds”.
Desirable though it might perhaps be in an ideal world to have armies of garbologists skipping blithely across the land, bearing uncalled-for bits of rubbish into old folks’ homes or celebrating ethnic diversity in the slag heap, we live in a world in which old men and women lie unvisited and unwashed and unloved, where delinquent teenagers wander without guidance into harm’s way and where mentally ill people go ignored and unconsoled. As it is, councils and health trusts don ’t have enough money to care for the people who truly need help.
One can only wonder what demented mentality it is that persuades well meaning apparatchiks that despite all this unmet need, taxpayers’ money should go instead to garbologists, or to sex outreach workers for the Irish community, or to advisers to men who want to have sex with men in public.
Cutting most quangos would be excellent, for instance; most are unnecessary or duplicate other bodies. Cutting targets sounds obvious, too, but there would have to be some way of measuring proper standards in public services. The discipline of an open market can do that, up to a point. But there’s the question of how the harshness of market disciplines can be softened for people unable to cope with them.
And there is the problem of hybridisation, when public and private bodies are grafted unnaturally together to produce something with the worst features of both.
The school dinners fiasco in Merton, southwest London, reported last week, is a perfect example of what is wrong with “privlic” hybridisation; the council has locked itself into a contract with a school catering company for 25 years, showing it has missed the point of private sector providers — you can fire them when you’re not pleased with them and try someone else.
Without these cuts public services will go on getting more expensive without getting better. Without cutting out the state sector middleman, the public money available for people in need will go on being whittled away by bureaucrats who simply stand between the needy and what they are entitled to.
Bureaucrats will continue to take it on themselves to decide for the needy what they need and whose needs are most important. This is wrong. Cuts into this bloated state blubber would mean better welfare, better healthcare, better education, better value and, not least, more personal freedom.
To be fair, some Conservatives have been saying this clearly. The unfortunate Howard Flight was one. George Osborne, shadow chief secretary to the Treasury, has also spoken of proposed cuts not “as what you might call efficiency savings in the main” but as “a reduction in government activity”.
I realise that the great British public tends to lose its head when anyone says cuts and the opposition and the media can be relied on to misrepresent them. Even so the Conservatives ought to have been insistent about this difficult and essential message — hugely more important than immigration or Blair-bashing.
“For if the trumpet give an uncertain sound, who shall prepare himself to the battle?” And those who are not properly prepared to the battle will lose it and will deserve to lose.
The Sunday Times | Sunday, May 01, 2005
