Town & Country Planning, January 2006
Some general elections ago, the former Times editor Simon Jenkins had the temerity to mention one of those things we all know about but don’t articulate: the BBC’s economic policy.
It isn’t generally acknowledged that they have one, he said. But actually they do: it is implied in so much of the questions they ask politicians. It is more government spending.
What he didn’t say was that the BBC also has a political policy: they want more centralisation, fewer local administrative peculiarities, less postcode lotteries. Listen to the tenor of the questions, and you will see what I mean.
I read this, I remember, when I happened to be listening to a feature on Woman’s Hour about the drawbacks of people not displaying the number of their homes clearly on their front doors (ambulances delayed, post lost, etc).
All the interviewer could think to ask about this, no doubt, intractable issue was: “When will the government legislate”?
I was thinking about this when I read the recent story about the government’s Key Worker Housing Scheme, which – despite a budget of £725 million – has led to a situation in London where a third of key worker housing is standing empty, half of it for more than three months.
It struck me that that those of us on the side of localism in the debate – if it can be glorified with that title – tend to be pretty defensive.
We are apologetic in the face of opinion-formers like the BBC – a more than subtle pressure in favour of accepted thinking – with their accusations of ‘postcode lotteries’. We are quick to accept that local control will mean some inefficiencies, and some mistakes. We talk earnestly among ourselves about the difficulties of answering these problems in the localism credo.
Yet it really should be the other way around. It is absolutely inconceivable that a local authority, however inefficient, would leave a third of the key worker homes it was responsible for empty. Only a central government agency can mess up on that scale.
You don’t have to dig out statistics about the Child Support Agency – now costing more than it raises – to prove this. Because a generation ago, oddly enough, most of us would take the inefficiency of big agencies for granted.
Then, we had seen the astonishing inefficiencies of a large centralised military machine. We might have done national service, and suffered from it at first hand.
Yet now, half a century since the end of national service, we have bought the big lie: that somehow the occasional efficiencies of scale can always outweigh the attention to detail, the imagination and thrift, of human-scale institutions.
Not only do monster institutions waste money and people, they also suffer from the kind of inefficiencies you get when people’s work is organised to minimise human contact and relationships.
Take giant hospitals, for example, where you never see the same doctor twice. It is no coincidence that the number of deaths caused by medication errors is rising, and this already costs the NHS £500 million a year.
The impact of hospital bugs is even greater. Up to 5,000 people a year die from infections caught in hospitals, and they are now affecting 100,000 people a year at a cost of £1 billion.
The diseconomies of scale are particularly apparent when it is clear that one person in ten who is admitted to a UK hospital now ends up suffering ‘measurable harm’ – whether it is from mistakes, bugs, faulty equipment or drug side-effects. Additional hospital stays as a result are valued at £2 billion a year.
These enormous and preventable costs are a direct result of giantism, of disconnecting staff from patients, of lack of ownership of problems, of alienation and the burden of extra management that enormous institutions entail.
If that is so of institutions like hospitals, it is so in just the same way of administrative ones. Because individual human beings take pride in their work, and respond to other human beings, in a way that administrative or virtual systems can never replicate.
So perhaps we who believe the UK urgently needs a massive dose of decentralisation, before we ever manage to make our public services and administrative systems work, should be a little less defensive about the likely effects.
Of course there will be problems, mistakes and even cruelties. But they will be small ones compared to the gigantic problems, mistakes and cruelties visited upon us by the centralised institutions so beloved of British governments.