The pseudo-science behind the political war on the disabled

It has been a bad week for those on benefits, with George Osborne announcing in his Autumn Statement that benefits will be uprated by less than inflation – in other words, cut in real terms.  Labour is promising to fight these cuts but the pronouncements of both Labour DWP spokesman Liam Byrne and Labour leader Ed Miliband do not exactly fill one with optimism.

People with disabilities have been in the forefront of the attack, and that attack has been reinforced by a narrative that unites all the mainstream players in Westminster politics.  If the cruelty and destructiveness of Coalition policy on benefits is to be exposed and combatted, it is essential that the story is understood.

There’s a detailed and referenced account of that narrative on the Disabled People Against Cuts website.  In summary, the piece indicates how the current approach, using a bio-psychosocial model of disability, is flawed and unsupported by evidence, but, encouraged by private sector organisations that see the potential for profit in carrying out bio-psychosocial assessments of those claiming benefits, has become a de facto orthodoxy.

The authors point out that the approach to disability has shifted from a social approach – one that emphasises to environment and context and sees society’s response to disability as the issue to be addressed – to a so-called bio-psychosocial approach that focuses on the individual and their reaction to the environment.  As the piece points out, it is an approach that can have value in dealing with individuals. But it’s all too obvious how such an approach can be picked up and abused by neoliberals.

Put briefly, the root of the ideological justification comes from the American sociologist Talcott Parsons’ concept of the sick role, which argues that sickness is in essence a form of social deviance, which needs to be policed by medical and other professions.  This is associated with the idea that work is essential to well-being (which is true in the sense that those denied the opportunity for meaningful work suffer mental and physical symptoms); it becomes very easy for neoliberals to conflate these into a doctrine in which you can argue that denying disabled people the ability to live without work is therapeutic (you can also use it to justify the idea of workfare in which benefits are contingent on unpaid work), and of course fits well with populist narratives of workshyness and scrounging.  The scarcity of meaningful jobs in long-term economic depression is not considered by this model).

Into this environment march private companies like ATOS and Unum, with experience of developing assessment regimes with a simple aim – that of reducing the number of people on benefits.  And add to this the recruitment of amateurs like banker Lord Freud, recruited to advise Gordon Brown on benefit reforms and now a Minister in David Cameron’s government; the potential for these companies to present a ready-made pseudo-scientific model to politicians and advisers in need of a quick result; and you have the current mess.  A policy that is obviously failing, but which has the appearance of scientific credibility and which flatters the ideological preconceptions and prejudices of those in power.  It is a subsititution of privately-generated pseudo-evidence – flatpack policy-making, as it were – for real evidence that is all too familiar to observers of how this coalition government conducts itself.

And as the authors of the DPAC piece make clear – this is pseudo-science, in which the work of the academics whose work underpinned the bio-psychosocial model has been misrepresented and distorted for profit by organizations who provide a convenient and potentially popular post-hoc rationalisation for what is the central policy goal – to reduce the amount paid in benefits to the disabled.  Political and media rhetoric, playing to the fears and prejudices of the ignorant, has done an astonishing job of destroying compassion and empathy in modern Britain, but one suspects that even for Tories and Liberal Democrats, stating openly that you want to cut the living standards of the disabled is a step too far.  It is one of the defining characteristics of the neoliberal project that it needs to subvert democracy, because open neoliberalism does not win elections; pseudo-science, like pseudo-economics, is what allows neoliberals to bridge that gap. And it allows the devaluaing of conflicting “expert” opinion.

The point about all of this is that none of it is surprising.  The devaluation of evidence is at the heart of coalition policy; evidence-based policy making is subordinate to ideology and profit.  But the point here is that this is not just a coalition policy; this kind of thinking was becoming mainstream under Labour government and underpinned Labour policy.  It quite obviously informs every pronouncement of Labour’s DWP spokesman Liam Byrne.  And it is one reason why I, for one, am deeply sceptical of Labour’s apparent change of heart on benefits – because I see no evidence that Labour’s underlying rationality has changed.

Is Cameron’s plan to tag offenders by GPS credible?

One of the most eye-catching aspects of David Cameron’s speech on criminal justice yesterday was the suggestion that GPS technology could be used to track offenders.  As someone who, during his time as a Civil Servant was actively involved in advising on the use of GPS technologies and has quite a bit of experience in the field I found myself unconvinced by aspects of  this proposal.  I’m not convinced that it is workable – yet – and I wonder whether No 10 has really sought good technical advice on this.

Politicians and the media in Britain do not, as a whole, exhibit a great degree of scientific or technical literacy. It means they are easily suckered by people selling technical solutions that give the appearance of being plausible; a lot of people in Whitehall spend quite a lot of their time telling Ministers that  the latest technical wheeze being offered by manufacturers, however impressive it may look in a small-scale trial,  is unsupported by any real evidence that it could be rolled out on a large scale in the messy real world

GPS is a  mature technology that has a huge range of real-world applications. Obviously it’s crucial to navigation systems but most smartphones contain a GPS chip, as do all ATMs (for date and time stamping rather than navigation).  The signs at bus stops telling you that the next 5A will arrive in 5 minutes use GPS technology.  But many commentators show themselves to be clearly clueless about how it works – witness this rather glorious piece of bad science from the Daily Telegraph following yesterday’s announcement. Put at its simplest, satellites do not track and cannot track anyone or anything; the same fallacy dominated the public debate over road pricing launched by the last Labour government.  Within Whitehall, Ministers and Special Advisers are notoriously susceptible to this kind of nonsense. A report in the Guardian today tends to confirm the suspicion that the work behind Cameron’s speech is worryingly light on evidence.

GPS works by taking location fixes from satellites.  It requires a clear sky view of at least three satellites to do this.  In order to track an offender, you would need to generate a series of such fixes, and  pass that information to the control centre.  Obviously, the more detailed the tracking, the more data you would need to store on the tag and the more frequently you would need to relay that information to the control centre.  And of course the tag would need a power source; GPS applications are notoriously battery-draining and the tag would need frequent charging.

Now obviously there is nothing here that couldn’t be done.  The most technically problematic part is generating fixes; GPS is notoriously susceptible to difficulties in streets with tall buildings, or where plate glass or water causes reflections and hence the possibility for false signals.  Now in the real world you can get round this either by map-matching (i.e. snapping the reads to digital mapping data stored in the tag) or simply discounting the odd outlying fix and using algorithms to approximate the missing data.  But in a world in which you are seeking to establish a criminal burden of proof, how far can you do this?  Equipment like safety cameras requires rigorous levels of type-approval before its output is admissible in court.  What level of locational accuracy would be required to sustain a prosecution of an offender who had broken the terms, say, of his bail?  And how much would it cost to produce a type-approved product that could demonstrate that an offender was in a particular place at a given time, beyond reasonable doubt?  Would you need corroborating evidence from eyewitnesses or cameras?

GPS does not work underground (obviously). Would London offenders be barred from using the Tube (which could be pretty counter-productive if one object of the scheme is to allow offenders to get back into jobs)?

And GPS can be spoofed, relatively cheaply and easily. How much security would be built into an offender tagging system? At what cost?

And what about data transfer?  How do you get data from the tag to the control room? The obvious answer is through mobile telephony, but to claim that you can pinpoint where an offender is at any given time requires real-time updating, and if tagging is to operate on any kind of scale you need to either transfer huge quantities of data in real time – and that can become seriously expensive (especially compared with the option of storing the information on the tag – memory is becoming very cheap – and transferring the data en masse when the networks are quiet).

In theory, there is nothing here that could not be overcome.  But it comes with a price-tag and there is the world of difference between running a successful pilot scheme and delivering something that is robust and cost-effective in the real world.  And – given that evidenced policy-making has not so far been the coalition’s strong point, I wonder just how far Special Advisers – for whom evidence is often the word of the last industry lobbyist who has bent their ear – are pushing this plan beyond its evidential base, and are relying on sales pitches from the private sector instead. I’d guess there are plenty of private sector providers who are very keen to get their foot in the door to get what could be some very lucrative contracts, and who are confident that they could lay off the risks on to the public sector.

It’s important, because in this case tagging seems to be the quid pro quo for moving towards a justice system which is based on rehabilitation.  I would argue for an approach based on rehabilitation and restorative justice; all the evidence I am aware of suggests that it is far more effective and way cheaper than prison, especially for less serious offences. But  I am concerned that a glib throwaway remark from a Prime Minister playing that old political trick of appearing to be tough on crime when things are not going well could lead to an expensive disaster, which could end up being used to discredit a move away from custodial sentencing.  And I have no confidence that either politicians or the media will give the idea of tagging the scrutiny it needs, or indeed that they are remotely capable of conducting a nuanced and evidenced debate around a really difficult issue.

Adam Curtis, loving machines and the dog that didn’t bark

The third film of Adam Curtis’ series All Watched Over by Machines of Loving Grace was as astonishing as the first two – visually arresting, compelling, throwing ideas at the viewer, sometimes brilliant, sometimes just plain wrong.  Television is a tabloid medium and the ideas could not be developed in this framework, but the questions were asked, to be considered at leisure.  The final bleak conclusion – that we have fooled ourselves into thinking that we are lumps of failing hardware destined to perpetuate a software of genetic code, in order to excuse our failures – was compelling, the more so for being intoned against a backdrop of commuters on a tube escalator.

The debates could – and will – go on for a long time.  But for me there was one dog that didn’t bark.  There is one essential area in which we are prepared to abjure responsibility and rely on a model of a self-stabilising system in which the best outcomes are deemed to emerge if the workings of that system are left alone – the dominant myth of the age, individualistic free market economics. The ruling ideology of our time is the belief that free markets will allow the setting of an intelligent price which will allocate scarce resources in the best possible way.  In the neo-classical economics that mysterious power is anthropormorphised in the person of the Walrasian Auctioneer, the mythic being used by the economist Leon Walras to explain the beneficent power of the market to move into a mutually satisfying equilibrium.

And, in many ways, the market follows Curtis’ formulation – it provides an illusion that masks a reality about power and the way in which the wealthy and powerful hold on to it.  As market ideology and neoliberalism have become entrenched in the last thirty years the economic outcomes for all but the rich minority have worsened, growth has slowed, inequalities have widened, wages have fallen consistently as a proportion of total income.  Yet the myth remains potent and – in Britain at least – is being perpetuated by the ruling coalition with disastrous vigour.

However valid the often extraordinary links and conclusions drawn by Curtis, it seems to me that the economics of the market could have provided a powerful and cogent illustration of his argument that to trust to mythical, self-regulating systems, abdicating the political, leads to disaster and failure.

All Watched Over by Machines of Loving Grace – hippies and hegemony

The second part of Adam Curtis’ documentary was another sensory attack.  Britten, Bartok, ecosystems, a hole in the side of a bison. Some commentators see it as a work of art rather than a straight documentary and you could see their point.  Here are some quick thoughts.

Put very simply, Curtis described how in the 1960s, influenced by ideas of nature as a self-regulating system and the growth of cybernetics, counter-cultures emerged which rejected political structures.  But this was futile – research showed that nature could not be modelled as a self-regulating system, and the revolutions in Georgia and Ukraine showed that non-hieararchical networks break down.

It was uneven and unencumbered by hard evidence.  On Georgia and Ukraine he was simply wrong – the internet may have spread the word at the time of revolution, but the causes are much more complex and owe far more to geopolitics than Curtis allowed.  Again, the fatal flaw was to look at the machines, not the motives behind the people using and manipulating them.

At the heart of this is a crucial and important idea – one that Curtis here, as in his first film, hinted at but never quite nailed.  This is that the non-political is a myth.  Power is present, and drives the creation of networks and, through the ownership of internet service providers and social networking systems, the means of delivery.  The illusion of the non-political and the atomisation of society into individuals is the tool of hegemony – in this case allowing power and wealth to remain in the hands of those who already wield it.  Based on such an assumption, a counter-culture as described by Curtis that claims to be non-political is inevitably doomed, because it can never challenge power.

The idea of self-regulating networks of course massively predates computers – it is at the centre of seventeenth century cosmology.  And we find it at the heart of neo-liberal economics, in which individuals are consumers or factors of production, in a model in which solidarity is absent.  It is at the heart of arguments for markets and privatisation, which tell us that somehow, through the miracle of the freely-operating network, and outcome that is beneficial to all will be achieved.

But we know it’s nonsense – history tells us that.  I don’t know what Curtis will argue in his final film, but it seems that whatever one thinks about the coherence of his thesis, the comparison with market economics is inevitable.

Swine flu – a very capitalist illness

Swine flu is, for some people, a highly profitable business. A report in yesterday’s Times pointed to the business bonanza coming on the back of swine flu. Other, less mainstream sources have pointed to the commercial interest that some producers of flu remedies might have in stoking up the panic.

But there is an increasing sense that the disease itself may originate in capitalist farming practices. Johann Hari, writing in the Independent, argues that factory farming, in which vast numbers of animals live together in conditions that greatly increase the risk of destructive strains of viruses developing, quoting in particular a report by the Center for Computational Biology at Columbia University which has been tracing the ancestry of the current outbreak.

He also describes how factory farming is dependent on pumping animals full of anti-biotics, while keeping animals in an environment in which bacteria can develop in ways which make them resistant to those anti-biotics.

It’s a horrifying scenario, and it’s not surprising that capitalist agriculture is deep in denial. And the fact that swine flu in the UK has not really (so far) lived up to the advance billing makes it that much more difficult to generate the sort of public concern that might shake the political class out of its complacency. We’re still waiting for the big one, and no government or regulator is going to want to be seen to raise the price of meat and especially cheap meat products unless the call for change is deafening.

But it’s difficult to avoid the conclusion that cheap meat in the shops comes with a much higher and deadlier price tag than most people imagine, and that, as so often, the drive for corporate profit may have the deadliest of consequences.

Privatisation and death rates

Here’s an interesting piece from The Times that reports on some fascinating research about the impact of mass privatisation in Russia following the collapse of Communism.

A recent piece in the Lancet by David Stuckler, Lawrence King and Martin McKee suggests that the rapid privatisation in a number of former Soviet and Eastern European states coincides with a spike in the death-rate of 18%. They suggest that the link between the two is unemployment, whose link to both stress and ill-health in a general sense and self-destructive behaviours like binge drinking is well-chronicled.

The report has caused a real storm, it appears.  In particular, it has brought forth a robust response from Jeffrey Sachs, the principal proponent of “shock therapy” to bring about irreversible capitalism in countries moving away from command economies.  But as the Times article says, the science looks pretty sound and the conclusion that key support networks risk being swept away in the name of economics is logical.

But most chilling is the fact that privatisation is only one type of economic shock. The toll of the extreme failure of market economics we are facing now could, on that basis, be a lot more than financial.

Dump the bottle

Some months ago, I posted about Elizabeth Royte’s book Bottlemania - a book that not only exposed the idiocy of the bottled water cult, but the damage that it does to the environment.  I see that Johann Hari has a piece in today’s Independent, announcing his intention to give up bottled water for the new year; it’s a useful reminder of one very simple way in which affluent Westerners can make just a little bit of a difference.

Hari also exposes the practices used by Coca Cola in its third world operations – again, an opportunity just to say no.

Cognitive behaviour theory and market ideology

I’ve only now caught up  with a fascinating piece in the Guardian by Darian Leader examining the Government’s recent decision to place much greater emphasis on Cognitive Behaviour Theory (CBT) in combatting the UK’s growing mental health problem.

Put briefly, CBT is an approach to therapy that seeks to correct erroneous thinking patterns to enable behaviour to change so that patients are better integrated with their environment.  Problems arose because patients’ thinking conflicted with reality. So, for example, depression is seen as the result of the individual’s bias towards negative interpretations of the world – which obviously feed on themselves when the patient has to deal with difficult situations.  The task is to get out of the cycle.

It’s a school of therapy that can point to an impressive array of empirical evidence, and has gained enormously in influence in recent years.  It is very much a “here and now” therapy, rather than considering in depth the childhood and background of the patient.  It’s also a relatively cheap form of therapy, significant in an environment where  -  in Britain at least – the knee-jerk reaction of most GPs when faced with a depressed patient is to reach for the prescription pad.

It’s always had its critics, of course.  Principal among these is the claim that it treats symptoms, not causes; and that its very cheapness has given it a head start with policy makers faced with a growing problem of depression and a shortage of resources to combat it.

Mental health and the market

Leader’s argument is that it is basically a market-driven approach to mental health.  He describes what he calls the “strange paradox of the modern self”:

“We are told that we are responsible for our own lives, that we have the power to transform ourselves. Yet at the same time we are treated as minors who lack the faculty of critical judgment and must be protected against unscrupulous and dangerous predators.

Today it is plasticity and change that govern our self-image. Personality itself is represented as a set of skills that we can learn and modify. Just as we can alter our bodies through cosmetic surgery, so we can change our behaviour through “work” on ourselves. Reality TV displays princes who become paupers, children who swap parents and geeks who become Don Juans. The possibilities of transformation seem endless. Thatcher’s dream of social mobility has become not just nightly entertainment, but also individual imperative.

CBT promises change just as swiftly. Unwanted character traits or symptoms are no longer seen as a clue to some inner truth, but simply as disturbances to our ideal image that can be excised. Instead of seeing a bout of depression or an anxiety attack as a sign of unconscious processes that need to be carefully elicited and voiced, they become aspects of behaviour to be removed.

The market has triumphed here, as our inner worlds become a space for buying and selling. We pay experts such as life coaches to teach us how to change in the desired way. Aspects of ourselves, such as shyness or confidence, become commodities that we can pay to lose or amplify. Depression or anxiety are seen as isolated problems that can be locally targeted without calling into question the rest of one’s existence, in the same way that a missile attack on a terrorist installation is supposed to get rid of the problem posed by terrorism.

This is a modern self for which depth has become surface. In soaps and reality shows characters share their innermost feelings and emotions, as if there were a perfect continuity between interior and exterior life. If there’s any ambiguity, a panel of experts is there, as on Big Brother, to explain people’s motivations. The self is no longer a dark cave; everything is laid bare. In effect, we have been robbed of our interior lives.”

It’s a powerful thesis, and one with which I have a lot of sympathy.  And I think there’s something rather deeper at work here; a sense that the model by which our ability to function normally is judged is conformity to prevailing social values.  But what happens if those values are themselves distorted, or based on a false reading of the world?  For example, we’ve seen in recent months the way in which the values of market economics have been shown to be, at the very least, fragile and at odds with a real world; and we’ve seen a lot of denial by those who wield power and wealth.

Just suppose that those people who can’t adjust to the values of the world around them – who may be showing symptoms of very real mental distress as a result – are the ones who perceive the truth?

The problem with the ideology (as one feels one must call it) of CBT is that it looks awfully like the belief that mental health lies in conformity with a society’s values; it can all too easily result in the branding of the non-conformist as sick.  It’s a problem recognised by writers as diverse as the psychiatrist R D Laing and the historian Christopher Hill; taken to extremes it was an active part of the Soviet Union’s methods of political control, with dissidents being sent to asylums.

It’s hard to get away from the view that there are at least some among the advocates of CBT for whom, wittingly or not, its implication is to reinforce prevailing value systems.  Or to put it another way; the distressed can keep on consuming until they get it right.